text:
HonorHealth Medical Group - Paradise Valley - Primary Care
Putting your needs first and delivering superior healthcare are the objectives of the family physicians and staff at this office.
The doctors here specialize in family medicine and treat patients age 10 and older. Opening early to accommodate busy schedules, the office is accepting new patients and offering same-day appointments.
For your convenience, a technician draws blood for tests that are sent to a nearby lab for quick results. The medical assistants perform the EKG testing.
The office is located on East Shea Boulevard just east of North Tatum Boulevard, near the Paradise Village Gateway shops. Plentiful parking is available in front of and around the building.
Family physicians and staff in the HonorHealth Medical Group's office in Paradise Valley treat you the way they want to be treated. They provide compassionate care and take the time to listen carefully. They avoid academic terms and explanations, taking care to answer all of your questions in easy-to-understand language.
That's important to patients. In a follow-up survey, one patient said, "I'm a new patient — just moved here — and have had the same doctor on the East Coast for a very long time. The doctor and her staff here were gracious, polite and thorough. I'm so glad I chose them."
Another patient commented, "The doctor excellent. I can't think of anything I could say that would improve my experience with her. She's great. I appreciate you calling and asking about this. It means a lot to me."
This dedicated team of doctors and staff are proud to be on a first-name basis with their patients. They look forward to becoming your partner in healthcare.
Primary Care Hours
Monday - Friday: 7 a.m. to 5 p.m.
See the Patient Resources page for forms, information about appointments, cancellations, billing and more.
Our Team
Contact & Location
HonorHealth Medical Group - Paradise Valley - Primary Care
5010 E. Shea Blvd., Suite D100, Scottsdale, AZ, 85254
Featured Services
Medical Group Services
- Assessment and treatment of all illnesses and accidents
- Blood pressure management
- Cholesterol management
- Chronic disease management
- Complete physicals
- Diabetes management
- EKGs
- Family medicine
- Headaches and migraines
- Health risk assessment
- Immunizations
- Lab on-site
- Medicare physicals
- Minor surgery/suturing
- Osteoarthritis and joint pain
- Pap tests
- Pre-operative exams
- Preventive care/Health screenings
- Pulmonary function testing
- School/sports physicals
- Well child exams
- Well woman exams
- Wellness visits (annual)
- Women's Health


text: 4/18/11 4/16/11 POPSUGAR Celebrity Rachel Bilson Pictures of Rachel Bilson With Huge Dog Rachel Bilson Rides a Huge Dog During a Lunch Date April 16, 2011 by Lauren Turner 2 Shares Chat with us on Facebook Messenger. Learn what's trending across POPSUGAR. View on One Page Photo 5 of 10 Start Slideshow ADVERTISEMENT () Share This Link Copy ← Use Arrows Keys → 5 Previous Next Rachel Bilson

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Manny Canseco Photographer
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Mr. CANTOR. I rise in opposition to this conference report.
Mr. Speaker, the flow of credit and capital throughout the financial system is the building block of American prosperity. It has enabled entrepreneurs to pursue their ideas. It has enabled people to balance their budgets, to achieve a better standard of living. But when businesses and families cannot access capital from banks, consumers don't spend, small businesses hunker down, and investment dries up. The economy simply can't grow jobs.
This legislation is a clear attack on capital formation in America. It purports to prevent the next financial crisis, but it does so by vastly expanding the power of the same regulators who failed to stop the last one.
Dodd-Frank is the product of a tired and discredited philosophy. It's the notion that you can solve a problem by reflexively piling vast new layers of bureaucracy, regulatory costs, and taxes on it. And who'll pay the price? It won't merely be the big banks who the bill's supporters rail against. Smaller, less-leveraged community banks will have a more difficult time surviving the regulatory costs. And most alarming, costs will be passed on to consumers and businesses in the form of higher prices for credit. We know this because last year's Credit Card Act is already having just that effect.
Before it was passed, Republicans warned that more government expansion and more Washington proscription would create additional costs borne by the consumer. It was common sense, and sure enough, we were right. In response to that legislation, lending rates were reset higher as credit became less available. Meanwhile, free checking accounts are becoming a relic of the past for all but the wealthiest bank customers.
Republicans agree that the financial system needs a shake-up to bring transparency and stability. But the fact is, Mr. Speaker, this legislation does not accomplish this goal. It's bad for private business. It's bad for families, and I urge my colleagues to vote ``no'' before we do any more damage.
Source: http://thomas.gov


