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NOTE: Although we love each and hate to part with any, we are pricing some of our mares for sale in an effort to 'thin out the herd'. All prices are FIRM! Mares that are bred come with a live foal guarantee- new owner is responsible for breeding costs (including AI and semen shipping charges) if the mare needs to be re-bred. All mares will be checked for pregnancy before leaving the farm, and will be up to date on vaccines, dewormings and Coggins test . Heights are approximate and mares will be measured on request. Feel free to email or call us with questions on individual mares! This is a super opportunity to own a gorgeous, well bred and colorful mare-bred to a nice stallion!
Most of our TWH mares are listed on this page for sale and can be bought with a stud fee to any of our stallions for $300 extra.
Gracie (Wendy's Lady Grace)
I have been negligent in keeping Gracie off this page for the past few years. Although she is not technically ours, she is our most special horse! Owned by our good friends Ralph and Teresa Webb in North Carolina, this wonderful Spotted Saddle Horse lady was delivered by C-section by Bryant shortly after I discovered I was pregnant with Bart. Her mother (a Standard Bred) was dying from jaw cancer when we delivered her and we had to struggle to keep Grace alive her first few days. Gaited Horse magazine published a story about her that Ralph wrote, then I wrote a story that was published in Chicken Soup for the Horse Lover's Soul Part 2. (I hope to link that story here soon). She blossomed into a healthy, gorgeous, good-riding mare. Ralph has generously loaned her to us as a pleasure mount and to breed to have a Gracie foal of our own. Sadly she had a stillborn foal September 2011- a gorgeous black and white curly colt by Bandit's Lucky Gold. She was bred back to Lucky for a fall 2012 foal and she gave us "Glory" the first week of September (see pix below!). Grace is the Diva of the farm and she knows it. Always up for a ride around the hills of the farm, and gentle with the boys, she is a wonderful family horse for us and she is a constant happy reminder to me that despite the darkness of cancer, life goes on. She is truly special and we are blessed to have her under our care for now.
Now that Glory has been weaned, Grace has gone home to the Webbs in foal Bandit, and her legacy will continue!
Note: The picture above is of Grace at our vet hospital in NC when she was a day old. The cat in the background is "Favorite", who hangs out here in the wooden barn now. He still oversees the horses and seems to especially like Gracie!
....and here she is! Grace's Faith and Glory born 9/8/12. A lovely and unusually marked white filly with a bay head, one spot in her left flank and a cute black tail tip! Not curly, but she has gorgeous conformation and a nice little gait, with the much-expected Diva attitude! We are keeping this one to grow up with Bart and Alex! thank you Ralph and Teresa Webb for making this dream come true!
Midnight Princess and Tjimkje B.
As our breeding interests drift toward Curlies and Friesians, we have been fortunate to acquire this stunning mother and daughter team of Friesian mares. Tjimkje B. is a studbook mare born in 1998 and imported from the Netherlands as a young mare. Her sire is Lute and her dam sire is Tjimme. She is about 16'2 and very quiet and easy going. Her daughter Midnight Princess follows in her footsteps. Princess's sire is Wander and she was born in 2004. She stands about 16'1. Princess is a FPS studbook mare, and her colt (CoalBee owned by Cindy McFarlane) by Feitse was a keuring Grand Champion colt several years ago! The mares drive as a team and we are anxious to hook them up together some day! We bred Tjimkje to Tietse 428 shortly after she arrived on our farm and she produced an exquisite filly July 25, 2010 (Haute has been sold). Tjimkje foaled a very leggy, large jet black colt September 2012. This will be one of the very last FPS registered Tietse foals ever, and he is for sale! Princess foaled a tall, nice moving buckskin tobiano filly by the First Aurora in June 2011, who is now owned by Foothill Friesians in Auburtown, TN. Due to the bad horse economy, we have not bred either mare back for 2013.
We would consider selling either of these mares to the right home. Email me for more info.
Tjimkje and Haute (2nd premie filly) 8/7/2010 Princess at 2010 keuring
Siesta is an unusual blue roan frame/splash overo non-gaited curly filly born in 2003. She is registered ICHO. Her dam is a gaited curly and her sire is a blue roan overo Paint. Siesta is large, pretty and has an unusual gregarious personality. She moves like a dream and should give us some super curly foals one day! Siesta's first foal, born 3-25-09, is by our past curly gaited buckskin tobiano stallion *Perseus . Siesta and Percy both passed on their color- this colt is a buckskin roan frame/splash overo! Whew! The colt has been sold, but Siesta can be purchased. Her price has been reduced to $2500 . She is currently open.
CBR American Blazer
Meet "Rosemary"- One of our favorite horses ever. She is a black tobiano gaited curly horse-registered ICHO, SSHBEA and NSSHA. She is out of our departed curly mare Star's Sage and her sire is Lucky Touch- a black tobiano curly SSH/MFT. Rosemary is 'all that'. She has awesome conformation, a sweet and solid disposition, tight microcurls, partly blue eyes, and a gorgeous way of going. She was born 5/2004. We suspect she is homozygous for curls. Rosemary consistently produces nicely gaited, curly, colorful foals with super personalities (see "Lucky Gold Bandit", "Aurora's Lucky Star" and "Golden Gaits Beau" on our For Sale page). She foaled a lovely smoky black tobiano curly gaited colt 5/2012 and had a surprise black and white curly filly July 2013 by her own son Aurora's Lucky Star! (Must have been an over-the-fence breeding!) See our For Sale page for pictures! Rosemary can be bought for $12,000.
Our search for a palomino/white TWH mare
led us to Georgia where we found this beauty.
Georgia is the dam of our first foal off of Generator's Aurora. We were hoping for a homozygous cremello colt and Georgia
and Rory filled the order in grand form! See photos of "The First Aurora" on our Stallion Page.
Georgia followed this act in 2003 with another awesome colt: Funky Gold Medina is an amber cream champagne spotted colt out of Pushin the Champagne. Georgia was bred to Belfast Bandit for 2004, and foaled a gorgeous, but sadly stillborn, buckskin colt in April. That same night she agreed to 'adopt' Dot's orphan colt raised him as her own! In 2005 she foaled a lovely bay tobiano filly by Bandit, who sadly broke her leg at one week of age. She is one of our favorite mares and is registered TWHBEA, SSHBEA and NSSHA. She stands about 14'3 and is green broke to ride. She is friendly, pleasant to be around and an easy breeder. She foaled a pretty solid buckskin Bandit filly in 2007. In 2008 she gave us a lovely perlino spotted Bandit filly (see Savannah on our For Sale page). She foaled a nice perlino solid filly by Bandit June 2011 (Marietta).
Georgia can be bought open for $6500.
We don't keep many of our foals, but we
had to make an exception! Revelator's Jacque Sue (named after our mothers)
was born here in May 2000 out of our sorrel TWH mare and palomino tobiano TWH Rainbow's Revelator (Lonesome Dove
Stables in Dunlap, TN). She is everything we could have hoped for: color, conformation, size, gait, pretty eye and cute personality.
We are happy to announce that Jacque Sue won the TWH and the SSH Weanling/Yearling Championship classes at the Firecracker Jubilee in 2001! She won 5th place in the Yearling Sweepstakes class at the 2001 SSHBEA Championship Show, 5th place in Yearling Fillies, and 8th place in the (very large!)Yearling Championship Class. Special thanks to Sherry Stewart Darrigan of Lexus Farms in Spring Lake for making her look awesome at the shows!!
Jacque Sue's first foal was a really nice homozygous spotted palomino colt off of Rory (Aurora Borealis Gold). Her second foal was another spotted palomino colt marked up just like Rory (Aurora At Dawn). #3 is a stunning bay tobiano colt by Bandit (Bandit's Revelation). #4 is another awesome colt- a buckskin tobiano by Bandit. Foal #5 is a sweet, solid buckskin filly-Bandit's Morning Glory, GGF. Her 2009 foal is a gorgeous palomino tobiano non-curly filly "Juno" owned by Cali Tatum, by *Perseus (curly SSH stallion). Her 2010 foal is a lovely cremello tobiano colt ("Nitro"- see our For Sale page), by The First Aurora.
Jacque Sue is registered TWHBEA, SSHBEA and NSSHA. She was born 5/10/2000. She is not broke to ride and stands 16h.
Our palomino sabino 5/01 TWH mare
was purchased as a weanling from Sallie Foley of Cedar Creek Farm (now in
She is out of the same dam as our stallion Generator's Aurora and she has the same presence and pizazz as he! Her sire is
Sensation's Showtime and her dam is a direct Pride's Generator daughter. She has the most elegant head and neck of any
TWH we've seen. She can really shake her tail when she walks, and her personality is impeccable also!
Sissy was the 2002 NC State Fair Yearling Filly TWH Champion!
She had her first foal by Bandit 4/1/2005-a perfect, super-moving tobiano perlino filly. Her second filly was a refined solid bay cutie. Her third foal was a charming buckskin sabino colt also by Bandit. Her 2008 foal was a flashy buckskin tobiano colt ("Dusty Bandit"). Dusty is the 2010 NSSHA World Grand Champion in Amateur Trail Pleasure! This year she gave us a very flashy bay tobiano/sabino colt ("Total Sensation, GGF"). Her foals are walky, with stunning necks and all over pretty conformation. Sissy is not yet broke to ride, is registered TWHBEA and SSHBEA, and stands about 15'2.
Sissy is for sale! $3500 OPEN
Colt above left is "Total Sensation" who has been sold
High Esteem
Pride's Generator X Under Cover Angel
Every hard-core TWH breeder wants a direct
daughter of Pride's Generator. Ginger is a gorgeous,
sorrel mare with a flax mane and tail. She has some training under her belt, as well as some great foals on the ground . Her dam was a horse named Undercover Angel, with Midnight Sun blood. Ginger was bred to The Stonecutter (a son of the Pusher) and had his first 2004 foal on 2/12. She is very pretty black filly with a nice walk. Ginger was bred back to Bandit for 2005 and produced an awesome bay colt. On 6/26/06 she produced a nice solid buckskin Bandit colt. On 3-30-08 she gave us a buckskin tobiano filly by Bandit. Her 2009 foal was a breath-taking palomino tobiano named "Solar Flare". She is registered TWHBEA, stands about 15'1 and is gorgeous! She is broke to ride, has had professional training, (but has not been ridden in years) and was born 10/15/89. A severe foot abcess several years ago renders her mildly lame occasionally and so she would not make a primary trail horse. She's an excellent broodmare and part-time riding horse!
Ginger foaled a wonderful palomino tobiano colt 1/16/13 by The First Aurora!!! He has been sold, but she is priced at $900
Aurora's Eye Candy, GGF
The First Aurora, GGF X CBR American Blaze ("Amy")
Bred, born and raised on our farm, this pretty filly is so special to us! She is a buckskin, homozygous tobiano curly filly born 4/2008. She is sweet, personable, has lovely conformation and is getting very tall. She is the kind of horse we aim to produce. We are keeping her as a future broodmare and riding horse. Candy is registered ICHO (Curly) and could be for sale. Her first foal is an exquisite buckskin tobiano curly filly sired by Lucky Gold Bandit. See our For Sale page for more info!
Golden Gaits Farm
(931) 695-3301
Click on the links below to navigate our site:
|Golden Gaits Farm Entrance
|Links Exchange


