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Neptune Thermostatic Sequential Shower System
Enjoy a luxurious shower experience with this amazing value full shower system from Hudson Reed. The sequential valve is made from solid brass and the single control determines the flow and temperature of the water. It is also made from thermostatic ceramic disc technology which allows it to hold a solid temperature, if the cold supply fails the valve automatically shuts off preventing any risk of burning.
The solid brass shower head comes in a 'paddle' style and delivers water in a heavy rainfall flow. This is designed to replicate the feeling of heavy rainfall like you may experience in a rain forest, whilst at the same time being heavy enough to rinse out shampoo from the hair.Hudson Reed Traditional Concealed Sequential Thermostatic Shower Valve
A stunning polished chrome finish ensures that the Traditional Concealed Sequential Thermostatic Shower Valve complements any Traditional bathroom or shower room. Constructed from brass, with modern ceramic disc technology, which operates from cold through to hot in a sequential movement.
Safety comes as standard with a pre-set maximum temperature and an anti-scald device.
|Paddle Shower Head - Chrome Plated Solid Brass
|Traditional Concealed Sequential Thermostatic Shower Valve
Please note that due to WaterSense regulations these products are not eligible for sale into California
|1-Outlet Shower System
|Valve Type
|Bar Valve
|Number of Outlets
|Temperature Control
|Inlet Connection
|Recommended Water Pressure
|10 Years
Free shipping to any address in the contiguous United States is included with every purchase (*surcharges may apply to addresses in Canada, Alaska, Hawaii and other offshore locations). All items will be delivered in 1-5 business days after they are dispatched, though exceptions may be made during holiday periods. Please note that your delivery may require a signature upon receipt
You may return your order within 30 days of purchase for any reason, though please note that you may have to cover the cost of returning the product. All returned items must be in their original condition, and include all original packaging, accessories and installation guides.
Top Tips
The ideal shower is one that awakens your senses and leaves you feeling refreshed and ready for the day ahead. Therefore, it is imperative you opt for a shower system which meets all of your specific preferences and requirements. Hudson Reed offer an expansive selection of luxury showers in a wide variety of modern and traditional designs, each of which are characterized by their unrivalled practicality and boundless aesthetic appeal. Our impressive collection spans an endless choice of models supplied in a vast array of shapes and sizes, ensuring there is an ideal shower to suit every need.
All Hudson Reed showers are supplied complete with a thermostatic cartridge, which helps to make sure your system always operates at a safe temperature, and assists the prevention of accidental scalding. Our showers feature a pre-programmed temperature of 100°F which can be manually modified, making them an ideal choice for any family home.
You should always make sure you have easy access to the inside of the shower in case any maintenance work ever needs to be carried out, and for instances where your shower mixer requires cleaning. Thankfully, Hudson Reed's range of thermostatic cartridges are highly resistant to the accumulation of limescale, and each of our showers are accompanied by a 10-year guarantee.
Hudson Reed shower systems, heads and faucets are designed to work at a wide variety of temperatures and pressures and are compatible with almost all hot water systems, from combi boilers and unvented systems to gravity-fed boilers. Every Hudson Reed shower product states the needed system requirements, and can be combined with shower pumps to ensure a superior showering experience.
Neptune Thermostatic Sequential Shower System


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Finding and buying a used car from private owner in Lexington is easy and could save you a lot on your next car purchase. Sell your car online, it's FREE!
3.5 Liter with direct injection, 302 horsepower, 273 Lb-ft torque,7 speed auto transmission w/shift paddles, 4matic
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305 med high rise 660holly carb trans 700r custom paint knobbles doors leather bucket seats all metal ground effects

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Fresh organic rhubarb stalks on gray granite table , top view. Healthy dieting and antioxidant food
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- 1 Building a reliable Website Reynolds Neck
- 2 Specialist looking Website
- 3 Have a Personal Domain
- 4 Be Secure
- 5 Have a Remarkable Domain
- 6 Include Your Business Name in Text
- 7 Have Your Company Address in Text
- 8 Make Get in touch with Info Easy to Locate
- 9 Highlight Your USP
- 10 Display Consumer Reviews
- 11 Welcome Visitor Feedback
- 12 Speak to Your Online Site visitors– Not Your Vanity
- 13 Offer Fresh Web content
- 14 Contain Key phrases
- 15 Make it Personal
- 16 Link to Various other Web sites
- 17 Have Other Internet sites Link to Yours
- 18 Make Checkout Easy
- 19 Connect with Social media site
- 20 Your Web site Ought to Not … Have a Great deal of Bells and Whistles
- 21 Usage Flash Computer animation, Moving Text, Fancy Cursors or Music
- 22 Post Images Without ALT Marks or Text Subtitles
- 23 Have Dead Hyperlinks
- 24 Checklist All Your Services and products
Building a reliable Website Reynolds Neck
Is your small business web site efficiently drawing in site visitors, keeping them around and also converting them to consumers? If your web site is a bit more than an on the internet placeholder, it's time to start putting it to work so you can grow your business and also benefit from the huge prospective customer base for the on the internet market.
Today's consumers are accessing your internet site from their desktop computers and laptops, and from their smartphones and tablets. This checklist will assist you ensure that your website is doing what it must for your small company– enhancing your earnings.
Your Web site Needs to …
Specialist looking Website
Careless, ordinary or homemade-looking web sites are a site visitor turnoff.
Have a Personal Domain
Even if you're utilizing a WordPress.com, investing the few bucks a month in a web host and domain tells visitors you're severe about your business– and also makes you a lot more trustworthy.
Be Secure
If you approve on-line charge card settlements for services or products, your website has to comply with the demands of the Payment Card Sector Protection Requirements Council (PCI DSS).
Have a Remarkable Domain
Make your exclusive domain something very easy to keep in mind. Ideally the name of your service.
Include Your Business Name in Text
Internet search engine cannot index words from your logo design photo. Make certain your business is findable.
Have Your Company Address in Text
Once more– no text, no search indexing. Regional search results page are more vital than ever, so your address should be prominent.
Have Your Company Telephone number in Click-to-Call Style
With numerous people seeking out businesses on mobile phones, supplying a one-touch means to call you will certainly bring you more customers.
Make Get in touch with Info Easy to Locate
Search engines typically aren't the only ones that need easy accessibility to your call information. See to it visitors could connect with you promptly and easily.
Inform Site visitors What You Do at a Glance
Via pictures, succinct descriptions or both, visitors to your site should be able to identify right away what your business does.
Highlight Your USP
Your distinct marketing factor (USP) allows site visitors know why they should remain as well as collaborate with you, instead of click back to the search engine result. Exactly what makes you stand apart from the competition?
Display Consumer Reviews
The very best means to inform people exactly how wonderful your business is is with somebody else's words.
Welcome Visitor Feedback
You could learn more about exactly what's working as well as what isn't on your site– and also get even more testimonies– by having a feedback kind for site visitors.
Speak to Your Online Site visitors– Not Your Vanity
Your website material ought to concentrate on how you can benefit your consumers, as opposed to how incredible you are.
Offer Fresh Web content
Maintaining your website updated makes both site visitors as well as online search engine delighted. An integrated small business blog is a wonderful means to do this.
Contain Key phrases
All-natural Search Engine Optimization (search engine optimization) methods are vital in obtaining brand-new site visitors to your internet site. Make certain you comprehend Google's Panda and also Penguin updates for the best efficiency.
Make it Personal
You do not need to share your favored colors or foods, however consisting of the names as well as biographies of local business owner and also personnel on your internet site gives things a personal touch.
Link to Various other Web sites
Outbound links could assist enhance search engine results and also make you look like a valuable resource.
Have Other Internet sites Link to Yours
Inbound web links lug even more online search engine juice.
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The even more steps clients need to go through to acquire something from your web site, the more frequently they'll desert their carts. Do not make them jump via hoops for an on the internet purchase.
Connect with Social media site
Area social sharing switches prominently on your site for boosted reach.
Your Web site Ought to Not …
Have a Great deal of Bells and Whistles
Like every widget as well as create you can discover packed into your home page. Clean and to the factor functions far better.
Usage Flash Computer animation, Moving Text, Fancy Cursors or Music
These points are unnecessary, aggravating to a lot of site visitors and decrease your loading time.
Post Images Without ALT Marks or Text Subtitles
Due to the fact that search engines cannot check out images and also detailed message helps to increase your rankings.
Have Dead Hyperlinks
Ones that lead nowhere or to an error page. Examine your links regularly to make sure they still function.
Checklist All Your Services and products
Don't do this in one long, constant scroll. Break points up normally as well as utilize clever navigating to assist visitors locate exactly what they require.


