text:
TITLE: Nutritional Considerations for Head and Neck Cancer
SOURCE: Grand Rounds Presentation, UTMB, Dept. of Otolaryngology
RESIDENT PHYSICIAN: Glen T. Porter, MD
FACULTY PHYSICIAN: Anna M. Pou, MD
SERIES EDITORS: Francis B. Quinn, Jr., MD and Matthew W. Ryan, MD
material was prepared by resident physicians in partial fulfillment of
educational requirements established for the Postgraduate Training Program of
the UTMB Department of Otolaryngology/Head and Neck Surgery and was not
intended for clinical use in its present form. It was prepared for the purpose
of stimulating group discussion in a conference setting. No warranties,
either express or implied, are made with respect to its accuracy, completeness,
or timeliness. The material does not necessarily reflect the current or past
opinions of members of the UTMB faculty and should not be used for purposes of
diagnosis or treatment without consulting appropriate literature sources and
informed professional opinion."
Cancer patients often present to their physicians in a poor nutritional state. Their nutritional deficits have a significant impact on mortality, morbidity and quality of life. Head and neck cancer patients are no exception. The literature indicates that up to 57% of patients with head and neck cancer present with significant malnutrition (manifest by greater than 10% weight loss from baseline body mass). Alcohol and tobacco use frequently exacerbates this problem. Alcohol provides a large amount of simple carbohydrates without essential vitamins, proteins, and fats. These "empty calories" may actually contribute to cancer growth and further nutritional decay. Tobacco is an appetite suppressant. Moreover, head and neck cancers may cause significant trismus, odynophagia, dysphagia, and aspiration. Large tumors can actually obstruct the aerodigestive system. Treatment options for head and neck cancer include surgery, chemotherapy, and radiation therapy. Each of these interventions have side effects that contribute to malnutrition. Thus, it is especially important that patients with head and neck cancer undergo pretreatment nutritional evaluation, appropriate nutritional supplementation, and continued attention to this detail during and after treatment.
Malnutrition is generally divided into two types—marasmus and kwashiorkor. The former is characterized by normal serum protein levels and total calorie deprivation from all food sources (starvation). Kwashiorkor is caused by a decrease in protein intake. Serum levels of protein are reduced. Most head and neck cancer patients present with protein-deficiency malnutrition. Thus, diminished nutrient intake, or diminished appropriate nutrient intake is one etiology of cancer malnutrition. As previously discussed, cancers of the head and neck can physically impede the intake of nourishment or cause trismus and odynophagia that limit oral intake. Alcohol and tobacco use, commonly seen in this patient group, add to the problem by providing "empty calories" devoid of essential nutrients, and suppressing appetite. Patients who consume excessive amounts of alcohol have also been shown to have a much decreased intake of fresh fruits and vegetables. A diet low in essential vitamins and minerals has been associated with increased risk of head and neck cancer. The treatment regimens for head and neck cancer often result in side effects that decrease oral intake. Surgical treatment can alter the anatomy such that chewing and swallowing can be temporarily or permanently dysfunctional. Radiation therapy and chemotherapy commonly result in mucositis, dysgeusia, anosmia, xerostomia, nausea, and vomiting. Poor dentition may also contribute by increasing difficulty with mastication. Radiation-induced dental disease can further exacerbate this.
The other factors that can lead to a malnourished state include increased nutritional losses, increased nutritional demand, and tumor-induced metabolic dysfunction. Increased nutritional losses are most commonly seen with vomiting and diarrhea, but can be caused by enterocutaneous fistulae or gastrointestinal malabsorption. Increased nutritional demands result from surgery, radiation, and chemotherapy. Pneumonia, wound infections, and sepsis can further increase nutritional demands. These demands often correspond to the time that oral nutrition is impossible or very limited, i.e. the early postoperative period, or during daily radiation treatments. The nutritional demands during this acute phase result in catabolism of stored glycogen (exhausted during the first 24 hrs) and proteins in the muscles and tissues. Energy stored in fat does not appear to be mobilized to meet the nutritional needs of this phase. After 3 to 7 days the body begins to slowly return to normal metabolism.
Finally, specific tumor-induced anorexia and metabolic dysfunction contribute to malnutrition. Anorexia of cancer is thought to result from alterations in neurotransmitters (possibly serotonin) and possibly from learned food aversions. Alterations in metabolism are profound. Most solid tumors derive their energy from glucose. They are unable to use amino acids or fat to create energy. Tumor factors (thought to include tumor necrosis factor, and interleukins IL-1, and IL-6) result in catabolism of muscle and tissue proteins which are converted to glucose in the liver and used for cell replication by cancer cells. Fat is also catabolized. Elevated levels of plasma free fatty acids are thought to be secondary to hepatic neoketogenesis and are responsible for a relative insulin insensitivity by normal body tissues. This results in a decreased ability for normal tissues to take up amino acids and further fuels gluconeogenesis which feeds the tumor.
Impact of Malnutrition
The impact of malnutrition on patient outcomes is
great. Mick, et al. studied a group of
patients with stage III/IV head and neck cancer treated with multiple
modalities. The strongest independent
predictor of survival was pretreatment weight loss. Brookes, et al. showed that head and neck
cancer patients have a significant 2-year survival if they are malnourished at
presentation (7.5% vs. 57%). Finally,
Bertrand, et al and Van Bokhorst-de Van der Shuer showed that 7-10 days of
preoperative nutrition resulted in a significant improvement in postoperative
quality of life, and led to a 10% decrease in postoperative infectious
complications. Patients that have lost
12-20% of their ideal body weight are at increased risk of postoperative
sepsis. Malnourished patients have
depressed immune systems with a particular decrease in cell-mediated
immunity. This is thought to be the
reason for the anergy often seen in cancer
patients. It is also proposed to be the
reason that malnourishment coincides with tumor size and prognosis—that a
decrease in the immune system leads to unimpeded tumor growth. Cachectic patients
are also frequently unable to tolerate antineoplastic
therapies which results in treatment delay and higher costs.
Because of the associated risks, it is important to be able to diagnose malnutrition in head and neck cancer patients. Malnutrition has been defined as weight loss greater than 10% of ideal body weight that is associated with loss of muscle. However, there have been multiple systems for assessing malnutrition proposed. A complete history and physical in combination with the 10% "rule" is probably the most commonly used method of evaluating nutritional status. The best muscles to assess for wasting are the quadriceps femoris and the deltoid muscles. Cheilosis, stomatitis, and dry scaling skin can be indicative of vitamin deficiencies. Other parameters include anthropomorphic measurements (tricep skin fold, upper arm diameter), skin testing (for anergy), laboratory values, total lymphocyte count (patients with TLC<1700 have 5X risk of wound infection), and weight as a percentage of baseline weight. Laboratory values include albumin, prealbumin, transferrin, and retinol binding protein. Albumin is often used to evaluate nutritional status, but is handicapped by a long half-life (20 days) whereas the prealbumin, retinol binding protein, and transferring are more indicative of the present nutritional state (half life of 8 days). The creatinine-height index, prognostic nutritional index (PNI), and subjective global assessment (SGA) are all methods of identifying nutritionally deficient patients using one or more of the above parameters. Once high-risk patients are identified, immediate intervention can result in a much improved outcome.
Patients with difficulty eating secondary to pain and anorexia can be offered medical treatment. Mucositis is common in patients receiving radiation therapy and chemotherapy. Treatment is generally with topical medications (analgesics, antifungals, coating agents, and antihistamines), and gentle local care. Dental care can address pain of dental origin and frequent sips of water, synthetic saliva, and pilocarpine can address problems of xerostomia. Chemotherapy-related nausea and vomiting have been significantly ameliorated with newer generation antiemetics such as Ondansetron and Granisetron. Patients who suffer from cancer-associated anorexia have shown good response to progestogens such as megestrol. Other agents under investigation include THC, thalidomide, melatonin, and pentoxifylline. The dysgeusia experienced by patients who undergo radiation therapy and chemotherapy usually resolves within a year of treatment. Pain management is important as maximal medical therapy may not be able to completely alleviate the pain associated with these disorders.
Once a patient has been evaluated and his risk of malnutrition identified nutritional counseling should be offered. Patients who appear to be healthy should be counseled in regards to their diet and encouraged to eat a balanced diet with emphasis on high-protein, high-calorie foods. Expectations for future treatments and their influence on nutrition should be discussed. Interestingly, patients who are counseled to avoid favorite foods during treatment periods seem to return to a normal diet quicker and have fewer food aversions. For patients with mild to moderate malnutrition who tolerate oral feeding, nutritional supplementation should be advised. The most complete nutritional supplementation is found in the commercially available enteral formulas. This can be fairly expensive, and is not necessary in patients who are able to chew and swallow effectively. These patients should be encouraged to eat a balanced diet with an effort to eat high-protein, high calorie foods. They might be counseled to use whole milk instead of fat-free, real mayonnaise instead of dressing, butter, eggs, meats, legumes, ice cream, and "instant breakfast" powders. These changes can significantly increase caloric intake with little change in actual volume. The patient should be invited to stop drinking alcohol and smoking tobacco.
Consulting a dietitian is appropriate whenever one identifies a patient currently malnourished or at risk of malnutrition. Their input is especially helpful when deciding the total caloric needs of a patient and when exploring the options for nutritional supplementation in patients with other medical problems. A dietitian is able to provide nutritional counseling throughout the course of a patient's cancer treatment and give valuable treatment suggestions for the otolaryngologist—head & neck surgeon.
Patients who are judged at high risk and are unable to eat by mouth should be given enteral feeding. Placement of feeding tubes into the gastrointestinal system effectively bypasses the most common areas of feeding difficulty. Dysphagia, odynophagia, and aspiration are usually not issues once feeding is started through a nasogastric tube, gastrostomy or jejunostomy. The questions of when to initiate tube feeds and what type of tube is appropriate have been addressed by many authors. If the patient is cachectic or unable to satisfy his/her basic caloric needs by oral intake they are a candidate for supplemental tube feeds. Gastrostomy placement before XRT has been shown to prevent weight loss, treatment interruption, and dehydration. In general, a nasogastric feeding tube can be used if expected length of use is less than 30 days. These tubes irritate the nasal mucosa and are not well tolerated. They clog easily and typically require replacement every 10 days. The tip of the tube can be placed in the stomach or the small intestine. If the patient has a history of reflux, or if aspiration is a concern, the tube should be passed into the duodenum. The pyloric sphincter acts as an additional barrier to refluxing feeds. Enteral formula (hypertonic) can be instilled directly through this catheter and given in bolus form. Most authors feel that stomach feeds are more physiologic and are the first choice if aspiration risk is low.