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The CRILA short story research group (JE2536) of the Université d'Angers, France, will be hosting an international conference in collaboration with Edge Hill University, U.K. on "The Figure of the Author in the Short Story in English," 8-9 April 2011 at La Maison des Sciences Humaines, Université d'Angers, France.
Plenary speaker: Charles E. May, Professor Emeritus, California State University, Long Beach.
The specter of the author has haunted the scene of contemporary literary criticism since the advent of 20th century authorial displacements. William K. Wimsatt Jr. and Monroe C. Beardsley heralded the age of Anglo-American New Criticism with "The Intentional Fallacy" (1946) and the "The Affective Fallacy" (1949), insisting that the meaning of a literary text is to be found in the text's status as an independent artifact and not in authorial intention. The author is later explicitly declared defunct in France with Roland Barthes' infamous "The Death of the Author" (1967), voicing the concerns of post-structuralism where the author is écriture rather than a historical, psychological figure. This tendentious essay, along with Michel Foucault's "Author function" in his 1969 essay "What is an Author?" helped foster an aura of suspicion and controversy around authorial identity, and the repercussions of authorial "death" or "disappearance" continue to ripple through literary criticism today. The author has "died" only to be replaced by a proliferation of conceptual guises: "implied author," "text," "structure," "intentionality," or even, perversely, "reader." French scholar Antoine Compagnon even suggests in Le Demon de la Théorie (1998) that the author is like a demon who is virtually impossible to expel from literary criticism. In the meantime, the rise of Creative Writing as a distinctive form of critical discourse in the US, UK, Australia and elsewhere, seems to place the biographical author once more at centre stage.
Wherever we turn, we are confronted with the question of authorship, particularly if we juxtapose criticism with the public sphere, where the expression "death of the author" meets with bewilderment as readers rush to book signings and author events Many authors actively cultivate authorial personas through websites, blogs, facebook and twitter . This conference proposes to re-investigate the question of authorship through the lens of the short story, as the brevity of the genre and its emphasis on form seem to intensify an impression of authorial presence. As Charles May has observed, short stories are "more dependent on craftsmanship and exhibit more authorial control than novels" (May 1994, xxvi.). We propose to bring together literary authors and scholars to examine the issue of authorial manifestations in the short story. Some questions to consider might include, but are not limited to, the following:
How has critical method evolved since 20th century "attacks" on the figure of the author ?
How might we assess our current critical practices regarding the authorial figure?
What concepts, such as the "implied author," have emerged in the wake of authorial "death," and how might these concepts be re-evaluated today?
What role does authorship (individual, corporate, anonymous, erroneous) play in both the composition and reception of literary works?
How might we draw connections between the theorization and study of authorship and the critical study of specific fictional works?
In what ways do short narratives amplify or attenuate perceptions of the authorial figure?
Has the gap between authors of fiction and the study of authorship been adequately addressed over the last 50 years? How do we perceive this gap in contemporary critical circles? How might we confront the perspectives of fiction writers and critics?
How do political contexts or concerns (race, class, gender….) affect perceptions of authorship? How does the authorial figure function in politically saturated fictional texts?
How do historical or cultural contexts affect concepts of authorship? In what ways have modern and contemporary writers recovered historical modes of authorship? (For example, contemporary appropriations of fairy tale or other forms of collective narrative (oral or written)).
How do contemporary practices and theories of intertextuality, parody, pastiche, affect our perception of authorship?
How do metafictional/metatextual modes allow us to contemplate the question of authorship? How do such modes affect perceptions of authorial presence or absence?
We also welcome presentations dealing with authorial issues arising from translation or cinematographic adaptation and studies of authorial performance or marketing techniques. Presentations from short story authors are particularly welcome.
A selection of articles will be published in two peer review journals: Short Story in Theory and Practice (www.edgehill.ac.uk/shortstory/shortfiction), published by Intellect Press, and The Journal of the Short Story in English (http://jsse.revues.org/), published by Université d'Angers
Paper proposals of approximately 300 words in English, followed by a short bio-bibliography, should be sent to the following conference organizers for 15 December 2010:
Michelle Ryan-Sautour (firstname.lastname@example.com)
Ailsa Cox (firstname.lastname@example.com)

subset: commoncrawl


text:
Daniel Nardicio, the director of marketing for the online adult magazine (which plans to re-launch a print version in the spring), tells PEOPLE his magazine received photos of an individual who appeared to be Woods, but "Playgirl has decided to turn down the alleged Tiger Woods nude photos, reportedly taken by camera phone by Woods himself. They were impossible to 100 percent verify, hence the unwillingness to go there."
Nardicio added that Playgirl's editorial policy leans toward shoots that have the blessing of the subject, like Johnston, who recently posed nude for the publication.
"This is a prime example of the direction Playgirl does not want to take," Nardicio said. "I prefer subjects who are willing."
See what other readers have to say about this story – or leave a comment of your own


text:
Vendor News
Our Vendor News offers news and announcements about vendors in the Chemical Processing industry.
Economic Snapshot
Our Ecomonic Snapshot offers news about the world economic atomsphere and how it may affect your bottom line.
Industry News
Analysis Shows Impact Of Carbon Pricing Models In Canada
New research shows carbon pricing can reduce emissions without harming economic growth.09/07/2016
CEPA Fails To Curb Harmful Emissions In Canada
The effectiveness of Canada's major environmental law is under review.08/08/2016
CCS Needs Funding To Meet Emissions Targets
Experts implore world governments that urgent funding is necessary to meet emissions targets agreed upon at the World Climate Summit.08/01/2016
Global Gas Analyzer Market Will Grow Through 2020
Advances in gas analyzer technology are predicted to drive the global gas analyzer market until 2020.07/08/2016
First Alaska Air Flights Take Off Using Gevo ATJ Biofuel
Alaska's biofuel-powered flights demonstrate new, scalable aviation fuel alternative.06/13/2016
Emerson Analyzer Is Certified For Use In Explosive Dust Areas
CSI 2140 Machinery Health Analyzer provides an early indication of defects before they lead to machine outages.05/20/2016
Industrial Scientific Unveils Gas Detection App
The Gas Detection Made Easy app is a training and reference tool for gas detection information on the go.04/25/2016
Hazy Data Suggests Possible Peak In China's Carbon Emissions
Some researchers believe emissions are falling more than a decade earlier than expected while others are not as convinced.04/14/2016
Ametek Demonstrates TDLAS Advances For Pharmaceutical Makers
Tunable diode laser absorption spectroscopy allows real-time monitoring of water solvent drying.03/22/2016
Google Steps Up Hiring As Driverless Cars Hit The Road
The self-driving car project is creating engineering positions related to motion control, displays, robotics and sensors.03/01/2016
Spectroscopy Offers Endless Possibilities For Process Control
Manufacturers benefit from real-time updates on blend uniformity, significantly improving their production and reducing possible waste material.02/26/2016
ABB Brochure Features In-Situ Analyzers
ABB's new brochure describes the in-situ Endura AZ oxygen analyzer series for process combustion control or emissions monitoring.01/28/2016
Nationwide Boiler Announces Executive Promotions
Nationwide Boiler names new president and director of sales.01/25/2016
GE Updates InSight Platform
GE enhances its InSight Industrial Internet solution, which allows customers to monitor facility data remotely.01/15/2016
Air Liquide Receives Innovation Award
Air Liquide wins an Innovation Award from the France-China Committee for its Heat Oxy-Combustion technology.12/14/2015
United Electric Introduces Switch Upgrade Program
United Electric Controls announces a new program to help companies assess their industrial switching needs and evaluate upgrade opportunities.12/09/2015
ABB Awards Dow "Control Room Of The Year"
Hydrocarbons Command Center at Oyster Creek, Texas is designed for operator effectiveness.11/13/2015
AW-Lake Flow Measurement Technology Receives Certifications
AW-Lake Company announces new ATEX and IECEx explosion-proof certifications of RT-30EX meter-mounted flow transmitter and HUB-41EX flow sensor for use in hazardous areas.11/02/2015
Sasol Selects Emerson For Petrochemical Complex
Sasol selects Emerson Process Management to help automate its $8.9 billion petrochemical complex in Lake Charles, La.10/27/2015
Spectrex Acquisition Expands Emerson's Safety Portfolio
Emerson acquires Spectrex, Inc.09/14/2015