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It Seems Like It's Going To Be pairs Tuttle's 41-verse poem with 41 corresponding works
Selections from the permanent collection are always on view. Artworks from different eras and places are often juxtaposed and change often to suggest visual "conversations."
Oct 11, 2012 - Feb 17, 2013
Eleven photographs document how artists use the camera to capture the sublime beauty and human destruction of the natural world. The exhibition brings together iconic works, contemporary examples, and 19th-century pictures.
Nov 3, 2012 - Feb 10, 2013
The most elaborate Intersections project to date, (IN)balance is the first major museum presentation of Veilhan's work in the US. It features 18 recent pieces in various media, from sculpture and painting to installation work.
Sep 6, 2012 - Jan 31, 2013
Art thumbs its nose at politics in this election-inspired gallery, featuring works by Honoré Daumier (French, 1808–79) and Patrick Oliphant (Australian, b. 1935) from the museum's permanent collection.
Oct 6, 2012 - Jan 6, 2013
One of Europe's most celebrated living artists, Per Kirkeby (Danish, b. 1938), is a painter, sculptor, geologist, filmmaker, writer, and poet. The exhibition features 26 richly layered paintings and 11 striking bronzes.
Jun 2 - Sep 9, 2012
Three watercolors by avant-garde composer John Cage—a close friend and collaborator of Jasper Johns—are on view with other works from the Phillips by contemporaries Mark Tobey and Morris Graves.
The Phillips presents drawings and sculptures by one of Britain's most high-profile living artists, Antony Gormley (b. 1950), the Turner Prize-winner's first U.S. museum exhibition of works on paper.
November 1 - November 30, 2012
This collaboration features artwork by older adults from D.C.'s Iona's Wellness and Arts Center.


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Anusol cream is a treatment for piles or haemorrhoids which can be used to help relieve symptoms of swelling, itching, or irritation. You can use Anusol cream for both internal and external piles, meaning you're protected whenever you need it most.
Piles, or haemorrhoids, are swellings that occur inside or around your anus which contain enlarged blood vessels. They usually don't cause any pain but they can be itchy and may cause redness or swelling around your anus. You may also notice bleeding after a bowel movement, or a lump which hangs outside of your anus and needs to be pushed back in after you've been to the bathroom.
Anusol cream contains three active ingredients which work together to treat piles. The first is Zinc oxide, this works as an antiseptic which helps to reduce bacterial growth in the affected area and helps to reduce swelling. Next, we have Balsam Peru, another mild antiseptic which helps to protect your sore areas. Finally, there's Bismuth oxide, an astringent and antiseptic which protects raw and irritated areas around your anus.
You should apply Anusol cream to the affected area at night, first thing in the morning, and after every bowel movement. Apply the cream sparingly and in an even layer. For external piles, wash and dry the affected area before gently applying the cream. For internal piles, wash and dry the affected area and then use the nozzle included to insert cream into your back passage. Wash nozzle after every use and wash your hands before and after you use Anusol cream.
Anusol cream should not be used by those under the age of 18. Do not use Anusol cream if you are allergic to this product or any of the listed ingredients. If you have rectal bleeding, blood in your stool, or are unsure whether any of your bleeding is caused by piles, speak to your doctor or Chemist 4 U pharmacist before using Anusol cream.
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If you experience these or any other side effects while using Anusol cream, speak to your doctor or Chemist 4 U pharmacist.
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If you are pregnant, trying to become pregnant, or breastfeeding, speak to your doctor or our pharmacist before taking this product. If you suffer from any allergies, ask your doctor or our pharmacist if this medicine is right for you.
Store all medicines out of sight and reach of children.
Please read the included leaflet carefully before using this product.
Please contact your GP if appropriate regarding this product.
Free UK Delivery on all orders over £30 - Delivery within 3-5 working days
Standard UK Delivery - £2.95 - Delivery within 3-5 working days
Please Note: These prices are shown as a guide only. All delivery times are approximate but have been obtained in good faith.
All our items are sent completely discreet for your peace of mind.
This means the packaging is plain, there is no mention of what product is inside your package and there is no mention of Chemist 4 U either.
We respect that many of our products are of a sensitive nature - this is why we take every step to keep your purchases private.
Didn't find the answer you were looking for? Submit a private question to be answered by one of our qualified UK pharmacists.
* Name and email address are only captured so you can be emailed a response when your question is answered by a pharmacist. No personally identifiable information is stored or displayed at any time.


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Home > Food & Drink > Biscuit
Model: T1L-67739Bar Code: 8711753006011Brand: Billys Farm
No stock, delayed despatch
Spiced Organic Wholemeal Cookies.DirectionsTypical values Per 100gNutrition:Energy 431kcalNutrition:Protein 7.3gNutrition:Carbohydrate 61.3gNutrition:Fat 23.9gIngredientsWholemeal four-grains (wheat, oat, barley, rye), vegetable oils (palm, coconut), date puree 13%, corn malt syrup 12%, spices (cinnamon), raising agent (sodium bicarbonate)*, salt*. (* non organic)
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VitaFusion™ Omega-3 EPA-DHA
Item # 686654
Free shipping available with any purchase over $49. No cash value. Void where prohibited, taxed or restricted by law. Valid at GNC.com or when calling 1-877-GNC-4700. Free shipping offer applies to ground shipping on orders shipped within the continental United States only. Free shipping offer does not include P.O. Boxes and APO/FPO addresses. Free shipping offer does not apply when shipping to Alaska, Hawaii or Puerto Rico. Not valid on previous purchases, exchanges or special orders. No substitutions or backorders. GNC may offer other free shipping offers periodically. Details of these offers will be set forth within the specific promotions. Free shipping offer excludes ready-to-drink products.
Size: 120 Gummies
The product quantity for an item in your shopping cart has exceeded our Maximum Purchasing Policy. Please adjust your quantity to (12) and try again.
Your product couldn't be added to the basket because it is out of stock.
Product Information
DescriptionAdult Vitamins
Helps Support Heart Health
Natural berry lemonade flavors
2 gummies provide:
- Omega-3 EPA, DHA & ALA: 100mg
- MEG-3 trust the source® Fish Oil
- Natural Flavors
- Gluten Free
PRODUCT DIRECTIONS / ADDITIONAl INFOAs a dietary supplement, take two (2) gummy vitamins per day. Chew thoroughly before swallowing.
Contains Soy, Fish (anchovy, sardine)
WarningsTake only as directed. Do not exceed suggested dosage. If you have a medical condition, are on medication or are
pregnant or nursing, please seek the advice of a qualified health care professional before using. Do not use if inner seal
is broken or missing. This product may settle during shipping. Do not exposed to excessive heat or moisture. Best if
refrigerated after opening. Colors will darken over time. This does not alter the potency of the product.
Other IngredientsGlucose Syrup, Sucrose, Water, Gelatin, Less than 2% of: , Colors (blueberry and carrot concentrates, purple carrot juice concentrate), Fumaric Acid, Lactic Acid, Natural Flavors, Soy Lecithin
Manufactured for Church & Dwight Co., Inc.
Ewing, NJ 08628
Ewing, NJ 08628
Nutrition Facts
3.0 / 5.0
2 Reviews
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I never got it
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A healthy candy that tastes great
Finally no large pills to swallow . Tastes like candy making it tempting to eat more than the daily serving. Love this product.
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Browse 2 questions Browse 2 questions and 1 answer
Is the vitamin d in omega 3 enough milligrams for adult?