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This cool Serenity Cake was made by The Bunny Baker. Serenity is the name of the spaceship in Joss Whedon's TV Series Firefly and movie Serenity. The detail on this cake is terrific. It looks more like a toy version of Serenity than a cake.
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Learning curve for laparoscopic staging of early and locally advanced cervical and endometrial cancer
- First Online:
- Received:
- Accepted:
- Citations
- 686 Downloads
Laparoscopic staging is rapidly evolving as an important surgical approach in the field of gynecology oncology. However, the specific learning curve associated with this approach remains poorly investigated. This study aimed to evaluate the learning curve for laparoscopic staging of uterine cancers.
A series of 28 consecutive laparoscopic hysterectomies with or without pelvic and/or para-aortic lymph node sampling for the treatment of early and locally advanced endometrial or cervical cancer were performed between July 2008 and January 2011. The analyses of the learning curves of the institution were performed for 20 patients who had undergone pelvic lymphadenectomy and/or para-aortal lymph node sampling. The learning curve period has also been compared with the last 26 patients who received laparotomy staging ("open" group) due to the same diagnosis and by the same surgical team. To assess the short- and long-term outcomes, we used validated questionnaires to record the clinical and follow-up results, any complaints or subjective reports from the patients, and details of their quality of life. All data were collected prospectively in a database and reviewed retrospectively. The learning was evaluated using the cumulative sum (CUSUM) method.
The CUSUM learning curve consisted of two distinct phases: phase 1 (the initial 9 cases) and phase 2 (the subsequent cases) which presented the mastery phase, with the operative time of 397.7 ± 63.5 versus 300.6 ± 19.4 min (p < 0.0001). The significance of the difference between the two phases and "open" group changed in terms of number of lymph nodes retrieved, intra-operative blood loss and hospital stay. The conversion rate of phase 1 was higher than phase 2 [2 (22.2 %) respectively 1 (9 %)].
This series confirms previous study findings concerning the feasibility and the safety of laparoscopic staging and provides information for surgeons in single centers considering adopting an endoscopic strategy to monitor the different aspects of outcomes during the implementation process for internal benchmarking. The operative outcome of laparoscopic staging intervention improves with experience. The data reported in this article suggest that after a learning curve of 9 patients, a relevant improvement at least regarding the duration of the operation can be achieved for experienced surgeons who start performing laparoscopic staging of uterine cancers. However, due to the limited number of patients as well as number of para-aortic lymph node sampling procedures, further studies are required for firm conclusions to be drawn.
KeywordsCervical cancer Endometrial cancer CUSUM Learning curve Operative time Laparoscopic staging
Cervical and endometrial cancers are, respectively, second and fourth most common malignancy in women worldwide [1]. The most frequently considered treatment of patients with these two gynaecologic malignancies is total and radical hysterectomy, and depending on the histopathologic findings, the staging procedure can encompass bilateral salpingo-oophorectomy, pelvic and para-aortic lymph node dissection, omentectomy, and peritoneal biopsies which traditionally are performed with laparotomy [2]. During the last decade, laparoscopic surgery has been widely used because of its clinical advantages such as reduced post-operative pain and rapid recovery over open procedures and has also been considered as an innovation in surgical instrumentation and technology in gynecologic oncologic field of surgery [2, 3].
While an increasing number of centers are adopting minimal invasive strategies in gynecological oncology, the goal is to identify and set specific quality parameters during the process. The acquisition of competency in novel surgical techniques represents a "learning curve" [4]. Defining a learning curve for laparoscopic procedures is a complex process; however, the identification of the number of cases necessary to achieve competence is a crucial factor, which could facilitate more effective training and integrating the laparoscopic methods [4, 5, 6, 7, 8, 9, 10, 11, 12]. The learning curve, in addition to being a function of the surgeon's understanding of the new technique, is improvements in support staff and peri-operative care [6, 9]. Furthermore, it is an important aspect of quality assurance in patient care [10]. A learning curve that defines the number of performed cases necessary to achieve a sufficient level is a graphic representation of the relationship between the experiences of performing procedure with the outcome variables that are of clinical interest [7].
Only a limited number of publications report on multi-dimensional assessment of the learning curve, including operating time, conversion rate, intra-operative complications, and post-operative complications in a new integrated surgical technique [13, 14, 15, 16, 17].
To the best of our knowledge, no study in the field of laparoscopic staging in cervical and endometrial cancers has used cumulative sum analysis (CUSUM), which transforms raw data into running total data deviations from their group mean, enabling investigators to visualize the data for trends not discernible with other approaches [11, 12]. In our institute, at the beginning of integrating laparoscopic staging, high clinical outcomes including tumor free resection boarders, complication-less operations and minimal bleeding have been set as primary aims in all the patients. Due to this fact, we have only investigated operating time as the main evaluating factor in our learning curve and investigated the changes in goal outcomes during the learning curve. This study aimed to analyze the initial learning curve for laparoscopic staging in cervical and endometrial carcinoma using CUSUM methodology.
Materials and methods
In July 2008, it has been started to use laparoscopic intervention in patients with early stages of endometrial or cervical cancers at the department for Gynecology and Obstetrics of the University of Heidelberg Medical School. Between July 2008 and January 2011, 28 consecutive patients underwent laparoscopic hysterectomy with or without pelvic (PEL) and/or para-aortic lymph node sampling (PAS) for the treatment of early and locally advanced endometrial or cervical cancer at our department. In this retrospective study, the patients who underwent laparoscopic staging in the mentioned period of time ("laparoscopy" group) have been compared with the last consecutive 28 patients who received laparotomy staging ("open" group). All these patients were preoperatively diagnosed as early stages of endometrial or cervical cancer and have been operated by the same team of surgeons. Demographic data, intra-operative findings, procedures details, post-operative parameters, morbidities, and outcomes were collected prospectively in our database and reviewed prospectively. To assess the short- and long-term outcomes, we used validated questionnaires to record the clinical and follow-up results, any complaints or subjective reports from the patients, and details of their quality of life. All patients have been followed up for 12–28 months.
The operative time was measured from skin incision to wound closure at completion. Conversion to open surgery was defined as any case that could not be completed laparoscopically as planned and that involved extension of the incision more than necessary for specimen extraction or creation of an alternative incision to complete the procedure. A complication was defined as any deviation from the normal intra- or post-operative course. The post-operative complication has been considered as any morbidity and readmission within 30 days after surgery. To classify the severity of the complications, we used the Dindo–Clavien classification consisting of five grades and two sub-grades.
Surgical technique in the laparoscopic group was completed as follows: under general anesthesia, the patients were placed in the dorso-lithotomy position. Mostly, the 4-puncture technique was used, a direct primary trocar was placed through the umbilicus, and the peritoneal cavity was inspected. The round ligaments were transected bilaterally, and paravesical and pararectal spaces were created by blunt dissection. In cases where para-aortic lymph node sampling was performed, one more 12-mm trocar was inserted in the left upper abdominal quadrant, and camera and surgeon's positions were changed. Pelvic lymph node dissection was extensively performed up to the parametrial area, and para-aortic lymph node sampling was performed up to the level of the renal artery with the sampling of para-caval, para-aortic lymphatic tissue as well as lymphatic tissues between vena cava and aorta.
A radical hysterectomy was performed as described in the following: the uterine artery was divided at its origin from the hypogastric artery. The ureter was then unroofed and dissected from the parametria and the bladder was dissected further inferiorly. Then, the anterior and posterior leaves of the vesico-uterine ligaments were dissected. The uterosacral and cardinal ligaments were isolated and resected as close as possible to the pelvic side walls, depending on whether a type II or type III radical hysterectomy was performed. The vaginal wall was incised circumferentially with a needle coagulator. The specimen was removed. In cases where a type I radical hysterectomy or a simple total laparoscopic hysterectomy was undertaken, there was no parametrial resection.
Demographic data, operative outcomes, and complications were analyzed by the Pearson Chi square test, Fisher's exact test and Mann–Whitney U test. A two sided p value of level of significance was defined at p value <0.05. The statistical analyses were performed using Statistical Package for Social Sciences (SPSS version 15.0 for Windows; Chicago, IL, USA).
Regarding the importance of the sufficiently performed lymphadenectomy and its considerable effect on the complexity of gynecology-oncological operations, the patients without lymphadenectomy have been compared separately; the learning curve has only been investigated in patients received PEL and/or PAS.
We used the cumulative sum (CUSUM) technique for quantitative assessment of the learning curve in laparoscopic operations which included PEL or PAS. The CUSUM is the running total of differences between the individual data points and the mean of all the data points. The CUSUM was used to assess the operative time, to calculate the CUSUM, the cases were arranged chronologically. CUSUM (SN) was defined as \({\text{SN}} = \sum \left( {X_{i} - X_{0} } \right)\), when Xi was an individual attempt and X0 was the mean operative time for all the cases. After each attempt, scores were sequentially added to the cumulative scores and was then plotted graphically. This study was approved by the Ethics committee of the Medical faculty of the University of Heidelberg.
During the study period of 29 months, 28 patients underwent laparoscopic staging of early stages of either cervical or endometrial cancer. All patients in both groups have been followed up between 12 and 28 months.
The patients in "laparoscopy" group have received the following intervention: 8 (28.6 %) hysterectomy with or without adnexectomy/ovariopexy, 13 (46.4 %) hysterectomy with PEL with or without adnexectomy/ovaropexy and 7 (25 %) hysterectomy with PEL and PAS with or without adnexectomy/ovaropexy. These staging operations were done in 17 patients with cervical cancer and 11 patients with endometrial cancer. The used technique in the patients with cervical cancer was laparoscopic radical hysterectomy. From 11 patients with endometrial cancer, 5 had undergone total laparoscopic hysterectomy and 6 had undergone laparoscopic assisted vaginal hysterectomies.
The last 28 patients who received laparotomy staging ("open" group) of early stages of cervical and endometrial cancer were as follows: 2 (7.1 %) hysterectomy ± adnexectomy/ovaropexy, 19 (67.9 %) hysterectomy with PEL ± adnexectomy/ovaropexy and 7 (25 %) hysterectomy with PEL and PAS ± adnexectomy/ovaropexy.
Generally, our "laparoscopy" group was significantly younger than our "open" group (48.8 ± 11.2 vs. 55.6 ± 10.10; p = 0.02) without any considerable differences in BMI (26.5 ± 6.0 vs. 26.73 ± 4.9). Previous operations were reported in 5 (17.9 %) patients in "laparoscopy" group (2 appendectomies, 1 cholecystectomy, 1 cesarean section (two times), 1 liver transplantation (two times)) and 5 (17.9 %) in "open" group (2 appendectomies, 2 cholecystectomies, 1 cesarean section). One patient received laparoscopic staging after two liver transplantations, which has been reported previously [18]. The operation time in the "laparoscopy" group (296.7 ± 94.4 min) was significantly longer than "open" group (221.9 ± 64.8 min) (p = 0.001). The "open" group had a higher blood loss in comparison to our "laparoscopy" group (231.2 ± 81.6 vs. 131.3 ± 103.8 cc; p < 0.0001) which was compatible with delta hemoglobin levels (2.7 ± 0.8 vs. 1.9 ± 0.6 cc; p = 0.002).
Learning curve
Operating time according to number of the cases in 2 phases of learning curve
Phase 1 patients' number
Operating time (min)
Phase 2 patients' number
Operating time (min)
Demographic and peri-operative data, comparison between two laparoscopic phases and "open" group
"Laparoscopy" group
"Open" group (26 patients)
p value
Phase 1 (9 patients)
Phase 2 (11 patients)
Phase 1 versus phase 2
Phase 1 versus "open" group
Phase 2 versus "open" group
Age (mean ± SD, years)
41.22 ± 6.7
54.7 ± 11.7
54.7 ± 9.9
BMI (mean ± SD, kg/m2)
22.5 ± 2.5
27.1 ± 5.5
26.1 ± 7.6
Previous operations
1 (appendectomy)
2 (1 appendectomy, 1 cholecystectomy)
3 (1 appendectomy, 2 cholecystectomy)
2 (22.2 %) intra-operative complications
1 (9 %) unexpected findings
Intra-operation complications
2 (22.2 %) grade IIIb
1 (9 %) grade I
1 (3.8 %) grade IIIb
Number of harvested PEL nodes (mean ± SD)
17.3 ± 7.7
22.5 ± 7.2
30.2 ± 15.8
Number of harvested PAS nodes (mean ± SD)
2 ± 1.3 (7 patients)
5.2 ± 3.1 (7 patients)
Number of total harvested lymph nodes (mean ± SD)
17.3 ± 7.7
24.4 ± 5.5
31 ± 16.6
Blood loss (cc)
222.2 ± 148.7
79.55 ± 15.6
249 ± 79.2
Delta Hb
2.3 ± 0.4
1.7 ± 0.6
2.7 ± 0.8
Post-operation complicationsa
2 grade I 1 grade IIIb (1 vaginal cuff hematoma)
2grade I 1 grade IIIb (wound colloid)
7 grade I 3 grade IIIb (1 wound hematoma, 2 wound dehiscence)
Operation time (min)
397.7 ± 63.5
300.6 ± 19.4
228.7 ± 61.5
Hospital stay (days)
14.8 ± 6.9
9.6 ± 4.0
13.4 ± 4.2
Histopathology details of studied groups
"Laparoscopy" group
"Open" group (26 patients)
Phase 1 (9 patients)
Phase 2 (11 patients)
Cervical carcinoma
8 (88.8 %)
5 (45.4 %)
12 (46.2 %)
Endometrial cancer
1 (11.1 %)
6 (54.5 %)
14 (53.8 %)
1 (11.1 %)
6 (54.6 %)
16 (61.5 %)
8 (88.8 %)
5 (45.5 %)
10 (38.5 %)
Differentiation or grade
Well (G1)
1 (9 %)
Moderate (G2)
5 (55.5 %)
4 (36.4 %)
Poor (G3)
4 (44.4 %)
6 (54.5 %)
Nodal involvement
1 (one pelvic node)
1 (one pelvic node)
9 (100 %)
10 (90.9 %)
25 (96.2 %)
Lymphovascular permeation
1 (11.1 %)
2 (18.2 %)
2 (7.7 %)
Not present
8 (88.8 %)
9 (81.8 %)
23 (92.3 %)
FIGO stagea
3 (33.3 %)
2 (18.2 %)
10 (38.5 %)
5 (55.6 %)
8 (36.6 %)
14 (52.2 %)
1 (11.1 %)
2 (7.7 %)
1 (9.1 %)
Post-operation complications reduced from phase 1 (44 %) to phase 2 (36 %) with no significant differences between two phases as well as open group (38 %). The grade I reported complication consisted of the patients' complaints about sensation, movement and edema in legs which did not need any interventions. Although hospital stay showed no significant difference between phase 1 and "open" group (14.8 ± 6.9 vs. 13.4 ± 4.2 days), reached a considerable better status in phase 2 (vs. 9.6 ± 4.0 days, p value = 0.01).
Quality of life and post-operative outcome, comparison between laparoscopic phases and "open" group
"Laparoscopy" group
"Open" group n (%)
p value
Phase 1 n (%)
Phase 2 n (%)
Phase 1 versus phase 2
Phase 1 versus "open" group
Phase 2 versus "open" group
Post-operation pain
Until 1 week
4 (44)
8 (72.7)
6 (23.1)
Until 1 month
3 (33)
3 (27.3)
14 (53.8)
Until 1 year
2 (22)
6 (23.1)
Pain strength
5 (55.5)
10 (90.9)
7 (26.9)
3 (33)
12 (46.2)
1 (11)
1 (9.1)
7 (26.9)
Return to normal life in
2 weeks
8 (72.7)
3 (11.5)
4 weeks
4 (44)
1 (9.1)
5 (19.2)
6 weeks
2 (22)
1 (9.1)
11 (42.3)
>6 weeks
3 (33)
1 (9.1)
7 (26.9)
Cosmetic satisfaction
6 (66.7)
6 (54.5)
4 (15.4)
3 (33)
4 (36.4)
12 (46.2)
1 (9.1)
10 (38.5)
The adaptation of new technology, due to moral and ethical concerns involving patient safety, is a challenge particularly in the practice of medicine [4, 5]. The learning curve is a graphic representation of the temporal relationship between the surgeon's mastery of a specifically assigned task and the chronological number of cases performed [6, 7, 8]. Although learning theorists often disagree about what learning curve is, they agree that its affects are clearly cumulative and may therefore plotted as a curve [10, 11, 12]. By cumulative it is meant that somehow the effect of experience carry over to aid later performance. This property is fundamental to the construction of learning curves [4, 5, 6, 7, 8, 9, 10]. The CUSUM technique is a method adopted by the medical profession in the 1970s to analyze the learning curve for surgical procedure [11, 12] and transforms raw data into running total data deviation from their group mean, enabling investigators to visualize the data for trends not discernible with other approaches [9, 10, 11, 12]. Defining a learning curve for laparoscopic procedures is a complex process; however, the identification of the number of cases necessary to achieve competence is a crucial factor, which could facilitate more effective training and integrating the laparoscopic methods.
We chose CUSUM analysis because meaningful conclusion cannot be drawn from raw data plotted by chronological cases [11, 12]. We used this method to investigate the learning curve in staging in early stages of cervix and endometrial carcinomas. However, to date few series have reported the learning curve associated with laparoscopic surgery in gynecology [19, 20, 21] and even fewer in gynecology oncology [22, 23]. Moreover, to the best of our knowledge, none of them have used CUSUM analysis. Our study using CUSUM analysis identified 2 unique phases of the learning curve in the field of laparoscopic staging: phase 1 found to require 9 cases which can represent the initial learning curve phase and phase 2 represent the mastery phase, with a reduction in operating time.
Publications investigating the learning curve in laparoscopic interventions in gynecology have performed their analysis used on chronological cases that split into predefined segments with univariate analysis performed to compare means across segments [19, 20, 21, 22, 23]. For instance, Wattiezet et al. [19], investigating the learning curve of total laparoscopic hysterectomy in benign uterine diseases, have compared two groups chronologically based on using a new uterine manipulator. In a similar study on the learning curve of total laparoscopic hysterectomy, Garrett et al. [20] divided the patients into 3 groups with 40 patients. Paek et al. [21] have published the learning curve for single-port access total laparoscopic hysterectomy, by dividing the first 100 consecutive cases into 5 groups with 20 patients. Holub et al. [22] have reported the learning curve of laparoscopic surgery in women with endometrial cancer by arranging the patients chronologically and dividing them into 3 groups. Chong et al. [23] have published the learning curve of laparoscopic radical hysterectomy with pelvic and/or para-aortic lymphadenectomy in early and locally advanced cervical cancer, with splitting the patients into two groups with 50 patients.
Normally, a higher complications rate is expected during a surgeon's learning curve [7]. It is demonstrated that gradually, the significant decrease of conversion to laparotomy and major intra-operative complications could be seen [19, 22, 23] among these complications—excessive hemorrhage and urinary tract injury are the prominent ones [19]. In our study, the conversion rate decreased from 22.2 % in phase 1–9 % in phase 2; while reasons of conversions in phase 1 was intra-operative complications, in phase 2 it was due to the unexpected finding (intra-operative difficulties including ventilation problems due to high adiposity) restricting the operating technique. The intra-operative complication rate and their complexity decreased from phase 1 to phase 2, in this regard phase 2 has also had better situation comparing to "open" group. Interestingly, the urinary tract injuries only happened in phase 1. Blood loss and the transfusion rate are also the variables that have been emphasized to decrease in the learning curve [19, 21, 22, 23].
In addition, longer operating time is expected during the learning curve as well [6]. Although the above mentioned studies [19, 20, 21, 22, 23], reporting learning curve in gynecology laparoscopy, have investigated different fields, all of them have reported a significant decline in operating time [19, 22, 23]. In our series, we have demonstrated a decline of approximately 90 min. Chang et al. [23], who have reported learning curve in laparoscopic staging of cervical cancer, have also shown a decrease of 100 (325 vs. 225, p < 0.001) minutes in operating time. They have also demonstrated the significant increase of the acquired number of PEL (15.8 vs. 26.9, p < 0.001). Although we have also shown an increase in harvested PEL nodes (17.3 vs. 22.5), this difference was not significant which is similar to the study done by Holub et al. (12.4 vs. 15.4) [22].
In our study, like other reports [22, 23] the number of patients who underwent para-aortic lymph node sampling was too small and their distribution was asymmetrical for comparison. This can explained by the fact that generally para-aortic lymphadenectomy is a more challenging procedure than pelvic lymphadenectomy and thus, achieving acceptable outcomes in patients needing para-aortic lymphadenectomy probably requires a longer learning curve with special training programs, which must be investigated in future studies.
Other important aspect of introducing a minimal invasive surgery is the decrease of hospital stay. All the studies reporting the learning curve have shown a significant decrease in hospital stay [19, 20, 21, 22, 23]. Although in our series, the hospital stay in phase 1 was similar to "open" group, in phase 2 we have seen a significant shorter hospital stay in comparison to "open" group. Between two phases, the decrease of 5 days hospital stay can be seen and in the other study, this has been reported about 3 days [23].
Garret et al. [20] have reported no significant changes during the learning curve, in the terms of complications, operating time and bleeding, which could be due to very high number of teaching cases in this series.
Holub et al. [22] demonstrated that in cases without lymphadenectomy, there was no significant difference in operating time, estimated blood loss, rate of conversion to laparotomy, operative complications and length of hospital stay among the compared groups which is similar to our findings.
In terms of quality of life and post-operative outcomes, we have demonstrated that in cosmetic satisfaction, even in the phase 1 in comparison to "open" group, we can expect significantly better outcomes. In phase 2, all the aspects including post-operative pain, pain strength and time to return to normal life as well as cosmetic satisfaction have significant better outcomes (Table 4).
This study demonstrated the feasibility and safety of performing laparoscopic staging. We have shown that an initial period is usually necessary for surgeons to become proficient in this procedure. Our data suggest that after a learning curve phase of 9 cases, the surgeon may achieve a higher level of competence and consider offering this approach to patients presenting with more complicated cases. Finally, it could be argued that the good outcome reported in this article is partly reflecting the previous laparoscopic experience. Undeniably, these facts may have an impact on the learning curve as well.
To our knowledge, this is the first series to evaluate the learning curve of laparoscopic staging using a CUSUM method.
However, due to the limited number of patients as well as number of para-aortic lymph node sampling procedures, further studies are required for firm conclusions to be drawn.
Conflict of interest
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Open AccessThis article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.


