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CNSNews.com asked Jordan, "Do you believe Obama has the constitutional authority to address minimum wage legislation without congressional approval?"
Jordan said, "Not past the federal contracting issue that he's talked about. We think that this is just bad economics but this decision, if anything, it should be left up to the states. Let states decide what is good and what's in the best interest of their states -- but certainly nothing past what he's done relative to federal contracting."
On Feb. 12, 2014, the White House issued an executive order to establish a minimum wage for federal contractors.
"This order seeks to increase efficiency and cost savings in the work performed by parties who contract with the Federal Government by increasing to $10.10 the hourly minimum wage paid by those contractors. Raising the pay of low-wage workers increases their morale and the productivity and quality of their work, lowers turnover and its accompanying costs, and reduces supervisory costs," according to WhiteHouse.gov.
In a weekly address to Americans on Feb. 22, 2014, President Obama said, "And as a chief executive myself, that's why I took action last week to lift more workers' wages by requiring federal contractors to pay their employees a fair wage of at least $10.10 an hour."
"In the year since I first asked Congress to raise the minimum wage, six states have passed laws to raise theirs, and more states are working on it as we speak. But only Congress can finish the job and lift Americans' wages across the country," Obama said.


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Nov 9, 2012 - StaffCheryl and Lee Arrington of Pavillion are pleased to announce the engagement of their daughter Kallie Dawn Arrington of Clearfield, Utah, to Devin West Martin of Evanston, the son of Natalie and Orrin Martin of Evanston.
The future bride is a 2006 graduate of Wind River High School and a graduate of Western Wyoming College and the University of Texas Health Science Center, where she received a master's degree in occupational therapy.
The prospective groom is a 2004 graduate of Evanston High School and a graduate of Western Wyoming College and the University of Wyoming, where he received a bachelor's degree in architectural engineering.
The wedding is planned for Nov. 17, 2012, at St. James Lutheran Church in Ganado, Texas.
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subset: commoncrawl


text:
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Woodland Grange is a spectacular residential conference centre 2 miles from Leamington Spa. Set in 16 acres of beautiful grounds, it offers award-winning facilities, free Wi-Fi and free off-road parking. Recognised as a Conference Centre of Excellence, the award-winning Woodland Grange features 26 meeting rooms, a large fitness centre and a games room. Residents can also enjoy an on-site sauna and spa bath. The bedrooms at Woodland Grange are comfortable and airy, with some boasting floor-to-ceiling windows and LCD TVs. Private dining is possible in the luxurious Oak Room, and buffet lunches and bar snacks are also available. Situated in the middle of the motorway network, the venue is 20 minutes from the M6, M40, M42 and M69. Newbold Comyn Golf Club is an 8-minute drive, and The Shires Retail Park is 10 minutes away by car. Leamington Spa Rail Station is 2 miles from Woodland Grange.
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text: It's like 10,000 Peas... May 22, 2012 16:28:55 GMT -8 Quote Select PostDeselect PostLink to PostMemberGive GiftBack to Top Post by Pea on May 22, 2012 16:28:55 GMT -8 ...WHEN ALL YOU NEED IS A SASQUATCH!!!!!!!!!!HA-PEA FUCKING SASQUATCH EVERYONE!!!!! ;D ;D ;D ;D ;D ;D ;DEDIT: Yes, there are exactly 10,000 peas there. A pea-per-post!


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cossin29's Mom Answers Activity
this sounds weird....... but does anyone else cut themselves? Watch this
Most recent answer (06/10/2012):
I understand, I use to cut myself and also hit my self with objects or with my fists. I am 26 yrs old and i started in my teens. I stoppe...posted by prred04
can I have a baby shower for my second child? Watch this
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You can consider having a baby "sprinkle" instead of a formal shower. This is less formal, no registry and just family and clo...posted by sugar&spiceX3


text:
scrappy doll by Fawn Pea
Welcome! You are browsing as a guestWould you like to see 37 projects made from this pattern and much more? create a free account What am I missing?
scrappy doll
This pattern is available for free.
Dolls are easy to make from whatever you have on hand, and fortunately children are easy to please when it comes to a new toy. This sweet felted doll is no different - she is made from leftovers and stashed bits. Find a handful of worsted-weight wool leftovers and you're ready to make a snuggly felted doll for your little one.
For more information, see: http://fpea.blogspot.com/2010/10/free-pattern-friday...


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Scientific Investigations Report 2006–5232
Scientific Investigations Report 2006–5232
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Methods of collecting water samples for this study generally followed guidelines established by the USGS and documented in the USGS National Field Manual (U.S. Geological Survey, variously dated), in the USGS Idaho Water Science Center Quality-Assurance Plan for water-quality activities (U.S. Geological Survey, Idaho Water Science Center, written commun., 2005), and in Bartholomay and others (2003). Containerization of purge water necessitated some minor adjustments to the guidelines in Bartholomay and others (2003). It was necessary to split the well discharge into three streams to accommodate sample collection, continuous measurement of the field-water-quality indicators (temperature, pH, specific conductance, and DO), and collection of excess purge water. Excess purge water was collected at the discharge point and routed through canvas hoses to trailer-mounted containers. Containerized purge water was then transported to an approved disposal site near INTEC.
DOE's Radiological and Environmental Sciences Laboratory (RESL) analyzed water samples for selected radiochemical constituents. A discussion of the procedures used by RESL for the analysis of radionuclides in water samples is provided in reports by Bodner and Percival [eds.] (1982) and U.S. Department of Energy (1995). Analytical methods used by the USGS National Water Quality Laboratory (NWQL) for selected organic and inorganic constituents are described by Goerlitz and Brown (1972), Skougstad and others (1979), Wershaw and others (1987), Fishman and Friedman (1989), Faires (1992), Fishman (1993), and Rose and Schroeder (1995). A list of some analytical methods currently used at the NWQL is available at http://wwwnwql.cr.usgs.gov/Public/ref_list.html. Other analytical methods from the USEPA currently used at the NWQL are available at http://www.epa.gov/epahome/publications.html. Analytical methods from the ASTM that are currently used at the NWQL are available at http://www.astm.org.
Concentrations of radionuclides are reported with an estimated sample standard deviation, s, obtained by propagating sources of analytical uncertainty in measurements. Guidelines for interpreting analytical results for radionuclides are based on an extension of a method by Currie (1984) and are given in a report by Knobel and others (1999). In this report, radionuclide concentrations less than 3s are considered to be below a reporting level.
Water samples were analyzed for the following selected non-radioactive chemical constituents: dissolved trace elements, common ions, nutrients, and purgeable organic compounds. Minimum reporting levels (MRL's), long-term method detection limits (LT-MDL's), and laboratory reporting levels (LRL's), are used by the NWQL to determine when a chemical constituent has been detected with sufficient confidence (Childress and others, 1999).
The MRL is the smallest measured constituent concentration that can be reliably reported using a given analytical method (Timme, 1995). In this report, MRL's are used only to report concentrations of purgeable organic compounds. The LT-MDL controls false positive error and is determined by calculating the standard deviation of a large sample population (at least 24 measurements) of spiked-sample measurements over an extended period (often 1 year). At the NWQL, the LT-MDL can change on a yearly basis. The chance of falsely reporting a concentration at or greater than the LT-MDL for a sample that did not contain the analyte is predicted to be less than or equal to 1 percent (Childress and others, 1999, p. 19). A falsely reported detection is known as a false positive and is an error of the first type in hypothesis testing. The LRL controls false negative error and is determined so the probability of falsely reporting a non-detection for a sample containing an analyte at a concentration equal to or greater than the LRL is predicted to be less than or equal to 1 percent (Childress and others, 1999, p. 19). Falsely reporting a non-detection is known as a false negative and is an error of the second type in hypothesis testing. The LRL generally is equal to twice the yearly-determined LT-MDL.
Analytes detected at concentrations between the LT-MDL and the LRL that pass identification criteria are estimated. Estimated concentrations are noted with a remark code "E." These data should be used with the understanding that their uncertainty is greater than data reported without the "E" remark code. For consistency with previous publications, estimated concentrations less than the LRLs are treated as censored data in this report. For censored data used in this report, values are less than the LRL or MRL.
Statistical equivalency of chemical-constituent concentrations in sample pairs was determined following the method outlined by Williams (1996). In this method, statistical equivalence is determined within a specified confidence level. A value for the standard deviate, Z, is calculated, and then the level of significance of the result is evaluated (evaluation of the level of significance assumes that the sample population is distributed normally). For this report, concentrations of individual constituents in sample pairs (constituent pairs) were considered equivalent when the results were within two standard deviations of each other. At this confidence level (95-percent), the level of significance, determined from a standard normal probability curve, was 0.05 for a two-tailed test and corresponded to a Z-value of 1.96.
The equation used to determine Z was adapted from Volk (1969):
, (1)
is the concentration of a constituent in the routine sample,
is the concentration of the same constituent in the sequential replicate sample,
is the standard deviation of x, and
is the standard deviation of y.
When the population is not distributed normally or an approximation of the standard deviation is used, a Z-value less than 1.96 must be considered a guide when testing for equivalence. Constituent concentrations in sample pairs were considered statistically equivalent when the calculated Z-value was less than or equal to 1.96. Constituent concentrations also were considered statistically equivalent, although Z-values were not calculated, when the concentration in both samples was reported as less than the LRL or MRL. In this case, the Z-value was reported as zero.
In this report, three types of sample pairs were evaluated for statistical equivalency: (1) a replicate-sample pair collected from well USGS 22 (fig. 1); (2) sample pairs collected after purging 1 and 3 wellbore water volumes at each of 17 wells (figs. 1, 2); and (3) sample pairs collected in an earlier study (Bartholomay, 1993) after purging 1, 2, and 3 wellbore volumes at each of 11 wells (figs. 1, 2). Each sample pair generates multiple constituent pairs.
Using equation 1 is straightforward in determining whether results of radiochemical analyses of a pair of samples were equivalent. RESL reports radionuclide concentrations with an estimated sample standard deviation obtained by propagating sources of analytical uncertainty in measurements. Estimated sample standard deviations can be used directly in equation 1 to calculate a Z-value. Concentrations of radionuclides and measurements of gross radioactivity, estimated sample standard deviations, and calculated Z-values are provided in table 1.
Equation 1 cannot be applied directly to results when no standard deviations or uncertainties are reported by the laboratory. The NWQL does not report standard deviations with analytical results for non-radioactive inorganic constituents. As a result, approximations of standard deviations were used. The USGS Branch of Quality Assurance conducts an Inorganic Blind Sample Program (IBSP) in which reference samples disguised as environmental samples are submitted to the NWQL. Maloney and others (1993) describe the program and present evaluations of the analytical results. Samples sent by the IBSP to the NWQL are prepared from standard reference water samples (SRWS's). SRWS's are used by the USGS SRWS project in a round-robin laboratory evaluation program described by Farrar and Long (1997). Until 1988, the SRWS project used means and standard deviations to describe the round-robin data sets. Since 1988, the project used median and F-pseudosigma as a summary of location and variability in data sets. Hoaglin and others (1983) showed that F-pseudosigma yields an unbiased estimate of standard deviation when the data distribution is Gaussian (http://bqs.usgs.gov/bsp/regress.htm).
Mean and median values in the SRWS data sets traditionally were referred to as Most Probable Values (MPV's). The IBSP uses SRWS data sets to estimate the MPV's of the IBSP sample mixes. MPV estimates are based on the proportion of the SRWS's used in making up the sample mixes. Because SRWS data sets are not always Gaussian, the regression equations were derived from a combination of parametric and nonparametric results. Regression equations were derived for each constituent by regressing the appropriate F-psuedosigma or standard deviation against the IBSP MPV using ordinary least squares. Helsel and Hirsch (1992) provided a general model for estimation of ordinary least-squares:
Fσi = βo + β1MPVi + εi i = 1, 2, …, n (2)
is the ith observation of the response variable, Fσ,
is the ith observation of the explanatory variable, MPV,
is the intercept,
is the slope,
is the random error or residual for the ith observation, and
is the sample size.
SRWS project summary data for semi-annual round-robin sample studies during 2004-05 were used by the IBSP to derive regression equations for each constituent. Concentration ranges of the SRWS project summary data sets used, the derived Fσ equations, and the correlations are available at http://bqs.usgs.gov/bsp/regress.htm. F-pseudosigma values were calculated for each analytical result using the regression equations provided by the IBSP. F-pseudosigma values, which correspond to the appropriate time period and concentration range, were then used as an estimate of standard deviations in equation 1 to calculate Z-values. Concentrations of non-radioactive inorganic constituents, F-pseudosigma estimated sample standard deviations, and calculated Z-values are provided in table 2.
The NWQL also does not report standard deviations with analytical results for organic constituents. As a result, approximations of standard deviations were used when appropriate. The Organic Blind Sample Program (OBSP) uses a F-pseudosigma method similar to the method described for non-radioactive inorganic constituents to estimate the sample standard deviations for total organic carbon (TOC) measurements in water samples. The F-pseudosigma equation is available at http://bqs.usgs.gov/OBSP/WY05Plots/TSbodyLC114TOTAL_ORGANIC_CARBON.html. Concentrations of TOC, F-pseudosigma estimated sample standard deviations, and calculated Z-values are provided in table 3. For purgeable organic compounds (POC's), analytical results were less than the respective MRL's for 61 sample pairs in each of 3 water samples. As a result, all 183 Z-values for POC's were set to zero (table 3).
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text: Kam Heskin is an actress turned writer living in Los Angeles who originally hails from the red state of Colorado. Over the past two years, she has written a comedic screenplay, a series of sardonic cartoons about the entertainment industry, as well as starting a humorous op-ed blog on a variety of topics called Three-Scoops.com. She is also a contributor to Genlux Magazine and has been referred to as a contemporized Candace Bushnell.


