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Mastering MRSA: Pilot Project Lowers Rates 73 Percent
From 2006 to 2008, investigators with the Plexus Institute developed a pilot program at six hospitals to control and reduce the rate of infections of methicillin-resistant Staphylococcus aureus (MRSA), one of the most virulent hospital-acquired infections in the United States.
Investigators used an approach called positive deviance, which identifies individuals and groups within an organization or community who have overcome seemingly intractable problems and spreads their solutions throughout the organization.
Key Results
- Six institutions participated in the pilot project:
- Albert Einstein Medical Center, Philadelphia, Pa.
- Billings Clinic, Billings, Mont.
- Franklin Square Hospital Center, Baltimore, Md.
- University of Louisville Hospital, Louisville, Ky.
- The Johns Hopkins Hospital, Baltimore, Md.
- VA Pittsburgh Healthcare System, Pittsburgh, Pa.
- MRSA rates declined by 73 percent in four of the six pilot units (Albert Einstein, Billings Clinic, Franklin Square Hospital Center and the University of Louisville Hospital Center). Two of the six institutions did not report unit-level data (The Johns Hopkins Hospital and VA Pittsburgh Healthcare System).
- The aggregate rate of MRSA infections per 1,000 patient days dropped from 4.36 in 2006 to 1.17 in 2008 among the four pilot hospital units that reported.
- Three of the six hospitals expanded the approach from the initial pilot units to at least one other unit (The Johns Hopkins Hospital, Franklin Square Hospital Center and University of Louisville Hospital).
- Three hospitals adopted the project throughout their entire institutions (Billings Clinic, VA Pittsburgh Healthcare System and Albert Einstein Medical Center).
- The results achieved by the pilot institutions spurred 53 additional hospitals in the United States, Canada and South America to adopt the positive deviance approach in their drives to prevent MRSA transmission.
The Robert Wood Johnson Foundation (RWJF) supported this project with a grant of $292,250 from January 2006 to January 2008.
See Grant Detail & Contact Information
Back to the Table of Contents
Between 5 and 10 percent of all hospital patients contract an infection during their hospital stays. Despite campaigns in hospitals to increase the rates of hand-washing and other antiseptic techniques, these hospital-acquired infections have risen significantly in recent years. According to the Centers for Disease Control and Prevention (CDC), about 1.7 million people acquire an infection while in a U.S. hospital every year, and nearly 100,000 die as a result of their infections. Hospital-acquired infections cost an estimated $6.5 billion in additional health care every year.
A growing cause of hospital-acquired infections is methicillin-resistant Staphylococcus aureus (MRSA), a virulent strain of bacteria resistant to commonly used antibiotics. The CDC reports that nearly 95,000 people developed MRSA infections associated with their hospital care in 2005, and approximately 18,650 of them died as a result. The United States now has the second highest MRSA infection rate in the world.
Researchers have documented effective techniques for preventing the transmission of MRSA. Some U.S. hospitals and hospital units, and countries such as Denmark, Finland and the Netherlands, have successfully brought MRSA rates under control using similar protocols, such as those described below:
- Active surveillance cultures to identify all patients with MRSA and isolation of all patients colonized or infected with MRSA.
- Barrier precautions (such as the use of gloves, gowns and disposable equipment) on all patients colonized and infected with MRSA.
- Strict hand hygiene before and after every patient contact.
- Environmental cleaning.
But traditional strategies designed to persuade hospital staff to adopt these practices and adhere to them faithfully—such as educational campaigns, initiation of best practice programs and other quality improvement initiatives—have not been effective. Although the necessary interventions are low-tech and inexpensive, they require changing behavior rather than recalibrating machines, and successful implementation is therefore much more variable. The problem is not lack of knowledge about control and prevention techniques, but the difficulty, and sometimes the inability, to translate that knowledge into social and behavioral changes within the complex structures of hospitals and health care systems.
According to RWJF's 2005 Annual Report, "[t]he Pioneer Portfolio supports innovative projects that can lead to fundamental breakthroughs in the health and health care of Americans. We seek to invest in high-return ideas that could have major impact in the future, even though the probability that projects will lead to such breakthroughs is uncertain.
"In 2005, the Pioneer Portfolio pursued this objective through a mix of projects aimed at helping us think more precisely about the trends and strategies that may define the future of health and health care.
"Our immediate focus is to develop a strategic approach that will attract new ideas and breakthrough innovations. Our longer-term objective is to assess and steer our investments toward projects that are most likely to result in breakthrough advances in health and health care."
RWJF issued its grant to the Plexus Institute for research on methods to reduce hospital-based transmission of MRSA (methicillin-resistant Staphylococcus aureus) in 2005. To read more about RWJF's interest in this subject, please visit the Pioneer blog.
The Plexus Institute, a nonprofit organization that uses "complexity science" to tackle problems in health care organizations and other institutions, developed a pilot program employing positive deviance to reduce methicillin-resistant Staphylococcus aureus (MRSA) infection at six U.S. hospitals. The project had three goals:
- Reduce MRSA infection rates in pilot nursing units by 75 percent.
- Expand MRSA prevention efforts in participating hospitals beyond the initial pilot units.
- Spread the positive deviance methodology for MRSA prevention to other hospitals.
What Is Positive Deviance?
Positive deviance is based on the observation that, in most communities, there are certain individuals or groups—positive deviants—whose special practices or strategies help them to find better solutions to prevalent, seemingly intractable problems, than do their peers, who have access to the same resources.
Through a process of facilitated small group interactions called discovery and action dialogues at the study institutions, participants identified these individuals and their strategies, and highlighted the strategies in order to spread them throughout the organization. The approach enables the very people whose behavior needs to change to discover effective solutions that already exist within their institution or community. Rather than imposing externally defined best practices, as is common in many quality-improvement initiatives, organizations using the positive deviance approach generate solutions from within. And because they come from within, these solutions are less likely to be rejected as impractical, too difficult or inappropriate for a particular institution's culture.
The positive deviance approach has been used around the world to generate solutions to complex health care problems, including childhood malnutrition, infant mortality and morbidity, poor pregnancy outcomes and the spread of HIV.
The Pilot Institutions
The six institutions Plexus chose to pilot the Positive Deviance MRSA Prevention Partnership were:
- Albert Einstein Medical Center, Philadelphia, Pa.
- Billings Clinic, Billings, Mont.
- Franklin Square Hospital Center, Baltimore, Md.
- University of Louisville Hospital, Louisville, Ky.
- The Johns Hopkins Hospital, Baltimore, Md.
- VA Pittsburgh Healthcare System, Pittsburgh, Pa.
These sites agreed to use positive deviance to engage staff in determining how to consistently employ the following evidence-based precautions in at least one pilot unit:
- Active surveillance MRSA cultures on all patients on admission/discharge/transfer.
- Hand hygiene before and after every patient contact.
- Barrier precautions (such as the use of gloves, gowns and disposable equipment) on all patients colonized or infected with MRSA.
- Environmental cleaning.
Project leaders at each hospital launched the intervention with a kick-off event attended by staff members from all hospital departments. Project leaders described the problem of MRSA infection and the positive deviance approach to reducing it. Patients told stories of their experiences with the infection. Project leaders then called for volunteers to help identify a pilot unit at each hospital where MRSA reduction techniques uncovered with the positive deviance approach could be introduced.
To identify positive deviant practices, the hospitals held discovery and action dialogues with hospital staff members. These small, facilitated group discussions, which included diverse front-line health care workers, ranging from physicians and nurses to lab technicians, housekeepers, unit secretaries, social workers, chaplains, food service staff and patient transporters, fostered wide networks and increased conversation. Facilitators asked staff members questions such as:
- What steps do you take to prevent transmission of MRSA?
- What prevents you from taking these steps all the time?
- Do you know of anyone who has overcome those barriers?
Project team members trained hospital staff to facilitate the sessions. They participated as coaches at first, and then transitioned out as the staff members became more adept at facilitation. The staff who led the sessions varied; they included nurses, infection control specialists, quality control personnel and organizational development staff.
Pilot hospitals held numerous dialogue sessions, at different times of day and on different days of the week so that all staff had an opportunity to participate. Once group members identified a new positive deviant (PD) practice during the discussions, facilitators called for volunteers to step forward to take on the spread of the innovation. Participants also created PD practices.
In addition to the small, group dialogues, the hospitals identified positive deviant approaches using statistics. If a hospital had a particular unit with much lower MRSA rates than the others, staff involved in the pilot project would visit that positive deviant unit and observe its practices to find out what its staff was doing differently.
The pilot hospitals supported one another and shared innovations through biweekly conference calls, as well as regular, informal e-mails and phone calls between participants. They also held regular, face-to-face meetings to share experiences, ideas and data.
Positive Deviants in Action
Some examples of positive deviants with innovative strategies for MRSA prevention included:
- Jasper Palmer, a patient transport worker at Albert Einstein Medical Center, became concerned that gowns were overwhelming hospital trash cans and spilling out of disposal bins, ending up on the floor and increasing contamination. Palmer created a method for taking off a gown, rolling it into the size of a baseball, and pulling his gloves over the gown to contain it. A nurse noticed his approach and spread it around as part of the positive deviance project. In most hospitals, surgical procedures are named after the surgeons who create them; this de-gowning approach was dubbed the Palmer Method. Hospital staff created a YouTube video of Palmer's technique. At a regional workshop on MRSA prevention, Einstein sent Palmer, a unit secretary and a nurse to speak.
- A patient transport worker at Albert Einstein Medical Center realized that guidelines from the CDC did not address specific situations he experienced in transporting isolation patients to support services. He and his colleagues worked with clinicians to develop precautions that included performing hand hygiene and donning gloves and gowns before moving the patient onto a gurney and wrapping the patient in a clean sheet. They then remove their protective garments, sanitize their hands and the hand rail, place a previously prepared clean plastic bag containing clean gloves, gowns and a small bottle of hand gel on the gurney, and transport the patient. The receiving department gets verbal instructions and the necessary supplies to adhere to precautions. This process is now part of everyone's routine.
- Staff members at the VA Pittsburgh Health System found that two patients who had become MRSA-positive during their stay had occupied the same room. Wondering if there had been contamination in the room that routine cleaning had missed, housekeeping staff observed room cleaning procedures and discovered they were highly variable. They designed, refined and tested a cleaning checklist that consisted of color photos of the room with black dots on areas requiring daily cleaning and red dots on areas requiring cleaning when a patient checks out.
