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Thou shalt not plow with an ox and an ass yoked together.
—Deuteronomy, xxii, 10
Caution: The many reports claiming the occurrence of this distant cross, cited below, require confirmation.
Most scientists today would reject the possibility of strange mixtures like ox-horses and ox-donkeys. Nevertheless, in centuries past, scholars did widely claim that such hybrids exist. Indeed, many asserted that they themselves had seen creatures of this sort. And the video at right, of a living animal with a cow's head but horselike hindquarters and tail, lends credence to their claims, in that it seems to confirm that horse-cow hybrids actually can be produced, at least on rare occasion (as do the numerous reports quoted below). Such animals are known by various names (see list at the bottom of this page), but perhaps the most common is jumart. This word has been used in English since at least the mid-eighteenth century, as evidenced by it's presence in Johnson's Dictionary of the English Language, defined as "The mixture of a bull and a mare."
There is a great deal of evidence that jumarts exist, eyewitness testimony, veterinary reports, comments of breeders, photographs and even the video shown here (and two additional videos embedded lower down on this page). But it seems such animals are quite rare, which would explain, at least in part, why they are not better known. The most obvious obstacle to the full acceptance of their existence is the lack of any DNA study verifying a particular specimen as a definite horse-cow hybrid (to my knowledge, no alleged specimen has been tested in this way). This page, however, attempts to collect whatever evidence is in fact available for this cross, and presents that evidence in an historical format.
The existence of such creatures has been reported since ancient times. A famous example is Alexander the Great's steed Bucephalus, whose name literally meant, "ox-headed" (see image right). Many classical authors seem to have taken it for granted that Bucephalus had the body of a horse but the head of a bull. Thus, Arrian (Anabasis, V, 18) writes that "The mark by which he was said to have been particularly distinguished, was a head like an ox, from whence he received his name Bucephalus." As portrayed on ancient coins contemporary with the life of the animal, Bucephalus did have horns like a bull. Chares of Mytilene, an historian who attended Alexander's court, wrote that Alexander's father Phillip paid 13 talents for the animal, an equivalent of 312,000 sesterces in Roman money (see Gellius, Attic Nights, V, 2). This would amount to something like a million dollars in modern money, so cow-horse hybrid or not, Bucephalus must have been a very special animal.
The scientific story of the jumart begins in the 16th century with Conrad Gesner, the founder of modern zoology, who, in his Historiae Animalium (Liber I, De Quadrupedibus viviparis, 1551, p. 19), writes,
In the same place, he mentions a cow-horse hybrid, saying that he has
Gesner, who was Swiss himself, was a professor at the Carolinum, the precursor of the University of Zürich. He later refers to the same event (Gesner 1551, p. 106):
One source of this information was likely the physician Jakob Ruf (1505-1558), who, according to his German Wikipedia biography, lived as a young man in a cloister at Chur up to the time of the Reformation in 1526, but later lived in Zurich, where he became the leading surgeon of the city. In his De conceptu, et generatione hominis, he mentions this same birth (Ruf 1587, p. 48), and gives a brief description:
Julius Caesar Scaliger, a scholar of the same era as Gesner and Ruf, called a hybrid of this type a "hinnulus." He said (Scaliger 1612, p. 650; see also p. 349) it
The Gabali and Arverni were two ethnic groups native to France. The former lived in the southeastern region of Aquitaine, the latter, in the Auvergne in central France.
Likewise, Giambattista della Porta, the Italian scholar, polymath and playwright, avers that "I myself saw at Ferraria [i.e., Ferrara], certain beasts in the shape of a Mule, but they had a Bull's head, and two great knobs in the stead of horns."
Paul Zacchias (1584-1659), personal physician to popes Innocentius X and Alexander VII, long resided at Rome. In his best known publication Quaestiones medico-legales (1651, p. 504), he winds up a section on hybrids by describing a jumart, which he claimed was for many years in the possession of Cardinal Borghesi.
And in the early eighteenth century, Dr. Patrick Blair (c. 1680–1728), a Scottish surgeon and a Fellow of the Royal Society, informs his readers that from "a Bull and a She-Ass is procreated a certain Animal, called Joumar, as I am credibly inform'd by the intelligent Dr. Sherard, who has often seen them in Turkey, where they are very frequent, and of great Use, as being excellent Beasts of Burthen, and of a quick Pace upon a March, a property not very incident either to Father or Mother. This Animal is a compound Mixture of both, and by being so, of a very unusual Shape" (Blair 1720, Part II, p. 310).
Indeed, eighteenth-century books on horse breeding gave explicit instructions on how to breed horse-cow hybrids, as shown here:
In late eighteenth-century France, belief in this equid-bovid hybrid seems to have been extremely widespread. For example, after the French Revolution the new official calendar renamed the months, and gave names taken from nature to each individual day of the year. The name of the 15th day of the new month of Messidor was Jumart. A French encyclopedia (Cours d'études encyclopédiques ou nouvelle encyclopédie élémentaire, vol. 6, p. 40), published during the revolutionary era, lists the beasts of burden as follows: "the horse, the ox, the ass, the mule, and the jumart." Voltaire, widely considered one of France's greatest Enlightenment writers, accepted the reality of cow-horse hybrids as much as he did that of mules (see Voltaire 1792, p. 200).
Zirkle (1935, p. 34) says this cross "was cited as an authentic instance of hybridization for well over two hundred years." He also notes that many of the descriptions "seem to be independent eyewitness accounts from several different countries, and no one ever seems to have doubted the creature's existence." This last statement, however, is not entirely accurate; many people, for example Buffon (1749-1804, vol. 14, p. 398), did express doubts, which is not surprising, given that cattle are artiodactyls ("even-toed ungulates") while horses and asses are perissodactyls ("solid-hoofed ungulates"), that is, they belong to two separate mammalian orders. In other words, on the basis of their scientific classifications, a horse and a cow are as distantly related as a pig and a chimpanzee.
But there were also many who adamantly embraced the reality of cow-horse hybrids (the longstanding controversy was similar to that seen in the case of cat-rabbit hybrids at the present day), especially in France. Thus, in his Histoire générale des animaux even the doubting Buffon included this illustration of a jumart, since he realized that his readers would expect to see one alongside pictures of oxen, horses, mules, donkeys, and all the other common animals:
One eyewitness from that era was Giuseppe Marco Antonio Baretti (1719-1789). Baretti was an Italian literary critic, translator and writer. In his book An Account of the Manners and Customs of Italy (London, 1769, vol. 2, pp. 281-285), he states the following:
As for the carrying of burthens, we [i.e., the Italians] make use of mules, and of another animal called Gimerro [In a footnote here Baretti says, "Gimerro in English is Jumart."], expecially throughout the mountains where horses would soon perish.
Of mules we have great droves continually carrying merchandises, particularly over those parts of the Apennine that answer to the port of Leghorn; those of the Alps that lie between Italy and Savoy, Switzerland, and Tyrol; and those which geographers call the Ligurian Alps. Some of the muleteers of the Apennine draw even carts with mules; but those of the Alps never do, or at least I never saw any that did. Perhaps the greater height of the Alps and their unconquerable ruggedness causes the want of this convenience.
It will not be improper to say something of the gimerros, as I find that no travel writer, of the many I have read, has ever mentioned them, and that they are but little known even to those of my English friends who delight in various and extensive reading. A gimerro is an animal born of a horse and a cow; or of a bull and a mare; or of an ass and a cow. The first two sorts are generally as large as the largest mules, and the third somewhat smaller. I have been told by some muleteers in several parts, that the sires of these animals are first shewn a female of their species just before the leap; then led forcibly to one of the species intended, which is kept at hand. The Alpine peasants assure us, that they might get a fourth kind between a bull and a female ass, but that they ordinarily prove sorry things. Of the two first sorts I have seen hundreds, especially at Demont, a fortress in the Alps (about ten miles above the town of Cuneo), that was much talked of during the last war between the French and the Piedmontese. There many of these gimerros were used, chiefly in carrying stones and sand up to the fortress that was then a-building on a high rocky hill. Of the third species, I rode upon one from Savona to Acqui, so late as the year 1765. [Here, Baretti inserts the following footnote: "Savona is a town on the Ligurian coast, belonging to the Genoese, and Acqui is the capital of Upper Monferrat, belonging to the king of Sardinia."] It was a sluggish beast, scarcely sensible of the bit and whip; but wonderfully sure-footed; and riding that way in January, as I did, in a most rugged by-road, the whole country round covered in a deep snow; many a mile in a narrow path, often on the brink of a precipice, and all the north sides of the frequent cliffs (over which I was to go) perfectly hidden under the hardest ice; going such a way, I say, I had really need of such a beast, that was very careful not to fall.
The gimerros resemble the mules so much, that, if you are not told, you will scarcely ever think of the difference, which chiefly consists in the ears, not so long as those of the mules; in the parts of the head about the nostrils and mouth, which in the gimerros are generally rounder than in the mules; and in the middle of the back, which is sharper in the mules than in the gimerros. Those between a bull and a mare have likewise a fiercer aspect than the other two species; and the species of that on which I went that journey, have upper fore-teeth remarkably more forward than their under; yet they feed very well. A careful examiner, I believe, would discover more distinguishing characteristics of the gimerros than I did. My eyes, which are none the best, and consequently not much used to survey objects with great exactness, did not help me to more.
So then, are these animals really horse-cow hybrids? A key to resolving this controversy will no doubt prove to be the fact that specimens are available, at least two at Kitale Nature Conservancy (the living animals shown in the videos above), and a skull in a Paris museum. Since these three would probably all be F₁ hybrids, it would be easy to test them with molecular genetic techniques. And given that there are at least two present in a single facility, at Kigale, they are probably not so rare that diligent search would fail to locate others. (If you are aware of others, please contact this website.)
I was first led to the Paris specimen after reading Ackermann (1898, p. 74), who stated that there was a skeleton of a jumart in France in the collection of the Musée Fragonard d'Alfort, an anatomical museum associated with the French National College of Veterinary Medicine at Alfort (Écoles nationales vétérinaires d'Alfort), located today in a suburb of Paris. Ackermann's assertion prompted me to explore the museum's website, which did indeed turn out to have a page discussing jumarts, and which includes a photograph of a skull (see figure above at right and high resolution image below). The following is a translation of that page (accessed Apr. 20, 2010): "Monstrosities were little studied in the early years of the Écoles Vétérinaire, but there is one exception that stirred a longstanding controversy: the jumard (or jumart or joumart). This animal,
The jumart skull mentioned in this translated text is pictured on the same webpage, which is somewhat surprising given that horse-cow hybrids today are generally considered imaginary, and given the museum website's claim that they do not exist "triumphed." The skulls of mythical animals do not end up in museum collections. So either this type of hybrid has been produced, or the skull pictured is a fake or that of some other creature. Note, however, that this skull, which the Alfort Museum describes as a jumart's, differs markedly from that of a cow, horse or ass (see pictures above, comparing these skulls). So if it is not a jumart, what is it? And what is the animal shown in the video at the top of this page? Here is an enlargeable image of the Alfort skull:
The French college of veterinary medicine is one of the world's oldest. Its main branch at Alfort opened in 1766, and its museum, the Musée Fragonard, located at that branch, opened in the same year. The founder of both (as well as the original branch of the college at Lyon, which first opened its doors on January 1, 1762), the veterinary surgeon Claude Bourgelat (1712-1779), began the museum's collection. He was a member of both the French and Prussian academies of sciences. Many veterinary colleges in other countries were founded by his students, who took the French college as their model.
Charles Bonnet, a Swiss scientist, was one of the foremost naturalists of the eighteenth century. While updating his Oeuvres d'histoire naturelle et de philosophie, an encyclopedia of natural history, he happened to read about a jumart supposedly once in Bourgelat's possession. As a result, he writes the following (Bonnet 1779, vol. 6, pp. 349-352): "Confronted with authorities of conflicting opinion, I greatly desired to be able to make up my mind
The skull pictured above is apparently that of one of the jumarts Bourgelat claimed to have had in his possession during the years he served as director and inspector general of the school. There seems little doubt that such is the case, given that the museum website describes it as the skull of a jumart, and explicitly states that it "dates from the time of Bourgelat." Moreover, it is well-known that Bourgelat began the collection that later became the museum's.
In the present context, it appears significant that (1) descriptions of jumarts regularly mention that the upper jaw is much shorter than the lower (the usual distance mentioned is "an inch and a half"), and (2) that in the picture shown above, of what the museum website describes as the "skull of a jumart," ("tête osseuse de jumard") that the incisors in the upper jaw do, in fact, fall far short of those in the lower. This is not the case in a horse or an ass, and a cow does not have upper incisors. There seems to be no known animal with a similar mismatching of the incisors, nor one with a tooth and skull configuration like that seen in this putative jumart. In an old description of these animals, Leger (1669, p. 7) says this mismatch generally prevented the jumarts he saw from grazing, except in fields with long grass they could crop by pulling it off with their tongues. Similarly, Paul Zacchias (quoted above) mentions that an old jumart belonging to Cardinal Scipione Borghese (1577-1633) had to be put down because it could not eat grass or hard food.
There is also the fact that this specimen has an obvious knob or prominence over each eye, another feature regularly mentioned in accounts of jumarts. (These knobs are better visible in the smaller of the two images of the Alfort specimen shown above, as the larger image was taken from an angle that makes it harder to see them.)
In the article quoted above, Bonnet (1779, vol. 6, pp. 351-352) includes an excerpt from Bourgelat's letter, a section describing the anatomy of a female jumart: "Fear of altering the anatomical description of this jumart in abridgment has prompted me here to transcribe nearly word for word from M. Bourgelat's letter. In its external appearance, this animal has a mouth or muzzle like that
Louis-Furcy Grognier (1774-1837), a member of the Academie Français and the French Society of Medicine, was a professor, and later, the director of the École nationale vétérinaire at Lyon. Like many French veterinarians of his era, Grognier believed that horse-cow hybrids exist, though he considered them rare. Thus, he says (Grognier 1841, pp. 83-84; see also Grognier 1805, p. 188), "Enlightened individuals worthy of credence claim to have seen these animals [but] most naturalists deem them imaginary. However, whatever the differences may
The encyclopedist Victor d'Azyr (1821, p. 391) concurred with Grognier's view that hybrids of this type are rare, for he says that in his native Cantal (a little populated region in the Auvergne) he had seen only two, though, he adds, several other people from the same region had assured him that they had seen others. Given that these animals are rare, if they exist at all, the attitude expressed by Grognier (1805, p. 194) seems reasonable enough:
In the same publication, Grognier (1805, pp. 194-195) mentions his friend and colleague, Claude Julien Bredin, who also served (from 1815 to 1835) as Director of the French School of Veterinary Medicine at Lyon, "while at Sospello [modern Sospel] in the Maritime Alps department [of southeastern France] where he was performing his duties as a veterinarian to the artillery, was shown an animal that was supposed to be the offspring of a bull and a she-ass. It was 3 feet 5 inches in height. Its body
Many French naturalists, however, who were not veterinarians held the opposite view. This school of thought seems traceable in its origins primarily to the Comte de Buffon (Histoire Naturelle, 1829, vol. 16, pp. 392-393), who tried and failed to produce a horse-cow hybrid: "On my family estate, in 1767 and subsequent years, the miller had a horse and a bull who lived in the same barn, and who
But not everyone agreed with Buffon, and many veterinarians continued to believe in horse-cow hybrids long after Buffon was dead, perhaps because reports of such animals continued to crop up. For example, the following brief notice about a horse-cow hybrid appeared on page 3, column 4, of the January 5, 1872, issue of The True Northerner, a newspaper published in Paw Paw, Michigan (source): "The latest freak of nature is an animal at Council Bluffs [Iowa], which is half horse and half cow." A similar notice, but in this case reporting a cyclops, appeared on page 16, column 2, of the July 23, 1893, issue of The Indianapolis Journal, a newspaper published in Indianapolis, Indiana (source): "A monstrosity in the shape of a colt with a head like a calf and having but one eye and no mouth was foaled on the Fair ranch in Sonoma County, California. It lived for two hours after its birth. The dam was a large draft mare."
Writing in the mid-nineteenth century, the eminent French zoologist Paul Gervais (1855, p. 154) commented that "Naturalists have accepted the opinion of Buffon, but such is not the case with veterinarians, who are far from convinced." (Translated by E. M. McCarthy. Original French.)
He went on to explain why he did not believe in jumarts himself: "Unfortunately, these singular productions have either not been described with the care they deserve, or in those cases where they have been, they are easily recognized as
It's easy enough to see why Gervais might suppose that all horse-cow hybrids are inviable. In fact, many of them are. It's a wide cross, and in wide crosses, the percentage of inviable hybrids is usually higher, all other things being equal. For example, an inviable horse-cow is reported in the following article from page 2, column 6, of the September 30, 1879, issue of the Hamilton Spectator, a newspaper published in Hamilton, Victoria, Australia (source).
And yet 14 years after Gervais' death we find a news report of a cow calving, not one, but two perfectly viable horse-cow hybrids. The following article originated with the Dunedin Star, a newspaper in Dunedin, New Zealand. But here it is transcribed from page 4, column 1, of the July 18, 1893, issue of the Poverty Bay Herald, a newspaper published in Poverty Bay, New Zealand (source).
Occasional reports of such hybrids continued into the twentieth century. The following appeared on page 5, column 1, of the February 22, 1905, issue of the Keowee Courier, a South Carolina newspaper (source).
The following report about a colt with a cow's hoof appeared on page 4, column 4, of the April 25, 1908, issue of Pullman Herald, a newspaper published in Pullman, Washington (source):
In a similar case later that same year, a pony foaled by a Shetland mare in Nevada, Iowa had three cow's hoofs instead of one. The report appeared on page 8, column 1, of the June 11, 1908, issue of the Monroe City Democrat, a newspaper published in Monroe City, Missouri (source). The same story appeared in many other papers across the country (for example).
Another case of a horse with cow hooves is described on page 2, column 4, of the July 17, 1902, issue of Jamestown Weekly Alert, a newspaper published in Jamestown, North Dakota (source):
On a separate page of this website a putative deer-horse hybrid is pictured which had deer hooves protruding from both of its front fetlocks. From the standpoint of taxonomic classification, deer-horse hybrids are similar to cow-horse hybrids.
The following report about a horse-cow appeared on page 2, column 4, of the August 3, 1901, issue of The Broad Ax, a newspaper published in Salt Lake City, Utah (source):
Another report alleges a three-way horse-cow-deer hybrid (perhaps simply a horse-cow hybrid?). It appeared on page 2, column 4, of the July 9, 1910, issue of the Charlevoix County Herald, a newspaper published in East Jordan, Michigan (source). It reads as follows:
A second report about the same animal described in the article immediately above supplies some additional information. It appeared on page 2, column 4, of the March 17, 1910, issue of the Heppner Gazette, a newspaper published in Heppner, Oregon (source). It reads the same as the article above, but has different headlins and adds a paragraph:
…On one of its front legs there protrudes a twin horn which measures four feet and ll inches from the tip to the base, turning up at the point and weighing about 25 pounds. The hind leg on the left side is put on backwards, so to speak, all the muscles of the leg are on the inside and the hoof points backwards.
That same year, a horse-cow in Stratford, Connecticut, was mentioned on page 8, column 5, of the November 14, 1910, issue of The Bridgeport Evening Farmer, a newspaper published in Bridgeport, Connecticut (source). The brief notice reads as follows:
The following question from a reader appeared on page 11, column 1 of the March 1, 1911, issue of The Ranch, a monthly newsletter published in Seattle, Washington (source):
A horse-cow hybrid is mentioned on page 3 of the March 17, 1915, issue of Bregenzer Tagblatt, an Austro-Hungarian newspaper published in Bregenz (now in western Austria). The report reads as follows:
A donkey-cow hybrid is reported on page 3 of the June 4, 1917, issue of Pilsner Tagblatt, an Austro-Hungarian newspaper published in Pilsen (now in the Czech Republic. The brief notice reads as follows:
Another horse-cow hybrid is mentioned on page 6 of the October 28, 1917, issue of Grazer Vorortezeitung, an Austro-Hungarian newspaper published in Graz in what is now Austria. The brief report reads as follows:
The gestation period of a cow is about 39 weeks, that of a horse, 48 weeks or more. So the length of gestation in this last-quoted case is intermediate between that of horse and cow. Hybrids typically have a gestation period intermediate in length between those of their parents.
Even more recently, an animal in an English news report appears to be a horse-cow hybrid. It belonged to Frans Buitelaar, a Boston, UK meat dealer back in the 60s or 70s, and is pictured in an online article in the Boston Standard. According to the brief comments accompanying the picture, a local vet was consulted at the time and he pronounced the animal "bovine." However, might it also have been equine? The Standard's image is shown below, along with those of a horse and a cow for comparison. Traits visible in the picture that seem consistent with the idea that this animal has equine inheritance are: (1) its very horse-like tail; (2) the rounded hip (i.e., croup) region, which does not at all have the pointed shape characteristic of a cow; (3) absence of an udder; (4) saddle in the back, unlike the straight back of a cow; (5) long, thick horse-like neck.
One might, of course, simply suppose that the image is a fake. However, although the former owner Frans Buitelaar is now deceased, his son, Adam Buitelaar, when contacted, said he does remember seeing the living animal and confirmed it did look like the creature shown in the image above. And, moreover, he said it did have a horse's tail. He also said that it was a female, which would make the fact that it lacked an udder very peculiar indeed—if it were a pure cow. Moreover, the two animals shown in the videos on this page above have a similar structure, and videos are far more difficult to fake than photos.
It can be seen that the Buitelaar animal differs substantially from the creature shown in Houël's eighteenth-century illustration. Possibly, this discrepancy simply reflects a high order of variability in the offspring from this cross, as is the case with certain other distant hybrids. The structure of the Buitelaar animal is, however, consistent with the brief descriptions of the Buchau, Neudorf and Colby animals in that the equine similarity is primarily restricted to the hindquarters and tail. The same can be seen in the two Kitale animals shown in the videos above. On the other hand, the Mountain Rest, Elizabethport and Friedingen animals were reported to have the reverse configuration, that is, they were described as horse-like anteriorly and cow-like posteriorly. And then, some of the early French cases and the New Zealand animals, from their descriptions, seem to have been of an equine character overall. And then we have the two animals born in the U.S. in 1908, which looked like ordinary colts, except that one had a single foot like that of a cow and the other had three. The basis of this extreme variability in what must be F₁ hybrids, if they are hybrids at all, is unknown. In closer crosses, F₁ hybrids typically show very little variability.
As usual, in the case of any hybrid of disputed status, I leave open the question of whether horse-cow hybrids exist, although the videos on this page do confirm, at the very least, that animals combining equine and bovine traits do exist and are viable. Reservation of judgment on such issues, however, is a matter of strict policy here on this website. However, it is clear that genetic testing of the alleged jumart skull (pictured above) held in the Musée Fragonard's collection, and of the two Kitale animals, would help to resolve this issue, at least with respect to that particular specimen (such testing would be straightforward given that it is presumably an F₁ hybrid, if it is a hybrid at all). Such a study could have potentially important results, in that any definite verification that this specimen is derived from hybridization between an equid and a bovid would demonstrate that the limits of mammalian hybridization extend far beyond what many scientists currently believe possible.
A probably phony report about a buffalo-horse hybrid >>
Human Origins: Are we hybrids?
On the Origins of New Forms of Life
Mammalian Hybrids
Cat-rabbit Hybrids: Fact or fiction?
Famous Biologists
Dog-cow Hybrids
Georges Cuvier: A Biography
Prothero: A Rebuttal
Branches of Biology
Dog-fox Hybrids