text: 2006 ff releases on Gigolo Records 2002 ff Herman Schwartz Online 2000 first forays into producing 1999 ff represents Gigolo Records 1998 ff spins Disco, Electro, House, Techno, etc. for 303 times at 33 locations - support for Hell, Miss Kittin, DJ Upstart, Egoexpress, Paula, etc. 1995 turntables, tape decks, 6-channel mixer, experiments, heard about Hell 1994 ff interest in Electro/Techno/House 1989/90 spins 60's Garage Punk Rock etc. 1988/89 Acid House - dancing 1987 ff bass guitar, 60's organ, E-Piano: Jazz/Rock, 60's Garage Punk Rock 1987 school band: drums: Hardcore, Metal, Punk 1985 ff 60's excursion, interest in mod culture 1984 ff 8-bit-processor soundprogramming, as well in machine-code as 'Dr. Beat'Herman Schwartz's biography Herman Schwartz Musician


text:
Cisco IT uses VPN to provide secure remote access to Cisco corporate intranet resources for employees. The Cisco Enterprise Class Teleworker solution uses Dynamic Multipoint VPN (DMVPN) architecture to provide a secure, scalable, and manageable solution for Cisco employees who need remote site connectivity when telecommuting. This flexibility increases employees' ability to work from home using a hardware VPN connection, which translates into far more flexible, reliable, and effective work environments.
This design guide provides details on connectivity, security, management, and provisioning of the Enterprise Class Teleworker solution.
Benefits of the Enterprise Class Teleworker solution include:
- Increased productivity and employee satisfaction.
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- Managed security and encryption of data at remote work sites.
- Lower operational costs.


text:
Annefødder wrist warmers by Anne Dyrholm Stange and Tora Frøseth
Welcome! You are browsing as a guestWould you like to see 117 projects made from this pattern and much more? create a free account What am I missing?
Annefødder wrist warmers
This pattern is available for free.
The stitch pattern is unvented by Anne Dyrholm Stange, and then translated and modified into wrist warmers by Tora Frøseth.
It is also available as a scarf pattern on Anne's blog (in Danish).
For more information, see: http://knittingalot.blogspot.com/2007/11/annefdder-w...


text:
1998 Acura SLX Problems
RepairPal has identified the most common problems with the 1998 Acura SLX based on complaints from actual vehicle owners. We'll tell you what the problem is and what it'll take to fix it.
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Using the incorrect oil in the rear differential on cars with a limited slip differential causes a clattering noise on turns. Replacing the oil with oil specified by Acura should fix the problem.


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Arlington Event Details
Rocklands BBQ Pig-and-Oyster Roast to Benefit Doorways
April 18, 2013
5:00 pm - 8:00 pm
Rocklands Barbecue & Grilling Company
3471 Washington Blvd
Arlington, Virginia 22201
On Thursday, April 18, from 5:00 to 8:00 pm, Rocklands will kick off patio season with a special evening of food and drink to benefit Doorways for Women and Families. Guests will mingle on the patio munching on pork pulled from a whole roast pig and fresh oysters roasted over a wood fire. Rocklands will tap a keg just for the event, and offer happy hour specials from the bar.
Rocklands is donating all the food and beer, so 100 percent of the ticket price goes directly to support Doorways' families and programs. Tickets to the event are $25, and may be purchased through the Doorways for Women and Families website (http://bit.ly/10LK19u) or at the door. Ticket price covers all your oysters, pulled pork and beer. Raffle tickets can be purchased for $5 (5 for $20); prizes include gift certificates to local restaurants and shops, DC United gear and more. Space is limited to the first 150 guests.
Rocklands is encouraging outrageous tipping for the bartenders, as all cash proceeds will go to support Doorways for Women and Families.
The event will be held rain or shine. Rocklands Arlington is located near Virginia Square Metro station (Blue and Orange lines); the 38B bus stops in front of the restaurant; and there is off-street and on-street parking available.


text:
With the cost of gas being so much we have been discussing getting a vehicle for the past month. Some of the companies I work for don't have any concern for how much gas one can use to get a job done. We went down to the dealership that we got my wife her car at so that we could get her license plates done for her NEW car. While there a truck caught my eye.
I spotted a 2006 White Ford F150. There was nothing wrong with the body at all. No scratches, or anything at all. We checked out the engine, and the inside of the truck. The truck was a single owner vehicle, and only had 46,000 miles. Knowing how car sales works I told the salesman to go get his best price. He did, and it was exactly what I thought.
Now that I have the truck I want to make it look a bit more personal to me. I was thinking of one of those license plate brackets made of silver chains, maybe a windshield visor, and definitelly some rain guards.
When you get a car do you make it a personal thing?


text:
The McRib Is Back
Ohhhh, YES!!! It's back. McDonald's McRib sandwich is back. LOVE, LOVE, LOVE IT!!! The 450 calorie, boneless barbeque pork sandwich is available at most McDonald's now through November 14th. McDonald's actually leaves it up to the franchises to decide whether to offer it on the menu.
McDonald's spokeswoman Danya Proud said the McRib's limited availability to a seasonal favorite like the Shamrock Shake, only available around St. Patrick's Day.
You can even locate a participating McDonald's by following this link!!
Right now, there is a Golden McRib hidden somewhere in the US. McDonald's is calling the promotion, "The Quest For The Golden McRib." Go online to unlock clues as to its where abouts. The winner will be crowned the truest McRib lover!!!
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Source: CNNMoney and Entertainment Weekly