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This coincides with changes to the Online Goods Tax that require online retailers to apply the 10 per cent GST to all online purchases shipped to Australia from overseas.
Online retail giant Amazon will block Australian consumers from its global sites to counter new laws forcing it to collect GST on transactions.
The ABC reports that, in an email to customers today, Amazon said from 1 July it would redirect Australian shoppers from its worldwide sites to amazon.com.au where products sold by Amazon US would be available on the new global store.
From 1 July Amazon will redirect Australian browsers away from its amazon.com site in response to GST changes introduced by the government. While Amazon did not specifically mention this, the ban will most likely apply to other Amazon online stores (such as those for Germany, UK, Japan, etc.), as goods bought from those stores are also susceptible to the same tax.
Both eBay and Amazon previously indicated that they may have to block Australian buyers due to the changes - and Amazon today confirmed that it would redirect Australian customers from its worldwide sites to Amazon.com.au.
New Zealand had also already applied GST to digital services from offshore, such as Netflix in 2016.
National Retail Association CEO Dominique Lamb said Amazon's move was a surprise.
Subtropical Depression Alberto bringing plenty of rain to the Carolinas
Alberto has been a subtropical storm since its formation because it lacked the warm core that forms the core of tropical storms. At 700 PM CDT (0000 UTC), the center of Subtropical Storm Alberto was located near latitude 30.9 North, longitude 86.1 West.
Kim and Moon meet again amid shaky U.S. summit plans
At the Saturday meeting, Kim was with his sister Kim Yo-jong and his top aide Kim Yong chol in charge of inter-Korean affairs. It was the first meeting between leaders of the two countries in 10 years. -South Korean military exercises.
Nine UK universities in new global reputation rankings
The 2018 rankings are based on a more than 10,000-strong survey carried out between January 2018 and March 2018. This is the first time India has snagged a spot on the list since 2011, Times Higher Education said.
Australian users weren't happy with their government's decision, and are calling the GST as the "Amazon tax".
He said the company 'had to assess the workability of the legislation as a global business with multiple worldwide sites'.
Amazon closing its worldwide stores to Australians to avoid paying GST is disappointing but Treasurer Scott Morrison is promising there will be no exemptions.
"If multinationals aren't forced to pay their fair share of tax, they will have a competitive advantage over retailers here in Australia, on our own main streets and in our shopping centers". "That tax revenue is used to fund essential services", the spokesperson said.
The move will likely drive traffic to Amazon's Australian website, testing the patience of shoppers who have complained about its thin product range - a tenth the range of its US site - and uncompetitive prices since it began taking orders in December.
"A number of other countries are taking a similar approach and adopting a vendor collection model to collect GST from low-value imported goods".


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Here we go again with the Chicken Little Sky is Falling predictions of doom and gloom. You guys actually believe this stuff?
There are several reasons why another civial war is very possible.
As stated, if our rights are taken away, many people will follow like sheep but there are others who will not go along with that program. This will lead to a war between liberal left wing and right wingers.
Having a black man as president is not going to be a joy ride. I worked in nyc when we had a black mayor. The local citizens felt that gave them a free ride to do what they wanted when they wanted. Riots were common as was just a general air of hositility towards people in uniform.
Growing up in the 50's and 60's, I remember the blood bath and the general horror of always being on edge, waiting for something bad to happen. if this new Pres is done away with, we will certainly see civil unrest like this country has never seen before. This will lead to a black/white war. We will than be led by biden a lunatic drunk.
The first thing that needs to be watched is that Israel now has only a 2 month window to do away with Iran. I for one don't think they will hesitate now knowing that come Jan 2009 they will be on their own.
Our new Koo Coo VP has said himself that within the first 6 months we will be tested and we will not like the response. Hmmmm, what in the world do you think he meant?
As we speak, the liberals are planning on cutting our military by 25%. Im sure that number will rise which leaves Americans to fend for themselves should the SHTF.
The future does not look bright.
Here we go again with the Chicken Little Sky is Falling predictions of doom and gloom. You guys actually believe this stuff?
People in the United States have never slosley read the Constitution of the United States. If you showed them on clause typed up in modern font, they will yell you should be hanged for treason. But it is still there. Any time a government becomes destructive of the ends of the people, then the people have the duty (note it says duty, not right) to overthrow that government and istitute a new one. this is what we did in the American Revolution when we overthrew the government of England.
A man without a gun is a subject; a man with a gun is a citizen.
I'll keep my freedom, my guns and my money. You can keep THE CHANGE.
An armed society is a polite society.
Mr Tats, its not doom and gloom or even chicken little. It is history and facts.
One of two things will happen if the worse case scenario occurs;
- We'll have a firearm version of Prohibition which will cause the biggest blood bath ever.
- We'll have a civil war.
The Firearm Prohibition era will either trigger a civil war or cause a repeal of Prohibition as it did in the 30's. There are a lot more presently legal firearms circulating in the USA than there was alcohol during the Prohibition era.
Know the law; don't ask, don't tell.
NRA & UT Certified Instructor; CT, FL, NH, NV, OR, PA & UT CCW Holder
Happy new 1984; 25 years behind schedule. Send lawyers, guns and money...the SHTF...
"A few well placed shots with a .22LR is a lot better than a bunch of solid misses with a .44 mag!" Glock Armorer, NRA Chief RSO, Pistol, Rifle, Shotgun, Muzzleloading Rifle, Muzzleloading Shotgun, and Home Firearm Safety Training Counselor
The sky is not falling, it has already fallen. It fell Nov, 4th
By faith Noah,being warned of God of things not seen as yet, moved with fear,prepared an ark to the saving of his house;by the which he condemned the world,and became heir of the righteousness which is by faith Heb.11:7
It is not the end of the world. There will be no civil war or whatever. I am with tattedup. this is nonsense talk
The nonsense is so many people voting for Obama!!
I'm stocking up!!
Last edited by Glockster20; 11-05-2008 at 11:55 AM.