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When Sacramento (Calif.) Pioneer High pitchers Robert Daugherty and Thomas Galart walked off the turf at Raley Field, home of the AAA Sacramento River Cats, they should have been celebrating a masterful achievement; the two had just combined for a no-hitter against Roseville (Calif.) High. Yet Daugherty and Galart found themselves looking up at Roseville, which emerged from the game with a 2-0 win and an equally impressive pitching performance, with Roseville ace Mark Reece tossing a no-hitter of his own in the game.
That's right: A rare double no-hitter, all in one of the most picturesque parks in California. Incredibly, the contest ended in the regulation seven innings. How did that happen?
According to the Sacramento Bee and Roseville Press Tribune, the answer has everything to do with errors and passed balls, as it turns out. Roseville scored its first run on an error by the Pioneer second baseman in the first inning, then added a second in the fourth inning on a passed ball. That second runner to score also reached base on a passed ball, stole second and third base, and then scored on another passed ball.
Talk about creating offense out of limited opportunities.
"Not only are [Reece, Daughterty and Galart] great baseball players, I could not have selected a better group from both sides to represent the game of baseball in such a beautiful venue," Pioneer coach Craig Marquez told the Bee.
How rare is a double no-hitter? While the feat has surely been accomplished more recently in other parts of the country, the Bee reported that it's believed to have occurred just once in the Sacramento region: In 1947, when Sacramento (Calif.) Lincoln High edged Elk Grove (Calif.) High 1-0 on a no-hitter by Fred Besana. Ritchie Myers threw a no-hitter for Elk Grove in the loss, and both pitchers eventually went on to compete in the major leagues some nine years later.
As for Reece, the victorious senior had special motivation for his statistical feat: He was pitching on his mother's birthday and promised that he'd deliver a no-no. He fulfilled that pledge, even if it was tougher to get the win during a no-hitter than he could ever have imagined.
"It's funny. When you have special days like this, you always have under-stories and stuff like that. It's absolutely amazing," Roseville coach Hank DeMello told the Press Tribune.
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subset: commoncrawl