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By Sharon Bishop, NP-S
Although older adults comprise just 12% of the total population in the United States, they represent a large proportion of all inpatients in hospitals. Given that the number of Americans older than 65 is expected to almost double by 2030, meeting the needs of this unique population during hospital stays is essential.¹
As adults age, their physiology changes in ways that can dramatically affect how they react to treatment in a hospital setting. These changes include a loss of muscle mass, decreased aerobic and ventilation capacity, decreased bladder function, possible cognitive decline, sensorial loss, and loss of bone density.² These "normal" aging processes often coexist with comorbidities and diseases that are far more commonplace among the older adult population, such as heart failure, diabetes, pressure ulcers, dementia and dehydration.
With current reimbursement demanding "sicker and quicker" discharges, it is easy to comprehend why older adults have such poor outcomes after hospitalization: functional decline, high readmission rates, high rates of skilled nursing home placement and a high 1-year mortality rate.³ During a hospital stay, older adults are more likely to experience complications such as sepsis, delirium, fractures, skin breakdown and loss of function.¹
Identifying and Adapting Care
Many models and processes can be incorporated into a care plan that is specific for the older patient. The first goal is to identify risk factors by performing a thorough geriatric assessment screening upon admission. An effective assessment should identify a broad range of elements, such as fall risk, nutrition status, polypharmacy, hearing and vision impairment, cognitive status and functional ability.
A study of existing assessment tools by Hoogerduijn et al4 found that the Katz index of independence in activities of daily living (Katz Index), the mini mental state examination, the complexity prediction instrument, the identification of seniors at risk, and the hospital admission risk profile are valid tools for this purpose. The research showed that these tools help identify significant predictors of decline, such as impaired cognitive status, depression and prolonged length of hospital stay.4
Simple adaptations can have a significant impact on older patients. For example, incorporating adequate oral care into daily routines can make eating easier and reduce infections. Patients should be provided with their dentures, hearing aids and glasses as needed. Fluid should be provided on a regular basis in a cup that is an appropriate size and weight for the patient.5
With careful monitoring of intake and output, the need for intravenous hydration is reduced and the patient is not hampered by lines and catheters. The environment should be uncluttered so that the patient can be assisted out of the bed as much as possible, if medically able. Large clocks and labeling of items like the remote control and telephone can help keep the patient oriented.5 Insomnia is often an issue, especially in a disruptive hospital setting, and it can have severe consequences in older adults. Interventions should address the fact that disturbed sleep often occurs due to noise, pain and a need to go to the bathroom. Providing regular rounding, adapting a flexible approach to medication administration, providing bedtime snacks, back rubs, warm drinks and stimulus control are all effective methods to reduce sleep difficulty.6
Inappropriate medication usage accounts for up to 30% of hospital admissions of geriatric patients.7 Older adults are more likely to experience significant morbidity and mortality related to pharmacokinetic changes in how they absorb, utilize and eliminate drugs. The Beers' criteria allow clinicians to cross-reference medications for interactions and identifies medications that are inappropriate for older adults. Considering that inappropriate prescribing occurs in 40% of community and nursing home residents, performing a thorough medication history should be a fundamental component of the admission assessment.7
Delirium and Dementia
One of the major problems that can occur with aging is delirium. It is often underrecognized by clinicians, and early warning signs can go undetected in as many as 67% of cases.2 Delirium is a cluster of multifactorial, transient symptoms that manifest as acute impairment in cognition and psychomotor behavior.8 It usually occurs as a result of a disease process outside the central nervous system, such as a urinary tract infection or pneumonia. It is preventable and reversible, but it is associated with increased mortality and suffering for the patient and increased hospital costs.8
The two most identifiable risk factors for delirium are advanced age and existing dementia. Other risk factors include dehydration, sleep deprivation, four or more medications, physical restraints, poorly managed pain, immobility and depression. A thorough geriatric admission assessment is essential for determining risk, prevention and intervention. Providing an appropriate environment will help prevent delirium.2,8 Examples may include reviewing medications, incorporating the assistance of family members, strict monitoring of vital signs and intake/output levels, avoiding overuse of catheters, and utilizing haloperidol for promotion of quality sleep in cases of hallucinations and severe agitation.2,9
Approximately 48% of all hospitalized patients older than 80 have a diagnosis of dementia. These patients can become disorientated and distressed in a hospital setting.9 Staff should be educated about simple steps to make the process as least disturbing as possible and to be aware of the unique needs of this population (e.g., anorexia and swallowing difficulties).9 Having a friend or family member stay with the patient is beneficial, as is assigning the same staff members to care for the patient as much as possible. Distractions and clutter should be eliminated; communication techniques such as good eye contact, simple sentences and face-to-face contact work best. Rest periods should be scheduled and visitors limited at this time. Predictable routine and familiar objects can also lower patient anxiety levels.1
Existing Working Models
Several models of care for hospital settings address the unique care needs of the geriatric patient. Acute Care for Elders (ACE) units offer individualized care for older patients in specially designed hospital units. The program serves 100,000 patients annually, with promising results. Recent research found that hospital stays for patients in these units was shorter, cheaper and had better functional status outcomes at discharge.1 An interdisciplinary team versed in geriatric needs provides care on units that are designed with safety, accessibility, stimulus control and ease of mobility in mind. The goals include having the patients out of bed for meals, ambulating twice daily, zero hospital-acquired pressure ulcers and zero restraint use. The Katz index was used at admission and discharge and overall, outcomes were measurably better when compared to similar patients on other hospital units.1,3
Nurses Improving Care for Healthsystem Elders (NICHE) is an international program designed to help hospitals improve the care of older adults. It is based at the New York University College of Nursing and its principal goals are to help nurses identify, interpret and apply evidence-based practice to optimize both care outcomes and the patient/family experience. NICHE has a strong emphasis on interdisciplinary collaboration, geriatric-specific resources and creation of an elder-friendly hospital environment. Close to 400 hospitals and healthcare facilities in North America currently participate in a NICHE program. For less than $5,000 per year, hospitals can have complete access to the programs' proven model of care, webinars, tools and resources.10
The Hospital Elder Life Program (HELP) is similar in function, with a focus on preventing delirium. Using trained staff and volunteers, older adults are monitored for risk factors related to delirium, such as dehydration, sleep deprivation and sensory overload. By addressing these issues and others, such as providing adequate visual aids, hearing devices and therapeutic activities, delirium incidence has been greatly reduced.1,5,6
Innovation for the Future
The Hospital at Home model is designed to be carried out in the home as a substitute for acute hospital admissions. It is based on the belief that caring for older adults who meet qualifying parameters in their own homes will provide effective treatment that is more satisfying for the patient and family, less costly and has better outcomes. In this physician-led program, patients older than 65 receive hospital-level of care in their homes. Admission criteria are that patients must have one of the targeted diagnoses: community-acquired pneumonia, cellulitis, or an exacerbation of chronic obstructive pulmonary disease or heart failure.11
Physicians make daily visits and an on-call physician is available round the clock. A Medicare-certified home care agency provides nursing and ancillary care, with pharmacy support, therapy staff and durable medical equipment also available. Many diagnostic studies are also performed in the home. The patient is followed until discharge, at which time care reverts back to the primary care provider.11
Research indicates that this program is effective and provides patients and caregivers with satisfactory outcomes.10 In a study of three experimental Hospital at Home programs, patient satisfaction was high and costs averaged 32% less than inpatient stays.12 The program has also been employed successfully in a number of other countries, including New Zealand, Europe, Israel and Australia.11
Close Attention Needed
The healthcare industry must pay close attention to meeting the needs of the geriatric population. This group is the largest consumer of healthcare spending, and this will continue in the future. From 2009 to 2010, an estimated 10 million Medicare recipients were admitted to hospitals and Medicare paid acute care hospitals approximately $116 billion for fee-for-service inpatient care. This cost is growing an average of 2.1% a year.13 Adapting care to optimize cost efficiencies without jeopardizing outcomes is paramount. The models and methods described meet both economic and quality criteria.
Related Content
Improving care for older adults does not have to involve complicated interventions or expensive equipment. The simple act of providing dementia patients with an activity kit containing items that distract from harmful actions or reduce agitation can make a big difference.5,8 Having a familiar face around can help keep older adults calm, receptive and on track with medical progress; the support of family members, friends and volunteers is integral to any good program.1,3,5,8
Recognizing risk factors upon admission and identifying areas for improvement through utilization of unit- and hospital-specific standards of care will lead to reduced decline during hospitalization.5 Older adults often do not have the ability to express their concerns and wishes, so it is essential that healthcare systems identify and meet their unique needs through use of interdisciplinary teams and targeted care. Many of the units described are inexpensive to start,3 but can result in vastly improved positive outcomes for the elderly patient, which should be a goal at the national level.
1. Kleinpell RM, et al. Reducing functional decline in hospitalized elderly. http://www.ahrq.gov/qual/nurseshdbk/docs/KleinpellR_RFDHE.pdf
2. Caring for the hospitalized elderly. Current best practice and new horizons. http://www.hospitalmedicine.org/AM/Template.cfm?Section=The_Hospitalist&Template=/CM/ContentDisplay.cfm&ContentFileID=1447
3. Greene A. Acute and post-acute care of the elderly: models for improving care. PowerPoint presentation by Adrienne Green, MD, University of California.
4. Hoogerduijn J, et al. Identification of older hospitalized patients at risk for functional decline, a study to compare the predictive values of three screening instruments. J Clin Nurs. 2010;19(9-10):1219-1225.
5. Balas MC, Casey CM. Comprehensive assessment and management of the critically ill. http://consultgerirn.org/topics/critical_care/want_to_know_more
6. Gilsenan I. Nursing Interventions to alleviate insomnia. Nurs Older People. 2012;24(4):14-18.
7. Barry PJ, et al. Inappropriate prescribing in the elderly: a comparison of the Beers criteria and the improved prescribing in the elderly tool (IPET) in acutely ill elderly hospitalized patients. J Clin Pharm Ther. 2006;31(6):617-626.
8. Conley DM. The Gerontological Clinical Nurse Specialist's role in prevention, early recognition, and management of delirium in hospitalized older adults. Urol Nurs. 2011;31(6):337-342.
9. Heath H. Improving quality of care for people with dementia in general hospitals. http://rcnpublishing.com/userimages/ContentEditor/1373367875414/Improving-dementia-care-quality.pdf
10. The NICHE program. http://www.nicheprogram.org/program_overview
11. Leff B, et al. Satisfaction with hospital at home care. J Am Geriatr Soc. 2006;54(9):1355-1363.
12. Graham J. Some patients can choose to be hospitalized at home.
13. Report to the Congress: Medicare Payment Policy. Hospital inpatient and outpatient services. http://www.medpac.gov/chapters/Mar12_Ch03.pdf
Sharon Bishop is a student in the adult-gero primary care nurse practitioner program at the University of Cincinnati. She has completed a disclosure statement and reports no relationships related to this article.
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The Dysfunctional Politics of Hand Soap
Recently, students at the University of Texas rallied to ban a product they deemed a serious threat to their collective health. Environmental groups have dedicated resources to doing the same thing nationwide. And Congress is involved, holding briefings about this product's dangers to our society. What scourge am I referring to? Automatic weapons, radioactive gas, or a deadly invasive species? Nope. The culprit: antibacterial hand soap.
After becoming aware of this controversy, I decided to investigate how something as seemingly beneficial to society as antibacterial hand soap became so political. And when did we, as a society, become more concerned about the germ-killers than the germs themselves?
The reason that hand soap is at the center of a controversy is because of an ingredient in antibacterial products named triclosan.
Scientists created triclosan in the late 1960s. It is a white, finely powdered organic substance that has a chlorinated odor that is pungent and sweet. In the 1970s, the FDA deemed triclosan safe for human use. Studies showed it was especially potent at treating oral diseases like gingivitis. It also helped combat the spread of bacteria in health care settings. In fact, it is currently in widespread use in hospital settings around the world.
But the FDA remained concerned about its effectiveness, so the agency would not issue a final ruling, even though it believed it was safe enough to be used by millions of Americans every day. FDA said it wanted to review documentation produced by industry and public sources.
Over the next 16 years, documentation was submitted. Nothing happened. At last, in 1994, the FDA made a move. Sort of. Unable to reach a decision, it deemed there was "insufficient data to make a determination." Today, the FDA is still looking at the data and has promised an update in the near future.
If the government has set as a priority eliminating confusion around the safety and effectiveness of triclosan, it isn't doing a good job. Complicating the matter is the EPA, which has jurisdiction over triclosan's use in non-healthcare related products, like kitchen knives and cutting boards. They classify triclosan as a pesticide because it kills germs and germs are, according to the EPA at least, "pests." It was deemed to be safe, yet EPA's decidedly unusual classification system -- calling triclosan a pesticide -- does not inspire confidence in the chemical's safety.
Why the government has failed to make conclusive determinations on triclosan is hard to say. Congress has tried to get resolution — to no avail. In 2010, Congressman Markey wrote to the FDA demanding to know the agency's plans "to finalize its regulation of over-the-counter topical antiseptic drug products…which were first proposed a startling 37 years ago." He added: "The pace of the activity on the part of the FDA is especially perplexing in light of advances in science." Still, no definitive action by the agency.
But the FDA and EPA obviously think triclosan is safe enough for widespread use, or it wouldn't have allowed it to be utilized in a whole range of products now for decades. However, the unwillingness by the agencies to do their jobs has created a vacuum — one in which opponents of the substance have stepped in and created fear around the product.
In my new e-book Pandemic: The Story of Germs vs. People, I note that the disease that has perhaps killed more people than anyone in history, the plague, is caused by a bacteria — and is still active to this day. According to the World Health Organization, as of 2002, infectious diseases accounted for 25 percent of all deaths globally. Obviously, germs haven't gone away.
Antibacterial products are as important today as they have ever been. Yet because of the inability of the government to take definitive action, the fate of one substance — triclosan — hangs in the balance. And not even Congress seems to be able to make the FDA or the EPA resolve the issue.
On its website, the FDA has promised to review all the science about triclosan and publish its findings in the winter of 2012. But I will go ahead and make this prediction now: FDA will again fail to make a definitive determination.
Why is the FDA unwilling to come clean on triclosan? My guess is because even though they know it is safe, if they say so, it will anger the environmental groups who have spent years saying triclosan is dangerous. So rather than drawing the ire of their ideological allies on the political Left, they will continue to review the science and monitor the situation. So no need to run to your bathroom to throw out your hand soap, just don't look for it in bathroom at the University of Texas.


