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Publications / Original Research
Research Briefs April 25, 2017
Natural gas power plants in California's disadvantaged communities
California's power plants are disproportionately located near communities with high cumulative socioeconomic and environmental burdens. By applying the environmental justice screening tool CalEnviroScreen 3.0, we find that half of California's natural gas power plants are located in communities.
Peer-Reviewed Publications April 19, 2017
Comparison of chemical use between hydraulic fracturing. . . and routine oil and gas development
Technical Reports January 18, 2017
Greenhouse gas emissions associated with. . . future Marcellus Shale development
Research Briefs December 13, 2016
Comparative analysis: environmental impacts of utility-scale and distributed solar
Technical Reports July 14, 2016
The Clean Power Plan in Ohio: Analyzing power generation for health and equity
Technical Reports July 14, 2016
The Clean Power Plan in Pennsylvania: Analyzing power generation for health and equity
PSE Healthy Energy, in partnership with NextGen Climate America, has produced "Our Air: Health And Equity Impacts Of Pennsylvania's Power Plants". These reports examine the health and equity impacts of fossil
Peer-Reviewed Publications July 7, 2016
A framework for siting and dispatch of emerging energy resources to realize environmental health benefits
Technical Reports June 22, 2016
The impact of methane leakage on achieving Clean Power Plan targets
The study found that increased deployment of renewable energy and energy efficiency is the best way to meet or even exceed the emission reduction targets for 2030.
Technical Reports June 14, 2016
Assessment of the health and safety implications of coal transport through Oakland
Peer-Reviewed Publications April 20, 2016
Toward an understanding of the environmental and public health impacts of shale gas development: an analysis of the peer reviewed scientific literature, 2009-2015
Report presents and reviews the available science on some of the most salient environmental and public health concerns associated with shale gas development as of the end of 2015.


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Gender help!
Discussion in 'What Breed Or Gender is This?' started by BfastPartyOf5, Nov 28, 2015.

subset: commoncrawl


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M&M's Lobbyist Fights for Almond Milk on Capitol Hill
Mars Inc. executive Shannon Campagna was hired by vegan lobby group Plant Based Food Association to take down the Dairy Pride Act.
Trade group Plant Based Foods Association (PBFA) recently hired senior policy advisor at law firm Alston & Bird Shannon Campagna to fight against the Dairy Pride Act. A group of congressmen from dairy-producing states proposed the legislation in question late last year in an effort to prohibit plant-based companies from using the term "milk" in the labeling of their products. Since the proposal, several groups—including American Soybean Association and the Soyfoods Association of North America, that have a stake in both the dairy cow feed and soy milk industries—denounced the Dairy Pride Act, stating that it was unconstitutional. Campagna has worked as the executive director of government affairs for candy company Mars Inc. (makers of candy products such as M&M's) for the last six years and plans to work with PBFA to educate Congress on why such an act would be harmful to the lucrative plant-based industry. "I am thrilled to join the Plant Based Foods Association team to represent the interests of this important food industry sector," Campagna said. The Dairy Pride Act was proposed amidst a boom in the plant-based industry—which amassed $5 billion in sales in 2016, $4.2 of which came from plant-based milk.
VegNews Stands Against Racism
We stand with Charlottesville. We stand with people of color. We stand with the oppressed. We stand united.
Read More »
Ne-Yo Embraces New Vegan Diet
The musician says he can never go back to eating animal products after watching vegan documentary What the Health.
Read More »
Texas Vegan Bakery Wins $25,000 Grand Prize
Austin-based vegan bakery Skull & Cakebones takes top honors at the annual Quest for Texas Best competition hosted by supermarket chain H-E-B Grocery Co.
Read More »
Vegan Cupcake Decorating Studio Opens in Miami
At the new Bunnie Cakes Studio, vegan-treats fanatics can have a hands-on experience decorating cakes, cupcakes, piñatas, and more.
Read More »
USC Gets New "Hogwarts" Vegan Dining Station
Students at the prestigious University of Southern California can now visit an 8,000-square-foot dining hall where chef-created vegan dishes await.
Read More »
More Flashbacks
- Jon Bon Jovi Removes Leather from His Clothing Line
- Vegan Bacon Cone Rolls into London
- Hampton Creek to License Clean Tech to Meat Companies
- German International School in India Goes Vegan
- P90X Founder Tony Horton Sticks to Vegan Diet
- Hawaiians Fight eBay Founder's Plans to Open Dairy Farm
- "Vegan Mafia" Secretly Funds Plant-Based Companies
- All Slaughterhouses in England Must Now Install Cameras
- Impossible Foods' CEO Speaks Out About Animal Testing
- Major Australian Shoe Brand Gets Vegan Certified
- More than 1 Million Eggs Pulled from 15 Countries
- NYC Chef Develops Avocado Pizza for Vegans
- Vegan-Friendly 10-Minute FroYo Gadget Debuts
- Lightlife Launches New Veggie-Forward Deli Slices
- Orange is the New Black Star Danielle Brooks Goes Vegan
- Dubai's Popular Vegan Makeup Brand Lands in US
- "Fattest City" Mayor Inspires Launch of New Vegan Group
- Ivy Leagues Order More Veg Food Than Other Schools
- Starbucks Launches Horchata Almond Milk Frappuccino
- Hampton Creek Ready to Debut "Just Scramble"


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Blue Onion Bistro's Macaroni and Blue Cheese With Chives
READY IN: 50mins
Recipe by Julesong
From Chef Scott Simpson comes Blue Onion Bistro's signature dish! A rich, velvety macaroni made with blue cheese. From Bon Appetit magazine, March 2003.
Top Review by mersaydees
Made as directed. I have that issue of Bon Appetit and have been making this for years! Just love it. Thanks for posting, Julesong!
See Discussion:4 Reviews
Ingredients Nutrition
- 1 lb uncooked spiral tube-shaped pasta
- 1 teaspoon olive oil
- 2 tablespoons butter
- 1⁄4 cup flour
- 2 cups whole milk
- 1 cup whipping cream
- 3 cups grated cheddar cheese
- 1 1⁄2 cups crumbled blue cheese, divided (Maytag or Danish)
- salt & freshly ground black pepper or tricolor pepper, to taste
- 1 dash cayenne, to taste (optional)
- 1 1⁄2 tablespoons minced fresh chives
Directions See How It's Made
- Preheat oven to 350 degrees F; butter a 13x9x2-inch glass baking dish.
- Cook the pasta according to package directions until tender but still firm to bite, stirring occasionally; drain and set aside (about 8 minutes).
- While the pasta is cooking, in a large heavy saucepan over medium low heat, melt the olive oil and butter together; add the flour and, stirring constantly, cook for 1 minute (don't let it brown), then gradually whisk in the milk and cream.
- Simmer mixture until it slightly thickens, whisking occasionally, for 3 minutes.
- Reduce the temperature to low, then gradually stir in the grated cheddar and 1 cup of the blue cheese and cook, stirring, until the cheese melts.
- Season to taste with salt, freshly ground pepper, and cayenne (if using).
- Stir in the cooked pasta, making sure it's well-coated with the sauce.
- Pour mixture into the buttered baking dish, sprinkle with the reserved 1/2 cup crumbled blue cheese, and bake at 350 degrees F for 30 minutes.
- Sprinkle with the minced chives and serve.
- Note: also good with a serving of carmamelized onions and sauteed mushrooms; also, you can use 2% or skim milk instead of whole, but using whole is how they make it at the restaurant.


