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Connective Tissue
October 2011
Questions and Answers about Heritable Disorders of Connective Tissue
This booklet contains general information about heritable (genetic) disorders of connective tissue (HDCTs). It describes what HDCT are, what causes them, and diagnosis and treatment options. Highlights of current research are also included. If you have further questions, you may wish to discuss them with your health care provider.
Heritable (genetic) disorders of connective tissue (HDCTs) are a family of more than 200 disorders that affect connective tissues. These disorders result from alterations (mutations) in genes, and thus are called "heritable." All of these diseases are directly related to mutations in genes that are responsible for building tissues. Alterations in these genes may change the structure and development of skin, bones, joints, the heart, blood vessels, lungs, eyes, and ears. Some mutations also change how these tissues work.
Some other connective tissue problems are not directly linked to mutations in tissue-building genes, although some people may be genetically predisposed to becoming affected. Many, but not all, of the disorders discussed in this booklet are rare. See the box "Some Common Heritable Disorders of Connective Tissue".
- What Is Connective Tissue and What Does Heritable Disorders Mean?
- How Do People Get Gene Alterations?
- Who Gets HDCTs?
- Does Anything Increase the Chances of Having a Genetic Disease?
- How Does Genetic Counseling Help?
- What Are the Symptoms of a HDCT?
- How Do Doctors Diagnose HDCTs?
- What Treatments Are Available?
- What Research Is Being Done on HDCTs?
- Where Can People Find More Information About HDCTs?
- Key Words
Information Box
Some Common Heritable Disorders of Connective Tissue
Physicians and scientists have identified more than 200 heritable connective tissue disorders. Some of the more common ones are listed below. Some of these are really groups of disorders and may be known by other names.
Ehlers-Danlos syndrome. The problems present in the group of disorders known as Ehlers-Danlos syndrome (EDS) include changes in the physical properties of skin, joints, blood vessels, and other tissues such as ligaments and tendons. People with EDS have some degree of joint looseness; fragile, small blood vessels; abnormal scar formation and wound healing; and soft, velvety skin that stretches excessively but returns to normal after being pulled. Some forms can cause problems with the eyes and spine. EDS can also lead to weak internal organs, including the uterus, intestines, and large blood vessels. Mutations in several different genes are responsible for varying symptoms in the several types of EDS. In most cases, the genetic defect involves collagen, the major protein-building material of bone.
Epidermolysis bullosa. The characteristic feature of epidermolysis bullosa (EB) is blistering of the skin, which results when skin layers separate after minor trauma. People with a mild form of the disease may have just a few blisters on skin, whereas others may have many blisters. In some forms, blisters may form in the mouth, stomach, esophagus, bladder, and other parts of the body. EB can be both disabling and disfiguring, and some forms may lead to early death. Defects in several proteins within the skin are at fault.
Marfan syndrome. People with Marfan syndrome tend to have a tall, thin build with long arms and legs and "spider-like" fingers. Other problems include a sideways curve of the spine (scolosis); crowded teeth; flat feet; abnormal position of the lens of the eye; and enlargement of the beginning part of the aorta, the major vessel carrying blood away from the heart. If left untreated, an enlarged aorta can lead to hemorrhage and even death. Marfan syndrome results from mutations in the gene that determines the structure of fibrillin-1, a protein important to connective tissue.
Osteogenesis imperfecta. Osteogenesis imperfecta (OI) is characterized by fragile bones, low muscle mass, and loose joints and ligaments. There are 11 identified types of OI, ranging in severity from mild to lethal. The appearance of people with OI varies considerably, depending on the particular form they have and its severity. Some may have a blue or gray tint to the sclera (whites of the eyes), thin skin, growth deficiencies, and fragile teeth. They may develop scoliosis, respiratory problems, and hearing loss. Also known as "brittle bone disease," this disorder is caused by a mutation in one of several genes that play a role in how the body makes collagen, the main component of connective tissue.
What Is Connective Tissue and What Does Heritable Disorders Mean?
Connective tissue is the material between the cells of the body that gives tissues form and strength. This "cellular glue" is also involved in delivering nutrients to the tissue, and in the special functioning of certain tissues. Connective tissue is made up of dozens of proteins, including collagens, proteoglycans, and glycoproteins. The combination of these proteins can vary between tissues.
The genes that encode these proteins can harbor defects or mutations, which can affect the functioning of certain properties of connective tissue in selected tissues. When this occurs, the result can be a heritable disorder—one that can be inherited, or passed from parent to child—of connective tissue.
How Do People Get Gene Alterations?
People with heritable disorders of connective tissue inherit an altered gene either from one or from both parents. We have two copies of most genes: one inherited from each parent. Males have one copy of each gene on the X chromosome, because they have only one X chromosome, and one copy of each gene on the Y chromosome. In contrast, females have two copies of X chromosome genes because they have two X chromosomes.
Some genetic disorders require that only a single copy of a gene be altered. These disorders can be seen in many generations of a family because the altered copy of the gene is passed from parent to child (dominant inheritance). The same disorder can occur in a person without a family history of the condition if there is a new mutation in the right gene at conception. Some disorders are seen only when the person has received an altered copy of the gene from each parent (recessive inheritance); in these families, the person with only a single copy is called a "carrier" and is not actually affected.
If a mutation occurs on an X chromosome, it generally produces a condition in which the pattern of affected individuals in a family is unusual. Often, women are carriers (that is, they have only a single altered copy of the gene), but males show the condition because they do not have a second protective copy of the gene. Such a condition is referred to as "X-linked."
Who Gets HDCTs?
By one estimate, more than a half million people in the United States are affected by the more than 200 HDCTs. Generally, these conditions affect people of all ethnic groups. All ages, and both sexes are affected. Many of these disorders are rare. Some may not be evident at birth, but only appear after a certain age or after exposure to a particular environmental stress.
Does Anything Increase the Chances of Having a Genetic Disease?
Several factors increase the likelihood that a person will inherit an alteration in a gene. If you are concerned about your risk—or the risk to your children or future children—you should talk to your health care provider or a genetic counselor.
The following factors may increase the chance of getting or passing on a genetic disease:
- parents who have a genetic disease
- a family history of a genetic disease
- parents who are closely related or part of a distinct ethnic or geographic community
- parents who do not show disease symptoms, but "carry" a disease gene in their genetic makeup (this can be discovered through genetic testing).
How Does Genetic Counseling Help?
People seek genetic counseling to make better decisions about their lives and families. Because genetic counselors understand how genetic disorders are passed on through families, they can help couples estimate the risks of having children with genetic diseases. They can also tell parents about tests to determine if they are carrying certain altered genes, tests for newborns who may have inherited certain altered genes, and tests that can be done in early pregnancy to determine if a fetus either carries an altered copy of a gene or is affected with a disorder. The information derived from all these studies can facilitate family planning.
Your health care team can help you find genetic counseling if you wish to better understand your or your child's disease or risk of disease.
What Are the Symptoms of a HDCT?
The symptoms are different for different disorders. Some of them cause bone growth problems. People with bone growth disorders may have brittle bones or bones that are too long or too short. Some cause people to be unusually tall (Marfan syndrome) or short (chondrodysplasias, osteogenesis imperfecta), or to have head and facial structure malformations (Apert syndrome, Pfeiffer syndrome). In others, joints may be stiff or immobile (fibrodysplasia ossificans progressiva or FOP).
Some disorders affect the skin. For example, Ehlers-Danlos syndrome results in stretchy or loose skin, while another connective tissue disorder, cutis laxa, deficient elastic fibers cause the skin to hang in folds. Epidermolysis bullosa results in blistered skin.
Other tissues can be affected as well. Pseudoxanthoma elasticum causes skin, eye, and heart problems, and closed-off or blocked blood vessels. Marfan syndrome and some forms of Ehlers-Danlos syndrome lead to weak blood vessels.
It is critical for people with these disorders and their family members to work closely with their health care teams to get a proper diagnosis and the best treatment. Symptoms of HDCTs are extremely variable, and some disorders can pose severe health risks even when affected individuals have no symptoms.
How Do Doctors Diagnose HDCTs?
Diagnosis always rests first on a combination of family history, medical history, and physical examination. Because many of these conditions are uncommon, the family physician may suspect a diagnosis but be uncertain about how to confirm it. At this point, referral to experienced clinicians, often medical geneticists, can be extremely valuable to either confirm or exclude the suspected diagnosis. Laboratory tests are available to confirm the diagnosis for many HDCTs, but not for all. Once a diagnosis is made, laboratory studies may be available to provide some or all of the following:
- prenatal testing to identify an affected fetus and assist in family planning
- newborn screening to spot a condition that may become evident later in life
- carrier testing to identify adults who, without symptoms, carry a genetic mutation for a disease
- predictive testing to spot people at risk for developing a genetic connective tissue disease later in life. These tests are helpful for diseases that run in the family.
What Treatments Are Available?
The term heritable disorders of connective tissue refers to a wide range of disorders, each requiring a specific program for management and treatment. In most instances, regular monitoring is important to assess, for example, the diameter of the aorta in people with Marfan syndrome, the extent of scoliosis (spine curvature) in people with OI and those with some forms of EDS, and whether there is protrusion of the spine into the base of the skull in people with OI. For some conditions, specific metabolic treatment is useful, for example, vitamin B6 in people with homocystinuria, a metabolic disorder resulting from a liver enzyme deficiency. In others, drugs like beta blockers are useful for slowing the dilation of the aorta, and bone-building drugs called bisphosphonates may be help strengthen fragile bones. Maintaining general health though a nutritious diet, exercise, and healthy lifestyle habits is also important for people with all HDCTs.
What Research Is Being Done on HDCTs?
Scientists are working to better understand these disorders at several levels: (1) to identify the genes in which the mutations reside, (2) to identify the mutations that result in the clinical condition, (3) to understand how these mutations result in the condition, and (4) to use all available information about the condition to plan new therapies and test their use and value, both in animal models and in affected individuals. Because most of these conditions are uncommon, and individuals with them are widely scattered, it is often difficult to gather information about the clinical course of the disorder and assemble enough people to plan effective clinical trials.
The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), a part of the Department of Health and Human Services' National Institutes of Health (NIH), is the lead Federal agency for connective tissue research. Several other NIH institutes are also studying HDCTs. NIAMS supports research through grants to scientists around the country, in national and international clinical trials, and at the NIH campus. This is some of the research underway:
NIAMS is conducting an indepth natural history study of people who have Marfan syndrome (which leads to abnormally long bones), nail-patella syndrome (a congenital skeletal disorder), Stickler syndrome (which causes eye and joint problems), and Ehlers-Danlos syndrome (which causes skin and blood vessel problems). All of these disorders have multiple, interrelated symptoms. NIAMS scientists are closely observing the people in this study over a long period to get a more complete picture of the diseases. They hope to improve their understanding of the genetic origins of the symptoms, of disease progression, and of mutations in patients and their relatives. Scientists expect their findings to apply to other HDCTs as well.
Specific areas of research and findings arising from this long-term study include:
- examining the efficacy of screening for dural ectasia (an enlargement of the membrane that surrounds the spinal cord) in the diagnosis of Marfan syndrome
- analyzing the prevalence of spinal and hip abnormalities in Stickler syndrome and their relationship to chronic pain
- documenting an increased risk of failure of the femoral head (the ball portion at the top of the thigh bone) in children with Stickler syndrome
- developing proposed diagnostic criteria for Stickler syndrome based on clinical and molecular studies in this population
- identifying a connective tissue disorder with features resembling Marfan syndrome, Stickler syndrome, and Ehlers-Danlos syndrome
- studying the mechanism of chronic musculoskeletal pain in people with HDCTs and exploring ways, including mindfulness-based stress reduction, to ameliorate it
- looking at some specific musculoskeletal complications of aging in patients with HDCTs, such as the prevalence and severity of osteoporosis and osteoarthritis