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Radiant News
Holiday Party Essentials For Your Home This Season
Each December weekend - and quite a few of the weekdays as well - is sure to be packed with party invitations, some of which you'll be sending out.
Updating Your Children's Rooms For The Winter Weather
Now that December is here, you're probably busy finding a tree, setting up the outdoor lights or taking the menorah out of storage.
Give Your Holiday Party Some Alternative Flair This Year
Christmas time is almost here, and whether you're celebrating that age-old institution or another classic like Hanukkah or even Kwanzaa, you're probably dying to throw something new into the mix.


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Tantric Fusion
Relax and be led through a spine tingling erotic journey, perfected in its purpose.
The word Tantra, literally means "to expand" or "weave" sensual energy. Yours to mine, mine to yours. The session is very erotic, gentle, and nurturing. It is a very gentle, GFE experience. You will be positioned to recieve, and guided into a deep meditative state. If you have never experienced it...allow me to explain.
It begins with a bath ceremony...
(availability varies upon facility accesssability)
Imagine yourself being disrobed within the soft glow of scented candlelight; helped into a rose petal covered bath. To relax in place where your Tantrica will soothe and lavish the most careful attention upon every inch of your aching body. Particularly those often neglected areas will be lovingly attended to.
Using a variety of soaps, scented oils and sponges your body will be caressed and relaxed. Soft hands and adept fingers will move about and caress every minute part of your physical being, massaging your head and temples, neck, shoulders, ever further down to your most sensitive areas. Even your feet and toes will not escape attention.
The warm water will melt away your stress and relieve your anxiety. In time you will begin to think only of the sacred space you and your Tantrica will soon be sharing. You will begin to feel reborn...as your newly invigorated body is gently dried with fluffy warm towels, knowing that you are only beginning your adventure.
What is Tantric Philosophy?
Tantra like Yoga or Zen, is a path to enlightenment, which has its roots in India. It is nicknamed the "science of ecstasy" and focuses on heightening and prolonging the special awareness and rapport that exists between lovers. This view holds that the greatest source of energy in the universe is sexual, and places high value on rituals. Sexual orgasm is seen as a cosmic and divine experience. Divine as it relates to the religion of tantra. Exploring such is a religious, and enlightening experience.
Tantric philosophy also teaches that everything is to be experienced playfully, yet with awareness and a sense of sacredness in every gesture, every sensory perception, and every action. The path of Tantra is a spiritual one, which includes and appreciates the experience of our sexuality and sensuality as a conscious meditation, as a flowing together of the physical, erotic and cosmic energies.
If you were a devoted student of tantric philosophy, you would go through an extensive program of physical, sexual and mental exercises to heighten your sensory awareness. Through slow and thoughtful practice in lovemaking techniques you would learn to comfortably extend the time of lovemaking. In this way you would train yourself to be aware of not only your own feelings but also those of your partner. The spiritual part of tantra is to use your sexual energy to merge ecstatically with your partner and through him or her to become one with the cosmos or god.
The art of prolonging the pleasures of lovemaking without reaching orgasm is described in the Kama Sutra, the Hindu sex manual written in the 4th century. "Karezza" is the term used to define a male's practice of pleasuring his partner and prolonging their intercourse by perpetuating his state of climax without actually ejaculating. These so called "dry orgasms", orgasms without ejaculation, are pleasurable, and still allow the sexual act to continue. The art of Karezza incorporates breathing control, meditation, work with postures, and finger pressure into the sexual act. Though sexually biased in its description as written (remember it was the 4th Century), the original focus of Karezza, prolonging the state of climax for a couple's mutual enjoyment, easily translates to both partners actively participating in learning to prolong their enjoyment before reaching orgasm.
Understanding Tantric Bodywork...
The Tantric meditation will make you feel as if you are in a trance, where physical boundaries dissolve, time disappears, worries and problems no longer seem important, or are forgotten altogether.
We will begin by having you recline on your back with pillows under your head and a towel covered pillow supporting your hips. Your legs will be slightly apart, your knees just a little bent. Your abdomen, thighs, feet, toes, chest, nipples and fingers are then gently touched with warm aromatic oil. Nothing will escape attention. Your energy flow is stimulated and senses awakened as your body's sensitivity increases with focus on cosmos or God. According to Tantric ideals, your entire body will touched, including those particularly sensitive areas.
Perceptions of sensuality and lust are located here, but these "intimate" areas are an important source of joy in life. You will feel relaxed, yet wide awake. You will be coached to breathe properly, as you sink into yet deeper level of relaxation. In this very loving ceremony you will be completely nurtured and pampered in the arms of your goddess, giving you a feeling of comfort and sense of well-being.
Touching a man...
At first blush it seems a simple proposition. Anyone can do it. However, the reality can be as different as "chopsticks" is to a Brahms concerto. A "stick figure" compared to a to a Vermeer painting.
The male body must first be understood before it may be played in the same manner as a virtuoso commands a musical instrument. Unfortunately most women have only marginal or little understanding of the male anatomy. The inevitable ineptitude often produces sour notes. [Conversely the same can be said about men and their level of appreciation for the female body, but this is another subject entirely.]
The problem stems from the fact that male and female genitalia are entirely different from one another. Understandably, the result is that it's difficult for a woman to know how to best touch a man. Despite the fact that a woman's clitoris is something of counterpart to a man's penis, stimulating each to the pinnacle of arousal involves very different techniques. This circumstance results in a host of faulty assumptions, guesswork and experimentation. While some women may mimic the techniques they might have seen in "Blue" movies, others may attempt to refer to what they've read in a range of publications.
Ultimately the majority simply proceed by trial and error, in the hope that their partners response will serve as a guide. The drawback with this methodology is that many men are not able to effectively communicate their desires verbally or may be embarrassed to make use of "show & tell". Quite a few men may not even be aware of the most effective techniques themselves.
Not surprisingly many men feel that women aren't sufficiently skilled at handling penises. Specific complaints range from grips which are too limp, to a lack conviction and exuberance. Women seem hesitant to apply pressure, and often pull or tug at inappropriate moments; continuously disrupting the all important rhythm.
Often women have little sense of how to control the ebb and flow of orgasmic sensations. My instruction, ( not demonstration I will again repeat) in tantric practice will guide you to mastery of the ceremony. A woman's hands are capable of amazing erotic pleasuring, much more than most anyone can imagine. It's little appreciated that this is an acquired talent. Subtle techniques, the male genitalia as well as adjacent erotic zones must first be understood...
Male Multiple Orgasm... It can be learned!
Any man can become "multi-orgasmic". It only requires a basic understanding of male sexuality and certain techniques. Most men's sexuality is focused on the goal of ejaculating, rather than on the actual process of lovemaking. Once a man becomes multi-orgasmic he will not only be able to better satisfy himself, but also more effectively satisfy his partner.
Technically, multiple orgasms occur in succession, without complete loss of sexual arousal in between. Women are blessed with the ability to have multiple orgasms. Not many are aware that men with proper training, can actually do the same. In the case of women, multiple orgasm means resuming sexual stimulation shortly after a first orgasmic climax, usually immediately or within a few minutes, so that a second climax may be reached. If the woman does indeed experience further climaxes during the same sexual encounter, she is said to be multi-orgasmic.
Most men mistakenly believe that being able to regain their erection as soon as possible after ejaculation and reaching another climax within some arbitrary period of time qualifies as being multi-orgasmic. This is false because the true multi-orgasmic male does not lose his erection between orgasms. Multiple male orgasms include only orgasm and not ejaculation. The only exception being, when ejaculation accompanies the final orgasm in a multi-orgasmic experience.
Before continuing it would be important to better understand the technical process involved in the " Sexual Arousal Cycle" *
1. Excitement Phase
- Vasocongestion
- Erection
- Increased heart rate
- Partial testicular elevation and size increase (Tumescence)
- Nipple erection
2. Plateau Phase
- Further increase in penis tip size and testicles
- Full testicular elevation
- Purple hue on corona (although not always)
- Cowper's gland (pre-cum) secretions
- Hyperventilation
3. Orgasm Phase (Consists of Emission & Ejaculation)
- Sperm and fluid are expelled from the vas deferens, seminal vesicles and prostate gland, causing seminal fluid fluid to collect at the base of the urethral bulb near the prostate.
- Myotonia - muscular rigidity just before the release tension
- Blood pressure and respiratory rate increase further.
Ejaculatory Inevitability (point of no return) There is a consciousness of imminent ejaculation.
- Bladder sphincter closes tightly
- Rhythmic contractions of the prostate, perinial muscles and penile shaft propel semen outward.
- A slight clouding of consciousness
4. Resolution Phase
- Erection loss
- Testes descend and scrotum thins
- Reversal in myotonia and vasocongestion
- Reduced heart rate and lowered blood pressure.
Multiple orgasms versus Ejaculatory orgasms
Both begin in the same way, moving from arousal until a point near ejaculation or "point of no return". At this point a man will experience a series of genital contractions lasting three to five seconds. These contractions are "pelvic orgasms" and at first feel like a "fluttering" or mild release of pressure. Once identified and controlled, these sensations will become progressively more intense.