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Stupid title, yes. It's also not entirely accurate.
Saw some interesting data looking at the impact of weekend binge drinking with one of my nutrition clients...
Client Description: Active Male, Mid 30's
Begininning of Week (Monday, Began GTS Nutrition Program)
- Starting weight: 183.4 lbs
- Starting Measurements:
- Arm (relaxed): 13
- Arm (flexed): 15
- Neck: 15
- Thigh: 23
- Waist: 33
- Hips: 36
- Chest: 41
- Arms & Chest: 48 1/2
- Weight: 180.4 (4 lb decrease)
- No Measurements
Monday the following week.
- Weight: 189.4 lbs (+ 6 lbs from one week ago, + 9 lbs from 3 days prior)
- Measurements:
- Arm (relaxed): 13
- Arm (flexed): 15 1/4
- Neck: 15 3/4 (+3/4 inch increase from starting week)
- Thigh: 24 (+1 inch increase from starting week)
- Waist: 34 (+1 inch increase from starting week)
- Hips: 36 1/2 (+1/2 inch increase from starting week)
- Chest: 41
- Arms & Chest: 48 1/2
Tuesday the following day (Back on GTS Nutrition program and post-detox workout)
- Weight: 182.8 (~ 7 lb drop from Monday)
Why this is interesting...
- You can see how drinking alone can cause quite the increase in measurements and weight.
- Notice that the majority of inches was gained in the mid section, hips and thighs.
- According to my client, he didn't go overboard while eating that weekend.
- He enjoyed himself for a weekend, but was able to quickly recover by getting back on the nutrition plan.
Get back on track!
This summer there will be no shortage of parties. Although I don't advise drinking while you're looking to accomplish a performance/nutritional/fat loss goal, I understand situations arise.
So while you're out with friends make sure the party doesn't spill over to the next day or week... Drinking often leads to poor food choices as you're feeling lazy and your body is recovering. You can see how 2 days of drinking can add up quickly on the body. If you're going to put your body through it, plan to get it back on track immediately!
Need help getting back on track? Ask about Online GTS Nutrition Coaching...


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Ijeoma Ruana Wrap by Diane Ugo
Welcome! You are browsing as a guestWould you like to see 3 projects made from this pattern and much more? create a free account What am I missing?
© Diane Ugo
© Adlerherz
© onlyonedrop
© Diane Ugo
© Diane Ugo
© Diane Ugo
© Diane Ugo
Ijeoma Ruana Wrap
This pattern is available for £4.50 GBP buy it now
This ruana is made in one piece. The finished size is approx. 149.8cm/59" x 104.1cm/41" (when laid flat), instructions are given on how to make the ruana longer.
The pattern includes both written and charted instructions. In total their are 3 charts (side border chart, central motif, and front panel), which at times are worked simultaneously. For ease of reading the rows in chart 2 have been shaded in groups of 12, making it easier to work alongside with chart 1.
This pattern has been tested.


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On Monday 26th June 2017 136 year 8 students from Outwood Academy Portland went to Hatfield Woods in Hertfordshire with The Bushcraft Company for 3 days.
On Thursday 27th June 2017 75 year 11 students arrived in style at Aston Hall in Sheffield to celebrate their time at Outwood Academy Portland.
On Monday 19th June 2017 two Outwood Academy Portland students attended the Rotary Club Children of Courage Awards at The Masonic Hall in Worksop.
On Thursday 23rd February 2017 Outwood Academy Portland held a celebration for students and their parents who completed the Better Reading Partnership programme.
We would like to remind parents and carers to ensure they send students to school with water, particularly during the current hot weather.


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Create an Account - Increase your productivity, customize your experience, and engage in information you care about.
The City of Red Wing has begun the realignment project at the intersection of Twin Bluff Road and Pioneer Road in Red Wing. As part of the Safe Routes to School Program, this project will include many safety improvements including construction of a roundabout, realignment of the intersection with Hay Creek Trail, sidewalk improvements, and changes to access for Twin Bluff Middle School vehicle and pedestrian traffic. The project is expected to be completed by September 1st, 2017. Anyone interested in receiving weekly project updates can sign up for more information on the City of Red Wing's webpage for this project.


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Visit the
Service Design Innovation (MDes)
page on the Ravensbourne website for more details!
My career was as a project engineer in the construction industry; in such a competitive sector my company was increasingly asking me to propose new processes and innovations.It was challenging to project manage and discover innovation - not least because I lacked the expertise and experience.However, I found the area of business innovation and service improvement appealing and it was this that lead me to the MDes course at Ravensbourne.I found the attitude here very open and refreshing - the Service Design course has allowed me to experiment and be challenging.Service design is about finding what people's needs are and designing for them, and the course has really enabled me to understand how to work, and communicate, with creative people and appreciate their perspectives. Whilst on the course I have done an internship at Barclays with their innovation and customer experience team - it was a great experience, and is just one example of new networks and contacts I've made.The future looks good, I've now got enough skills to be successful, and I'm confident I can operate at a higher level and make a valuable contribution to industry.
The Professor Robin Baker Scholarship is a merit-based award which is open to applicants to Ravensbourne's postgraduate programmes.Professor Robin Baker was director of Ravensbourne from 1994 to 2015. In that time, he developed Ravensbourne's pioneering strategic emphasis on the creative use of digital technology. Professor Baker's vision led to our relocation to our current building and transformation of Ravensbourne into the cutting edge and innovative specialist higher education institution we are today.The purpose of the Professor Robin Baker Scholarship is to: - Encourage national and international applicants for Ravensbourne's postgraduate courses with the greatest academic potential and creative talent - Encourage excellent postgraduate work which demonstrates innovation and creativity in the use of technology - To provide access to Ravensbourne's innovative postgraduate courses to those who might otherwise find it financially challengingNormally, Ravensbourne will award either one full fee scholarship (up to £9000) or two part-time/half full time fee scholarships (up to £4500) annually depending on the range and calibre of applicants.- SelectionApplications for the scholarship will be evaluated and ranked by a selection panel consisting of: - Head of Student Services (Chair) - Two members of the postgraduate academic staff - Head of International DevelopmentRanking will be on the basis of the evidence provided of the applicants': - Previous, and current academic or professional performance and future potential. - Creativity and innovation in the application of technology - Benefit to be derived from the course and ScholarshipAward of scholarship: The successful applicant will be informed on 31 May 2016.
Students beginning a postgraduate course at Ravensbourne are encouraged to apply for a postgraduate scholarship. Applications are welcome from Home & EU students. Qualifying students will need to have been offered and accepted, a place to study a postgraduate course at Ravensbourne.If you have been successful in obtaining a scholarship, Ravensbourne will communicate this to you. There are ten postgraduate (Home/EU) scholarships available worth £1,000 each, paid in two instalments of £500. Please note all applications must be emailed to [email protected]
This scholarship is aimed at promoting postgraduate studies to students with the ability to make an exceptional contribution at Masters level. We invite applications from students with an outstanding portfolio, academic merit and dedication for high quality study in their chosen discipline area. We look for the articulation of how this scholarship will contribute to the applicant's long-term career aims.There are three scholarships available worth £1,500 each, paid in two instalments.
Ravensbourne is very grateful to The Stationers' Company for this generous bursary support of postgraduate students. There are three awards available worth £3,000 each.
Over 1,800 dynamic future leaders from all over the world, and from all professional backgrounds, have arrived in the UK to start a life-changing year studying and discovering the UK as a Chevening Scholar. This time next year, this really could be you, and the first step to being awarded a prestigious Chevening Scholarship is to apply.What are Chevening Scholarships?: Chevening Scholarships are the UK government's global scholarship programme, funded by the Foreign and Commonwealth Office (FCO) and partner organisations.Available in over 160 countries and territories, the scholarships are awarded to outstanding emerging leaders to pursue one-year Master's degrees in any subject and at any UK university.Chevening Scholars have ambition and leadership potential, a strong academic background, and an excellent record of rising to prominent positions in their countries.There are over 44,000 Chevening Alumni around the world, together forming an influential and highly regarded global network.
Find A Masters.
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All rights reserved.


