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With John Howard poised to control both houses of parliament after Saturday's election, what are your thoughts on the election outcome?
Limiting yourself to one or two sentences, explain your hopes and fears for the next three years.
This topic is now closed - this is what you said.
A majority of Germans voted for Hitler too.
Tony D
My Two Bits...John Howard has won a fourth term in the job based on 'economic credentials' and his appeal to the hip-pocket (interest rates). We have the economy we have because of Bob Hawke and Paul Keating.
Simon aka MelbourneWolf
Does anyone know what, if any, protections the government proposes for employees of small businesses which it proposes to exempt from unfair dismissal laws ?
Col mate,
IQ only 135? No *wonder* i always feel like i need to dumb it down for you! ;D
Brent "Time for a few home truths ladies & gents...Australians to their credit have again rejected the loud and obnoxious rantings of pumped-up fringe groups; self-absorbed minorities; habitual apologists; socialists; whingers; and self-appointed social engineers. "
Well put Brent... to all these "ashamed whingers"... - flights leave Tullamarine Daily, you will not be missed!
The Irrepressible Col Rouge
To all the lefties out there who thought that Latham was going to get in tuff "mammary glands of a human female".
So Sad
I'm most concerned about changes to cross-media ownership laws. I think it'll be easier for the ALP to win power in three years, after the Coalition has what may be free rein in the senate. And as for the Family First debacle: all I can say is...let's all vote below the line in future!
Blue Mabel
Yes, the silent majority of 51 percent got up. There's a good reason why they are silent, their views do not stand up to scrutiny in terms of social progress and justice.
Tony Corbett
With the re-election of the Howard government, i know i will have a job, afford a house and be part of sustainable environmental, forestry and mining practices. Maybe a little less loony from the other parties would have woo-ed my vote.
As for Iraq, how many people would saddam have continued to kill if he had not been removed?
Alex Thompson
here is a message to the liberal loggers of Tasmania:
your absolute selfishness will ultimately undo you.
just wait and see what Howard will do to industrial relations with the power he has in the senate.
Sian Griffiths
Let this be a leason. VOTE BELOW THE LINE PEOPLE!!!! When you vote above the line you are trusing 'them' with your vote. It is only once every 2.5years, spend an extra 10min for God sake!
When are we going to get over the lie that a majority of people voted for Howard? 41% of the primary vote (46% with the Nats) does not constitute a majority (and Lib supporters are surprised when they're called stupid - go do the math, oops too stupid I forgot).
Abolish preferences and intrudce proportional representation.
Leonard Smith
Christopher Reeve has just died - how about we stop the sensless bickering and instead agree, as a voting population, to hound BOTH parties to form policies that allow and encourage stem cell research?
Its dangerous to give one party control of the whole system, very dangerous, and who's to say Family First can't be bought: bet you they can: As to the overall result; Howard chased the hip pocket and won.
David Finnis
I would expect The Age's revenue from the Obit. pages to go up in 2005.
So long and thanks for all the fish...
From the AEC web site today
Registered voters 13,021,230
Liberal pirmary votes 5,048,885
38.8 % of the primary vote
This means that 61.2 % of the population did not vote for the Liberals
Sorry Geeze-
I interpreted your words as meaning you believed Labor was more liberal than the Liberals, not claiming that I believe either of them are. All the major parties in Australia believe in high levels of government control, the Liberals just slightly less than the others.
Ben C
I have to say that I have great concern for the editor of this forum if/when Telstra is fully privatised. Those of us unable to gain access to broadband because of the archaic phone lines in our area will be stuck with a timed local call to post here and read the comments of the Irrepressible Col Rouge.
Shamed to be aussie,
I hardly call queue jumpers who pay Indonesian fisherman thousands to smuggle them illegally are genuine refugees. A real refugee is someone who has no money, no home, no food, no clothes.... Not someone arranging travel plans at a Maccas in Jakarta
To my way of thinking, it's more scary the Coalition having that rubber stamp in the Senate, than an icreased majority in the Lower House. Watch the "mandates" come thick and fast now!
What an indictment on us all.
Dillo, W.A.
Ashley Dillon
Ed what is happening here. This was only a small proportion of what I wrote. I also notice that I'm not the only person asking what's happening with posts and yes before I post I always make sure that the last line I want posted shows up in the comments box.
3/4 of my post has been cut.
Maggie, nearly all posts have been heavily edited today. Because of the sheer volume of responses election topics generate and the ability of many people to waffle on needlessly, the decision was made today to limit responses wherever possible to a sentence or two so that everyone can have a say. I try to edit them in a way that allows your response to reflect your view. If you don't want them edited, stick within today's guidelines. - Ed
Gay Whale On Acid,
You wrote, "Say goodbye to a profit making state owned enterprise"
Just wait and see what the American companies are going to do to Australia Post under the FTA!
If Canada Post's experience is anything to go by, expect UPS, FedEx etc to start ripping Aussie Post apart in the courts...
John Howard and his mates George and Tony should be going to The Hague instaed of being re-elected. They are all guilty of Crimes Against Humanity.
What a bunch of left-wing whingers. The majority of Australians suspected and have clearly voted against the drive of federal labour for a welfare state. Do you honestly think we are that stupid to be bluffed by a simple theme of Labour equals High Interest Rates?
Stop crying
The Prof,
I think you're right about the IQ test, that will get rid of the bulk of Labour voters who tend to come from a lower socio-economic (IQ) group. But removing compulsory voting will probably have the same effect.
I think the taste of Coaltion victory, especially after listening to the screetching lefties sour grapes in this forum and elsewhere is sweet indeed. As for Bob Brown's 12 percentage prediction,y eah pigs can fly, people are not stupid to buy in to his party's policies.
It's pretty sad to see how bitterly divided the readers of this forum are. Is this an example of the attitudes of the wider Australian community?
Heil Howard.
Rubber Stamping Senate,
we won't be run by churches per se, but by adulterous, money-driven American evangelical frachises ...
Screaming Lord Sutch II
Let the 53 percent of the electorate who voted Liberals based on the economy explain their reasons when "world economic growth stalls" and collaspes in about 3 years time due to the accumulated world debt (living beyond our means)forcing markets to react and pushing interest rates much higher.
Kevin Hoffman
Turning a shade greener,
I agree, Latham's aggressive suburban persona and retro-blokey outlook made him UNELECTABLE.
No to BEAZLEY, LATHAM and CREAN and the other good old boys, time for a real change.
Faith No More
Wow, imagine the uproar if there had been Your Say when Paul Keating (Labor government) sold the Commonwealth Bank.
If the biggest fear that most posters have from Government control of the Senate is that they might sell their lingering 50% stake in a company listed on the ASX and essentially privatised already, then there really isn't much to fear at all. Is there?
Ben C


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CITIC Resources Holdings, a listed subsidiary of China's state-owned CITIC Group, has told UBS it is no longer looking for opportunities in Australia after receiving $1.2 billion in cash last month from selling out its investment in Queensland miner
In an email to clients on Tuesday, UBS Resources Research said CITIC was now looking at gold targets in Russia after growing frustrated in its pursuit of offshore iron ore and coal assets.
"[CITIC is] no longer looking in Australia, reviewed Africa, but cannot trust political regimes there [and is now] looking at gold targets in Russia," said UBS analysts led by Glyn Lawcock.
Last month CITIC agreed to accept a $4.9 billion takeover bid from Peabody Energy and ArcelorMittal for Macarthur Coal making it the third party to make a fortune from takeover activity surrounding the miner.
UBS said it was told by CITIC that its call to sell its stake in Macarthur was an investment decision and the company now wanted to move in.
Zhu Lianliang, a director of Chinese state-owned steel producer China Shougang International Trade & Engineering, told UBS the company is proceeding with its long-term plan to secure steel raw materials from around the globe as a way to manage steel production costs.
It receives most of its iron ore from Australia and does not use what it regards as lower quality ore from India, while UBS said it had been looking for met coal assets in Mongolia and Australia but was concerned by the lack of government support in Mongolia and the array of taxes in Australia.
China-based UBS economist Harrison Hu said he expected Chinese gross domestic product growth to slow to 8.3 per cent in 2012, bottoming out in the first quarter of 2012 at 7 per cent quarter on quarter.
"While we expect the economy here to slow over coming months, the central government will probably move to support it," Mr Hu told UBS's research team in China.
"Easing credit conditions is the likely tool it will use for this."
Mr Hu's view on economic growth was supported by property group Jones Lang LaSalle's China national director and head of research Michael Kilbaner.
He said the potential threats to Chinese economic growth are exaggerated.
"Media and hedge-funds have conspired to convince the world of some kind of terminal decline in China's economic activity," Mr Kilbaner told UBS in China.
Uranium is another commodity that is capturing the attention of Asian industrialists as China looks to nuclear energy as a way to satisfy its future energy needs.
Songbin Zhu, managing director of business consultancy Soniglin Group, said Japan's nuclear disaster in March would only delay China's nuclear build-out.
"Fukushima will have no impact on China's nuclear build-out program, beyond slowing it for a few years," Mr Zhu said.
Meanwhile, Australian listed contractor
"China's so hot that we're confident that we can grow both our margin and the top line over the short-to-medium-term," China executive vice president Brad Andrews said.
Finally, the UBS team signed off the email saying they were moving to a nearby "classy French restaurant", presumably to digest all the good news on China.
"We're off to Capital M, the place we haunt here in Beijing: classy French restaurant that overlooks the city's Imperial Gates," the UBS team said.
The Australian Financial Review

subset: commoncrawl


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SARASOTA - Sign-holders are free to stand on city streets, thanks to a Sarasota judge's ruling.
The injunction -- effective immediately -- allows people holding signs to do so without interference.
In response, Sarasota Police Chief Bernadette DiPino issued an order Friday instructing officers not to arrest, cite or bother anyone seen holding a sign -- regardless of the sign's message.
This order comes just weeks after officers wrongly arrested a homeless man and charged him with soliciting funds.
The order allows an exception when it is clear the individual is creating an unsafe condition or blocking traffic.