- using molecular genetic studies to identify both new genes contributing to Stickler syndrome and Ehlers-Danlos syndrome, and mutations in previously recognized genes.
- NIAMS-supported researchers have succeeded in healing wounds in a mouse model of a particularly severe form of epidermolysis bullosa called recessive dystrophic epidermolysis bullosa (RDEB) by injecting the mice with RDEB patient cells in which the gene defect has been corrected. This approach may be useful in developing therapies for the disease. Other NIAMS-supported research shows it may be possible to grow healthy new skin in the lab for people RDEB by using skin cells from patients that were modified to express a normal gene for type VII collagen. Having successfully transplanted the modified skin on mice, scientists can now try to grow larger sheets of skin and graft them back onto people affected by RDEB.
- NIAMS is examining gene defects that lead to abnormal elastin, the connective tissue protein that allows arteries, muscles, and other organs to respond in certain ways to movement. So far, the investigators have shown how elastin gene mutations cause two specific diseases: a skin disease (cutis laxa) and a blood vessel disease (supravalvular aortic stenosis). Scientists hope to learn more about how mutations affect elastin fiber and tissue growth. They also hope to find out how gene defects lead to the development of elastin disease.
- NIAMS is supporting research looking for ways to treat diseases such as osteogenesis imperfecta by using gene therapy. Stem cells, which have the potential to develop into more specialized cells, would replace bone cells that have gene defects. This research is being conducted on specially bred mice. Other research on osteogenesis imperfecta treatment focuses on the use of growth hormone (rGH) therapy to promote height increases and bone density. In some cases, rGH is being used in combination with medications known as bisphosphonates.
- NIAMS is encouraging the establishment of new research registries for connective tissue disorders and other conditions. Through these registries, demographic and medical data from patients and families could be collected and used in research on disorders. Epidermolysis bullosa is one of the disorders for which the Institute has already established a research registry.
Other NIAMS-supported research is focused on:
- the chemistry and biology of elastin genes
- collagen gene defects (several types) that cause bone diseases
- collagen IV gene defects in mice and humans (Alport syndrome)
- proteoglycans, a group of proteins that maintain tissue stiffness
- fibroblasts, cells that form the fibrous tissues in the body
- cartilage, joints, and skin layers.
- Ongoing studies of aneurysms (weak spots in blood vessel walls that threaten to burst) are taking place at several NIH institutes. Aneurysms can prove deadly to people with Marfan syndrome and other HDCTs. NIAMS has supported these studies by pioneering development of a breed of mice prone to aneurysms. Scientists hope the mutant mice will improve understanding of aneurysms and ways to prevent them.
- The National Institutes of Health supports the annual Gordon Research Conference on Elastin and Elastic Fibers, which brings together basic scientists and clinicians to exchange data on the makeup of and problems associated with these critical components of connective tissue.
- Studies have shown that the blood pressure medication losartan prevents aortic aneurysms in a mouse model of Marfan syndrome, and one small study of 18 patients with Marfan syndrome showed that losartan slowed the enlargement of the aorta. A large multicenter trial receiving funding from the National Heart, Lung, and Blood Institute is now under way to further evaluate the use of losartan in people with Marfan syndrome.
- At the Eunice Kennedy Shriver National Institute of Child Health and Human Development, scientists are working with young patients who have osteogenesis imperfecta. They hope to learn more about the genetics of the disease and the natural history of the many secondary features involved, as well as rehabilitation techniques.
- Clinical trials organized by the National Eye Institute are comparing different antiangiogenic compounds (drugs that inhibit blood vessel formation) for pseudoxanthoma elasticum (PXE). New antiangiogenic agents are also in development.
Scientists at the National Institute of Dental and Craniofacial Research are carrying out clinical studies on fibrous dysplasia of bone.
Where Can People Find More Information About HDCTs?
People with HDCTs can contact professional and support groups that can supply more detailed information than is found here. Most of them also have Internet websites. Some major groups are listed below.
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Information Clearinghouse
National Institutes of Health
1 AMS Circle
Bethesda, MD 20892-3675
Phone: 301-495-4484
Toll Free: 877-22-NIAMS (877-226-4267)
Fax: 301-718-6366
Email: firstname.lastname@example.com
Website: http://www.niams.nih.gov
Other Resources
American Academy of Orthopaedic Surgeons (AAOS)
Website: http://www.aaos.org
American Academy of Dermatology (AAD)
Website: http://www.aad.org
Coalition for Heritable Disorders of Connective Tissue
Website: http://www.chdct.org
Genetic Alliance
Website: http://www.geneticalliance.org
National Organization For Rare Disorders (NORD)
Website: http://www.rarediseases.org
National Society of Genetic Counselors, Inc.
Website: http://www.nsgc.org
Dystrophic Epidermolysis Bullosa Research Association of America, Inc. (DebRA)
Website: http://www.debra.org
Ehlers-Danlos National Foundation (EDNF)
Website: http://www.ednf.org/
National Association for Pseudoxanthoma Elasticum (NAPE)
Website: http://www.pxenape.org
National Marfan Foundation (NMF)
Website: http://www.marfan.org
Osteogenesis Imperfecta Foundation
Website: http://www.oif.org
PXE International
Website: http://www.pxe.org
For additional contact information, visit the NIAMS website or call the NIAMS Information Clearinghouse.
Key Words
Apert syndrome. One of a group of genetic disorders, called acrocephalosyndactyly, characterized by malformations of the skull, face, hands, and feet. Apert syndrome is an autosomonal dominant trait due to a mutation in a gene called FGFR2 (fibroblast growth factor receptor 2).
Beta blockers. A class of medications also known as beta-andrenergic blockers that affect the body's response to certain nerve impulses. This, in turn, decreases the rate and force of the heart's contractions, which lowers blood pressure and reduces the heart's demand for oxygen. In addition to treating high blood pressure, beta blockers may be used for angina, and to prevent heart attacks, migraine headaches, and glaucoma.
Carrier. A person who carries a gene for a recessive genetic disorder. The person has the potential to pass the disorder on to his or her child, but is not personally affected by the disorder.
Chondrodysplasias. Once referred to as dwarfism. A group of genetic disorders, often caused by a single gene variation that affects the structure or metabolism of the bone, cartilage, or connective tissue.
Collagen. The principal protein of the skin, bones, cartilage, tendons, and other connective tissues.
Cutis laxa. Latin for loose or lax skin, cutis laxa refers to an extremely rare connective tissue disorder in which the skin lacks elasticity and hangs in loose folds. Caused by underlying genetic defects in connective tissue structure, the disorder can also result in serious problems with vocal cords, bones, cartilage, blood vessels, and vital internal organs.
Dominant. A genetic trait (or genetically transmitted disorder) that is evident when only one copy of the gene for that trait is present. Most dominant traits are due to genes on the autosomes (nonsex chromosomes). They affect males and females equally.
Dural ectasia. An enlargement of the dura, a primary membrane of connective tissue that covers the spine and contains the spinal fluid. Common in people with Marfan syndrome, dural ectasia occurs mainly in the lower spine and can cause low back pain, abdominal pain, headaches, leg pain, and perineal pain and numbness.
Ehlers-Danlos syndrome. A heritable connective tissue disease characterized by easy bruising, joint laxity (the ability to bend beyond normal range of motion), lax skin, and tissue weakness.
Epidermolysis bullosa. A potentially disabling, disfiguring, and sometimes lethal connective tissue disorder caused by defects of several proteins in the skin, resulting in skin blistering. Some forms of the disease may involve the gastrointestinal tract, the pulmonary system, muscles, or the bladder.
Fibrodysplasia ossificans progressiva (FOP). An extremely rare disorder in which a genetic mutation causes fibrous tissue such as muscles, tendons, and ligaments to ossify, or turn to bone, when damaged. The disease is also characterized by a deformity of the big toe.
Glycoprotein. An organic compound composed of a protein and a carbohydrate joined together. In the body, these compounds have many uses and comprise many of the proteins released by cells into the blood and other fluids.
Heritable. Capable of being transmitted from parent to child through genes.
Homocystinuria. A genetically transmitted disease in which an enzyme deficiency permits the buildup of the amino acid homocyteine. The result, if not treated, can be mental retardation, blood vessel disease, and atherosclerosis (hardening of the arteries).
Marfan syndrome. A heritable disorder of connective tissue resulting from mutations in the gene that specifies the genetic code for fibrillin-1, a protein important to connective tissue. The disorder is characterized by excessively long leg bones and long "spider-like" fingers. Other problems include skeletal malformations, abnormal position of the lens of the eye, and enlargement at the beginning part of the aorta, the major vessel carrying blood away from the heart. If left untreated, an enlarged aorta can lead to hemorrhage and even death.
Mutations. Changes in genes that can occur randomly or as a result of some factor in the environment.
Nail-patella syndrome (NPS). A rare genetic disorder that causes abnormalities of bones, joints, fingernails, and kidneys. NPS is commonly characterized by absent or underdeveloped kneecaps and thumbnails. It is estimated to occur in one in 50,000 newborns.
Osteogenesis imperfecta. A condition that results from mutation in two genes that make type I collagen, a protein important to bones and teeth. These mutations cause the body to either make too little collagen or poor-quality collagen. The result includes bones that fracture easily, low muscle mass, and joints and ligaments that move beyond their intended range of motion.
Pfeiffer syndrome. Also called type V acrocephalosyndactyly, Pfeiffer syndrome is one of a group of genetic disorders characterized by malformations of the skull, face, hands, and feet. Like the more common Apert syndrome, Pfeiffer syndrome is caused by a mutation in the FGFR2 (fibroblast growth factor receptor 2) gene.
Proteoglycans. A class of glycoproteins that perform various functions and serve as the "filler" substance between the cells. An inability to break down proteoglycans is characteristic of a series of genetic disorders called mucopolysaccharidoses.
Pseudoxanthoma elasticum (PXE). A rare disorder of degeneration of the elastic fibers with tiny areas of calcification in the skin, the back of the eyes (retinae), and the blood vessels. PXE typically causes skin abnormalities, eye abnormalities that can lead to blindness, atherosclerosis (hardening of the arteries), mitral valve prolapse, and fragile blood vessels that can lead to problems with circulation and abnormal bleeding into internal organs, including the bowel. PXE is inherited either as an autosomal recessive or as an autosomal dominant trait.
Recessive. A genetic trait or disorder that is usually expressed when only two copies of a gene for that trait, one from each parent, are present.
Scoliosis. A lateral side-to-side curvature of the spine. In most cases the cause is not known, but it may be more common in people who have a family history of the condition. Treatment can include braces, physical therapy, and, in some cases, surgery.
NIAMS gratefully acknowledges the assistance of the following individuals in the preparation and review of the original version of this booklet: Alan Moshell, M.D., and Bernadette Tyree, Ph.D., NIAMS; Peter Byers, M.D., University of Washington, Seattle; Priscilla Ciccariello and Sharon Terry, Coalition for Heritable Disorders of Connective Tissue, Washington, DC; Hal Dietz, M.D., Johns Hopkins University School of Medicine, Baltimore, MD; Jeanne Mandeville, Osteogenesis Imperfecta Foundation, Hopkins, MN; Dianna Milewicz, M.D., Ph.D., University of Texas-Houston Medical School; Francesco Ramirez, Ph.D., Mt. Sinai Medical Center, New York, NY; Joel Rosenbloom, M.D., University of Pennsylvania School of Dental Medicine, Philadelphia; David Rowe, M.D., University of Connecticut Health Center, Farmington; Heller An Shapiro, Osteogenesis Imperfecta Foundation, Gaithersburg, MD; and Jouni Uitto, M.D., Ph.D., Thomas Jefferson University Hospital, Philadelphia, PA.
The mission of the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), a part of the Department of Health and Human Services' National Institutes of Health (NIH), is to support research into the causes, treatment, and prevention of arthritis and musculoskeletal and skin diseases; the training of basic and clinical scientists to carry out this research; and the dissemination of information on research progress in these diseases. The National Institute of Arthritis and Musculoskeletal and Skin Diseases Information Clearinghouse is a public service sponsored by the NIAMS that provides health information and information sources. Additional information can be found on the NIAMS website at www.niams.nih.gov.
For Your Information
This publication contains information about medications used to treat the health condition discussed here. When this publication was developed, we included the most up-to-date (accurate) information available. Occasionally, new information on medication is released.
For updates and for any questions about any medications you are taking, please contact
U.S. Food and Drug Administration
Toll Free: 888–INFO–FDA (888–463–6332)
Website: http://www.fda.gov
This publication is not copyrighted. Readers are encouraged to duplicate and distribute as many copies as needed.
Additional copies of this publication are available from:
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Information Clearinghouse
National Institutes of Health
1 AMS Circle
Bethesda, MD 20892-3675
Phone: 301-495-4484
Toll Free: 877-22-NIAMS (877-226-4267)
Fax: 301-718-6366
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Website: http://www.niams.nih.gov
NIH Publication No.: 12-7843