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Monterey County Herald (http://www.montereyherald.com)
Monday, July 23, 2018
NEWRY, Maine (AP) — The racing is hot at the New England Forest Rally. Sometimes it's too hot.
Officials say Ken Block and Alex Gelsomino escaped unharmed after their rally car rolled twice and crashed into flames. Block's helmet camera, posted on social media , shows the car hitting a large rock on a corner, rolling several times and bursting into flames.
Rally racing involves a driver and navigator speeding along twisty dirt roads at speeds topping 80 mph. Karl Stone, marketing manager for the rally, said crashes are not uncommon.
The 1991 Ford Escort Cosworth was gutted by the flames on Friday, the first day of the event. Block, the driver, called it "torturous" to have to watch his vintage racer burn. He said he's committed to getting another one.


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Prepare today for the 2013 LLSA with the industry's most trusted resource – EM Reports' Study Guide for the Emergency Physician Self-Assessment Exam, Vol. 10. With more than 13,000 sold, this guide is widely recognized as a dependable, authoritative and convenient resource that provides the full text and study points for the ABEM designated articles. Study where you want, when you want – this study guide is all you need to prepare for recertification.
ABEM has released the reading list for the 2013 LLSA. Focus topics are immune system disorders, nontraumatic musculoskeletal disorders, and thoracic-respiratory disorders, systemic infectious disorders, and obstetric and gynecologic disorders.
Continuing Education: Valid through September 1, 2015
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The principal clinical question to be answered by CHAT (Clozapine Haloperidol Aripiprazole Trial) is the relative efficacy and tolerability of combination treatment with clozapine plus aripiprazole compared to combination treatment with clozapine plus haloperidol in patients with an incomplete response to treatment with clozapine over an appropriate period of time.
Allocation: Randomized, Control: Active Control, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
University of Verona
Active, not recruiting
Universita di Verona
Published on BioPortfolio: 2014-07-24T14:23:31-0400
Aripiprazole for Schizophrenia Outpatients Completing BMS Clinical Trials
The purpose of this study is to provide aripiprazole to schizophrenic outpatients and Community Treated Patients who are currently receiving aripiprazole therapy on another BMS sponsored c...
Aripiprazole in Adolescents With Schizophrenia
The purpose of this trial is to test the safety and efficacy of aripiprazole in adolescent patients with schizophrenia for a period of at least 6 weeks.
Aripiprazole Oral Acceptability Trial
The purpose of this trial is to study liquid aripiprazole in patients with stable schizophrenia.
A Double-Blind, Controlled Study of Aripiprazole in Co-Morbid Schizophrenia and Cocaine Dependence
The purpose of this study is to gather systematic clinical data on whether aripiprazole, a partial dopamine agonist, beneficially affects schizophrenia plus cocaine dependence subjects. S...
Aripiprazole Open-Label Rollover Study
The purpose of this study is to test the long-term safety and tolerability of aripiprazole in adolescent patients with schizophrenia.
Can Aripiprazole Worsen Psychosis in Schizophrenia? A Meta-Analysis of Double-Blind, Randomized, Controlled Trials.
Numerous case reports have reported psychotic worsening when switching to or adding aripiprazole in patients with schizophrenia. The risk of psychotic worsening related to aripiprazole was evaluated t...
The effects of brexpiprazole and aripiprazole on body weight as monotherapy in patients with schizophrenia and as adjunctive treatment in patients with major depressive disorder: an analysis of short-term and long-term studies.
The aim of this analysis was to explore the effects of brexpiprazole and aripiprazole on body weight when used as monotherapy to treat schizophrenia and as adjunctive treatment to antidepressant treat...
Efficacy and safety of aripiprazole for the treatment of schizophrenia: an overview of systematic reviews.
To conduct an overview to summarize the efficacy and safety of aripiprazole for the treatment of schizophrenia.
Aripiprazole Lauroxil NanoCrystal Dispersion Technology (Aristada Initio).
Nonadherence to antipsychotic medications for the treatment of schizophrenia is a widely recognized concern, leading to poorer clinical outcomes and higher treatment costs. Long-acting injectable (LAI...
DNA methylation of ANKK1 and response to aripiprazole in patients with acute schizophrenia: A preliminary study.
Epigenetic modification including DNA methylation may affect pathophysiology and the response to antipsychotic drugs in patients with schizophrenia. The objective of the present study was to investiga...
Schizophrenia, Paranoid
A chronic form of schizophrenia characterized primarily by the presence of persecutory or grandiose delusions, often associated with hallucination.
Schizophrenia, Catatonic
A type of schizophrenia characterized by abnormality of motor behavior which may involve particular forms of stupor, rigidity, excitement or inappropriate posture.
Schizophrenia, Childhood
An obsolete concept, historically used for childhood mental disorders thought to be a form of schizophrenia.
An antipsychotic agent that is structurally related to piperazines and quinolones. It is a partial agonist of SEROTONIN RECEPTOR, 5-HT1A and DOPAMINE D2 RECEPTORS, where it also functions as a post-synaptic antagonist, and an antagonist of SEROTONIN RECEPTOR, 5-HT2A.
Schizophrenia, Disorganized
A type of schizophrenia characterized by frequent incoherence; marked loosening of associations, or grossly disorganized behavior and flat or grossly inappropriate affect that does not meet the criteria for the catatonic type; associated features include extreme social withdrawal, grimacing, mannerisms, mirror gazing, inappropriate giggling, and other odd behavior. (Dorland, 27th ed)
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Psychiatry is the study of mental disorders and their diagnosis, management and prevention. Conditions include schizophrenia, severe depression and panic disorders among others. There are pharmaceutical treatments as well as other therapies to help...
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Imagine telling Siri to open the lock on your front door and your lock actually opens. Yes, you can do that now!
Paired with a smart lock called August and designed by Yves Behar, your iPhone and other iOS gadgets can be used to send a command to unlock your door. This smart lock, which will be sold in Apple's U.S. stores, is part of Apple's plan for HomeKit – a platform that will integrate smart gadgets through iOS.
Aside from unlocking your door with this integrated lock system, you can also set the door to automatically open and lock at certain times of the day, as well as to track the comings and goings of everyone. It's perfect for all homeowners and also tenants renting out their homes.