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PARAMOUNT - The Moore League went 3 for 3 on the first day of play at the American Legion Area 4 playoffs.
Summer teams from Millikan, Lakewood and Wilson all earned victories Saturday at Paramount High and advanced to winners' bracket games today.
Millikan, the top seed in the eight-team, double-elimination tournament, edged Downey 1-0 to open the day, and Lakewood topped St. John Bosco 5-4.
That set up a 7 p.m. showdown between the longtime league rivals. Wilson followed with a 7-2 victory over Narbonne to also advance to the winners' bracket, where it will face either Bellflower or El Segundo at 4 p.m.
Results of the Bellflower-El Segundo game were not available at press time.
Millikan went hitless against Downey left-hander Randy Labaut for the first 3 2/3 innings, and didn't score until a two-out error in the bottom of the sixth. Fortunately for the Rams, Jacob Hughey and Reece Buska were just as strong, holding the Vikings to just two hits.
"The pitchers did an excellent job for both teams, and it came down to one play," said Millikan coach Scott Glasser. "It could have gone on for three or four more (innings)."
Millikan scored its run with two outs in the sixth on Downey's only error of the game. Johnny Weeks and Spencer Steer had drawn walks, and stood at second and first when Hikaru Furuya's routine grounder was bobbled and thrown away by second baseman Victor Hernandez. Weeks came around to score, and Buska retired the Vikings in order in the seventh to earn the victory.
Labaut struck out eight and retired the first 11 hitters Millikan sent to the plate. He worked out of a bases-loaded jam in the fourth and allowed just two hits.
"He was throwing strikes and getting ahead of guys," Downey coach Jess Gonzalez said of Labaut.
Lakewood right-hander Ryan Hare was equally good against Bosco, allowing three hits and two earned runs in 6 1/3 innings. He struck out eight and was allowed to start the seventh despite being over his 100-pitch limit.
But when two of the first three hitters singled, Hare was replaced by Caleb Lew, who recorded the final two outs.
"He's doing a great job," Lakewood coach Spud O'Neill said of Hare, who was outstanding last summer in Lakewood's run to the American Legion World Series. "He was kind of a swing guy for last year as a sophomore, but now he gets a chance to be one of the top guys for us."
At the plate, Austin Colvin went 2 for 2 with a double, triple and two RBIs, and No. 9 hitter Matt Fields had two singles and an RBI. Leadoff hitter Eric Fields added two hits, two runs and two stolen bases.
Defensively, Lakewood committed three errors and allowed two unearned runs.
A pair of misplayed groundballs led to two SJB runs in the fifth, and Hare had to work around another error in the sixth.
"We've got to shore up our defense if we want to have a chance to win this thing," said O'Neill.
Paced by first baseman Sean Williams, Wilson was never really challenged by Narbonne. Williams was 4 for 4 and drove in four runs, including a bases-clearing double in the second. He added a triple in the fourth inning and needed only a home run to hit for the cycle. Instead of homering in his last at-bat, Williams laced a sharp RBI single to left field.
"He's seeing the ball really well right now, which is good," said Wilson coach Andy Hall. "You certainly need that out of your No. 3 hitter.
Right-hander Tyler Radcliffe pitched four innings and earned the victory, but left with a sore right elbow. Will Johnston pitched the final three innings, allowing two hits, two walks and no runs.
Play continues today with elimination games at 10 a.m. (Downey vs. Narbonne) and 1 p.m. (SJB vs. Bellflower or El Segundo).


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Regional job growth continues, but at slower rate
Job growth in the region continued at its modest but steady pace in March, with the Buffalo-Niagara Falls metro area adding 3,200 jobs, most in the private sector, over the previous 12 months, the state Labor Department reported Thursday.
The region added jobs at a pace of 0.6 percent over the period between March 2013 and March of this year, a slightly slower pace than the 0.9 percent annualized growth for the 12 months ending in February and the 0.8 percent for the 12 months ending in January.
That level of growth is strong considering the deep freeze that gripped the region well into April and likely stymied construction, tourism and other weather-sensitive economic activity, said John Slenker, the Labor Department's regional economist in Buffalo.
"The biggest economic news we had the past three, four months was the weather," Slenker said.
The March jobs data put the Buffalo area in a tie for fifth among the 14 largest metro areas in the state, though the region's growth rate was half the statewide rate of 1.2 percent and well behind the national rate of 1.6 percent, according to the Labor Department.
Overall, New York added 103,600 jobs over the 12 months ending in March, with the state adding 108,200 private-sector jobs and losing 4,600 government jobs. Soaring job totals in the educational and health services sector offset further losses in the manufacturing and financial arenas.
The statewide unemployment rate crept up from 6.8 percent in February to 6.9 percent in March, as more people felt confident enough to enter the job market, though New York's jobless rate has fallen sharply from the 7.9 percent rate in March 2013. The national jobless rate remained unchanged between February and March at 6.7 percent.
Compared with its peer metro areas in the state, the 0.6 percent rate of job growth over the previous 12 months for Buffalo-Niagara Falls bested the rates for Putnam-Rockland-Westchester counties (0.3 percent), Albany-Schenectady-Troy (flat), Rochester (0.4 percent) and Syracuse (dropped 0.5 percent).
The region's annual job growth trailed the rates for New York City (1.9 percent), Kingston (1.9 percent) and Poughkeepsie-Newburgh-Middletown (1.5 percent).
Looking at private sector jobs alone, the Buffalo-Niagara Falls metro area gained 3,100 jobs over the previous 12 months, at an annual growth rate of 0.7 percent.
Slenker said trade, transportation and utilities (up 1,700 jobs over March 2013); professional and business services (up 1,500 jobs) and health and educational services (up 900 jobs) paced the local job growth. Financial services (down 800 jobs) and manufacturing (down 600 jobs) were a drag.
State data shows that 544,000 people in the Buffalo-Niagara Falls metro area had jobs in March, a total that Slenker said was the highest since March 2001.
email: firstname.lastname@example.com


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Carmine Warren Photographer
Lianna GerkenModel Female Winter Springs, Florida, US
Mayhem # 2891586
About MeI have done promotional modeling for Barbizon after I graduated from Barbizon's modeling and acting lessons. I have a passion for any kind of modeling. I love runway, print modeling, and commercial modeling. I have interned for a modeling company, I am signed by an agency, I was an extra on a TV show and I have worked as a runway model in a fashion show in Tampa. I have done a few photo shoots and a runway/commercial competition, all of these times it just have gotten me more in love with modeling. I am willing to hear any offer someone has for me to start my modeling career off right. I can look like completely different people in my photos, and I believe that is one of my strong points. I am a new fresh face.
Have you worked with Lianna Gerken? Add Credits for Lianna Gerken! >>
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Henman, 31, overcame former Wimbledon champion Agassi 6-4 6-4 in the pair's first meeting on grass.
In baking conditions at Queen's Club, the pair traded early breaks before Henman moved ahead at 4-3.
After taking the first set, Henman then broke the American in the first game of the second before wrapping up the win.
But fellow Briton Martin Lee was soundly beaten 6-3 6-2 by Spaniard Fernando Vicente, while Scottish teenager Andy Murray looks set to start his campaign against Serb Janko Tipsarevic on Tuesday.
But it was Henman who was first to kickstart his grass-court season with a promising win against eight-time Grand Slam winner Agassi.
The American was seeded 12th on his return to competition after more than two months out.
The 36-year-old opted to miss the entire clay-court season in order to rest his troublesome back and get the best out of the grass-court season.
But he was outclassed by Henman, who has also struggled with back problems during a slump to 76th in the world and third in Britain.
"I've been serving pretty good and that bodes well - it's a good sign," said three-times finalist Henman, who landed seven aces during the match.
"I'm feeling pretty good physically - I've had a minor blip but feel like I've managed it well.
"It's just making the transition from clay to grass - you're waiting for the ball and sometimes it's dropping a lot.
"The extra bending put a bit of stress on my back but I didn't feel too restricted and served extremely well when I needed to."
Other Britons in action this week are wildcards Alex Bogdanovic and Jamie Baker.
Baker will meet Surbiton Trophy winner Mardy Fish on Tuesday with a second-round clash with French Open champion Rafael Nadal the prize, and Bogdanovic faces Russia's Dmitry Tursunov.
Nadal, defending champion Andy Roddick and Lleyton Hewitt have all been given first-round byes.


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$ 98.70
Mr. Auldridge has unleashed a creative masterpiece for this set of five. This twisted limestone set offers comfortable finger positions within the deep textured crevasses. Pinch or pocket pull your way to a more enjoyable session. Other related holds: Strep Throat.
Questions? Check the FAQ.
Hold Count: 5
Size: Features
Style: Pockets
Difficulty: Moderate
Shaper: Mike Auldridge
Weight: 10.00 lbs
Ultra Bomber Urethane
Hardware Included


text:
Teasers – what a clever way for companies to build up hype around their products and services! The latest one comes straight from the official LG Facebook page and hints at something that could be a new smartphone, or just about anything else. There aren't any clues as to what LG is about to unveil, just hints that it has something to do with the letter L.
"GenuineLy Compassionate. Esteemed VaLue. Perfection with DetaiLs. TimeLess FuLfiLLment." – sounds like something right out of a Myst video game, doesn't it? Four seemingly meaningless tag lines with capitalized L-s.
LG Optimus T, Optimus M, and Optimus S. It could as well be a new series of toasters, of course.
In any case, it won't be long until the mystery gets revealed, or as today's post says: "Tomorrow, we'LL teLL you what aLL the L has been about!" In the meantime, if you love riddles, feel free to inspect the image you see here, as well as what is posted on LG's Facebook page, and do not hesistate to make a guess in the comments below.
source: LG via Android Central


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Oil-Filled Nanocapsules
Publication Date4/13/04
Read full article onlineFull Article
Feynman was correct when he predicted "There's Plenty of Room at the Bottom." Since Feynman's talk, given at Caltech in 1959, there has been an explosion of research in the ever-shrinking areas of nanoscience. A nanometer (nano—Greek for dwarf) is one billionth of a meter, or ten times the size of an individual hydrogen atom. Since the mid-1980s, there has been a substantial increase in interest over the creation and use of nanocapsules, a subset of nanoparticles. Nanocapsules have a number of potential applications, some of which include dye dispersants, nanoreaction vessels, and encapsulation media for fragrances, flavors, or drugs. This article will discuss the specific case of oil-filled nanocapsules. Such structures readily encapsulate lipophilic/hydrophobic and oil-soluble compounds, allowing them to be dispersed and transported through aqueous media.