When approaching "the point of no return" the goal is not to crest over into ejaculation but to decrease stimulation, just long enough to gain control over the arousal rate. Effective control can be achieved by squeezing the PC muscles. Learning to control the PC muscles is essential to sexual health and stamina.
In the diagram below, the plateau stage is represented roughly as a heightened state of arousal which will eventually lead into orgasm if stimulation is allowed to continue.
Notice how the two charts differ. In a typical singular orgasm including ejaculation, the plateau phase is reached and passed fairly quickly as the orgasm subsides and ejaculation occurs. In a multiple orgasmic encounter, the plateau phase is reached and sustained after the initial orgasm and between the next orgasm. The successive orgasms are also slightly stronger than the previous ones, if and when the man decides to ejaculate with the final orgasm. Ejaculation is optional, after several orgasms it may be decided not to ejaculate at all. In which case, the arousal pattern closely follows that of a woman and gradually declines over about an hour's time instead of declining very sharply after ejaculation.
How is multiple orgasm possible?
The male and female sexual "response cycles" are strikingly similar. The primary difference between the two is male ejaculation. Multi-orgasmic women are able to have successive orgasms if stimulation is resumed shortly after the first orgasm because they do not ejaculate (not withstanding reports that some women are able to ejaculate, as this has never been adequately scientifically explained).
Ejaculation initiates the refractory period in males. During this time, most men are unable to achieve another erection or even receive further stimulation due to the loss of sexual tension and the penis is usually too sensitive to touch. Since women are not biologically programmed to ejaculate, they do not have this annoying feature and are able to learn about and achieve multiple orgasms much easier than men.
The first key to understanding how men can have multiple orgasms is to understand that orgasm and ejaculation are distinct events, which one can learn to distinguish and separate. Most men have always accepted orgasm and ejaculation as one in the same because they happen in such rapid succession, orgasm beginning slightly before (ejaculation) then tapering off during ejaculation.
The second key to navigating the path to multiple orgasm is gaining the ability to separate orgasm and ejaculation.
The ability to separate these events involves the pubococcygeal muscle, or pelvic floor muscle, or "PC muscle" as it's more commonly known. You may know this muscle for its ability to stop the flow of urine in mid-stream. If stopping the flow is difficult, you have a weak PC muscle. If this is the case you will need to work on strengthening the PC muscle before you'll be able to have multiple orgasms. If you squeeze or contract the PC muscle you should feel like everything deep in your pelvis is being drawn upward.
Breathing Exercises
- Sit in a comfortable position relaxing the shoulders.
- Place hands on the abdomen, just below the belly button.
- Inhale deeply. Breathing deeply through the nose, so that the belly pushes out.
- Exhale fully. Exhale to a point to a point of which the belly contracts back to the spine. The pelvis and testicles may feel as if they are pulling up slightly.
- Repeat this exercise from 9 to 36 times.
Preparing yourself
Having multiple orgasms as a male is pretty remarkable, but it will take a great deal of preparation. As mentioned earlier, one of the first steps is to discover the PC muscle. It's essential to become intimately familiar with this muscle in order to learn to control it very precisely. Some of this control will come with experience, but most will come by strengthening it through regular exercise. Once it's been discovered where it is (most easily while urinating), it can be exercised anywhere, without anyone knowing.
- You can begin experimenting on your own at first (while masturbating).
- Make yourself comfortable and then begin masturbating as you might normally.
- Stop just before you reach the point of no return (the point where you would ejaculate). Contract (squeeze) and hold your PC muscle for a count of ten.
- Allow yourself relax and take a few minutes break.
- Begin masturbating again, this time bringing yourself just a bit closer to the point of no return, again contracting your PC muscle.
- Continue masturbating while paying very special attention to your own state of arousal and emotional feelings. The key here is to learn more about your own sexual response so that down the road you'll be more in control of it.
Stopping "right" before ejaculation
Continue masturbating, except this time, keep going until you reach orgasm. Right as you orgasm you should notice several contractions that signal the beginning of ejaculation in the base of your penis and perhaps even deeper inside your pelvis. As these contractions begin or preferably just before (but still during the orgasm), stop all stimulation to the penis and squeeze the PC muscle tight. You'll probably feel yourself trying to ejaculate, but hold it back! Squeezing your PC muscle effectively shuts off your ejaculation, if you are successful, and erases the refractory period.
A small amount semen may seep out, but not with any of the force you might normally experience during an unrestrained singular orgasm. If you were able to hold off ejaculating after your orgasm, start masturbating again now. It should feel as though you are still very aroused, not like you just ejaculated. You should be able to continue for a short time until you have another orgasm.
If you were unable to keep from ejaculating the first time, either your PC muscle isn't strong enough yet or you squeezed it at the wrong time. If you begin squeezing too late after the ejaculatory contractions have already begun, it is nearly impossible to shut stop the process completely. With practice you will learn the timing.
There are many possible techniques you can use to greatly increase your success in becoming multi-orgasmic. Perhaps the greatest technique you can practice is to share your experiences in becoming a multi-orgasmic man with your romantic partner. If you are eventually successful, this can be a wonderful opportunity for you to significantly increase the pleasure you both receive during lovemaking.
Overcoming problems
Undoubtedly the biggest obstacle most men will report when trying to become multi-orgasmic is failure to squeeze their PC muscle sufficiently during orgasm to ward off ejaculation. You may feel some contractions, but do not stop squeezing at this point because a few ejaculatory contractions are likely even if you are successful in eventually stopping them. If you are successful, the contractions will stop before you ejaculate and you should be able to resume stimulation without a loss of sensitivity, as would be present during the refractory period after ejaculation.
Another common problem many men may report with these techniques is failing to determine exactly where the boundaries of plateau, orgasm, and ejaculation begin and end. If you cannot determine the difference between orgasm and ejaculation, a key to becoming multi-orgasmic, you can only succeed by accident and not intentionally.
Some men may try to stimulate themselves very quickly and rigorously, and this is not the best way to become aware of your personal level of sexual awareness. Taking the stimulation slower rather than faster will allow you to discover your personal boundaries between arousal, plateau, and orgasm more easily. With these discoveries you will have a much greater chance of learning when to squeeze your PC muscle, when to stop stimulation, and when to relax your PC muscle and resume stimulation to experience another orgasm.
Pelvic pressure after arousal. Pressure in the pelvic area is a natural result of increased blood flow into the genital area. If the level of this pressure is uncomfortable, it will be helpful to breathe deeply, elevate the lower extremities and massage the perineum and testicles lightly. This will help the body assimilate the energy from the testicles to the rest of the body. It would be best also to stay in a reclined position for 5 - 10 minutes.
Other Benefits
It is quite possible that if you have other sexual problems such as premature ejaculation, learning to become multi-orgasmic will help you tremendously during lovemaking. Not only will you be able to greatly prolong the session by suppressing ejaculation until you choose, but you will be free to release your worries and anxiety and focus more on pleasing your partner. The list of positive effects can be nearly endless!
Some men may wonder if age can have any effect on the chances of success in becoming multi-orgasmic. There's no reason why sexually mature men of all ages shouldn't see the same high rate of success, assuming they are sexually active and have a high level of personal sexual awareness.
If you have no trouble reaching singular orgasms either by yourself or with a partner, then learning how to become multi-orgasmic may only be a matter of patience, determination, and effort. If you do have trouble having singular orgasms or opening up sexually with yourself and your partner, however, then perhaps there are other issues that you need to deal with before multiple orgasms will be a possibility for you. This guide is not prepared to address any problems with orgasms beyond the relatively simple matters discussed in this section. If you are experiencing more serious problems, please consider consulting your healthcare provider or a therapist. They should be able to provide you with the professional advice that we are not equipped to handle.
Ancient Ideas
The concept of being a multi-orgasmic male is not new at all. Ancient Chinese philosophers called Taoists, have known about this and many other profound sexual concepts and practices thousands of years ago. Many of these sexual secrets remain surprisingly unknown, even now in the age of sexual awareness and liberation. Despite the fact that during the 1940s and 1950s several sex researchers in the West studied and confirmed the ability of males to experience multiple orgasms. Even at present, the amount of sexual ignorance, misdirection, and confusion is astonishing.
In Closing
The bottom line is that your ability to have multiple orgasms depends on your overall sexual awareness, and the strength and control of your PC muscle among many other factors. As with all noteworthy achievements, this is not something that can necessarily be accomplished all at once. While reading this guide and having multiple orgasms in one night is certainly possible, you should understand that it could take several weeks or even months before you succeed. Your results will depend on your own personal effort and determination.
Please note that the tantric experience is not available for purchase. Any monies exchanged is solely for membership to my website. Should we agree to meet personally and further explore the topic presented on this website, you agree that it is a matter of choice between two consenting adults. Contacting me in any manner constitutes agreement to these terms.