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EPA Issues Policy Supporting Tribal and Indigenous Communities
Release Date: 07/25/2014
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WASHINGTON – Today, Environmental Protection Agency (EPA) Administrator Gina McCarthy signed the EPA Policy on Environmental Justice for Working with Federally Recognized Tribes and Indigenous Peoples, reinforcing the agency's commitment to work with tribes on a government-to-government basis when issues of environmental justice arise.
"All tribal and indigenous communities deserve environmental and public health protection. Through this agreement, we are reinforcing our commitment to tribal communities, especially in addressing issues of Environmental Justice," said Administrator McCarthy. "We know that tribes are uniquely impacted by a changing climate, which highlights the importance of this agreement and other agency actions, including funding research through the STAR Tribal health grants."
Over the past 20 years, the agency has made substantial progress in developing both its tribal and environmental justice programs. Building on EPA's Plan EJ 2014, the policy integrates 17 environmental justice and civil rights principles. The plan also identifies existing informational and resource tools to support EPA in its endeavor to make indigenous regions environmentally safe.
This policy, started in 2011, was developed through tribal government consultations, meetings with state and tribal organizations and three public comment periods engaging indigenous communities and other stakeholders.
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ceiling lamp tms 360g
Strala's ceiling lamp TMS 360G
Our passion for awakened thoughts, the joy of research and the fascination for the essence of matter are the driving force behind the emergence of our objects. TMS 360G The spirit of Strala is that of a seeker who is constantly challenged to get closer to the cause of the substance and to understand what is hidden behind the curtain. Strala pursues the scent of an intriguing idea, not to kill her, but to breathe life into her.
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Where different worlds collide, the frictional forces that we create through our object art & amp; Furniture materialize. Because precisely there, the thought is no longer black or white – it is completely free of values. For a fraction of a moment, there is that immediacy which contains neither knowledge TMS 360G nor meaning, and is therefore more sensuous than anything else in the world.
In recent years, Strala has created a unique collection of art objects that is independent of short-lived trends and constraining norms. Strala's objects are acknowledged and appreciated as timeless, precise and attractive works of art and use. This is Strala's DNA.
light object TMS 360G
Was born in 1974 in Zurich. He finished his studies of architecture at the ETH in 2001 with distinction. Since 2002 Tom Stala has his own studio and soon afterwards his own exhibition space in the Zürcher Seefeld.
Afterwards, exhibitions were held in prestigious museums, galleries, universities and juridical mandates as well as lectures at the ETH in Zurich, or at the CCA (California College of the Arts) in San Francisco. Strala realized projects for star architects such as Zaha Hadid, Sir Norman Foster, Mario Botta, David Chipperfield and Duke de Meuron, winning the best furniture among other honors such as "Europes Luminaire of the Year" and "AD Choice".
In the meantime, Strala is regarded as a pioneer of design, which questions established values and generates new ones.
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Strala was founded in 2001 by Tom Strala. The first luminaire series was developed during four years of passionate research. Since 2008, Strala has been organized as a stock company and is continuously intensifying the local and international activities within the arts and architecture. In the meantime, Strala is regarded as a pioneer of design, which questions established values and generates new ones.