- Walter Fairfax, M.D., a critical care physician at the Billings Clinic stopped wearing ties to the hospital, since ties can transmit MRSA. After he did this, medical students cultured ties and found a variety of organisms, so many medical staff members stopped wearing neckties, white coats and long sleeves.
Reduction of MRSA Rates
Between 2006 and 2008, the Positive Deviance MRSA Prevention Partnership significantly reduced the rate of methicillin-resistant Staphylococcus aureus (MRSA) infections in the pilot units:
- MRSA rates declined by 73 percent in four of six pilot units reporting. These were Albert Einstein, Billings Clinic, Franklin Square Hospital Center and the University of Louisville Hospital Center. The Johns Hopkins Hospital declined to report MRSA infection rates after running afoul of federal reporting requirements on another project. The VA Pittsburgh Healthcare System began its positive deviance MRSA prevention program on a facility-wide basis and did not pilot test.
- The aggregate rate of MRSA infections per 1,000 patient days dropped from 4.36 in 2006 to 1.17 in 2008 among the four pilot hospital units that reported.
Specific hospital units achieved the following results:
- The surgical intensive care unit at Albert Einstein Medical Center achieved a 70 percent drop in the rate of hospital-acquired MRSA infections from 2006 to 2008, yielding a 2008 rate of 0.81 infections per 1,000 patient days.
- The intensive care unit at Billings Clinic achieved a 100 percent drop in the rate of MRSA infections from 2006 to 2008, yielding a 2008 rate of 0.00 infections per 1,000 patient days.
- The intensive care unit at Franklin Square Hospital Center attained a 100 percent drop in the rate of MRSA infections from 2006 to 2008, yielding a 2008 rate of 0.00 infections per 1,000 patient days.
- The intensive care unit at University of Louisville Hospital realized a 65 percent drop in the rate of MRSA infections from 2006 to 2008, yielding a 2008 rate of 4.33 infections per 1,000 patient days.
From 2006 to 2008 five of the six hospitals reported hospital-wide reductions in MRSA infection rates:
- Albert Einstein Medical Center—35 percent reduction.
- Billings Clinic—89 percent reduction.
- Franklin Square Hospital Center—49 percent reduction.
- University of Louisville Hospital—36 percent reduction.
- VA Pittsburgh Healthcare System—33 percent reduction.
Expanding Beyond the Pilot Units
- Three of six pilot hospitals expanded their initial efforts beyond the pilot unit to at least one other unit in the hospital.
- University of Louisville expanded to four units.
- Franklin Square Hospital Center expanded to two units.
- The Johns Hopkins Hospital expanded to three units and to another hospital in its system.
- Three hospitals adopted the project throughout their entire institution. These were:
- Billings Clinic.
- VA Pittsburgh Healthcare System.
- Albert Einstein Medical Center.
Online MRSA Surveillance System
- Creation of the nation's first online MRSA surveillance system, in partnership with the Centers for Disease Control and Prevention (CDC).
- Initially developed to help the pilot sites evaluate their performance, the system has now been incorporated into the CDC's National Healthcare Safety Network (NHSN), making it available to all hospitals in the United States.
Expansion to New Hospitals
According to the project team, the results achieved by the pilot institutions spurred 53 additional hospitals to adopt the positive deviance approach in their effort to prevent MRSA transmissions. These included:
- Five Department of Veterans Affairs hospitals.
- Some 35 health care facilities participating in a statewide collaborative led by the Maryland Patient Safety Center and the Delmarva Foundation.
- Six hospitals participating in a regional MRSA collaborative led by Indiana University.
- Two hospitals in Colombia, South America.
- Six hospitals in a MRSA collaborative sponsored by Ontario Agency for Health Protection and Promotion (OAHPP) in Canada.
- Engagement of front-line staff is even more essential than leadership support in changing behavior. Senior leadership were actively involved in initiating the positive deviance process at their hospitals, established a supportive climate and dealt quickly with systematic barriers to good infection prevention practices. Nonetheless, positive deviance did not gain real traction in the pilot sites until unit and other hospital staff became engaged. (Project Director/Lindberg)
- More intensive, early coaching would speed the implementation of positive deviance. Pilot site leaders and their coaches said that more intense coaching in the beginning of the effort would have helped the process move along more rapidly. (Project Director/Lindberg.)
- Use of selected positive deviance process measures, such as the number of discovery and action dialogues held and the diversity of participants (referred to in positive deviance parlance as unusual suspects), would also have supported more rapid uptake of the approach and would have served as indicators of progress. "Attention in the beginning of the process was on outcome data (methicillin-resistant Staphylococcus aureus [MRSA] infections and transmissions) and infection control process (hand hygiene, gloving, gowning). Upon reflection, this should have been coupled with attention to process measures," said project director Lindberg. (Project Director/Lindberg)
- Be patient and let the plans emerge from the staff. "We called it 'go slow to go fast,'?" project director Lindberg said. "Infection control is dependent on the actions of literally hundreds of staff members. They have to be engaged in some way at some time, but once they do get engaged, then it begins to cook. In our hospitals, it took about a year for things to really start moving." (Project Director/Lindberg)
Jon Lloyd, M.D., a retired surgeon who served as the coordinator of the Pittsburgh (methicillin-resistant Staphylococcus aureus) MRSA Prevention project, joined Plexus as senior clinical advisor, MRSA prevention, to help maintain and expand the network of organizations devoted to positive deviance and MRSA prevention.
Plexus was slated to serve as a major subcontractor, on a $1.8 million grant to Indiana University for MRSA prevention and research, from the federal Agency for Healthcare Research and Quality.
Plexus is assisting six Canadian hospitals in a positive deviant MRSA prevention collaborative sponsored by the Ontario Agency for Health Protection and Promotion.
The Centers for Disease Control and Prevention (CDC) awarded a grant to the Delmarva Foundation (a national, not-for-profit organization with a mission to improve health in the communities they serve) to develop and implement a protocol for social network analysis (SNA) in hospitals using positive deviance in MRSA prevention efforts. Plexus planned to partner with Delmarva on this $300,000 grant, which is renewable for four years.
Plexus engaged the New York-based National Executive Service Corps to develop a business plan for expanding its positive deviance MRSA initiative nationally.
Plexus planned to publish a book on the project, co-written with help from individuals at the pilot institutions.
Plexus was invited by The Joint Commission to submit an article on the PD MRSA initiative. The article was submitted October 3, 2009.
Reducing methicillin-resistant Staphylococcus aureus infections in hospitals by using the positive deviance approach to organizational change
Plexus Institute Inc. (Bordentown, NJ)
Amount: $
Dates: January 2006 to January 2008
Curt C. Lindberg, M.H.A., D.Man.
(609) 298-2140
Web Site
(Current as of date of this report; as provided by grantee organization; not verified by RWJF; items not available from RWJF.)
Buscell P. "Mapping the Positive Deviance/MRSA Prevention Networks at Pennsylvania and Montana Health Care Facilities Shows Promise." Prevention Strategist, 41–45, Autumn 2008.
Cohn J. "Positive Deviance Model Keeps MRSA at Bay," Occupational Health and Safety Online, January 23, 2008. Available online.
Lindberg C, et al. "Letting Go, Gaining Control: Positive Deviance and MRSA Prevention." Clinical Leader, in press.
Lloyd J, Buscell P and Lindberg C. "Staff Driving Cultural Transformation Diminishes MRSA." Prevention Strategist, 10–15, Spring 2008.
Buscell P. More We Than Me, How the Fight Against MRSA Led to a New Way of Collaborating at Albert Einstein Medical Center. Bordentown, NJ: Plexus Institute, January 2008. Also available online.
MRSA Tumaround Document: Description of New Approaches That Have Evolved During the Course of the PD/MRSA Initiative to Combat Health Care Acquired Infection. Bordentown, NJ: Plexus Institute, August 2008.
Singhal A and Buscell P. From Invisible to Visible: Learning to See and Stop MRSA at Billings Clinic. Bordentown, NJ: Plexus Institute.
Singhal A and Greiner K. Do What You Can, With What You Have, Where You Are: A Quest to Eliminate MSRA at the VA Pittsburgh Healthcare System. January, 2008. Available online.
Audio-Visuals and Computer Software
Antibiotic Resistant Bacteria, a 60-minute audiotape of presentation and community discussion. Bordentown, NJ: Plexus Institute, February 15, 2008. Available online.
Positive Deviance in the Fight Against MRSA, a 60-minute audiotape of presentation and community discussion. Bordentown, NJ: Plexus Institute, June 6, 2008.
MRSA Attack Plan. A 2-minute video produced with Medstar television about the positive deviant MRSA project at Johns Hopkins. Bordentown, NJ: Plexus Institute.
Survey Instruments
"Social Network Mapping," Plexus Institute, fielded March 2007.
World Wide Web Sites
http://PDMRSA.blogspot.com. Created by Plexus Staff member Tuyen Tran for member discussion and information and contribution by invited bloggers.
www.plexusinstitute.org/complexity/index.cfm?id=3. Web page devoted to positive deviance and methicillin resistant Staphylococcus aureus, includes stories and articles from several sources about this work.
Presentations and Testimony
Jon Lloyd, "Positive Deviance and MRSA Prevention," at the International Society of Microbial Resistance Policy Forum George Mason University on February 9, 2007, Fairfax, VA. Proceedings available online.
Jerry Sternin and Monique Sternin, "Positive Deviance and MRSA," at the Association of Professionals in Infection Control (APIC) National Conference, June 24, 2007, San Jose, CA. Conference proceedings available online.
Jon Lloyd, "Update on Healthcare-Associated Infections Part 1: The Changing Face of MRSA in the Hospital and the Community," for the Voluntary Hospital Association, October 23, 2007. Live satellite broadcast and webcast.
Jon Lloyd, "Update on Healthcare-Associated Infections Part 2: Building a Culture of Safety," for the Voluntary Hospital Association, October 23, 2007. Live Satellite broadcast and webcast.
Jon Lloyd and Margaret Toth, "Engaging Your Team: Advanced Collaboration Techniques; Who to Include and How to Get Buy-in From the People That Matter Most," for Voluntary Hospital Association VHA Accelerated Improvement Network: Eliminating MRSA—Wave 2, Session #1 November 2007 webinar.
Jon Lloyd, "Positive Deviance: How a Unique and Innovative Approach Is Making a Difference," at Annual Safer Healthcare Now! Conference, April 1–2, 2008, Winnipeg, Canada. PowerPoint® presentation available online.
Curt Lindberg, "Positive Deviance: Tools and Application," at Safer Healthcare Now Western Node MRSA Collaborative Meeting, October 27–28, 2008, Calgary, Canada. Proceedings are available online.
Jon Lloyd, Curt Lindberg and John Jernigan, "Positive Deviance: A Different Process, Better Results," at the IHI Annual Forum, December 8, 2008, Nashville, TN.
Nancy Iversen, et al, "Billings: Hospital-Wide Decrease in Methicillin-Resistant Staphylococcus aureus (MRSA) After an Intervention in a Community Hospital," CDC analysis was presented at a special late-breaker session during the Society for Healthcare Epidemiology of America's 19th Annual Scientific Meeting on, March 21, 2009. The CDC team concluded that successful implementation of the multifaceted MRSA prevention program using positive deviance resulted in significant MRSA reduction with sustained decreases demonstrated over time. Abstract available online.
Katherine Ellinson, et al, "Multi-Center Prevention Effort Significantly Cuts MRSA," CDC analysis was presented at a special late-breaker session during the Society for Healthcare Epidemiology of America's 19th Annual Scientific Meeting on, March 21, 2009. The CDC team concluded that successful implementation of the multifaceted MRSA prevention program using positive deviance resulted in significant MRSA reduction with sustained decreases demonstrated over time. Abstract available online.
Report prepared by: Gina Shaw
Reviewed by: Richard Camer
Reviewed by: Marian Bass
Program Officer: Rosemary Gibson