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October 5, 2001
Subject: Clarification of the Prohibition of the Importation of all Ruminant Meat, Meat Products and Other Ruminant Protein Products from Japan due to Bovine Spongiform Encephalopathy (BSE)
To: U.S. Importers, Brokers, and Other Interested Parties
On September 10, 2001, the Office International des Epizooties (OIE) received information from the Director of Animal Health Division, Ministry of Agriculture, Forestry and Fisheries, Tokyo, reporting a highly suspected case of bovine spongiform encephalopathy in Japan. Due to this reporting, the U. S. Department of Agriculture (USDA), Animal and Plant Health Inspection Service (APHIS), Veterinary Services (VS) is placing a prohibition on the importation of ruminant meat, meat products and other
ruminant products from Japan. This prohibition is effective immediately, September 10, 2001, because APHIS believes that the current situation in BSE-affected countries is a potential threat to the health and safety of U.S. livestock. Therefore, APHIS is taking emergency measures to mitigate this risk and to protect livestock, livestock producers, and industries in the United States.
Effective immediately, we are suspending the importation of edible and inedible ruminant meat, meat products, and other ruminant products that have been stored, processed, or otherwise associated with a facility located in Japan.
The prohibited edible and inedible ruminant products include but may not be limited to: meat, processed animal proteins (such as meat and bone meal (MBM), meat meal, bone meal, blood meal, protein meal, etc.), offal, tankage, processed fats and oils, ruminant glands, unprocessed ruminant fat tissue and tallow (that could be incorporated into animal feed). It also includes derivatives of processed animal protein, or any product containing such ruminant materials. Products containing any of the prohibited materials are also prohibited.
As with restrictions placed on other BSE affected countries, importations from Japan of inedible, processed, non-ruminant material (i.e., feather meal) will not be eligible for entry until APHIS can verify that these products have not been commingled or cross-contaminated with ruminant products. In making this determination the following criteria will be considered and verified by APHIS:
Importations from Japan are affected by this action. Other BSE countries are listed in Title 9 Code of Federal Regulations (CFR), Part 94.18(a)(1) and (2), as well as on the APHIS home page at http://www.aphis.usda.gov/NCIE/country.html .
An interim rule concerning this action is being prepared and will be published in the Federal Register in the near future.
I ask for your immediate cooperation in discontinuing all shipments of ruminant meat, meat products, and other ruminant products that have been stored, processed, or associated in any way with products or processing plants in Japan (in addition to Europe or Oman).
I am aware that this prohibition places a burden upon you. However, APHIS' obligation to protect U.S. agriculture is paramount. The steps we are taking are absolutely necessary to meet that obligation and prevent BSE from occurring in U.S. Livestock.
Thank you for your cooperation and support.
/s/Andrea M. Morgan [for]
Karen A. James-Preston, DVM
Assistant Director
Technical Trade Services
National Center for Import and Export
U.S. Importers, et al. 3
N. Cook, Pet Food Institute
J. Rydell, American Feed Industry Association
T. Cook, National Renderers Association
P. Maloney, Meat Importers Council of America, Inc.
L. Kosty, American Meat Institute
S. Sundloff, FDA
C. D'Onofrio, US Customs Service
B. Simmons, FAS
A. Thiermann, IS
Karen Morris, FSIS
J. Greifer, Trade Support Team
A. Cielo, IS
L. Thomas, PPQ
VS Regional Directors
VS AVIC's
G. Colgrove, VS, Riverdale
L. Ferguson, VS, Riverdale
N. Faizi VS, Riverdale
C. Gipson, DAO, Washington, DC
A. Torres, DAO, Washington, DC
B. Bokma, VS, Riverdale
Andrea Morgan, VS, Riverdale
TTS VMOs, VS, Riverdale
National Customs Brokers/Forwarders


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The Strong Case
The human story from mystical beliefs to provable purpose principles of a sexually bound ergodic cosmology
Looking back, evolutionary processes have given rise to humanity on a planet that, from involutionary processes, arose in a solar system that arose in a galaxy that arose amongst other galaxies making up an ergodically cyclical "uni-verse." Born from charged stardust, the 'dust' of human thought is the present specificity auguring ergodic religarence. Presently, humanity has ascertained that these being-cycle 'arisings' result from persistently ordered but not ultimately measurable homeostatic interactions. Specific to the being-cycles arising in planetary biospheres are the refinement processes of minerals becoming thought. With the complexity of human brain dynamics in the vanguard, the biosphere is a cosmopomorphic function. Looking forward, we humans are a biospheric function through which future arisings are immanent. The personal work to transmute one's random thought-space into a coherent attention-space sufficient to sustain the arising of a Psyvolutionary intention-space, defines the present pressure of ergodicity. The human experience-of-existence---specifically our existence---indicates that the increasing capacity for information processing is the transmutative potential for the refinement of the vibrations of thought. Emotion is the 'womb' of Impartial Conscience, and further, thought is the 'womb' of Objective Reason. The arising and conscious sustenance of such a work is the immanent---though daunting and dissipatively fragile---religarent obligation due from humans in our branch of the Milky Way. The "late fees" are accruing (but only arithmetically).
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Truck Graphics & Racks of Gaithersburg
7845 Airpark Road, Unit N
Wall Decoration Online
We offer a full line of vinyl wall decoration under our new Popitay brand. Whether you want to decorate your kid's room, garage or office, we offer unique art work for you. Please scroll through our offerings.
If you are local, please visit us to buy.
If you are not conveniently nearby, please click on the product. You will be taken to our online store where you can easily purchase your product online.
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Contact Details:
Truck Graphics & Racks of Gaithersburg
7845 Airpark Road, Unit N
Gaithersburg, MD 20879
Phone: 301-330-2955
|Truck Graphics & Racks, Inc. @ 2003-2010


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These institutions join around 60 others that hope to put increasing pressure on the publishing giant in ongoing negotiations for a new nationwide licensing agreement.
On the Other Hand
September 1, 2014|
Handedness, a conspicuous but enigmatic human trait, may be shared by other animals. What does it mean for evolution and brain function?


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I have recently been having severe pain in my left side and bad acid problems. I have been to the ER once and they gave me some pain medications, fluids, a CT Scan, and X-rays, and then they sent me to a specialist. I then had an endoscopy where the doctor diagnosed me with a hiatal hernia and GERD. He told me to continue to take acid medications.
It has been almost four days since then and the pain has subsided some, but the burning and pain in the middle of my stomach is still there. I am still unable to eat much of anything, and when I do eat it causes the pain again. I am to the point where I can't handle it any more because I have a job I have to go to and a daughter to take care of. My doctor said he couldn't do anything more for me and sent me back to the specialist. The specialist said to continue to take the medication and increase to two times a day, which I had already been doing. When he found that out, he said that he wanted to see me but I feel like I am not going to get anywhere and that I will always feel this way.
I can't feel like this all of the time. I did stop taking the Protonix and the pain in my left side has subsided, but the constant food in my throat feeling and pain in middle of stomach are getting me down. I am becoming very depressed at this point and know that I can't go down that road again. I need help and feel that I am not going to get anywhere with this.


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Improving health outcomes during the transition from prison to the community - Ingrid A. Binswanger, M.D., M.P.H.
The Robert Wood Johnson Foundation Physician Faculty Scholars Program was designed to strengthen the leadership and academic productivity of junior medical school faculty who are dedicated to improving health and health care.The purpose of this project is a study on improving health outcomes during the transition from prison to the community.
Grant Details
Amount Awarded $299,998.00
Awarded on: 6/24/2008
Time frame: 7/1/2008 - 11/30/2011
Grant Number: 64306
University of Colorado School of Medicine
Anschutz Medical Campus, Building 500
13001 East 17th Place Campus Box C290
Aurora, 80045-2559
Ingrid Alexandra Binswanger
Project Director


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Democracy Now! is a non-profit organization funded through individual donations and foundation
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sustain and grow Democracy Now!
Party Time: RNC Awash in Corporate, Lobbyist-Funded Events for GOP Delegates and Lawmakers
Ex-Ohio Secretary of State Ken Blackwell Questioned on Vote Suppression, from '04 to Wave of ID Laws
As ID Laws Risk Disenfranchisement, Intimidation Fears Grow with Tea Party Group's "Poll Watcher"
Rachel Corrie's Parents Denounce Israeli Military Exoneration for 2003 Killing in Gaza
The Rise of Marco Rubio: Manuel Roig-Franzia on the Emergence of GOP, Tea Party's Rising Latino Star
On Katrina's 7th Anniversary, Tropical Storm Isaac Poses Biggest Test to NOLA's Rebuilt Levees
Comedian, Author Baratunde Thurston on Vote Suppression & Romney's 0% Support from African Americans
Storm Cancels RNC's First Day, But Hundreds Brave Tampa's Wind and Rain to Protest GOP Agenda
Workers at Bain-Owned Illinois Factory Bring Fight to Save Their Outsourced Jobs to Romney and RNC
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Delta and Brian lead the charts
Page Tools
Criticism in the British press over Delta Goodrem's relationship with former Irish boy-band member Brian McFadden has failed to dampen their popularity in Australia, with the couple's duet Almost Here debuting on top of the Australian singles chart.
Goodrem has been portrayed as a "home wrecker" in some UK tabloids for her relationship with McFadden, who only recently separated with his wife.
Almost Here knocks Over and Over by Nelly and Tim McGraw off the top spot which it held for more than a month.
Meanwhile last week's number number two, Evie by the Wrights, falls to number eight.
On the Australian albums chart Jack Johnson's In Between Dreams keeps top spot holding off 50 Cent's new release The Massacre which is at number two.
The week's big mover is Simple Plan's Still Not Gettin' Any which moves up four places to be at number eight.
Australian singles chart
1(-) Almost Here - Delta Goodrem and Brian McFadden (EPI/SBME)
2(1) Over And Over - Nelly feat. Tim McGraw (CRB/UMA)
3(4) Let Me Love You - Mario (J/SBME)
4(3) Rich Girl - Gwen Stefani (INR/UMA)
5(6) Beautiful Soul - Jesse McCartney (FMR)
6(7) Get Right - Jennifer Lopez (EPI/SBME)
7(5) Nasty Girl - Nitty (UMA)
8(2) Evie Parts 1, 2 & - 3 The Wrights (FP/U)/(EMI)
9(10) 1, 2 Step - Ciara (LAF/SBME)
10(9) Since You've Been Gone - Kelly Clarkson (RCA/SBME)
Australian albums chart
1(1) In Between Dreams - Jack Johnson (UMA)
2(-) The Massacre - 50 Cent (INR/UMA)
3(2) It's Time - Michael Buble (WARNER)
4(6) American Idiot - Green Day (WARNER)
5(4) Love, Angel, Music, Baby - Gwen Stefani (INR/UMA)
6(5) The Sound Of White - Missy Higgins (VIR/EMI)
7(3) Hot Fuss - The Killers (IUS/UMA)
8(12) Still Not Gettin' Any - Simple Plan (EW/WAR)
9(8) Songs About Jane - Maroon 5 (RCA/SBME)
10(7) Awake Is The New Sleep - Ben Lee (INERTIA)
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Movies: Scott Pilgrim vs. The World, Ip Man, anything with Tony Ja, Eternal Sunshine of the Spotless Mind, Visioneers, Ghost in the Shell, Spirited Away, Princess Mononoke, Shinobi: Heart Under Blade (only the japanese version), Let the Right One In, Gladiator, anything with Sidney Poitier, Before the Music Dies, The Great Mouse Detective
First, the ones that inspire me at this moment, Jay electronica, Mos Def, Outkast, Janelle Monae, Regina Spektor & Currn$y
There are so many more than this, but i'll give you an idea.
Tokimonsta, Pelican City (old Dangermouse stuff), Raul Midón, Freddie Gibbs, Flying Lotus, Gorillaz, Erykah Badu, Ghostface Killah, Aesop Rock, Citizens of Sleep, Baraka Noel, MF Doom, Wu-Tang, King Geedorah, KMD, Alicia Keys, 2pac, Earth, Wind & Fire, Sean Blaze, Marvin Gaye, So Timeless, Gil Scott Heron, Jamie xx, Raekwon, Lupe Fiasco, Lee Fields, J Dilla, Gnarls Barkley, Gif, Louis Armstrong, The Roots, Lhasa De Sela, Japanese Drum Troupe, Con Brio, Art Blakey, Evil Needle, Erykah Badu, Caits Meissner, k-os, RJD2, Blackalicious, Kendrick Lamar, Black Star, Madlib, Common, Curren$y, John Coltrain, Billie Holiday, Ella Fitzgerald, System of a Down, Little Brother, Danger Mouse, The O'Jays, Fugees, Carlos Santana, Barry White, Al Green, Temptations, lianne la havas, Musiq Soulchild, Dead Prez, The Stylistics, Eric Clapton, Boys 2 Men, Kanye West, John Legend, N.E.R.D, Papoose, Ludacris, Jay-Z, Naz, Usher, The Beatles, Murs, Savant of RAREBREED, Hir-O, Saul Williams, Dunce Apprentice
I have to admit...I'm a big anime fan. I just re-watched Samurai Champloo and it was AMAZING :D
But recently, thinking a lot about the types of people in my life, and how I can learn from them.
oh yea, and i'm just learning how to skate, so if you see me around, don't laugh! you'll hurt my marshmallow like feelings.
I'm just kidding, you can laugh. shit's funny.
(ok! i can skate now! :D but you can still laugh while i try to learn all these other new things i'm terrible at)
-you're interested... isn't that what we're on here for???
-(now this is going to sound boring but) if you want to just chill and listen to music, or share something you think is interesting/something you care about. and just talk.