If the patient is likely to require more than 30 days of tube feeds an enterocutaneous feeding tube is indicated. Enterocutaneous feeding tubes can be placed into the stomach or small bowel. They can be performed laporoscopically, open, under fluoroscopy, or endoscopically. When performed endoscopically, the tube can be "pushed" from the oral cavity into the stomach and through an incision in the stomach and skin, or "pulled" through a skin incision into the stomach. Complications are rare with any of the applications, though morbidity is somewhat higher for open procedures. There are case reports of cancer cells seeding the feeding tube site after endoscopic placement. This complication theoretically is avoided by "push," open, or fluoroscopic procedures.
No matter which type of tube is used, placement of the tip into the stomach is preferred. The stomach acts as a reservoir (allows for bolus feeds) and allows for hypertonic feeds. If the patient has delayed emptying time or other gastric dysfunction (often seen in the critically ill patient) a feeding tube placed into the small bowel may be more appropriate. Other indications for jejunal feeding include proximal fistula or leak, and severe reflux of gastric contents. Jejunal feeding is associated with a decreased rate of pneumonia in critically ill patients. This is thought to be a result of less reflux aspiration. When instilling enteral formula into the small intestine bolus feeds are contraindicated. Instead, a constant rate of up to 180cc/hr is well-tolerated. One study compared nasogastric tube placement with gastrostomy tube placement one day before surgery. Those patients with tonsil or laryngeal SCCA that received a gastrostomy tube spent a significantly shorter time in the hospital (60+% reduction) (Gibson, et al.). Saunders, et al showed that patients tolerated gastrostomy tube placement long-term with high satisfaction levels. Scolapio, et al. followed patients who received a gastrostomy before starting radiation therapy. He reported a significant prevention of weight loss, treatment interruption, and hospitalization for dehydration. Enteral nutrition is well-tolerated and effective. It likely does not matter what tube is used to supply to formula, its effects are the same.
There are a wide variety of enteral formulas available. Most formulas provide 1-2 kcal/ml. In general, enteral feeding formulas can be separated into polymeric, monomeric, and disease-specific formulations. Polymeric contain carbohydrate polymers, complete proteins, and triglycerides. They can be used safely in the vast majority of patients. These formulas can be instilled in the stomach or small intestine. Monomeric formulations are essentially the breakdown products of the polymeric formula. As such, it contains carbohydrates in the form of oligosaccharides or maltodextrin, protein in the form of short peptide chains or free amino acids, and lipids as a mixture of short and long-chain triglycerides. Monomeric formulations are considered more appropriate for patients with poor absorption or other digestion dysfunction. There have been no studies to clearly confirm the benefit of their use. Disease-specific formulas are made specific to a patient's disease state. There are formulations for diabetes, renal insufficiency, pulmonary disease, hepatic dysfunction, and immunosuppression. Enteral feeding formulas rich in arginine, glutamine, omega-3 fatty acids, and polyribonucleotides are thought to alter immune function. This has resulted in their increased use for cancer patients. Although a met analysis of relevant studies failed to show any survival benefit in cancer patients, patients on this formula have been shown to have 50% fewer post-op infectious complications. One other important specialized enteral feeding formula is the medium-chain triglyceride formulation which is traditionally used in patients with post-operative chyle leaks (Lipisorb, Mead-Johnson, and Travasorb MCT, Clintec). Although there are formulas to calculate a patient's daily nutritional needs, metabolic needs are generally 35 kcal/kg/day for maintenance, and 45 kcal/kg/day to support an anabolic state.
Parenteral nutrition is the feeding option of "last resort," and should be employed only when enteral feeding is not possible or is contraindicated. Total parenteral nutrition (TPN) can be valuable when treating severely malnourished patients who need immediate treatment. This intervention is much more expensive, requires a central line, and is associated with significant complications. The formula is a hypertonic mixture of amino acids, dextrose, fat emulsions, vitamins, trace elements, and electrolytes. Insulin is often added to the formula to treat the hyperglycemia TPN can cause. This allows for automatic titration of the insulin to the amount of formula being administered. TPN requires daily electrolyte monitoring and composition adjustment. Complications include line-related problems, infection and sepsis, and metabolic complications. Patients should always be weaned off TPN before surgery as inadvertent hyper/hypoglycemia can result. Studies show improvement in postoperative morbidity in malnourished patients receiving TPN. Preoperative TPN seemed to provide the most significant improvement. When compared with enteral nutrition, TPN provided no added benefit over enteral feeds. PPN is peripheral parenteral nutrition and is a diluted form of TPN. It is generally used as an adjunct to enteral feeds.
Often, patients are noted to have aspiration or increased dysphagia with certain food consistencies. A growing number of companies now offer a full line of food products adapted to these sorts of needs. Thickened water, juices, and pureed food lines are available if the patient wishes to pursue oral feeding. Long-term enteral nutrition with occasional pleasure eating by mouth is also an option. Patients who undergo surgical or radiation therapies may have long-term nutritional challenges as a result of treatment-related dysphagia and should be evaluated in cooperation with a skilled speech language pathologist.
Alternative Medicine
When discussing nutrition with patients it is important to recognize the role of alternative medical treatments. A growing number of Americans are turning to alternative medicine to either replace or supplement traditional western medicine (estimated at 1/3 of the American population). Much of the alternative or non-western approach is based on nutritional supplementation. Many of these supplements have been shown to be efficacious and useful. Others have little objective data to base judgments on. It is important to communicate that no treatments currently known to the scientific world can "cure" head and neck cancer outside of the modalities of surgery, radiation, and chemotherapy. Alternative interventions can, however, alleviate symptoms, and increase quality of life for patients with cancer. One study found that 15% of patients with head and neck cancer used alternative medicine. Interestingly, patients were usually well-educated and from high socioeconomic groups. Most patients used alternative medicine in conjunction with mainstream medical treatment. Chinese medicine (acupuncture and herbs), homeopathy, naturopathy, herbal medicine, Ayurvedic medicine, massage, mind-body medicine, chiropractic manipulations, and osteopathic manipulations are all forms of alternative medical practice that might be employed to treat a patient who presents with cancer. Low-dose ginger can be used as an antiemetic (may interfere with anticoagulation and cause hypoglycemia). Of all the alternative interventions, "mind-body intervention" seems to be the most successful. Many studies have shown treatment modalities that concentrate on "mind-body intervention" are effective in helping patients tolerate the side effects of medical therapies. One study comparing patients with melanoma treated with the standard of western medical care with and without mind-body treatments showed decreased recurrence and mortality in the group receiving alternative intervention. Recently, food compounds have been identified that may have an impact on health. Several of these are currently undergoing clinical trials. It is interesting that allopathic medicine is also investigating food nutrients for possible preventional value.
Looking to the Future
Preventing cancer by changing your diet is an emerging
field. Some authors have started looking
at food-related substances in an effort to identify what foods might offer a
protective value against head and neck cancer. Low serum levels of vitamin A or B-carotene
have been associated with cancer of the head and neck and cancer of the
lung. Schantz, et al.
showed an increased risk of head and neck cancer in patients who ate foods
deficient in cryptoxanthin, lycopene,
and Vitamins C and E. He postulated that
these substances might act as free radical scavengers and thus "protect" DNA
from mutation. Recently, studies looking
at n-3 polyunsaturated fatty acids derived from fish oils have shown some
effect in patients who are immunocompromised. This resulted in development of special enteral formulas which contain arginine,
dietary nucleotides, and n-3 fatty acids.
Studies have shown some improvement in postoperative infection. A meta analysis of
these studies, however, showed no added benefit when compared with regular enteral feeds.
Comprehensive care of head and neck cancer patients includes an evaluation of their nutritional status. Once a patient has been identified as suffering from malnutrition they should be assessed for their ability to take food by mouth, and their expected treatment course reviewed. Appropriate supplementation should then be provided. Enteral feeding is very successful in bypassing disease states of the upper aerodigestive system and results in improvement in treatment tolerance, post-treatment morbidity, as well as long-term quality of life and mortality. Alternative medical interventions may also be effective as adjuvant therapies. Scientists with hopes of identifying preventative substances for head and neck cancer may soon find that the best medicine we can take is the food we eat.
Benjamin F., et al. Complementary and
Alternative Medicine in Otolaryngology Laryngoscope 111(8):1383-1389, Aug 2001.
Bertrand, Pauline Coti a, et al. Preoperative nutritional support at home in head and
neck cancer patients: from nutritional benefits to the prevention of the
alcohol withdrawal syndrome Current Opinion
in Clinical Nutrition & Metabolic Care5(4):435-440, July 2002.
R.H., et al. Postoperative enteral vs.
parenteral nutrition. A randomized
controlled trial Archives of Surgery 121(9):1040-1045, Sept. 1986.
Stanley J., et al. Nutritional Management of Head and Neck Tumor Patients Comprehensive Management of Head and Neck
Tumors by
Chris Nutrition support in palliative
care Nursing Standard 17(2):47-52, 54-55, Sept 2002.
K. Palliative care in patients with
cancer of the head and neck Clinical
Otolaryngology 22(2):117-122, April
S., Wenig B.L. Percutaneous endoscopic
gastrostomy in the management of head and neck carcinoma. Laryngoscope 102:977-980, 1992.
L. Kathleen, Escott-Stump, Sylvia Krause's
Food, Nutrition, and Diet Therapy W.
B. Saunders Company, Philadelphia, PA, 1996.
Giovanni, et al. Managing Cancer-Related
Anorexia/Cachexia Drugs 61(4):499-514, 2001.
R., et al. Prognostic factors in
advanced head and neck cancer patients undergoing multimodality therapy. Otolaryngology Head & Neck Surgery 105:62-73,
James J. Nutritional Management of
Patients with Head and Neck Cancer Cancer of the Head and Neck by Eugene
N. Myers and James Y. Suen. Churchill
JR Jr, et al. Percutaneous endoscopic
gastrostomy in patients with head and neck malignancies. Am J Surg 162:381-383, 1991.
Stimzon P., et al. Genetic
Susceptibility to Head and Neck Cancer:
Interaction Between Nutrition and Mutagen Sensitivity Laryngoscope 107:765-781, June 1997.
Mark Enteral Nutritional Support of the
Patient with Cancer: Route and Role Journal of Clinical Gastroenterology 36:297-302, Apr 2003.
Scolapio, James S., et al. Prophylactic Placement of Gastrostomy
Feeding Tubes Before Radiotherapy in Patients with Head and Neck Cancer: is it Worthwhile? Journal of Clinical Gastroenterology 33(3):215-217, Sept 2001.
John M., Shike, Moshe Nutritional
Management of Patients with Head and Neck Cancer Head and Neck Cancer A Multidisciplinary
Approach by Louis B. Harrison, et al.
Carl H., et al. Reduced Postoperative
Infections with an Immune-Enhancing Nutritional Supplement Laryngoscope 109(6):915-921, June 1999.