text:
Kumon Math & Reading Center telephone number is (302) 674-9040.
Telefax: No fax number available
Website: No web address available
Biz owner? Moderate reviews or edit listing.
Search entire category for Gifts - All
Gifts, in Dover, are tokens or souvenirs of love, affection, honour, gratitude, friendship, etc, that are given or sent to recipient/s on special days and occasions marking a turn of event, as on birthdays, weddings, anniversaries, promotions, births, Christmas, New Year, Lovers' Day, Parents' Day, etc.
Governor Cuomo Announces Growth Of Clean Technology Companies And Creation Of 980 Jobs
$14 million Investment in Cleantech Business Incubator Initiative Supports the Development of 141 Clean Energy Companies across the State (Long Island, NY) Governor Andrew M. Cuomo today announced that 141 clean technology companies have been supported and primed for further growth through the Governor's Cleantech Business Incubator initiative. The initiative has attracted more than $215 million in private capital..


text:
Legal Writing Is Not What It Should Be
Wayne Schiess
University of Texas School of Law
Southern University Law Review, Vol. 37, p. 1, 2009
This Article presents and discusses nine reasons that legal writing is not as good as it should be. The reasons include inadequate preparation in college and law school, over-reliance on forms, complacency, a misguided sense of professionalism, and time pressure. The Article concludes by offering four recommendations: continue to improve law-school legal-writing programs and begin including legal drafting and plain English, train new lawyers in editing, require legal-writing training in continuing legal education, and encourage lawyers to take more individual responsibility for improvement.
Number of Pages in PDF File: 24
Keywords: Legal Writing, Style, Self Expression, Undergraduate, Knowledge Telling, Legal Analysis, Legal Drafting, Judicial Opinions, Time Pressure, Forms, Revising, Editing, Over-Formality, Complacent, Mediocre
Date posted: August 19, 2010
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text:
Source: Sammobile
quote: I post a fraction of what you guys do
quote: - Plays HD content without downscaling
quote: If its a conversation about the high end, high end Androids absolutely pound the iPhone into the dust.
quote: It's dominating because you can do anything with it, from low end cheapo phone to the highest of high end with all bells and whistles, to tablets to smartwatches to (soon to be) SmartGlasses.
quote: See, right there tells my you don't know anything at all. On the large list of completely wrong things that you regularly post, that sentence tops it. Completely uneducated and ill though through.
quote: And games? Same thing, you are clueless. You spend so much time with your head buried in IOS you have no idea what is going on outside that world.


text:
A 20-year-old man went before a Clay County Judge on Friday to plead guilty in a domestic violence case that included a picture that went viral on Facebook.
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text:
New Palm Court Will Lose the Harp
It's cheaper!By Daniel Maurer
It's cheaper!By Daniel Maurer
He'll be working with Govind Armstrong and focusing on in-house cures and new marination techniques.By Daniel Maurer
Multicourse Haute Barnyard is out upstairs, and wood-fired steaks are in.
Meet William Rhodes.
The $35,000 La Besse Giraudon rotisserie at Country is among the mightiest of the city's engines of gastronomy.
"We've changed everything," says Willis Loughhead, the new chef at Country.


text:
Return to SwingLifeStyle.com The Swingers Home Page
There are a total of 9620 Meadowbrook swingers, within 100 miles.
The list below is a subset of the swingers in the Meadowbrook area.
Create a free swingers account so you can see and write to them all.
WE Are Back and Ready To Play, F in search of Hot Wet Tastey F That loves being spoiled!
Looking for some play
In search of a regular playmate
Nudist couple seeking friendship with couples for parties, socializing, visiting nudists resorts
looking for lust
Ready to play
Sexxxy Milf loves to play
nice to meet you...
REMEMBER...the toes you step on today may be attached to the ass you have to kiss tomorrow!
Fun loving guy BBC here, just looking to have a good time!
Showtime's bday party 1/18/2014 will host at The Back Nine club need big 100 people to come!!!! :-)
Have you ever gone down the Cahaba River?
Sweet Desires party Oct 8th Saturday come find us check on the event :-)
Looking for fun and easy going couples!
naughty fun couple
Fun & Flirty
Would love to join You for a fun Teaser!!!! ;). But better than that let's tease as we have Fun!!!! Sexy Fun!!!! :)
I'm FREE TO BE ME.... Join me??
Looking to be spontaneous!
***/blue*** ***/blue*** We are a couple but interested in finding a fun partner for me, the wife.
Active Swingers as of 01-Oct-16.
This site does not contain sexually explicit images as defined in 18 U.S.C. 2256.
Accordingly, neither this site nor the contents contained herein are covered by the record-keeping provisions of 18 USC 2257(a)-(c).
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text:
Rice isn't primal.
I eat about half a serving (7 or 8 crackers) with my tuna and such. I used to eat handfuls of these before I went completely primal. They are made mostly of rice and seeds and are USDA organic. Thoughts?
Rice isn't primal.
Organic Alcohol? That's funny. I'd say no due to the rice and soy (which is probably tiny amounts, but still).
Grain and soybeans? No.
Nightlife ~ Chronicles of Less Urban Living, Fresh from In the Night Farm ~ Idaho's Primal Farm! http://inthenightlife.wordpress.com/
Latest post: Stop Being Stupid
I'll stick to celery and carrots with my tuna. Thanks
I usually make these, minus the soy sauce. I use flax seed meal instead of the whole flax seeds as well:


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Is HITECH Working?
After only one year, it is too early to assess the true impact of the Health Information Technology for Economic and Clinical Health Act. The first reimbursement payments to physicians for electronic health record adoption won't go out until 2011, after all. But early signs suggest that the program is pushing more physicians to adopt EHR systems, and that it is well on its way to accomplishing its long-term goals.
For example, in the 2010 HealthLeaders Media Industry Survey, we asked physician leaders about their plans for taking advantage of HITECH funds. More than 40% expect they will meet the meaningful use requirements and be eligible to receive reimbursements for EHR use by next year. Although quite a few respondents said it was still too early to tell if they will be eligible down the road, only less than 10% expected to not be eligible at all.
That's good news for an industry that seemed like it would take decades to get fully onboard with EHR use.
The Bush administration initially set the goal of EHRs for every American by 2014, and with an executive order in 2004, Bush created the new position of the National Coordinator for Health Information Technology to oversee the transition. This was a big first step toward improving national adoption, but the recent success seems to boil down to one factor: Money.
The promise of a financial carrot for adoption—as well as the eventual stick of lower Medicare reimbursements—has gotten physicians' attention.
As my colleague Gienna Shaw pointed out in a recent column, money has always been the biggest concern for doctors when it comes to technology. When I first wrote about the HITECH Act last year, most of the feedback I received from physician readers included concerns about costs, as well.
But there are other worries. According to a new survey from the Medical Group Management Association, a majority of practices fear that meaningful use criteria are too complex and will decrease provider productivity. There were two specific requirements that had providers worried:
- The proposed requirement that 80% of all patient requests for an electronic copy of their health information be fulfilled within 48 hours
- The proposed requirement that 10% of all patients be given electronic access to their health information within 96 hours of the information being available
While maintaining productivity is a concern, it is primarily a transitional issue, not a problem that should completely prevent adoption. No one said the transition would be completely painless, but with most of the costs taken care of, practices are in a much better position to solve the operational challenges before 2011.
Interestingly, despite concerns about its implementation, the HITECH Act is one of the most popular components of the Obama administration's efforts to reform healthcare. More than 54% of respondents to the HealthLeaders Media survey have a positive view of it, which is considerably higher than anything else under the reform umbrella.
Note: You can sign up to receive HealthLeaders Media PhysicianLeaders, a free weekly e-newsletter that features the top physician business headlines of the week from leading news sources.