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Rising construction costs are likely to push the price tag of the Kingdom's first nuclear reactor to some $10 billion, according to an international nuclear organisation.
A report issued recently by the World Nuclear Association [2] - a consortium of industry leaders and nuclear power advocates - said that the cost of the country's first nuclear power [3] plant might reach $9.8 billion, not counting financing and decommissioning costs.
Based on current market rates, the association projected construction costs to reach some $4,900 per kilowatt-hour for the planned 1,000-1,100-megawatt reactor.
In a monthly report issued last month, the association reported that Jordan was likely to enter a long-term power purchasing agreement with a strategic operator, over a 45-year period in keeping with industry standards, in order to limit the impact of the project on the Kingdom's burgeoning budget deficit.
Last year, the Jordan Atomic Energy Commission short-listed French energy giant GDF Suez, Russian Rosatom, Chinese Datang International Power Generation Co. and Japanese Kansai Electric Power Co. as strategic operators and investors in the plant, to be constructed on a site near Mafraq, 40 kilometres northeast of the capital.
On Sunday, the commission announced that it had entered parallel talks with Russian Atomstroy Export and a consortium of French firm AREVA and Japanese Mitsubishi Heavy Industries for the construction of the Generation III reactor, expected to be online by 2020.
According to nuclear energy officials, financing and projected electricity costs will be among the deciding factors in the final selection. Energy officials have singled out nuclear power [4]as key to weaning the country off energy imports, which currently cost the Kingdom one-fifth of its gross domestic product.
The nuclear drive comes amid ongoing cuts in Egyptian gas supplies [5], the country's main energy source, which has pushed the Kingdom's national energy bill to $4 billion and is expected to lead to higher electricity tariffs.
[1] http://www.syndigate.info
[2] http://www.world-nuclear.org/
[3] http://en.wikipedia.org/wiki/Nuclear_power
[4] http://www.albawaba.com/business/jordan-nuclear-energy-423326
[5] http://www.albawaba.com/%E2%80%98unstable%E2%80%99-gas-supplies-highlight-potential-energy-crisis-402863
[6] http://www.jordantimes.com


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- Do it all with one powerful yet easy-to-use product
- Count on step-by-step assistance with photo editing
- Create a polished movie instantly
- Full Version
- Retail
Some manufacturers place restrictions on how details of their products may be communicated.
Good value for non-pro's 12/12/2012
This review is from: Adobe Photoshop & Premiere Elements 11 for Windows & Mac - Full Bundle Version
I used to dabble in PS "back in the day" but I have never been an artist. I bought this because I needed to make simple web graphics and edit videos. To date, I have not edited a single video, so I can't comment on that yet. However, I have made several web graphics, and I've also edited several photos. In fairness, I'm a huge fan of Picasa for simple editing of photos because it can't get any easier than "I'm feeling lucky". I don't like/know enough about editing photos in this PS 11 to properly comment on it, however I will say it's not as intuitive as Picasa. It also seems that Picasa is better at it, but again, not familiar enough. In time, I will learn, but in the meantime, I need Crop and I'm Feeling Lucky and nothing further because the majority of the photos I edit are being uploaded to our Facebook business page.
So moving on to graphics creation. Our small business has a website so we need graphics too. I like this program for that! The interface is a good bit different from the PS I remember working with years ago (no surprise) but I was able to find everything I needed, and create graphics that looked pretty professional very quickly. This made me so happy I can not explain. It's been years, and I've forgotten a lot.. and I was never an artist to begin with.
So, if you're a pro, get the real one. If you need graphics, and you're not a pro, you're going to be very happy with this.
Photo editing - Not very intuitive for the average user. If your photo did not come out of the camera perfect, you're going to have a tougher time cleaning it up. If you just need to crop, get Picasa.
Other Thoughts:
Thanks Newegg, super happy with this purchase. :)
4 people found this review helpful. Did you? Yes / No Thanks for the valuable feedback you provided!


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The Catholic Parish of Saint John the Baptist
Situated in Andover in the county of Hampshire, UK, the parish is in the Catholic Diocese of Portsmouth. With other parishes in Basingstoke, Tadley and Hook, it forms the North West Hampshire Pastoral Area.
Mass Times
Holy Mass is celebrated here every Saturday evening at 6.00pm (Sunday Vigil Mass), and on Sundays at 10.30am. Times of weekday Masses and all other services are available on the Parish Newsletter. Holy Mass is also celebrated at the Church of Saint John Fisher in Whitchurch to the east of Andover on Sundays at 9.00am.
Parishioner Registration Form (Census Form)
If you haven't registered with the Parish Office, then please find below a Parishioner Registration Form in the 'new' format. Completed forms need to be sent to the Parish Office.


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|Phishing Alert: Fraudulent ACH Email
SunTrust has been made aware of a new fraudulent email that appears to be from NACHA related to an ACH payment that has been cancelled. DO NOT click on the link as it will attempt to download a virus on your PC. Recipients should forward the email to firstname.lastname@example.com and delete the email.


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This content has been marked as final. Show 2 replies
1. Re: 12.0.4 Migration from RedHat Linux 4.0 (32-bit) to RedHat Linux 5.0 (64-BitHussein Sawwan-Oracle May 19, 2012 5:42 PM (in response to Raghuveer S)
3) I did not upgrade the JDK 1.5 from 32-bit to 64-bit.Keep the 32-bit version -- Using Latest Update of JDK 5.0 with Oracle E-Business Suite Release 12 [ID 384249.1], "Step 1 Download Latest Update of JDK 5.0"
Is it a must to upgrade the JDK from 32-bit to 64-bit after the migration or will the application work fine if the JDK is left untouched?
We also plan to upgrade to 12.1.1 and then to 12.1.3 on RHEL 5.0 64-bit which I think requires JDK 6.0 as per the note 752619.1.The 32-bit is good enough -- Using Latest Java 6.0 Update With Oracle E-Business Suite Release 12 [ID 455492.1], "Step 2.1: Download Latest JDK 6.0 Update" section.
AS a part of JDK upgrade, Do I have to have JDK 6.0 64-bit for the application to work properly or JDK 6.0 32-bit is good enough?
2. Re: 12.0.4 Migration from RedHat Linux 4.0 (32-bit) to RedHat Linux 5.0 (64-BitRaghuveer S May 19, 2012 7:32 PM (in response to Raghuveer S)Thanks Hussein. Eventhought this was my first post, a lot of your answers to queries from other people helped me in getting me over the hump of migrating E-bus from 32-bit to 64-bit and other problems. Thanks for the awe inspiring work.


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Family Law
Family Law Questions? Ask a Family Lawyer Online.
Hi, and Welcome to JustAnswer. Thank you for your question. My name isXXXXX am a licensed, practicing Attorney and would be glad to help
good, because I need it
my name is Amy
1. In order to be sure that you are notified for the upcoming hearing, you should go to the Office of the Court Clerk in Family Court, tell them what happened in the past - that you we3re never notified of any hearing date - that you want to appear at the hearing because you have some issues to bring to the Court's attention and you want to be certain that you receive proper notice of the date, time, Court Room Number, etc. The Court Clerk will take your contact information and note the records that you came in and requested this. He will then make sure that you are notified for the next hearing,
is there a special form I need to file a motion for indegence, and how do I do it
In order to Answer your second question, I need a bit more information, if you do not mind Q. 1. How much do you owe in back child support in total ? Q. 2. How many children are there and what are there ages ?Q. 3. How old are you ? Q. 4. Do you work ?
1)around $30,000
4) I do not work, and was a stay at home Mom, and i am a recovery alcholic, suffer from depression, and anxiety/panic attacks, all from the strss of this which staryed in Feb. 2002. I am 47
2. You can file as an indigent party by filing a "Petition to Proceed in Forma Pauperis". However, if your Petition is granted, this will only excuse you from paying the Court's filing fees. It does not excuse you from paying child support Do you receive Social Security Disability ?
I just applied last week. I dont have any money, and there is no help for free in going after the alimony arrears. The judge did once in nov. 2006, took what I owed and deducted it from what he owed
do I need to attach any type of info to prove I have nothing
2. (Answer No. 2, Continued) You should file a Petition to Modify Child Support and request a decrease. However, the decrease will be effective only as to future child support payments, not to any past due amounts. If you receive Social Security Disability, the Court will recalculate your child support obligation based on what your former husband's income and on the amount you receive in Social Security Disability. The Petition to Modify Child support should be filed as soon as possible, so you should hand deliver it to the Clerk of the Family Court. You can ask for the form to fill out for your Petition. You can fill it out yourself, give it to the Family Court Clerk and ask that he assign it the same hearing date as hearing for contempt. 3. You should also ask the Family Court Clerk to give you the form to fill out for a Petition for Contempt against you former husband for his failure to pay you alimony. When you fill out the Petition for Contempt against your husband, give that also to the Family Court Clerk and ask that your Petition for Contempt be given the same hearing date as his Hearing date. That way, all issues will be decided at once and it will be easier on you in that the Judge can reduce the $65,000 he owed you in alimony by what you owe in child support. 3
For the moment, you do not have to attach anything. And as I previously stated (Above), the fact that a parent has nothing, does not excuse their obligation to pay child support. The best that can be done is to reduce the amount of alimony he owes you by the amount which you owe in back child support, Please be kind enough to press "Accept" so that I will receive credit for assisting you and Answering your questions, Thank you. You can still ask follow up questions for any clarification at no additional charge.
ok, and Thank you very helpful. How do I ask follow up if needed?
You would ask for clarification of anything you do not understand in my Answers.
1 more question, the hearing is in front of a hearing officer with DOR representing my ex, broward county FL does not have any support for alimony so they will not let alimony issues in this type of hearing only the Judge can
It does not matter. The sooner you file your Petition for Contempt, the better off you will be because you can tell the hearing officer that he owes you over $65,000 in alimony, that you were forced to file a Petition for Contempt against him for this, and it will give you a "bargaining edge" in holding the Petition for Contempt and the $65,000 over his head. Please be kind enough to press "Accept", otherwise I do not receive credit for assisting you, nor would I receive any payment at all for my time and effort. Thank you for your consideration and understanding.
I understand and will press accept, Thank you for your help, not so scarry now I have some direction.