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Silent Night with Artist Laurie Pace
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Humboldt Park Montessori would not exist without the many community members who have volunteered time, resources, and energy to promoting Montessori education for Humboldt Park. Our team believes whole-heartedly that every child in our neighborhood deserves an education that inspires wonder and self-directed exploration.
We believe in the potential that exists in each child.
We believe in the power of education to change lives.
We believe in the strength of a community to walk alongside parents and support them as they raise the next world-changers.
OUR Educators
Kristen Ediger - Executive Director
A Humboldt Park resident, Kristen has spent the last 5 years developing Montessori programs in Humboldt Park to provide this education to as many families as possible. She is passionate about giving all children access to a natural, beautiful way of learning. Before founding Humboldt Park Montessori, Kristen developed a mentoring program for teen mothers and worked at an after-school program on the south side of Chicago. She enjoys walking through Humboldt Park with her two young children, reading, and visiting Chicago's many cultural locations.
Nora Freeman - Preschool Educator
Nora has relished the role of teacher of young children since the age of 5 and has worked with preschool-age children in different capacities continuously since her early teens. Nora has a degree in Cultural Studies from Columbia College Chicago, where her major interest was alternative models of education. She happily received her Montessori Lead Teacher certificate in 2014. Nora is moved every day by the compassion, perseverance, and ingenuity that the children exhibit in the classroom. She is proud to help make HPM a vibrant embodiment of Maria Montessori's philosophy. At home, Nora enjoys painting and rudimentary knitting projects. She loves being out in her neighborhood (Humboldt Park!), visiting small galleries, and exploring Chicago's forest preserves with her husband and baby daughter.
Kristina Carr - Assistant
Kristen Ediger, Founder and President | Executive Director, Humboldt Park Montessori School
Dr. Morgan Halsted, Treasurer | Professor, Malcolm X Community College
Diane Lena, Secretary | Montessori Educator, Oscar Mayer Elementary School
Carrie Davenport | Legal, Shaw Fishman Glantz & Towbin LLC
Our Board is essential to developing the work of Humboldt Park Montessori. We rely on these special individuals to help us gather the resources we need to continue our work growing children, uniting families, and strengthening our community. If are interested in joining our board, please download an application.