text:
- Musician's Friend Best Selection, Price & Service. Guaranteed.
Need Help? Ask our Experts or call 800-449-9128
Asistencia en Español 866-226-2919
Need Help? Ask our Experts or call 800-449-9128
An exceptionally well-built cab that's musical sounding with tight bass and silken treble.
The Engl PRO Slanted E412VS 4x12 Guitar Speaker Cabinet 240W offers demanding performers warm harmonic midrange with tight bass and silken treble. It's super nice for lead sounds and can be used in either mono or stereo modes. It features 4 x 12" Celestion/E Vintage 30 speakers that can handle 240 watts mono, or 2 x 120 watts stereo. The cab is constructed of 14 ply Siberian birch for excellent sound and durability.
Enjoy professional sound from this exceptional cab. Order today.
Our product catalog varies by country due to manufacturer restrictions. If you change the Ship-To country, some or all of the items in your cart may not ship to the new destination.

subset: commoncrawl


text:
July 6, 2012
On the Trail of a Weird Dinosaur
"Therizinosaur" isn't a household name. This group of feathery dinosaurs hasn't been around long enough to have the same cultural cachet as the tyrannosaurs, "raptors", or other famous dinosaur tribes. But the therizinosaurs really do deserve more popularity. Although they were cousins of the carnivorous, sickle-clawed deinonychosaurs, the therizinosaurs were long-necked, pot-bellied omnivores and herbivores, albeit ones that had insanely long claws on their hands. They are some of the strangest dinosaurs ever found, and a track discovered in Alaska adds a few flourishes to our picture of the therizinosaurs.
Paleontologists Anthony Fiorillo and Thomas Adams describe the trace fossil in the new issue of the journal PALAIOS. Discovered in the roughly 70 million year old rock of Alaska's Denali National Park, the track is the impression of a dinosaur's hind foot. Exactly what genus of dinosaur left the footprint is unknown, but, based on the arrangement of toes and other details of foot anatomy preserved in stone, Fiorillo and Adams narrowed the list of candidates to an as-yet-undiscovered therizinosaur that must have once walked in southern Alaska. The four large, slender, and forward-facing toe impressions were the key – no other group of dinosaurs had feet quite like that.
The lone track is the first record of a therizinosaur from Alaska. And even though the Arctic habitat the dinosaur lived in would have been a bit warmer than Alaska today, this wasn't a steaming jungle or warm swamp. As Fiorillo and Adams point out, Alaska's Cretaceous dinosaurs would have experienced short summers and long, dark winters. Just think of something like Nothronychus shuffling through the snow during the extended Arctic night. The image is wholly different from the dinosaurs I first met as a kid, and the unconventional setting is perfect for a creature that has pushed the boundaries of what we think a dinosaur is.
Fiorillo, A., Adams, T. (2012). A THERIZINOSAUR TRACK FROM THE LOWER CANTWELL FORMATION (UPPER CRETACEOUS)
OF DENALI NATIONAL PARK, ALASKA PALAIOS DOI: 10.2110/palo.2011.p11-083r
Sign up for our free email newsletter and receive the best stories from Smithsonian.com each week.
4 Comments »
He reminds me of one of the large ground sloths!
There's your Sasquatch right there!
@psweet: Therizinosaurs remind other people of ground sloths, too, so much in fact that one of them is named after a ground sloth: Nothronychus ("sloth claw")!
This means we may find therizinosaur fossils in Hell Creek one day… :O
RSS feed for comments on this post. TrackBack URI


text:
FEMA Tribal Affairs
Tribal governments and their members are an essential part of our nation's emergency management team. Effective relationships with tribes are necessary to fulfill FEMA's mission of working together to improve our nation's disaster preparedness and response. FEMA is committed to supporting Indian Country in its efforts to build more resilient and better prepared communities.
Along with the need to ensure the safety of tribal communities and tribal lands in the face of disasters, FEMA shares the U.S. government's unique government-to-government relationship with federally recognized tribes. FEMA acknowledges the sovereignty of federally recognized tribes and is committed to enhancing our working relationship with tribal governments to improve emergency and disaster responsiveness throughout Indian Country.
Highlights & Updates
Active Tribal Consultations
Proposed Tribal Consultation Policy: This policy will establish a process to guide FEMA officials on how to engage Indian tribes and Tribal Officials in regular and meaningful consultation and collaboration on actions that have tribal implications. FEMA is currently accepting comments on this proposed policy until March 3, 2014.
Now Available:
Process for Tribal Governments to Request a Presidential Declaration
On January 29, 2013, President Obama signed the Sandy Recovery Improvement Act, which amended the Stafford Act. The Act included a provision to provide federally-recognized Indian tribal governments the option to request a Presidential emergency or major disaster declaration independent of a state. To help tribal governments in considering whether to request a Presidential declaration, FEMA provided overview and FAQ documents of the current procedures to make a declaration request.


text:
Learner's Edge Pure Kids Natural Detoxification, Capsules
Size/Count 90.0 ea
- Nature's support for natural detox
- Supports hepatic detoxification
- A dietary supplement
Receiving Options
Check product availability at a Walgreens near you.
! Please enter a valid ZIP code
We apologize for the inconvenience. Our systems are experiencing difficulties and there was a problem connecting to this service. Please try your request again later.
There are no walgreens stores within 25 miles of .
! Please enter a valid ZIP code
We apologize for the inconvenience.Our systems are experiencing difficulties and there was a problem connecting to this service. Please try your request again later.
There are no walgreens stores within 25 miles of .
Enter ZIP Code:
Stores near Change See only stores that have it
No results found for your search. Verify your location, or try a new search.
In-stock status is approximate and is subject to change without notice.
Pricing may vary by location and may not reflect online pricing.
Size/Count 90.0 ea
Receiving Options
Dietary Supplement
Nature's Support for Natural Dextofication*
PureKids™ is a dietary supplement designed to support hepatic detoxification in children.*
Contains no sugar, salt, yeast, wheat, gluten, corn, soy, dairy products, artificial coloring, artificial flavoring, or preservatives. This product contains natural ingredients; color variations are normal.
*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.
Take 3 capsules daily with food, or as recommended by your healthcare practitioner. For best results, take 2 or 3 divided doses. If desired, capsules may be opened and contents mixed into cold food.
©Integrative Therapeutics, Inc.
If pregnant, nursing, or taking prescription drugs, consult your healthcare practitioner prior to use.
Nutrition Facts | ||
Serving Size : 3 Capsules Serving per Container : 30 |
Amount Per Serving | % Daily value* | |
Total Carbohydrate <1 g | <1 | |
Alpha Ketoglutaric Acid 250 mg | ||
Milk Thistle 150 mg | ||
Trimethylglycine 150 mg | ||
Choline 100 mg | ||
L Methionine 100 mg | ||
Taurine 100 mg | ||
Calcium D Glucarate 100 mg | ||
MSM (Methylsulfonylmethane) 100 mg | ||
N Acetyl Cysteine (NAC) 25 mg | ||
L Glutathione Reduced 25 mg | ||
Selenium 25 mcg | 36 |


text:
Quotes from authors born on Sep 17th
In Hollywood a marriage is a success if it outlasts milk.
Rita Rudner
Before I met my husband, I'd never fallen in love. I'd stepped in it a few times.
Rita Rudner
I do not bring forgiveness with me, nor forgetfulness. The only ones who can forgive are dead; the living have no right to forget.
Chaim Herzog
A man will go to war, fight and die for his country. But he won't get a bikini wax.
Rita Rudner
File sharing is our radio; that's the way people hear our stuff.
Guy Picciotto


text:
looking very crisp now, great job
looking very crisp now, great job
Kenny Carmody
Student for 3D-Modelling and 3D-Sculpting
ShowReel May2012 - http://vimeo.com/42027953
CGHub Portfolio - http://kc-production.cghub.com/
Blogfolio - http://kennycarmody-art.blogspot.de/
I started a new project ... I hope I'll finish this one this time.
She's a merchant ... and she got a giant toad carrying her stuff
I love it thus far. like too see more!
I love this to, love the creature design. I will keep my eyes on this thread
Thanks guys ! I kept working on this toad ... I almost done. Rendered with BPR, tweaked in Photoshop
Last edited by Guedin; 06-18-12 at 05:26 PM.
Amazing work partner!!
Carlos De Almeida Romanelli
Graphic Designer - Illustrator - 3D Generalist
My Blog
"The simplicity of the design is its true beauty."
Fantastic Work!
Really clean and great details. Keep it up!
Akin Bilgic | Modeler & Generalist
CGGallery.com - Portfolio Website
I agree with RockinAkin. Great work!
May I ask how you went about making the scrolls?
Nice work on this, and a lot of lovely tiny details!
A trick to avoid floating characters is to trim the base of their feet with clipCurve!
Can't wait to see this finished!
Thanks a lot for the kind words !
@Hendrik F : I did them in 3DS Max with spline and then soft selection. It was really quick.
Almost done with this guy. I'll take a step back from him and work on the girl, before making a final polish pass.
Also, I set up a livestream account to keeping me motivated : http://www.livestream.com/guedin
And here's some tweaks I'm planning to do :
Last edited by Guedin; 06-26-12 at 10:22 AM.
Duuuuuuuuuuuuuuuuuude!!! Awesome toad. Seriously this guys is really really cool! Great work!
Dom War V - Trianna - Goddess of Rage
"There is no tomorrow!"
-Apollo Creed
very cool
My Internets Page - http://www.vfxforge.com
Wow that is so cool, thanks for that scroll tutorial btw, I learnt something new today !!! listen if yu have the time could you tell me how did you make the rope, ive tried a few aproaches but no success ... thanks and again, awesome work !!!
Last edited by renthehungry; 06-26-12 at 11:19 AM.
Great attention to detail, and digging the mini-tutorials too!
Can't wait to see this one painted up.


text:
Child Health Insurance at a Price You Can Afford
• MIChild Brochure MIChild is a health insurance program. It is for uninsured children of Michigan's working families. MIChild services are provided by many HMOs and other health care plans throughout Michigan.
Interested in Applying for MIChild?
• Apply On-line Complete and submit your application on-line
• Get A Paper Copy of the Application Here View or download & print out the MIChild application.
Q&A About MIChild
• Answers to Frequently Asked Questions Brief information about who is eligible, what is covered, who provides services, cost, and how to apply.
Info for MIChild Providers
• Information for MIChild Providers Information for MIChild providers such as fee schedules, correspondence and the MIChild manual.
• MIChild Manual Full eligibility manual, covers general information, special populations, eligibility criteria, application process, application form, premiums, and other detailed information about MIChild coverage.