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Meet Nayda Collazo-Llorens, currently our Stuart and Barbara Padnos Distinguished Artist in Residence. (Read more)
It combines training in established methods with the exploration of non-traditional strategies by incorporating new materials and technologies, installation, as well as experiential contexts. The curriculum fosters intellectual inquiry, creative activity, and practical skills in making as well as thinking about art. In addition to wood working, metal fabricating, and foundry techniques, the curriculum also incorporates three-dimensional computer modeling technologies. Activities in and out of the studio help students develop individual approaches to the medium. In addition, they are encouraged to incorporate other studio processes such as metalsmithing, ceramics, or printmaking into their sculpture practice.
Students may pursue a BA or BS in Art Education or a BFA in Studio Art in this emphasis.
In the sculpture program, students benefit from well-equipped studios that allow them to create wood working, metal fabricating, and foundry projects. The three –dimensional computer modeling lab allows them to explore new materials and technologies as they progress through the program. Majors earning a BFA in this program have individual studio spaces in a common area shared with jewelry and metalsmithing students.


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Ripe is a classic heavy metal band from Copenhagen, Denmark. Signed on record label, Mighty Music and distributed by Target distribution. Ripe released their 2nd studio album "The Eloquence of Silence" on 26 November 2012.
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Philips, along with most other companies, showed their version of a Glasses-Free 3D TV at this year's CES. And Philips stood out. Their ultra-low profile 60-inch Glasses-Free 3D TV is unfortunately, still a prototype. However, it was noted that unlike other models, the Philips offered a much wider horizontal-plane viewing area. This allows for larger […]
Entries Tagged as 'glasses-free TV'
Philips Demos 60-Inch Glasses-Free 3D TV at CES 2013
January 28th, 2013 · No Comments · 3D Content, Newsflash
Tags:CES·glasses-free TV·Philips
Glasses-free 3DTV experience coming soon?
January 7th, 2013 · No Comments · HDGURU3D News
We've talked recently of the forward progression of glasses-free 3D TV and now Stream TV is trying to make that a very near reality.
Tags:3D·3D glasses-free·3D Stream TV·3D TV·3dtv·Glasses-free 3DTV·glasses-free TV·stream TV·Stream TV 3D
Big glasses-free TV company makes big plans
September 11th, 2012 · No Comments · HDGURU3D News
Moving in strides for glasses-free TV, Magnetic 3D has come into a partnership of sorts with a production company for their expanding 3D.


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We were all impressed by the movie-quality Rocket Raccoon costume Christina Borchardt made for her 6-year old son. But now we get to see what actually went into the build.
Starting in June of this year, Borchardt chronicled her work as it progressed on the Replica Props Forum. Everything was entirely made from scratch, including Rocket's head which she designed using a plaster mold of her son's face. She then sculpted the entire face and cowl, attached faux fur which was shaped and painted, and affixed teeth to a movable upper and lower jaw.
Her work is so good that even James Gunn took notice and gave it a shout out on Instagram.
Check out more photos of this parenting win after the break.


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Battle Seasonal Affective Disorder With Golla Gadget Bags
Start Slideshow
Battle Seasonal Affective Disorder With Golla Gadget Bags
I'm looking for signs of Spring anywhere I can get it, and when I saw these laptop and cell phone bags from Finnish company Golla at CES, I knew they would seriously stave off my winter doldrums. So bright and cheery — Wouldn't you agree that the lower pattern looks very much like another Finnish company Marimekko, no?
I have liked what Golla has brought to the table in the past, and these prints continue to be pretty and stylish without being too girly, which is exactly the balance I like to see. Now all they need to do is make a pretty floral one for the MacBook Air, and I'll be all set! Check out more styles below!


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Concert Pianist Khatia Buniatishvili to Perform at Mesa Arts Center, 2/28
Khatia Buniatishvili made her piano debut at the young age of six in Tbilisi, Georgia and was invited to play internationally as a guest performer in Switzerland, the Netherlands, France, Germany, Belgium, Italy, Austria, Russia, Israel, and America. On Thursday, Feb. 28 at 7:30 p.m., the Mesa Arts Center welcomes one of the most talented pianists in the world into the Piper Repertory Theater. Tickets are available through the Mesa Arts Center Box Office at MesaArtsCenter.com or by calling 480-644-6500.
Introduced to the piano at as a child by her mother, Khatia became instantly recognized after her orchestral debut. When she won the prestigious Horowitz Piano Competition in Kiev in 2003, she met Oleg Maisenberg who convinced her to transfer from the Tbilisi State Conservatoire to Vienna's Academy for Music and the Performing Arts. After transferring, she won third prize at the 12th Arthur Rubinstein Competition in 2008 and was named the Best Performer of a Chopin Piece as well as declared the Audience Favorite. She subsequently appeared at a multitude of top festivals including, but not limited to, Verbier Festival, Gstaad Festival, and the Saratoga Festival. Khatia also performed with the Israel Philharmonic, the St. Petersburg Philharmonic Orchestra, the Philadelphia Orchestra.
Khatia Buniatishvili made her American debut in 2008 when she dazzled audiences at Carnegie Hall playing the Chopin Piano Concerto No 2. The following year she performed the Mendelssohn Double Concerto with Gidon Kremer at the Musikverein Vienna and then toured with him and the Kremerata Baltica to Milan, Rome, Pavia, and Istanbul. She was named a BBC Radio 3 New Generation Artist in 2009-2011 and has regularly collaborated with BBC orchestras. She received a Borletti-Buitoni Trust Award in 2010 and has also signed an exclusive recording contract with Sony. Mesa Arts Center is so excited to have a wildly talented and beautiful international performer appear on a local stage.


text: On Fri, 19 Sep 2008 11:40:50 -0500 Tom Rudwick wrote: Hi Tom, > If you have torque keeping track of disk space, you can just put > a default requirement on a queue or the server that specifies a > required free disk amount. Under that case, no jobs should run on > nodes that do not have enough free disk space. Ok, I have defined a "dynamic" resource at /var/spool/pbs/mom_priv/config and it's monitored by torque: cat /var/spool/pbs/mom_priv/config [...] espacio !/usr/local/sbin/espacio.sh $ pbsnodes td008.pic.es td008.pic.es state = free np = 8 properties = slc4,magic ntype = cluster status = opsys=linux,uname=Linux td008.pic.es 2.6.9-42.0.3.ELsmp #1 SMP Thu Oct 5 15:04:03 CDT 2006 i686,sessions=? 0,nsessions=? 0,nusers=0,idletime=3634169,totmem=32637848kb,availmem=32394068kb,physmem=16632016kb,ncpus=8,loadave=0.00,gres=espacio:102668424+cpu_factor:=1.52375,netload=3726282356,state=free,jobs=,varattr=,rectime=1222078967 Now, I try to submit a job requesting that resource, but I think I don't know how to specify it correctly: echo sleep 5|qsub -l "other=espacio=1234567891234" -q short I'd like to define it as "size" default resource, that Specifies that the available and configured disk space in the <FS> in kb... is it possible? If not, I'm thinking that I'll use size in certain nodes (the ones that have small disks) and nothing in others, but, could someone predict toque/maui behaivour when sending jobs reqeusting a resource that some nodes have and some not? thanks for your reply. > Tom Cheer, Arnau


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Tom Cruise Tops Forbes List of Hollywood's Highest-Paid Actors (PHOTOS)
The magazine reveals that Cruise earned nearly twice as much as his closest competitors, Leonardo DiCaprio and Adam Sandler.
Forbes estimates that the Rock of Ages star earned $75 million US between May 2011 and May 2012, compared to $37 million US each for DiCaprio and Sandler.
Which other actors made the list?
Forbes' highest-paid actors in Hollywood
Tom Cruise ($75 million)
Leonardo DiCaprio ($37 million)
Adam Sandler ($37 million)
Dwayne Johnson ($36 million)
Ben Stiller ($33 million)
Sacha Baron Cohen ($30 million)
Johnny Depp ($30 million)
Will Smith ($30 million)
Mark Wahlberg ($27 million)
Taylor Lautner ($26.5 million)
Robert Pattinson ($26.5 million)
In compiling this yearly list, Forbes considers factors such as upfront pay, profit participation, residuals, endorsements and advertising work.
The ranking was released Tuesday on Cruise's 50th birthday (July 3) and just days after news emerged that his third wife, actress Katie Holmes, has filed for divorce.
Holmes announced her decision to divorce the actor, 49, on Friday. A rep for Cruise said he was "deeply saddened" by the announcement.
She is seeking sole custody of her 6-year-old daughter, Suri, with a source noting, "She felt she had to get out to save her daughter."
No changes are to be made to this player