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Author | exchange4media News Service | Wednesday, Dec 01,2004 8:24 AM
MasterCard International today announced the results of its second MasterIndex of Consumer Confidence survey conducted across South Asia, Middle East and African Region (SAMEA). The survey showed decrease in the overall Indian consumer confidence with India's MasterIndex ratings falling from 63.5 in February to 58.0 in August, out of a possible index of 100.
Conducted bi-annually, the survey analyses consumers' perceptions on economic conditions over the next six months in seven selected markets in the SAMEA region, comprising South Africa, Egypt, Kuwait, Lebanon, Saudi Arabia, United Arab Emirates (UAE) and India. The scores are based on respondent answers to questions related to five factors: employment, economy, regular income, stock market and quality of life.
Nitin Gupta, Vice President and General Manager, MasterCard International, South Asia, said, "MasterIndex is a unique initiative that truly exemplifies MasterCard's thought leadership in the global payments industry. I feel the survey is a very interesting way of studying and understanding consumer sentiments across the region."
Of the seven countries researched in the region, Saudi Arabia has led the way with a highly optimistic score of 98.4, followed closely by Kuwait (90.6) and United Arab Emirates (83.0). Overall consumer confidence in Egypt and Lebanon remains as low as the previous period with 37.0 and 32.5 scores respectively.
On the survey, Dr Yuwa Hedrick-Wong, Economic Advisor, Asia Pacific MasterCard International, said, "As the Indian economy continues to liberalise and with the sustainability of domestic demand becoming increasingly important, consumer confidence takes centre-stage in driving economic growth. This is a message that must be fully embraced by both policy makers and captains of industry alike."
The latest round of the MasterIndex result shows that the level of confidence over the outlook of the next six months in India has dipped from 63.5 to 58.0. While a result of 50 and above indicates optimism, 58 is only very mildly optimistic. Three of the five dimensions that have dragged down the result most are the outlook on the economy, the stock market, and the quality of life. This suggests that consumer confidence, and therefore consumer spending in India is affected more than just by the income immediately available, but also by its much broader outlook, including how they see the economy is going and how their own quality of life is changing or failing to change.
Programming HeadRadio Mango