text:
This girl's dad on Say Yes to the dress looks like he's the same age as her
So I was passionately singing "Don't let me be the last to know"
And then my dad walks in.
Yes that face makes quite a nice souvenir
It will only result in utter humiliation.
She's like :
While me in the back :
I am stunned.
"Hey Tommy, you abusive asshole, remember me, your ex-wife Mariah Carey ?"
"Oh yeah hey Mariah long time no see ! Have you met my new wife, Thalia, a less popular version of you ?"
One word : Awkward.

subset: commoncrawl


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Truckers News Celebrity Series 2011-2012
TN: Everyone's talking about the hot tub scene where you are filmed in your bikini. Tells us about that!
MS: I was surprised that they used it and not particularly happy about it. We decided to check out the hot springs and even though they were filming, it didn't seem like it would be part of the story. I want to be taken seriously as a trucker. This didn't help.
TN: What's the main question other truckers ask you?
MS: They always ask, "What made you want to drive a truck?"
TN: How did you and Lisa Kelly get along?
MS: She was great! We really had a good time, got along and hope to keep in touch. I'm very grateful for her help on and off the screen.
TN: A lot of women consider you and Lisa to be role models for female truckers. Is it a hard life?
MS: Thank you! It was hard starting out. As a woman in a man's industry, we have to work twice as hard to earn respect and be recognized as someone who can get the job done and get the job done well. I did it all on my own with no help or guidance. As time went on trucking got easier and I'm thankful to have started my career in one of the toughest areas to drive (tri-state area including New Jersey). I am thankful that all my experiences with others have been positive and supportive except for a few in the workplace who were jealous of my accomplishments. On my days off I'd rather be trucking than doing anything else. So much for calling it a job!
TN: How does it feel now, to be back as a regular trucker?
MS: After the season, I took a month off and started trucking again in New Jersey. Can't live without my passion! I drive for a small family-owned trucking company that's more relaxed than my previous job.
TN: Will you be back for season six?
MS: If they ask me, I will!
TN: What kind of learning curve did you have when you joined the crew?
MS: I learned a lot from Phil (Krom), Tony and Lisa. I learned a lot in general. One thing for sure is it's a totally different style of driving and you need to know the rules of driving the Dalton. Without knowing certain things, there's a slim chance that someone would make it without ultimately wrecking or losing their life.
TN: How can truckers help their public image?
MS: Be proud of what you do for a living. We are not recognized and appreciated for what we do. I think that truckers have to join together and just be heard and educate the world about our purpose. It's tough to be respected without recognition. Look at all the other professions with recognition; we have doctors, policemen, firefighters and teachers. Truck drivers keep America moving. So where's our recognition? What would happen without us? Be proud of your career and purpose as a truck driver and be heard; we can change our image for the better and finally get the respect and recognition we deserve.
I think the show has increased the image of truckers and made people notice us. We are simple people, honest and hard working. We need to take pride in what we do and the rest will follow.
TN: Do you get recognized when you go out?
MS: I'm getting recognized more often. It was funny to be asked to sign an autograph at the tollbooth on the Jersey Turnpike!
TN: What else do you like to do besides trucking?
MS: Hunting, working out, being with family.
TN: Readers are going to want to know, married or single?
MS: I have a boyfriend!
TN: It sounds to me like you are having fun.
MS: I'm having a blast! I'm living my dreams and doing what I love to do. I couldn't ask for more.
SPONSORED BY: 5 Hour Energy
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This photo with 14 notes was posted 3 years ago on the 29th of July, 2011.
Tags: #Mugi #What a coincidence #statue #waitress #personal #collection
So.. I went to order this from one of my 'my figure collection' friends, then realized it was the friend from Atlanta(where I'm from) THEN realize as I scrolled through our old messages that he lives in the SAME exact area that I will be moving to in August!and when I say "area" I dont mean just county I mean most likely same street. SO instead of me paying for shipping I wonder if I can meet him and get the Mugi xD.. I feel like that would be awkward haha. I dont want to buy her though till Im settled in my apartment so I told him late august.