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- 1 stick (4 ounces) unsalted butter, 4 tablespoons softened
- 2 tablespoons minced flat-leaf parsley
- 1 1/2 tablespoons minced tarragon
- 2 1/2 teaspoons minced chives
- Salt
- 2 cups frozen baby lima beans (10 ounces)
- 1 small onion, halved
- 1 thyme sprig
- 2 beefsteak tomatoes (1 pound), coarsely chopped
- 1 small shallot, minced
- 1/2 cup fresh corn kernels (from 1 ear)
- 1/4 cup finely diced smoked ham
- Pinch of Old Bay seasoning
- 1 cup Champagne
- 1 medium tomato, seeded and cut into 1/4-inch dice
- 2 tablespoons vegetable oil
- Four 6-ounce black cod fillets, skin scored
- Freshly ground pepper
- 1/4 pound lump crabmeat, picked over
In a food processor, combine the softened butter with the parsley, 1/2 tablespoon of the tarragon and the chives. Season with salt. Transfer the herb butter to a large piece of plastic wrap, form into a cylinder and refrigerate.
In a medium saucepan of boiling water, cook the lima beans with the onion, thyme sprig and a pinch of salt over moderate heat until the lima beans are tender, about 10 minutes. Drain and discard the onion and thyme.
In a food processor, puree the beefsteak tomatoes. Strain the puree into a medium bowl; you should have about 1 1/2 cups of tomato puree.
In a large skillet, melt 2 tablespoons of the butter. Add the shallot and cook over moderate heat until softened, 2 minutes. Add the corn, ham and Old Bay seasoning and cook, stirring, for 2 minutes. Add the Champagne and simmer over moderately high heat until reduced by half, 3 minutes. Add the diced tomato, lima beans and tomato puree. Simmer over moderate heat until flavorful and the liquid has thickened slightly, 4 minutes. Remove from the heat.
In a large skillet, heat the oil until nearly smoking. Season the cod with salt and pepper and cook, skin side down, over high heat until the skin is browned and crisp, about 4 minutes. Turn the fish, reduce the heat to moderately low and cook until just opaque throughout, about 3 minutes longer.
Stir the crabmeat and the remaining 1 tablespoon of tarragon into the stew; simmer for 1 minute to heat through. Off the heat, swirl in the remaining 2 tablespoons of butter; season with salt and pepper. Spoon the stew into bowls and set a cod fillet in each. Top each fillet with the herb butter and serve.


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"Syndrome" isn't able to step over into the terroitory of 1% viewership.
According to AGB Nielsen Media Research, JTBC drama "Syndrome" took in an average 0.798% of viewers across the nation.
"Syndrome", which spent just KRW3 billion on medical tools for the drama, seemed to be doing well on its first episode with 0.926% viewership, but it's been falling ever since. The second episode stopped at 0.796%, the third at 0.770% and the fourth at 0.798%. It's been hanging around 0.7% since the first episode.
Meanwhile, TV Chosun's "Hanbando - Drama" rated 1.143%.
Source : news.nate.com/view/20...Copy & paste guideline for this article
""Syndrome" beat by "Hanbando - Drama", can't seem to reach 1%"
by HanCinema is licensed under a Creative Commons Attribution-Share Alike 3.0 Unported License.
Based on a work from this source
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[Spoiler] "Dream High 2" Jiyeon practices and practices just to survive
2012/02/21 (Source)
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Drama of the week
By Cédric Collemine | Privacy policy | Contact | Partners | Advertising by


text:
I'm probably going to vote for Obama, but I want a robust discussion leading up to the campaign. I am disappointed that so few pro-Romney Utah voters are writing letters to the editor in The Tribune explaining why they plan to vote for him.
I know The Tribune is perceived as liberal, but it does run letters from both sides. So, come on, conservatives, write about more than an over-the-top Bagley cartoon and why the Old Testament book of Leviticus justifies discriminating against gays. Give us your best arguments for the Republican take on the issues of the day.
There are a lot of important issues, and we need your participation in what my college professor called "the grand discussion," by which he meant being part of the broad public discussion of issues that makes our nation great.
Utah's Republicans overwhelm Democrats. It's a shame their supermajority makes them think they don't need to debate with people who think differently.
Alan "Blue" Bayer
Salt Lake City