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A MAN who tried to sell drugs in a Bromsgrove pub was promptly arrested when staff told police, Worcester Crown Court was told.
Ryan Corrigan asked at the Dog and Pheasant last December if they knew of anyone who sniffed m-kat, the drug mephedrome.
He was found with 23 packages of the drug and a further supply was found at his home, said Siobhan Collins, prosecuting.
Corrigan, 22, of Denver Court Road, Birmingham, pleaded guilty to possession of the drug with intent to supply.
He was given a 10-month jail sentence suspended for 12 months and ordered to pay £670 costs. Judge Michael Cullum also imposed an 8pm to 6am curfew.
Diljit Bachada, for Corrigan, said he had just been taken on as a trainee electrician. He had tried to sell the drugs to pay off a £1,200 gambling debt and had been naive to approach pub staff.


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Listen to free music played by pham3r
Blip.fm is internet radio made social. It's easy to search for, play, and discover free music recommended by real people. Join today to create your own free station and start listening to @pham3r.
pham3r Music for another late night
pham3r Got to kick at the darkness 'til it bleeds daylight


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Remodeling Services
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We Stand behind our Installations and Believe In our Products enough to Provide A Labor Warranty & Lifetime Product Warranty On majority of Products we Install. Walk In Tubs For Safety and Enjoyment, Walk In Showers, and 1-3 day Tub to Tub/Shower Conversions In majority of our Installations. We take your ideas and make it your reality. Quality workmanship, reasonable rates and friendly customer service.
Call for a Free In Home Consultation!


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Hey, everybody, I am from Québec, I like hunt, I'm sorry for my english because it's not perfect, but I try!!
I 'want to go next year to Saskatechewan because you get the nice big buck and I am looking for a place, I'am a good hunter, if you have a place for me, please lease me a message and I'll anwser you so it's possible.
I need many informations, like period riffle hunting, licence, road and moore....
this is my buck 2009 quebec
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Easy DIY Bubble Gum Recipe | How to make Bubble Gum at Home | HooplaKidz Recipes
Learn how to make Bubble Gum/Chewing Gum at home with this easy to make DIY recipe, fun idea that is quick and easy to make even for kids, From HooplaKidz Recipes the best channel for Kids Recipes
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Flap on Children's Coverage Settled
Insurers Say They Will Accept Pre-Existing Conditions After Dispute on Timing, Warn of Higher Prices
Insurers said they would comply with regulations the government issues requiring them to cover children with pre-existing conditions, after a dispute with lawmakers over interpretation of the new health-care legislation.
The Obama administration has made near-immediate coverage for sick children a priority in its health-care overhaul. But shortly after the bill's passage last week, insurers contended that the law didn't require them...