text:
This is a momentous moment, really. Obsidian Entertainment senior designer Chris Avellone is about to show, for the first time, Fallout: New Vegas running live. Let us not forget, Fallout 3, the game New Vegas spins off from, was one of the greatest - some say the greatest - games of this generation. And yet there is a palpable sense of scepticism from the audience. Perhaps even disappointment.
In this business, first impressions can be as damaging as they are potent. But they're often misleading. So it is with Fallout: New Vegas. Our first impression is that it looks just like Fallout 3, a game that'll be two years old this Christmas. Our first impression is that if Bethesda released New Vegas as a expansion, no-one would bat an eyelid.
Perhaps our first impressions have been unduly influenced. Obsidian is not Bethesda, and for some Fallout 3 fans the fact that the game is being built on an ageing game engine by a developer whose track record depresses as many as it impresses fills them with the fear.
How ironic. Fallout 3 fans cringe at the thought of New Vegas being farmed out to a developer that knows nothing of the cult series, so the theory goes. How many Fallout 1 and 2 fans who idolise old Black Isle Studios legends Tim Cain and Feargus Urquhart felt the same when they discovered that Bethesda was developing Fallout 3? And now the merry-go-round comes full circle as Avellone and other ex-Black Isle Studio developers find themselves returning to the world of Fallout. So, all you Bethesda-haters should be pleased, right?
It's not until Chris' presentation comes to an end that I realise just how misleading first impressions can be. Don't get me wrong: Fallout: New Vegas's visuals could be better than they are. But the game's strengths lie elsewhere. Wonky animations and ugly textures aren't the point; the point is that the quests and dialogue are so memorable and the game's post-apocalyptic Nevada setting is so atmospheric that all of New Vegas' imperfections melt away like the skin of a Ghoul.
Still, the issue of innovation hangs over New Vegas' head like a vulture waiting to pounce on a Brahmin corpse. New Vegas is not an expansion or an update. It's a proper sequel, set three years after the events of Fallout 3 and with a map just as big. We're not asking for Obsidian to rewrite the Fallout rulebook, but given that two years will have eventually passed between the two releases, it is only right that the developer improves on what's gone before.
Chris, it appears, agrees. In a lengthy gameplay demo he showcases scores of improvements and tweaks, and they begin with character creation. Fallout 3 began with your birth; New Vegas starts with your death. You're kidnapped by a group of thugs, shot twice in the head and then dumped in a shallow grave outside of a small town called Goodsprings. The only reason you survive is because your body is recovered by a mysterious robot called Victor, who takes you to Goodsprings' kindly healing hand, Doc Mitchell. The character creation process begins as you recuperate with the Doc in his house.
Via the same first-person NPC interaction we saw in Fallout 3, the Doc hands you a Reflectron and you adjust your appearance. All the options that were in Fallout 3 are present and correct, but because you haven't emerged from a Vault, you have a few new sliders to play with. The age slider, for example, lets you pump up your age to fifty or sixty, if you fancy looking like a weathered wasteland veteran. After settling on a name and an appearance, you walk over to a Vit-O-Matic Vigor-Tester - the Old West equivalent to a love tester machine - to spend points on statistics.
You then take a seat on the Doc's couch to "see if your dogs are still barking". He asks you to tell him how much various statements sound like something you'd say. Statements like "I 'aint given to relying on others for support", "I'm always fixin' to being the centre of attention", and "I charge in to deal with my problems head on". Then, a Rorschach test. At the end of the session, the Doc suggests tag skills. In this case, though, we ignore his advice completely and go for barter, explosives and guns. And that's it. Character creation's done, and the Doc shows us out. Compared to Fallout 3's lengthy character creation sequence, New Vegas' is over in a jiffy, as one of its retro-futuristic Fifties throwbacks might have said.


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House Sitting Positions Available
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The former girlfriend of the man who killed a Washington State Patrol trooper pleaded guilty in Port Orchard Friday to rendering criminal assistance and was sentenced to six months in the Kitsap County Jail.
The Kitsap Sun reports Jessi Leigh Foster made phone calls and sent text messages trying to help Joshua Blake escape after he shot Trooper Tony Radulescu last February near Gorst. Blake later killed himself.
Another woman, Corinne Nelson, pleaded guilty to rendering criminal assistance in the case and was sentenced Monday to 14 months in prison.
Of six people accused of criminal assistant or interfering with police in the case, five have pleaded guilty or been convicted and one awaits trial.
-- The Associated Press


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I think the diet would be do-able. It would mostly be fish, vegetables, and fruit. There's actually a lot that you *can* eat, even though it would be an adjustment.
I think the diet would be do-able. It would mostly be fish, vegetables, and fruit. There's actually a lot that you *can* eat, even though it would be an adjustment.
[QUOTE=KimInGA;1023889]The insomnia got MUCH worse for awhile right after I went primal, but has now subsided to where it's not too much worse than before. And by that I mean, I can follow every rule for good sleep that's out there, but I still rarely get more than 6 hours and almost always wake up already feeling tired and crappy. I was really hoping primal would help these symptoms, because they really detract from my quality of life. It just didn't though.[/QUOTE]
Are you sure it's diet-related and that you don't just have some kind of sleep disorder? Not getting sufficient high quality sleep could be causing your other problems--fatigue and headaches. Have you tried seeing a neuropsychiatrist who specializes in sleep disorders?
[QUOTE=KimInGA;1023889]It's been pretty much the same. The bloating/gas got noticeably better with primal, but is still around enough to be annoying about 1/3 of the time. The insomnia got MUCH worse for awhile right after I went primal, but has now subsided to where it's not too much worse than before. And by that I mean, I can follow every rule for good sleep that's out there, but I still rarely get more than 6 hours and almost always wake up already feeling tired and crappy. I was really hoping primal would help these symptoms, because they really detract from my quality of life. It just didn't though.[/QUOTE]
Have you gotten your magnesium checked? If you're the typical muscle meat and vegetable Primal eater, grains were probably your only (poor) source of magnesium. Look into magnesium supplementation or start consuming more cocoa powder, brazil nuts, molasses and sunflower/pumpkin seeds. Magnesium deficiency is often linked with poor sleep. You can find supplements for dirt cheap. Take with dinner.
Looks like you can eat frogs and snails.
Probably the best news you can get, go vegetarian. This primal diet is slowly killing people and damaging their health. Eating meat, eggs, high fat all day, every day is a suicide diet. You have been rescued.
I'm in school for natural medicine and the ALCAT is not reliable. There is ONE food sensitivity test at ONE lab that is accurate that just came out in the last year but I cannot for the life of me remember the name.
I would highly recommend the GAPS diet for you, or at least elements of it like organs, tons of broth and plenty of fermented foods. It will help heal those food sensitivities and likely the headaches and bloating. It is not a quick fix but it will help heal you.
The bloating (and possibly headaches) tell me you probably need to raise your stomach acid levels. To do this, you can add a little apple cider vinegar in water to drink just before a meal and/or use bitters to stimulate them. You might want to do a hydrochloric acid challenge. Take one pill, and if you feel a little burning, your stomach acid is fine. If not, at the next meal take two. Hopefully, you get results otherwise you've got some work to do to get those levels up.
Are you on any adaptagenic hebs, like ashwaganda, licorice, rhodiola, etc? These could probably help you but I cannot say you should definitely take them because I have no clue about your health history. Consider taking this quiz about adrenal fatigue: [url=http://www.adrenalfatigue.org/could-I-be-experiencing-adrenal-fatigue]Could I Be Experiencing Adrenal Fatigue?[/url]. Adrenal fatigue isn't the whole story but it is an indication of overall metabolic health. Also, look into SIBO: [url=http://www.siboinfo.com/]SIBO- Small Intestine Bacterial Overgrowth - Welcome[/url]
Are you on probiotics? I found it was helpful to do a probiotic bomb, like high levels for three months, and then stick with fermented foods.
Due to the ALCAT test, I assume you are working with an ND. Don't be afraid to find another one. An even better option would be an ND, LAc.
I had a lot of weird symptoms a few years ago and fixed myself about 80% with GAPS and array of neutraceuticals and an adaptagenic formula. I finally found an excellent Chinese medicine doctor that specialized in herbs and he got me to about 95%.
I did the E95 basic food panel and it pretty much confirmed all the things that I was strongly suspecting. It is considered an allergy test, not intolerance. Casein, dairy at diff. degrees whether it be goat or terrible for cow. Eggs whites off the charts. Egg yolks moderate. Almonds also off the charts (I suspect all tree nuts,but didn't test for all) Those were the strongest, good for all meat. Even gluten and wheat ok.(think that is more an intolerance). Everything else mentioned that is more moderate I will test for individually. It at least gives me a start. My naturopath has found that to be the case with the testing. It is controversial but he found that for his patients that it confirmed their suspects. So really hard eating out, no dairy, no eggs, no grains........ I am sad too. :(
In your case given the amount of things they mention. Beef would be the biggest prob. for me ackkks!! I think I would start only eliminating the strongest first and go from there. Particularly the things that you really feel are a problem. My test really only confirmed my suspects. Added a few more for me to test, but even then had an inkling. When there are a lot of intolerances it can be really hard to figure it all out because you feel bad all the time. Hopefully removing the worst will give you some positives to work on.
Oh my god, I don't think I can live without those :eek:
I am no expert and I know anything about this diet, but I have a question: Did you check you thyroids?
Again, she must check thyroids.
What I like about this primal thing is flexibility. There are some great minds in the movement (unlike idiotic veganism) who respond to problems and make adjustments.
Yes, there is a problem with VLC diet and I am glad that this problem has been noticed. I thought I wasn't low carbs (I didn't want to be VLC), but the familiar problem with T3 (and headaches and bad sleep and fatigue) forced me to start counting and more importantly eating more carbs.
Jaminet has a series of articles on the topic with contributions of many.