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Debra Humphris reports on why a team-based approach could yet prove to be a life-saver
Just as a Formula 1 pit-stop crew choreographs its every move, so too must a cardiac arrest or intermediate care team. Regardless of whether a task involves changing tyres or providing
diagnosis and care, teamwork is critical to performance. But teams do not just happen. Individuals can form a group but not function as a team - that ability has to be actively encouraged and developed.
Sir Ian Kennedy, who led the 2001 inquiry into the management of care of children receiving complex heart surgery at Bristol Royal Infirmary, recommended that students following a range of health and social-care programmes be given more opportunities to learn together as teams.
A survey of multidisciplinary teams led by Carol Borrill, executive director at Aston University's Centre for Health Service Organisation Research, concluded in 2000 that good team working can make a critical contribution to the quality of patient care and innovation in the National Health Service. Another finding was that effective teams are good for members' wellbeing and stress levels. They suggested that the NHS should design work around teams rather than hierarchies.
The Department of Health has encouraged universities to develop such opportunities. The New Generation Project at the universities of Southampton and Portsmouth is a leading example. The project, involving students from 11 different professions, commences in October 2003.
Four units, based on collaborative learning, interprofessional team working, enabling change in practice and interprofessional problem-solving, are being set up. Students will work in small groups on specially designed activities in university and clinical settings. They will focus on learning to work in a team, auditing practice, exploring innovation in services delivery and learning from critical incidents.
A strong characteristic of an effective team is mutual respect. But there needs to be room for constructive criticism. As students progress they will do peer assessment and give feedback to help improve performance and recognise good practice.
University and practice staff, who will be involved as team facilitators, will not be immune to all this. They will be working with students with whom they have had little previous contact. It will be a culture change, but one that everyone recognises is necessary.
Debra Humphris is director of the New Generation Project based at the University of Southampton. Details: www.mhbs.soton. ac.uk/newgeneration/
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20th Century Fox Original U.S. One-Sheet Poster (27x41) Folded Good Condition Only
20th Century Fox original one-sheet poster (27x41), folded, for the Russ Meyer directed film BEYOND THE VALLEY OF THE DOLLS (1970.) The film starred Meyer's wife, Eve Meyer as well as Edy Williams, Erica Gavin, Charles Napier and Pam Grier. The film is, of course, a comment, a parody, a sequel, an hommage, if you will to the potboiling film THE VALLEY OF THE DOLLS (1967). In only three years, Fox would allow Meyer to send up one of their biggest sucesses from the Summer of Love. This poster has some significant rippling from exposure to dampness. Condition is graded as good only. Could stand to be linen-backed. We are offering it here for a favorable price. MovieArt guarantees that this poster is an authentic one-sheet poster from this film. MovieArt Austin will sell no reproductions.
Edy Williams - Actor
Erica Gavin - Actor
Charles Napier - Actor
Pam Grier - Actor
HAJI - Actor


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I am a large proponent of supporting Federal authorities in protecting our community. Democratic Colorado lawmakers recent actions in attempting to create a 'Sanctuary State' statue is in direct defiance of Federal law and downright criminal. Any jurisdiction that harbors undocumented immigrants or allows immigration with expired visas is breaking Federal Laws specifically 8 U.S. Code § 1324. We all need sanctuary not just people who are living in the country illegally. Ask yourself what Federal laws do you and your neighbors get to break on a daily basis without consequences?
I full-heartedly support legal immigration and enjoy the many cultural aspects our immigrants bring to Colorado on a regular basis.
It pains me to see legal immigrant communities being used and abused by Democratic leadership. These communities are dumped with higher rates of criminal activity, financial burdens, and lower rated school districts at the expense of turning a blind eye for "humanity". I want to protect all legal immigrant communities from these discriminatory practices by helping to provide them with the same judicial protections that all law-abiding Americans deserve. I want all communities to be able to live under the highest safety standards and the only way to do that is hold consistent law and order across the board.


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Kivells Market Reports
Kivells operate four of the leading livestock markets in Devon and Cornwall, located at Exeter, Holsworthy, Hallworthy & Liskeard together with farm sales and private treaty sales. Their sales calendar contains lists of all types of auctions including fat & store stock; cattle, sheep, dairy, pigs; Pedigree and breed society sales; machinery, equestrian, poultry, grass keep, fodder and straw/crop.
Read the latest Market Reports - click here
You can also sign up to receive weekly newsletter updates direct from Kivells.


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...we smelled the deliciousness of Triple Crown (Sat-10/28/17). So we stopped and boy was this a huge success. The pulled pork was amazing, the sauces were delicious, the baked beans with apples was outstanding and the cole slaw was the best I've had in a long time. The service was great - super friendly - and the food was ready quickly. The location is easy to get to and there's tons of seating and parking. They even have wet wipes for cleaning up after the meal - AWESOME!! When you're in the Luray area, you have to stop there and gnosh - you will not be disappointed.
Own or manage this property? Claim your listing for free to respond to reviews, update your profile and much more.


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Solutions Squad offers FREE Microsoft Office 365 trials to clients in the South Florida area.
Try Office 365 now
Get virtually anywhere access to the latest Office applications, plus cloud-based IT services including business email.
Get your free trial now!
Join us for the second episode of a two-part Modern Workplace special security series, "Cyber Intelligence—the human element," airing March 7, 2017 at 8 a.m. PST / 4 p.m. GMT. In this episode, get a deeper look inside the biggest threat to an organization's security—its employees. In addition, you will learn how to motivate your team to proactively help prevent a breach.
Featured guests:
- Cyber intelligence advisor, Dr. Jessica Barker, shares simple steps you can take today to motivate your organization to help keep security threats at bay.
- CISO for Nielsen, Phil Ferraro, discusses five common security myths you must avoid to protect your data.
Plus, learn how Office 365 Advanced Threat Protection can help enterprise businesses detect, investigate and respond to advanced threats.
Related content
- Download the eBook, "Insider's Guide to Social Engineering."
- Download the eBook, " 5 Questions for Security Teams."
- Watch the video, "Stay Secure with Advanced Threat Protection in Office 365."
The post Learn how to protect your organization from the human element appeared first on Office Blogs.


text: The Heavy Duty Scraper is used in the first phase of glass tinting preparation, especially in the removal of old film. Tinter can also use this Heavy Duty Scraper for those tough scraping jobs that require a more rugged blade. The handle allows for easy blade changing and secure holding and features a protective blade cover. Just be careful when using for compound-curved glass because of its blade length and inability.Red Heavy Duty Handy Scraper Glass Removal Tool,click here to get more details:http://www.tintingtool.com/scrapers-and-blades/red-heavy-duty-handy-scraper-glass-removal-tool-p-108323.html


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Essaouira, Morocco
The stable North African country of Morocco has featured in Friendship Travel's winter and summer programmes for several years and is immensely popular. We are delighted to add the charming coastal resort of Essaouira to our line-up which already includes Marrakech and the Atlas Mountains.
Essaouira is on Morocco's Atlantic coast and with a direct flight from Luton and no time difference, this is an easy option for a long weekend as well as a full week: we offer both options for single travellers.
Essaouira's sweeping beach is magnificent, but thanks to the Atlantic winds the resort attracts more wind- and kite-surfers than beach babes, and that breeze makes for consistently pleasant temperatures, averaging 16-20C for our winter dates, and 20-22C for our early and late summer departures.
Examples of excursions/activities available on this fantastic holiday –
- Moroccan Cookery Day Course
- Berber Souk Tour
- Full day visit to Safi
- Windsurfing/Kitesurfing
(All at own expense and payable locally).


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Back in late March of 1974, my husband decided to buy a new car.
Little did I realize how long my relationship with that would last.
We liked a Dodge anyway, so we drove to a dealership down in Hollywood to see what he had available.
Right at the start, I spotted this green Dodge Dart Swinger in the showroom, and told my husband how nice I thought it was.
We looked around a little more, though, and he was convinced. "Let's get that one," he said.
Little did I know my husband was buying it for my birthday in April.
What a surprise when he broke the news to me!
He has since passed away, but I still drive my Swinger, and every time I do, I think of all the wonderful trips we took together.
I still take good care of the car, too. It is just as trusty and reliable as it was the day we picked it out.
It has been going strong for 20 years now, and it is still my favorite car.
More than 100,000 Dodge Dart Swingers rolled off the production line in 1974, most of them equipped with Chrysler's venerable slant-6 engine which produced just under 100 horsepower. The engine is considered one of the most reliable ever put in an American production car.
Eldra Durham has lived in Fort Lauderdale for 60 years.
You are invited to share memories of your favorite car. Write: My Favorite Car; Sun-Sentinel; 324 Datura St., Suite 150; West Palm Beach, Fla. 33401.