text:
We created Pandora to put the Music Genome Project directly in your hands
It's a new kind of radio –
stations that play only music you like
Tha Ho In You
I'm your host, Johnny Ray, what you say, what you say?
Yeah, all the ladies in the house tonight
Alright, we got a dedication going out to all these hoes
Features of This Trackwest coast rap roots
gangsta rap influence
r&b influences
funk influences
highly syncopated beats
funk beats
clear pronunciation
sexist lyrics
explicit lyrics
lyrics with heavy erotic content
the use of chordal patterning
an electric bass riff
a slow moving bass line
the use of clean-sounding organs
electric guitars
subtle use of electric keys
the heavy use of funk samples
the heavy use of R&B samples
use of electric pianos
These are just a few of the hundreds of attributes cataloged for this track by the Music Genome Project.show more
Similar Tracks
Special dedication to all the hoes!!!


text:
This section contains 5,903 words
(approx. 20 pages at 300 words per page)
Critical Essay by Ellen Pifer
SOURCE: "The Book of Laughter and Forgetting: Kundera's Narration against Narration," in Journal of Narrative Technique, Vol. 22. No. 2, Spring, 1992, pp. 84-96.
In the essay below, Pifer examines the way that Kundera's notion of the novel informs his narrative methods and practice, focusing mainly on The Book of Laughter and Forgetting
In Milan Kundera's novel, The Book of Laughter and Forgetting, the narrator diagnoses the disease of "graphomania." "An obsession with writing books," graphomania has, he says, overtaken contemporary mass society and reached "epidemic" proportions. While graphomaniacs attempt to write their way out of the isolation induced by an advanced state of "social atomization," their obsession with self-expression paradoxically reinforces and perpetuates the sense of "general isolation" that is symptomatic of the disease. Kundera's...
This section contains 5,903 words
(approx. 20 pages at 300 words per page)


text:
Nice Saddle 17in seat is equivilent to a 15in western saddle.. this saddle comes with western stirrups and a cotton girth
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Free shipping on this item to continental U.S.! If you would like a quote on international shipping, e-mail us at email@example.com or call us at 330-628-1039.
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WAUSAU, Wis (WSAU) Nationwide Insurance is laying off 40 workers in Wausau -- about a-third of its local work force - because those jobs are being transferred to another facility in Ohio.
The layoffs will start in May, and will be finished by the summer.
The company told workers about the change yesterday. The facilities in Columbus and Cincinnati have new computers to more-easily-handle retirement accounts and record-keeping.
Nationwide will still have about 100 workers in Wausau, and no additional layoffs are planned.


text:
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President Barack Obama makes a point during remarks in the White House Briefing Room in Washington, Monday.
Pablo Martinez Monsivais/ASSOCIATED PRESS
Visit the Photo Place
Date published: 10/30/2012
Associated Press
WASHINGTON--Hurricane Sandy overran White House politicking Monday, with President Barack Obama and Republican Mitt Romney calling off campaign rallies as the strengthening storm bore down on the East Coast.
With eight days to go before Election Day, Nov. 6, neither candidate could afford to totally shut down operations. The political barbs continued in campaign ads and between aides trying to show the upper hand in a race as tight as ever.
Obama, trying to show effective leadership in a time of impending crisis across some of the country's biggest population centers, met with federal officials monitoring the storm from a video hook-up and then addressed the country from the White House. He repeated that his administration is ready to help respond to and warned that the consequences could be deadly if people don't follow instructions. "The great thing about America is that when we go through tough times like this, we all pull together," Obama said in a six-minute appearance.
The president turned aside a shouted question about the storm's impact on the campaign, saying safety was his top priority.
"The election will take care of itself next week," he said, pivoting back to the microphone to answer after having turned to leave. "Right now, our No. 1 priority is to make sure we are saving lives, that our search and rescue teams are going to be in place, that people are going to get the food, the water, the shelter they need in case of emergency and that we respond as quickly as possible to get the economy back on track."
Romney didn't have official duties to allow him to play a commanding role, and his Boston-based campaign staff debated whether to keep him on the trail away from the storm's path. But they were mindful of the optics of politicking while millions of people faced grave hardships and canceled events Romney and running mate Paul Ryan had scheduled for Monday night and Tuesday.
"Sandy is another devastating hurricane by all accounts, and a lot of people are going to be facing some real tough times as a result of Sandy's fury," Romney said at a stop in Ohio. He also planned to stop in swing state Iowa before standing down as the storm was predicted to make landfall Monday night.
Romney urged the Ohio crowd to make a contribution to the Red Cross or other relief agency "in any way you can imagine to help those in harm's way."
In Virginia, Senate candidates George Allen and Tim Kaine both suspended all campaign appearances for Monday; Kaine canceled his for Tuesday as well.
"As a former governor who's dealt with emergency situations, Governor Kaine is urging everyone to prepare and exercise caution," said an email from the Kaine campaign.
A tweet from the Allen campaign said he was canceling Monday events "to encourage Virginians to stay safe and off the roads."


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Thus, the standard Abt motor upgrade package for this engine comes with 600 hp at 8000 rpm. Where the stock motor has 391 lb-ft of torque at 6500 rpm, the Abt version boasts 406 over a broader range, from 6400 to 7000 rpm. The zero to 62 mph time drops by 0.1 second to 3.8, and top speed goes up from 196 to 202 mph. The GTR uses this as a base and gains a further 20 hp with a bespoke stainless steel exhaust system to reduce backpressure, allowing the motor to breathe more freely at high revs. The big numbers are 620 hp at 8100 rpm and 413 lb-ft from 6400 to 7000 rpm.
There's an interesting story behind the exhaust system that needs to be told. Titanium may be the flavor of the month because of its ultra-lightweight properties and a material resonance frequency that produces a deeper exhaust note. However, there's a darker side to titanium. If you do not use titanium of sufficient thickness and construct the system to the highest possible standards, the system can fail after a year or so. Because these systems cost so much, they are very expensive to replace, resulting in one very unhappy customer.
Abt experimented with a hybrid system combining stainless steel with titanium parts to get the best of both worlds. However, the cost and complexity of this didn't add up, so they decided to stick with stainless steel, which has a long track record in performance, cost and reliability.
Thus, while 40 pounds might have been saved with a titanium exhaust, the 200 pounds actually saved by the GTR over the standard V10 coupe comes from the boot lid, fenders, front and rear bumpers, door mirrors, and the tailgate being molded from carbon fiber. Makrolon is used for the rear quarter lights and vented rear engine cover glazing, removing further weight motorsport style. The front splitter and rear wing are also made from carbon, and provide around half the downforce of Abt's LMS race car. Abt would not be drawn on an exact downforce number, but said that the car was perfectly stable at its top speed.
While the doors are the factory steel structures for safety reasons, their interior trim panels are made from carbon fiber. In fact, even the steering wheel is made from carbon fiber, resulting in lower inertia you can feel when you turn the wheel.
The lightweight Recaro seats are trimmed in leather and cross-stitched Alcantara, with Alcantara on the dashboard and headliner, and lightweight carpet on the floor and rear bulkhead. The matte carbon trim on the Alcantara-wrapped steering wheel is a nice touch. Normally I don't like shiny carbon or wood on steering wheels because of the drastic change of surface friction and temperature when your hands move from one material to the other, but the matte carbon offers good grip and looks purposeful. Four-point race harnesses supplement the normal seatbelts, which are more convenient to use on the street. Incidentally, I went looking for GTR logos all over the car and stopped counting at 21.
The 19-inch lightweight forged alloy wheels are wrapped in Michelin Pilot Sport Cup rubber. These wheels weigh just 18 and 22 pounds front and rear, respectively, and are specially made for the GTR. They cost a whopping €9,000 a set (about $12,000) because of the low volume. Abt worked with H&R to develop the height-adjustable coilover suspension for this car. As tested, it sits about 35mm lower than a stock R8 V10, but this can easily be altered to suit road or track work.
The lightweight rear engine cover, relative lack of soundproofing and the sports exhaust have a significant effect on the decibels reaching your ears. In this respect, I found that the stock Spyder suits my fun driving mood even better than the hardtop, but the GTR strikes a happy balance between the two.
On the airfield runway, the GTR left the line with a brief flurry of wheelspin from all four tires, followed by one long sustained blast of acceleration, punctuated by the upshifts prompted by my right fingers pulling the paddle.