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Asthma Overview Center - Cape Coral, FL
- WebMD Physician Directory of Cape Coral Asthma & Allergy Specialist Doctors
- Related Asthma Overview Articles
- Cape Coral Emergency Contacts
- Nearby Cape Coral Hospitals
- Find a Local Pharmacy on RxList - Cape Coral
Cape Coral Asthma & Allergy Specialist Doctors for Asthma Overview
Type of Physician: Asthma & Allergy Specialist
What is a Asthma & Allergy Specialist? A certification by the Board of Allergy & Immunology; practitioners are expert in the evaluation, diagnosis and management of immune disorders.
Specialty: Allergy, Asthma & Immunology
Common Name: Allergy Doctor
Asthma & Allergy Specialist Doctors in Cape Coral * results
- 2
Robert L. Pineiro
Allergy & Asthma Care Center
4017 Del Prado Blvd S
Cape Coral, FL 33904
(239) 549-1398
- 2 office location(s)
- 3
Lazaro L. Castillo-Sanchez
Allergy & Asthma Care Center
4017 Del Prado Blvd S
Cape Coral, FL 33904
(239) 549-1398
- 2 office location(s)
- 4
Donald P. Schwartz
Seth S Schurman MD
2684 Swamp Cabbage Ct
Fort Myers, FL 33901
(239) 939-2828
- 1 office location(s)
- 5
Seth S. Schurman
Adult Pediatric Allergy Asthma
1052 6th Ave N
Naples, FL 34102
(239) 262-0505
- 2 office location(s)
- 6
Charles G. Turnier
Lee Physicians Group Pediatrics
4761 S Cleveland Ave Ste 3
Fort Myers, FL 33907
(239) 343-9722
- 1 office location(s)
- 7
William N. Dakos
William N Dakos MD
13831 Metropolis Ave
Fort Myers, FL 33912
(239) 896-3963
- 1 office location(s)
- 8
Leeann Dunnington
Lee Physicians Group Pediatrics
4761 S Cleveland Ave Ste 3
Fort Myers, FL 33907
(239) 343-9722
- 1 office location(s)
- 9
Usha Chandrahasa
Naples Medical Center
3400 Tamiami Trl Ste 201
Port Charlotte, FL 33952
(941) 743-2277
- 1 office location(s)
- 10
Kevin P. Rosenbach
Care One Health Center Naples Allergy Center
2500 Vanderbilt Beach Rd Ste 1103
Naples, FL 34109
(239) 596-5560
- 1 office location(s)
- 11
Elvin M. Mendez
Elvin M Mendez MD
3410 Tamiami Trl Unit 1
Port Charlotte, FL 33952
(941) 255-3722
- 2 office location(s)
Don't see your city? Use the WebMD Physician Directory to expand your search.
What is asthma?
Asthma is a complex clinical syndrome of chronic airway inflammation characterized by recurrent, reversible, airway obstruction. Airway inflammation also leads to airway hyperreactivity, which causes airways to narrow in ...
Other Related Asthma Overview Articles
Emergency Contact for Cape Coral
- In case of Emergency, call 911
Nearby Cape Coral Hospitals results
- 1Cape Coral Hospital
636 Del Prado Blvd S
Cape Coral, Florida 33990
(239) 424-200
- 2Lee Memorial Health Systems
2776 Cleveland Ave
Cape Coral, Florida 33901
(239) 343-200
- 3Gulf Coast Medical Center
13681 Doctors Way
Cape Coral, Florida 33912
(239) 343-100
- 4Health Park Medical Center
9981 S Healthpark Dr
Cape Coral, Florida 33908
(239) 343-500
- 5Lehigh Regional Medical Center
1500 Lee Blvd
Cape Coral, Florida 33936
(239) 369-210
- 6Riverside Behavioral Center
733 E Olympia Ave
Cape Coral, Florida 33950
(941) 637-247
- 7Charlotte Regional Medical Ctr
809 E Marion Ave
Cape Coral, Florida 33950
(941) 639-313
- 8Faucet Memorial Hospital
21298 Olean Blvd
Cape Coral, Florida 33952
(941) 629-118
- 9Peace River Regional Med Ctr
2500 Harbor Blvd
Cape Coral, Florida 33952
(941) 766-412
- 10NCH North Naples Hospital
11190 Health Park Blvd
Cape Coral, Florida 34110
(239) 552-700
- 11Physicians Regional Medical Cen
6101 Pine Ridge Rd
Cape Coral, Florida 34119
(239) 348-400
- 12Englewood Community Hospital
700 Medical Blvd
Cape Coral, Florida 34223
(941) 475-657
- 13NCH Downtown Naples Hospital
350 7th St N
Cape Coral, Florida 34102
(239) 436-500
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The subtle and smooth flavor of Timothy's breakfast blend K-Cup packs is strong enough for that morning-pick-me up while not overpowering.... view
There are not many things as comforting as a hot cup of Timothy's Cinnamon Pastry coffee. The sweet and spicy cinnamon pairs deliciously with this rich medium bodied roast.... view
Layers of chocolate, caramel, and vanilla flavors paired with Timothy's exceptional specialty-grade coffee make for an outstanding combination. Bakery fresh chocolate cake in a cup!... view
Timothy's Italian Blend is a remarkably smooth espresso roast made with the highest grade Arabica beans. Its flavor profile is subtly sweet and full bodied with a hint of smokiness.... view
Timothy's Rainforest Espresso is a rich and satisfying extra bold coffee for those who love the darkest roasts.... view
A slightly sweet and smooth decaffeinated roast sourced from the central highlands of Colombia. Its well-balanced character makes it a great everyday decaf.... view


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Fixed PriceBudget: $13
Start DateMay 26, 2013
I'm looking for an experienced writer to write content for my website.
I need 10 articles of 300-400 words each.
All articles will be about "macadamia nuts"
you can choose the topics for the articles.
Writer should be familiar we SEO basics:
-Keyword must appear exactly as is.
-Required Keyword density 3% - 4%.
-Keyword must appear in articles title.
---The keyWord is "macadamia nuts"---
About the Client
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Bendix Electric, Inc.
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ATLANTIC CITY — Atlantic City's main casino workers' union demonstrated today outside the offices of the largest owner of the Revel Casino Hotel, demanding job security in the event of a sale.
The protest by Local 54 of the Unite-HERE union came hours after Revel president Scott Kreeger said prospective purchasers of the casino all intend to keep operating it after a sale.
The union tried to meet with officials of Chatham Asset Management at the firm's Morris County headquarters, but was rebuffed.
Local 54 has expressed concern that a sale could result in the shutdown of the casino, or large-scale job losses.
Kreeger says he hopes a sale, a joint venture or a partnership with another company can be reached by the end of the year.
• New Revel owners OKd by NJ casino regulators


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A bat can measure thespeed of a moving target by bouncing a sound wave from the targetand detecting the frequency shift. Call the frequency emitted bythe bat f0, and say the bug is flying with speed v awayfrom the bat.
a) What is the frequencyf1 of the sound as perceived by the bug?
b) The sound wave being reflected by the bug is equivalentto the bug emitting a sound wave of frequency f1 back towards the bat. What is the frequency f2 ofthis reflected signal heard by the bat?


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Created in this Craftsy class
In Craftsy's first-ever Block of the Month, Amy Gibson brings you 10 specific quilting techniques - appliqué, string quilting, paper piecing and more.
Other projects made as part of this class:
Offer some kudos...
Join the conversation...
Ask a question...
Add your comment...
|Here are some details about my project:
|Traditional, Retro / Vintage, Modern, Classic, Casual
Thing I'm most proud of is that with my funky cardboard templates, I managed to get perfect seams and a 12.5" dead on block. Thing I'm most fed up about? I'd sewn the whole thing almost together before I spotted the wonky square. Ah me,,,,pride and the fall are well named
Hey Essem! Don't sweat it. At least you spotted it before th block was in the top :-) Love this block - keep up the gorgeous work!
Thanks Jean, I appreciate the support, I've got to admit that I'm having to brace myself to tackle the Cleopatra block though. but at least I managed to sort out the problem with the Double Star, now I've got contrast and then some! You get there eventrually don't you?