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How to write academic research proposal
10 steps to writing an academic research proposal this hub discusses some of the common elements in a research proposal whether you are doing quantitative or qualitative research, it is important that you outline the reasons why you propose doing the study and what process or procedures you will. Writing a research paper proposal includes the thesis of the paper, at least three important points in the paper and at least three primary and secondary sou. A guide for proposal writing introduction the staff of the division of undergraduate education activities in education and research faculty writing proposals are advised to contact nsf program. Academic proposals in graduate school show why your research idea is interesting within the field graduate students are often asked to write grant proposals along with their thesis proposals. How to write a term paper how to write a term paper april 10, 2018 types of this academic writing assignment must be well-written, analytical, organized related: how to write a research proposal. Wondering how do you write a research proposal for academic writing it is basically outlining proposed research on an academic subject and outlining any types of procedures for quantitative or qualitative research on a subject.
Learn how to write a research proposal before you start as it will help to keep your research on track a research proposal is a document in which you outline the case for undertaking the research project with good academic reasons for your selections. Definition of a research project proposal a research proposal is defined as, a document that is typically written by a scientist or academic which describes the ideas for an investigation on a certain topic. Undergraduate research project proposal guidelines important note about writing a proposal: proposals are informative and persuasive writing academic discipline this may include scientific research in the physical or biological. Writing a good phd research proposal what is a phd proposal a phd proposal is a an outline of your proposed project that is designed to: define a clear question and approach to answering it significance of the research (in academic and, if appropriate, other fields. Daad deutscher akademischer austausch dienst : german academic exchange service how to write a research proposal introduction when applying for a doctoral position or a research grant in germany you will usually be asked to submit. How to write a research proposal what's a research proposal for research proposals make you: outline steps in your proposed research think through your experiments be creative (and you can use parts of it in your final paper) justify.
Academic research (1982-1987) • mass spectrometry 6 american chemical society petroleum research fund proposal writing rule #3 write with confidence, but not with disregard for writing excellent research proposals. Lynn santelmann assistant professor, applied linguistics portland state university [email protected] outline for research project proposal when writing, please use section headings to indicate where the information can be found. Think of it as the front porch of your grant proposal explain why the issue is important, and what research you did to learn about possible solutions 04 goals and objectives how to write an effective grant proposal cover letter. Research proposal writing guide - guidelines on writing a good research proposal when you apply for a research degree, like a phd, you are asked to write a research proposal as part of your application.
How to write a research proposal you are to write a research proposal of about 2000 words, maximum 8 type-written pages (including figures and tables), double-spaced. Guidelines for writing academic research proposals and theses in the school of education revised2013 philosophy: this revised edition of school of education proposal writing guidelines was prompted by the need to respond appropriately to education. Putting it together: writing the proposal following is a suggested format for grant proposals you will need to prove that you have an understanding of the problem and the latest research on the problem for example. Develop a research proposal writing my proposal - sample proposals sample research proposals review the following sample research proposals as you review each, consider how each element in the proposal is described and explained by the researcher.
Academic and professional writing analysis papers learn how to write a review of literature what is a review of literature writing the introduction a review is a required part of grant and research proposals and often a chapter in theses and dissertations generally. Proposal writing is its own genre the writing required for a research proposal is not like other, more familiar, forms of writing readers of your proposal want to know: talk about how this project will help you meet your academic or professional goals.
How to write academic research proposal
How to write a research proposal, including its major stages of conceptualization and development request an experienced academic to proofread your proposal in order to ensure the proposal conforms to institutional and international academic standards. Writing an academic research proposal is a challenging writing project the writing will be reviewed by peers in the academic community you can create a manageable writing project by considering yourself, your audience and your purpose. How this research will affect the academic community and society at large for this paragraph in how to write a research proposal 7 participate in the study how to write a proposal templatedocx.
Pick original and interesting research proposal topics because this choice is important for the success of your work r$ do you want to make your academic research valuable and successful restrictions when choosing your topic it's not easy to write research proposals. A sample research proposal with comments are not allowed to enroll in a research course without an approved proposal for students planning to start their a comprehensive review of current industry practices and academic researches finally. Develop a research proposal the introduction and the information located in this website will help you to write this section of your proposal as you begin to write your introduction the clearest way to arrange your definitions is to list terms in alphabetical order. Writing a research proposal a good title should provide information about the focus of your research study in academic writing effective titles in academic research papers have several characteristics that reflect general principles.
Often, one of the trickiest parts of designing and writing up any research paper is writing the hypothesis. Effective proposal-writing style (for history students) contributed by b zakarin, office of fellowships, [email protected] posted: 2010. Writing a thesis/ research proposal: a step by step guide note: the learning centre offers workshops on clearer writing and writing in an academic style 33 structure of the proposal of the proposals examined for these materials. Before you begin your actual research project, many times you need to submit a research proposal to an educational institution or company check out our research proposal samples to know how to write one yourself.


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The climax to the 2015 season for Wakefield Trinity Wildcats and Bradford Bulls arrives on Saturday when the two teams face off in the Million Pound Game. Wakefield have home advantage in the tie after finishing fourth in the Qualifiers, while Bradford, who are boosted with a fully fit squad to pick from, finished in fifth with notable wins over Salford Red Devils and Leigh Centurions. Both the Wildcats and Bulls finished their regular Qualifiers campaigns with a loss, but who will bounce back at the most perfect time?
Last Time Out
Wakefield Trinity Wildcats signed off in the middle eights with a loss to Sheffield Eagles at Bramall Lane. The Wildcats were second best in most parts of the field, and their final ball just seemed to be lacking as the try-line evaded them on numerous occasions. Scott Turner and Cory Aston scored the first two tries of the match to send Sheffield into a 10-0 lead but returning Wakefield captain Danny Kirmond replied in good fashion with a blind-side try. Menzie Yere and Ben Kavanagh exchanged scores for the hosts and visitors respectively before half-time hit, with the scoreline at 16-10 to Sheffield. The first points of the second half came in the final quarter through Pat Walker, who struck a penalty goal to extend his side's lead to two scores. When James Davey fed Quentin Laulu-Togagae for a deserved four-pointer for the full-back, the result of the match was decided and Wakefield were left to lick their wounds in preparation for a massive encounter with Bradford this weekend.
Bradford Bulls were hammered in their own back yard by Halifax. James Lowes will have been fuming with his players after a very dismal performance ahead of the biggest game of the season. Matt Ryan opened the scoring for Bradford before Fax's ball was set rolling with tries from Tommy Saxton and Steve Tyrer. A couple of Ryan Shaw tries for the hosts put them out in front once again but their lead was cut to two points by the break due to a last minute Dane Manning score. The second half belonged to Fax but it didn't start in the best way for them, Ryan Maneely was sin-binned for a high tackle on 41 minutes. Many expected Bradford to pull away from then on in but that wasn't to be the case, Saxton notched the go-ahead try while his side still had a numerical disadvantage. There was no looking back for The Shay side afterwards. Three tries in less than ten minutes killed the game as a contest, to the delight of the travelling Halifax fans. Tyrer scored his second try of the afternoon before Ben Johnston picked up two tries after slick combination work with Jacob Fairbank on both occasions. Adam Tangata, Ben Heaton and Tyrer once more scored tries before the final hooter sounded.
Key Battle
Both sides possess very good back-row forwards, and you need to look no further than Wakefield captain Danny Kirmond. Even though he's been out of action for a while, his return at Sheffield last weekend was a good performance and his presence on the field helps Wakefield tenfold. The pick of the back-rowers for Bradford is Dale Ferguson. The Scotland international has been an ever-present in a Bulls side which came second in the Kingstone Press Championship this season. Tomorrow's clash is sure to be one with blood and thunder in abundance, the back-rowers will provide that on their own.
Wakefield will go into this big game as favourites but Bradford won't take any notice of what the bookmakers think. The Bulls have been building up to this game ever since they beat Leigh Centurions in the Qualifiers, can they pull it off when it really matters? Or will Wakefield, once again, defy those pre-season critics and pull yet another Super League survival out of the bag? – Wakefield by 10
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Published: 26.02.2018
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Guidance and Resources
At VDCI, we believe every student should have the appropriate guidance and resources to be successful in their academic and career goals. Below you will find information to help you.
The VDCI faculty and staff are here to support you.
Our doors are always open to counsel you on your professional direction.
Academic Advising & Counseling
Academic Support – VDCI is committed to provide many resources to our students, to help you succeed and advance in your academic and professional career.
Certificate Program & Academic Advising – Our team of academic advisors is available to help you find the right path in your long-term, short-term professional and educational goals. Appointments are available Tuesdays through Thursdays between 10 am and 3 pm. To schedule an appointment with an advisor, please click here.
Academic Counseling & Tutoring – If you need assistance with a particular course or project, we recommend that you schedule an appointment with your instructor or your course Teacher Assistant (TA). If you need more hands-on guidance from your instructor, you may schedule a tutoring session. The instructors are available for on-on-one tutoring on Tuesdays and Thursdays only. There is an additional charge for this one-on-one tutoring. There is a minimum of two hours for these sessions. To schedule an appointment or a tutoring session with your instructor or course TA, please click here.
Careers & Networking
Aligned with our school's mission and objectives, VDCI does our best to offer you networking and job opportunity connections to help you jump-start your career in the construction industry.
We strongly encourage you to participate in our VDCI Student Lounge and to join our VDCI LinkedIn School Page. They are both terrific vehicles to keep you engaged with your classmates, introduce yourself to VDCI alumni and learn about professional opportunities throughout North America.
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Find job openings in your area or search for opportunities nationwide with these resources:
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Typical Career Paths
VDCI Employment Preparation Assistance
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- Job/Wage Resources Online