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inochiventures necesitaba un nuevo diseño de página web y lanzó un concurso de diseño en 99designs.
Un ganador ha sido elegido entre 7 diseños de 2 diseñadores freelance.
We are putting an umbrella over our application development. We work primarily on mobile but also Facebook etc. We need a homepage at which enquiries can land and prospective companies can find a bit more about us.
We are targetting companies and individuals who are looking to have applications developed.
We would like a homepage for our business, featuring the name 'Crab' and a crab image (can be sourced or designed as long as it is nice, as that will be the emblem of our company). That image can be central and dominant or small, we are flexible.
It needs to have space for around 5 images which we would like to be framed.
It also needs space for 2-3 paragraphs of text, which will explain what we do and how to contact us.
We'd like this to be spread around rather than in one place (text and pics)
Quite flexible overall, there just needs to be room for all the information. No restrictions on colours, etc either.


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Methadone, Morphine, or Oxycodone in Treating Pain in Patients With Cancer
|The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
|ClinicalTrials.gov Identifier: NCT00726830
Recruitment Status : Terminated (Low Accrual.)
First Posted : August 1, 2008
Results First Posted : December 6, 2012
Last Update Posted : December 6, 2012
- Study Details
- Tabular View
- Study Results
- Disclaimer
- How to Read a Study Record
RATIONALE: Methadone, morphine, or oxycodone may help relieve pain caused by cancer. It is not yet known whether methadone is more effective than morphine or oxycodone in treating pain in patients with cancer.
PURPOSE: This randomized clinical trial is studying methadone to see how well it works compared with morphine or oxycodone in treating pain in patients with cancer.
|Condition or disease
|Brain and Central Nervous System Tumors Chronic Myeloproliferative Disorders Leukemia Lymphoma Lymphoproliferative Disorder Multiple Myeloma and Plasma Cell Neoplasm Myelodysplastic Syndromes Myelodysplastic/Myeloproliferative Neoplasms Pain Precancerous Condition Unspecified Adult Solid Tumor, Protocol Specific
|Drug: methadone hydrochloride Drug: morphine sulfate Drug: oxycodone hydrochloride
|Not Applicable
- To compare the effectiveness of an opioid rotation to oral methadone versus an opioid rotation to another long-acting strong opioid (sustained-release morphine or oxycodone) in controlling pain (i.e., analgesia) in patients with cancer.
- To compare the tolerability of an opioid rotation to oral methadone versus an opioid rotation to another long-acting strong opioid (sustained-release morphine or oxycodone).
- To identify a subset of patients most likely to benefit from an opioid rotation to oral methadone, in terms of significant improvement in pain control or opioid tolerability.
OUTLINE: This is a multicenter study. Patients are stratified according to their baseline opioid (morphine vs oxycodone). Patients are randomized to 1 of 2 treatment arms.
- Arm I: Patients are switched from their current opioid medication (oxycodone or morphine) to methadone. Patients receive oral methadone 2-3 times daily for 4 weeks.
- Arm II: Patients currently receiving oxycodone are switched to sustained-release (SR) morphine. Patients currently receiving morphine are switched to SR oxycodone. Patients receive either oral SR morphine or oxycodone 2-3 times daily for 4 weeks.
Patients are assessed for pain control and complete a symptom questionnaire on days 1, 8, 15, 22, and 28.
|Study Type :
|Interventional (Clinical Trial)
|Actual Enrollment :
|1 participants
|Intervention Model:
|Single Group Assignment
|None (Open Label)
|Primary Purpose:
|Supportive Care
|Official Title:
|A Randomized Comparison of Oral Methadone as a "First-Switch" Opioid Versus Opioid Switching Between Sustained-Release Morphine and Oxycodone for Oncology-Hematology Outpatients With Pain Management Problems: The "Simply Rotate" Study
|Study Start Date :
|March 2009
|Actual Primary Completion Date :
|September 2010
|Actual Study Completion Date :
|October 2010
Experimental: Arm I: Opioid rotation to oral methadone
Participants are switched from their current opioid medication (oxycodone or morphine) to methadone. Participants receive oral methadone 2-3 times daily for 4 weeks.
Drug: methadone hydrochloride
Given orally
Other Names:
Experimental: Arm II: Opioid rotation to another long-acting strong opioid
Participants currently receiving oxycodone are switched to sustained-release (SR) morphine. Participants currently receiving morphine are switched to SR oxycodone. Participants receive either oral SR morphine or oxycodone 2-3 times daily for 4 weeks.
Drug: morphine sulfate
Given orally
Drug: oxycodone hydrochloride
Given orally
Other Names:
- Number of Participants With at Least a 3-point Reduction in Pain Score on the M.D. Anderson Symptom Inventory (MDASI) [ Time Frame: 28 days ]MDASI questionnaire completed on days 8, 15, and 22 after enrollment. The 'primary success' is defined as a 3-point reduction in pain score on the MDASI. Scores from baseline and from four weeks later compared using the MDASI average pain intensity on a scale of 0 (no pain) to 10 (worst pain).
- Number of Participants With 30% Reduction in Total Summary Score for the Individual Composite Drug Toxicity Score (CDTS) Items [ Time Frame: 28 days ]
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.
|Ages Eligible for Study:
|18 Years and older (Adult, Older Adult)
|Sexes Eligible for Study:
|Accepts Healthy Volunteers:
- Receiving ongoing care in the outpatient medical oncology setting
Self-reported pain (of any cause) for which long-acting strong opioids (morphine or oxycodone) have been prescribed or administered
- Oral morphine-equivalent daily dose (MEDD) of existing opioid regimen (long-acting or immediate-release) 40-300 mg/day
- Worst pain score on a scale of 0 (no pain) to 10 (worst pain) of ≥ 5 for ≥ 1 week duration based on verbal self-report AND/OR ≥ 1 persistently bothersome symptom attributed to an opioid side effect (e.g., fatigue, confusion, depressed level of consciousness, memory loss, personality change, anorexia, constipation, dehydration, nausea, vomiting, weight loss, pruritus, urticaria, impotence, reduced libido, and urinary retention or hesitancy)
None of the following conditions that could predispose the patient to prolonged QT interval-associated tachycardia:
- Serum potassium < 3.0 mg/dL
- Cocaine abuse within the past 3 months
- Family history of sudden death
- Advanced heart failure (ejection fraction < 40% and/or New York Heart Association (NYHA) class III or IV heart disease)
- No known or suspected cognitive impairment that could interfere with adherence to the medication plan or self-report of symptoms and side effects
- Not pregnant or nursing
- Fertile patients must use effective contraception
- See Disease Characteristics
- More than 4 weeks since prior radiotherapy or surgery for local control of cancer or pain palliation
- More than 60 days since prior use of the same long-acting opioid (i.e., the new long-acting opioid) that patient is switching to on the study
- More than 12 weeks since prior methadone therapy
- More than 3 days since prior and no concurrent transdermal fentanyl, oxymorphone, or buprenorphine
- Concurrent systemic anticancer therapy or bisphosphonates allowed provided therapy was initiated ≥ 4 weeks ago
Concurrent tricyclic antidepressants, Nonsteroidal Antiinflammatory Drugs (NSAIDs), anticonvulsants, or other adjuvant analgesics or psychostimulants allowed provided therapy was initiated ≥ 2 weeks ago
- Dose expected to remain stable until after the first week of opioid rotation on study
- No concurrent methadone maintenance therapy for opioid addiction
- No concurrent intrathecal infusion of analgesics
- No concurrent antiarrhythmic medications (e.g., amiodarone or quinidine)
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00726830
|United States, South Carolina
|Palmetto Hematology Oncology, PC at Gibbs Regional Cancer Center
|Spartanburg, South Carolina, United States, 29303
|United States, Texas
|M. D. Anderson Cancer Center at University of Texas
|Houston, Texas, United States, 77030-4009
|Study Chair:
|Michael J. Fisch, MD, MPH, FACP
|M.D. Anderson Cancer Center
|Study Chair:
|James D. Bearden, MD
|CCOP - Upstate Carolina
Additional Information:
|Responsible Party:
|M.D. Anderson Cancer Center
|ClinicalTrials.gov Identifier:
|Other Study ID Numbers:
CDR0000598283 ( Other Identifier: NCI Identifier )
|First Posted:
|August 1, 2008 Key Record Dates
|Results First Posted:
|December 6, 2012
|Last Update Posted:
|December 6, 2012
|Last Verified:
|November 2012
unspecified adult solid tumor, protocol specific
accelerated phase chronic myelogenous leukemia
acute undifferentiated leukemia
adult acute myeloid leukemia with 11q23 (MLL) abnormalities
adult acute myeloid leukemia with inv(16)(p13;q22)
adult acute myeloid leukemia with t(15;17)(q22;q12)
adult acute myeloid leukemia with t(16;16)(p13;q22)
adult acute myeloid leukemia with t(8;21)(q22;q22)
atypical chronic myeloid leukemia, BCR-ABL1 negative
blastic phase chronic myelogenous leukemia
chronic myelomonocytic leukemia
chronic phase chronic myelogenous leukemia
mast cell leukemia
meningeal chronic myelogenous leukemia
progressive hairy cell leukemia, initial treatment
prolymphocytic leukemia
recurrent adult acute lymphoblastic leukemia
recurrent adult acute myeloid leukemia
recurrent adult T-cell leukemia/lymphoma
refractory chronic lymphocytic leukemia
refractory hairy cell leukemia
relapsing chronic myelogenous leukemia
secondary acute myeloid leukemia
stage III adult T-cell leukemia/lymphoma
stage III chronic lymphocytic leukemia
stage IV adult T-cell leukemia/lymphoma
stage IV chronic lymphocytic leukemia
T-cell large granular lymphocyte leukemia
untreated adult acute lymphoblastic leukemia
Multiple Myeloma
Neoplasms, Plasma Cell
Nervous System Neoplasms
Central Nervous System Neoplasms
Precancerous Conditions
Myelodysplastic Syndromes
Myeloproliferative Disorders
Lymphoproliferative Disorders
Myelodysplastic-Myeloproliferative Diseases
Neoplasms by Histologic Type
Lymphatic Diseases
Immunoproliferative Disorders
Immune System Diseases
Pathologic Processes
Hemostatic Disorders
Vascular Diseases
Cardiovascular Diseases
Blood Protein Disorders
Hematologic Diseases
Hemorrhagic Disorders
Bone Marrow Diseases
Neoplasms by Site
Nervous System Diseases