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Hello everyone,
I've been following a roughly Primal diet for over a year, but have only just become very strict and got rid of the sugar completely, except for dark chocolate. I've been pregnant and had a wonderful natural birth during that time, and my daughter (who is exclusively breastfed, she's three months old) will be getting primal goodies right from the start. I'm so excited for her.
I live in East Yorkshire, England. It's a bit of a "backwards" place, which means not many people know about Primal living (none that I know of), but it is very easy to get great pastured meat and eggs, as there is a lot of green space here.
My husband is just getting into the benefits of a really primal lifestyle and it's helping him put on weight. My daughter actually has the weight of a six month old baby, but she's not fat by any means. She can already roll from belly to back and vice versa. She's an incredibly strong little bub, and I'm sure this is down to the awesome primal milk she's getting.
I have a few questions:
My husband would like to bulk out. He's almost 6ft and 142lbs, which is skinny for his height, but he has some good lean muscle. Is his best bet to up the protein and fat, simply, or should I be feeding him plenty of carbs, as he burns it so fast? We both have an awful "carb history", sugary cereal as kids and such, so is it best for him to be low or high (by primal standards) on the carb scale? He currently has a coconut cream smoothie, lots of yogurt and berries in the morning, then bacon, eggs and sausage late morning, and meat and veggies at night. Usually some snacks too, a banana and some jerky. Is this too much in carb load? I also eat as much as this, but have been getting light-headed. Should I up my carbs or my protein? I'm 5'5" and 130lbs.
Thanks to anyone for any advice. Happy to be here!
Here's our primal girl, Summer:


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Download citation file:
From Westat, Rockville, Maryland; National Institute of Diabetes and Digestive and Kidney Diseases and National Institutes of Health, Bethesda, Maryland; New England Research Institutes, Watertown, Massachusetts; Veterans Affairs Medical Center and Georgetown University School of Medicine, Washington, D.C.; and Baylor College of Medicine, Houston, Texas.
Acknowledgments: The authors thank Song Li and David Chang, Westat, Rockville, Maryland, for data processing and statistical programming support and Jim Korelitz and Stephen Durako for review and comment on earlier drafts of the manuscript.
Grant Support: By contracts N01-HB-87047 and N01-HB-37093 from the National Heart, Lung, and Blood Institute.
Requests for Single Reprints: Leonard B. Seeff, MD, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Disorders, 31 Center Drive, Room 9A18, Mail Drop MSC2560, Bethesda, MD 20892-2560; e-mail, firstname.lastname@example.com.
Current Author Addresses: Drs. Harris and Gonin: Westat, 1650 Research Boulevard, Rockville, MD 20850.
Dr. Alter: Department of Transfusion Medicine, National Institutes of Health, Building 10, IN307, 9000 Rockville Pike, Rockville, MD 20892.
Dr. Wright: New England Research Institute, 9 Galen Street, Watertown, MA 02472.
Ms. Buskell: Hepatitis Research, Room 3A-128, Veterans Affairs Medical Center, 50 Irving Street NW, Washington, DC 20422.
Dr. Hollinger: Baylor College of Medicine, NS BCM 3B5, One Baylor Plaza, Houston, TX 77030.
Dr. Seeff: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Disorders, 31 Center Drive, Room 9A18, Mail Drop MSC2560, Bethesda, MD 20892-2560.
Author Contributions: Conception and design: D.R. Harris, R. Gonin, E.C. Wright, Z.J. Buskell, F.B. Hollinger, L.B. Seeff.
Analysis and interpretation of the data: D.R. Harris, R. Gonin, Z.J. Buskell, F.B. Hollinger, L.B. Seeff.
Drafting of the article: D.R. Harris, R. Gonin, H.J. Alter, L.B. Seeff.
Critical revision of the article for important intellectual content: D.R. Harris, R. Gonin, H.J. Alter, E.C. Wright, Z.J. Buskell, F.B. Hollinger, L.B. Seeff.
Final approval of the article: D.R. Harris, R. Gonin, H.J. Alter, E.C. Wright, Z.J. Buskell, F.B. Hollinger, L.B. Seeff.
Provision of study materials or patients: H.J. Alter, F.B. Hollinger, L.B. Seeff.
Statistical expertise: D.R. Harris, R. Gonin, E.C. Wright.
Administrative, technical, or logistic support: D.R. Harris, Z.J. Buskell, L.B. Seeff.
Collection and assembly of data: D.R. Harris, R. Gonin, H.J. Alter, Z.J. Buskell, F.B. Hollinger, L.B. Seeff.
Background: Although concomitant alcoholism is widely believed to enhance liver disease progression in persons with hepatitis C virus (HCV) infection, this relationship has not been well quantified.
Objective: To quantify the relationship of transfusion-associated HCV infection and history of heavy alcohol abuse to development of cirrhosis.
Design: Retrospective cohort study.
Setting: Liver clinics in university and government hospitals.
Patients: Extended follow-up of 1030 patients in prospective investigations of transfusion-associated viral hepatitis conducted in the United States between 1968 and 1980.
Measurements: Development of cirrhosis and history of heavy alcohol abuse were determined from review of interviews with patients or their proxies, medical records, death certificates, and autopsy and biopsy reports. Logistic regression was used to estimate the risk for cirrhosis associated with transfusion-associated HCV infection and history of heavy alcohol abuse.
Results: The absolute risk for cirrhosis was 17% among patients with transfusion-associated HCV; 3.2% among patients with transfusion-associated non-A, non-B, non-C hepatitis; and 2.8% among controls. Patients with transfusion-associated HCV were more likely than controls to develop cirrhosis (odds ratio, 7.8 [95% CI, 4.0 to 15.1]). A history of heavy alcohol abuse was associated with a fourfold increased risk for cirrhosis. Hepatitis C virus infection plus a history of heavy alcohol abuse led to a substantial increase in risk for cirrhosis (odds ratio, 31.1 [CI, 11.4 to 84.5]) compared with controls without such a history.
Conclusions: Heavy alcohol abuse greatly exacerbates the risk for cirrhosis among patients with HCV infection. This finding emphasizes the need to counsel such patients about their drinking habits.
Seroprevalence data from the Third National Health and Nutrition Examination Survey (1984 to 1999) suggest that 3 million persons in the United States are infected with the hepatitis C virus (HCV) (1). Treatment fails to clear the virus in 80% to 85% of acutely infected persons. Not all persons who remain infected eventually develop progressive liver disease (2), but in those who do, clinical evidence of liver damage may not appear until decades later (3). It is widely believed that progression of liver disease in persons with chronic HCV infection is enhanced by concomitant heavy alcoholism (4–12).
We sought to quantify the association of transfusion-associated HCV infection and history of alcohol abuse with development of cirrhosis among patients followed from the time of acute HCV infection.
The source of this investigation, described in detail elsewhere (13), is a long-term follow-up study of acute non-A, non-B hepatitis in patients included in earlier prospective studies of transfusion-related HCV infection. All patients provided informed consent, and the study was approved by the relevant institutional review boards. Briefly, non-A, non-B hepatitis was identified by otherwise unexplained elevations in serum alanine aminotransferase (ALT) levels developing 2 to 24 weeks after transfusion, in the absence of serologic evidence of hepatitis A or B (13). The ALT level had to be elevated on two consecutive measurements, and at least one of the values had to exceed twice the upper limit of normal.
Stored sera from case-patients and controls from three of the prospective studies—the second Veterans Administration Cooperative study (14), the Transfusion-Transmitted Viruses study (15), and the National Institutes of Health Blood Bank Study (16)—were tested for anti-HCV by enzyme immunoassay (HCV EIA 2.0, Abbott Laboratories, North Chicago, Illinois). Transfusion-associated HCV infection was diagnosed if anti-HCV appeared and persisted, was temporally related to elevated ALT levels, and was confirmed by using the supplementary recombinant immunoblot assay (RIBA version 3.0, Ortho Diagnostics, Raritan, New Jersey). Because repository samples were not optimally stored for minimizing nucleic acid loss, HCV RNA testing was not performed.
Controls consisted of transfused patients from the original three prospective studies who had not developed hepatitis (13). Controls were matched to case-patients by initial treatment center, sex, ethnicity, use of hepatitis immune globulin, presence or absence of a history of alcoholism, age, number of units of blood transfused, and date of transfusion.
We excluded patients with anti-HCV–positive samples that predated the index transfusion and those with anti-HCV reactivity but no confirmatory test. Anti-HCV–positive/RIBA-negative and anti-HCV–negative patients were classified as having transfusion-associated non-A, non-B, non-C hepatitis. Controls with anti-HCV in repository samples were excluded.
We used a multifaceted approach to gather information on each patient's history of liver disease from participation in the prospective studies through initiation of the follow-up study (13). Vital status was ascertained through searches of death registries, and copies of death certificates were obtained. Patients or their designated proxies (if the patient was deceased or incompetent) were invited to participate in a personal interview that included questions about previous hospitalizations. Authorization for release of medical records was obtained, and information on all hospitalizations at each facility identified was requested. Medical records, death certificates, and biopsy and autopsy reports were reviewed by trained abstractors for the diagnosis of cirrhosis, which was based on the occurrence of features of portal hypertension and overt clinical manifestations of cirrhosis. Evaluation of a sample of records indicated a high level of agreement between abstractors and one of the investigators.
Potential risk factors were derived primarily from personal interview. A composite variable aimed at identifying a history of heavy alcohol abuse was designed to minimize the possibility of misclassifying "unexposed" patients. The composite variable was based on one or more of the following criteria: loss of friends, family, or a job because of drinking; admitting to ever having a problem with alcoholism; evidence of heavy drinking abstracted from medical records; or quantification of usual intake of more than 80 g of alcohol per day during the years when the patient drank.
Univariate methods (the Fisher exact, exact Fisher–Freeman–Halton [17], and Wilcoxon rank-sum tests) were used to compare the distribution of characteristics between patients included in and those excluded from the analysis and to examine associations between potential risk factors and development of cirrhosis. The strength of the association between risk factors and cirrhosis was assessed by using the odds ratio obtained from multiple logistic regression. The likelihood of developing cirrhosis associated with a combination of risk factors was estimated from the logistic model (18).
Of 1030 patients who were followed up from the original prospective studies that had collected repository samples, 836 (81.2%) were included in this analysis. We excluded 108 patients whose repository samples were exhausted, 79 with ALT levels or HCV assays that did not permit reliable classification of hepatitis status, 1 with cirrhosis that predated the index transfusion, and 6 with data inconsistencies that could not be resolved.
As shown in Table 1, included and excluded patients differed only in median number of blood units originally transfused. The number of units received could affect the probability of developing acute transfusion-associated hepatitis or its severity but would probably not influence development of cirrhosis decades later.
Preliminary analyses indicated that development of cirrhosis was unrelated to tattooing, ear piercing, occupational exposures, extended travel to areas in which hepatitis is endemic, and use of injection or other illegal drugs. Information on prescription drug use was unavailable for analysis. Development of cirrhosis differed (P < 0.05) according to transfusion-associated hepatitis status, study cohort, race/ethnicity, units of blood originally transfused, history of heavy alcohol abuse, and vital status at follow-up (Table 2). The absolute risk for developing cirrhosis was higher among patients with transfusion-associated HCV infection (17.0% [35 of 206 patients]) (P < 0.001) than among those with transfusion-associated non-A, non-B, non-C hepatitis infection (3.2% [3 of 95 patients]) or controls (2.8% [15 of 535 patients]) but did not differ between the latter two groups (P > 0.2). The median time from index transfusion to initiation of follow-up (15.6 years overall) did not differ by cirrhosis status, transfusion-associated hepatitis status, or race/ethnicity (P ≥ 0.10).
Logistic regression modeling indicated that patients with transfusion-associated HCV infection were 7.8 times (95% CI, 4.0 to 15.1 times) more likely to develop cirrhosis than controls, after adjustment for history of heavy alcohol abuse and study cohort. Patients with transfusion-associated non-A, non-B, non-C hepatitis were at increased risk for developing cirrhosis, but this finding was not significant (odds ratio, 1.4 [95% CI, 0.4 to 5.0]). Patients with transfusion-associated HCV were 5.6 times (CI, 1.6 to 19.3 times) more likely to develop cirrhosis than those with non-A, non-B, non-C hepatitis. A history of heavy alcohol abuse was associated with an increased risk for developing cirrhosis (odds ratio, 4.0 [CI, 2.1 to 7.7]).
The Hosmer–Lemeshow goodness-of-fit test indicated that the model fit the data well (P > 0.2). From this model, it was estimated that patients with both transfusion-associated HCV infection and a history of heavy alcohol abuse were 31.1 times (CI, 11.4 to 84.5 times) more likely to develop cirrhosis than controls without a history of alcohol abuse. Patients with transfusion-associated non-A, non-B, non-C hepatitis and a history of heavy alcohol abuse were also more likely than controls without such a history to develop cirrhosis (odds ratio, 5.5 [CI, 1.3 to 24.3]).
Although cirrhosis was less common among African-Americans (2.2%) than among persons of other ethnicities (7.2%), addition of race/ethnicity, follow-up duration, units of blood originally transfused, vital status, and receipt of additional transfusions to the model changed the risks associated with hepatitis status and history of heavy alcohol abuse only slightly. None of these factors made a significant independent contribution to the model (data not shown).
Patients who contracted transfusion-associated HCV infection were at increased risk for developing cirrhosis (odds ratio, 7.8), and this risk increased substantially if the patient also had a history of heavy alcohol abuse (odds ratio, 31.1). Although numerous reports have identified a strong role of alcohol in promoting progression of liver disease among persons with chronic HCV infection (4–12), our findings provide a quantitative measure to assess the strength of this association.
Some patients who were originally classified as having acute non-A, non-B hepatitis tested negative for HCV infection. These patients developed cirrhosis more frequently than controls, but not significantly so. This finding suggests that the elevated ALT levels observed during the original prospective studies were caused by intrinsic liver disease. It remains to be determined, however, whether these patients had been infected with a virus other than hepatitis A, B, or C virus or whether the elevated enzyme levels resulted from other causes (for example, nonviral infection or exposures to toxins).
An advantage of our study is that follow-up could be done among patients from earlier prospective studies that used a similar protocol to diagnose acute hepatitis virus infection and that periodically monitored ALT values for an extended period. In addition, serum repositories were maintained by three of the original studies, which permitted subsequent serologic and molecular testing for HCV infection.
Death certificates, medical records, and autopsy and biopsy reports are subject to possible bias due to omission of information on liver disease; however, omission of such data was unlikely to have differed between study groups. Although patients with non-A, non-B hepatitis may have had close medical follow-up, the prevalence of cirrhosis did not differ between controls and patients with transfusion-associated non-A, non-B, non-C hepatitis, suggesting that this possibility did not greatly influence the results.
Patients are unlikely to have overestimated or fabricated a history of alcohol abuse, but they may have underestimated such a history because of social stigma. Our inability to establish the exact timing and duration of alcohol abuse created additional uncertainty about the accuracy of this variable. We asked patients about the usual quantities of beer, wine, and liquor consumed per week during the time when they drank, but we could not determine whether the alcohol was consumed during a brief period or over an extended period.
In general, the potential limitations of our study may have led us to underestimate the risk for developing cirrhosis associated with transfusion-related HCV infection and a history of heavy alcohol abuse. These results stress the need to counsel patients with HCV about their drinking habits. Finally, although it was not significant in multivariate analysis, the lower frequency of cirrhosis observed in African-Americans compared with persons of other ethnicity warrants further examination, since this phenomenon has been observed previously (19).
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Relationship among Transfusion-Related Hepatitis C, Alcohol Abuse, and Cirrhosis
The summary below is from the full report titled "The Relationship of Acute Transfusion-Associated Hepatitis to the Development of Cirrhosis in the Presence of Alcohol Abuse." It is in the 16 January 2001 issue of Annals of Internal Medicine (volume 134, pages 120-124). The authors are DR Harris, R Gonin, HJ Alter, EC Wright, ZJ Buskell, FB Hollinger, and LB Seeff, for the National Heart, Lung, and Blood Institute Study Group.
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Practice what you have learned, for theory without practice is like a spirit without a body. One who is content with learning alone is not learned, for the truly learned seeks more than mere words. Divine guidance entails self-mortification, without which contemplation is unattainable.
- Al-Hujwiri, "The Kashf al-Mahjub"
Wednesday, October 28, 2009
Practice what you have learned
Posted by Shahul Hameed at 2:01 PM
1 comment:
- Muhammd Naeem Sattar said...
Subahanallah! Very nice blog, May ALLAH bless us all with HIS fazal.
If someone want to read full book KASHAF AL MAHJOOB by HAZRAT DAAT ALI HAJVIRI GANJ BAKHSH (R.A) please visit: http://www.buy92.com/faqr/kashaf-al-mahjoob-%DA%A9%D8%B4%D9%81-%D8%A7%D9%84%D9%85%D8%AD%D8%AC%D9%88%D8%A8/
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- The Nonprofit Sector in China and Russia: A Comparative Forum
Nov. 24 - Bios
- Managing Growth and Change in Nonprofit Organizations
Oct. 27 - Bios
- Outstanding Nonprofit Board Leadership: A Conversation With the Winners of the 2015 Brooke W. Mahoney Award for Outstanding Board Leadership
Sep. 21
- New York City: Global Leader in International Nongovernmental Organizations
Apr. 23 - Bios - International NGOs Key Findings - Amani Global Works
- Consulting Day For New York's City Nonprofit Community
Mar. 25 - List of Consultants
- Social Impact Metrics for Attracting Investment
Feb. 24 - Bios & Slides
- National Immigrant Communities Project
Nov. 11 - Bios & Slides
- Outstanding Nonprofit Board Leadership: A Conversation With the Winners of the 2014 Brooke W. Mahoney Award for Outstanding Board Leadership
Oct. 23
- Current Priorities for Regulation of New York's Nonprofit Organizations
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May 20
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In the back of our song book is a part called the Chorus Section. Here you will find choruses comprised of a few short lines and categorized by topic: Prayer, Holiness, even Warfare.
"Meet my need, Lord,
Meet my need, Lord,
Meet my need just now;
I am waiting and thou art coming
To meet my need just now" – chorus #86
I don't know why there's a chorus section or where these choruses originated. There are no composers listed and, as usual, no music. But there they are. This collection of choruses I haven't heard sung in years.
"Silently now I wait for thee,
Ready my God thy will to see,
Open mine eyes, illumine me.
Spirit divine." – chorus #99
This chorus section came to mind a few days ago as one of these short verses set to music has been flitting through my mind. I picked up the book to find it but it's not there. Could be it's the chorus to a song or something that was traditionally sung to a song or alone but not in print. There are a few of those little things you pick up over the years.
Today has given way to "praise and worship" style music. Our men enjoy that. We enjoy that. They are often easier for our men to sing than the hymns they don't know. We sing the hymns too, thanks to a volunteer pianist that knows them well, but the choruses, no.
"Where he leads me I will follow,
Where he leads me I will follow,
Where he leads me I will follow,
I'll go with him, with him, all the way." – chorus #57
As I paged through I saw so many we've sung over the years. First heard them sitting next to mama in church and watching her worship in song. The words simple and direct and I realize how much those choruses informed my beliefs and strengthened my faith. As meaningful as scripture, these words with their melody hold fast in my mind. Such comfort words can bring, such truth they hold.
"To be like Jesus!
This hope possesses me,
In every thought and deed,
This is my aim, my creed;
To be like Jesus!
This hope possesses me,
His Spirit helping me,
Like him I'll be." – chorus #107


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The Houston Texans may be the NFL's newest franchise, but it's safe to say at this point that the Texans have officially ditched the moniker of "expansion team."
In each of the past two seasons the Texans have won the AFC South and a postseason game, but now the team is looking to take the mythical "next step" and advance past the divisional round of the playoffs.
That means addressing needs that include the wide receiver and linebacker positions, and the team will look to fill those holes and more at the 2013 NFL draft later this month.
Let's take a look at all the latest news, rumors and pre-draft speculation involving the Texans. This tracker will also be updated regularly as the draft approaches, so be sure to check back often.