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The RaLk'jo bat'telh was a martial art that was practised by the Klingon race.
Noted as an ancient style of combat that was largely ceremonial in nature which required no warrior present a move that had not been perfected in combat. This meant that an opponent was capable of gauging their opponent's strengths. A stance presented by an opponent was rated by level with the fourth level being that used by most amateurs and juvenile positions.
There were several different moves in this disciple which included
- Heaven's Centered Balance, First Level
- Dragon's Passage from Thought to Action, Third Level: conservative open, shows respect
- Position of Unwavering Determination, Third Level: will not give in to idle threats
- Gentle Cut
- Repose of the Dragon's Teeth, First Level
- Mountain's Scorn, Fourth Level: point-forward pose, disbelief at other's level of proficiency
- Whelpling's Lunge, Tenth Level: First move taught to children.
(TOS novel: The Return)


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MIRANDA BENNETT STUDIO Tempest Dress
MIRANDA BENNETT STUDIO Tempest Dress
One-Size fits sizes 0-10 Back Shoulder Seam to Hem: 43", Sleeve Opening 18" total, Hem Opening 50" total. Bust 24.5" Across. Hand wash in mild detergent and line dry or dry clean. Hand made in Austin, TX.
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Do you have questions about this product? We're here to help!


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MOUNT OLIVE TWP. In a pre-season preview of his Mount Olive High School softball team, head coach George Ottavinia said he wouldn't be afraid to use either Kristin Abels or Robyn Conlon in the pitcher's circle this season. That confidence was rewarded three-fold last week. Just look at the numbers: Three games pitched. Two runs allowed. Seven hits allowed. Three victories. Two winning pitchers. One happy coach. The Marauders swept through the first week of the season unscathed in victories over West Morris (7-0 on April 3 at home), Hanover Park (6-1 on April 4 at home) and Hopatcong (4-1 on April 7 at Hopatcong).
The arms of Abels and Conlon were in mid-season form.
Abels kicked off the season with a three-hit shutout of West Morris in a game in which her control wasn't as sharp as it could have been. Abels struck out four but walked eight and didn't allow a run in seven innings of pitching.
Mount Olive also had only three hits but one of them ws a two-run single by Emily Rimassa in the fourth inning. Karen Perry was the only other Marauder to hit safely in the game and she had two hits in two at-bats.
Rimassa's single highlighted a five-run fourth inning for Mount Olive that put the game away.
Mount Olive scored all the runs Abels would need in the first inning, when the Marauders scored two runs thanks to a bunch of walks issued by West Morris pitcher Mandy Lee.
Conlon took the mound in Wednesday's game against Hanover Park and was in command from the outset.
She allowed just one hit, a fifth-inning double by Robyn Simpson, who went on to score Hanover Park's only run.
Conlon struck out five and issued no walks in seven strong innings.
Mount Olive struck with two runs again in the first inning on four hits. They added two in the second and two more in the fifth in a 15-hit attack.
Sara Guterman had two hits, two runs batted in and scored two runs in three at-bats for Mount Olive, while Rimassa and Rachel Regina each connected for three hits with an RBI in four at-bats.
Abels had Mount Olive's only extra base hit, a double.
Katie Vecchione took the loss for Hanover Park.
In Saturday's victory over Hopatcong, Conlon was around the plate again as she issued no walks in a 4-1 win. She struck out seven and allowed just three hits, two of them doubles by Hopatcong's Ariel Maruglio, in seven innings of work.
Abels connected for a two-run double in the first inning, when Mount Olive scored three runs.
Kim Lyko checked in with two hits and two runs scored in three at-bats, while Rimassa was 2-for-4 with an RBI and Kristy Fry 2-for-4.
Mount Olive began its second week of action at Voorhees on Monday and at Dover on Tuesday before hosting Mendham on Wednesday.


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MLD massage; surgeon recommends 2 within the first week. Can someone clarify please?
Doctor Answers 2
Post Vaser care
Thank you for your question.
According to the British Association of Body Sculpting (BABS) guidelines on post-operative care following Vaser a minimum of 4-5 follow up sessions are recommended during first 6 weeks following operation and 3 of those have to be during first 2 weeks.
Most doctors will want to see a patient for MLD and a review next day (after overnight stay as after most HD vaser overnight monitoring is recommended), 3 days, 1 week, then 2 weeks. Final check up is normally advised after 6 weeks to see a preliminary result and assess skin retraction , scars.
BABS study showed that slower recovering patients (for example those who develop seroma) will require additional 3 appointments for MLD and follow up treatments.
You will feel very sore and MLD or any manipulation will be uncomfortable but it helps you to restore your natural lymphatic drainage system (clogged up by surgical injury) as quickly as possible.SO you surgeons advise is based on those recommendations.
Learn more: http://www.dralexchambers.co.uk/blog/Page-2.html
Getting Gorgeous Results
Lymphatic massage is extremely gentle and I recommend it to patients as part of our aftercare protocol after VASER procedures. I also recommend RF treatments externally like venus legacy, exilis ultra, Vanquish, shock/vibration therapy like Cellutone/z wave, hyperbaric oxygen and compression in order to decrease swelling and improve results. If you have questions about aftercare protocols, consult your Dr. Best, Dr. Emer
Learn more: https://www.youtube.com/channel/UCa6C2fuS-AgOnvBjr6_VSQg
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.


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New Website Helps Students Find Authentic Catholic Education at Univ. of Notre Dame
November 10, 2015 | By Justin Petrisek | Cardinal Newman Society
In response to numerous concerns from students and parents over the years about the quality of Catholic education at the University of Notre Dame, Notre Dame history professor Father Bill Miscamble, C.S.C., launched a new project this week, NDCatholic.com , that he told The Cardinal Newman Society will help students find professors supportive of the University's Catholic mission and an authentic Catholic education.
"I want to encourage serious Catholic students to attend Notre Dame. But they should come here with a clear-headed recognition that they must be very intentional in choosing their teachers and courses," Fr. Miscamble said. "If they do so, they will find an education that allows them to face deep questions of meaning and serves to deepen and enrich their Catholic faith."
The website, which is in its beginning stages, features profiles of approximately 100 faculty in the College of Arts and Letters personally recommended by Fr. Miscamble for their supportof the University's Catholic mission. Fr. Miscamble hopes to expand the website soon to include the faculty from the other colleges including business, science, engineering and architecture.
"I realized that there were somany excellent faculty here but that students needed some guidance in finding them and selecting the right courses to take," said Fr. Miscamble, who was inspired by the many students and parents who have requested personal recommendations over the years. "NDCatholic is the result of my desire to assist students."
Each NDCatholic faculty profile includes the professor's areas of research, teaching style and a brief description of their contribution to the University and its Catholic identity.
"Knowledgeable observers are aware that the University of Notre Dame can provide an excellent Catholic education for her students. But it certainly is not guaranteed. Students who simply drift through Notre Dame with its present core curriculum are unlikely to gain the full benefits that the University can offer," Fr. Miscamble stated on the website. "Consequently, students must take the initiative in order to receive a genuine and rich Catholic education."
Fr. Miscamble did note that not all of the faculty recommended are themselves practicing Catholics, nor do they fully endorse Catholic doctrine and teaching. "I have sought to clarify where this is the case," he told the Newman Society, "and have outlined why students might still benefit from study under these professors. Of course there are a good number of true Catholic intellectuals also listed on the site."
"It is a question of balance, and unhappily the necessary balance in favor of Catholic faculty has been lost over the years at Notre Dame in its drive for secular acclaim," stated the Sycamore Trust, an alumni group dedicated to preserving Notre Dame's Catholic identity, in its announcement of the website.
"The faculty no longer comes close to meeting the University's own Mission Statement test of Catholic identity: a majority of committed Catholics on the faculty. Perhaps 25 percent to 30 percent of the faculty may fit this description," the Sycamore Trust stated, noting the urgent need for Fr. Miscamble's project.
In addition to the list of supportive faculty, Fr. Miscamble provides a list of excellent student groups, his rationale for the website, suggested reading on issues in Catholic higher education and an analysis of the importance of Ex corde Ecclesiae, the Church's constitution on Catholic higher education.
"Ex corde Ecclesiae must be the essential charter for every authentic Catholic university in all aspects," Fr. Miscamble told the Newman Society. "Without attending to its central provisions, Catholic universities will ignore those essential questions, namely: what is taught and who teaches it."
"I can only hope and pray that Notre Dame deepens its commitment to Ex corde Ecclesiae in the coming years," he said.
Fr. Miscamble also hopes that, especially for those students and parents concerned with the state of Catholic identity at the University, NDCatholic will be a source for reassurance in seeking out genuine Catholic education.
"For a Catholic institution to live up fully to its promise, it must have devoted teachers and scholars who aim to stir in their students a hunger for the truth," he stated. "In short, I hope NDCatholic will serve to provide information to students at Notre Dame to help them obtain an excellent Catholic education here."