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A Constitutional Court challenge is now all that stands in the way of the secrecy Bill being enacted into law, after the controversial piece of legislation was pushed through the National Council of Provinces (NCOP) on Tuesday.
This is the inevitable truth that faces activists and opposition parties, who have rallied against the contentious legislation, which is now set to return to Parliament in 2013.
The ANC used its NCOP majority to force the secrecy Bill through the council's special ad hoc committee, raising the ire of opposition politicians.
Opposition parties were given just 10 minutes to study a 22-page report on the deliberations of the committee and the amendments that were agreed for the Protection of State Information Bill – also known as the secrecy Bill.
They then staged a walk-out, allowing the ruling party to approve the report and vote in favour of the Bill being debated this Thursday in a plenary session of the council.
In a statement released on Tuesday, committee chairperson Raseriti Tau said that the committee had done everything it could to ensure that it produced "a constitutionally sound piece of legislation that is informed by the views of our people and bears resonance to the principles of our democracy".
"We truly believe that we succeeded in this regard," he said.
Tau dismissed what he called "disproportionate misinformation paddled on public platforms" and the "mischievous political deportment" of those who want to "push newspapers' headlines and project themselves and whatever grouping they represent, as the champions of democracy".
The public participation process run by the NCOP, to allow the public to make inputs into the Bill, was heavily criticised by organisations such as the Right2Know (R2K) Campaign, which highlighted misinformation, bias and inadequate access to and participation by the public in the hearings.
Once the Bill is approved by the NCOP it will return to the National Assembly for the amendments to be validated. It will then be presented to President Jacob Zuma to be signed into law.
As Parliament will adjourn for recess on December 7, it is likely this will happen early next year.
But the Bill could still be challenged in the Constitutional Court, either by members of the public or by members of Parliament who are opposed to the Bill.
Members of the public must follow the legal route to ask for a Constitutional Court review of the Bill. This process could be both time consuming and expensive.
Meanwhile, MPs who wish to refer the Bill to the Constitutional Court must garner the support of at least 30% of the MPs in Parliament.
This means that 120 of the 400 MPs would need to support the move. The ANC, which has backed the Bill since its inception, holds 264 seats in Parliament. Although ANC MPs could vote against the Bill, it seems unlikely that this would happen. The last time the house voted on the secrecy Bill, two ANC MPs – Ben Turok and Gloria Bornam – abstained from the vote. They were later subjected to a disciplinary hearing for failing to toe the party line.
The margins needed would require most of the opposition MPs to oppose the Bill. Alf Lees, DA representative on the ad hoc committee that has been dealing with the Bill at the NCOP, said this would not be an obstacle.
"This Bill is so contentious, so we're fairly confident we could get [the 30%]," said Lees.
Lees said that opposition parties still had "enormous problems with the Bill" and that if the National Assembly were to approve the Bill, opposition parties would "immediately start that petition".
"We're already doing the groundwork," he said.
The Bill proposes harsh penalties for journalists and citizens found to be in possession of classified documents as well as harbouring state secrets.
It is unclear at this stage if there will be an independent appeals mechanism available to citizens who wish to access information that may have been classified as secret without justification.
Though there is a provision for a mostly independent body to review decisions, citizens do not have access directly to it.
The Bill has been widely condemned by civil society and advocates of transparency. Just this month, former intelligence minister Ronnie Kasrils called the Bill a "dog's breakfast".
Murray Hunter of the R2K said court action at this stage seems inevitable.
"From the very beginning we've campaigned to have our concerns with the Bill addressed in Parliament, and would certainly want to avoid a court battle if we could," Hunter told the Mail & Guardian.
"But if the Bill were to pass into law in its current form, we'd be willing to take it all the way to Constitution Hill."
Glenda Daniels, senior researcher at Wits Journalism and author of Fight for Democracy: The ANC and the Media in South Africa, said the Bill had been flawed from the start.
"It should really be completely scrapped and they should start from the [beginning], to look at what the issue – what national security – is. If they can define properly what national security is, the rest will follow," she said.
Daniels added that this was the only way the Bill would have any integrity. "Obviously this is not going to stand constitutional muster. It's going to go to the Constitutional Court," she said.
"I have absolutely no doubt that we will win this. [The Bill] is absolutely in opposition to the free flow of information."
Jonathan Klaaren, professor of law at the University of the Witwatersrand, said it is clear the Bill will go to the Constitutional Court.
"I'm 100% certain this is going to end up in front of the Constitutional Court, even if the Bill was to be changed dramatically," said Klaaren.
"The question is if it will be referred there [by Parliament] or if it will be taken there by litigants."
He said that because the Bill had been so contested – and was so contestable – it would be a good idea, for its effectiveness, to have Constitutional Court authority and vetting behind it.
This may represent a move in politics to bring the Constitutional Court more into play as a political actor in considering contested legislation, he said, pointing out that in some countries, a Constitutional Court review is part of the legislative process.


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Alaska's wolves, lynx, and coyotes at risk on Wildlife Refuge!!!! TIME SENSITIVE --- BY JULY 31ST!
Long Time Wildlife Viewing Area Could Become a Killing Field. ALL Federal Wildlife Refuges in Alaska are at Risk! The Skilak Wildlife Recreation Area (Skilak WRA) is a 45,000 acre prime wildlife viewing and photography location and has been so for over 30 years. The Alaska Board of Game has recently authorized opening this small portion of the Kenai National Wildlife Refuge to the hunting of wolves, lynx, and coyote. The USFWS has ultimate say on this land and is not required to go along with the state BOG. The USFWS needs to hear from every American possible that values the non consumptive use of Alaska's precious wildlife. Let there be no doubt, if the BOG gets their way with this unprecedented action all Federal Wildlife Refuge land in Alaska will be in the crosshairs of the BOG's extreme predator killing programs. This means that an additional 77 million acres of Alaska will be put at risk!
Send your comments of protest and outrage to:
Refuge Manager, P.O.Box 2139Soldatna, Alaska 99669Fax: 907-262-3599Phone: 907-262-7021
Also contact:Secretary of the Interior, Sally Jewell, email -- [email protected] & Director of Wildlife Services, Dan Ashe, email [email protected]
If you live in Alaska or nearby -- please attend one or both of the hearings (you can bet that trophy hunters will be there in droves):
July 31st: 6-9 P.M. Gilman River Center 514 Funny River Road Soldotna, AK August 1st: 6-9 P.M. U.S. Fish and Wildlife Service Regional Office 1011 East Tudor Road Anchorage, AK
Give them an inch and they will take 77 million acres of wildlife refuge!


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commercial bakers yeast starter vs. sourdough starter
I got interested in using a starter for breadmaking several months ago. I sent for a good sourdough dry start through Friends of Carl (Oregon Trail Sourdough) and while I was waiting for it to arrive set myself up to learn the process using commercial bakers yeast. I use regular dry yeast, not instant dry yeast.
I was very happy with the result! It worked well for a long time, until suddenly it didn't. My yeast starter started going down and finally dying. I had to re-start the starter from scratch 3 times, each time it lasted a shorter period of time.
I think I thoroughly understand the requirements of proliferating yeast. I've read widely on this site and elsewhere. What I'm wondering is this, and this is my question today -- could it be that keeping the starter in the refrigerator is part of the problem? I bake only 2 - 3 times per week, so I keep the starter in the refrigerator, taking it out overnight to refresh before baking day.
Although, come to think of it, sometimes I don't do this. Sometimes I decide to bake in the morning and just remove a cup of starter for my bread, refreshing the starter and returning it to the refrigerator after an hour or two. Is this part of my problem?
The commercial yeast starter was wonderful when I first set it up, very tangy in smell and taste, very bubbly and active after refreshing. But the new starters have never been that good, even though I am careful about hygiene/prevention of contamination/using a perfectly clean mixing bowl and cover. I experimented with different kinds of covers and I use glass bowls.
Any insight would be appreciated. Now that I'm having this kind of trouble keeping the commercial yeast starter going I'm afraid to start my sourdough. I've had the dry start from Friends of Carl for several weeks and I don't want to waste it if I don't have my technique down right.


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Organize and protect your valuable blueprints, drawings, artwork and maps in Sandusky Lee's space-saving 10-Drawer Flat File Cabinet with Closed Base. This heavy-duty welded steel file has hinged paper weights in the drawer fronts and hoods at the rear to keep papers from curling. Nylon ball bearing rollers allow the drawers to glide open and shut with ease. The centered lock system comes with two keys for your convenience. Each drawer holds up to 50 pounds and features two rounded pull handles and a stylish chrome label holder. The 4" high closed base lifts your flat file off the floor for a polished, professional look. Choose from several powder-coat paint colors for your Sandusky Lee 10-Drawer Flat File with Closed Base.
Key Features
- Heavy-duty steel with powder-coat paint finish
- Hinged paper weights and hoods keep your papers from curling
- Nylon ball bearing rollers allows for easy opening
- Sits on a 4" high closed base
- Each drawer holds up to 50 pounds
- Includes two keys
- Material: Internal frame – 16-gauge steel; Side, back, top and drawer fronts – 22-gauge steel; Drawer body – 24-gauge steel; Handles – aluminum
- Finish: Powder-coat paint
- Capacity: 50 pounds per drawer
- Drawer Dimensions: 50"W x 38 1/2"D x 2"H (inside)
- Width: 55 3/4"
- Depth: 41 3/8"
- Height: 38 1/4"
- Base Height: 4"
- Lead Time: Ships within 6 weeks
- Shipping Method: Freight
- Weight: 440.00 pounds


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Syrian leaders tried to impose a media blackout on the country's civil war. They failed. As CPJ's Dahlia El-Zein reports, foreign journalists responded by smuggling themselves into the country, while Syrians picked up cameras and uploaded videos online. They all did so at extreme risk. (4:13)
Read CPJ's special report on journalists killed in Syria and worldwide in 2012. And visit our interactive database.