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Call of duty 2
Call of Duty® 2 redefines the cinematic intensity and chaos of battle as seen through the eyes of ordinary soldiers fighting together in epic WWII conflicts. Call of Duty 2 Gameplay HD in Deutsch/German kommentiert von Pactain. Besucht uns im Forum. http. i hope the d day mission on cod WW2 is gonna be omaha beach . ahhh. call of duty 2. my very first cod. thanks. Infinity Ward president Grant Collier said:. Enable Reviews Beta what is this? Perry described the presentation as "classy and well-produced", and said the graphics were some of the best on the Xbox at its launch. Titanfall 2 New first person shooter from Electronic Arts. It is also important for scouting, though most of the game takes place in personal, close combat situations reducing the importance of this tactic.


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Panels for walls
Stabilit opaque plastic laminates replace steel sheets and other traditional metals used as wall panels. These panels are fire retardant and impact resistant. With Stabilit opaque panels our customers :
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These opaque panels are used in:
- Warehouses
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Start here for Success.
With access to degree programs from six South Dakota universities, University Center offers academic curriculum to change and enrich your life. Choose from a wide variety of degrees, including nursing programs, IT degrees, business and more. Want to move ahead in your career, but not quite sure where to go? Don't worry – our academic advising team is always there to help.
Classes that challenge.
The minute you walk into your first class at UC, you'll notice a change in yourself. With degree programs that encourage critical thinking, group discussion, independent study and hands-on learning experiences, University Center's curriculum will open your mind, while opening doors for your career.
Instructors who understand.
Going back to school can be exciting – and exhausting. UC's experienced instructors understand the unique needs and goals of adult students. Not only will they make sure you're getting a top-notch education, but they also provide one-on-one advice and assistance so you get the most from your college education.
News & Events
2018 Native American Day
There will be no classes and UC offices will be closed on Native American Day.View Details
Join us for Career & Program Exploration Night
Posted: September 18, 2018
Featuring Sociology, Psychology, Human Development & Family Studies and Criminal Justice. Thursday, Sept 27 4pm - 6pm Avera Hall. Learn about these majors & network with professionals. FREE REFRESHMENTS.Read More
Fall 2018 Mid-term Deficiencies Due
Fall 2018 Mid-term Deficiencies Due; instructors are required to send midterm deficiency notices on behalf of students who are at a grade below C allowing students time to take action, discuss with advisors, and talk with instructors about improvement.View Details


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Join Us
This is an exciting opportunity to lead the integration of science and medicine to treat comorbidity successfully. As a Research Partner you will have access to the Partner Portal that allows you to reach out to other leaders across all levels of membership. We will also provide you with secure access to the Data Commons, Health Data Research Management System, and I Am Heard Research Viewer.
Our collaborative environment provides a voice to lead the brain comorbidity frontier. The ability to use scientific and clinical evidence to better understand the how the disease pathway influences the patient's pathway, provides the interdisciplinary knowledge to develop clinical services or technologies that manage two conditions simultaneously. We are excited to work with you and manage the research you need to hasten the scientific, clinical, and technological innovation that will relieve the physical and financial burdens of people with multiple conditions.
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Boeing B-1 Lancer
Image #316
Taken: Mildenhall 26th May 2001
More pictures: Event: Previous All Next Type: Previous All Next The light shines through the wings and makes the flaps easily discernable. There's a lot of flaps on this bird.
All images are the property of and copyright © 1983-2012 Jo Hunter unless stated otherwise. Please ask before using content from this site. Unauthorised reproduction of these photographs is forbidden.