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You may be eligible for a VA burial allowance if:
In addition, at least one of the following conditions must be met:
There is no time limit for filing reimbursement claims of service-related deaths.
In nonservice-related cases, claims must be filed within two years after permanent
burial or cremation.
VA will pay up to $2,000 toward burial expenses. If the veteran is buried in a VA
national cemetery, some or all of the cost of moving the deceased may be reimbursed.
VA will pay up to $300 toward burial and funeral expenses, and a $300 plot interment
allowance. If the death happened while the veteran was in a VA hospital or under
contracted nursing home care, some or all of the costs for transporting the deceased's
remains may be reimbursed.
VA provides an American flag, which usually drapes the casket. After the funeral
service, the flag may be given to the next of kin or a close associate.
The Presidential Memorial Certificate is a parchment certificate with a calligraphic
inscription expressing the nation's recognition of the veteran's service. The veteran's
name is inscribed and the certificate bears the signature of the President. Certificates
are issued in the name of honorably discharged, deceased veterans. Eligible recipients
include next of kin, other relatives and friends. We will apply for this certificate
for you.
VA provides headstones and markers for graves of veterans anywhere in the world
and for eligible dependents of veterans buried in national, state veteran or military
cemeteries. Flat bronze, flat granite, flat marble, upright granite and upright
marble types are available. Niche markers are also available to mark mausoleum crypts
or inurnment of cremated remains.
Eligibility – Veterans and armed forces members who die on active duty. An eligible
veteran must have been discharged or separated from active duty under honorable
or general conditions and have completed the required period of service. Veterans
entitled to retired pay as a result of 20 years creditable service with a reserve
component are also eligible. A U.S. citizen who served in the armed forces of a
government allied with the United States in a war also may be eligible. Spouses
and minor children of eligible veterans and of armed forces members also may be
buried in a national cemetery. A surviving spouse of an eligible veteran who married
a nonveteran, and whose remarriage was terminated by death or divorce, is eligible
for burial in a national cemetery.
Burial benefits in a VA national cemetery include the gravesite, opening and closing
of the grave and perpetual care. Headstones and markers and their placement are
provided at the government's expense.
For more information, you may visit the Veterans Administration website at http://www.va.gov.
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Met Art presents a fascinating collection of the most beautiful nude girls and their erotic pictures in the world. Tube Porn. You will not find filth or dirty sexual games at Met Art, but only beauty of a perfectly shaped teen body. These girls will still let you enjoy their bodies in every detail, but they will do in the special style peculiar to Met Art only.
Sono il delirio sessuale spinto ai livelli estremi. Tu sei il "tempio della voluttà" Atlantide "isola persa"


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Merriam Webster's Dictionary defines the word rodeo as, "an exhibition that features cowboy skills (as riding and roping)." So when I began to think about how the Kentucky High School Rodeo Association has affected my future I had come to realize that this particular sport doesn't just feature a cowboy's skills but instead all of the most essential qualities needed to succeed in life.
Imagine yourself sitting in the stands at the short go of the National High School Finals Rodeo where the most prestigious cowboys and cowgirls vie for the National title. What you don't see however, are the moments when these contestants become so tired they want to quit but don't. Or when they learn to deal with disappointment after failing time and time again. Rodeo teaches those to be disciplined, while taking care of their bodies or achieving nearly unattainable goals. Rodeo creates an opportunity to make lifelong friends, holding themselves accountable for their animals and learning the importance of team work. Rodeo teaches those that a champion isn't made overnight, however hours and hours of practice will put you there. In the midst of it all, cowboys and cowgirls turn to our Lord and Savior for strength and guidance before every performance.
My first year competing at the NHSFR I was the 2013 Kentucky High School Rodeo Queen. It was an action packed 10 days filled with horsemanship patterns, speeches, interviews, etc. I devoted hours upon hours to train myself, my brain, and my horse to be the very best. 20 outfits later and many of singed hairs fewer, I stood on the arena floor awaiting what I thought was the biggest moment of my life. And just like that, I didn't win! At that particular time in my life, I convinced myself that I wasn't good enough and carried that disappointment for the remainder of my high school career. After graduating, I sought higher education at the University of Kentucky. It was here, that I realized what Kentucky High School Rodeo had done for me. There have been moments that I have wanted to quit because life became so stressful it seemed easier to throw in the towel, but I didn't. Rodeo taught me to have discipline and work hard for what I was aiming for. So how could I work so hard for something such as a rodeo queen pageant only to throw it away over one loss?
John 13:7 says "You don't understand what I'm doing now, but someday you will" and just like that I awaited God's plan. I am now a junior in college pursuing a degree in Marketing where I plan to become an Adoption Lawyer. Remember me saying that rodeo presents lifelong friends? I currently work on a farm for a rodeo family very near and dear to my heart. As for my rodeo queen career? In less than 30 days I will be competing in the 2017 Miss Rodeo America Pageant representing the Bluegrass State. For this, I am forever indebted to the Kentucky High School Rodeo Association because I learned how to deal with disappointment after failure. I realized that a champion isn't made overnight but over many years of hard work and dedication. But most importantly, I learned to remain humble no matter where life takes me. There are so many qualities that the KYHSRA can teach a cowboy or cowgirl that they may not otherwise obtain. So the next time you hear the word "rodeo" remember those who don't give up, who make it their life ambition to succeed, and who devote their life to God in hopes for a brighter future.
With love,
Miss Rodeo Kentucky 2016
Alivia Conkwright
Volume 1 Number 1


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A babe cloudburst is oft the give emphasis to of an anticipant mother's pregnancy. Planning one requires one plan and cerebration for the expectant mother's partisan thing. Baby heavy shower favors are among the items that essential be reasoned once readying a plumbing fixture.
Baby heavy shower favors do not have to be detailed to receive an impressionable impact on company. Most family are paradisal adequate to come in to the shower a moment ago to stop by the mom to be in all her great honour. Baby rainstorm favors nonetheless can give a gift of the imaginative event and contribute a pure way to convey guests for visiting and celebrating the mother's event of joy.
Baby shower favors come through in all size, contour and form. Some comfortable grant concept view the following:
- Candles
- Miniature boxes of chocolates or candy
- Bath and physical structure items
- Pictures
- Gift baskets
- Lotto tickets
- Movie tickets
Keep in mind that to variety any do even more than fun and eventful, infant favors that cooccur near the "theme" of the gala are even much fun to go past out. For example, if the anticipant female parent is carrying twins, and the subject matter of the shower revolves on all sides multiples, it possibly will be possible to present some gifts that cooccur beside this theory. Some ideas in this state may well enmesh the following:
- Double Bubble
- "Twix" Candy Bars
- 2 pairs of anything
- Identical image frames
- Manicure and care set
- Pair of coffee spoons
One smart model for toddler favors is to have all guest distribute a "white proboscidean gift". The view of white elephant gifts as usual surfaces during Christmas time, once guests are welcome to bring up a "mock" payment to a shindig for switch. This may cover silly items such as as used family appliances, a gyration of bathroom newspaper or an sympathetic box of Oreo cookies. Guests are provoked to face the gifts, afterwards all associate of the do can superior a figure and game of chance gifts. Using white elephant gifts as entertainment favors is a large way to quota laugh and joy in a deluge picture.