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[Query] I am initiated into Baalaa mantra. Can I perform shodha nyasa and shambhava rashmi nyasa? Also, my brother was initiated into panchadashi without bala. Is this normal?
shrImAtre namaH
To answer your second question, no. That does not seem normal, even for the unsophisticated and simplistic anuyAyIs of the kalpasUtra.
Adau bAlA mahAdevi sarvAdyA parikIrtitA |
yAM vinA pa~nchadashyAM vai nAdhikAraH katha~nchana ||
bAlAyAmadhikArI chedbAloktAn vinyasedbudhaH |
There are nyAsas like akShara nyAsa, kAma-ratyAdi nyAsa, subhagAdi nyAsa etc. peculiar to bAlA Krama - to perform which one has the adhikAra, if initiated into bAlA mantra.
pa~nchadashyadhikArI chetpa~nchadashyAdikaM charet ||
If initiated into pa~nchadashI, one is eligible to perform nyAsas such as dashadhA mAtr^ikA, laghu ShoDhA, mUlavidyA, chakra, shakti, dIpinI, kullukA etc.
ShoDashIdIkShAyuktashchet mahAShoDhAdikaM charet ||
If initiated into mahAShodashI, one can perform the seven-fold ShoDhA nyAsas for sundarI, dakShiNA, navaratna kubjikA etc.
parAdIkShaNayuktashchet ShaDAdhArAdikaM nyaset ||
One initiated into parA vidyA, which is after mahAShoDashI but before pUrNAbhiSheka and mahAvAkyopadesha, one can perform ShaDAdhAra, Shad-darshanAdi nyAsas.
parAprAsAdayuktashchet tattanyAsAn samAcharet |
prAsAdaparAyuktashcettAneva vinyasedbudhaH ||
If initiated into UrdhvAmnAya mahAvidyA, one can perform the twenty-seven nyAsas including the mahAcharaNa, nirvANacharaNAdi nyAsas. This is what is called shAmbhava mahAdIkShA without which
vidhis peculiar to UrdhvAmnAya such as ShaDanvaya shAmbhavAkhya yajana, gurumaNDala pUjA, oghatrayAtmaka dakShiNAmUrti AvaraNa, chinmUrti nyAsa, four-fold kAmakalA nyAsa, tripa~nchikA vidhi, nADikA yoginI nyAsa, chatuHShaShThi yoginI bhairava nyAsa, dashottarashata UrdhvAmnAya bhairava nyAsa etc. cannot be performed. Twenty-seven dIkshas starting with parAprAsAda till nirvana charaNa, mahAprAsAda and the associated pAdukA chatuShka constitute the mahAshAmbhava dIkShA.
bhAskararAya states the same somewhat succinctly:
chatushcharaNadIkShA tu mahAprAsAdagocharA ||
One is not eligible for shAmbhava dIkSha till one has obtained
pUrNAbhiSheka and mahAShoDashI vidyA:
ShoDashIM tu vinA devi nAnyatra hyadhikAritA ||
Also, mahAshAmbhava Krama can be approached only through shrIvidyA and not through kALyAdi vidyAs, as stated in several UrdhvAmnAya tantras, even those not belonging to shrIkula. puNyAnandanAtha notes the same elsewhere:
shrIvidyAM tu vihAyAtha nAdhikAritvamiShyate |
shrIvidyAyAM tu sampUrNaH sarvamargI bhavet priye ||
Right from the heart of bhagavatpAda to the Yoga Siddhas of kAshmIra and Krama siddhas of nepAla, if shrIvidyA stands proud and tall amongst other vidyAs with the samj~nA of rAjarAjeshvarI, it is not without a reason. And pUrNAbhiSheka, which to most is what is described in kalpasUtra or pAdukAnta dIkShA (sigh!) does not replace the need for shAmbhava dIkSha, which clearly is a pUrNAbhiShekottara dIkShA:
parAprAsAdadIkShAdyAH ShoDashyuttaragAH kriyAH |
tattatantroktavidhinA tattaddIkShAdibhiryutaH |
tattatkarma prakurvIta nAnyathA sha~NkaraM vachaH ||
The same is stated elsewhere:
adhikAre samApanne parA pUjAdike vidhau |
ShaTshAmbhave maheshAni hyadhikArastato bhavet ||
ShaTshAmbhavo maheshAni sarvottara itIritaH |
ShoDashyuttaragA dIkShA kAryA vA tviyameva vA ||
Here, the samjnA of ShoDashI is for shuddhavidyAdi pAdukAntA mahAShoDashI.


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Events - 8 Mar 17
Oyamel's 10th Annual Tequila Mezcal Festival
Mon, Feb 27 - Sun, Mar 12
This two week-long festival begins with Oyamel's annual Tequila Mezcal Festival's Kickoff Party on Monday, which will feature more than a dozen unique tequila and mezcal tasting stations, passed bites and specialty cocktails, live music, and more. The festival will feature a series of complimentary tastings in the bar as well as ticketed dinners hosted by tequila and mezcal purveyors Fortaleza Tequila/El Silencio Mezcal, and 123 Organic Tequila. The kick-off party will be held from 6:00 to 9:00 p.m. Complimentary tastings will be held on March 6 and 7 from 4:00 to 6:00 p.m. The Tequila Mezcal Dinners will be held on March 6 and 7 at 6:30 p.m. There will be special dishes available throughout the festival, as well. 401 7 Street NW. For more information, please click here.
Cherry Blossom Pop-up Bar At Mockingbird Hill And Southern Efficiency
Wed, Mar 01 - Sat, Apr 15
Drink Company returns this Spring with the Cherry Blossom PUB (Pop-up Bar), where James Beard Award-nominated Mockingbird Hill and Southern Efficiency will take on Japan with a cherry blossom-inspired transformation. The two bars will roll out new decor and exclusive menus, inspired by Washington, D.C.'s most beautiful season. Draped in pink, Southern Efficiency will feature an origami crane chandelier and an impressive collection of maneki-neko, Japan's world-famous lucky "waving cats" against a beautiful backdrop of cherry blossom art by iconic D.C. artist Maggie O'Neill. At Mockingbird Hill, nostalgia will reign supreme with an ode to the beloved Super Mario Bros., featuring an entire room dedicated to the Mushroom Kingdom and a special corner reserved for super villain King Koopa. Mockingbird Hill and Souther Efficiency will be open March 1 through April 15, 5:00 pm to 12:30 am Sunday through Thursday and 5:00 pm to 1:30 am Friday and Saturday. Mockingbird Hill is located at 1843 7th Street NW. Southern Efficiency is located at 1841 7th Street NW. For more information please call 202.316.9396.
Michael Schlow Hoagie At Taylor Gourmet
Wed, Mar 01 - Tue, Mar 14
James Beard award winning chef Michael Schlow is teaming up with Taylor Gourmet to create a limited edition hoagie, The Alta Strada. The sandwich, named for Schlow's Italian restaurant, features house-roasted turkey and imported ham topped with herbed fresh mozzarella, charred tomato, marinated long hot peppers, shredded lettuce, shaved red onion, extra virgin olive oil and Michael's Ultimate Vinaigrette. The hoagie will be priced at $7.99 for a regular and $11.99 for a large and all proceeds from the Alta Strada will go to Chance for Life. The Alta Strada hoagie will be available March 1-14 at all Taylor Gourmet locations (excluding National Airport). For more information or to find locations click here.
10th Anniversary Virginia Wine Expo
Wed, Mar 08 - Sun, Mar 12
The 10th Anniversary Virginia Wine Expo presented by Kroger is a national destination event celebrating Virginia's, Spain's, Portugal's and Sonoma County, California's extraordinary wines and the Richmond region's craft beverage and culinary excellence. You'll enjoy 20+ events, including the legendary Walk-Around Grand Tastings (by far the biggest events on the schedule), where you can taste more than 650 bottles of Virginia, Spanish, Portuguese, and Sonoma County, California wine. Spain and Portugal is the International Guest Region and Sonoma County, CA is the National Guest Region. In addition to the extremely popular Walk-Around Grand Tastings, this year's event schedule is packed with exceptional wine and food experiences that highlight many of the chefs and restaurants behind RVA's emergence as a craft beverage and foodie destination. Three of the signature events (as well as the seminars) – the Walk-Around Grand Tastings, Burger Blast and SMOKED! – take place at the Greater Richmond Convention Center, strategically located in downtown Richmond's hottest culinary district and within walking distance or short shuttle ride to more than seven hotels. The other events, such as A Noodle & Dumpling Affair, take place at venues throughout Richmond. There are multiple ticket packages available, as well as tickets to individual events, ranging from $20 to $380. 403 North Third Street, Richmond, VA. For more information on each days' events as well as ticket information, please click here.
Beer Tasting: Let's Get Crafty At Via Umbria
Wed, Mar 08
Join Via Umbria for an evening of arts and craft beers. Beer Director Scott Weiss will introduce a selection of four beers: two from Birra Perugia and two from Birrificio del Ducato. Resident arts and crafts expert, Rachel Enoch will have a selection of art projects for you to complete as you taste your beers. Sign up now to get crafty with both arts and beers. $25 per person. 7:00 p.m. 1525 Wisconsin Ave NW. For more information and to purchase tickets, please click here.
Nifty Whiskey At Takoda DC
Wed, Mar 08
Chef Damian at Takoda DC has paired three dishes with two awesome whiskey cocktails, and an entire whiskey flight. Delve deeper into America's favorite spirit. $55 per person. Seatings available 5:00 p.m. until 9:00 p.m. 715 Florida Avenue NW. For more information and registration, please click here.
Stango Rocks At W Washington DC
Wed, Mar 08
Join W Washington DC for a night of rock music to celebrate the launch of visionary pop artist John Stango's newest portraiture series featuring some of the greatest music icons of our time. Come dressed as your favorite rock idol and dance to the beats of DJ Shea Van Horn while you mix and mingle with some of your favorite D.C. Drag Queens. Event is free. Event begins at 6:30 p.m. 515 15 Street NW. For tickets and more information, please click here.