text:
About the Book
Features & Details
- Category Arts & Photography
Standard Landscape, 10×8 in, 25×20 cm
24 Pages
- Publish Date Apr 11, 2007
About the Creator
Richard D. Schoenberg has been a photographer for 25 years. Originally from the New York City area, he worked for several entertainment newspapers. During that period he compiled a portfolio of rock photos that were published in 2002. The book titled, "Seventy Nine - Eighty" documents some of the early performances of the B-52's, John Mellencamp and The Pretenders. Having relocated to Los Angeles, he attended the American Film Institute as a cinematography fellow. For six years he pursued a career as a Director of Photography, working on television commercials, music vi deos and several feature-length films. Having spent two and half years working on, "The Only Easy Day Was Yesterday", a 288 page book about the training of the US Navy SEALs, it was published in December, 2004
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text:
ACE indicates angiotensin-converting enzyme; ARB, angiotensin II receptor
Lee DS, Tu JV, Juurlink DN, Alter DA, Ko DT, Austin PC, Chong A, Stukel TA, Levy D, Laupacis A. Risk-Treatment Mismatch in the Pharmacotherapy of Heart Failure. JAMA. 2005;294(10):1240-1247. doi:10.1001/jama.294.10.1240
© 2017
Author Affiliations: Institute for Clinical
Evaluative Sciences (Drs Lee, Tu, Juurlink, Alter, Ko, Austin, Stukel, and
Laupacis, and Ms Chong), Department of Health Policy, Management, and Evaluation,
University of Toronto (Drs Tu, Juurlink, Alter, Austin, Stukel, and Laupacis),
and Sunnybrook and Women's College Health Sciences Centre, University
of Toronto (Drs Tu, Juurlink, Alter, Ko, and Laupacis), Toronto, Ontario;
and the Framingham Heart Study of the National Heart, Lung, and Blood Institute,
National Institutes of Health, Framingham, Mass (Drs Lee and Levy).
Context Patients with heart failure have a wide spectrum of mortality risks.
To maximize the benefit of available pharmacotherapies, patients with high
mortality risk should receive high rates of drug therapy.
Objective To examine patterns of drug therapy and underlying mortality risk in
patients with heart failure.
Design, Setting, and Patients In the Enhanced Feedback for Effective Cardiac Treatment (EFFECT) population-based
cohort (1999-2001) of 9942 patients with heart failure hospitalized in Ontario,
Canada, we evaluated 1418 patients with documented left ventricular ejection
fraction of 40% or less and aged 79 years or younger with low-, average-,
and high-predicted risk of death within 1 year; all patients survived to hospital
discharge. Administration of angiotensin-converting enzyme (ACE) inhibitors,
ACE inhibitors or angiotensin II receptor blockers (ARBs), and β-adrenoreceptor
antagonists was evaluated according to predicted risk of death.
Main Outcome Measure Heart failure drug administration rates at time of discharge and 90
days after hospital discharge.
Results At hospital discharge, prescription rates for patients in the low-,
average-, and high-risk groups were 81%, 73%, 60%, respectively, for ACE inhibitors;
86%, 80%, 65%, respectively, for ACE inhibitors or ARBs; and 40%, 33%, 24%,
respectively, for β-adrenoreceptor antagonists (all P<.001 for trend). Within 90 days following hospital discharge,
the rates were 83%, 76%, and 61% for ACE inhibitors; 89%, 83%, and 67% for
ACE inhibitors or ARBs; and 43%, 36%, and 28% for β-adrenoreceptor antagonists
for the 3 risk groups, respectively (all P<.001
for trend). The pattern of lower rates of drug administration in those patients
at increasing risk was maintained up to 1 year postdischarge (P<.001). After accounting for varying survival time and potential
contraindications to therapy, low-risk patients were more likely to receive
ACE inhibitors or ARBs (adjusted hazard ratio [HR], 1.61; 95% confidence interval
[CI], 1.49-1.74) and β-adrenoreceptor antagonists (HR, 1.80; 95% CI,
1.60-2.01) compared with high-risk patients (both P<.001).
Conclusions Patients with heart failure at greatest risk of death are least likely
to receive ACE inhibitors, ACE inhibitors or ARBs, and β-adrenoreceptor
antagonists. Understanding the reasons underlying this mismatch may facilitate
improvements in care and outcomes for patients with heart failure.
Heart failure affects more than 5 million people in Canada and the United
States and is associated with a high mortality rate.1,2 Medications
shown to reduce the mortality and morbidity of this condition include angiotensin-converting
enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), and β-adrenoreceptor
antagonists.3- 5 These
drug classes have been studied extensively and recommended strongly by disease
management guidelines.6,7 Given
the proven mortality benefits of these drugs, it is important to ensure that
patients at the highest risk of death receive these therapies.8- 12
Intuitively, it might be expected that higher propensity to receive
treatment would occur in those individuals at highest risk. However, prior
studies suggest that the opposite may occur in practice.13- 18 For
example, among elderly patients with acute coronary syndromes, rates of treatment
with 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors were lower
among patients with higher probability of death,19 despite
the proven benefits of such treatment.20,21 Discordant
patterns of treatment rates and risk of death may significantly impact disease
outcomes of other conditions associated with mortality burden. Heart failure
is associated with substantial mortality, and failure to treat higher-risk
patients with life-sustaining therapies could adversely affect outcomes. Prior
studies have not evaluated whether the propensity to treatment is directly
or inversely associated with risk of death in patients with heart failure.
A requisite for study of the patterns of risk and treatment rates is
the availability of an objective method for identifying risk. Recently, our
group developed and validated the Enhanced Feedback for Effective Cardiac
Treatment (EFFECT) heart failure mortality risk-stratification method, which
stratifies patients with heart failure according to their probability of death.22 In this study, we examined the use of drug therapies
for heart failure in relation to predicted 1-year mortality rates. We hypothesized
that patients at greatest risk of death would be the least likely to receive
beneficial drug therapies.
The patients included in our study were those hospitalized for heart
failure as part of the EFFECT study. The EFFECT study included 103 acute-care
hospitals in Ontario, Canada, providing care to patients with heart failure
from April 1999 to March 2001; details of the study have been described previously.22 Patients with a primary diagnosis of heart failure,
according to the International Classification of Diseases,
Ninth Revision, in the Canadian Institute for Health Information discharge
abstract database and who met the Framingham heart failure criteria23 were identified for detailed chart abstraction of
presentation clinical variables, comorbidities, laboratory measurements, and
left ventricular ejection fraction (LVEF). Ethics approval was obtained from
all participating institutions before the study, and individual-level informed
consent was deemed not required.
We initially examined all patients with heart failure aged 79 years
or younger who had an LVEF of 40% or less by echocardiography, radionuclide
ventriculogram, or left ventricular angiography, and subsequently expanded
the analysis to include elderly patients older than 79 years. Because the
primary outcomes of the study were drug prescription rates at discharge or
90 days after hospital discharge, we excluded patients who died during hospital
admission. In additional analyses, we examined a healthier subset of patients
with heart failure without life-limiting noncardiac comorbidities (cancer,
cerebrovascular disease, dementia, and hepatic cirrhosis). In these individuals,
we anticipated that prescribing patterns would not be affected by perceived
lack of adherence and competing risks of noncardiac death. Deaths in hospital
were identified using both the Canadian Institute for Health Information and
the registered persons vital statistics database.
Hospitals were categorized as teaching, community, or small (<50
in-patient beds), according to the classification of the Joint Policy and
Planning Committee, which links the Ontario Hospital Association and the Ministry
of Health.24 Patients were assigned to an attending
physician, identified as the physician who submitted the most attending fee
codes to the Ontario Health Insurance Plan billing database. Physician specialty,
categorized as cardiologist, noncardiology internist, or general or family
practitioner, and physician age were determined from an Ontario Ministry of
Health health care organization database.25
Rates were determined for drugs prescribed at discharge in the medical
record and prescriptions filled within 90 days after hospital discharge. The
former were determined by abstracting the medical record and the latter by
linking hospital data with the Ontario Drug Benefit formulary database, which
contains detailed prescription records for all ambulatory patients aged 65
years or older. We examined all medications classified as ACE inhibitors,
ARBs, and β-adrenoreceptor antagonists. We also examined rates of drug
administration up to 1 year after hospital discharge.
All patients were classified according to their baseline predicted risk
of 1-year mortality using the validated EFFECT heart failure risk prediction
score. The risk scoring method uses age, vital signs at presentation, comorbidities,
and laboratory test result values to calculate an aggregate risk score.22 Based on the 1-year mortality score, patients were
categorized into 3 groups (low risk [score, ≤90], average risk [score,
91-120], or high risk [score, ≥121]). From prior model validation, the
corresponding 1-year mortality rate ranges for low-, average-, and high-risk
groups were 17.7% or less (upper 95% confidence interval [CI]), 26.3% to 34.0%
(95% CI), and at least 49.4% (lower 95% CI); the model's performance
characteristics have been previously reported.22 We
compared observed 1-year mortality rates in each category of predicted risk
by querying the registered persons vital statistics database.26 Rates
of drug administration at discharge, at 90 days, and up to 1 year following
hospital discharge were examined according to predicted baseline risk of death.
Sensitivity analyses were conducted to further explore the risk-treatment
association in selected clinical subsets relevant to prescription of ACE inhibitors,
ARBs, and β-adrenoreceptor antagonists. For example, we anticipated that
increased serum creatinine concentration (≥2.0 mg/dL [≥176.8 μmol/L])
might influence prescription of ACE inhibitors or ARBs; therefore, treatment
rates were reexamined in patients with creatinine thresholds varying from
less than 2.0 mg/dL (<176.8 μmol/L) to less than 1.6 mg/dL (<141.4 μmol/L).
Similarly, because of the blood pressure lowering effects of these drugs,
we examined patients without hypotension, defined by systolic blood pressure
threshold of at least 115 mm Hg, as used previously.27 For β-adrenoreceptor
antagonist administration rates, we examined those patients without bradycardia
(heart rate ≥60/min) or bradycardia-related complications during the hospital
stay, and those without chronic obstructive pulmonary disease or asthma. We
also examined treatment patterns according to risk for all patients with heart
failure irrespective of LVEF.
Trends in rates of discharge drug prescription according to risk category
were evaluated using the Mantel-Haenszel χ2 test for trend28 and, when small cell sizes were present, statistical
significance was assessed using permutation tests.29 The
primary results are reported as unadjusted drug administration rates stratified
by risk category. The effect of patient age and sex, risk category, attending
physician specialty and age, and hospital type on the likelihood of ACE inhibitor
or ARB and β-adrenoreceptor antagonist prescription was assessed using
logistic regression. The logistic regression model was estimated using generalized
estimating equation methods to account for the clustering of patients within
physicians, adjusting for hospital, physician, and patient characteristics;
standard errors increased negligibly.
Time to first outpatient discharge prescription was analyzed using Cox
proportional hazards regression analysis with risk stratum as the predictor
variable, using the high-risk group as the referent category, censoring patients
at death. The Cox proportional hazards regression analysis was restricted
to those patients aged 65 years or older, in whom Ontario Drug Benefit outpatient
prescription records were available. Kaplan-Meier survival curves were constructed
for time to drug prescription event stratified by risk category and compared
using the log-rank statistic. Statistical analyses were performed using SAS
version 8.2 (SAS Institute Inc, Cary, NC); P<.05
was considered statistically significant.
A total of 9942 patients were hospitalized for heart failure and met
clinical criteria for inclusion. Overall, 8641 patients (86.9%) survived hospitalization
and, of these, 5218 (60.4%) were aged 79 years or younger. Among this group,
2681 patients had left ventricular function documented, of whom 1418 with
LVEF of 40% or less constituted the study cohort. Of the 1418 patients, 784
(55.3%) were categorized as low risk, 473 (33.4%) as average risk, and 161
(11.4%) as high risk. A total of 1020 patients were aged between 65 and 79
years for postdischarge outpatient drug prescription analysis. Baseline characteristics
of patients, hospital type, and health care practitioner specialty by risk
category are shown in Table 1. The attending
physician was identifiable for 98.7% of low- and average-risk patients and
for 98.8% of high-risk patients. The median number (interquartile range) of
cardiovascular prescription drugs was similar across risk categories (4 [3-6]
in low-risk, 5 [3-6] in average-risk, and 4 [3-6] in high-risk groups).
Rates of drug prescription at hospital discharge for all patients aged
79 years or younger with an LVEF of 40% or less are shown in Table 2, according to mortality risk category. Observed 1-year mortality
rates were associated with predicted risk of death. With increasing mortality
risk, discharge prescription rates of ACE inhibitors, ACE inhibitors or ARBs,
and β-adrenoreceptor antagonists decreased. Similar patterns were observed
for prescription rates at 90 days posthospital discharge in patients aged
65 to 79 years with an LVEF of 40% or less. In patients with heart failure
aged 79 years or younger with an LVEF of 40% or less and without major comorbidities,
higher mortality risk remained associated with lower rates of ACE inhibitor,
ACE inhibitor or ARB, and β-adrenoreceptor antagonist prescriptions at
discharge and within 90 days postdischarge. The risk-treatment mismatch remained
for all heart failure drugs when patients older than 79 years with an LVEF
of 40% or less were also included in the analysis (Table 3).
Prescription rates for ACE inhibitors or ARBs at hospital discharge
and 90-day outpatient administration of β-adrenoreceptor antagonists
are shown in Table 4 for those patients
without reduced blood pressure, bradycardia, increased creatinine concentration
(ACE inhibitors or ARBs), or chronic obstructive pulmonary disease or asthma
(β-blockers). A risk-treatment mismatch was present in a broad range
of possible heart failure patient samples. Analyses repeated for ACE inhibitor
prescriptions alone paralleled that for either ACE inhibitors or ARBs, and
when patients with intolerance to these drugs were excluded, similar results
were observed. Inclusion of patients who died in hospital (and their treatments
at the time of death) into the analysis also yielded similar results. P values obtained from permutation tests were similar to
the corresponding Mantel-Haenszel χ2 statistic for all analyses.
Age was not associated with prescription of ACE inhibitors or ARBs at
discharge (P = .64) or within 90 days postdischarge
(P = .11). Although increasing age decreased
the likelihood of receiving β-adrenoreceptor antagonists at discharge
(odds ratio [OR], 0.98; 95% CI, 0.97-0.99; P = .002,
per year of age), it was not associated with 90-day postdischarge administration
per year of age). Patient sex did not influence drug administration at either
time point and there were no significant interactions between age and sex.
Adjusting for patient age, sex, and their interactions, and physician
and hospital characteristics, ORs for ACE inhibitor or ARB prescriptions were
2.28 (95% CI, 1.54-3.38; P<.001) and 3.35 (95%
CI, 2.21-5.07; P<.001) at discharge for average-
and low-risk groups, respectively, relative to those patients in the high-risk
group. Adjusted ORs for prescription of ACE inhibitors or ARBs within 90 days
were 2.42 (95% CI, 1.58-3.71; P<.001) for average-risk
and 4.47 (95% CI, 2.79-7.18; P<.001) for low-risk
groups. Similarly, β-adrenoreceptor antagonists were more likely to be
prescribed at discharge in low-risk patients, with adjusted ORs of 1.55 (95%
CI, 1.03-2.33; P = .04) in average-risk
and 1.84 (95% CI, 1.22-2.79; P = .004)
in low-risk individuals. Within 90 days, the adjusted ORs for β-adrenoreceptor
antagonists were 1.44 (95% CI, 0.96-2.17; P = .08)
and 1.88 (95% CI, 1.25-2.84; P = .003)
for average- and low-risk groups, respectively, relative to the high-risk
Although there was no effect of hospital type on ACE inhibitor or ARB
prescription, patients who were admitted to large community hospitals were
less likely to receive β-adrenoreceptor antagonists than teaching hospitals
at discharge, and OR, 0.70; 95% CI, 0.50-0.97; P = .03
within 90 days). Small community hospitals exhibited a similar directional
trend for β-adrenoreceptor antagonist prescription (OR, 0.55; 95% CI,
0.25-1.21; P = .14 at discharge, and OR,
0.49; 95% CI, 0.19-1.28; P = .14 within
90 days). There was no effect of physician specialty or physician age on heart
failure drug prescriptions.
Kaplan-Meier plots for time from discharge to first outpatient drug
prescription demonstrated significant differences (all log-rank P<.001) among risk strata (Figure).
In the Cox proportional hazards regression analysis relative to patients at
high baseline risk, patients at low risk (hazard ratio [HR], 1.61; 95% CI,
1.49-1.74) and average risk (HR, 1.38; 95% CI, 1.28-1.48) were significantly
more likely to receive ACE inhibitors or ARBs (both P<.001).
Similarly, those patients at low risk (HR, 1.80; 95% CI, 1.60-2.01) and average
risk (HR, 1.30; 95% CI, 1.17-1.46) were more likely to receive β-adrenoreceptor
antagonists after hospital discharge compared with those at high risk (both P<.001).
Although the benefits of ACE inhibitors, ARBs, and β-adrenoreceptor
antagonists in patients with heart failure are well established,3,5,30 these
drugs were underused in those patients at highest risk of death. In all clinical
subgroups examined, an inverse association was found between probability of
death (ie, higher a priori risk) and rates of treatment with these pharmacotherapies.
Even after eliminating perceived contraindications and life-limiting comorbidities
that could potentially confound the risk-treatment relationship, the mismatch
remained. Thus, among hospital survivors without increased serum creatinine,
there were lower rates of ACE inhibitor or ARB administration in those at
higher mortality risk. In addition, among patients without obstructive pulmonary
disease, a paradoxical relationship between β-adrenoreceptor antagonist
treatment rates and risk was observed. Indeed, the inverse relationship persisted
in subsets of patients without major comorbidities and the wider population-based
sample of all patients with heart failure admitted to the hospital. The inverse
relationship between risk and treatment propensity was also not explained
by patient age or sex.
Several studies have found that there are equivalent or greater benefits
of heart failure therapy in patients at higher risk of death. Greater absolute
benefits of ACE inhibitors were found in patients with heart failure and characteristics
associated with higher risk, including hyponatremia,31 low
LVEF,32 and impaired functional capacity.33 Additionally, ACE inhibitors have been demonstrated
to be beneficial in elderly patients34,35 and
those with perceived contraindications to therapy.36,37 The
Metoprolol Controlled Release/Extended Release Randomized Intervention Trial
in Chronic Heart Failure (MERIT-HF) study found greater absolute reductions
in sudden death, death from worsening heart failure, and all-cause mortality
in older patients who were treated with metoprolol.38 The
Cardiac Insufficiency Bisoprolol Study II (CIBIS II) investigators found preserved
benefits of bisoprolol in the spectrum of higher-risk individuals defined
by a composite of age, New York Heart Association classification, LVEF, systolic
blood pressure, and heart rate.39 In the Carvedilol
Prospective Randomized Cumulative Survival (COPERNICUS) trial, low pretreatment
systolic blood pressure signified both a higher risk of death and greater
absolute treatment benefits with carvedilol.8,9 Given
the preserved or larger relative benefits and higher baseline probability
of death in high-risk patients, these studies collectively suggest that patients
at higher risk of death should not have life-sustaining treatments withheld.38
We found that high mortality risk was associated with lower rates of
ACE inhibitor, ARB, and β-adrenoreceptor antagonist administration. Other
studies have reported similar findings in patients with acute coronary syndromes
and myocardial infarction, with lower rates of therapeutic intervention in
elderly patients.19,40- 42 Our
findings add to current knowledge regarding risk-treatment patterns by demonstrating
that a mismatch between rates of treatment and mortality risk exist in patients
with heart failure even when the patient cohort is limited to potential real-world
counterparts of patients eligible for randomized controlled trials. Because
drug administration was inversely associated with risk, the potential benefit
of heart failure pharmacotherapy will not be realized if current patterns
continue. Greater quality improvement efforts aimed at increasing use of heart
failure drugs in higher-risk individuals may be needed.
We demonstrated that even among patients with reduced LVEF without potential
contraindications to ACE inhibitors or β-adrenoreceptor antagonists,
the paradoxical association between mortality risk and utilization rates was
still evident. However, prior studies have found that the beneficial effects
of β-adrenoreceptor antagonists extend to the broader sample of patients
with nonasthmatic chronic obstructive lung disease.43,44 Although
ACE inhibitors have been studied in heart failure trials among patients with
serum creatinine levels as high as 3.4 mg/dL (≤300.6 μmol/L),10 we found that the risk-treatment mismatch persisted
despite restricting the analysis to lower thresholds (<1.6 mg/dL [<141.4 μmol/L])
than those used in randomized controlled trials.45,46 The
partial attenuation of the gradient in treatment rates that occurred when
those patients with increased serum creatinine were excluded suggested that,
although important, renal dysfunction did not fully explain the risk-treatment
mismatch. Accounting for differences in hospital type, physician characteristics,
and patient age and sex, and in clustered multivariable regression analyses
also did not abrogate the risk-treatment mismatch.
A potential explanation for the inverse relationship between risk and
treatment rates could be under appreciation of the benefits of therapy, particularly
in patients with chronic disease who are at risk of death from noncardiac
causes.19 Additionally, clinicians may be distracted
from heart failure care in patients with multiple comorbid conditions.47 However, despite excluding patients with several
potential life-limiting comorbidities, the treatment mismatch remained. The
possible need for multiple prescription medications could also be a consideration
in withholding therapy. However, we found that the median number of cardiovascular
prescription drugs at discharge was similar across risk categories. Alternatively,
there may be uncertainty about risks vs benefits in treating patients who
are underrepresented in randomized controlled trials, or perceived potential
for harm associated with treatment particularly in high-risk patients.48 All of the above could also affect the clinician's
discussion with patients regarding their preferences when making informed
treatment-related decisions.
Our findings are relevant to clinicians since pharmacologic therapy
is the cornerstone of heart failure management. Additionally, this study has
implications for performance measurement and quality improvement efforts,
where drug utilization rates are commonly reported as an aggregate statistic.49 Given our findings, heart failure outcome improvement
may be accelerated by greater utilization in those patients at higher risk
of death. In our study of patients with heart failure with an LVEF of 40%
or less, only 11% of low-risk patients did not receive ACE inhibitors or ARBs
within 90 days postdischarge, whereas 33% of high-risk patients did not receive
therapy. For β-adrenoreceptor antagonists, 72% of high-risk patients
remained untreated up to 90 days after hospital discharge. The mismatched
pattern of drug administration persisted up to 1 year after hospital discharge,
even after accounting for variable survival times. The implications of our
study likely extend to other regions, since reported rates of heart failure
drug prescription are comparable between Ontario and other jurisdictions.37,50,51 Additionally, the
potential reasons for the risk-treatment mismatch would also not be limited
by geographic boundaries, and thus common underlying reasons for this paradox
may exist.
Some limitations of our study merit emphasis. Although we accounted
for several important contraindications, other relative contraindications,
such as cough or hypoglycemia, were not assessed.52 However,
given the literature demonstrating benefits of drug therapy even in those
patients with perceived contraindications, exclusion of patients from the
analysis based on less important relative contraindications was considered
unjustified. Furthermore, repeat analysis excluding patients who had a documented
history of drug intolerance did not alter the results. Our study was limited
to patients with heart failure in the acute care hospital setting and, although
our findings cannot be directly extrapolated to patients initially identified
as outpatients, we hypothesize that similar results would be observed in the
latter case based on the consistent pattern of discharge prescriptions and
postdischarge drug administration. Although our study was able to identify
patterns of association between treatment and risk, the underlying reasons
were beyond the scope of this study and are potential areas for future research.
In conclusion, the predicted and observed risks of death in patients
with heart failure were inversely associated with discharge and postdischarge
administration of potentially life-saving drug therapies. This finding is
particularly important because patients at highest risk of death have great
need for effective treatment. Clinical use of quantitative multifactorial
risk profiles or algorithms that convey information regarding probability
of poor outcomes could be applied to better identify such patients. Further
study is needed to quantify the adverse consequences attributable to the mismatch
between risk and treatment rates and may also identify potential solutions
to correct this undesirable phenomenon.
Corresponding Author: Andreas Laupacis,
MD, MSc, Institute for Clinical Evaluative Sciences, Room G-106, 2075 Bayview
Ave, Toronto, Ontario, Canada M4N 3M5 (firstname.lastname@example.com).
Author Contributions: Drs Lee and Laupacis
had full access to all of the data in the study and take responsibility for
the integrity of the data and the accuracy of the data analysis.
Study concept and design: Lee, Alter, Stukel,
Acquisition of data: Lee, Tu.
Analysis and interpretation of data: Lee, Juurlink,
Ko, Austin, Chong, Stukel, Levy, Laupacis.
Drafting of the manuscript: Lee, Chong.
Critical revision of the manuscript for important
intellectual content: Lee, Tu, Juurlink, Alter, Ko, Austin, Stukel,
Levy, Laupacis.
Statistical analysis: Lee, Stukel, Laupacis.
Obtained funding: Lee, Tu.
Administrative, technical, or material support:
Study supervision: Alter, Laupacis.
Financial Disclosures: None reported.
Funding/Support: This study was supported by
a grant to the Canadian Cardiovascular Outcomes Research Team (http://www.ccort.ca) from the Canadian Institutes of Health Research (CIHR) and the Heart
and Stroke Foundation. Dr Lee was supported by a clinician-scientist award,
Drs Juurlink and Austin were supported by new investigator awards, Dr Laupacis
was supported by a senior investigator award from the CIHR, and Dr Tu was
supported by a Canada Research Chair in Health Services Research.
Role of the Sponsors: The CIHR and the Heart
and Stroke Foundation did not participate in the design and conduct of the
study, in the collection, management, analysis, and interpretation of the
data, or in the preparation, review, or approval of the manuscript.
Acknowledgment: We thank Donald Redelmeier,
MD, from the Institute for Clinical Evaluative Sciences, for reviewing an
earlier version of the manuscript and also acknowledge the work of Linda Donovan,
BScN, MBA, Institute for Clinical Evaluative Sciences, who was the project
director for the Enhanced Feedback for Effective Cardiac Treatment study.
Neither Dr Redelmeier nor Ms Donovan received any compensation for contributing
to the study.