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Flames NewsFlames Home > Football Home > News
LFSN 2013 Opponent Preview: Monmouth
Each week during the 2013 football season, the Liberty Flames Sports Network will preview the Flames' upcoming gridiron matchup, continuing this week with a look at Monmouth.
The Flames will begin their 25th season of competition at Williams Stadium on Saturday against a first-time opponent, but one that will become a familiar foe.
Liberty will face the first of four first-time teams on its 2013 when it welcomes the Hawks to Lynchburg on Saturday. Liberty will start to regularly face Monmouth in the future as the Hawks will join the Big South Conference as an associate member for football only in 2014.
Just like the Flames, Monmouth is coming off a Thursday night opening road loss, as the Hawks dropped their 2013 lid-lifter to No. 2/2 Montana State last week, 42-24.
Kickoff is set for 7:07 p.m. and the game will be televised on the newly expanded Liberty Flames Sports Network and ESPN3. For more information about the game, visit Liberty's Game Day Central page.


text: JB - Unregistered July 23, 2009 1:58 PM I think that it is great that they are coming to Brands. If I remember correctly, Hannspree done the same last year in supersport but got disqualified for using WSBK fuel. The more green the better I say!!! 4 agree 0 disagree


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If it is less costly pfsense or cisco, has nothing to do with my
request: a monowall with carp would be well accepted.
Actually, there are more reasons which make me prefer monowall to
pfsense (i.e. not mounting a flash disk for intensive work and/or
swapping, better shaping, impressive I/O performance), which are valid
for all, despite of local needs.
Instead, network topology and network features are topics which are
competely different from company to company, so you cannot make a
general assumption.
Il 01/01/2011 14:34, Klaus Stock ha scritto:
> ?> We switched from monowall to pfsense only for redundancy reasons,
> but we
>> miss speed and semplicity of monowall, and we'd love to switch back
>> whenever possible.
> I suppose that a major part of the speed and simplicity of m0n0wall
> vs. pfSense is that such "exotic" features are being left out.
> A fully redundant internet connection with fully transparent
> (unnoticeable) failover also requires quite a bit of complexity on the
> internet provider's side, which makes it so costly that very few
> people actually consider this. And if you pay $$$ for the neccesseary
> infrastructure on the provider's side, you might as well afford to
> spend a bit more money for labor and hardware on your side.
> Unless you plan on using it only for an inner firewall. Here you might
> get away by not using a single HA firewall (with CARP and enerything)
> but by two separate simple firewalls. This assumes that you have
> redundant machines both in the DMZ and the backend. So one firewall
> betwen pirmary DMZ machine and primary backend nachiness, and another
> one between secondary DMZ and backend machines. The failover machnism
> which switches for primary DMZ to secondary DMZ machines may then take
> also care of failing backend machines or inner firewalls.
> And still pfSense appears more accessible that what for example Cisco
> has to offer ;-)
> Best regards, Klaus
Inter@zioni Interazioni di Antonio Nati
http://www.interazioni.it tonix at interazioni dot it


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Six Flags Magic Mountain Grad NiteIf you have questions in regards to an
existing trip, please click here. Otherwise:
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You can ride the extreme roller coasters all night long with little to no lines. See live performances by hot contemporary artists, and groove to the music at multiple DJ dance clubs. Enjoy everything Magic Mountain has to offer with these exclusive events not open to the general public!
USA Student Travel makes your Six Flags Magic Mountain Grad Nite the very best it can be. We can include whatever you need from transportation, hotel stay, admissions, additional tours and attractions, meals for the trip, liability insurance, invoicing, and staffing on-site. With USA Student Travel your Grad Nite will be a blast!
- All-night Private Party (11:00 PM–5:00 AM)
- DJ's playing top hits on multiple stages with dance areas
- Access to extreme roller coasters all night long
- Safety #1 Priority!
- Exclusive controlled event—no student in & out privileges
- Open exclusively to seniors and chaperones—not open to the public
- Only buses and chaperone driven vehicles allowed
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Park admission is limited and available on a first-come, first-served basis.
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2016 Grad Nite Dates:
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text:
Laurea in Biology: University of Rome "La Sapienza"
PhD in Biology: Yale University
Senior Research Scientist and Lecturer, Department of Ecology & Evolutionary Biology, Yale University
Director of Center for Genetic Analyses of Biodiversity, Yale Institute for Biospheric Studies
Director of DNA Analysis Facility in Science Hill
CV complete CV
Contact email@example.com 203-432-5259
Additional Positions
Associate Editor for Conservation Genetics, Journal of Heredity, BMC Evolutionary Biology, Zoo Biology
Curatorial Affiliate, Vertebrate Paleontology, Peabody Museum, Yale University
Conservation Science Panel Member for SEI (Sustainable Ecosystems Institute)
Member of the Wildlife Conservation Society (WCS) Science Resource Center
Council Member for Society for the Study of Evolution (SSE) and Systematic Biology Society (SSB)
Chair of the SSE International Committee
Course Offerings
Molecular Approaches to Systematics, Conservation Genetics, and Behavioral Ecology (EEB 375)
Laboratory for Evolutionary Biology (EEB 226Lb)
Laboratory in Molecular Systematics (EEB 315La)
Conservation Genetics (EEB 320)
Molecular Ecology (EEB 326)
My research interests span molecular evolution, phylogeography, and conservation genetics. Visit the CGAB website for a comprehensive list of Current and Past Projects, People and Publications.
Questions that interest me range from understanding the evolutionary processes in small isolated populations, to the use of molecular markers to infer current and historical population processes at various spatial and temporal scales. I am question driven rather than organism bound. Thus, I work with a variety of invertebrate and vertebrate taxa. As Director of the YIBS, Molecular Systematics and Conservation Genetics Center, I facilitate training in the use of molecular tools to approach a wide variety of organismal and environmentally based questions, for undergraduate and graduate students, post-doc's and faculty.