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Math Blaster Episode Two- Secret of the Lost City is an educational game in the Blaster Learning System by Davidson & Associates and is the sequel to Math Blaster Episode I: In Search of Spot. In the plot of this math game, the evil Dr. Minus shoots down Blasternaut, Spot, and Galactic Commander as they search for the Lost City in their Galactic Cruiser. They crash, thankfully, next to the Lost City. Dr. Minus' 'Negatrons' try to stop you as you unlock the secret of the Lost City to save Galactic Command.
Number Hunt-Pull chains, hit pressure pads, or punch buttons to activate doors or elevators to collect operators and numbers to complete the Equation.
Creature Creator - Solve the equation above using estimation to unlock this room.
Position Splash - Get the Negatrons with the right number (the one that completes the equation) into the bottom tubes. Hit the Negatrons with the wrong numbers with 'Position Pods.' to keep them out.
Maze Craze- create a creature by using the tools at the left. Each arrow indicates the number of changes that occur from box to box. You need to complete all of the other sections before unlocking this section.
There are different gameplay levels: Space Rookie, Space Captain, and Master Blaster.
There are also three different math levels as well as different operations: Addition, Subtraction, Division, Multiplication, Percents, Decimals, and Fractions.


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Doctor insights on:
Vitamins After Gastric Bypass
Which vitamins can someone with gastric bypass take?
Vitamins: Vitamin supplementation is extremely important after gastric bypass and there is a handful of comercially available vitamins specially formulated for bariatric patients. ...Read more
Gastric Bypass Surgery (Definition)
Gastric bypass surgery is a restrictive and malabsorptive procedure to help lose weight. Restrictive is in the fact that the stomach is down sized to a 2 oz pouch and malabsorptive is in bypassing part of the stomach and 100 to 150 cm of the small ...Read more
I had gastric bypass 2 years ago & my hair is very thin. What specific vitamins can I take for hair growth/volume?
Vitamin injections: After gastric bypass your body has a hard time absorbing certain vitamins. Injections bypass this issue so talk to your doctor about injectable vitamins such as b-12 and b-complex. ...Read moreSee 1 more doctor answer
Can I take iron and b12 plus my prenatal vitamin .I had gastric bypass in 1996 . Im 32 now. Feeling 75 precent weaker?
Yes: Very unlikely too much iron etc.Get a more detailed answer ›
Today i started to smell metal, i do not have any symptoms of sinusitis, i am not on any medication except vitamins for gastric bypass?
A few causes: The first thing I think of is your vitamins. Do they contain zinc, copper, or chromium? If so, this may be the source and you may need to change formulations. Periodontal disease or tooth decay can contribute. Sometimes women in early pregnancy note a metallic taste. Hope this helps. ...Read more
Nutritional ramifications and gastric bypass surgery? What are the nutritional ramifications to gastric bypass surgery? What vitamins can't be absorbed?
ADEK: They can be absorbed but not as well. Also b12, iron , calcium. And protein. ...Read moreSee 1 more doctor answer
What's the vitamin(s) requirement for pregnant gastric bypass patients? Adding a pre-natal on top of the vitamins i already take seems too much. Surgery was over five years ago. All blood work ok.
Go back: To your bariatric surgeon to discuss and get a dietician and your OB physician talking. We don't have good data on this yet and it takes a team effort. Malnutrition is our main concern. ...Read moreSee 2 more doctor answers
What vitamin deficiency usually causes memory lapses? Post gastric bypass 9/2011
Vitamins: The most common vitamin deficiencies seen after gastric bypass are with vitamin b12, vitamin d and iron. Some have low calcium. Vitamin B12 deficiency can affect the central nervous system and memory. ...Read moreSee 1 more doctor answer
Had gastric bypass in 2005 and teeth keep breaking i now have 5 broken teeth and they even break on soft foods am taking vitamins regularly?
Ok: They can also be susceptible to the acid reflux which can occur from the gastric bypass. The acid destroys the enamel and makes it easier to get decay and erosion. Mi paste is good to use can reflux into the. ...Read moreSee 2 more doctor answers
I had gastric bypass in 05 and I have developed a vitamin defficiency. Taking 975 mg fe. What is normal daily dose of vitamin d for grown woman?
Vitamin D: For my gastric bypass patients with a vitamin d deficiency, if their level is greater than 20ng/ml i usually give them 1000 international units per day, and sometimes 5000 iu a day. If their level is below 20ng/ml, i give them a prescription for high dose vitamin d. 50, 000iu once a week for 6 weeks in addition to 1000iu daily. ...Read moreSee 1 more doctor answer
12 years post op rny, iron 20 & vitamin d at 10. Seeing a new dr that hasn't worked with deficient gastric bypass, is 325ferrous 3x and 2000d 1x okay?
Nutrition!: A gastric bypass is a very complex nutrition situation. If your physician has not dealt with it much i would suggest asking for a referral to a nutritionist or a bariatric center. That being said, the dosage of iron is fda approved treatment for iron deficiency, and the vitamin d is a reasonable amount. You have many nutrient levels that should be monitored and carefully watched! ...Read more
Gastric (Definition)
This refers to something that is ...Read more
- Talk to a doctor live online for free
- Vitamins after gastric bypass surgery
- Vitamins needed after gastric bypass
- Vitamin d deficiency after gastric bypass
- Ask a doctor a question free online
- Vitamins for gastric bypass patients
- Gastric bypass vitamins schedule
- Gastric bypass vitamin recommendations
- Aspirin after gastric bypass
- Talk to a gastroenterologist online


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Casa Vicente Send to Phone
OpenDinner Tues.-Sat.
- Parking lot
- Dress code: Casual
- Entertainment: Entertainment (various)
- Full bar
- Reservations suggested
- Romantic setting
* Click here for rating key
Text data on Casa Vicente to your phone, or a friend's cell phone.
Find out which restaurants and chefs top the list of GAYOT's 2016 Annual Restaurant Awards.