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Der Lauf der Dinge/OK Go.
By veronique | March 19, 2012
TAGGED AS Buca Massi, Chain Reactions, Der Lauf der Dinge, Fischli & Weiss, Music Video, Ok Go, Swiss
This music video by OK Go was shared with me by my good friend Buca Massi from Brazil.
It is clearly inspired by the Swiss duo Peter Fischli and David Weiss' art piece " Der Lauf der Dinge (The Way Things Go)" – which is all about chain reactions. I promise it is worth watching all the way through – it is so impressive! Have a look at the difference between them…


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Here is a quick workout that provides both cardio and strength. For more cardio-based: lighter weights, more reps. For strength: heavier weights, fewer reps.
It is perfect for beginners; it's a great right-before-you-jump-in-the-shower workout; it can be done on the road!!!
Do it for time, but ALWAYS have good form!
You can mix in different bicep and shoulder exercises, as well as abs!!
And, as you get stronger, don't forget to increase the weight of your dumbbells!


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|Home | About | Journals | Submit | Contact Us | Français
Dr. Black: Johns Hopkins University School of Medicine and Berman Institute of Bioethics, 1809 Ashland Avenue, Baltimore, MD 21205.
Dr. Ersek: School of Nursing, University of Pennsylvania, Room 329, Fagin Hall, 418 Curie Boulevard, Philadelphia, PA 19104-4217.
Dr. Hanson: Division of Geriatric Medicine and Center for Aging and Health, University of North Carolina, 5003 Old Clinic, CB 7550, Chapel Hill, NC 27599-7550.
Drs. Miller and Teno: Brown University Program in Public Health, Department of Health Services, Policy, and Practices, Alpert Medical School at Brown University, 121 South Main Street, Providence, RI 02912.
Dr. Sachs: Division of General Internal Medicine and Geriatrics, Indiana University School of Medicine and Indiana University for Aging Research, Regenstrief Institute, Inc., 1001 West 10th Street, OPW-M200, Indianapolis, IN 46202-2879.
Dr. Morrison: Department of Geriatrics, Box 1070, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY 10029.
Dementia is a leading cause of death in the United States. This article outlines the current understanding of advanced dementia and identifies research priorities for the next decade. Research over the past 25 years has largely focused on describing the experience of patients with advanced dementia. This work has delineated abundant opportunities for improvement, including greater recognition of advanced dementia as a terminal illness, better treatment of distressing symptoms, increased access to hospice and palliative care services, and less use of costly and aggressive treatments that may be of limited clinical benefit. Addressing those opportunities must be the overarching objective for the field in the coming decade. Priority areas include designing and testing interventions that promote high-quality, goal-directed care; health policy research to identify strategies that incentivize cost-effective and evidence-based care; implementation studies of promising interventions and policies; and further development of disease-specific outcome measures. There is great need and opportunity to improve outcomes, contain expenditures, reduce disparities, and better coordinate care for the millions of persons in the United States who have advanced dementia.
More than 5 million Americans have Alzheimer disease, and this number is expected to reach 13 million by 2050 (1) (Figure 1). In 2009, Alzheimer disease was the sixth-leading cause of death in the United States, a ranking that has steadily risen during the past decade (2). Aggregate health care expenditures for dementia are projected to exceed $183 billion in 2011 and reach $1.1 trillion by 2050 (3). Expenditures are highest in late-stage disease, largely because of Medicaid spending for care at nursing homes (4), where approximately 70% of these patients die (5). Altogether, the societal burden of advanced dementia is substantial and increasing.
Advanced dementia has been relatively underrecognized as a terminal illness (6–8). Initiatives aimed at improving the experience of patients dying of this disease have lagged behind those of more commonly recognized life-threatening conditions, such as cancer. Advanced dementia emerged as a topic in the scientific literature approximately 25 years ago (9). Since then, research devoted to this field has increased (10). The objectives of this article are to outline our current understanding of advanced dementia and, with that foundation, identify the most pressing research priorities for the next decade.
The last year of life in persons with advanced dementia differs from that of persons with other common causes of death, in that it is characterized by a prolonged trajectory of severe disability (11). The Global Deterioration Scale (12) is a validated and reliable instrument that describes the clinical progression of dementia (Table 1). The scale ranges from stages 1 to 7, with higher scores indicating more severe dementia.
Stage 7 of the Global Deterioration Scale provides a useful description of the features of advanced dementia for clinical and research purposes: profound memory deficits (inability to recognize family members), speech limited to fewer than 5 words, total functional dependence, incontinence, and inability to ambulate. The CASCADE (Choices, Attitudes, and Strategies for Care of Advanced Dementia at the End-of-Life) study used this definition to describe the clinical course of 323 nursing home residents with advanced dementia (13). Over 18 months, 55% of the cohort died, 41% had pneumonia, 51% had a febrile episode, and 86% developed an eating problem. Other major acute illnesses (for example, hip fracture and myocardial infarction) were rare.
The CASCADE study thus confirmed that advanced dementia is characterized by a high mortality rate and the onset of infectious episodes and eating problems. Moreover, it demonstrated that most patients with advanced dementia die of this disease and its expected complications, not other acute illnesses.
Prognostication has important implications for clinical decision making and for accessing Medicare hospice benefits, which requires an estimated survival time of less than 6 months (13–15). The development of risk models for mortality that accurately estimate survival in advanced dementia has unfortunately proved elusive (16–21). In a prospective validation study (16), the 12-item Advanced Dementia Prognostic Tool predicted 6-month survival with only modest accuracy (area under the receiver-operating characteristic curve, 0.67); however, these findings were better than those of current Medicare hospice eligibility guidelines (area under the receiver-operating characteristic curve, 0.55) (16). The difficulty of estimating 6-month survival in advanced dementia suggests that access to palliative care for these patients should be guided not by their prognosis but rather by their preference to focus care on maximizing comfort and quality of life.
Patients with advanced dementia commonly experience distressing symptoms that are amenable to treatment (6, 13, 22–29). In the CASCADE study, the proportion of nursing home residents with advanced dementia who experienced pain and dyspnea increased as death approached, in a pattern similar to that of patients with cancer who are dying (30). Assessing patients' symptom distress is difficult because of their loss of language skills, but advanced dementia-specific instruments have been developed that quantify symptoms on the basis of the observations of caregivers. Several measures have gained greater endorsement because of their favorable psychometric properties and increasing collective experience among investigators (31–34).
Treatment decisions in advanced dementia should be guided by patients' care preferences as specified in advance directives or as perceived by their proxies. Goals of care must be used to guide initiation of new treatments, as well as the withdrawal of ongoing treatments. Most proxies state that comfort is the primary goal of care (13, 35), although patients with advanced dementia commonly receive treatments that are inconsistent with this goal (36–43). Possible reasons underlying this disconnect include such factors as inadequate advance care planning (40, 43, 44), the challenges of prognostication (16–21), providers giving misinformed and inconsistent counseling to proxies (13, 45), cultural influences (43, 46–48), limited access to high-quality palliative care that is tailored to the unique needs of patients with dementia (7, 39), and misaligned fiscal incentives in a fee-for-service health care system (49, 50).
Treatment choices regarding eating problems and infections are the most common decisions that proxies confront (51). A substantial body of research exists on managing feeding problems in advanced dementia (41, 44, 52–60). This topic has served as the paradigm for approaching dementia as a terminal illness with respect to examination of outcomes, decision making, and health care utilization.
Treatment options for feeding problems include continued assisted oral feeding (when possible) or tube feeding. In the United States, approximately one third of nursing home residents with advanced dementia who develop feeding problems are tube-fed (40). However, observational studies have consistently failed to demonstrate any clinical benefits of this intervention in this population (41, 44, 53). This evidence, together with an appreciation of eating problems as part of the natural history of advanced dementia, has led experts to advocate against the use of tube feeding in this condition (53, 55, 61).
Decision making for infections involves whether to administer antimicrobials or to use supportive measures only. Antimicrobial use is extensive in advanced dementia (62–66) and increases as death approaches (66). Up to 40% of patients with advanced dementia receive antimicrobials in the last 2 weeks of life (66). The extent to which antimicrobials meaningfully extend life or improve comfort in these patients, for whom infections are often a terminal event, remains unclear (38, 65, 67–69). Nursing home residents with advanced dementia are 3 times more likely than other residents to be colonized with antimicrobial-resistant bacteria (70). Altogether, the widespread use of antimicrobials in advanced dementia raises concerns not only from the perspective of individual benefits and burdens near the end of life but also from a public health standpoint with respect to the emergence of antimicrobial-resistant bacteria.
Approximately 16% of persons in the United States who die of dementia do so in hospitals (5). Nursing home residents with advanced dementia experience an average of 1.6 hospital transfers in the last 90 days of life (42), and residents living in regions with higher transfer rates experience worse end-of-life outcomes (43). Hospitalizations can be traumatic for these frail patients (37), as they receive care from unfamiliar providers and undergo uncomfortable tests and interventions (36, 38, 42, 42).
In the CASCADE study, hospitalizations accounted for 30% of Medicare expenditures; care at skilled nursing facilities after hospitalization accounted for an additional 10% (50). Research suggests that most conditions precipitating hospitalization in advanced dementia (for example, pneumonia) can be treated with the same efficacy in the community or nursing home setting (64, 65, 71, 72). For most patients for whom comfort is the priority (13, 35), hospitalization is seldom consistent with this goal, albeit with rare exceptions (for example, a hip fracture).