text:
The Soap Box Derby
The Soap Box Derby, a peculiarly American institution, thrives on the U.S. teenage passion for anything that has four wheels and goes fast-even if driven by gravity.
- By Paul Dickson
- Smithsonian magazine, May 1995, Subscribe
Museum catalog item 318011.1 was built and raced in the finals at Akron in 1961 by Robert Pusateri. It was donated to the Smithsonian by his father.
The official catalog description for item 318011.1 is simply "Car, soapbox." It is painted blue and carries on its side the name of its sponsor, the Hartford Times. Fair enough for a museum catalog. But to the boy who built it-now in his mid-40s-this item was not just a car but a racer and a means of transportation to one of young America's dreams of glory.
This particular racer ran in the 1961 All-American Soap Box Derby in Akron, Ohio. It was conceived early in the summer of 1960 by Robert Pusateri, then 11 years old. Robert had just lost a soapbox qualifier in Connecticut. His brother, Anthony, was about to race another car in Akron, but Robert was already deep into plans for 1961, the new "soapbox year."
By Columbus Day, though the only power tool Robert used was an electric drill, his new car had axle trees and floorboards roughed in. By Easter 1961, Robert and others had spent hundreds and hundreds of hours gluing, clamping and, especially, sanding and polishing the body to cut down drag.
By Derby rules the combined weight of racer and driver is limited. Because gravity is what drives soapbox cars and weight combats air resistance, competitors want to weigh in with their cars as close to the limit as possible. During the painstaking work of building the car and in the preliminary competitions to qualify for Akron, Robert had lost some weight. In order to compensate, he added heavier wood to the construction. "There is a lot of oak in that old car," he says today.
He took the Connecticut Championship and qualified for Akron. But he lost out in the nationals, perhaps because his car might have been crooked in the starting block. Soapboxes are delicately balanced; they race at speeds upwards of 30 miles per hour.
Each year the cars that win the finals stay in Akron and are put on display in the Soap Box Derby Hall of Fame-76 of them to date. Most trips to Akron, however, are round trips. So Robert brought the racer home, and in 1975 his father, Anthony Pusateri sr., donated it to the Smithsonian (currently it is not on display). It had then-and still has-great meaning to the family, particularly Robert. He went on to study engineering and became a manager in the Polaroid Corporation. Like many past Derby contestants, he is convinced the discipline and effort that went into the racer helped him choose-and become a success in-his profession.
Since the Soap Box Derby got its start in the depths of the Great Depression, the story of Robert's racer, and its disappointing round trip to Ohio, has been repeated thousands of times. In 1933 a photographer named Myron Scott was photographing three boys, each sitting in a cratelike frame fixed to baby-buggy wheels, rolling down a bumpy hill in Dayton. Scott invited the boys to come back a week later and bring their friends-for a bigger race. Nineteen racers came. A considerable crowd gathered. One of the contestants was a local 12-year-old named Bob Gravett, who had painted the number 7 on his car-it was the easiest number to draw, he explained. An image of Old No. 7 has been used ever since on the official Soap Box Derby logo.
Subscribe now for more of Smithsonian's coverage on history, science and nature.
Related topics: American History Games and Competition
Comments (1) |
How do i find out what years i raced in the soap box derby? I believe the late 50's i raced in akron at the derby downs. i believe it was the first years the big hill was used for the local race. I'am 65, have both of my helments, but no years on them. any info would be super, really. Thank you, Bill
Posted by bill forrester on June 23,2012 | 10:54 PM


text:
Winnie the Pooh Disney Baby Girls Tracksuit with Sweat Top and JoggersYour little one will look stylishly sporty donning this lovely baby girls adidas Winnie the Pooh tracksuit featuring a sweat top and jogging pants with a striking cartoon print and 3 stripe logo detail. Contrast colour on this baby girls adidas Winnie the Pooh tracksuit adds an abundance of definition to the design for retro appeal. They'll be enthralled by the bright colour on the top that makes for an eye-catching finish. The tracksuit bottoms are cuffed for warmth and elasticated at the waist for adjustable comfort. This adidas baby girls tracksuit is the perfect pick for their everyday clothing. Add trainers or plimsolls to complete the look. Useful info:
View all adidas products | |
Please wait while we process your request
Please wait while we retrieve the user's information
Your bio is currently empty. Now is a great time to fill in your profile.
This profile is private.
This profile is under review.
Please wait while we send the email.
Email This
You may send this to 5 e-mail addresses. Please separate each address with a space.


text:
Sign Language Lessons: Common Phrases : Cleaning Phrases in Sign Language
Learn how to sign wash, clean, dirty, comb, soap, and toilet with American Sign Language (ASL) tips in this free online sign language video tutorial clip.
105 Minutes to Learn French
Learn French in 105 minutes? This is the creator's title, but of course, one can not learn French in such a short time. However, with this video, one can get a head start with some of the vocabulary words. The words are highlighted by a transparent red bar or red circle. The words are said once by a native speaker and there is no English definition, but the red indicators tell you what the words mean. (01:45:21)
FROM ENGLISH TO FRENC, Part #4 (starts with the letter 'L')
Each word appears on the screen in both English and French. Each word is said four times by a native French speaker. (33:47)
I Like Spring - Song
What season do you like? This song - with the text on screen - sings about the four seasons, and the types of weather that accompanies each.... The singer in this song - likes different korean foods - depending upon what season it is! The lyrics run across the screen as they are singing. Run time 01:34.
Collective Nouns - Knewton.com
This video defines collective nouns and then gives examples of collective nouns and how they are used. It specifically talks about how to determine what kind of verb to use with collective nouns. (2:02)
English as Second Language Vocabulary Lesson-Verbs
This video helps to improve English vocabulary and pronunciation. The focus of this video is verbs (playing, cleaning, climbing, cooking, etc.). A matching picture is shown while the commentator says the verb and then uses the verb in a very simple sentence (He's climbing). This is a good resource for our English as Second Language Learners and for the typical classroom as an introductory lesson for verbs (1:52).
Helping Verbs Lecture
This lesson is a lecture about helping verbs. The instructor discusses different helping verbs and provides examples and a few chances to practice selecting helping verbs to complete a sentence.
IRREGULAR VERBS - Past and Past participle form
A slide show which lists the base form the past form and the past participle form of irregular verbs. There are images that show the meaning of the verb. Run time 05:32.
Irregular Verbs-The Past Tense
An English teacher shows the simple and past tense forms of irregular verbs. The video is in lecture format with an instructor standing in front of a dry erase board. (05:44)
Spoken List of Irregular Verbs
This is a video clip that teaches about irregular verbs by showing example of irregular verbs. Irregular verbs are shown on screen and turn red as speaker says aloud the word (Running Time 3:04).
Washington's Birthday
This is a video clip about George Washington. George Washington was born on February 22nd, 1732. His birth date is a holiday. (Amateur video aimed at ESL students.)
How Elevators and Pulleys Work
This is a short (01:08), but well-done, simply-animated video (with narration) that shows how elevators and pulleys work.
What Is an Electrical Inverter?
An electrical inverter is a device that can create an alternating
current from a direct current, allowing the current to go backwards and forwards instead of in only one direction. Find out how an electrical inverter works from a science teacher in this
Addition and Subtraction of Decimal numbers
The concepts of addition and subtraction of decimal numbers are explained using real life examples. Instructor uses a place value chart for demonstration.
Rap Video: Converting Fractions, Decimals, and Percents
Rapping teacher explains how to figure improper fractions and percents. Pretty decent rap with cool animations of the numbers. Grades 7-10. 2:33 min.
Basic Math: Lesson 6 - Video Clip #9 - Arithmetic of Fractions: Addition
Concepts covered: Addition of Improper and Proper Fractions and also Mixed Numbers.
Multiplying Two 3-Digit Numbers Quickly
This video shows how to quickly multiply together two 3-digit numbers without writing down the partial product with some practice.
Basic Addition With a Number Line
Introduction to addition strategies. Teacher demonstrates counting objects and constructing a number line, Instructor demonstrates while using an interactive whiteboard. (7:42)
The 7 Times Table
It doesn't get much simpler than this. This slide show features the 7 times table. (:58)
Multiplication Facts for the 8s
Set to music, students will have the eight times table memorized in no time. Equations appear one by one on a slide with a black background. Call and response chants for each equation. Repeats several times. (6:23)


text:
Located in Metro North Atlanta Georgia we provide a complete line of home inspection needs for the entire Metro Atlanta Georgia area. Read more... Visit website www.ineedaninspector.com
See-Thru House
Expanding on this need of education for home inspectors and home owners Mr. Garnet and others created the See-Thru House which is displayed two times a year at the Atlanta Home and Garden shows every Spring and Fall.
With professionals on site at the SEE-THRU HOUSE™, homeowners and buyers can ask questions about the latest security technology or how to keep their basements dry or even prevent water damage," says Garnet. "Where else can a homeowner ask a Pro a question without getting a bill?"
Available twice a year at the Atlanta Home Show
Read more…
In 2007 Mr. Garnet established an organization, Consult a Home Pro, of reputable contractors to provide home owners repair and remodeling services.