text:
After graduating from the New York State College for Teachers in Albany (1951), Milk served in the U.S. Navy during the Korean War and was discharged in 1955 (Milk later said that he was dishonourably discharged due to his homosexuality, but military records do not support this claim). He held several jobs before becoming a financial analyst in New York. In 1972 he moved to San Francisco, where he opened a camera store and soon gained a following as a leader in the gay community. His popularity grew when he challenged the city's gay leadership, which he thought was too conservative in its attempts to gain greater political rights for homosexuals.
In 1973 Milk ran for a seat on the city's Board of Supervisors but was defeated. After another unsuccessful bid in 1976, he was elected in 1977, becoming one of the first openly gay elected officials in U.S. history. The following year Milk and the city's mayor, George Moscone, were shot and killed in City Hall by Dan White, a conservative former city supervisor. At White's murder trial, his attorneys argued that his judgment had been impaired by eating junk food (a tactic later derided as the "Twinkie defense"); his conviction of the lesser charge of voluntary manslaughter sparked an uproar in the city that was subsequently termed the "White Night Riot." Numerous books and films were made about Milk, including the 1984 documentary The Times of Harvey Milk, which earned an Academy Award, and ; an opera, Harvey Milk (1995); and Milk (2008), a cinematic depiction of his political career that starred Sean Penn.


text:
Mix Up Your Onionsby Food Network Magazine in Food Network Magazine, October 29th, 2012
Hot Tips From Food Network Kitchens' Katherine Alford:
Keep red onions on hand: They're milder than yellow or white ones, so you can eat them raw. Plus, you can substitute them for shallots in most recipes, like the vodka sauce in this Penne With Vodka Sauce recipe. Use 1/2 small red onion for every large shallot.
(Photograph by Lara Robby/Studio D)
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