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OIG to Revisit Potential Duplicate Medication Payments through Hospice/Part D
CMS Makes Big Changes to Three Payment Models
NAHC Board Announces Strategic Planning
Help Build the New NAHC – Send Us Your Nominations for the Board of Directors
Hospice Quality Updates – Deadline Tomorrow!
CMS Launches Hospice COMPARE Quality Website
Home Health Value-Based Purchasing Program Payment Adjustment Process and Enforcement of Service Codes on Home Health Claims
In the various roles he has undertaken through the years, Val J. Halamandaris has been a singular driving force behind the policy and program initiatives resulting in the recognition of home health care as a viable alternative to institutionalization. His dedication to consumer advocacy, which enhances the quality of life and dignity of those receiving home health care, merits VNA HealthCare Group's highest recognition and deepest respect.
- VNA HealthCare Group
I have the highest respect for them, especially for the nurses, aides and therapists, who devote their lives to caring for people with disabilities, the infirm and dying Americans. There are few more noble professions.
- President Barack Obama
Home health care agencies do such a wonderful job in this country helping people to be able to remain at home and allowing them to receive services
- U.S. Senator Debbie Stabenow (D-MI) Chair, Democratic Steering and Outreach Committee
Home care is a combination of compassion and efficiency. It is less expensive than institutional care...but at the same time it is a more caring, human, intimate experience, and therefore it has a greater human element...it's a big mistake not to try to maximize it and find ways to give people the home care option over either nursing homes, hospitals or other institutions
- Former Speaker of the U.S. House of Representatives Newt Gingrich (R-GA)
Medicaid covers long-term care, but only for low-income families. And Medicare only pays for care that is connected to a hospital discharge....our health care system must cover these vital services...[and] we should promote home-based care, which most people prefer, instead of the institutional care that we emphasize now.
- Former U.S. Senator Majority Leader Tom Daschle (D-CD)
We need incentives to...keep people in home health care settings...It's dramatically less expensive than long term care.
- U.S. Senator John McCain (R-AZ)
Home care is clearly the wave of the future. It's clearly where patients want to be cared for. I come from an ethnic family and when a member of our family is severely ill, we would never consider taking them to get institutional care. That's true of many families for both cultural and financial reasons. If patients have a choice of where they want to be cared for, where it's done the right way, they choose home.
- Donna Shalala, former Secretary of Health and Human Services
A couple of years ago, I spent a little bit of time with the National Association for Home Care & Hospice and its president, Val J. Halamandaris, and I was just blown away. What impressed me so much was that they talked about what they do as opposed to just the strategies of how to deal with Washington or Sacramento or Albany or whatever the case may be. Val is a fanatic about care, and it comes through in every way known to mankind. It comes through in the speakers he invites to their events; it comes through in all the stuff he shares.
- Tom Peters, author of In Search of Excellence
Val's home care organization brings thousands of caregivers together into a dynamic organization that provides them with valuable resources and tools to be even better in their important work. He helps them build self-esteem, which leads to self-motivation.
- Mike Vance, former Dean of Disney and author of Think Out of the Box
Val is one of the greatest advocates for seniors in America. He goes beyond the call of duty every time.
- Arthur S. Flemming, former Secretary of Health, Education, and Welfare
Val has brought the problems, the challenges, and the opportunities out in the open for everyone to look at. He is a visionary pointing the direction for us.
- Margaret (Peg) Cushman, Professor of Nursing and former President of the Visiting Nurses Association
Although Val has chosen to stay in the background, he deserves much of the credit for what was accomplished both at the U.S. Senate Special Committee on Aging, where he was closely associated with me and at the House Select Committee on Aging, where he was Congressman Claude Pepper's senior counsel and closest advisor. He put together more hearings on the subject of aging, wrote more reports, drafted more bills, and had more influence on the direction of events than anyone before him or since.
- Frank E. Moss, former U.S. Senator
Val's most important contribution is pulling together all elements of home health care and being able to organize and energize the people involved in the industry.
Anyone working on health care issues in Congress knows the name Val J. Halamandaris.
- Kathleen Gardner Cravedi, former Staff Director of the House Select Committee on Aging
Without your untiring support and active participation, the voices of people advocating meaningful and compassionate health care reform may not have been heard by national leaders.
- Michael Sullivan, Former Executive Director, Indiana Association for Home Care
All of us have been members of many organizations and NAHC is simply the best there is. NAHC aspires to excellence in every respect; its staff has been repeatedly honored as the best in Washington; the organization lives by the highest values and has demonstrated a passionate interest in the well-being of patients and providers.
- Elaine Stephens, Director of Home Care of Steward Home Care/Steward Health Systems and former NAHC C
Home care increasingly is one of the basic building blocks in the developing system of long-term care. On both economic and recuperative bases, home health care will continue to grow as an essential service for individuals, for families and for the community as a whole.
- Former U.S. Senator Olympia Snowe (R-ME)
NCOA is excited to be part of this great event and honored to have such influential award winners in the field of aging.
- National Council of Aging
Health care at home…is something we need more of, not less of. Let us make a commitment to preventive and long-term care. Let us encourage home care as an alternative to nursing homes and give folks a little help to have their parents there.
- Former President Bill Clinton
The Bipartisan Better Care, Lower Cost Act seeks to improve care coordination for beneficiaries with multiple chronic conditions, the most-expensive and fastest-growing portion of the Medicare population.
Senators Ron Wyden (D-OR) and Johnny Isakson (R-GA) and Representatives Erik Paulsen (R-MN) and Peter Welch (D-VT) earlier this week introduced the Better Care, Lower Cost Act. The new bill aims to improve care coordination for Medicare beneficiaries with multiple chronic conditions. The legislation would expand the use of multidisciplinary health teams to keep patients as healthy as possible in their homes and communities.
According to Centers for Medicare and Medicaid Services, 68 percent of Medicare enrollees have multiple chronic conditions, and account for 93 percent of Medicare spending. Additionally, 98 percent of costly hospital readmissions involved beneficiaries with multiple chronic conditions.
"Medicare reform must be built around offering better quality, more affordable care for these seniors," said Senator Wyden. "Fortunately, there are pioneering practices and plans that are paving the way. The point of our bipartisan legislation is to break government's shackles on innovation so that these providers are the norm rather than the exception."
Said Senator Isakson, "I'm proud to join Senator Wyden in introducing this legislation, which addresses our health care system's challenge of managing chronic medical conditions by allowing patients to voluntarily enroll in a program that incentivizes health care providers to invest in prevention and keeping patients healthy. I encourage my Senate colleagues to support this legislation because it is critical to the future of Medicare and our health care system."
The legislation creates the "Better Care Program," allowing health plans and groups of providers to form "Better Care Plans" or "Better Care Practices," (BCPs) respectively. This program would be voluntary and open to Medicare enrollees suffering with chronic illnesses. Participating plans and practices would receive newly calculated risk-adjusted, capitated payments rewarding better health outcomes for enrolled beneficiaries.
BCPs would be allowed to focus and specialize in chronic care delivery and management. Under current law, the so-called "attribution rule" strictly limits the ability of provider-led organizations to reach out to sicker patients and provide them with the highest-quality, integrated chronic care services.
NAHC staff is currently reviewing the details of the legislation. Any developments on this bill and NAHC analysis will be provided in future issues of NAHC Report.
For more information on the Better Care, Lower Cost Act, please click here.
About NAHC
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AVM Short Sleeve Shirt - Floral Pattern
For sale: clothing, clothes, fashion and beauty in Nigeria
AVM Short Sleeve Shirt - Floral Pattern
Price in Naira: NGN 5,500
Location: All Nigeria
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An everyday essentialâ,â Short Sleeve Shirts can totally redefine a man's styleâ.â A shirt with the perfect fit is not only dapperâ,â but is also classy and timelessâ.â Pair with Formal Pantsâ,â Casual Pantsâ,â Chinos and Denimsâ.â Choose from our selection of Short sleeve shirts in formal and casual stylesâ.âÂ
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- Express Delivery Available
- Main Materialâ:â Cotton
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- Short Sleeve Shirt
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Please, do not hesitate to contact us with any question!
Address Phil Fashion B01 & B02, First Floor, China Town, Ojota, Lagos.
ATTENTION! Do not make any advance payments to any seller on Mobofree, not even for delivery! You may get scammed by unfair seller. Please report abuse to help us stop scam! To keep yourself safe, make sure to follow our Safety tips!