text:
This sugar canister from Garden Trading is rustic in style and features a chrome handle. In a beautiful shade of clay this is a must have kitchen accessory, providing invaluable work-top storage. It is printed with the word sugar on the front and there are matching kitchen accessories from Garden Trading also available, including tea and coffee canisters.
Garden Trading is passionate about designing and producing high quality, original accessories, and they strive to make their products using responsibly sourced materials, within the EU wherever possible and from ethically-responsible manufacturers.
UK delivery £3.95*Next Day delivery is £5.95 and Saturday delivery will be charged at £9.95.
Free for orders over £70
Other customers have given their feedback on this product:
Excellent: | 3 |
Good: | 0 |
Poor: | 0 |
Bad: | 0 |


text:
As a couple, we stayed for around NZD75 for one night Decent rooms with ensuite Nice little backpackers - some rooms have nice view of inlet Bonus was free bike usage (though they are a bit run down), and use of good shared kitchen Lovely little town, recommend a short stay Good driving access from here North to Hot Water... More
- Also Known As:
- Tairua Backpackers Beach Villa New Zealand, South Pacific
- Official Description (provided by the hotel):
- A social atmosphere where mature travelers can relax in comfort and enjoy the ideal location for day trips around the Coromandel Peninsula. Hot Water Beach and Cathedral Cove just 20 min drive north. Lovely walks, great fishing and beautiful surf beaches - something for everyone. ... more less


text:
MAM FreeBass 383
Another monophonic analog TB-303 clone! The FB 383 is a re-packaged version of the MB 33 with a special front-panel design as part of an exclusive deal with Turnkey music shop UK. Just like the MB 33, the FB 383 offers all the same basic sounds and controls as the original TB-303 in a 1-unit rack module. It has just 8 basic knobs for the same basic 303-like control: tune, filter cutoff, resonance, envmod, accent and decay. Unlike the 303 however, the oscillator can be varied from sawtooth to square from a knob on the front! Also featured is an external audio input to the filter for processing other elements.
The FB-383 makes a decent 303 sound however it lacks too many functions that should be there. Controls do no send or receive MIDI and there is no memory for storage of your own sounds. However, at its low price tag, you get what you pay for and for a quick and easy 303 the FreeBass comes in handy!
Throw me a line @ mooseheadmoosic [at] gmail (dot) com.
It's a 303 clone, but it does not really sound exactly like 303, but for me it doesn't matter at all! I've had it for several years now and it's for keep :)
- Demos & Media
Modded FB383 sequenced by X0xb0x + dr550Audio Clip 1 - Listen to a few various 303 type patterns created on a FreeBass 383.
- Specifications
- Polyphony - Monophonic
- Oscillators - 1 VCO
- LFO - None
- Filter - Cutoff, Resonance, EnvMod
- VCA - Accent, Decay
- Keyboard - None
- Memory - None
- Control - MIDI
- Date Produced - 1996
- Resources & Credits
Images from Perfect Circuit Audio.
Errors or Corrections? Send them here.


text:
CHALK PAINT® 101 workshop Saturday 10/19 10am-1pm
http://www.ArtisticHomeStudio.com/workshops.htmlfor more information.
CHALK PAINT® 101: Learn to use Chalk Paint® decorative paint by Annie Sloan to makeover old furniture, give cabinets new life, or add color to your home. Find out what all the excitement is around this no-sanding, no-priming, no-stripping, EZ, DIY friendly paint! You will leave inspired, with samples and the confidence to complete your own projects at home with great results! Visit
+ Leave a Comment
- Menlo Park-Atherton Patch Editor
- Dave Colby
- firstname.lastname@example.com
Copyright ©2013 Patch. All rights reserved.


text:
Alzheimer's walk at Shelby Farms this weekend
Do something fun this Saturday, September 15, and join hundreds of Mid-Southerners at the visitor's center at Shelby Farms for the Walk To End Alzheimer's.
The walk begins at 9 a.m.
The Alzheimer's Association Walk to End Alzheimer's is the nation's largest event to raise awareness and funds for Alzheimer's care, support and research.
Held annually in more than 600 communities nationwide, this inspiring event calls on participants of all ages and abilities to reclaim the future for millions.
Together, we can end Alzheimer's disease, the nation's sixth-leading cause of death.
You can register and walk for free by going to http://www.alz.org


text:
Please enter your current email address to receive instructions on resetting your password.
Your password has been reset. Please check your email for further instructions.
You are sending a link to the page. Please completely fill out the form below.
Add an additional message below.
The URL for the page will automatically be added to your message.
Through Tuesday, December 24, 2013
$179+tax for 2 people
Linden Row Inn and RVA Trolley Company invite you to enjoy a one night getaway where you and a guest will enjoy a relaxing ...
Through Monday, February 17, 2014
$285 per room, per night
Join us at The Jefferson Hotel for the blockbuster exhibition, Hollywood Costume, at the Virginia Museum of Fine Arts. This ...
Through Friday, March 14, 2014
$660 for two people, plus tax
Hike a half-day with Melanie Perl, someone who has hiked the Blue Ridge mountains for over 20 years! Customize the type of half-day ...
$850 for two people, plus tax
Fly with John Corradi of Blue Ridge Biplane Rides in his open-cockpit 3-place 1942 Waco ZPF-7 for a breath-taking view of the Blue ...
Through Thursday, November 20, 2014
$550 for two people, plus tax
No experience necessary! Let American Canoe Association certified kayak instructor, Beth, teach you basic kayaking skills and lead you ...
Through Wednesday, December 18, 2013
Will be responsible for all fees.
Nestle into Nelson County by getting cozy in the 160 year-old home now known as the Afton Mountain Bed & Breakfast ...
Through Monday, December 30, 2013
$24 daily resort fee
$150 Resort Credit has rolled in with the Tides
Escape to this Chesapeake hideaway and take advantage of a $150 resort ...
Through Monday, June 30, 2014
This charming gazebo in the Wintergreen area offers views of the mountains and rural countryside. It is the perfect setting for a ...
Through Sunday, February 16, 2014
$18 Valet parking per car per day
Hollywood comes to Richmond at the Virginia Museum of Fine Arts with the Hollywood Costume Exhibit!
Hollywood Costume explores ...
Through Monday, January 13, 2014
package price includes hotel accommodations and two adult tickets to Dominion Gardenfest of Lights
Celebrate the holidays with a visit to one of Richmond's greatest traditions at Lewis Ginter Botanical Gardens for the Dominion ...
Order your Free 2013 Virginia Travel Guide.
What's going on around Virginia? Subscribe to the Virginia eNews.
Thank You! For subscribing to the Virginia eNewsletter. You will begin receiving 2 email newsletters each month.
View Our Newsletter Archive
Online Travel Guide
Virginia Green
Weather Forecasts
Virginia iPhone Apps


text:
On View: Betsey Beckwith
This portrait depicts one half of a prominent couple from Dutchess Country. Nathan Beckwith was a land surveyor and his wife was the sister ...
Browse by Decade
Hiroshige's One Hundred Famous Views of Edo
Hiroshige's 118 woodblock landscape and genre scenes of mid-nineteenth-century Tokyo, is one of the greatest achievements of Japanese art.
On View: Hollow Head of a Crocodile
In the Old Kingdom (circa 2670–2195 B.C.) silver was more valuable than gold, but this grad...
Forgot your password?
Brooklyn Museum Posse:Exploring the collection
When you join the posse, your tags comments and favorites will display with your attribution and save to your profile.
Found 13218 Items Tagged "1844-1818 B.C.E"


text:
Hot-button issues
Senators revamp '07 immigration proposal
Weapons ban in peril in Senate, Feinstein says
The Daily Briefing
Buckeye Forum Podcast
The Dispatch public affairs team talks politics and tackles state and federal government issues in the Buckeye Forum podcast.
Your Right to Know
WASHINGTON — Leading Senate Democrats and Republicans said yesterday there were encouraging signs in the push to overhaul U.S. immigration laws — a top priority for President Barack Obama's second term — and they would introduce their plan this week.
With Obama set to begin his push for immigration reform with a speech on Tuesday in Las Vegas, three Democratic and three Republican senators have been working for weeks on a plan.
One of those senators, John McCain, R-Ariz., said on ABC's This Week program that the group still had hard work ahead, but he was pleased with the progress and the principles of a comprehensive plan would be put forth this week.
McCain said the plan was much like a 2007 immigration proposal that died during the presidency of George W. Bush. That plan included a path to citizenship for undocumented immigrants, tighter borders, a guest-worker program and requirements for employers to verify workers' immigration status.
Obama, who received overwhelming support from Latino voters for his re-election in 2012, cited immigration as part of his agenda when sworn in for a second term last week.
McCain said the political aspect of immigration reform should sway any Republicans who object to a pathway to citizenship for undocumented immigrants.
"We are losing dramatically the Hispanic vote, which we think should be ours, for a variety of reasons, and we've got to understand that," he said.
McCain said change also was needed because "we can't go on forever with 11 million people living in this country in the shadows in an illegal status. We cannot forever have children who were born here, who were brought here by their parents when they were small children, to live in the shadows, as well."
On another high-profile issue, Sen. Dianne Feinstein, D-Calif., who is leading the charge to revive a U.S. assault-weapons ban, conceded just days before hearings on gun control open that winning Senate passage for her bill will be tough. But she said she has been assured she will have the chance to bring it up for a vote.
Obama, who has made gun control a top priority after 20 children and six adults were killed by a gunman on Dec. 14 at a Connecticut elementary school, said in remarks published yesterday that gun-control advocates should take into account the views of rural Americans who use guns for hunting.
"Part of being able to move this forward is understanding the reality of guns in urban areas are very different from the realities of guns in rural areas," Obama told The New Republic magazine.
Feinstein said Majority Leader Harry Reid has promised that even if the assault-weapons ban is left out of a broader package intended to curb gun violence, she will have the opportunity to offer it as an amendment on the Senate floor.
"This has always been an uphill fight. This has never been easy. This is the hardest of the hard," Feinstein said on CNN's State of the Union.


text: This is such a beautiful place and its right in the heart of the city! I go here all the time since I live in the city. I love it here; it's a great place to sit down and rest and also to have a few minutes of silence. It's a very popular place for locals and for tourists all... More


text:
Origin: China
Leaf Type: Black Tea
Taste: Rich and Malty
Drink: With or Without Milk
Brew: 3-5 minutes according to taste with water off the boil
When to drink: Throughout the day
Assam, the land of storm clouds and rolling fertile plains, is where a small-leafed, strong-tasting wild tea was found by the British in the 19th century. Since Mr Whittard's day, we have been selling this gloriously strong and rich amber tea. We still use leaves rolled in a traditional method to give our blend its strength and malty character.
Assam Loose Tea Pouch
Item Code: 271106 / Net weight: 125g / 4.41oz
Our Price: $9.25
Out of stock
Recently Viewed
Product Reviews
Not a strong and malty as many Assam's however it has a beautiful aromatic quality with a bright freshness. Unlike most Assam's this is perhaps better suited to an afternoon rather than morning cup of tea.
A really high grade Assam at a really sensible price. Brilliant.
lovely strong flavoured tea
1 star is just too much of a rating for this extremely weak and tasteless assam, cheap supermarket teabags are stronger and have more flavour.
(written by someone with 20 years experience with assam tea, and backed up by another person with over 40 years experience)
again excellent product but no longer available in 500g
All Whittard of Chelsea US deliveries are made by courier.
If we do deliver to you at home and no one's in, our couriers will leave a card telling you about how to collect your delivery or rearrange the delivery. Any unclaimed or undelivered orders will eventually make their way back to our warehouse.
Whittard of Chelsea does not recommend tha customers leave instructions to our couriers for your goods to be left outside your delivery address.
All US orders are shipped from our warehouse in the UK and may be subject to additional customs charges. Please be aware that Whittard of Chelsea is not liable for these charges.
Our United States deliveries are charged by weight. Once you have finished shopping and are ready to complete your order, the delivery charge will appear in the checkout pages. Please allow up to 14 working days for United States deliveries to arrive.
- Up to 11 pounds (5kgs) $5.00
- 12 to 44 pounds (5.1 - 20kgs) $37.50
- 45 to 77 pounds (20.1 - 35kgs) $60.00
- 78 to 110 pounds (35.1 - 50kgs) $82.50
We deliver to the UK and to international countries. Should you wish to deliver an order outside of the United States, please visit our website www.whittard.co.uk.