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It's occurred to me recently that I may be afraid of relationships. All my significant relationships in the past five (!!!) years have been long distance. Maybe it's because NYC guys aren't my type, but the likely reason is that while the emotions and commitment may be real, it allows my day-to-day lifestyle to be that of a single woman.
Maybe I'm afraid of getting bored, bickering over small things, being annoyed because he doesn't clean the sink after he shaves,feeling smothered.When I'm single or in a long-distance relationship, none of these issues are a factor. We're so excited to be together that it's like vacation every time. Compromise is hard. People can hurt me. I'm a fast mover and love new things. And all of these can be problematic in a real, in-person relationship.
I want this man fast to be about me, even as it evolves past a "fast" in the strict sense. (In the past month or so, I've been on dates, flirted with guys, had crushes. This is OK with me.) But I also want to address my fear of a real, lasting commitment. Maybe I really do want to be single, and that's great. But if it's because I'm scared of the alternative, then it becomes a problem.
It's all about balance, and I need to make sure I find mine.
I was talking to N yesterday about the man fast, and she brought up the most interesting point I've heard yet.
"That sounds great," she said. "But don't let it become a crutch you use because you're afraid of intimacy."
I've been burned a lot, and I've been burned recently. And maybe she's right; maybe I am man fasting partly because I'm afraid and too burned out to deal with it all. Especially recently, my focus seems to have come back around from taking care of myself to avoiding dating.
Avoiding dating isn't the point. I need to figure out who I am and what I want before I can have a healthy relationship, and that's really the point of this exercise (or whatever it is). Running away from intimacy should never be a focus of my life.
So I'm thinking of renaming this blog and the fast in general. Any thoughts about a more appropriate name?
While some parts of the man fast are difficult for me — no body hating, no flirting, no crushes, no talking about exes — the one thing I've excelled at is going on fantastic friend dates.
This weekend, my good friend S and I went to Breakneck Ridge, about an hour's train ride outside NYC, to do a 5-mile hike and rock scramble. The trees were beginning to change color, the hike was perfectly challenging without being too hard, and Sue and I had a great time. After the hike, we went to a local diner and ate hamburgers the size of my head.
Today I had another friend date with R, my workout and running buddy. We did a 9-mile run (the longest either of us has ever run), chatting and laughing the whole time. Afterward, we felt such a sense of accomplishment. (I almost cried. It was weird.)
And the best thing about these athletic friend dates? If I get disgusting and sweaty, it doesn't matter. They don't want to make out with me anyway.
I've always pushed myself to achieve, to improve, to attain. It's defined my whole life, and I can't remember a time when I wasn't striving. I wanted to read before everyone, write cursive before it was required, excel in this sport or that, get the best grades, good scholarships, a great internship.
I'm an adult now, and I'm still striving. My goals may have changed slightly: many are now career-related or athletic or accomplishment-based. I want to run a half-marathon. I want to write a book of short essays. I want to get new freelance clients and take on more work for the ones I currently have. I want to get fitter and more toned. I want I want I want I want.
Rules 5 and 6 (my friend K calls them challenges, and maybe that's a more appropriate word) forbid body-hating and negative self-talk. And I've been thinking a lot about this. When does ambition and the drive to change and achieve become negative? When does my desire to get fitter and lose weight veer into the territory of negativity about my body as it is now? Can I want to change and still accept and love myself as I am?
I know I'm not capable of sitting still and accepting the way things are. I always want to move forward and set new goals for myself. But I need to learn to do it in a way that recognizes how great I am now instead of tearing myself down. My body is amazing and can do so many fantastic things. It can run 8 miles and climb mountains and do yoga and take long walks. Improving my body should be because I love it and want to take care of it, not because I hate it. It's the same with my career/accomplishments. I've achieved a lot, and I should be proud of that. But pride in my accomplishments doesn't need to lead to complacency. I can use my previous successes to give myself the confidence to take on more and grow further, not because I'm not good enough, but because I'm that good.
I just need to remember this framework and not get lost in the negativity. Growth is good. But it's also important to remember how far I've come and thank myself for the effort I've made.
Rule number 11 is my stumbling block. I keep planning to have a solitary dinner out, or a movie with popcorn for one, but something always comes up and takes precedence.
When I am alone I like to be very alone, like I am now. In my apartment, coffee in hand, and the world happening…
Today is my 50th day of the man fast.
In general, it's been going great. I haven't really thought much about the fast itself recently, which I suppose is a good thing. I don't talk about guys as much and I haven't dated, although I have slipped up and flirted on occasion.
Last weekend, I found myself slipping into old habits at a party. I saw an attractive guy and began doing my usual thing — focusing on him, flirting, joking around — almost without realizing it. We hung out the entire time, and at the end of the party, he asked if I wanted to hang out more and, you know (wink wink). I freaked out. I turned him down and bolted. My friends teased me about my "man-fast fail," and it made me think about whether the fast was, in fact, at its end.
My original goal was 30 days, and I'm well past that. But my reaction, to run away, makes me feel like I still need more time. I'm enjoying being single without feeling guilty, as if I should be looking for someone. I ran a 10K and have started to train for a half-marathon. I'm meeting up with friends more frequently and reading a ton. I still have to write the list of 50 things I like about myself, and I need to buy flowers for a friend, but other than that, the rules are pretty much checked off.
So I guess I'll keep going, for now, until it feels right to stop.
Christmas has always been my favorite day of the year. When I was a kid, it meant not having to go to school, seeing all my cousins at my grandparents' house, playing in the snow and, most important, getting a huge box of books from my parents.
Sure, they gave me other presents too, and they were probably more exciting. But the thing I remember most was the thrill when I opened the heaviest box, which would be stuffed with a dozen books they'd ordered for me. On Christmas afternoon, I'd curl up on the couch and begin reading. By New Year's, all the books would be consumed.
I still love to read, and my apartment is stuffed with bookshelves. But adult life gets in the way, and I often find myself spending months trying to get through just one novel. When I'm in a relationship, I read even less. Spending time with a significant other means doing things around the city, going out to eat or, if we're feeling chill, watching a movie together. Rarely do we end up sitting in the same room just reading.
This month, I've made an effort to read more, to try to carve out at least a bit more time to dedicate to the books I've been meaning to get to. So far, I've read Oryx and Crake, City of Thieves and Cloud Atlas. It feels a bit like Christmas vacation.


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Voltz War
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FDA Approves New Treatment for Rare Pancreatic Cancer »
"On Thursday, the U.S. Food and Drug Administration approved Afinitor (everolimus) to treat patients with progressive neuroendocrine tumors located in the pancreas (PNET) that cannot be removed by surgery or that have spread to other parts o"...
Read the FDA Approves New Treatment for Rare Pancreatic Cancer article »
In animal studies, everolimus showed a low acute toxic potential. No lethality or severe toxicity was observed in either mice or rats given single oral doses of 2000 mg/kg (limit test).
Reported experience with overdose in humans is very limited. Single doses of up to 70 mg have been administered. The acute toxicity profile observed with the 70 mg dose was consistent with that for the 10 mg dose.
AFINITOR is contraindicated in patients with hypersensitivity to the active substance, to other rapamycin derivatives, or to any of the excipients. Hypersensitivity reactions manifested by symptoms including, but not limited to, anaphylaxis, dyspnea, flushing, chest pain, or angioedema (e.g., swelling of the airways or tongue, with or without respiratory impairment) have been observed with everolimus and other rapamycin derivatives.
Last reviewed on RxList: 7/14/2014
This monograph has been modified to include the generic and brand name in many instances.
Afinitor FDA Prescribing Information
Additional Afinitor Information
Afinitor - User Reviews
Afinitor User Reviews
Now you can gain knowledge and insight about a drug treatment with Patient Discussions.
Here is a collection of user reviews for the medication Afinitor sorted by most helpful.
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
Get the latest treatment options.