Hospice care is a beneficial (26, 73–75) yet under-utilized service in advanced dementia (7). Patients dying with dementia who received hospice care have better symptom management (26, 74), fewer terminal hospitalizations (76), and greater family satisfaction with care than those not receiving hospice care (28, 74). Trends indicate that hospice enrollment of patients with dementia is increasing; however, only 11% of hospice recipients in 2009 were reported to have a primary diagnosis of dementia, whereas 40% had cancer (77). Hospice professionals cite prognostication as the main hindrance to enrolling patients with dementia (78).
There are profound disparities in advanced dementia care. Nonwhite race is the most consistent risk factor associated with outcomes considered markers of poor-quality end-of-life care, including increased use of tube feeding (40), terminal hospitalizations (43), and lack of advance directives (46, 47). However, even after patient characteristics are controlled for, these outcomes vary dramatically across the United States in a strikingly consistent pattern, with a general propensity for worse quality of care in the southeast (42, 43, 48, 52, 54, 58, 79). The reasons for these disparities remain unclear, but they underscore that care of advanced dementia care is driven by a complex interplay of individual preferences, cultural influences, regional market factors, facility characteristics, local practice patterns, and health care policies.
Our understanding of successful strategies to improve care in advanced dementia is largely based on observational data. Modifiable factors most consistently shown to be associated with better palliative care outcomes for patients with advanced dementia in cohort studies include the presence of advance directives (for example, do-not-hospitalize orders) (40, 43–45, 50), better counseling of patients' health care proxies (13, 45), residence in a special care dementia unit (45, 51), use of hospice (26, 28, 74, 76, 80), and the presence of nurse practitioners on-site in a nursing home (40, 47).
There are few randomized, controlled trials (RCTs) of interventions in advanced dementia, of which only 2 had adequate methodological rigor to warrant comment (56, 81). Both studies evaluated decision support tools. In one study, healthy elderly persons who were randomly assigned to watch a video showing a patient with advanced dementia were more likely to prefer comfort care (vs. life prolongation) than were persons who were randomly assigned to listen to a verbal description of advanced dementia (81). The second study was a cluster RCT in 24 nursing homes of a decision aid to help proxies of residents with advanced dementia make treatment decisions for feeding problems (56). Proxies in the intervention facilities (vs. the control facilities) had reduced decisional conflict, increased knowledge, and better communication with providers about feeding decisions.
To date, research has largely focused on describing the experience of patients with advanced dementia and the care they receive. This work has delineated abundant opportunities for improvement. Addressing those opportunities must be the overarching objective for advanced dementia research in the coming decade. Table 2 shows the research priorities needed to achieve that objective, categorized by discipline; lists specific goals within each discipline; and provides examples of research initiatives for each goal.
Designing and testing interventions that promote high-quality, goal-directed care across health care settings will be a cornerstone for future research in advanced dementia. An example of such a study would be an RCT of an intervention to avoid unwanted hospitalizations of nursing home residents with advanced dementia whose goals of care are primarily comfort. Interventions that reduce disparities in the quality of care provided to patients with advanced dementia who are of various ethnic and racial backgrounds are also needed. Clinical trials in advanced dementia, while essential, will not be straightforward to conduct; interventions are often complex, settings are not well-suited to research (for example, nursing homes), and outcomes are challenging to define and measure. Nonetheless, the success of prior RCTs that faced similar challenges demonstrates that these hurdles can be overcome (56, 71, 81, 82).
Health policy research is essential to move advanced dementia care forward. A primary goal of this research should be to identify policies that incentivize cost-effective and evidence-based care without comprising the quality of palliative care provided to these vulnerable patients (49). Expanding access to the Medicare hospice benefit and broad-based palliative care programs is a key part of the equation. For example, prior work clearly shows that the 6-month hospice eligibility guidelines are problematic (16). Thus, research that explores novel approaches to enroll dementia patients into hospice is warranted. Comparative effectiveness research that evaluates different strategies to treat common complications (such as pneumonia) would also inform policy.
The anticipated complexity of clinical interventions and policies to improve advanced dementia care necessitate the inclusion of implementation science as a key priority to ensure that they can be effectively translated into practice. The Patient Protection and Affordable Care Act presents a timely opportunity for demonstration projects that evaluate alternative financial structures to reduce unwarranted and unwanted hospitalizations for nursing home residents with advanced dementia, such as bundled payments or capitated programs, similar to the Program of All Inclusive Care for the Elderly (which integrates Medicare and Medicaid financing for frail elderly patients) (49).
Although progress has been made in outcomes measurement, many gaps remain. For example, there is no measure to quantify the stress that families of nursing home residents with advanced dementia experience. A disease-specific utility-based measure that takes into account health-related quality of life must be developed to conduct comparative and cost effectiveness research. Finally, greater delineation of meaningful effect sizes of existing measures is necessary to plan trials that will use these instruments as outcomes (31–34).
The research priorities set forth in this report align with those of the National Alzheimer's Project Act, which was signed into law in January 2011. This projects calls for the expansion and coordination of research and health services delivery across federal agencies for Alzheimer disease and related dementias in order to achieve 2 top priorities: improve the health outcomes of patients with dementia and reduce the financial burden of the disease at an individual and societal level. The act further prioritizes the need to reduce disparities and improve the coordination of dementia care, and it stresses the need for initiatives aimed at prevention and early detection of dementia. However, if the top priorities of the act are to be met, significant focus must be placed on the millions of persons in the United States in the advanced stage of the disease, for whom there is great need and opportunity to improve patient outcomes, contain health care expenditures, reduce disparities, and better coordinate care.
Accomplishing these priorities will depend on several factors, including research funding. To date, roughly 63% of advanced dementia research has been supported by grants from the National Institutes of Health. However, with the National Institutes of Health budget at unprecedented lows, greater support from other federal agencies and philanthropic sources will be critical. In addition, the number of senior researchers dedicated to this field is small. Ongoing work will require close collaboration and intellectual and financial investment into the training of young investigators. Dissemination of key research findings through the education of policy-makers, health care providers, and the public will be an essential step in translating this work into better advanced dementia care. Finally, the millions of Americans with dementia and their families are perhaps the most important stakeholders in this research. Ultimately, their advocacy and enfranchisement may play the greatest role in driving advanced dementia research forward through the next decade.
Grant Support: By the National Palliative Care Research Center and grants K24AG033640 (Dr. Mitchell) and K24AG022345 (Dr. Morrison) from the National Institute on Aging.
The information presented in this article is based on Research in Advanced Dementia: State of the Science and Future Directions, a conference held in Boston on 20 June 2011. This conference was funded by the National Palliative Care Research Center. Participants included the authors of this report: a group of multidisciplinary senior investigators from across the United States who are focused on advanced dementia research. Each senior investigator was assigned to review, summarize, and present the existing literature on advanced dementia in a specific area (for example, cohort definitions, clinical course, outcomes, study design, health care utilization, strategies to improve care, and funding). Each presentation was followed by group discussion with the explicit purpose of reaching consensus about key findings that were well-established by the literature. After individual topic presentations, a broader group discussion was dedicated to reaching agreement about the remaining critical knowledge gaps and the overriding top research priorities for the field.
Potential Conflicts of Interest: Dr. Mitchell: Grant (money to institution): National Institutes of Health. Dr. Black: Employment: Johns Hopkins University; Grant (money to institution): National Institutes of Health, National Institute on Aging; Royalties: DEMeasure. Dr. Ersek: Grant (money to institution): National Institutes of Health; Support to travel to meetings for the study or other purposes: National Palliative Care Research Center. Grants/grants pending: New York Department of Health, National Institutes of Health. Dr. Miller: Support for travel to meetings for the study or other purposes: National Palliative Care Research Center; Support for travel to meetings for the study or other purposes (money to institution): National Palliative Care Research Center; Grants/grants pending: Alzheimer's Association; Grants/grants pending (money to institution): Alzheimer's Association. Dr. Sachs: Support for travel to meetings for the study or other purposes (money to institution): National Palliative Care Research Center; Consultancy: CVS Caremark; Grants/grants pending (money to institution): National Institutes of Health, Agency for Health-care Research and Quality, Alzheimer's Association, National Palliative Care Research Center, Retirement Research Foundation. Disclosures can also be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M11-2121.
Author Contributions: Conception and design: S.L. Mitchell, B.S. Black, L.C. Hanson, A. Sachs, R.S. Morrison.Analysis and interpretation of the data: M. Ersek, S.C. Miller.
Drafting of the article: S.L. Mitchell, L.C. Hanson, A. Sachs, J.M. Teno, R.S. Morrison.
Critical revision of the article for important intellectual content: S.L. Mitchell, B.S. Black, M. Ersek, L.C. Hanson, S.C. Miller, A. Sachs, J.M. Teno, R.S. Morrison.
Final approval of the article: S.L. Mitchell, B.S. Black, M. Ersek, L.C. Hanson, S.C. Miller, A. Sachs, J.M. Teno, R.S. Morrison.
Obtaining of funding: S.L. Mitchell.
Administrative, technical, or logistic support: S.L. Mitchell, R.S. Morrison.
Collection and assembly of data: S.L. Mitchell, M. Ersek, S.C. Miller.
PubMed Central Canada is a service of the Canadian Institutes of Health Research (CIHR) working in partnership with the National Research Council's national science library in cooperation with the National Center for Biotechnology Information at the U.S. National Library of Medicine(NCBI/NLM). It includes content provided to the PubMed Central International archive by participating publishers.