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Warner, N.H. • Maxine Kumin, a prolific New England poet and U.S. poet laureate who won the Pulitzer Prize in 1973 for her work "Up Country," has died. She was 88.
The Bennett Funeral Home in Concord says Kumin, who wrote more than three dozen books of poetry, fiction, non-fiction and children's literature, died Thursday at her home in Warner after a year of failing health.
Kumin was an advocate for women writers, human and political justice and animal rights. Her final work, "And Short the Season," is scheduled to be released later this year.
Born in Philadelphia, she graduated from Radcliffe College and lived for a while in Newton, Mass.


text:
AUS-Tasmania-L ArchivesArchiver > AUS-Tasmania > 2005-12 > 1134462279
From: "Chris Beasley" <>
Subject: Re: [AUS-Tas] Legal name change
Date: Tue, 13 Dec 2005 19:24:56 +1100
References: <010401c5ffa1$5ef291a0$93108aca@oemcomputer>
Hi Ray and others interested
I am facing something in regard to this dilemma at the moment with one of my
great ggrandmothers having had 3 illegitimate children by one party and
another 8 by her next partner The first three having adopted the succeeding
partners surname and also having in at least two of the cases a change in
forename as well
The three of them lived and died with the adopted names and from what I can
gather were happy to do so,
the connection to the biological father completely and utterly severed
If these offspring were happy enough to adopt another mans name ,then so am
Sometime in the future I may go back and chase up that biological connection
but for me, at the moment ,the other family holds far more interest
There is no compulsion on us as researchers to follow any particular line
and in my case I seem to follow the path of least resistance until something
beckons me back to the trail I started from and when you're looking for the
family connections of 16 gggrandparents things can get pretty messy my
advice would be to chill out and go with the flow
If anyone has an issue with the way you've approached your data entry, let
them sort it out
cheers Chris in Tremont
----- Original Message -----
From: "Ray Edmunds" <>
To: <>
Sent: Monday, December 12, 2005 5:49 PM
Subject: Re: [AUS-Tas] Legal name change
> Hi,
> I think Bob raises an important issue of ethics here, and is right to say
> that each researcher must determine their own standard. However, there are
> a
> number of aspects which should be considered in reaching such a decision.
> I think it is important to recognise that, for what ever reason, a person
> has
> a right to choose to adopt a surname different from their birth name,
> use this name throughout their life (without changing it by deedpoll), and
> maybe raise a family who are registered under this name. In such a case I
> think it incumbent upon us to respect that person's decision. If we
> don't then we also compromise them and their descendants right to that
> name.
> How do we treat those who change their name by deedpoll?. Do we ignore
> this
> more emphatic desire to rid themselves of a previous birth, and sometimes
> painful, surname or, as Bob suggests, rename them and their descendants
> with
> their birth surname? If we say that a name changed by deedpoll is a legal
> change and thus acceptable, why then treat an informal change any
> differently, after all their desire for a change of recognition is the
> same
> in both cases.
> To arbitrarily change the surname to what may have been the birth name
> can,
> in my view, be disrespectful and unethical.
> We can incude an alias - true or false - in our family's history and make
> appropriate comments of explanation.
> Most family history programs have a AKA (Alias) facility and the ability
> to
> make a qualifying note, which can be included in a printout. The ability
> to
> recognise an alias and qualify its use is, in my view, the proper way of
> highlighting the birth surname, particularly where it has not been used.
> These are some of the issues we should consider before deciding our
> standard;
> or is it not a universal genealogical standard?
> I will be interested to hear what other listers have to say on this
> fairly
> important subject.
> Regards.
> Ray E
> ----- Original Message -----
> From: "Bob Millman" <>
> To: <>
> Sent: Wednesday, December 07, 2005 11:50 PM
> Subject: RE: [AUS-Tas] Legal name change
>> Surely the registered birth name to be entered as the name of the person.
>> Any other name would be considered an alias of this name. Depending on
>> the
>> particular program being used the method of entry of the alias would also
>> vary accordingly. I have an ancestor who was registered under certain
>> birth name but was always referred to under a different name. I have
>> entered this alternative name as an additional name.
>> You may wish to establish your own standard for identification of your
>> ancestors but usually birth registration name is accepted as the norm.
>> Bob
>> --
>> No virus found in this outgoing message.
>> Checked by AVG Free Edition.
>> Version: 7.1.371 / Virus Database: 267.13.12/193 - Release Date:
>> 6/12/2005
>> ==== AUS-Tasmania Mailing List ====
>> Tasmanian Sites of Interest
>> Decisions of the Nineteenth Century Tasmanian Superior Courts
>> http://www.law.mq.edu.au/sctas/index.htm
>> --
>> No virus found in this incoming message.
>> Checked by AVG Free Edition.
>> Version: 7.1.371 / Virus Database: 267.13.13/197 - Release Date:
>> 9/12/2005
> ______________________________
This thread:
|Re: [AUS-Tas] Legal name change by "Chris Beasley" <>