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Bonita Vormawor, MathWorks
Learn how you can use MATLAB to augment your existing C or C++ workflow, helping you design, implement, and verify your algorithms more quickly. MathWorks engineers will show how you can quickly develop and analyze your algorithms and build applications. Through product demonstrations, you'll learn about:
About the Presenter: Bonita Vormawor is a senior application engineer at MathWorks, with a focus on application deployment using MATLAB. Prior to joining MathWorks in 2011, she gained years of experience working across various industries in numerous professional roles, including senior software engineer, associate scientist, laboratory administrator, database developer, and research assistant. Her former employers include Raytheon Company, Polaroid, Tufts University School of Dental Medicine, and the University of Pennsylvania School of Medicine. Bonita earned an M.S. degree in computer science from the National Technological University, and a B.A. degree for a double major in computer mathematics and natural sciences from the University of Pennsylvania.
Recorded: 8 Aug 2017


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JOB TITLE: Client Service Rep I
LOCATION: Justin Drive II
DEPARTMENT: Laboratory Medicine
WORK SCHEDULE: Evenings
WORK TYPE: Part-Time
Responsible for problem solving and communication with internal and external customers in order to provide prompt, accurate, friendly and quality service. Utilizes appropriate computer systems to document calls, dispatch couriers, register patients, facilitate billing, accession laboratory specimens, and provide information to all customers. Performs all Contact Center functions.
Demonstrated ability to read, write, and perform simple mathematical calculations.
Ability to comprehend data management systems and perform tasks specific to a variety of these systems.
Ability to behave in a professional, personable, sensitive manner with customers and Healthcare professionals.
Must demonstrate the ability to function within a stressful environment.
Demonstrated strong interpersonal skills and the ability to communicate well with the public.
Well-developed telephone and computer skills are desired.
Working knowledge of medical terminology and word processing preferred.
Demonstrated excellent customer service skills.
Demonstrated the ability to multi-task using a variety of PC based resources.
Demonstrated the ability to work independently and have strong problem solving and investigative skills.
Requires a high school diploma or equivalent.
Minimum of one year related experience in client services environment required.
Requires heavy use of telephone/communication equipment and sitting for long periods.
The specific statements shown in each section of this description are not intended to be all-inclusive. They represent typical elements and criteria considered necessary to successfully perform the job.
Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation.
GML uses cutting-edge technology and state-of-the-art information systems to provide laboratory services throughout central and northeast Pennsylvania. GML offers a wide range of routine and specialized testing in clinical and anatomic pathology.
We offer the resources of a national laboratory with the convenience and personalized attention of local service. We are dedicated to service excellence, teaching, accountability, respect and teamwork, and we offer many growth opportunities. Our laboratories are accredited by the College of American Pathologists and AABB.
One of the nation's most innovative health services organizations, Geisinger serves more than 1.5 million patients in Pennsylvania and New Jersey. The system includes 13 hospital campuses, a nearly 600,000-member health plan, two research centers and the Geisinger Commonwealth School of Medicine. Geisinger is known for its focus on caring and innovative programs including the ProvenCare® best-practice approach to maximize quality, safety and value; ProvenHealth Navigator® advanced medical home; Springboard Health® population health program to improve the health of an entire community; ProvenExperience™ to provide refunds to patients unhappy with their care experience; and Geisinger's MyCode® Community Health Initiative, the largest healthcare system-based precision health project in the world. With more than 215,000 volunteer participants enrolled, MyCode is conducting extensive research and returning medically actionable results to participants. A physician-led organization, with approximately 32,000 employees and more than 1,800 employed physicians, Geisinger leverages an estimated $12.7 billion positive annual impact on the Pennsylvania and New Jersey economies. Repeatedly recognized nationally for integration, quality and service, Geisinger has a long-standing commitment to patient care, medical education, research and community service. For more information, visit geisinger.org or connect with us on Facebook, Instagram, LinkedIn and Twitter.
We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners.* Perhaps just as important, from senior management on down, we encourage an atmosphere of collaboration, cooperation and collegiality.
** Does not qualify for J-1 waiver. We are an Affirmative Action, Equal Opportunity Employer Women and Minorities are Encouraged to Apply. All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of disability or their protected veteran status.
*Domestic partner benefits not applicable at Geisinger Holy Spirit.
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The Armed Services Vocational Aptitude Battery is the most widely used multiple-aptitude test battery in the world. As an aptitude test, the ASVAB measures your strengths, weaknesses, and potential for future success. The ASVAB also provides you with career information for various civilian and military occupations and is an indicator for success in future endeavors whether you choose to go to college, vocational school, or a military career.
Your ASVAB Score can be Critical
ASVAB test scores are broken down by the individual sub-tests and composites of the sub-tests. One of the most critical of these scores is the Armed Forces Qualification Test, which is used to determine if you are qualified to join the military service. Each service determines the qualification AFQT score for enlisting in their service.
The AFQT is comprised of your test results in Arithmetic Reasoning (AR), Math Knowledge (MK), and Verbal Composite (VE) x 2. Your Verbal Composite score is a combination of your Word Knowledge and Paragraph Comprehension scores. Check out the following AFQT qualifying scores for each branch of service.
|Service Branch
|Required AFQT Score*
|Air Force
|Coast Guard
|* These scores are subject to change without notice.
In addition, your scores on the other ASVAB composite tests will determine your career field or military occupation eligibility. Since enlistment bonuses are usually tied to your choice of occupations, the better the score, the more opportunities you have. But keep in mind, it is impossible to literally "ace" the ASVAB, so your goal should be to simply do your best.
TIP: Be sure you are ready before you take the ASVAB -- use the Military.com ASVAB practice tests to find the areas you may need to work on. In addition you can read about ASVAB study techniques.
Three Versions of the ASVAB
There are three distinctly different versions or formats of the ASVAB; the CAT-ASVAB (computer adaptive test), the MET-site ASVAB, and the Student ASVAB. Each ASVAB has different benefits and limitations. Many potential military recruits take the CAT-ASVAB.
Interested in Joining the Military?
We can put you in touch with recruiters from the different military branches. Learn about the benefits of serving your country, paying for school, military career paths, and more: sign up now and hear from a recruiter near you.


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All information you submit to the USPTO at any point in the application and/or registration process will become public record, including your name, phone number, e-mail address, and street address. By filing this application, you acknowledge that YOU HAVE NO RIGHT TO CONFIDENTIALITY in the information disclosed. The public will be able to view this information in the USPTO's on-line databases and through Internet search engines and other on-line databases. This information will remain public even if the application is later abandoned or any resulting registration is surrendered, cancelled, or expired. To maintain confidentiality of banking or credit card information, only enter payment information in the secure portion of the site after validating your form. For any information that may be subject to copyright protection, by submitting it to the USPTO, the filer is representing that he or she has the authority to grant, and is granting, the USPTO permission to make the information available in its on-line database and in copies of the application or registration record.
For more information, please consult the FAQs Personal Information in Trademark Records.


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Stephen Law on "Playing the Mystery Card"
Critics point out that [you believers] have little in the way of argument for what you believe, there also seems to be powerful evidence against it. If you want, nevertheless, to convince both yourself and others that your beliefs are not nearly as ridiculous as your critics suggest, what can you do? Play the mystery card..." Read his lengthy response.