text:
13 Meetup Groups match "French Culture" near Brookline, MA
Meet local French language and culture lovers for conversation and fun! Come to a French Language Meetup and make new amis as you practice speaking, build your vocabulary and finally figure out those verb conjugations! All ages and levels welcome.
This is a group for parents and childcare providers who are interested in speaking French to their children. This is both for native speakers of French as well as learners of French at every level. The only requirement is that you are dedicated to speaking French to your child. We will meet up to have French playgroups and attend family-friendly French language and cultural events.
This group offers an alternative to many enthusiastic francophiles eager to learn the language. This is your opportunity to start or continue learning French! These classes held online are relatively small but conducive to healthy exchanges while allowing personalized help from the instructor. Yes, students do get to converse with fellow students of the same level who are attending the class simultaneously. A native speaker with fifteen years of experience teaching in a French Lycée, I can help …
¡Saludos a todos hispanohablantes! Salutations à tous francophones! This group is for anyone interested in learning, practicing and conversing in Spanish or French. All levels of speaking ability are welcome, from beginner to native. Feel free to bring along a text book, phrase book or dictionary, and don't hesitate to ask questions if you don't understand. We will generally meet every Tuesday to converse in Spanish, and every Thursday to converse in French. All meetings, regardless of language. …
There are no upcoming Meetups.
This story time is designed to introduce babies, toddlers, and preschoolers to a second language by reading stories in French, singing French songs, and making crafts.
There are no upcoming Meetups.
We connect French & US professionals with innovators and entrepreneurs in Cambridge or Boston, MA. At our events you can pitch, grow your business, and network with innovative startups in both tech and non-tech industries. We also cover the following topics: Big Data, IT Health, pitching your startup, and launching a US company.
There are no upcoming Meetups.
This group is for intermediate French speakers who may have studied French rules and tenses, but are now looking to become much better French conversationalists. This group helps you to create, refine, and practice, French conversation 'scripts' that you can use when you first meet new, French-speaking people, say at another meetup, at a gathering, on a train, or in a bar. When we first meet new, English-speaking people, we often cover the same topics: "Where do you live?"; "What do you do?"; "A …
There are no upcoming Meetups.
French Conversation Group! Bienvenue, C'est Facile! Similaire a la groupe "Boston metro-west French meet-up" meme endroit. A Panera Bread a Needham. A Bientot, RachelLE
A chance to meet and socialize with people from all over the world who share your passion for Europe. Meet Europeans living in the Boston area and non-Europeans who have an appreciation for European culture. Enjoy sharing stories and experiences living in Europe or places you visited in Europe. Get help planning for your future Euro vacations. Enjoy the opportity to learn from other cultures. Conversations will be in English but you might find a language partner and learn new languages. All …
There are no upcoming Meetups.
There are no upcoming Meetups.
New in the city? Love to eat out? Want to meet new people? Want to try different type of cuisine? Well this is a group for young, hungry and open-minded professionals interested in exploring Boston and its many international restaurants (Belgian, French, Indian, Spanish, Italian, Lebanese, Turkish, Chinese, Japanese,....). We would meet every other week for brunch, lunch or dinner. The meetup will be limited to 10 people, it is so much more enjoyable when we are not too big of a group and so muc …
Meetup details are available only to members.
Have you traveled widely? Always interested in other cultures and not sure why? Love to meet people from all walks of life and different cultures? Curious to learn new languages? Enjoy learning about and making a difference in the world? Well, you are not alone. There are French clubs and Spanish clubs- African clubs and Asian Clubs. The Global Citizens Meet UP is not about one culture or people, but about bringing all globally-minded people together to share, learn, and explore ways to create p …
There are no upcoming Meetups.
Fritanese: FRench, ITalian, SpANish, PortuguESE, and more Mix it up (one at a time) with one or more languages that you're working on, over lunch in Downtown Crossing.
Get an alert email when new Meetup Groups like this start near you.
You'll get advice, help finding members, and tools to make running a Meetup Group easier.


text:
Last Updated on 25 Aug. 2008, Total: 13 Knowledge Base Tips
This article explains a single command you can use to update the Group Policy settings on remote computers. Please note this applies to Windows 2000 Computers only!... Read More
This article explains why Microsoft's new workplace join feature could make the Bring Your Own Device trend much more appealing to administrators... Read More
In this article we'll review the changes to the Server Message Block (SMB) protocol in Windows 8 and Server 2012 (SMB 3.0) and in Windows 8.1 and Server 2012 R2 (SMB 3.02)... Read More
How to create easily a Windows PowerShell array... Read More
This tip explains the use of Windows Troubleshooting Packs from command line... Read More


text:
I just joined the club and got my bag tag last week and I had a few questions.
From the bag tag rules it sounds like there used to be a section on the forum for posting challenges, reporting results, and tracking the tags that everyone has. What happened to it?
Does the club keep track of what tag # everyone has? Is there a list somewhere?


text:
Home » News » Business
Car World sold to national firm
LKQ Corp., a publicly traded auto parts firm, has purchased Car World, located at 134 Raymond Road in Candia, from Jeffrey S. Kantor.
Terms of the sale were undisclosed.
"All the employees will be remaining there which was important to me," said Kantor, who will be 69 in July, in a telephone interview. There are about 20 employees.
"We not only look at the quantitative side of our acquisitions but the qualitative side of our acquisitions. Obviously Jeff built an exceptional business that we are excited to add to the LKQ network," Joseph P. Boutross, LKQ's director of investor relations, said.
Kantor built the business from his 1977 purchase of Murray's Auto Parts, then near the Massabesic Traffic Circle in Manchester, where Capital Auto Auction is now.
He changed the named to Car World in 1990 and moved the business to Candia.
Kantor, who is still working as a consultant to LKQ Car World, said, the business is donating a motor home to the Loki Wolf refuge in Chatham on Monday.
Kantor, a Dunbarton resident, has been active in the New Hampshire Prostate Cancer Coalition since being diagnosed and treated for prostate cancer 13 years ago.
Kantor said he decided to sell the business after learning about a year ago that the disease had returned and spread.
"That's why I'm so active with the prostate cancer coalition because men don't think about prostate cancer," he said. The coalition is running an ad this Sunday — Father's Day — urging men to go talk to their doctors.
LKQ also owns LKQ Keystone Automotive at 101 E. Industrial Park Drive in Manchester.
Chicago-based LKQ is traded on the New York Stock Exchange under the symbol LKQ. It operates more than 450 facilities, with a presence in the United Kingdom, Canada, Mexico and Central America.


text:
The visiomatic® System paves the way so you can easily access global and personal information, using the visiomatic® information filter.
You can search the Internet, read or write your emails, check the weather for any country or city of your choice, look for cooking recipes and any other information using the visiomatic® screens.
Related links
Have we raised your interest?
Please contact our Sales Team.
The visiomatic® traffic screen Austria informs you about the actual traffic news in Austria: Traffic jams, risk or location of traffic accidents or construction zones.
You can switch between the austrian regions or Alpine passes according to your needs. On the right you can see the short review of the road holding for the selected region. You will find a detailed description of the road holding at the bottom of the screen.To scroll up and down you can use the navigation arrows of the menu bar.
You are allways on the safe side with the visiomatic® Traffic screen.
- Shows the traffic news:
- traffic jams
- risk of traffic accidents
- location of construction zones
- Regions and freeways choice
- Road maps of the selected regions
- Current time and date


text:
Don't forget to check our constantly-updated Los Angeles Concert Calendar Monday, October 7 Fiona Apple & Blake Mills WALT DISNEY CONCERT HALL Singer Fiona Apple and guitarist Blake Mills are calling their current tour of a dozen North American cities Anything We Want, after the surreally hopeful ... More >>
The long, hard truth
More than ever, boiling this concluding year down to the 10 "best" movies feels both arbitrary and reductive. Ideally, I'd have 25 unnumbered slots. I'd cite another five, formally varied nonfiction films: Tchoupitoulas, Detropia, The Ambassador, Only the Young and How to Survive a Plague. And were ... More >>
The San Fernando Valley doesn't come to mind when you think "iconic clubs," but in the 1980s the West Valley was the place to see acts like Tom Petty, Merle Haggard, Metallica and U2. See also: What Makes the Hollywood Bowl So Perfect? The Reseda Country Club, located on Sherman Way near Reseda B ... More >>
Paul Thomas Anderson excels at coaxing brilliant work out of his collaborators -- which, on his last two features, specifically means not only his leading men but also composer Jonny Greenwood and cinematographers Robert Elswit and Mihai Malaimare Jr. -- and directing them so expertly that he distra ... More >>
See our other Toronto Film Fest posts, including: *Cloud Atlas, by the Wachowskis *Threesomes at the Fest, Including James Franco Vanessa Hudgens *Joaquin Phoenix in P.T. Anderson's The Master As the summer of self-plagiarism comes to a close, add Terrence Malick to the list of those accused of t ... More >>
There's something startlingly noncommittal about many of the initial reviews of The Master that leaked out following the impromptu screenings writer/director Paul Thomas Anderson organized in 70mm-equipped houses across the country, and later in response to the film's official bow at the Venice Film ... More >>
Paul Thomas Anderson on his new 70 mm film
Last night a lavish postmodern public masturbation session went down at the Rockwell in Los Feliz, with a full cast performing the movie music of director Paul Thomas Anderson. The show, titled For The Record: Boogie Nights, also featured music from other Anderson films including Magnolia, Punch Dru ... More >>
A group of angry apocakids from the video for Foster the People's "Helena Beat" (Sony Music)As the debt ceiling languishes unraised, whole regions of the US lie under floodwaters while others dry into baked earth, and the wedding cake topper industry finds itself facing major overhauls, peopl ... More >>
D-Bird's Peter WalkerAs Thom Yorke announced at Radiohead's fantastic surprise show at the Fonda on Sunday night, the benefit gig raised -- "fuck me," exclaimed Yorke -- $572,754 for victims of the godawful Haitian disaster. Tickets were sold by auction, which made it possible for inspired at ... More >>
Editor's note: West Coast Sound is thrilled to introduce to our blogging world the director Jason Reitman, whose new film, Up in the Air, has just opened in Los Angeles and New York, and opens across the country on December 25. The movie stars George Clooney and Vera Farmiga, it's true, but like his ... More >>
Although the official start of Fall is still a couple of weeks away, Hollywood's Autumnal Equinox is already upon us, as the books are closed on the 2009 summer movie season and the curtain goes up on the Toronto International Film Festival, the still-humid summer air starting to hum with the fir ... More >>
(Some serious gourmet shit)
Battle RoyaleWhen Ella Taylor asked me to rename my top five films of all time, I tattled off the obvious titles. She then asked, "Any since the last 17 years?""In my top five?" I asked incredulously. "Well, okay, top 10," she relented."Well, let me think about that."And upon later reflection, I rea ... More >>
Nikki DarlingThe studio formerly known as Rumbo, where "Rocket Queen" was recorded It was a time when the Valley lingered somewhere between Frank Zappa's ramblings and a real life version of Paul Thomas Anderson's Boogie Nights. A mix of agriculture, dust, white wagon wheels, diners, car dealershi ... More >>
Somehow, I doubt that Paul Thomas Anderson is going to love this so much that he'll grab it to hang in his house the way Murakmai did with Augor and Revok's piece a couple of weeks ago. Shelley Leopold got this picture of an excellent billboard liberation project done by Augor at Melrose and Man ... More >>
There Will be Blood director on making his masterpiece, and how baseball may have saved him
Support group
Blood soundtrack, Caltroit mixtape and No Disco Future
Annus mirabilis
No argument about this list
As his fourth film in a decade arrives in theaters, the movies most enigmatic leading man reveals the method behind his onscreen madness
Cinematheque exhumes the American new wave
12 Steps to better box office
Thinking about Deep Throat
Dog Days and the New Austrian Cinema
Wes Anderson�s road to fame
Edited by Kateri Butler
Wrong turns on the road to Wonderland
Sandler runs with Punch-Drunk Love (plus Bowling for Columbine)
The 55th Cannes film festival
A few of our favorite reads this year
The best of '99
Paul Thomas Anderson's third symphony
Doug Liman's gone Go