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It's A Mother's Day Miracle
But I cleaned out my van. To include:
Taking out all the carseats (6 of 'em for those that are counting) and washed the covers. Vacuuming the floor and seats and even using the little crevice tool.
Please notice in this photo the lack of any people old enough to do it without supervision, as well as the boy who thinks he is a monkey.
This is no small feat. My van is larger than the apartments that many of our NYC friends live in. Truthfully. My husband has a co-worker who lives in a 300sq ft one bedroom apartment. That is pretty much smaller than any one room in my house, aside from a bathroom. I had asked if she could cook and serve herself breakfast in bed, and maybe shower at the same time, because that could be a selling point.
In any event, my van is now free of petrified french fries, gum wrappers, assorted papers, lollipop sticks, and half eaten, now unrecognizable foods.
And how did we celebrate? Did I ban the children from stepping foot into the van so I could enjoy the cleanliness?
Nope, we took a field trip to a local organic farm, where the kids all climbed in compost heaps and took turns plating onions in his field. Then they each planted their own six pack of lettuce seeds to bring home. One of which I knocked over in the van and had to try and scoop up the dirt and itty bitty seeds and get them back into the planter with no one noticing.
And then we stopped at the batting cages so the oldest two could practice hitting. 150 balls each later, they were done.
We stopped at Dairy Queen on the way back home. Because what goes better with dirt than drippy ice cream cones.
We never go to Dairy Queen because Rob has "issues" with it. He hates the idea of standing outside, in a dirty parking lot, licking an icecream cone. Personally, I think standing next to a dumpster, along a chain link fence, in a dirty parking lot just adds to the ambiance. Where else can filthy dirty children enjoy a good icecream cone AND provide entertainment for passerbys at a busy intersection.
As we were about to drive away, my 9 yr old discovers that he had stepped in gum. And tracked it all over the van. He was upset because if I hadn't cleaned out the van, "you wouldn't even notice."
In the words of my 10 yr old, "It was inevitable."