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The state of Vermont was not one of the original 13 colonies and did not join the union until 1791, the year the First Amendment was ratified. That tardiness may explain its inability to interpret the First Amendment correctly. Vermont was settled by the French from whence its Ver (green) mont (mountain) name emerged as well as, perhaps, its penchant fouler aux pieds (to trample) the limitations the First Amendment places on state power—including the regulation of food manufacturers' speech. While Vermont's food pedigree is unassailable—it is the maple sugar capital of the U.S. and gave birth to Ben and Jerry's ice cream—when it comes to the First Amendment, it has a knack for serving up leftovers and for getting it wrong. In fact, the most important U.S. Supreme Court ruling in U.S. history impacting the "labeling" of products regulated by the Food and Drug Administration (FDA) came from Vermont. In Sorrell v. IMS, the Supreme Court found that a Vermont statute barring manufacturers from using certain commercially available information was unconstitutional under the First Amendment.
First Amendment cases are rare in the realm of the Food Drug and Cosmetic Act (FDCA), but Sorrell v. IMS was followed shortly afterward by U.S. v. Caronia, a small case involving a $50 penalty and 100 hours of community service. That little case sent shock waves throughout the country. Vermont was not the only one deaf to the news, however; the FDA itself ignored the fresh approach being taken by the court. The pace is now accelerating in the second circuit with Amarin v. FDA (see our post here) and Pacira v. FDA (see our post here).
Grocery Manufacturers Association v. Sorrell
First Amendment cases under the FDCA are rare because the FDCA is a criminal statute. Given that a win would likely produce little more than a pyrrhic victory, its penalties, including the threat of criminal convictions and debarment, are too steep and frightening to risk. Fighting on First Amendment grounds when the FDCA is invoked generally involves an extraordinary set of facts—something unique, outrageous, grossly wrong, or threatening to cause real injustice—or a party with nothing to lose by fighting. In Grocery Manufacturers Association, et al v. SorrelI1 a case which met those criteria, industry trade groups sought an injunction on First and Fifth Amendment grounds—arguing Commerce Clause violations and federal preemption—and challenged Vermont's Act 120 insofar as it restricted speech on the one hand and compelled speech on the other.
Vermont's Act 120 requires that "certain manufacturers and retailers identify whether raw and processed food sold in Vermont was produced in whole or in part through genetic engineering (the GE Disclosure Requirement). Act 120 further prohibits manufacturers from labeling or advertising GE foods as "natural," "naturally made," "naturally grown," "all natural," or "any words of similar import" (the act's Natural Restriction). The trial court ruled in Vermont's favor on the GE Disclosure Requirement but found the Natural Restriction exceeded the state's power under the First Amendment.
The GE Disclosure Requirement – Compelled Speech
Act 120 requires that a "packaged raw agricultural commodity" be labeled by GE manufacturers "with the clear and conspicuous words 'produced with genetic engineering.'"2 The trial court observed that the state made some findings to support this compelled disclosure. Among the findings the trial court noted: "[w]ith regard to GE food safety, the General Assembly declared in its 'Findings' that GE foods 'potentially pose risks to health, safety, agriculture, and the environment," as evidenced by the following:
- Labeling gives consumers information they can use to make decisions about what products they would prefer to purchase,"
- Public opinion polls indicate labeling is relevant to consumers, and
- Persons with certain religious beliefs object to producing foods using genetic engineering [and object] to tampering with the genetic makeup of life forms and the rapid introduction and proliferation of genetically engineered organisms and, therefore, need food to be labeled as genetically engineered.3
The trial court rejected GMA's argument that in-state and out-of-state impact violated the Commerce Clause.4
In denying the challenge to Act 120's GE Disclosure Requirement on federal preemption grounds, the court stated that a review of FDA's regulations "clearly implies that, at least from the FDA's perspective, GE ingredient information may be provided without violating federal law or misbranding a food product."5 Under the Draft Guidance, manufacturers may label their food and beverage products as "genetically engineered" or containing ingredients that were "produced using biotechnology."
The trial court further found the GE Disclosure Requirement was not barred based on conflict preemption grounds. The court stated that because "the term 'genetically engineered' is not federally regulated or defined for purposes of food and beverage labeling, it can hardly be said that a state definition that differs from definitions used in federal policy and guidance statements is "false and misleading," or "stands as an obstacle to the accomplishment and execution of the full purposes and objectives of Congress."6
The trial court also rejected the Grocery Manufacturers Association's (GMA's) viewpoint discrimination claim that the GE Disclosure Requirement "singles out Plaintiffs' members for special burdens in order to tilt public debate in a preferred direction" that GE foods are unsafe and requires Plaintiffs' members to 'accommodate' that view and convey it to their customers."7
The Commercial Speech/Strict Scrutiny Debacle
The trial court rejected GMA's argument that the speech at issue is not commercial speech stating: "While the 'core' notion of commercial speech is 'speech which does no more than propose a commercial transaction,' 'the Supreme Court has also defined commercial speech as 'expression related solely to the economic interests of the speaker and its audience.'"8 The court went on to pronounce that "'[p]roduct labeling requirements are traditionally regarded as commercial speech even if they effectively discourage the product's consumption."9
Deciding whether the speech at issue is commercial speech is the linchpin of determining the level of scrutiny the reviewing court will apply to the state action, and the issue of the definition of commercial speech has not been resolved by the Supreme Court. In Nike v. Kasky, the Supreme Court had the opportunity to define commercial speech but refused to reach the issue by dismissing the petition for lack of jurisdiction. Before dismissing the petition, however, the Supreme Court received 34 briefs, heard oral argument and—in its multiple opinions dismissing the appeal—suggested that even blended speech might be subject to heightened scrutiny. Thus, the issue of what constitutes "commercial speech" remains very much unresolved and central to the analysis of cases such as GMA v. Sorrell.
The Natural Restriction
Act 120's Natural Restriction, however, was not able to pass even the lower standard of intermediate scrutiny. Like the FDA regulations, Act 120 does not define the term "natural" or the phrase "any words of similar import." The trial court addressed the First Amendment challenge to the Natural Restriction as follows:
The State argues that it may freely regulate and even ban the use of "natural" and similar words to describe GE food products as such usage is inherently or actually misleading. To the extent Act 120's restriction on the use of "natural" terminology and "any words of similar import" is ambiguous, the State asserts that it can rely on the Final Rule to avoid and correct any ambiguity. Plaintiffs counter the State is wrong on both points. The court agrees.10
Act 120 does not define "natural," "naturally made," "naturally grown," and "all natural." The Final Rule also does not define these terms. The State thus faces an uphill battle in arguing that a GE manufacturer's use of 'natural' terminology is actually or inherently misleading because the alleged deception cannot be measured against a statutory, or even a regulatory, definition of the restricted terms.
The trial court's reasoning is as follows:
Greenhouses, fertilizers, pesticides, and even the watering, weeding, and pruning of plants are "manmade," "purposeful interference" in plant production, not "existing in nature," and thus can readily and reasonably be deemed an 'artificial means' of food production. More particularly, altering seeds and plants from their "natural" state has occurred for centuries through techniques such as selective breeding, hybridization, cross pollination, and grafting. Act 120's "natural" restriction thus subjects GE manufacturers to a standardless restriction that virtually no food manufacturer could satisfy.11
The trial court recognized that at best, the State:
mustered some evidence that some consumers may find the use of 'natural' terminology in conjunction with GE food misleading depending on how 'natural' is defined. This evidence does not rise to the level of 'evidence of deception' sufficient to support an outright ban on commercial speech. 12
The court concluded that Vermont failed to "establish that Act 120's Natural Restriction directly advances a substantial state interest and is no greater than necessary to serve that interest. Under Central Hudson, the state's complete ban on the use of 'natural' terminology in the advertising, labeling, and signage for GE food products therefore violates the First Amendment."13
Congress may bring national uniformity to what is emerging as a patchwork of state laws. It is poised to consider H.R. 1599, which passed the house in July 2015 that in its current form, commands the FDA to, at long last, define the term "naturally."
The FDA's repeated refusal to provide a definition has also given rise to pernicious litigation. While GMA won the first round in its challenge to Act 120 (and will likely prevail at the Second Circuit), an FDA standard would end food labelers' national regulatory confusion and put the term "naturally" back into the labeling lexicon. This development would, naturally, be welcome for manufacturers, retailers, and consumers.
1. 2015 U.S. Dist. LEXIS 56147 (D.VT April 27, 2015)
2. 9 V.S.A. § 3043(b)(1).
3. Id. at 13-14 (citations omitted).
4. Id. at 40.
5. Id. at 54 (citing the FDA, Draft Guidance on Voluntary Labeling for BE Foods, at 6-7 (2001).
6. Id. at 65
7. Id. at 83
8. Id. at 94-95.
9. Id. at 95.
10. Id. at 121.The court rejected the state's attempt to argue that an administrative rule would clear up the statutory ambiguity.
11. Id. at 124-125.
12. Id. at 17.
13. Id. at 136.
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