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Carlos Boozer's Whoring* Diary, Cont.
In the wake of his interviews in Chicago and Miami, Carlos decided it was time to broadcast his desperation desires to the entire world.
In CHINA, FB told the Guangdong Gazette:
To be honest, I've never liked sitting down to take a dump, which is why, obviously, I feel that a country full of squat toilets would be ideal for me and my family. There are so many reasons why I would love to play in China. I've always felt that communism was the best way to run a country. Also, coming from Alaska, I've never had the opportunity to experience pollution firsthand. Yo, Guangdong Southern Tigers, I hear y'all looking for a PF to replace Yi. Holla baby! Also, I saw a lot of hot women while I was in Beijing for the Olympics and obviously since my wife and I mutually agreed to divorce, I'm technically kind of single, which is good enough for me.
At DUKE, FB told the Duke Daily:
I am committed to going back to school and finishing my degree. I still have one year of eligibility left, and I would love to play for Coach K again. Even though the Olympics didn't really work out, he and I are very, very close. Duke is my number one choice. North Carolina was my second home, and it's where I met my wife. I think that I can, obviously, bring leadership to the team as a veteran presence, and I would love to bring the championship title back to Duke.
In GERMANY, FB told Germany Today:
The Jazz and I mutually agreed to go in different directions, so here I am. I was born here and it's obviously my first home. Lots of Germans and I became very, very close back in the day. I've always been an admirer of the country that produced such tough, rugged NBA players, obviously players like Dirk. I would love to play in Europe, and Germany especially, and return to my roots. I feel that Germany and I are the perfect fit because I am a huge David Hasselhoff fan. Oh and by the way, everyone sign up for my basketball camp in Miami! Parents, feel free to drop off your kids on the day of if you happen to be in the neighborhood!
Back STATESIDE to start more rumors, FB told the White House Media Affairs Office:
Barry O's personal aide, Reggie Love, is a very good friend of mine. He recently told me that they are looking for players for the White House Rec League, and since the Jazz and I mutually agreed to part ways, I immediately knew that this situation would be very beneficial to me and my family. As an Olympian, obviously, I have a great grasp on foreign affairs and I will encourage Barry to assert himself more as a leader because the president is like the quarterback of our nation. At the same time, obviously, I look forward to asserting myself as a leader in the league.
Back to his world tour, FB heads to ISRAEL and tells the Israeli Post:
I am very, very close with both Dee Brown and Carlos Arroyo, who are two of the most athletic guards I have ever had the pleasure of playing with. By the way, I am also, obviously, really good friends with DWade. Anyway, Maccabi Tel Aviv would really just be the perfect situation for me and my family and it's my number one choice. At the same time, as an American and a leader of the free world, not to mention a two-time Olympian along with DWade, I look forward to asserting my leadership in the Gaza Strip, as I would, obviously, add a lot to the region.
To close out his first World Tour, FB spoke with CNN:
I have always wanted to see outer space and I would love to play on Mars for the Martian League. I love the laid-back attitude and quality of life on Mars and the sun there is so much better than the sun in Miami. It would be an educational experience for me and my family, and the absence of taxation on the planet makes Mars very attractive to me. I am very excited to begin the next chapter of my life after, obviously, the Jazz and I mutually agreed for me to be traded.
*Apologies to whores for the comparison to Carlos Boozer.
July 22, 2009 8:45 pm
Holy crap moni, this is hilarious.
prodigal_punk permalinkJuly 22, 2009 10:03 pm
Apologies to whores. Too funny


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Syntron Material Handling is a global leader providing Material Handling Solutions for conveying, feeding, screening, elevating, and mining controls of bulk product. We are committed to understanding your needs and partnering closely with you to provide vibratory and conveying technologies with state-of-the-art controls, automation and information systems that improve performance and minimize operating cost. Whether it is performance optimization of existing systems or newly customized plants, our dedicated team of engineers and sales staff will provide you with the most efficient and cost-effective solutions to meet your specific material handling needs.
Manufacturer Product Categories
- Drying & Thermal Solids Processing
- Feeders
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text:
cool music :D
The New Universe adds many new systems, stations, ships, factions, equipment, etc. to the Freelancer universe. It contains new equipment like hull upgrades and special guns/shields. The mod contains a Stargate and a StarWars area. For mor information please read the mod readme!
Only registered members can share their thoughts. So come on! Join the community today (totally free - or sign in with your social account on the right) and join in the conversation.
This is one of the 3 custom intro's we made for NewUniverse 1.7.
U can get the more here at this board and more infos about our community and the mod at www.flnu.net


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In an effort to help more Iowa employers and workers recover from the national recession, we must increase access to high-quality Internet services across the state.
Iowa ranks 11th out of 12 Midwestern states in the TechNet State Broadband Index, which ranks states based on how many households use broadband, network speeds and the number of jobs that benefit from broadband technology.
According to a survey from Connect Iowa, 71 percent of Iowa households have adopted broadband, but only 47 percent can access broadband at high speed (50 Mbps). Broadband is used even less by low-income families, rural households and senior citizens. Among Iowa businesses, about 23,000 are not using high-speed Internet services.
Article Photos
State Senator Steve Sodders
Broadband can be a powerful economic tool for Iowans and businesses. Better broadband access, particularly in rural areas, could spur economic development through job creation and business expansion.
That's why legislators in the House and Senate are looking at ways to improve access broadband in Iowa. Under a Senate proposal, companies could get tax breaks if they invest in broadband infrastructure. The bill also would establish a loan fund for businesses making broadband investments.
In September, Governor Branstad announced a new broadband initiative, Connect Every Iowan. A task force made up of stakeholders and legislators met to discuss broadband connectivity issues, as well as how we can increase access to and use of broadband throughout Iowa. To view the task force's report and learn more about Iowa's work to expand broadband, go broadband.iowa.gov.


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I am looking to get back into playing D&D after a couple years break. If you would be interisted in having an extra person in your group or know someone who does, please let me know. I started playing almost 20 years ago ranging from 1st to 3.5 edition. Any help would be appreciated.
Thank You,
I noticed that we live pretty close to each other. I'm looking for people that are interisted in playing dungeons and dragons. Please let me know if you are interisted.


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The Latest Edition of The Trinitarian is Available Now
Please click the button below to view and/or download the February 2019 edition of The Trinitarian.
Thank you for providing your email address for Newsletter (and other notices) distribution. If you would prefer to receive notices at a different email address than this one, please let me know.
A Brief Note from the Parish Office
The bulk-mail (paper) copy is being mailed out later today. If you asked to receive the newsletter by 'email only,' you should not receive this paper copy. If you do get a paper version, as well as the email copy, and would be willing to give up the paper delivery so we may be good stewards of our natural resources, please let me know! If you previously requested 'email only' distribution of the newsletter, you don't need to let me know again unless you get a new paper copy in the mail.
Thank you,
Magee Lambert, Parish Secretary


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For the most part, we are a culture obsessed with personal cleanliness; we have shelves brimming with soaps, shampoos, deodorants, cleansers, anti-bacterial wipes and a host of other products to keep us fresh and sparkling.
But what if we have it all wrong?
The last few years have seen more and more people stepping away from the soapy things; we've begun shunning shampoo and giving the cold shoulder to showers.
And now, even face soap – one of the most sacred weapons in the beauty routine arsenal – is being ditched by a legion of reformed women who have turned to cleaning their faces with oil.
Yes, oil.
Why would someone clean their face with the very thing they are trying to remove from their face? Well, there are plenty of reasons, and they make perfect sense, as crazy as it may sound. Consider the following:
It actually cleans your skin
Dr. Heather Rogers, a Seattle dermatologist, told Today.com that scientifically speaking, the oil cleansing method (OCM to those in the know) is logical.
"The concept is that like dissolves like," she said. "If you put oil onto your skin, it will then combine with the oils that are layered on your skin. ... It will also cut through some of the dirt, and the grease."
Many OCM adherents use a mix of castor oil with another type of oil; and as it turns out, castor oil is close to a surfactant, an important substance in soaps. "Castor oil, it's actually closer to a surfactant than the other oils," Rogers said. In castor oil, she explains, "there's a part that likes oil, so it connects to the oil on your skin, and there's a part that likes water, so it allows the oils to be carried away by the water."
It moisturizes
While soap strips away the natural oils in your skin and can lead to dryness, oil doesn't, leaving skin quenched and potentially alleviating your need to apply moisturizer.
It can clear up acne
For many people, cleansing with oil works to clear acne. A post on acne.org notes that most commercial facial cleansers and toners use chemicals to strip the skin's oil, an action that irritates the skin and causes it to produce more oil as a result. "When done properly and consistently, the OCM can clear the skin from issues like oily skin, dry skin, sensitive skin, blackheads, whiteheads and other problems caused by mild to moderate acne — while leaving your skin healthy, balanced and properly moisturized," says the site.
It's potentially better for your health
Do you need to be slathering your face with petroleum distillates, parabens, sodium laurel sulfates and synthetic fragrances? If you select cold-pressed or expeller-pressed organic oils, you will be treating your face to sumptuous natural products that are better for your body and, depending on the oils you use, easier on your wallet.
It's better for the planet
Soaps with triclosan and other chemicals end up going down the drain … and then find their way to aquatic habitats. In rivers and streams, these chemicals are thought to affect how fish mate and spawn, scientists warn, even when the substances are not present at levels high enough to cause visible damage.
You'll glow
Although it might take a few weeks for your skin to adjust, most OCM advocates testify to softer skin and a big boost in the radiance department.
It's easy
No need to pre-clean your skin, just give it a quick rinse with warm water. Pour some oil in your hand and rub it gently all over your face. Massage for two minutes and then let sit for 30 seconds. Soak a washcloth in hot water and cover your face with it; leave it there for 15 seconds or so, then begin to wipe the oil away. Rinse the washcloth and repeat until the oil is gone.
You get to make custom blends
Because who doesn't like to play scientist from time to time? Unlike pre-made commercial products, you can customize the oils you use. You can start with castor oil for its surfactant-like properties and its low cost, but it can be drying so other oils can be added. Crunchy Betty, the blog that has become the go-to place for all things OCM, recommends the addition of the following oils:
Jojoba: all skin types, but very desirable for acne-prone skin
Sweet almond: all skin types, especially oily
Grapeseed: all skin types, especially oily
Avocado: dry and aging skin
Sunflower seed: all skin types
Apricot kernel: dry, aging and normal skin
Argan: all skin types, especially aging skin
Plus, you can add a few drops of pure essential oil for an extra kick. And note: while coconut oil is truly a wonder, it is a comedogenic and may block pores, so it may be best to skip this one for cleansing.
For more on incorporating oils into your beauty practice:
- 5 ways to use healthy oils for skincare
- 5 simple, cost-saving ways I use coconut oil in my beauty routines
- What is oil pulling?