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A very dexterous apprentice of the Keep fit of Wicca has incited us to reveal the use of correspondences when it comes to timing your services. As we all know, astrological signs plea the work we do and there is a parcels along with decree, for opportunity, a healing ritual for a focus attack and Aries.
All the way through a 24-hour day we move (that is, the earth rotates) along the twelve signs of the zodiac. Respectively sign exerts the peak powerful plea for a two-hour taste. As normal we part mottled get older of the engagement to the dawn sign, and dawn is normally lovesick as 6 a.m. in the time expanse everywhere you are working. The astrologers in the company of you can in fact work this out in pompous abundance and entwine you completely when Aries (for tutorial) is in its ascendant.
So if you finish equal it that Aries is at 6 a.m., on a day that the moon is full, when you train a repellent ritual at midnight, what sign courage you be in at that hour? That is, which sign courage benefit from the strongest plea blank your efforts? To the same degree midnight is is 18 hours shown from 6 a.m., that channel you courage benefit from stimulated 9 signs around the zodiac. This courage place you in Sagittarius; that's why you poverty do everything reduced-size to Sagittarius to adjust your work to the totally sign. All you benefit from to do then is (1) citation out when you courage engagements your service, (2) citation out what is the dawn sign, and then (3) reckon around the signs to the one reduced-size for your service.
You may benefit from solemn to do the service at 10 p.m. In this case you would reckon around right 8 signs. Flimsy, isn't it?
Race... wealth... healing... If you privation a accurate diagram of correspondences that courage middle name the peak reduced-size day and time for your tenacity, send the Keep fit a printed addressed No. 10 container with an unnecessary assurance inside; we'll send you a design of such a diagram. A above accurate protest of this entity can be found in our book Regulate Yourself with Astromancy from Parker Publishing.
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This country former had no everyday public, but was populated virtuously by spirits and n^agas, with which merchants of uncommon countries carried on a distribute.... Regulate the coming and leave-taking of merchants... on one occasion they went apart, the sprint of their uncommon countries heard how nice-looking the land was, and flocked to it in attendance arable farm it became a vigorous nation...
Ecclesiastical Si UnitsI sometimes find, Adore Reader, that general public power alarming anxiety understanding the SI materialize of dimensions. And is it so surprising? To the same degree metric procedures are particular in terms of wavelengths of light, how can everyone understand them?
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Oic Ramps Up islamophobia Campaign
oic ramps up islamophobia Grudge
February 28, 2013 By Deborah Weiss Explanation (12)
16Duplicate This Watch
The Group of Islamic Help (OIC) has inclination been on the forefront of the Islamist occupation to document the invariable of Islamic blasphemy laws in the West. Now, appearing in its 12th Islamic Crest thought in Cairo February 7-8...
She Is Also The Goddess Of Sovereignty BranwenBranwen (elevated Bran-oo-wen) is the Welsh Divine being of love and beauty. She is teen of Llyr, god of the sea and Penarddun also a Divine being of beauty. She is intentional the Venus of the Northern seas.
The name Branwen maneuver colorless raven' in Welsh.
Branwen is one of the five Goddesses of Avalon.The full moon in June is Branwen's moon.She is also honoured from first to last the waxing moon each month...