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Leaving Orbit: Notes from the Last Days of American Spaceflight by Associate Professor of English Margaret Lazarus Dean will be the next Life of the Mind selection that next year's freshmen will be asked to read prior to arriving on campus in fall 2016.
Life of the Mind News
Knoxville Immigrants Invited to Participate in 'Unknown Americans' Project
The First-Year Studies program is partnering with Cristina Henriquez, the author of this year's Life of the Mind book, The Book of Unknown Americans, and inviting the Knoxville community to participate in "The Unknown Americans Project" on Tumblr. The aim of the project is to shed light on the often untold stories of immigrants in America.
Life of the Mind Discussion Leaders Needed
First-Year Studies is seeking nearly 200 discussion leaders for the 2015 Life of the Mind program with the incoming first-year class.
2015 Life of the Mind Book Chosen
The 2015–16 Life of the Mind book will be The Book of Unknown Americans by Cristina Henriquez. It's a fictional tale about two immigrant families—one from Mexico and one from Panama—who come to America in search of better lives.
What to Read? Life of the Mind Program Seeking Book Suggestions
The Life of the Mind Program is seeking suggestions for its 2015–16 common reading selection for first-year students. A Ready for the World initiative, Life of the Mind is a component of First-Year Studies 100, a required online course that helps first-year students develop the right mindset for the college experience. As part of the course, students read the Life of the Mind book, submit a creative response, participate in a small-group discussion session, and attend a lecture by the book's author.
UT Selects Daytripper as 2014 Life of the Mind Book
Daytripper, an award-winning Brazilian graphic narrative that offers a powerful examination of life, love, and other timeless themes, will be UT's 2014 Life of the Mind book. The Life of the Mind Program is a component of First-Year Studies 100, a required online course that helps first-year students transition successfully to college.
Noted Environmentalist, Author Bill McKibben to Speak Monday
Noted environmentalist Bill McKibben, whose latest book, Eaarth: Making a Life on a Tough New Planet, is this year's Life of the Mind selection for freshmen, will speak on campus on Monday. His lecture, part of Welcome Week, begins at 5:30 p.m. in Thompson-Boling Arena. While freshmen are required to attend McKibben's lecture, the event is free and open to the public.
Life of the Mind Program Wants Ideas for 2014 Book; Theme is Creativity
IBM surveyed leaders from thirty-three different industries in sixty countries to determine their most highly valued professional trait. The answer? Creativity. UT will celebrate creativity during the 2014-15 academic year by making creativity the theme of that year's Life of the Mind book. A committee of faculty, staff, and students will review many books to select a common reading experience for the Class of 2018, centered on the theme of the creativity. The committee is seeking book nominations from the campus community.
More Life of the Mind Discussions Leaders Needed
With a large first-year class expected this fall, the Life of the Mind Program needs additional faculty and staff members to serve as discussion group leaders. Life of the Mind is UT's common reading experience for all first-year students. About thirty more faculty and staff members are needed to serve as leaders. Discussion Leader training will be held from 1:00 to 3:00 p.m. on August 13 and 14. Participants can attend one of the sessions.
Wanted: Life of the Mind Discussion Leaders
Faculty and staff members are invited to sign up to lead Life of the Mind small-group discussions during Welcome Week in the fall. Next year's common reading selection is Bill McKibben's Eaarth: Making a Life on a Tough New Planet. McKibben will be on campus August 19 to speak to first-year students as well as members of the university and surrounding community. Discussion leader training will take place from 1:00 to 3:00 p.m. on Tuesday and Wednesday, August 13 and 14. Discussion leaders can attend either session.


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Everything needed to start playing for ages 7 and up.
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VA - Blues With The Girls (1992) MP3/Flac
Artist: VA
Title Of Album: Blues With The Girls
Year Of Release: 1992
Label: Epm Musique
Genre: Blues
Format: Monkey's Audio (image+cue), log-file
Bitrate: Lossless
Total Time: 01:07:30
Total Size: 385 MB
Sarah Streeter was raised in Chicago, Illinois, from early childhood, where she sang in gospel choirs in South Chicago churches.[1] At age 14, she began singing blues at the Morgan's Lounge Club, and in the 1970s she played with musicians such as Magic Slim, Buddy Guy, The Aces, Junior Wells, Johnny Bernard, and Erwin Helfer. Her experience playing with Sunnyland Slim led to her first solo release, a single released on his label, Airways Records. Teamed with Zora Young and Bonnie Lee in 'Blues with the Girls', Sarah toured Europe in 1982 and recorded an album in Paris, France. From 1989 she performed with a group called The Big Time Express. Since 1993 she has recorded for Delmark Records.
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Attorneys have a variety of academic backgrounds - economics, English, history, philosophy and political science. Law schools do not designate a major program concentration as a prerequisite for admission. Law schools admit students who are broadly trained and who evidence analytical skills, good writing and oral communication abilities, as well as social awareness.
You can therefore prepare for law school by fulfilling the general education requirements at Marygrove College, and choosing from a variety of majors and minors.
Your academic major can help prepare you for law school. It can also provide you with training for an alternative career should you choose not to enter law school immediately after graduating from Marygrove College.
A pre-law counselor is available at Marygrove to assist you in planning your education and identifying professional opportunities. The counselor keeps abreast of trends in legal education and can assist you with law school application procedures, options for financial assistance information on The Law School Admission Test (LSAT) and career planning.


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Today is my 5-year Blogiversary.
In that time I have created 3007 posts, including this one - an average of about 1.6 per day. Assuming I have spent 1.2 minutes on each post, I have spent 60 hours, or 2.5 24-hr days, writing the blog.
Posted by Zorak on 3/18/2007 02:43:00 PM
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East Oak Street is located in Bumtown, the opposite of West Oak Street. It's rundown and in bad shape. The street was once visited by Homer. Classy Girls Strip Club and 1501 East Oak Street are located here. It is also the home to Silicon Alley, where the Silicon Alley Strip Club is.
- Episode – "The Food Wife"
- Episode – "Them, Robot"


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Podio helps users better organize their projects. The application includes a number of versatile tools that give the user control over tasks, schedules and more. The Podio activity stream gives the user a condensed overview of recent actions, including edits, comments and status updates. Users can also build their own spaces which provide a place to centralize project tasks and activity. The task features allow users to create to do lists and delegate items to others. Calendars are also included so the user can schedule tasks and monitor progress to get things done on time. Users can also schedule meetings for their team or group. Podio will also store the user's contacts, which include full profiles for each that can be integrated into the user's work. Users can customize Podio using existing apps from the Podio App Store or by creating their own apps.Show more screenshots »
Podio was founded in March of 2009 by Anders Pollas, Kasper Hulthin and Jon Froda. Based out of Copenhagen, the company currently consists of nearly 15 individuals, including CEO Tommy Ahlers, CTO Phil Chambers, chairman Thomas Madsen-Mygdal and founding developer Andreas Haugstrup. The headquarters is currently located in Copenhagen, however the company is expanding its reach to include British, German, Danish and French employees. After two years of being in a beta version, Podio was officially launched in March 2011.
Podio offers many of the same features that are expected with this type of application. Although it may not have anything strikingly original, it does offer the things most users want. These features appear time and time again because they are effective and flexible enough to work for almost any kind of project. Podio brings these items together with its own interface design, which some users may prefer over alternative applications.
The Podio website invites users with a blue and white color scheme, complemented by screenshots and video testimonies. The application itself has a very clean design that is reminiscent of Facebook. The user can see each item along with the poster's name and image. All follow up comments are presented under the item Podio also allows users to create a full profile for each contact they add, centralizing all the information into one convenient virtual location that can be accessed on the web or by iPhone.
A new user can begin by clicking the green "Get Started for Free" button found near the center of the Podio homepage. Doing so will direct the user to the short registration form which requires a name, organization or company name, email address and password. The user must also check the terms of service agreement box at the bottom of the form before submitting their information. The user is automatically taken to their account dashboard and can begin exploring Podio.
After signing up, users are automatically given a free account. The free membership includes unlimited spaces, unlimited apps, unlimited storage, SSL security, standard level support and up to 10 users. Users can also upgrade to a paid membership which costs approximately $100 per month and includes up to 25 users, priority level support, reporting features, user management features, user permission settings and the ability to add additional users for around $4 each per month. Accounts created for 100 users or more maybe eligible for a bulk discount
Podio offers a number of tried and true tools that are ideal for organizing information and completing projects. The application gives users one place to store contacts, schedules and other vital items. The pricing system is also simple and even offers a free version which small businesses can really appreciate.


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login with
Sleep training
I walked out of his room at 9:08pm and listened to the baby monitor and at 9:15pm he stopped crying. My baby is knocked out. Ugh that hurts me but he is sleep. Thank God
Comment deleted
Oh gosh I hope tomorrow is easier. I have to do it when his father is gone to work because if he hears him crying is gosh rushing into the room like I was mistreating the baby…LOL
Well that sounds like good news to me! :)
that great. I'm glad he's sleeping and you can relax
didnt take long at all! thats great! just stick to it and there wont be any crying before you know it!
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About Denice
Born: Miami, Florida
Current: Orlando, Florida
Birth: December 31
On Moms.com since: Dec 18, 2013
First time mom of a baby boy named Carter. He is my pride and joy. God bless us with him. Being a stay at home mom is the most rewarding job ever.
All Recent Denice's Posts


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Black And Gold Dancers String Bikini-Stripper Clothing
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This product is unavailable
See more: Pole Dancers Clothing
It's a work of art! Abstract patterns and an intricate network of black straps make this sexy two piece set a masterpiece. The string bikini features a black and gold geometric print, and the set pulls on with no ties to fasten.
Imported By Espiral