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COURIER-JOURNAL / SEARCH: 201 River Crest South Mount Washington, KY 40047
- 4 beds
- 2 baths
- $313,990 price
- 1733701 mls id
- Square Feet: 2,954 sqft
- Neighborhood: Twin Falls at River Crest
Listing Description
Twin Falls at River Crest features our Designer Collection of new homes in Mt.. Washington, Kentucky located off of Bogard Lane. Enjoy the beautiful waterfall at the River Crest community entrance. Amenities include a swimming pool, splash park, clubhouse, paved walking paths, park benches, playground, and a dog park. The community is conveniently located near shopping and dining on US 150. Twin Falls at River Crest is in the Bullitt County Public School District – Pleasant Grove Elementary, Eastside Middle School, and Bullitt East High School.
- Builder Website
- NewHomeSource Listing
- NewHomeSource Subdivision Website
- New Construction Yes
Subdivision: Twin Falls at River Crest
- Price Range $245.9K - $354.9K
- Subdivision StatusCloseout
- Subdivision Website
Courtesy of: Fischer Homes
Office Phone: 502-806-8466
Updated: 10th April, 2020 12:49 AM.
201 River Crest South Mount Washington, KY
Real Estate | Courier-Journal Powered by Placester


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A timeless beauty in desirable location. This charming, lovingly maintained, one owner home sits on a wooded lot in a quiet setting. Freshly painted and thoughtful updates complement a flexible floor plan with ample space for everyone. 5 bedrooms, one on main level. Enjoy the gorgeous hardwood floors, gracious spaces, & finished basement. Great opportunity for a buyer to make this home their own. Walking distance to CHCCS schools, Whole Foods & Eastwood Lake. Convenient to UNC, Duke and RTP. Welcome home!
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Miley Cyrus sure knows how to throw a party. In her latest music video "Decisions" with Israeli DJ dubstep DJ Borgore we see it all.
Throughout the four-minute video Miley can be found jumping out of a cake, making out with a unicorn mask worn by fiancé Liam Hemsworth and of course, throwing cake. There are appearances by midgets, a goat and porn star Jessie Andrews, who the song was written about.
"Decisions" was filmed at Beacher's in Los Angeles. Borgore told Rolling Stone that the song is about, "How much b****** love cake." But it's also about interpreting "becoming successful, or… the way you look, or because you've got money" as having "cake."
The video kicks off with Borgore cycling across the coastline at sunrise with a huge birthday cake attached to his bike. His catchy beats are soon heard alongside Miley's familiar vocals.
"I want to eat the whole cake/ I'm not sharing," they sing before Borgore raps, "You shoulda learned b****** love cake."
Borgore soon arrives to the party, which is hidden in a secret passage behind a mansion bookshelf. Singing about porn stars and the president surrounded by an eclectic group of people, stuffed and live animals and lots of cake, the party soon begins.
We're introduced to a whole different side of Miley and she doesn't seem to mind.
"That s*** was crazy!" she said told Rolling Stone. "[Borgore] walked into his hotel room, and it was people in the weirdest clothes you've ever seen. My fiancé was dressed as a unicorn. We make out in the video, which is very funny. It's just the most random group. We walk in and we're like, 'This feels like a party,' so it's dope."
Fans seem to agree as they're already making gifs of the performance.
haha @mileycyrus check out this gif of you and Liam from the video! love it 25.media.tumblr.com/tumblr_mctn6sq…
— Miley's Dogs ❤ (@FloydLilaZiggy) November 1, 2012
-Annie Reuter, CBS Local
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text:
Name: Magna Primus
Transformers fan since: 1983
Year of Birth: Well before 1983
Primary Residence: Texas
First Transformer Ever bought: Hound
First series ever paid attention to: G1 and before
Favorite TF Cartoon: The one we all started with
Favorite Comic: The more recent ones that feature superior artwork, the ones that did the 'who's who' series
Least favorite TF persona/toy: Too many to list. Basically, if the toy is poorly engineered or articulated, I'm gonna dislike it. Also, any 'bot that has WAAY too big a price for the product - I'm specifically talking about the awesome fanmade Arcee, Warbot Defender/Springer, the Punch/Counterpunch that like four people were able to afford...
Top 5 Favorite Toys of all time:
1.) Roadbuster
2.) The entire G1 revamp/Generations line. About time, Hasbro.(I'm including the entire fan-driven toy reboot, aka fansproject/igear/warbot defender/headrobot as well. Man, these are some great bots comin' out!)
3.) Fort Max
4.) Star Saber
5.) Metroplex
Most rare TF collectible I own: Too many to list here.
Lightning round!
Coke or Pepsi:? Pepsi, but I'd prefer water or Gatorade, thanks.
Night owl or early bird? Night owls forever!
Autobot or Decepticon? Autobot for the duration of this spark!
Others will be surprised to know that: I'm as into GI Joe ARAH as TF, and had started a custom line of 1/6th Joes about 5 years before Sideshow got their contract.


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The 2 bed-apartment with harmonious colour will give you a refreshing feeling at Masteri Thao Dien, Ho Chi Minh City.
Please Note: The above PRICE is subject to change by landlord without prior notice. Price and availability have to checked at the time or enquiry.
BEST PRICE and FREE SERVICE
We have a lot of apartments for rent in Masteri Thao Dien, Masteri An Phu, The Estella Heights, The Estella, The Gateway, The Nassim, City Garden, Vinhomes Central Park, Vinhomes Golden River. And River Garden, Tropic Garden, The Vista, Thao Dien Pearl, Xi, Diamond Island, The Sun Avenue, Palm Heights, Feliz en Vista, Sala...
And we also have many other serviced apartments, house, villas for rent in HCMC.
Please feel free to contact us if you need any further information.
Email : email@example.com
Website: honeycomb.com.vn honeycomb.vn


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| 11.7°C Belfast
Jonny May accepts breaking his nose for a second game in succession when England play Scotland on Saturday is a strong possibility.
May will take his place on the left wing of an unchanged starting XV after being given the all-clear to play at Murrayfield despite incurring a undisplaced fracture to his nose against France.
The Gloucester rookie lasted only eight minutes of the 26-24 RBS 6 Nations defeat in Paris after colliding with the knee of team-mate Mike Brown.
Withdrawn from the Stade de France as a precautionary measure, a specialist subsequently cleared him for the trip to Edinburgh, where he is expecting a recurring problem to strike once again.
"I've broken my nose in the past and I've had a few knocks on it recently. It was waiting to go almost," May said.
"I will probably get a smack on the nose early in the Scotland game, but it's sore most of the time anyway. It gets hit in most games!
"If that happens it might bleed, in which case I'll go off and get it treated and go straight back on if I can.
"At least we're aware of what it is this time. I'm not worried about it."
May has ruled out the need to wear a protective face mask at Murrayfield and, despite the brief duration of his second cap, he enjoyed every second of it.
"I wasn't fazed by the occasion and was relishing the environment," the 23-year-old said.
"There was no point getting down in the dumps about the nose when I didn't know what the situation was. Luckily enough there was a positive outcome.
"It wasn't particularly painful at the time - it's just that there was so much blood and the doctor wasn't too sure of what it was.
"In terms of trying to protect me, he made the decision that I wouldn't go back on because he was worried that I might have fractured by cheekbone or eye socket."
It is the first time in Stuart Lancaster's two-year reign as England head coach that the same starting XV has been retained for successive matches.
England were crushed by their late defeat at the Stade de France, but have been consoled by a spirited performance full of attacking intent that was worthy of a different outcome.
"We want the team to build on the display against France and use that defeat as motivation," Lancaster said.
"It's a second chance for this team. Having reviewed the game there were a lot more ups than downs. We have to trust the players to get the win this time."


text:
Technical Certificate Programs
Smart Home Technology
Course Descriptions
SHT101 - Smart Home Technology IThis course develops skills in automating a home. The students will learn how to install and control a security, surveillance, lighting, stereo, HVAC, programmable thermostat, phone, motion detection, vehicle detection, irrigation, pool, and spa system. More importantly, they will learn how to install the devices without causing damage to the home.
SHT102 - Smart Home Technology II
This course develops skills in viewing and/or controlling automated devices in a home via the internet. The students will learn about interface options and software application necessary to monitor the devices remotely from any computer that has an internet connection, or from any Smartphone/PDA.
SHT103 - Designing Home Theater Systems
This course develops skills in establishing a home theater system. Students will learn details about video applications, audio systems, lighting plans, and seating arrangements. Also, students will learn specifications of AV receivers, speakers, speaker arrangements and mounting plans, subwoofers, music enhancers, Blu-ray disc players, etc. Understanding specifications will allow students to design and obtain a system pursuant to a budget.
SHT104 - Computer Hardware Applications
This course develops skills in understanding the function of computer hardware; e.g.: motherboard, hard drive, floppy drive, power supply, monitor, video display controller, removable media devices, memory, sound card, networking devices, and other peripherals. Students will also learn about hardware options for smart home technology applications.
SHT105 - Computer Software Applications
This course develops skills in utilizing computer software. Students will learn how to prepare various type documents by utilizing a word processor and/or electronic spreadsheet. Moreover, the students will gain exposure to utilizing the internet. They will also learn computer terminology, other software applications, and more.


text:
Change my domain
With Website Builder, you can change the domain name associated with your account.
Note: You cannot change the domain name for a free Website Builder account, nor a domain where a SSL (Secure Sockets Layer) certificate has been applied. To upgrade Website Builder, see Upgrading Your Website Builder Plan.
- Log in to your GoDaddy account.
- In your Products list click Website Builder, and then click Manage next to the account you want to use.
- Hover over Settings.
- Click Site, and then select one of the following:
- Select an available domain from your account — Select a domain in your account from the Select Available Domain list.
- Enter a domain not registered in this account — Enter a domain that isn't in your account, such as one from another registrar.
- Enter a subdomain for a domain in this account — Create a subdomain for your website, such as site.coolexample.com
- Click OK.