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Investigators spent their first full day at the site of the deadly bus crash in Orland and spoke to a couple who witnessed the crash.
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Romo, Giants miss chance to make themselves heard
Gaudin hopeful Giants' fortunes will turn around
The Giants have lost five straight series, and 10 of their last 12 games. (USA TODAY IMAGES)
SAN FRANCISCO – On the list of problems that currently plague the Giants, Sergio Romo blowing off the media ranks somewhere on Page 106, just below Mike Murphy needing to reorder more sheets of those eye black stickers.
Romo can walk past as many microphones and notepads as he wants after the game. There might be a few fans who care if he is accountable afterwards. There are many, many more who just want him to spot his slider with the outcome at stake.
On Sunday, one of those sliders hovered over the plate to A.J. Ellis with the bases loaded in the ninth inning , turning a tie game into a 4-1 victory for the Los Angeles Dodgers. That one pitch and one swing also made the difference between a series victory or defeat for the Giants, who so desperately needed to take two of three.
[REPLAY: Kershaw continues dominance of Giants]
They did not. They've lost five straight series now, and 10 of 12 games.
This one came against the hottest team on the crudite tray that passes for the NL West. It came at AT&T Park, where the Giants still play with at least a speck of confidence. It came after an eight-inning stalemate against Clayton Kershaw, who makes his offseason home atop Mt. Olympus.
And it came at a time when Giants GM Brian Sabean is trying to determine whether there's any difference between upgrading this roster on the trade market and paying for an addition while your house is disappearing down a sinkhole.
Sunday afternoon might not be the last place the Giants could've made a U-turn. But the coast was so, so clear.
Instead, the Dodgers cut off the Giants on the freeway, and gave them the finger, too. Nothing boils the blood quite like that, does it?
The ninth inning was personal, no doubt about it.
Start with Yasiel Puig, who didn't lead off the inning with a home run but flipped his bat just the same. He singled off Romo, who had struck him out a day earlier. Then Adrian Gonzalez reached on an infield single off first baseman Buster Posey's glove, with Posey compounding the problem by trying a desperate flip to second base for an error.
With runners at the corners, Hanley Ramirez tried to hit a 3-0 pitch over the Coke bottle and instead tapped back to Romo for a forceout. Then came an intentional walk and a masterful strikeout of former teammate Juan Uribe.
But just when it appeared Romo would escape, he hung an 0-1 slider to Ellis.
"That one, it didn't do anything," catcher Guillermo Quiroz said. "It was the only one he left in the strike zone."
Romo stood and watched, hands on hips, as his outfielders tried to run it down in left-center field. Anything to avoid making eye contact with the Dodgers who rounded the bases.
Puig kept shooting glances back to the mound as he approached the dugout steps. Ramirez stood on the top step, too, and appeared to share a few choice comments.
A day earlier, Romo mimicked Ramirez's "lo viste" hand gesture. The Dodgers responded by showing him the back of theirs.
"Yesterday, he struck me out, he controlled Hanley, and he celebrated," Puig said in Spanish. "Today, it was our turn to celebrate. We were screaming at him, but it wasn't anything bad."
Romo had nothing to say afterward. He dressed quickly at his locker, kept a phone pressed to his ear as he walked past a crowd of awaiting reporters, and muttered into the receiver, "Only want to talk to me when I do (poorly)? Can't be human in this clubhouse."
It's not the first time Romo has blown off reporters following a loss or a failed save opportunity. His forerunner, Brian Wilson, was not a champion in the accountability department, either. There's no rule that requires a player to talk with the media after a game, good or bad. But players who conduct themselves with maturity and professionalism usually hold themselves to a certain standard and make themselves available – no matter what the questions might be.
Giants manager Bruce Bochy didn't pay much attention to any extracurriculars in the ninth. And he made it clear that he wouldn't ask Romo to tone anything down.
"That's how he pitches, with a lot of passion and sheer emotion," Bochy said. "If we thought it was out of control, we'd say something. But I don't want to change the guy. He goes out there with a lot of fire and he competes with anybody.
"He's a hitter away from getting out of that. So I don't want to take away anything, if it's under control. The guys who play with emotion … that's who they are."
Romo might have taken the loss, but it doesn't take much level-headed analysis to know that he wasn't the reason they lost the game. He's not the reason they've lost their way as a team.
Romo is 20 for 23 in save chances and almost certainly is headed to the All-Star game as a replacement for one of the three NL pitchers scheduled to start on Sunday. He's been as steady as ever. The Giants are 31-1 in games when they lead after eight innings.
The bigger issue is that the Giants are 4 for 54 (.074) with runners in scoring position over their last 10 games. Although they get a note from their parents when facing Kershaw, Hunter Pence is has an 0-for-22 streak going and Pablo Sandoval hasn't been much better.
Combined, the two middle-of-the-order hitters are checking in at 5 for 74 (.068) with four walks and 19 strikeouts over the last 10 games.
Bochy said he saw better balance and better swings from Sandoval on Sunday. So there's that. There's also Chad Gaudin's seven very tidy innings in his return to the rotation. That might be the best sign to come out of an afternoon that went awry in the ninth.
"The best way we can get out of it is to do it together, as one unit," Gaudin said. "I think we're busting our tails and doing all we can to turn it around."
Even dysfunctional clubhouses can turn things around with one hot series.
Back in 2010, the Giants were in a funk nearly as bad as this current stretch and heading to Colorado when Aubrey Huff made an outlandish suggestion: It might be a good thing that they were facing Ubaldo Jimenez, who was 14-1 with a 1.83 ERA at the time.
The Giants hung seven runs on Jimenez and won that day. Then they went to Milwaukee, took a torch to the Brewers pitching staff and won the NL West on the final day of the regular season.
That team was in fourth place and four games out at the All-Star break. This current club is in fourth, and 6 ½ behind the suddenly hot Arizona Diamondbacks, who have won five consecutive.
Kershaw might have been their Ubaldo.
But the slider stayed up. The opportunity passed them by.
And the rest you could mutter under your breath, with a phone pressed to your ear.


text: Subway passengers affected by the sarin gas attack on Tokyo's subway system are carried into St. Luke's International Hospital in Tokyo on March 20, 1995. Thirteen people were killed and more than 6,000 injured in the attack, which was carried out by the Aum Shinrikyo cult. Chikumo Chiaki/AP hide caption toggle caption Chikumo Chiaki/AP Parallels Chemical Weapons Used Rarely — But With Deadly Effect August 27, 2013 The horrific effects of chemical weapons used during World War I led to a treaty banning their use. But Iraqi leader Saddam Hussein deployed them several decades later during his country's war with Iran, as well as on Kurds in the town of Halabja. Before the latest reports of a chemical weapon attack in Syria, a Japanese cult used sarin gas in a 1995 attack on Tokyo's subway system.


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Fuse Creativity System Project Guide: Fun Party Themes, Idea for Handmade Cards, And More Paper Crafts from Fiskars
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Mica Stencil Greeting Cards
By: Susan Pickering Rothamel
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Cut corners this holiday season and save money on common items like cards. Greeting card crafts projects allow you to get creative and try something new. Make Mica Stencil Greeting Cards from Susan Pickering Rothamel and change the way you look at paper crafts.
- Cut Bond Create Adhesive Film (CBC)
- Mica D'Lights
- Gildenglitz Gold Leaf (optional)
- Stencil – Metal or Plastic
- Pick & Pierce Tool
- Texture Sponge
- Cardstock
- Scissors
Cut the CBC to fit either all or a portion of a stencil. The stencil may be metal or plastic.
Using the Pick & Pierce Tool, remove the white liner of the Cut Bond Create by gently poking the liner corner. Grab it as it comes away, and pull off the entire liner layer.
Place a stencil onto the sticky side of the Cut Bond Create.
Lightly sprinkle on several different colors of Mica D'Lights until all areas have been covered.
Use your fingers to rub and blend the colors together, which gives a sparking watercolory appearance.
Use the Texture Sponge to press and remove the extra bits of mica, filling in the holes and lighter areas with any extra Mica D'Lights.
Gently remove the stencil.
Either sprinkle a contrasting color of Mica D'lights onto the remaining tacky areas, or use Gildenglitz! Once again use your Texture Sponge to press down and remove the excess bits.
Use your Pick & Pierce™ Tool to remove the back liner of the Cut Bond Create (this liner is is the grid part and allows you to cut along the lines for trimming).
- Attach your image to a piece of cardstock, trim if necessary and create a greeting card.
Any type of stencil will work (metal or plastic). But if using a stencil with fine detail, remove the stencil very carefully so as not to bend any of the little wire-like areas.
The Pick & Pierce tool makes it easy to remove any type of liner. You don't have to struggle, especially if you have no fingernails!!
- Trim the decorated piece of Cut Bond Create to create several pieces of artwork!
For a comprehensive video tutorial of this project, check out How to Stencil with Mica.
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