text:
Proper Use
A doctor or other trained health professional will give you this medicine. This medicine is given through a needle placed in one of your veins before you have a SPECT scan.
You will need to urinate right away and as often as possible for 48 hours after receiving this medicine. Drink plenty of fluids before and after receiving this medicine so you will pass more urine.


text:
- November 25, 2012
- 2:16 p.m.
- Suggest removal
- Reply to this post
trulytex writes:
in response to CUPCAKE2012:
Dear George: my small business has been doing better every year for the past 4 years. It was the year before that... when I lost my job due to the crashing economy, that I created my small business. I expect this year to be the best of all. I love this country no matter what...and suggest you move to another one where life will be better for you. I am sure there is a place out there where everything is done as you would like it to be.Today I am thankful & grateful for the United States of America and it's citizens who support my small business. And a big thank you and prayers to the troops who protect us.
You must be in the Repo Business. I hear that business is BOOMING!
Want to participate in the conversation? Become a subscriber today. Subscribers can read and comment on any story, anytime. Non-subscribers will only be able to view comments on select stories.


text:
Central Scotland, with an overall average price of £141,275 was more expensive than nearby Glasgow and Surrounding Areas (£133,956) and South West Scotland (£122,853), but was cheaper than Edinburgh and Lothian (£202,437). The priciest area within Central Scotland was Stirling (County) (£176,893) and the least expensive was Falkirk (County) (£119,369).
During the last year, sold prices in Central Scotland were similar to the previous year and 52% down on 2007 when the average house price was £297,376.


text:
You're watching...
Crash survivors describe plunge off cliff
Race car drivers Jeremy Foley and Yuri Kouznetsov walk away from treacherous fall
Aug 16, 2012
Jeremy Foley & Yuri Kouznetsov
You're watching...
Race car drivers Jeremy Foley and Yuri Kouznetsov walk away from treacherous fall
Aug 16, 2012
Jeremy Foley & Yuri Kouznetsov
Also in this playlist...
Auto-advance: ON
Auto-advanceThis transcript is automatically generated
Eight minutes before Cavuto washing machine of -- man.
Look at this.
-- Where's the last year have Blanchard -- that's one race car driver -- describing the crash after his car careened off the side of the mountain and Colorado.
That Mitsubishi rolled over and over more than a dozen times -- -- pikes peak international hill climb on the Sunday.
Believe it -- not into guys in that car survived no serious injuries.
Here's the view from inside the -- seen this before let's watch together right.
Fans call this part of the mountain the devil's playground in the way we go left.
Well the guys behind that with the guys in the car here Jeremy Foley and -- -- in itself.
Close enough right all right you get a -- -- -- -- located shoulder you both have all kinds -- witness in the eyeballs.
I guess he -- burst blood vessels in your eyes you in the left in you in the right Iraq.
And this helmet will get to that in a minute what.
Did you know what was happening.
I did you know I did the secondly -- off the cliff that it was going to be a horrific crash and and unfortunately had to.
To be conscious for the whole ordeal.
Every impact every Toro every twist.
And then you get to the bottom and are you -- yourself feel like them.
I would have thought I'd have been dead after that -- you fill a football field plus plus fifteen hour.
Were you surprised when you got to the bottom that the breathing was still happening.
Definitely holidays because I actually got knocked out there and one of the roles so we got -- the bottom of being hit that we took -- thankfully slowed us down.
That's when.
Lights out for me Jeremy was like -- -- -- may be looking -- actually be -- -- the whole thing but when I came to -- the -- everywhere and are we there we hear what's going on so how long was it until somebody got to you actually pretty.
Quickly I would say from the point that we came to arrest two.
The point that we had a first responder on site was made even under a minute while -- who it was quite remarkable.
Technically I did help -- out of the car first though we had people on site immediately.
You guys were aware they call this turn the devil's playground -- yeah.
And and then he went up there -- -- known.
At the it's hard to say but over seventy miles an hour if I were your father let's say you're in tough but I'm not you know -- -- -- had some of the helmet.
This this is -- wearing.
And this was a pretty red -- -- before it started out.
Com you -- it's clear they're cracked here in the -- see there's this all the way through there and no one -- -- time just completely flimsy.
And then a bunch or rocked amateur in the side where you see this is -- my head pretty malicious contacted straight Roch the guessing it was.
I mean it's you guessing that's where you get knocked out either that are aware that cracks happened to us yes.
For -- it was like seven washing machine of violent washing machine -- -- so.
I -- am guessing that after this violent washing machine of pain in this horrific incidents that -- you're going to get right regulatory news again right.
Not right back in good.
A good at least -- to tell the eventually while potentially.
Well it was great video to watch what a -- change that change the race or could they put one there.
You know I think a guardrail would do almost nothing at that corner the speeds are just -- -- Well maybe slow down.
-- it's fun to watch good -- man that was we've we've we've we've made a lot of money off -- video.
We'll be back.
Filter by section


text:
Spring has sprung … and the Cubs have finally come out of hibernation, as the girls cruised to a 7-2 victory Friday afternoon,
April 26, over non-conference opponent Long Prairie/Grey Eagle.
Kimball first-year coach Eric Primus was excited for the new season.
Lexi Rose picks up the win for the Cubs in the season opener. Staff photo by Marguerite Laabs.
Records fall at Maple Lake Relay Meet
The EV-W-K track and field teams got together Thursday for an exciting competition at the Maple Lake Coed Relay Track Meet. This type of meet is a bit crazy, as far as how so many different athletes square off in so many different events and races. EV-W-K's Austyn Schlueter broke the school record for shot put again, for the second week in a row. The shot put team took second place with the efforts of Austyn Schlueter, Matt Benson and Tyler Smith; and the ladies shot put relay team of Ariel Laabs, Raevon Wilner and Kaylee Petty. The high jump team of Connor Wittenberg, Kirby Knutson and Austin Marx, finished second, with the ladies high jump relay team of Tiffany Kuechle, Emma Kuechle and Hannah Ehlinger. The 800-meter medley team of Deshaun James, John Salzl, Austin Marx, and Austin Pelkey, took first place; while the 1600-meter medley relay team of Deshaun James, John Salzl, Austin Pelkey, and Kirby Knutson, also grabbed first place, breaking an all-time meet record in the process. The freshmen 4x100-meter relay team of John Salzl, Tommy Lochen, Tommy Newman, and Deshaun James, also took first place.
Senior, captain Kirby Knutson, from EV-W-K track team runs in the 1200 at Maple Lake Relay Meet. Kirby also competes in triple jump, high jump, and other runs.
Junior Cameron Hunt avoids getting hit by a stray pitch in the game v LPGE Thunder Friday, April 26. The Cubs would lose in their first game of the season to Long Prairie-Grey Eagle, 2-6. The Cubs were held to four hits, with two runs in the bottom of the second inning alone. Staff photo by Marguerite Laabs.
It is so hard to believe that a year has passed since my dreams came true, and I was crowned a 2012-2013 Stearns County dairy princess. This past year has been filled with so many incredible memories to last a lifetime. To quickly recap, the first large event was this past May when all six of the newly crowned dairy princesses competed at the May Event, a weekend training seminar and judging session to choose the 12 Princess Kay finalists.
Two of Stearns County's own dairy princesses, Kirsten Meier and Christine Reitsma, were named finalists, kicking off an exciting summer for the county. June 2, was the famous Stearns County Breakfast on the Farm held at Landwehr's Dairy in Watkins where more than 2,200 people were served breakfast and given farm tours. June Dairy Month continued on with multiple library visits, grocery store visits, and bank visits where we got to serve a lot of ice cream.
Here are the latest golf schedules for the Kimball-Eden Valley-Watkins girls' and boys' golf teams. Several meets have been cancelled; many more have been rescheduled.
Mon., April 29, 1:30 pm, at Lynx G.C. in Sauk Centre
Fri., May 3, 4:15 pm, CMC Invit. at Shamrock G.C., Corcoran
Tues., May 14, 4:15 pm, at Maple Lake (Albion Ridges G.C.)
Thurs., May 9, 4:15 pm, v. HLWW, BBE, and Osakis
Fri., May 10, 4:15 pm, v. Maple Lake
Thurs., May 13 (was 4/11), 4:15 pm, at Pierz
Fri., May 17, 2 pm, at Belgrade-Brooten-Elrosa
Mon., May 20, 12 noon, at Dassel-Cokato (Albion Ridges G.C.)
Tues., May 21, 4:15 pm, at Howard Lake-Waverly-Winsted
Thurs., May 2, 4:15 pm, at Pierz
Mon., May 6 (was 4/15), 4:15 pm, at Osakis Golf Course
Mon., May 6 (was 4/22), 10 am, at Sartell (Blackberry Ridge G.C.)
Tues., May 7, 4:15 pm, at Maple Lake (Albion Ridges G.C.)
Mon., May 13, 1 pm, at Belgrade-Brooten-Elrosa
Mon., May 20 (was 4/18), 11 am, at Milaca (Stones Throw Golf Course)
Wed., May 22, 12 noon, at Dassel-Cokato (Albion Ridges G.C.)
May 23, 3 pm, CMC Invitational at Shamrock G.C., Corcoran
Check either school's website for last-minute changes in schedule: kimball.k12.mn.us or evw.k12.mn.us


text:
Spotlight: Member Stories
Me and my husband have just recently started trying last 2 months i got negetive tests and got my period as per normal now this month my period is due...More
Helpful Tips
Why 1st morning urine?
I bet some of you are wonder why you should always use 1st morning urine when testing with home tests. Well the theory is that because ... More
68 found this helpful
- pregnant with negative test results and then a miscarriage
- Am I Pregnant Poll!
- Why Maybe False Negative.
Helpful Resources
Related News
Report Problems to the
Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.