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Study Evaluating Response against Dose Establishes Connection. Sometimes, processing emergency prescriptions for the sick, or explanations to anxious parents is part from the job. A pharmacy, whether situated in a retail environment or set up exclusively to provide supplies to your medical facility, must follow certain rules. A less than a year program may not provide you with a solid foundation whether it is time to look at your qualifications examination. You can report any suspicious looking sites to the telltale guys as well.
Today, after over 50 years, the shoe store has evolved into being a network of 44 large-scale departmental stores not only inside the Philippines but throughout Asia and lays state they three with the world's top 10 shopping centers: the SM City-North EDSA (ranked 3rd), the SM Mall of Asia (ranked 4th) and SM Mega - Mall (ranked 7th), that happen to be all located in the Philippines. You can't say for sure, it may cover way over you think - Vitamins, hospitals in the area, alternative medicines, health clubs, safety equipment, and also the list goes on. Neonatal or baby care: When a baby finds it tough to engulf an all natural pill or other medicines as a consequence of strange taste or smell, medication management works wonder. But with advances in medical science most diseases are already controlled by making use of high powerful antibiotics as well as other life-saving drugs. You'll never see commercials for generic medications, but that doesn't mean they're not out there, doing the identical exact thing for their brand counterparts, only for the lot less money.
This article explains the best way to recognize a web based health fraud or medical scam. Studying for this Ex - CPT exam can be done by getting the "National Pharmacy Technician Training Program" study guide. " It is essential to note a Doctor of Pharmacy Degree is different than finding a Ph. Identifying the different faulty factors in prescribing, dispensing and administration of medication may help in reduction of this dangerous health care crime. If you are searching for a fast-paced career with numerous responsibilities, consider learning to be a pharmacy technician.
This will allow you to take your regular dose without leaving a poor aftertaste in your mouth. Now that person has access with a potential method for committing suicide. Most online Canadian pharmacies accept all major credit cards. The process already exists for breast cancers, but similar indications are actually identified helping medical professionals increase prognostic value while detecting one with the most prevalent lung cancers inside United States and worldwide. Some employers appear to have noticed that their workers must feel financially rewarded along with some cases add a bonus on each year.
See Also: Biotechnology Applications in Pharmacology. India can be a country where you are able to employ some of the most talented and skilled professionals that will handle all of your website designing work. Pharmacy technicians can easily advance into supervisory positions over time, but to turned into a pharmacist specialized training is required. The online pharmacies often provide links to medical aids including clinics, gov departments, hospitals and health organizations. It' s not so simple to execute these chores, but with qualified planning programs you is going to be able to complete it.


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Tamiya TOYOTA HILUX Bruiser Mountaineer Body Mount
- Sold for: Start Free Trial or Sign In to see what it's worth.
- Item Category: Toys, Dolls, Games & Puzzles
- Source: eBay
- Sold Date: Jun 17, 2010
- Channel: Auction House
Condition :____Used (SCORE: 8 of 10)___ Shipping : Please select a or b. a)__$6 Worldwide. Airmail - No guarantee, no insurance, no tracking ___ b)__$15 Worldwide. EMS - guarantee, insurance, tracking ___ ___WE WILL COMBINE SHIP___ ___We will offer a shipping discount if you win multiple items___


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What's better than a big black cock? An entire room FULL of black cocks! Thugzilla from Thug Orgy is holding a sex party, and I've counted at least 8 men in action sucking, stroking and fucking. Man, there's all kinds of hot ebony studs in action, and every one is hard, horny and has the kind of ass you'd just love to grab and fuck. There's so much gay sex going on here that it's hard to keep track, but I think it's fair to call what's going on here an orgy!
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Spades N-1120; ©1962; Anthony Blotta - Skirt. Topped by a blouse, sweater or jacket, this gently widened skirt is geared to lead a busy life with reasonless good looks. A flaring front pleat that always returns to its original crispness springs additional fullness into the skirt whenever you more. Its pretty flare is beautifully suited to our jacket #N-1119.
Links to reviews/blog postsEdit
Add a photo to the gallery by clicking the "modify" button below.
[insert your username, and make sure your preferences allow for people to contact you via e-mail. Do not list your email address here!]


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Thomas Heflin's debut CD, "Symmetry" demonstrates his amazing ability as both player, composer and producer. This debut effort captures the magic and spontaneity of this gifted artist. Read The Official Press Release. For personnel on this recording, view on AllMusic.com
Blue Canoe Records
Blue Canoe Records
© 2003-2017 Blue Canoe Records and Blue Canoe Digital LLC. All Rights Reserved


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Bloated Carp was a Sake house of Sunda Mizu Mura. It was known for privacy and exceedingly low prices. [1]
- ↑ Dark Tide Rising, by Shawn Carman and Rich Wulf
|This Crab Clan related article is a stub. That means that it has been started, but is incomplete. You can help by adding to the information here.


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(CNSNews.com) - Armed with a report in Monday's New York Times, Democratic presidential hopeful John F. Kerry today fired new accusations at President Bush -- accusing him of doing nothing while terrorists "may be helping themselves to 'the greatest explosives bonanza' in history.
"President George W. Bush who talks tough -- talks tough -- and brags about making America safer, has once again failed to deliver," Kerry said at a campaign stop in Dover, N.H.
"After being warned about the danger of major stockpiles of explosives in Iraq, this president failed to guard those stockpiles where nearly 380 tons of highly explosive weapons were kept.
Monday's New York Times reported that the "Iraqi interim government has warned the United States and international nuclear inspectors that nearly 380 tons of powerful conventional explosives -- used to demolish buildings, make missile warheads and detonate nuclear weapons -- are missing from one of Iraq's most sensitive former military installations."
The place where the explosives were stored, the report said, has been "picked over by looters."
In a press release on Monday, the Kerry campaign outlined "three major concerns."
It said the explosives "could end up or have already ended up in the hands of a terrorist group; the explosives might be used against our troops on the ground; and the explosives could be used to carry out a deadly attack against America or our allies."
Sen. Kerry, echoing the concern about terrorists, warned on Monday that "terrorists could use this material to kill our troops, our people, blow up airplanes and level buildings."
Kerry noted that in May 2004, the International Atomic Energy Agency "warned that terrorists may be helping themselves to quote, 'the greatest explosives bonanza' in history. And now we know that our country and our troops are less safe because this president failed to do the basics.
"This is one of the great blunders of Iraq; one of the great blunders of this administration," Kerry continued. "And the incredible incompetence of this president and this administration has put our troops at risk and put this country at greater risk than we ought to be.
"Let me say this as directly as I can - that the unbelievable blindness, stubbornness, arrogance of this administration to do the basics has now allowed this president to once again fail the test of being the commander in chief.
Every step of the way, this administration has miscalculated, Kerry said. And he blasted Defense Secretary Donald Rumsfeld - who "cavalierly dismissed" the looting in Iraq. "And now we know the impact," Kerry said.
Kerry said American troops have been "doing their job honorably." The problem is, he added, "the commander in chief has not been doing his."
"If President Bush can't recognize his failures in Iraq -- which he doesn't admit, won't acknowledge -- you can't fix them. And then he's doomed to repeat the same mistakes elsewhere, whether it's North Korea or Iran or in any of the other risks that we face ahead of us.
"My fellow Americans, we can't afford to risk four more years of George Bush's miscalculations."
President Bush, campaigning Monday in Colorado and Iowa, was expected to discuss the war on terror -- using "new language" to make his point, a spokesman said.
In a taped interview that aired on ABC's "Good Morning America" on Monday, President Bush said he "calculated as best I could the cost of going to war."
President Bush said it was a "very, very heavy decision" for him to make. "You can't put a price tag on a person's life," Bush said. "If the commander in chief withdraws before the mission is completed, it's too great a price."
Bush said it was "essential that we succeed in Iraq...because if we do not succeed in Iraq ...the terrorists will rejoice."
Send a Letter to the Editor about this article.


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NEXT SEABIRD HANDLERS COURSE – Saturday November 22nd 2014, Ballina, NSW. 9:00am to 4:00pm. Contact our Ballina Office on 02 66 862 852 to register.
Ever seen a waterbird with fishing line entanglement, around its leg or wing perhaps, and thought there was no hope for it because it can still fly?
Because they share the habitat we humans love to go boating and fishing in, pelicans, seagulls and crested terns are just some of the species that suffer fishing line entanglement and accidental hooking.
What to do? There's nothing worse than feeling helpless!
In 1992, the late Lance Ferris discovered that over one-third of the local pelican population in the Richmond River at Ballina was hooked, entangled, crippled and suffering infection. Most of them could still fly. The challenge was to figure out how to capture them in order to alleviate their suffering.
Capturing wildlife without an appropriate license is illegal in NSW, sever penalties apply. For the purposes of rescuing sick, injured or orphaned wildlife in NSW, and for your own personal health and safety you must be a member of a group licensed by the National Parks and Wildlife Service, and have completed the appropriate training course. Training courses are offered by each branch of Australian Seabird Rescue. Participants receive a copy of "Rescuing the Australian Pelican" (Ferris et al, 2004) including valuable veterinary case studies and rehabilitation advice, and for a limited time, a hard copy of the complementary First Responders Resource Guide for Seabird Emergencies and Pocket Guide published by Australian Seabird Rescue in collaboration with the NSW Government and funded by the NSW Environmental Trust*. A DVD training aid has also been produced and is available on request to Australian Seabird Rescue Inc, Ballina.
Follow this title to a permanent link to the free pdf download of the First Responders Resource Guide for Seabird Emergencies.
Follow this title to a permanent link to the free pdf Pocket Guide for First Responders to Seabird Emergencies.
ASR members deliver training for the capture, handling and first aid of seabirds, shorebirds and other wildlife found along our coastline. Book training for your area by contacting our Ballina office or follow our branches on social media for news of upcoming events.
*This project has been funded by the NSW Environmental Trust. The Trust is an independent statutory body established by the NSW government to fund a broad range of projects that enhance the environment of NSW. The Trust is administered by the NSW Office of Environment and Heritage
Ferris, L.I., Bonner, M and Kosack, E. (2004). Rescuing the Australian Pelican. Australian Seabird Rescue Incorporated, Ballina, NSW.
The pioneering work of co-founders Lance Ferris and Marny Bonner propelled ASR into the media for their work rescuing the Australian pelican.
Because these birds share their habitat we humans love to go boating and fishing in, pelicans, silver gulls, crested terns and penguins are just a few of the species that suffer fishing-line entanglements and accidental hooking. You can read our report on the Impacts of Recreational Fishing on Estuarine Birdlife on the Far North Coast of New South Wales, which gives a representative sample of what we see around the country.
Page 1 of 2 | Next page