text:
Shun Kageyama
He, for most of the series, operated as Kamen Rider TheBee, acquiring the TheBee Zecter after Kagami relinquished it. Prior to it, Kageyama was originally under Yaguruma's command and a good friend of his, believing deeply in his superior's philosophy of teamwork and "Perfect Harmony". After TheBee Zecter rejected Yaguruma and chose Kagami, Kageyama attempted to make Kagami understand his new responsibilities. He was baffled when Kagami rejected TheBee Zecter in favor of his friendship with Tendou, whom he developed a grudge against.
Becoming the new leader of Shadow, Kageyama turned his back on Yaguruma and used many methods that contradict his former mentor's beliefs of "Perfect Harmony", Tendou saw Kageyama unfit to be a leader. Overtime, Mishima also sees Kageyama as being unable handle the missions assigned to him. Eventually, Kageyama is defeated by a vengeful Yaguruma who relieved him of the TheBee Zecter which ended up in Tendou's possession. No longer qualified as TheBee, Kageyama was ousted from the Shadow elite and cast into humiliation and shame. Battered and broken in both body and mind after being facially scarred in the crossfire between Shadow and the Worms, Kageyama is saved by Yaguruma, who once again invites Kageyama to hell, this time giving him his own Hopper Zecter as a present which allows him to transform into Kamen Rider PunchHopper. Now under Yaguruma's wing, he refers to him as "aniki" (Bro or boss).
Once their partnership formed, both Kageyama and Yaguruma set out for revenge against Kabuto by ambushing him and Gatack within an abandoned factory. Kick and PunchHopper demonstrate their new abilities, easily defeating Kabuto and Gatack in a matter of minutes after the two were weakened by the activation of the 'Red Shoes' system. Unlike Yaguruma, Kageyama is not completely into the darkness yet and Yaguruma often corrects his way of thinking whenever Kageyama shows signs of 'reaching the light'. This is first shown when he tries to grab onto a bit of light after meeting a young girl who he defends from Leptophyes Worm. Yaguruma tells him that his way of thinking is wrong and even the slightest bit of light will destroy them. After discovering the girl Kageyama saved early had become a Worm, PunchHopper along with Kick Hopper annihilate the Worms together, and they manifest in their own power. Kageyama once again questions the value of the light, but Yaguruma tells him that they live in a world of darkness, and that he should not seek the light.
Kageyama works with Yaguruma in an attempt to destroy a confused and weakened Rena Mamiya during episode 40, in hopes of eliminating her early. Their attempt almost works, but Rena is saved by Kamen Rider Drake along with Gon, who distracts them, allowing their party to escape. Their plan did have a side effect however, resulting in a recovery of Rena's Worm memories. Kageyama later asks Yaguruma why he didn't kill her, and an extremely happy Yaguruma answers by saying that he has indeed taken a liking to her. Even more so, Yaguruma protects Rena from Subst Worm when she is endangered. This led to an infuriated Kageyama, as it went against their beliefs of abandoning the light. Yaguruma is shocked however, when he gets rejected by a temporary Uca Worm, and his bond with Kageyama is restored.
During episode 41, Kageyama and Yaguruma defeated Tsurugi, and through depressed, Tsurugi is tricked into joining them. The trio then eventually encounters Reiji Nogi who makes short work of them using "reflect" to use all their Rider Finishers against them. Kageyama and Yaguruma watch as Reiji Nogi advances on Area Z during episode 44, and Kageyama wants to help them fight, but Yaguruma laughs at him for trying to be an ally of justice. Kageyama reverts to his old self briefly and picks up the abandoned TheBee Brace, until after being defeated by Reiji Nogi. Ultimately, he returns to his old style and becomes PunchHopper again. Kageyama also follows Yaguruma's way of regaining the darkness by binding himself with chains. He ignores Tendou's request for help, stating that he will not help humans. Along with PunchHopper, KickHopper defeats Cassis Worm Clipeus in episode 46. The two Hoppers utilize the Rider Jump function to send Cassis Worm flying into the air, destroying him with a Rider Kick and Punch as he falls down.
Kageyama then becomes one of the many looking for the Worm identification necklaces, believing them to be useful in his mission. Upon seeing Kageyama with a Worm identification necklace, Tendou tries retrieving the device but failed. In episode 48, Kageyama tells Yaguruma that he has become a Native and can no longer control himself due to fact that having three Native necklaces sped up his transformation. As a show of pity, he uses a Rider Kick to end Kageyama's suffering. As Kageyama dies in Yaguruma's arms, Yaguruma mentions that after all they've gone through, the two will always be partners. They will look to the light for a new future.
Kamen Rider DecadeKageyama later appears in Kamen Rider Decade episode 2 and 3 with his partner KickHopper appear in the World of Kuuga during a dimensional distortion caused by Narutaki to fight Decade. However, when they start focusing their rage on Kuuga, Narutaki causes another dimensional distortion that sends the two to another world where Kamen Riders Delta and Tiger appeared to be waiting.
Diend later summons Punch Hopper in the World of Decade to fight Kick Hopper. They fight and Kick Hopper appears to have the upper hand, but the result of the fight is not shown.
This Kageyama also might be an A.R. version of Shun Kageyama as the one in the original series died during the last episode of Kamen Rider Kabuto.
OOO, Den-O, All Riders: Let's Go Kamen Riders
Kamen Rider PunchHopper was part of a group of reinforcement riders led by Akira Date/Kamen Rider Birth to aid the primary riders in defeating the Rock Great Leader. All the Kamen Riders got on their bikes and performed the All Rider Break attack which destroyed the Great Leader. It is unknown whether this PunchHopper is the A.R. World version or the revived original version from the main series.
Video Game appearances
Kamen Rider Kabuto video game
Kamen Rider PunchHopper appears with the other Kamen Riders in the Kamen Rider Kabuto video game.
All Rider Generation 2
Kageyama, alongside Yaguruma, are unlockable characters after the game is cleared.
Fighting Style
As either TheBee or PunchHopper, Kageyama uses a fighting style themed around punching attacks.
Originally, Shun fought as Kamen Rider TheBee, but after losing those powers, he became Kamen Rider PunchHopper, alongside Sou Yaguruma, who became Kamen Rider KickHopper.
|~ Transformation announcement
- Height: 192cm
- Weight: 127kg
Ability Perimeters
- Punching Power: 8t
- Kicking Power: 9t
- Maximum Jump Height: 21m
- Maximum Running Speed: 100m/8.6s
Kamen Rider TheBee's (仮面ライダーザビー) strong, heavily armored, but less offensive form resembling a beehive. This the default form until the rider rotates TheBee Zecter around the wrist to initiate the Cast Off! command.
|Cast Off! Change Wasp!
|~ Transformation announcement
- Rider Height: 192cm
- Rider Weight: 92kg
Ability Perimeters
- Punching Power: 3t
- Kicking Power: 6t
- Maximum Jump Height: 39m
- Maximum Running Speed: 100m/5.6s
- Finisher Power: 17t
TheBee's sleeker, faster, and more offensive form which morely resembles the wasp motif. In this form TheBee can initiate the Clock Up command to travel at near light speeds match the speed of Worms. By pressing a button on TheBee Zecter, the Rider Sting tachyon-powered punch is activated, allowing the user to pierce through a Worm with the stinger on the TheBee Zecter.
|Henshin! Change PunchHopper!
|~ Transformation announcement
- Rider Height: 192cm
- Rider Weight: 93kg
- Ability Perimeters:
- Punching Power: 3t
- Kicking Power: 6.5t
- Maximum Jump Height: 39m
- Maximum Running Speed: 100m/5.6s
- Finisher Power: 19t
Unlike all of the other Riders in Kamen Rider Kabuto, the Kamen Rider Hopper Series Riders only have one form that they transform into. Kamen Rider PunchHopper (仮面ライダーパンチホッパー) has a black Acrida cinerea motif and by raising the legs on the Hopper Zecter, PunchHopper can jump high into the sky. By lowering the legs on the Hopper Zecter, the energy is concentrated into a tachyon-powered Rider Punch. The impact upon landing on the ground again powers up another punch.
TheBee's ArsenalTheBee Zecter
- Device Type: TheBee Brace ('Henshin' Brace)
- Animal: Animal: Bee or wasp
- Color: Yellow
- Cast Off System: Flipping the TheBee Zecter's wings out, then rotating the Zecter clockwise 180°.
- Cast Off Announcement: "CHANGE WASP!!!"
- Clock Up System: Slip fingers along the Trace Switches on the ZECT Buckle.
- Primary Finisher: RIDER STING - A power charge begins when the button on TheBee Zecter is pressed. When attacking, TheBee uses the prick-stinger of the Zecter Needle to punch at the Worm. Because of its extended charge-life, TheBee can deal consecutive 'stings'; usually when confronted by multiple opponents. This is a variation of the classic finisher "Rider Punch."
Rider Brace: The device that is used to call upon the TheBee Zecter. It serves as the docking device for the TheBee Zecter and allows for the transformation. Zecter Needle: A prick-stinger used to perform Rider Sting attack. It has extended charge-life and can be used to destroy multiple opponents.
Machine Zectron: Standard-issue bikes for each Rider; mass produced by ZECT. Zectron Pinch is the standard weapon equipped to the bike. It launches a molecular shock forward, ridding any obstacles ahead. Each Rider has its respective symbol located on the windshield of the bike. Kamen Rider TheBee under Sou Yagurama was the first Rider to use his Machine Zectron.
PunchHopper ArsenalRider Belt: A standard belt produced by ZECT that is capable of holding the Hopper Zecter. The front of the belt flips down to reveal a latch where the Hopper Zecter can then be docked onto.
Hopper Zecter [Red Side]
- Device Type: Rider Belt ('Henshin' Belt)
- Animal: Grasshopper
- Color: Brown
- Change Announcement: "CHANGE PUNCH HOPPER!!!"
- Primary Finisher: RIDER JUMP >>> RIDER PUNCH - Punch Hopper's finishing attack; When the legs of the Hopper Zecter are pulled up, a charge surges to Punch Hopper's right leg where he leaps high into air. From here, he sets up his attack by pulling the Hopper Zecter's legs back down (to default position) and attacks off his right arm with a punch from above. With the aid of the Anchor Jack, Punch Hopper takes the power of several lightning-fast punches, plus the tachyon energy released from the Hopper Zecter's core, and channels it all into one massive attack, causing tremendous damage to the victim.
Anchor Jack: The gold-joints installed onto the right arm of Punch Hopper. Shaped like grasshopper legs, these joints have the ability to click down and rebound back up. This rebounding force helps Punch Hopper punch multiple times at high speeds.
Rider Cards
- Kamen Ride: Punch Hopper: A Rider Card containing the power of Kamen Rider PunchHopper. Used by Diend to summon Kamen Rider PunchHopper. First used in the World of Decade to fight Ouja and KickHopper. Also available to be summoned by Diend in Kamen Rider: Climax Heroes OOO.


text:
Sports and Celebrity Dinners
Through our extensive network within the bespoke event business we offer our clients only the very best and most unique dinners and lunches within the UK. Each event is held at the most prestigious venues that the UK has to offer, with the greatest sporting heroes of our time combined with the funniest entertainers within show business, all adding up to a first class experience for you and your guests.
Some of the recent events we have procured for our clients include distinguished celebrities and speakers from the likes of Fabio Capello, Marco Pierre White, Martin O'Neill, Melanie Sykes, Chris Evans, Michelle Platini, Sir Viv Richards, Andrew Strauss, Ricky Pontin, Sir Ian Botham, Sven Goran Eriksson, Mark Ramprakash plus many many more…
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Our network of  famous Sports Stars, Football Legends and Public Celebrities have all made their names on the highest stage, within their respective fields. We work with our Celebrities and Personalities so that their skills and roles at your event can be adapted to your specific requirements and budget. This can range from an appearance at your corporate or social event, offering your guests the opportunity to mix with the previously untouchable through to a motivational speech from someone with the experience and knowledge to inspire others.
Get in touch to discuss how we can work with you to organise your own corporate event with a celebrity
We put tremendous energy, creativity and passion into what we do, and working with clients on an individual basis, we can help you to create a dinner or event theme to include the private and exclusive provision of your very own celebrity guests and speakers which will make your event truly unique and memorable for all involved.
We will provide a full management service of your event, including the careful selection of your venue, theme and guests celebrities and speakers. We will take care of every element from the creation, format and itinerary, right through to the execution, tailoring the event to meet your specific requirements and budget.
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- Company Anniversaries
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- Christmas Dinners & Lunches
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If you would like some more information on the Sporting & Celebrity Dinner packages we can provide tailored to your every requirement, please contact us on 0116 2753323 or use the contact form.


text:
Slit This One Out Floral Tunic
€15.00 €30.00
style #AGG99485-1Add to Crushes
Slit This One Out Floral Tunic
€15.00 €30.00
Slit down. This tunic top features a floral design, scoop neckline, midi silhouette, and slit at front. We love it with a fedora and shorts.
Details and CareFabric: 95% Polyester, 5% Elastane. Machine Washable. Model wears Size S/M.
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