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Our speakers and performers turn the impossible into the possible. Human rights, cutting edge technology, breakthrough science, innovative design: these people make it happen.
Amber Rae. Creative Catalyst
Amber Rae is a creative catalyst and starter of meaningful things. She's currently the chief evangelist of Seth Godin's new publishing venture, The Domino Project. When she's not spreading ideas and inspiring movements, she curates stories of change-makers and culture-shapers who take initiative at revolution.is
Learn More
Amber also co-founded what the New York Times calls "The Fraterntity of the Wired Works in the Wee Hours" aka New York Nightowls, a late-night coworking group that's active in 30 cities and 14 countries. Above all, Amber believes in chasing what makes you feel alive and being unreasonable in the pursuit of your dreams.
Dr. Michael "Doc" Chemers. Professor of Dramatic Literature
Michael Mark Chemers first came to Carnegie Mellon in 2003 as a Postdoctoral Fellow of the Center for the Arts in Society, and joined the School of Drama faculty in 2004. He is the founder and director of the School's Dramaturgy BFA Program. Michael holds a PhD in Theatre History and Theory from the University of Washington (2001) and an MFA in Playwriting from Indiana University (1997). He was a Wimmer Faculty Fellow of the Eberly Center in 2006.
Learn More
He is the author of Ghost Light: An Introductory Handbook for Dramaturgy (Southern Illinois University Press, 2010) and Staging Stigma: A Critical History of the American Freak Show (Palgrave, 2008), which was honored by the Association for Theatre in Higher Education with an Honorable Mention for the Outstanding Book Award of 2009. Michael's work as a theatre historian and theorist has appeared in Modern Drama, Nineteenth Century Theatre and Film, Theatre Survey, Theatre Topics, New England Theatre Journal, Journal of Theatre and Performance, TheatreForum, Comparative Drama, and Disability Studies Quarterly. Michael has also written chapters for books on South Park and The Rocky Horror Picture Show.With J.A. Ball, he adapted a Lysistrata (Carnegie Mellon University Press, 2007) that has been revived at universities across the US. He authored the independently-produced film When Tyrants Kiss (2004) which appeared in the Three Rivers Film Festival.
His playwriting has received many national awards and has been performed across the country. He has over two decades of experience in dramaturgy, most recently with the Leon Katz International Theatre Collective headquartered in Smolyan, Bulgaria. He also acts, most recently appearing in the School's The London Cuckolds.Michael lives in Pittsburgh with his wife Farhana and his son Zain. In his spare time he collects masks, teaches martial arts at USA Professional Karate, and juggles things that are on fire.
Paul Dateh. Songwriter, Violinist, Singer
Paul is an independent musician who has made a name for himself by being multi-talented artist. Youtube has been an outlet for Paul's work these last few years as he is able to display his wide range of jazz, pop and hip hop renditions along with a musical comedy series entitled Violince.
But he didn't start out with Jazz— Learn more about his beginnings
While he began his education at the University of Southern California, Paul had matriculated as a Violin Performance major but much to everyone's surprise, he enrolled into the Jazz Studies Vocal program instead within days of arriving at USC. While it is often taboo for classically trained musicians to venture into the jazz world, Paul found it to be a passion. Since then, he has helped sculpt the environment of self-starting Youtube musicians to become a high quality, innovative, entertaining world. It's probably important to note that many of his viewers refer to him as the Asian Brad Pitt.
Ken Belcher. Singer, Songwriter, Guitarist
Ken is one of those people who was musical from the day he was born. By the time he was 5 years old, he had already become better at the piano and ukulele than people thrice his age and size. Within the next 5 years, Ken was given his first acoustic guitar and midi keyboard and proceeded to produce two albums of original music and a rock opera based on the biblical Moses story.
And the rest is history…
A decade and then some later, Ken became an alumni of the University of Southern California's Thornton School of Music for jazz/studio guitar. He has spent his post-college years as part of several bands including The Jazz Three-O and Absolute Stereo with who he composes and performs original pieces. Ken's independent works as well as his collaborations are testaments to his love for music. Amongst his current endeavors, Ken is the guitarist on his collaboration album with Paul Dateh, The Good Life which you can find here.
Mickey McManus. Chief Mad Scientist
Mickey McManus is the CEO of MAYA design, an ubiquitous computing firm in Pittsburgh. As President, CEO and Principal, Mickey leads a highly skilled, interdisciplinary team that creates innovative ways to integrate information and technology into satisfying user experiences.
Wow. A CEO. But he's a lot more than that. Find out more.
Mickey graduated with honors from the University of Illinois in Chicago, School of Art and Architecture with a BFA in industrial design and extended studies in communication design and mathematics. In 2005, Mickey spearheaded the launch of MAYA's Pervasive Computing practice, which focuses on ways to design information objects so that all sorts of data can flow easily among vastly distributed devices, many hidden in the environment. MAYA's work in pervasive computing has been featured in the Harvard Business Review and the Wall Street Journal. Mick's design awards include the 2005 Consumer Electronics Innovation Award, two Addy Awards for advertising and video production, the AIGA Communications Show Judge's Choice Award, SuperComm 2000 Best of Show in Design, and the Exhibitor Award for Best Conceptual Design. His articles and work have been published in Innovations, Graphis, and Space magazines.
William Gahl. Medical Mystery Man
William Gahl, MD, PhD is the clinical director of the National Human Genome Research Institute at the US National Institutes of Health. Called a "super–diagnostician" by the University of Wisconsin School of medicine, Dr. Gahl leads the Undiagnosed Diseases Program (UDP) at the NIH and essentially sees patients who lack a diagnosis after years of visits to other doctors.
Sounds a lot like Dr. House right? Find out more here.
He also studies very rare inborn errors of metabolism and recently encountered a disease so rare that he, essentially, discovered it. The media has often compared him to the fictional Dr. House, but where exactly do the similarities end? Dr. Gahl's work has been featured in CNN, Newsweek, People Magazine, The New York Times, and Nature. In 2011, Dr. Gahl received the American Medical Association' s highest honor, the Dr. Nathan Davis Award for Outstanding Government Service.
Michealene Risley. Daring Human Rights Activist
Michealene Cristini Risley is the founder of Fresh Water Spigot. She has long been an entrepreneur who has created some of the largest deals in consumer products and the entertainment industry. But, entrepreneur turned activist, her most recent project was the film "Tapestries of Hope" which explores the rape and abuse of thousands of women in Zimbabwe by men under the belief that it will cure their HIV/AIDS.
Activism isn't her first revolutionary act. Find out more here.
Michealene launched the first-ever branded maternity line in conjunction with Adidas. As Vice President of Licensing and Character Development for Sega of America, she championed the Sega Girls Task Force and produced well over 100 episodes in animation. She also wrote, produced, and directed a short film called "Flashcards," which won Best Cinematography at the California Independent Film Festival, Best Short film at the New York International Independent Film and Video Festival, and the film screened in the Cannes Film Festival "Shorts Du Jour" program.
Charlie Hoehn. Marketing Genius
Charlie Hoehn is just 24 years old and has interned for Seth Godin, helped write and market the #1 New York Times bestseller, "The Four Hour Body", and wrote the 30–page guide called Recession-Proof Graduate that's been read more than 80,000 times, and is one of the top 10 most popular "career" Slideshares (read what Seth Godin had to say about it, or you can see how a bunch of other people responded).
Wait! But that's not all! Find out more.
Luis Von Ahn. MacArthur Fellow & Professor of Computer Science
Professor Luis von Ahn works in the Computer Science Department at Carnegie Mellon University. His research has changed the world. You know that annoying little anti–spam image thing (a CAPTCHA) that you have to type all the time on the internet to prove that you're a human? Well, he invented that.
Okay, okay. Mind totally blown. What else has Luis been up to?
His current research interests include encouraging people to do work for free, as well as catching and thwarting cheaters in online environments. He is the recipient of a MacArthur Fellowship, a Packard Fellowship, a Microsoft New Faculty Fellowship, and a Sloan Research Fellowship. He has been named one of the 50 Best Minds in Science by Discover Magazine, one of the 100 Most Creative People in Business of 2010 by Fast Company Magazine, one of the "Brilliant 10″ scientists of 2006 by Popular Science Magazine, one of the 50 most influential people in technology by Silicon.com, and one of the Top Innovators in the Arts and Sciences by Smithsonian Magazine..
Jacob Cass. Design Guru
Jacob Cass is a dedicated, passionate and influential designer who has recently emigrated from Sydney, Australia to NYC to pursue his career in the world of visual communication. Jacob has worked with clients such as Disney, Red Bull, Nike & Star Wars and although his skill set is vast, his major skill sets lie in the world of visual design, brand identity, brand strategy, UX, UI, new media design and print design.
And he's amassed quite a following on the internet.
Jacob has a thorough understanding of social media and the latest web technologies which has allowed him to build up a strong personal following of over 37,000+ Twitter followers and 28,000+ blog subscribers. You can find Jacob on one of his three websites; JustCreativeDesign.com,LogoDesignerBlog.com and LogoOfTheDay.com.
Jenny Blake. She does everything. Seriously.
Jenny Blake is an author, blogger, life coach, Googler and yoga teacher. She has worked at Google for over five years in training, coaching & career development. Prior to Google and halfway through her junior year at UCLA, Jenny took a leave of absence to help launch a political polling start-up company with her college professor and mentor.
And what happened next?
She returned to finish at UCLA in the spring of 2005. The experience of leaving school before her friends inspired her to start a blog, LifeAfterCollege.org, which she has now translated into a book. Life After College: The Complete Guide to Getting What You Want is a portable life coach for 20-somethings, filled with tips, quotes and coaching exercises to help people focus on the BIG picture of their lives…not just the details.
"Impossible is not in the dictionaries of leaders."
Be sure to check out who spoke in 2010.