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US First Lady Michelle Obama's veterans hiring initiative has reached triple its goal by generating jobs for 290,000 former servicemen and their spouses to date, she announced at the White House today.
The program, called Joining Forces, collects commitments from companies to hire or train a certain number of veterans and military spouses.
Originally, the program had asked US companies to commit to training or hiring 100,000 veterans and military spouses by the end of 2013.
At today's event, attended by President Barack Obama, Vice President Joe Biden and Jill Biden, Mrs. Obama announced that the program had gathered another set of pledges from companies to hire or train 435,000 more veterans in the next five years.
These include promises from private equity firm Blackstone Group (50,000 workers), Deloitte (to double its veteran hiring over the next three years), financial services and insurance company USAA (30 percent of new hires), McDonald's (100,000 workers), Home Depot (55,000 workers), UPS (25,000 workers) and BNSF Railroad (5,000 workers).
"These efforts are about so much more than a paycheck. This is about giving these men and women a source of identity and purpose," Mrs. Obama said. "This is about providing thousands of families with financial security and giving our veterans and military spouses the confidence that they can provide a better future for their children."
Nearly one out of five veterans under the age of 25 are unemployed, the Associated Press reported. The overall unemployment rate for veterans serving since the Sept. 11 attacks was 9.9 percent in 2012.
It's projected that nearly 1 million members of the military will become civilians in the next few years, the AP reported.


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B.ed Result
July 20, 2010 by staff
B.ed Result ,, B. The University of Lucknow Jee Ed 2010 results are available online at the official website of the LkoUniv, available at the link below.
For the University of Lucknow B. Ed Results 2010
Deepti Singh of Varanasi has surpassed the results of the general category with 324 points.
The result has been available online at the official website last night. The first result expected to be available in the morning but was delayed until the afternoon. Commenting on the declaration of results online, University of Lucknow GP registrar Tripathi said: "When given the task of conducting the examinations of the bed, the University of Kanpur took 62 days to declare the results. Similarly, it took 47 days for the University of Agra to release the outcome, and beating the Lucknow University has done in 30 days. "
Please feel free to send if you have any questions regarding this post , you can contact on
Disclaimer: The views expressed on this site are that of the authors and not necessarily that of U.S.S.POST.


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295 Smith Street Fitzroy, Victoria 3065
|Opening hours
|Sun-Wed 11.30am-11pm,Thurs-Sat 11.30am-1am
|Vegetarian friendly, Licensed
|Cheap (mains under $20)
|eftpos, AMEX, Visa, Mastercard
|03 9419 2130
The striking New Orleans workers of 1929 would have laughed if told of plans to open an eatery dedicated to the 'poor boy' sandwich that gave them sustenance in hard times. That's just what the team behind Gumbo Kitchen food truck has done. Fillings such as Cajun-battered catfish (basa) dressed with tomato, lettuce, pickles, mayo and Louisiana hot sauce; deep-fried shrimp (prawns); and smoked pulled pork bulge from crusty loaves; with sides of Cajun slaw, red beans and chicken and smoked sausage gumbo a nod to Louisiana roots. There's lemon 'ice-box' pie (like a sorbet tart). Who's laughing now?


text: Built in 2008, this new and modern 4-star hotel in the centre of Cáceres comprises 127 guest rooms, conference facilities, caf�, restaurant, car park and garage (for a fee). Further facilities at the air-conditioned establishment include 24-hour reception and check-out service, lift access, TV lounge, bar, WLAN Internet access and room and laundry services.The spacious, comfortable and bright rooms come equipped with an en suite bathroom with bathtub, hairdryer, plasma TV, telephone, minibar, safe, desk and wireless Internet access. The air conditioning and heating are individually regulated.


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StubThis article is a stub. You can help Borderlands Wiki by expanding it.
Battle: Bar Room Blitz is a story mission in Mr. Torgue's Campaign of Carnage.
- Gather at rally point
- Kill badasses among the bar patrons
Once the mission started, the countdown runs. Time is limited for this mission and it is equal 5:00 minutes. If Vault Hunters fails this mission, they must come back to Pyro Pete's Battle Board to start again.
- "The Badasses of Pyro Pete's Bar will now treat you with a fear and respect one would generally reserve for diseases, natural disasters, and dinosaurs."
Turn In: Pyro Pete's Battle Board
- This mission counts towards the Battles Completed challenge in the Campaign of Carnage challenge list.
- The mission title references the song "The Ballroom Blitz" by Sweet.


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What is JotForm?
JotForm is a free online form builder which helps you create online forms without writing a single line of code. No sign-up required.
At JotForm, we want to make sure that you're getting the online form builder help that you need. Our friendly customer support team is available 24/7.
We believe that if one user has a question, there could be more users who may have the same question. This is why many of our support forum threads are public and available to be searched and viewed. If you'd like help immediately, feel free to search for a similar question, or submit your question or concern.
Feature request: add information text for fieldsAsked by nhpnl on September 23, 2014 at 09:53 AM
Second it would be nice to have info text for each options in a radio group. Example: http://www.nhp.nl/banksparen/index.php?product=8
I fixed this by using html in hover text, see radio group "U wilt een offerte voor", but info buttons would be nicer.
Maybe this is possible with the image element, but I could not make it happen.
JotForm Support
I have forwarded your request to our development team to see if this is something they may be able to add. I cannot give you a time frame as to when we will be able to address this, but we will update you in this thread as soon as we have any further information.
Just to clarify, you would like the ability to add extra information to your fields in the form of an extra button or symbol. In the case of the form you referenced, the question mark to the right of the radio buttons:


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The time of year called summer is almost here. High daytime temperatures and humidity require large concrete placements to be done at night when cooler conditions prevail.
There is nothing I love more than standing at a dimly lit jobsite; flashlight in one hand, two-way radio in the other hand, guiding ready-mix drivers close to the pour-out spot and hoping that they see and hear me.
Years of good and bad experiences (hey, no one is perfect) have taught me a few guidelines that I will pass along in the hopes of making your nighttime pouring a happy experience.
PLENTY OF LIGHTING - The general superintendent should be responsible for this as well as the concrete superintendent. Nicely explain that in addition to the pump truck or pour-out area, roadways leading in and out and washout areas need to have their own lighting.
LOTS OF READY-MIX TRUCKS - Dispatch managers have a tendency to cut back on the number of trucks that should be used. I advise working with the dispatch manager to put in accurate travel times and onsite times for pouring out and washing out. Better to have an extra truck available at the beginning of a pour than trying to rouse a driver in the middle of the night.
BACKUP BATCH PLANT - Having another batch plant on standby is a good thing, especially for a major pour. Or you can batch out of both plants, based on the jobsite location. Remember, you want your customers to know that your company gets the job done at a fair price, instead of just being the most cheaply priced company in town. At 2:00 a.m., you will have few options if a problem arises.
DISPATCHER ON DUTY - This is not the time to put all responsibilities on the batch plant manager. Everything takes longer at night when visibility is limited. He has a full plate keeping the overhead bins full and preventing collisions between the loader and ready-mix trucks.
The dispatcher should be the one keeping track of trucks and knowing which truck to load next. The dispatcher also communicates with the drivers and onsite people to keep the jobsite pour going smoothly.
ONSITE SALES AND QUALITY CONTROL – "Enough already," you are saying. "Who will be available for operations in the daytime?" However, a sales representative should be onsite talking with the customer, dispatch, and drivers. A quality control person should test at least the first two or three trucks for concrete temperature and visual slump inspection. A full battery of tests, including cylinders, should be performed on one of the first three trucks to ensure conformance with projects specifications. Afterwards, the QC person can help watch over third-party testing people and guide drivers on the jobsite as needed.
For the record, I do not have all of the answers to problems that can arise on a daily basis within a ready-mix concrete company. I have been chewed up several times by an onsite superintendent and held responsible when concrete failed to arrive at a jobsite on time. Hopefully the tips listed above will help lessen the chewings you receive from your customer — or his customers — in the future.
Tom Johnson has spent the past decade getting to know the ins and outs of the concrete industry from various viewpoints including driver, salesman, dispatcher, and quality control professional. Contact Tom with comments or suggestions at firstname.lastname@example.com.