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Colton Black Royse City, Texas
I am recording and mixing my music as I learn more about the process in order to grow in my craft and put out the most professional sounding product with minimal equipment. The truth in my intent is what makes my music such a formidable outlet.
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Think things are hopeless? Republicans control it all?I just saw a hawk flying straight towards my house, being chased by a dozen small finches. Be the finch.
Nai-post ni Shelley Powers noong Lunes, Hulyo 17, 2017
But his emails…
Social media is abuzz with the proof of Donald Trump Jr's collusion with Russian officials. He actually released the emails containing the proof on Twitter, but only because the New York Times was about to release content from the emails.
Here's my statement and the full email chain pic.twitter.com/x050r5n5LQ
— Donald Trump Jr. (@DonaldJTrumpJr) July 11, 2017
Here is page 4 (which did not post due to space constraints). pic.twitter.com/z1Xi4nr2gq
— Donald Trump Jr. (@DonaldJTrumpJr) July 11, 2017
Here's why Donald Trump Jr. just tweeted out his emailshttps://t.co/U9R1jNIscx pic.twitter.com/icHYUpj6CK
— Bradd Jaffy (@BraddJaffy) July 11, 2017
Groups Challenge Trump's Terminator two-fer order
NRDC, The Communication Workers of America, and Public Citizen just filed a lawsuit against Trump's infamous "two-fer" rule. This is the rule I've designated the Terminator Rule.
From the lawsuit:
To repeal two regulations for the purpose of adopting one new one, based solely on a directive to impose zero net costs and without any consideration of benefits, is arbitrary, capricious, an abuse of discretion, and not in accordance with law, for at least three reasons.
First, no governing statute authorizes any agency to withhold a regulation intended to address identified harms to public safety, health, or other statutory objectives on the basis of an arbitrary upper limit on total costs (for fiscal year 2017, a limit of $0) that regulations may impose on regulated entities or the economy. Second, the Executive Order forces agencies to repeal regulations that they have already determined, through notice-and-comment rulemaking, advance the purposes of the underlying statutes, and forces the agencies to do so for the sole purpose of eliminating costs that the underlying statutes do not direct be eliminated. Third, no governing statute authorizes an agency to base its actions on a decisionmaking criterion of zero net cost across multiple regulations.
The Terminator rule is nonsensical in the extreme and violates all administrative procedure and law when it comes to forming regulations and rules. To instruct agencies to only include costs, not benefits, virtually cripples the federal government.
I have to wonder at this time if Trump even has access to lawyers. If so, where did they get their law degrees? Trump University?
I'll be following this case on PACER.
Photo by Gage Skidmore CC BY-SA 2.0
The Army Corps Decision on Dakota has serious ramifications
The Army Corps of Engineers announced Tuesday it would approve development of the last section of the Dakota pipeline. In a cryptic letter, the Corps announced it was terminating the Environmental Impact Statement process in the Federal Register. The reason? Trump told them to do so.
As former State Department lawyer Keith Benes said to the Washington Post, the Corps can't just drop the EIS process for arbitrary reasons. And Trump demanding they do is an arbitrary reason.
Keith Benes, a former State Department lawyer who helped oversee pipeline permitting decisions under the Obama administration and now works as an environmental consultant, said in an interview that opponents could mount a strong legal challenge because the only justification the Army gave for terminating its environmental review was the president's Jan. 24 directive. The agency had been seeking public input on whether to consider an alternate pipeline route, and the comment period was due to close Feb. 20.
"Supreme Court precedent is really clear that agencies can change their minds about policies, but they need to provide a reason," Benes said, noting that the justices most recently upheld this position in the 2009 case FCC v. Fox Television Stations, Inc. "The president telling you to change your mind is not enough of a justification for changing your factual finding."
The Corps decision was sudden and unexpected. The Corps had already filed a notice to the Federal Register asking for comments about the EIS scope, the first step in the process. Until this week, there was absolutely no indication that the Corps was planning on terminating the EIS.
Trump's administration has completely disregarded environmental law, not to mention tribal rights and treaty in this decision. Yes, the decision can and will be successfully challenged in court. But there's more at risk than our water with this decision.
All Federal Agencies are bound to follow laws in their actions. One of the laws is the National Environmental Policy Act or NEPA. Though agencies can follow different routes within the NEPA framework, they can't work outside of it. Not unless expressly given permission to with other laws. There is no other law at play with the Corps Dakota Pipeline decision.
The Army Corps not only dropkicked NEPA to the curb, they pissed on it in passing. And they did so specifically because of a demand from the Trump administration. The Trump administration action demonstrates either a profound ignorance of a law that has been in existence for decades, or that the administration considers itself not bound by the law. I suspect the latter.
The Executive Branch of the government's primary duty is to uphold the laws of the United States. Trump cannot just ignore the laws because they don't suit him. To do so is to introduce a level of chaos we have never seen before in our history.
Don't Make Gorsuch into a Purity Test for Democrats
I normally agree with much of what Think Progress writes, but not in one of its latest pieces on how Senate Democrats stand on Gorsuch appointment. It's interpretation of their stand is obvious from subheadings of "Team Spine", "Team ¯\_(ツ)_/¯", and "Team Trump".
I am not happy with a Gorsuch appointment because of his strong beliefs against the Chevron Defense. This legal standard has allowed federal agencies to survive challenges to laws typically related to the environment and endangered species. He's also a conservative judge when we had a chance to appoint a moderate who would actually make decisions based on the law, not ideology.
At the same time, Gorsuch is a much better option than some of the judges Trump was considering. And these latter judges may be up for consideration in the next few years if another Justice retires or dies. Gorsuch has demonstrated a willingness to buck conservatives in decisions if he interprets the law in a way that's independent of their reasoning.
If I were a Democratic Senator, I wouldn't vote for Gorsuch, but I wouldn't filibuster his appointment, either.
By not voting for Gorsuch, I'm signaling that I believe the seat he'll feel is a stolen seat. I'd want him to know that this "stolen seat" legacy will follow him throughout his years, and his decisions. I'd want him to think about this legacy, especially in light of his professed love of the law. I'd want him to remember that Merrick Garland is highly qualified, more experienced, and was lawfully appointed by the President of the United States.
However, by not filibustering him, I am acknowledging that he is a better option than what we could face from Trump. It's a long two years until the Senate race when we can hopefully take back the Senate. The Senate Republicans will destroy the SCOTUS filibuster rule if Democrats filibuster Gorsuch. Guaranteed.
Gorsuch will still be judge, but we'll have lost the ability to force in-depth, stringent confirmation hearings for future appointees; hearings that may cause some Senate Republicans to question whether what's being said in these hearings is worth the possible hit in their upcoming re-election bid. Because there's a whole lot of Republicans coming up for re-election along with the Trump administration in 2020.
With the filibuster in place, Senate leaders are going to be more willing to allow for lengthy, robust questioning during the committee hearings, in hopes of appeasing those who might be thinking of filibustering the appointment. Without the threat of filibuster, why should they waste time when they know the control the votes to just vote the person in?
A longer confirmation process may expose information that not only is game changing for Democrats but could be game changing for some Republicans. Republicans who might actually join the Democrats…especially if they're coming up for re-election.
That's my take. Others, including many Democratic Senators, have different takes. Regardless of how each Senator handles the Gorsuch appointment, one thing I'm adamant about: I'm not turning this into a purity test for Democrats.
Purity tests, inspired by Sanders and sledgehammered by Jill Stein, helped us lose the election and put Trump into the Presidency. Trump's Presidency has already hurt people. Trump's Presidency has already killed people.
That Garland isn't a Supreme Court Judge is the Republicans' fault. That Gorsuch and not Garland is the current choice is Trump's fault. Trump, his cabinet, and the Republican-controlled Congress are, and will remain, my only targets. My entire focus is to limit the damage this Congress and President can do, and to kick them all out in the next three federal elections. To me, nothing else matters.
Photo courtesy of Elvert Barnes CC BY-SA 2.0


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Catch up on all that's happening with CBDA!
Dixon Hughes Goodman Donates 773,741 Pounds of Food in Sixth Annual Count the Cans Campaign
July 26, 2017 2:22 PM
Dixon Hughes Goodman held its annual Count the Cans food drive in June with employees and partners across its footprint donating dollars, canned goods and volunteer hours to hunger relief
Marathon Consulting Announces Team Additions – 2017 Q1 & Q2
July 26, 2017 2:16 PM
Marathon Consulting, LLC, a leading Information Technology Consulting and Digital Marketing firm, announced a recent expansion resulting in the addition of seven (7) team members. Each of the new
Fulton Bank names senior vice president, senior relationship manager
May 5, 2017 4:12 PM
Henry (Hank) A. Boyd, of Virginia Beach, VA, was named senior vice president and senior relationship manager in Fulton Bank's Commercial Real Estate Group. In this position, he will be responsible for
Pender & Coward Shareholder Richard Garriott Inducted as Fellow of American Bar Foundation
May 5, 2017 4:09 PM
Pender & Coward is pleased to announce that Richard Garriott has been inducted as a Fellow of the American Bar Foundation (ABF). The Fellows of the ABF is an honorary society of lawyers and jurists
Pender & Coward Attorney Drew Kubovcik Elected to Virginia State Bar Council
May 5, 2017 4:00 PM
Pender & Coward is pleased to announce that attorney Drew Kubovcik has been elected to the Virginia State Bar Council to represent the First Judicial District covering the city of Chesapeake. The
Dixon Hughes Goodman Welcomes Government Contracting Senior Consultant, Jacob Barclay
May 5, 2017 3:56 PM
Dixon Hughes Goodman (DHG), a top 20 public accounting and advisory firm, is pleased to announce that Jacob Barclay has joined the firm as a Senior Consultant in the Government Contract Advisory
April 13, 2017 4:11 PM
The following ten Pender & Coward attorneys have been recognized as 2017 Virginia Super Lawyers or Rising Stars*.Duncan G. Byers – Business LitigationByers focuses his practice on intellectual
Ruth's Chris is Open on Easter
April 11, 2017 1:57 PM
Pu ton your Sunday Best and enjoy Easter dinner at Ruth's Chris Stteakhouse! Open on Easter, 11 AM - 7:00 PM. Make your reservation now!
Fulton Bank Breakfast Seminar - April 25
April 11, 2017 1:51 PM
Get Strategic in Your Community Involvement to Build Your Brand! Presented by: Susan Long-Molnar Tuesday, April 25th, 9:00-10:30 am4429 Bonney Road,
Marathon Consulting Named as one of the Best Places to Work in Virginia for the Fourth Time
February 24, 2017 3:11 PM
Marathon Consulting, LLC, a leading IT Consulting and Digital Marketing firm based in Hampton Roads, today announced that the company was named to the 2017 Best Places to Work in Virginia. Following