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Chapter 3
description of the stands (continued)
This site was 125 feet above the canyon floor, at an elevation of 6,500 feet. It was halfway up a southwest facing talus slope of 35° (fig. 12). The vegetation is a juniper-pinyon community with scattered big sagebrush. The trees are small and widely spaced (fig. 13), the average distance between them being more than 20 feet, which is considerably greater than in the other stands (table 12). Most of the local shrubs, with the exception of oak and fendlerbush, are represented in the community. Sagebrush is confined to deep, well-drained soils at other sites on the mesa, but on talus slopes it is common on the heavy soils associated with shale outcroppings. Since there are lenses of shale throughout the slope, sagebrush is the characteristic shrub of the stand. The other species present are listed in table 2.
The largest juniper and pinyon were 24 and 14 inches in diameter, respectively. The oldest of 10 pines sampled was 240 years, and the average for the 10 was 160 years. This is the only stand type sampled in which juniper is more abundant than pine.
The soils on the steep canyon slopes are formed partly from coarse colluvial-alluvial materials and partly from the underlying bedrock. Because several different soils could be recognized and because of the steepness of the slope, the general soil type suggested for the southwest facing talus on which C1 is situated is the Mughouse Rock Outcrop Complex. The soil at the site is classified as a shallow phase of Mughouse stony loam. It is shallower, less developed, and somewhat more brown than normal, but it fits the series fairly well.
Developing on interbedded shales and sandstones of the Menefee formation, the soil is quite stony, with most of its coarse material having come from the more resistant Cliff House sandstone above. The depth of the soil is variable; below the cliffs it is often less than 12 inches deep. Many shallow outcroppings of shales and sandstones occur on this broad talus slope. The profile description in table 13 is taken from the open area just to the right of the shelter in figure 13.
*Soil classified as Mughouse stony loam.
A contact zone between the Cliff House sandstone and the underlying Menefee formation (primarily shales) is replete with seeps and springs. Below this point of contact, moisture from lateral flow of ground water seems negligible, at least over much of the canyon slopes. Thus the primary source of water for the slope vegetation is precipitation, but retention of moisture varies greatly where soils are so variable. Where coarse colluvium occurs, the interstices between the rocks and boulders trap and retain much of the runoff to the advantage of the deeper rooted plants. But where the soils are fine textured along the shale lenses, porosity and water permeability are low, even though the water-holding capacity (as shown in table 5) is quite high.
The C1 site represents a segment of the Mesa Verde terrain whose climate is controlled by the local topography or, more precisely, by exposure. Facing west-southwest, the slope receives more insolation, on an annual basis, than any of the other sites. This is especially pronounced during the winter months. (See air temperature data in the appendix). As a result, daytime temperatures exert the greatest influence on the environment. Whereas M1 represents the most arid mesa-top environment, C1, indicative of the more exposed canyon slopes, is in the more arid part of the canyon landscape.
At C1, moderate soil temperatures during the winter and the southerly exposure favor early spring development of the vegetation. Snow rarely blankets the slope for any extended period of time. During the winters observed, snow persisted from the latter part of December through late January; otherwise, cover was generally spotty. All these factors support the conclusions drawn from our phenological information: that plant growth commences earliest at this site. In 1963, the flowering, of Phlox hoodii began the third week in March and was abundant by the end of the month. This was delayed about a week the previous year. Flowering of the shrub species, beginning with Amelanchier, also occurred first at the C1 site.
In brief, the environment of the southwest-facing canyon slopes is comparable to that along the southern part of Mesa Verde, and plant growth is least favorable at these locations. Data on the atmospheric factors are given in table 11 and the appendix.
Last Updated: 16-Jan-2007


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Reblogged from homesicknesstop-deactivated2014
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"You have to maintain a fine balance between hope and despair. Yes, in the end, it's all a question of balance."
------ My name is Alyssia. I love cats and politics and activism, among other things.
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Amy Hamilton
What a beauty
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Fuuck your systems of oppression
(Source: ForGIFs.com, via rockit-in-the-pockit)
cats are assholes
adorable little shits
I think I'm a cat
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Words to live by
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From Debbie Sterling's TEDxPSU talk, "Inspiring the next generation of female engineers." Sterling is the creator of GoldieBlox, a set of toys featuring Goldie, a female engineer who guides girls to develop problem-solving skills and build projects, introducing girls to the world of engineering through a tech-savvy female role model.
Watch Sterling's entire talk below, and learn more about GoldieBlox at its website:
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This is my fitblr
I love this! Safe fitspo :)
You are not a machine.
It's okay to love your body :)
(Source: fit-fabstroid, via bijou1986)


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the 'sometimes i dress like a cowboy' edition.
on summer evenings, i feel like there is only one choice of what to do. be outside. and sip wine. so what am i doing tonight? i'm going to get clams with my dad and sip wine and then go to my best friend, mary's house to sip some more. because there is no better place to be than outside when it's NICE out.
plaid button down - JCrew
boots - Frye
nails - Essie Sew Psyched
Tags: cowboy fashion frye JCrew
fashion forward. loving life.
here i am. adrienne marie. welcome to my life. addicted to wine, fashion, running, and OPI nail polish always on my nails. glass half full.
here you'll find snippets of things i like, am inspired by, lust after, opinions, thoughts, quotes, memories, and of course fashion. happy reading.
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is a colorful and happy place inhabited by some tiny crochet creatures. They are available for adoption. For information and order, email me at firstname.lastname@example.com
Meet me here:
Etsy shop
Personal blog
SPECIAL DEAL on shipping cost! It only valid until 25 February 2014.Take a look at my etsy shop for more info: www.desaboneka.etsy.com. :)
Sleeping Beauty Finger Puppet set
New listing: https://www.etsy.com/listing/156777883/finger-puppet-sleeping-beauty-set?ref=shop_home_active
Snow White and the 4 Dwarfs Finger Puppet set
New listing here: https://www.etsy.com/listing/154958631/finger-puppet-snow-white-set?ref=shop_home_active
Finger Puppet series by Desa Boneka. New listing on my shop :)
Updating my etsy shop. Some of the animals are available now :)
These cutesy itsy bitsy teeny weeny dolls are the cutest troops in the world.Even though they're tiny in size, they safeguard the village citizen in Desa Boneka.Some times they have mistakenly seen as candy by human.
Full post: click here
Christmas series :)
Check out my blog post here!
Who loooooves Angry birds? Those cute upset little birds and those silly green pigs. I'm sure everyone loves them! :D
Angry birds character © Rovio Entertainment ltd
Officialy open!! :D
I'm listing a few items. Please check it out :)
'Under the sea' series


text: 4 . 10 . 12 sungyeol infinite nothing's over mv for member kpop of course i would use yeol for nothing's over you guys can help me to choose the member on be mine mv just send me an ask ok i'm still thinking who i will use woohyun would be great but i already put him for come back again otl mv:infinite edit edit:infinite 1k +1419


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Her Secret Man- Rated M
Summary: Hans and Anna get married but as Hans carries out his plan, he grows to love the only person who's ever cared about him. However, when something bad happens to Elsa, (Okay…so she dies.) Anna blames Hans for her death and becomes closed off to him and the whole world until one day she bumps into an unruly blonde ice master who kindles a fire in her she never knew was there.
Chapters: idk how many but I'm writing chapter two and it's 4 am. My writers block decides to disappear NOW???
EDIT: FORMAT WAS SCREWY. so i fixed it.


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Sucker Punch the studio behind the upcoming inFamous Second Son for the Playstation 4 has released new concept arts of the game.
The studio is hard at work to get the game at gold status as soon as possible, as we are approaching the game release date fast.
Second Son is set seven years after the good ending of Infamous 2, in which Cole MacGrath activated the Ray Field Inhibitor (RFI) to destroy a Conduit (superhumans named for their ability to "channel" powers) named John White, also known as the Beast. The explosion that resulted was originally thought to have killed all Conduits across the globe; however, those outside of the blast radius or with a natural resistance have survived. Fearing the Conduits' abilities after the destruction of Empire City, the US eastern seaboard and the worldwide economy, the Department of Unified Protection (DUP) is formed. Now, major cities across the United States are heavily monitored for Conduit activity, whom the DUP have labeled collectively as "bio-terrorists".
The game is set in Seattle, Washington, now under DUP jurisdiction. Players control Delsin Rowe (Troy Baker), a 24-year-old graffiti artist with no real direction in life. One day, Delsin witnesses a bus crash and attempts to help; in the process, he comes in contact with a Conduit, and his own hidden Conduit abilities awaken. With his new abilities and his older brother Reggie (Travis Willingham), a police officer, Delsin dedicates himself to fighting back against the oppressive DUP, as well as other Conduits such as Abigail "Fetch" Walker (Laura Bailey). In an interview, it was stated that for InFamous fans there would be a few familiar faces in the game, but it 'would ruin the joy of discovering them' to reveal exactly which known characters will be present in Second Son.
InFamous Second Son will be released on March 21, 2014 for the Playstation 4.
Screenshots below :