text:
Fifty Shades of Grey: News
Looks like Dylan Neal will be working some doubles! The TV star, who is currently shooting the second season of The CW's Arrow, has just been cast as Anastasia Steele (Dakota… more »
Who could give birth to and raise someone as hugely-successful and sexually-aggressive as Fifty Shades of Grey's Christian? Apparently, someone a lot like Marcia… more »
Since it was first announced that Fifty Shades of Grey would be brought to life on the big screen, fans have expressed their concerns that it couldn't possibly stay… more »
Rita Ora's career is pretty hot right now! The UK singer-songwriter has landed a role in the highly anticipated film adaptation of E.l. James' Fifty Shades of Grey … more »
Vancouver, we are feeling an "Oh, my!"-level of jealousy of you after seeing photos from the Fifty Shades of Grey set in your fair city. Director Sam… more »


text:
the owner of som guesthouse is really friendly. Based on my experience, we got new room that always clean everyday. The situation in this guesthouse so quiet even in front of this guesthouse so many shop that open until midnight. Just walking around 1 km or 5 minutes, we can find patong beach. And don't worry for meal because so... More
- Also Known As:
- Som Guesthouse Patong, Phuket
- Official Description (provided by the hotel):
- All rooms have private toilet, air-condition, refrigerator, TV, DVD, Safety box, free wi-fi, hot shower. ... more less
- Reservation Options:
- TripAdvisor is proud to partner with HostelWorld and HostelBookers so you can book your Som Guesthouse reservations with confidence. We help millions of travellers each month to find the perfect hotel for both holiday and business trips, always with the best discounts and special offers.


text:
NYX Cosmetics Color Lip Balm
NYX Cosmetics Color Lip Balm Reviews
So Impressed with NYX
This is an incredible lip balm. It moisturizes as well as deposit rich color. There is a good collection of colors, and they look very natural. The price is excellent. I hate when my lips feel dry from allergies; they're not cracked, just dry. So, I reach for this wonderful lip balm that really works and is not greasy like Carmax and others. I have found a product line that does not "cost an arm and a leg." — 1 year, 2 months agoThis review is: Helpful | Not helpful | Inappropriate | 4 of 4 people said helpful
One of the Best Tinted Balms
I think this tinted lip balm is the best next to the Fresh Sugar balms and much, much cheaper. After reading Carole's reviews of NYX products (thank you, Carole!! You ROCK!!!), I decided to get a few to try as she really finds great stuff and her reviews are spot on. This one was one of my top favorite items that I tried. The formula is so nice, very moisturizing but not greasy and they smell ...read moreamazing. The price is exceptional, you get a lot of product for the price and they have a wide range of colors. Also, the brand is cruelty free and I love that. I have Shukran, which is a pinky-nude, MLBB shade and also Tack, which is a little more on the nude side of pink and matches their stick blush shade, Waterlily, (which is another fave! LOL) perfectly. I will definitely be ading to my collection of these balms! — 8 months agoThis review is: Helpful | Not helpful | Inappropriate | 0 of 0 people said helpful
Feels supple
The way this balm feels is ridiculous. It is really soft and you can actually layer to achieve the color you want. I also love that the names of these balms are all "Thank you" in different languages! "Obrigado," "Xie Xie," "Shukran." and many more. Anyway, if you don't want to wear lip gloss because it might be tacky, this is great! My all time favorite is "Shukran." It's the right amount o...read moref nude and still leaves your lips supple. I recommend using this if you really like your lips to feel great and look fantastic at the same time! — 1 year, 8 months agoThis review is: Helpful | Not helpful | Inappropriate | 21 of 21 people said helpful
Buy It Now


text:
Improve health and promote wellbeing.
Exceptional quality and compassionate care for every person, every family, every day.
Rockingham Memorial Hospital, located in Harrisonburg, VA, is an independent community hospital that has been providing healthcare services since 1912. Serving a seven-county area with a population of close to 200,000, the 238-bed hospital admits more than 15,500 inpatients annually and delivers close to 1,750 babies per year. RMH averages more than 18,000 surgical procedures annually, and the RMH Hahn Cancer Center provides more than 16,000 cancer treatments per year. The RMH Emergency Department treats more than 70,000 patients per year.
Community wellness and outreach are the primary cornerstones of the overall mission of RMH. Below is a listing of just some of the comprehensive services offered:
To learn more about RMH Healthcare please visit RMHOnline.com.


text:
LEGO Shop Home Themes Star Wars™ LEGO® Star Wars™ Republic Frigate™
LEGO® Star Wars™ Republic Frigate™
- Item: 30242
- Ages:6-12
- VIP Points: 6
- Pieces:45
- Available Now
Collect the iconic triple-engine Republic Frigate™ from Star Wars™: The Clone Wars™ featuring iconic details in an easy-to-build mini-scale!
Price 6.99 CADBlast into battle aboard the Republic Frigate™!
Keep the Republic moving at warp speed with the iconic, triple-engine Republic Frigate™, straight from Star Wars™: The Clone Wars™. Featuring turbo-laser cannon details, this converted combat cruiser is equipped to battle the Separatists in an easy-to-build smaller scale.
• Features the iconic details and colors of the real thing
• Fire up the massive trio of engines to speed into battle!
• Blast the Separatists with the turbo-laser cannons!
• Easy-to-build
• Measures over 5" (13cm) long, 2" (6cm) wide and 1" (3cm) high
• Ages 6-12. 45 pieces.


text:
What does Spring have to do with Rails 4.1, Rails security news, a few cool tips like pundit, pry rescue and RASK, good advice for upgrading to capistrano 3, and the plan to sunset bundler all in this RubyLoco-powered Ruby5.
This week we watch, lint, memoize, error handle, say hello to and write more idiomatic Ruby.
Ruby fixes a heap overflow, Rack::Attack protects your app from abusive clients, a proposal for changing Rails Session Storage, learn about Rake File Tasks and Demystify the Ruby GC.
In this episode, automatic length validations for your ActiveRecord models, Angular.js vs Ember.js, the Ionic framework, Watson for inline issue tracking and faking it with remote services.
PostgreSQL lands on Amazon RDS, using chruby and ruby-install over RVM and rbenv, a free shopping cart Rails app, integrating Quickbooks with Rails 4, Mixpanel with Ruby, and Ruby Under a Microscope.


text:
Marc by Marc Jacobs
Nikolai Sweater
Fashion legend Marc Jacobs introduced his diffusion line, Marc by Marc Jacobs, with a spring 2001 runway show. He has gone on to win seven CFDA awards including Womenswear Designer of the Year, Accessories Designer of the Year and Menswear designer of the year.
- 75% wool 25% nylon
- Dry clean only
- Styled with Siwy Jeans Rose Skinny in I'll be Around.
- Styled with Vanessa Mooney The Labyrinth Square Ring in Silver Metal.
- Styled with Unearthen Rainbow Bronze Double Ring.
- Modeled in size S. See fit guide for model's dimensions.
- Revolve Style No. MARC-WK43
- Manufacturer Style No. M1122743


text:
Check In
Hotel Review: Aloft Cleveland Downtown
By ERIK PIEPENBURG
This property, which opened in June, gives Cleveland a boost of contemporary hotel design in an area not known for style-centric accommodations.
Visitors often bolt from the capital soon after arriving, headed to Sri Lanka's outdoorsy attractions. Here's what they're missing by not lingering a little longer.
In recent years, the city's brasseries have gained a reputation for mediocrity. But at these four spots, diners can find both a lively atmosphere and satisfying food.
How can art deepen the travel experience? Following the trail of artists ranging from Dalí to Vermeer reveals some answers.
Dumplings and doughnuts were just two of the ingredients that fueled a budget-friendly getaway to this region north of New York City.
With the country ranked first on a world happiness list, visiting Copenhagen during the festive Christmas season.
An area on the fringe of Chinatown is making a comeback, drawing people looking for everything from food to fashion.
From tubs to shower heads, lighting to mirrors, tracking trends that are changing that tricky hotel space.
This property, which opened in June, gives Cleveland a boost of contemporary hotel design in an area not known for style-centric accommodations.
Both the name and the menu of this former food truck swerve away from the conventional.
A recent Supreme Court case may have travelers wondering what could get them removed from a frequent flier program. Here's some guidance.
The Mediterranean island-nation of Malta couples a tranquil, movie-set surface with an astoundingly rich past.
From discovering Wi-Fi hot spots to booking last-minute hotels to finding restaurants at the next highway exit, these apps can help make travel a little easier.
Inside the research, drama and, at times, staggering economics of trying to take the family pet on an overseas move.
Durian stinks so badly that it's banned from airplanes, hotels and mass transit in most Southeast Asian cities. So why does the author adore it?
Caterina Fake, founder of a new location-based website, talks about the value of documenting the stories behind places.
From group tours to airlines to pets at hotels, our Getaway columnist covers a diverse set of travel topics.
Get Seth Kugel's tips for budget-friendly travel and follow his tales from all over the world.
"Seeing the flames reflect off the crowd's awe-struck faces was mesmerizing."
We have now posted more than 120 photos that you've taken in destinations on our list. See them all and submit your own.
We asked you to send us photos of your favorite walks in Europe. Here are some highlights.
Your advice for visiting the city with children.