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Masala Coorgi Puris recipe |
Crab Rangoon
Crispy pork belly (Siu Yuk) one of my favorite Cantonese dishes for the years in Guangdong province. Each time when I have a chance to enjoy Gu...
Easy Sesame Chicken Recipe
Moo Goo Gai Pan - Easy recipe for Chinese chicken and vegetable stir fry tossed in a nutty, sour, sweet and savory, gooey sauce (ready in 20 minutes!). We love this for a simple and healthy work lunch! Recipe, chicken, stir fry, dinner, easy, Chinese | pi
North Indian cuisine is distinguished by the proportionally high use of dairy products; milk, paneer, ghee are all common ingredients. I think this could be a reliable site because it was dawnload new information in april of 2013. It is very complete and it doesn't has commercials.
Lobster Rolls with Crispy Ginger & Scallions
Butter chicken curry


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Name: Madi Banks
School: University of New Brunswick (Fredericton)
Year: 3
Major: Joint Honours in Classics and Archaeology
Fav thing about your campus: How innovative and forward thinking we are and are becoming.
Dream Job: I would love to work for National Geographic as a Travel Journalist and Photographer, but right now I'm working towards my PhD in Classical Archaeology, which will allow me to travel and discover.
What is your connection to mental illness?
I'm always telling myself "keep it short but sweet, Madi," and I think that's what I have to do in this situation as well, even though I have a lot to say. Like everyone, I had a pretty hard time in middle school and high school, with friends, stress, and schoolwork. It was really internalized and most people didn't notice it. Unlike everyone, however, these things really wore on me, and I just felt myself getting heavier and heavier. Like there was a tiny weight tied to the back of my tongue that slowly grew heavier, pulling my head down from the inside. My moods changed rapidly, and when I was happy, I told myself that I couldn't be depressed. It was as much of a lie to myself as a lie to everyone else. Fast-forward 6 years, I'm in my second year of University, and I'm being diagnosed with Social Anxiety, ADHD (Attention Deficit Hyperactive Disorder), and (the kicker for me) OCPD (Obsessive Compulsive Personality Disorder), after already knowing I had depression (which was being managed as well). It was a little shocking (a lot shocking) because it began to explain why my depression wasn't ceasing, even when being managed in a multitude of ways. In the larger timeline of my life, this diagnosis wasn't that long ago, and I'm currently on the road to recovery and rediscovery. I'm learning how to manage these things I always had problems with instead of learning to deal with "new problems." All these things just kind of make me who I am, and even though they have a negative impact on my life sometimes, I'm learning how to control the negative while keeping who I am.
How do you deal with stress from school?
Oh gosh. I'm an OG when it comes to stress, but definitely not the best at dealing with it. Something I've learned to fall back on now is being open with anyone and everyone in my life that my stress affects. Its not always easy, but 99% of the time they get it. Friends, employers, professors, they all get it. I never let my stress be an excuse, but now that I've learned to be open about it, I am able to breathe a little easier.
I take a lot of time for myself, and I make sure to justify it. I don't want to feel guilty laying in my bed watching Netflix, or spending 2 hours playing with my pet rats instead of studying for Latin. I mean, schoolwork is important, but feeling good and doing well is better than doing great and being exhausted physically, mentally, and emotionally. At least for me. My ADHD makes me impulsive and one thing that I have learned is to define my impulses into ones that are going to benefit me and ones that I am just doing to stay distracted. So the other night when I was up at 1:00am cause I couldn't sleep, and I was watching reruns of Community I had already seen, but all I wanted to do was paint, you betcha I got right out of bed and listened to that impulse. And maybe I only painted for 10 minutes until I went to sleep, but it would have been another 20+ minutes on Netflix being deconstructive.
What does your campus do to help students' mental health?
I'm very blessed to go to the school I do for this reason. My mental health wasn't totally something I understood when coming into university, and although I knew I was aware of it, I don't think the ways in which I was dealing with it was anything to be proud of. One thing I want to highlight about UNB is how accepting we are of people battling and struggling with so many different things, mental health and beyond. We have exceptional counselling services, who are extremely active and visible on campus, and we have *excitingly* just added coverage for mental health under the healthcare our student union provides.
Our student union also hires a Mental Health Coordinator and a mental health committee to help out with various events throughout the year, such as our Wellness Week, and other events geared towards raising mental health awareness. Apart from these, there are many different groups/societies/clubs on campus that, while do not have, contribute to the overall mental health and wellbeing of the individuals they are enacted for such as Qmunity, Spectrum, and Best Buddies, to name a few. From campaigns to committees, our University community goes above and beyond, and continue to recognize when more support is needed.
Do you have any school year self care tips to share with other students?
I thought I would have a lot to say for this question, and I probably do somewhere, but only one thing seems to be repeating itself in my head. If you're anything like me, a lot of my journey has been trying to internalize this struggle, always maintaining a self-aware persona. I think this helped keep a lot of what I was feeling secret. I don't regret this, even though I had outbursts, I think being so self aware allowed anything I was dealing with to be easier for those around me, and because of this, I became more and more driven into helping other people, even though it was hurting me. If you're anything like me, you will always put other people first, and this is something I'm slowly learning to balance out. My piece of advice would be something my doctor is constantly reminding me of: you need to take care of yourself before you help others. I think there's a lot of truth to this, and sometimes I think me helping others is just a distraction to what I'm going through at the moment. Don't forget about yourself while reminding others not to forget about themselves.


text: HomePortugalLeiriaObidos Property Details Bedrooms: 3 Bathrooms: 3 Features Views Over Countryside Countryside Views Great Rental Opportunity Attic Room Balcony Short Drive To Beaches 45 Minutes To Lisbon Garage 3 Bathrooms 5 Minutes To Obidos Castle En Suite Full Description A great rental opportunity.3 Bedroom house located within a short distance of the Silver Coast beaches, including the Super Pipe beaches in Peniche, which hosts international tournaments surfing and the famous Praia do Baleal. It is only 5 minutes from Obidos castle and a few minutes from Obidos Lagoon, the golf courses and riding centre.The villa consists of ground floor, first floor and stairs up to the attic room. On the ground floor there is a living room, kitchen with pantry and guest bathroom. Upstairs has 3 bedrooms, one en suite, another bathroom and a balcony with lovely countryside views. The attic is large and with good ceiling height.Outside you can enjoy the patio and barbecue for outdoor dining. There is a garage for one car.It is located next to restaurants, cafes, markets, health centre and pharmacy. Because of its location this is excellent for holiday rentals; Lisbon and the international airport are a 45 minute drive away.*The house will be repainted prior to being sold*Bedrooms: 3Bathrooms: 3Plot size: 261 square metresAV1586 more Send enquiry This property listing (ref: AV1586) is an advertisement supplied by Buy Portugal and does not constitute property particulars. While aplaceinthesun.com (APITS Ltd.) requests all advertisers supply correct details, it does not carry out checks on the information supplied and cannot be held responsible for any inaccuracies. Aplaceinthesun.com recommends seeking independent legal advice prior to any overseas property purchase.