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Corinthian sued in latest for-profit college crackdownShawna Ohm at Hot Stock Minute21 hrs ago
The Consumer Financial Protection Bureau is suing Corinthian Colleges (COCO) for a slew of predatory practices, including inflating students' job prospects and tuition.
In its complaint, the CFPB says Corinthian – which runs Everest, WyoTech, Heald College – paid employers to temporarily hire graduates and classified just one day of work as job "placement."
The complaint also includes quotes from internal Corinthian documents instructing employees to target prospective students with "low self-esteem" and with "[m]inimal to non-existent understanding of basic financial concepts."
The document goes on to say that Corinthan encouraged students to take out so-called Genesis loans to cover the funding gap between federal student loans and cost of tuition. Corinthian then reportedly purchased the Genesis loans and took "aggressive" actions to collect from students who were overdue, including pulling students out of class to talk money.
Sony warns of big loss; FedEx delivers a beat; General Mills misses estimatesKathy Cherpelis at Hot Stock Minute22 hrs ago
Here is a look at some of the stocks the Yahoo Finance team will be watching for you today.
FedEx (FDX) shares were higher in early trading. The package delivery company reported profits and sales that topped analysts' estimates thanks to strength in its express and ground businesses. The company also said yesterday it will raise shipping rates in the U.S. on average by 4.9% in January.
General Mills (GIS) fell before the bell. The company known for its Cheerios cereal and Betty Crocker cake mix reported earnings that missed estimates by $0.08. Quarterly profit fell 25% and sales also came in below expectations. The company is citing challenging U.S. market conditions and other factors for the shortfall. Earlier this month, the company said it would buy Annie's to expand its presence in the natural-and-organic-foods aisles.
Consumer prices unexpectedly fall; Fed decision day; Nelson Peltz takes aim at DuPontYahoo Finance at Hot Stock Minute23 hrs ago
Stocks were slightly higher ahead of the Federal Reserve's policy decision and Fed Chair Janet Yellen's news conference Wednesday afternoon.
Meanwhile, more evidence this morning that inflation remains under wraps after accelerating in the second quarter.
Consumer prices unexpectedly fell for the first time in almost 1-1/2 years in August. The Labor Department reported that the Consumer Price Index fell 0.2% last month largely due to a big drop in energy prices, which offset an increase in food and housing costs. Economists were expecting overall prices to be unchanged.
The so-called core-measure, which strips out volatile food and energy costs was unchanged last month. Economists were looking for an increase of 0.2%.
Related: Sony warns of big loss; FedEx delivers a beat; General Mills misses estimates
UPS boosts holiday hiring to 95,000 in 2014Shawna Ohm at Hot Stock Minute1 day ago
UPS wants to make sure you get your packages in time for Christmas. The company says it will hire as many as 95,000 seasonal workers this holiday season.
It's also a big deal for the thousand of Americans who didn't get their packages in time for Christmas last year.
The 2013 Holiday Scramble
Boeing 'space taxi' contract; Eli Lilly and AstraZeneca team up; Majesco shares slideKathy Cherpelis at Hot Stock Minute1 day ago
Here is a look at some of the stocks the Yahoo Finance team will be watching for you today.
Yahoo (YHOO) shares remain very much in focus. Our parent company which holds an almost 23% stake in Alibaba was slightly higher before the bell after the Chinese e-commerce company raised the range of its initial public offering to $66 -$68 a share . That's up from its initial price range of $60-$66 a piece. Alibaba is expected to make its market debut on the New York Stock Exchange on Friday.
We are also watching shares of Boeing (BA) this morning after the Wall Street Journal reported that the aerospace giant is likely to win NASA's multi-billion-dollar "space taxi" contract. A space taxi ferries astronauts to and from orbit. Boeing is competing against Elon Musk's Space-X and Sierra Nevada for the funding, although a joint award is also possible
UPS hiring for the holidays; Fed meeting kicks off; Calpers exits hedge fundsYahoo Finance at Hot Stock Minute1 day ago
Investors remain cautious amid speculation that the Federal Reserve may signal it will raise interest rates sooner rather than later as it begins its two day meeting today.
The Fed doesn't have to worry about inflation for the time being. The Labor Department reported that producer prices were unchanged in August as the cost of gas and food declined.
Related: UPS boosts holiday hiring to 95,000 in 2014
UPS (UPS) is boosting its hiring for the 2014 holiday season. The package delivery company is hiring up to 95,000 seasonal workers this year. Last year, UPS faced some backlash after overwhelming holiday demand meant they couldn't get every package delivered by Christmas. This year, the company has taken steps to fix that problem - spending some $500 million dollars on everything from pop-up distribution centers to new equipment. They expect the biggest shopping day for them to be Cyber Monday.
Yum brands bets on fast casual, VietnameseShawna Ohm at Hot Stock Minute2 days ago
The company that brought you Pizza Hut and KFC is now bringing you… Vietnamese sandwiches?
Yum brands (YUM) opened a "banh mi" (a Vietnamese sandwich) shop in Texas over the weekend (called, creatively, Banh Shop) offering six types of Asian sandwiches plus rice and pasta bowls and salads. Prices start at just under $7 dollars – putting the chain on a higher pay scale than its YUM brethren.
Apple's new iPhones break pre-order record; RadioShack shares rally after CFO resigns; Yahoo continues to rise ahead of Alibaba IPOKathy Cherpelis at Hot Stock Minute2 days ago
Here is a look at some of the stocks the Yahoo Finance team will be watching for you today.
Apple (AAPL) shares are in the spotlight this morning after the tech company revealed that pre-orders for its new iPhone 6 and iPhone 6 Plus hit a record. Apple said pre-orders topped more than 4 million in just 24 hours. The company said that strong demand is outstripping pre-order supply, which means customers may have to wait three to four weeks to get their hands on the new iPhones. The iPhone 6 and iPhone 6 Plus will go on sale in U.S stores on Sept. 19th.
OECD slashes growth forecasts; Heineken rejects SABMiller; Lew warns China on anti-monopoly probesYahoo Finance at Hot Stock Minute2 days ago
Stocks are adding to last week's losses after disappointing industrial production data out of the U.S. and China. Investors also continue to weigh the possibility that the Federal Reserve may signal it will raise interest rates sooner than expected at its two day meeting, which kicks off tomorrow.
The Organization for Economic Cooperation and Developmentcut its growth forecasts for the U.S. and other advanced economies amid rising geopolitical concerns and deflation risks in the eurozone.
The OECD now projects that the U.S. economy will grow 2.1% this year instead of 2.6%.
Related: Apple's new iPhones break pre-order record; RadioShack shares rally after CFO resigns; Yahoo continues to rise ahead of Alibaba IPO
Olive Garden owners 'pleased' with chain's progress despite pasta promo debacleShawna Ohm at Hot Stock Minute5 days ago
The owner of Olive Garden says it's "pleased" with the chain's progress. "The Olive Garden renaissance is well underway," wrote Darden Restaurants (DRI) in the company's earnings release. Still, sales at the chain were down 1.3% in the first quarter.
Olive Garden is trying to get customers back in the door – most recently with a highly public promotion for seven weeks of never-ending pasta. The deal was only available to 1,000 people and sold out within hours, crashing Olive Garden's web site in the process.


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It's finally here! The video we've all been waiting for. The best freaking video ever. The video to end all videos.
Okay… So I might be getting carried away there, but check it out and decide for yourself! We had so much fun getting the footage for this project! For a full behind-the-scenes account, see our previous blog post (link). Thanks to the people of San Francisco for being so AWESOME!!! Here's the official link if you want to share it with your friends :) http://www.youtube.com/watch?v=XEd0u9lAiwY&feature=colike Spread the laughter!


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Noob Q&A: Do You and Your Wife Apply For the Same Cards?2
Q: Do you and your wife apply for the same rewards cards?
This question was emailed to me this week, from an inquiring mind. And it's one that I get often, so I thought I would let you guys in on how Jordan and I do our app parties.
A: Yes, we do.
Jordan and I usually sign up for the same rewards cards. This helps us maximize our points/miles. Many loyalty programs will allow households to pool their points together. Just another perk of being married.
We use Chase's Ultimate Rewards program the most to combine points, or to transfer out to each others' loyalty programs. I know what you're thinking, and yes – I steal Jordan's Ultimate Rewards points all the time. Shhhh.
Being able to pool together our points has helped us tremendously to travel classy for pennies. We have earned over 300,000 Ultimate Rewards "household" points just through sign-up bonuses on these cards this year. That's incredible. Through the sign-up and purchase bonuses, we were able to stay at many Hyatts, fly on Southwest throughout the year, and we were able to go to Europe in September on business class. We are also going to start off 2013 by visiting Thailand in January on first class.
We apply for the same cards, but we don't apply for them at the same time. We're both pros at throwing app parties (apply for multiple rewards cards on one day every 90-95 days). Shocker? Probably not to anyone who reads the blog. Again – we usually sign up for the same rewards cards.
Even with the easy ways to meet minimum spending requirements (Bluebird, Amazon Payments, & Buying Vanilla Reloads), it would be crazy hard to meet them if we were both singing up for multiple cards on one day.
Instead of both of us applying on the same day, I space out our applications about 45 days. That way, we're constantly meeting minimum spend requirements and earning mega miles/points. Plus, it's easier to manage. I will space out our apps farther if I'm not comfortable applying for more cards, if our credit scores haven't bounced back, or if we have enough minimum spending requirements to meet.
We are more conservative with Jordan's applications because she wants to be – and I respect that. Even if I'm more aggressive, you should only apply for cards that you're comfortable applying for.
Being able to double-dip and apply for the same cards as someone in your household is a huge advantage that allows you to be able to travel at a price you can afford. If only one spouse is applying and earning miles, it's going to make it more difficult to travel together with miles/points.
I love love love traveling, but I love traveling with my wife even more. We wouldn't be able to travel as much as we do without each of us applying for multiple rewards cards every 90-95 days, and then using these cards daily.
— Geoff Whitmore