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Both coaches are under the blowtorch, but Wests Tigers coach Jason Taylor has welcomed the sort of heat forecast for Saturday's NRL clash with the Warriors.
With temperatures expected to nudge the late 30s at Campbelltown Stadium in south-west Sydney, Taylor on Friday ruled out requesting drinks breaks, believing his team could handle it better than their Auckland-based opponents.
"I just hope that it remains that way and we don't get a late change, because I'd like to think that that's going to play in our favour," Taylor said.
"There's a lot of work to be done before we get a result, based on how hot it is, and we haven't talked about that as a team for a second.
"(But) it'd be nice if it's nice and hot for us."
Both Taylor and Warriors counterpart Andrew McFadden are pressure to find success early in 2016 after their teams' poor seasons in 2015.
McFadden's Warriors were bolstered by arguably the best recruitment drive of the summer, netting stars Roger Tuivasa-Sheck and Issac Luke in key positions, while wily veteran Jeff Robson and prop James Gavet were also crafty additions.
Still, Taylor insisted mercurial Warriors playmaker Shaun Johnson remained the key threat, one to be negated by shutting down his forward pack.
"For me, Shaun Johnson is still the number one danger, he's so talented. And then having Tuivasa-Sheck and Luke around him, it adds another dimension," he said.
"But it'll be what happens in the middle. Their forwards are strong and we need to hold them. If we don't do that, then those guys on the edges will be too hard to handle."
After a disastrous 2016 where the joint venture won just eight games and finished equal last, a winning start on Saturday would be a big fillip for Taylor.
But the former point-scoring wizard insisted he wasn't concerned by the heat on his job.
"I just want the guys to play well," he said.
"We want to win in round one, and we'll want to win in round two, and we'll want to win in round three.
"(Pressure is) just part of this game.
"We've had a great pre-season and we're all upbeat about the season and we're looking forward to it starting."


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10 Beats 1 Radio Shows You Need to Hear
To help you get a grasp on which programming will suit your ears, The Boombox is here to help. Check out 10 Beats 1 Radio Shows You Need to Hear.
To help you get a grasp on which programming will suit your ears, The Boombox is here to help. Check out 10 Beats 1 Radio Shows You Need to Hear.
The Internet exploded last night (Feb. 26), and this time it wasn't because of Kim Kardashian's butt. Instead, it was due to a highly fueled debate over the color of a dress. Kanye West, Joe Budden, Ariana Grande, Justine Skye and more sounded off with their opinions on this Internet meltdown.
Joshua Prince, co-founder of Fool's Gold Records, has passed away. The cause of the 38-year-old designer's death is unknown, but DJ A-Trak confirmed the sad news on Instagram Monday night (Feb. 2).
Grammy-nominated DJ/producer A-Trak opens up about his creative process in a new collaboration with Grand Marnier.
Travis Scott travels through a trippy universe in Low Pros' video for '100 Bottles.'
The Roots performed their haunting track 'Never' on 'The Tonight Show Starring Jimmy Fallon' on Tuesday (May 20).
The Dipset gang reunite in the video for 'Dips---s,' the newest effort to come from Cam'ron and Atrak's collaborative album,'Federal Reserve.' While the track is not a complete reunion for the team, for Dipset fans, it's a step in the right direction.
After announcing their collaboration in January, Cam'ron and A-Trak finally open the lid on the new project that everyone's talking about, 'Federal Reserve.' The Fool's Gold founder and Dipset rapper sit down with Complex to talk about the Damon Dash connection, their first meeting and how food and music make for a better recording process.


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Background Image: The uploaded image sources are not updated between Builder and Advanced DesignerAsked by seth on February 27, 2017 at 05:34 AM
When you upload an image from builder as a page background, then upload another image from Advanced Designer, the uploaded image source on builder is not updated.
JotForm Developer
It is fixed now.


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Ref: AusNeu211611
Apartment for rent from € 66/day in Neukirchen am GrossvenedigerName/Address:
Image disclaimer: It is the responsibility of the hotel chain and/or the individual property to ensure the accuracy of the photos displayed. Dream Home Shop is not responsible for any inaccuracies in the photos.
65sq. m.
2 1
The cottage Scherer-Gütl is a suitable accommodation both for a relaxing summer or a winter holiday. The house has three cosy and comfortable apartments. Your apartment (ca. 65m2) is situated on the ground floor. The cottage is situated on the edge of the famous Neukirchen am Großvenediger. The centre is a 5 minutes walk away. The house benefits from a sunny location in the centre of a large mountain field. You will have a lovely view on the fascinating mountain landscape. In summer you can make nice walks here. The Tauern cycling route starts from your cottage. In direct proximity (500/700m) there are a mountain lake and a mini golf. Experience a lovely holiday in Scherer-Gütl and let the beautiful landscape surprise you!
The position on the map may not be accurate
No info provided


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Richard Samuel Griffith (1895-1959) was a tram driver and local politician.
Born in Lambeth, he was the son of Robert Griffith, a compositor. In 1919 he married Elizabeth Selina Marke in Peckham. His profession was described on the marriage certificate as a "motorman" or tram driver.
A resident of Nunhead, he sat as a Labour Party councillor on the London County Council representing Camberwell North from 1946-49.
He was a justice of the peace for the County of London and the chairman of the management committee of St Lawrence's Hospital, Caterham.


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Yousaf Khan Sherbano Story in Urdu
Yousaf Khan Sherbano Story in Urdu Pdf Free Download
Yousaf Khan Sherbano traditional Pashto love story of Yousaf Khan and Sher Bano in Urdu language. This historical love legendary has been transfer in Urdu by Ishtiaq Fatima Uzma.
Yousaf Khan was a handsome young hunting man of Turlandi a village near Sawabi district of Khyber Pakhtunkhwa. On his way to his hunting grounds at Karamar hills, he would pass through a village daily. In this village one day he saw a very beautiful girl named Sher Bano.
To read more visit the below mentioned links to read online or download in pdf format to read this love legendary offline.