text:
Dr. Bejarano has received consultant fees, speaking fees, and/or honoraria (less than $10,000 each) from Abbott and MSD.
Special Article
Relationship between early bone mineral density changes and long-term function and radiographic progression in rheumatoid arthritis
Version of Record online: 28 DEC 2011
DOI: 10.1002/acr.20553
Copyright © 2012 by the American College of Rheumatology
Arthritis Care & Research
Volume 64, Issue 1, pages 66–70, January 2012
Additional Information
How to Cite
Bejarano, V., Hensor, E., Green, M., Haugeberg, G., Brown, A. K., Buch, M. H., Emery, P. and Conaghan, P. G. (2012), Relationship between early bone mineral density changes and long-term function and radiographic progression in rheumatoid arthritis. Arthritis Care Res, 64: 66–70. doi: 10.1002/acr.20553
Publication History
- Issue online: 28 DEC 2011
- Version of Record online: 28 DEC 2011
- Accepted manuscript online: 18 JUL 2011 09:39AM EST
- Manuscript Accepted: 5 JUL 2011
- Manuscript Received: 25 MAR 2011
Funded by
- Arthritis Research UK
- Abstract
- Article
- References
- Cited By
To ascertain whether bone mineral density loss during the first year of treatment for early rheumatoid arthritis (RA) as assessed by dual x-ray absorptiometry (DXA) is associated with long-term function, quality of life, and radiographic progression.
Early RA patients, prior to commencing disease-modifying antirheumatic drug therapy, underwent evaluation with DXA scans of both hands, femoral neck, and lumbar spine at the time of diagnosis, then at 1 year and final followup at >6 years. Clinical and laboratory data and hands and feet radiographs were obtained at baseline and final followup.
Sixty-four patients were assessed. At baseline, median disease duration was 6 months, mean 28-joint Disease Activity Score was 5.85, and median Health Assessment Questionnaire score was 1.38. Median followup was 6.4 years (range 5.1–7.2 years). For erosion scores, 86% of patients with hand bone density loss above the smallest detectable change after 1 year progressed versus 55% of those with no hand bone density loss (P = 0.006). However, baseline radiographs showed a similar strength of association. Eighty-four percent of patients with erosions at baseline had erosion progression versus 57% of those with no baseline erosions (P = 0.021). Additionally, first-year bone density loss was not associated with function and quality of life status at followup.
Hand bone loss during the first year of treatment in early RA, as assessed with DXA, was associated with a high likelihood of radiographic progression; however, in the current study this was not superior to baseline radiographs. Furthermore, it was not associated with patient-reported outcomes.
Rheumatoid arthritis (RA) affects approximately 0.5–1% of the general population. While there have been significant therapeutic advances such as the introduction of the tumor necrosis factor (TNF) antagonists, there is still the need for simple and feasible prognostic tools that allow a rational use of expensive biologic therapies, most obviously by helping select those patients with bad prognostic factors at the time of diagnosis.
Current demographic, clinical, and laboratory variables that are associated with a bad prognosis are female sex, poor function as assessed by the Health Assessment Questionnaire (HAQ), rheumatoid factor (RF) positivity, anti–cyclic citrullinated peptide antibody positivity, presence of the shared epitope, and radiographic erosions at baseline (1–3). Hoff et al recently reported the prognostic ability of cortical hand bone mineral density (BMD) loss during the first year of disease in RA as assessed by digital x-ray radiogrammetry. Radiographic progression of erosions at both 5 and 10 years was significantly higher in those patients with early hand BMD loss compared with those without early BMD loss (4). Dual x-ray absorptiometry (DXA) is widely available and early reports from our group suggested that hand BMD loss as assessed by DXA was more sensitive to RA-related bone damage than conventional radiographic erosions (5). Therefore, the aim of this study was to establish whether DXA-measured hand BMD loss during the first year of treatment in patients with early RA would be associated with long-term radiographic progression, function, and quality of life, and therefore offer a simple and widely available tool for predicting poor prognosis.
Significance & Innovations
Dual x-ray absorptiometry (DXA) has been proposed as a more accurate tool to assess bone damage in rheumatoid arthritis (RA) compared with radiographs.
The evidence of DXA value as a prognostic tool in early disease is limited.
We have found a previously unrecognized association between first-year hand bone mineral density loss and long-term radiographic progression in this group of patients with early RA.
The first-year DXA-measured hand bone loss does not provide any more information than baseline radiographs of the hands and feet.
This research was approved by the local research ethics committee. Patients with early RA (1987 revised American College of Rheumatology classification criteria [6]) with a disease duration of <1 year and who had never taken disease-modifying antirheumatic drugs (DMARDs) were recruited to 3 different studies between 1995 and 1999. They had a DXA assessment at the time of diagnosis, at 1 year, and at final followup, and data were acquired for the hands, lumbar spine, and right femoral neck. All scans were performed by the same equipment (Lunar Expert). More than 100 patients were included in the original studies; however, an upgrade of the DXA equipment took place during the recruitment to the followup study and a decision was made to limit the enrollment to those patients who were able to have a DXA scan with the same equipment that had been used for the original studies, allowing meaningful comparisons between the measurements taken by the same machine. Standard clinical and laboratory data were collected at the DXA time points. This included 66/68 tender joint counts (TJCs) and swollen joint counts (SJCs), visual analog scale (VAS) scores for pain and patient's assessment of disease activity, HAQ score, RA Quality of Life (RAQoL) questionnaire score, C-reactive protein (CRP) level, and erythrocyte sedimentation rate. Conventional radiographs of the hands and feet were also available at baseline and final followup. They were scored by a single experienced radiologist using the Genant method (7). The reader was blind to both treatment group and chronological order.
The patients received their first treatment at the time of diagnosis and according to the 3 different study protocols. Fifty-three percent of the participants in the current study were originally enrolled in the study by Proudman et al and received either a combination of methotrexate (MTX) and cyclosporin A (CSA) or sulfasalazine (SSZ) monotherapy for 24 months (median dosages at 1 year: MTX 15 mg/week, CSA 200 mg/day, SSZ 3 gm/day [8]); the number of patients enrolled in the current study from each treatment arm was similar. Another 45% were treated with MTX monotherapy for 12 months (mean dosage 17 mg/week) (9) and 2 patients received infliximab 10 mg/kg and MTX up to 15 mg/week for up to 9 months (10). Once all of the patients completed their participation in these studies, they resumed standard clinical care with addition of other DMARDs at the discretion of their physician.
Given that the number of patients was predetermined, a sample size calculation did not take place. Nonparametric statistical analyses, including Spearman's rank correlation, Pearson's chi-square test, and binary logistic regression, were used.
The smallest detectable change (SDC) in DXA values applied in this study was calculated previously: the SDC for mean hands BMD was 0.0071 gm/cm2, for femoral neck was 0.0539, and for lumbar spine was 0.0598 (5).
DXA data were available for 64 patients. The mean age at baseline was 54 years and 58% of the patients were women. Sixty-six percent were RF positive. This was an early disease cohort with severe disease activity (baseline median disease duration 6 months and mean 28-joint Disease Activity Score [DAS28] 5.85) and significant functional and quality of life impairment (median HAQ score 1.38, median RAQoL score 17) (Table 1). The median followup time was 6.4 years (range 5.1–7.2 years). At followup, the cohort still had moderate disease activity (DAS28 3.33, HAQ score 1.00, RAQoL score 11) (Table 1).
|Age, mean ± SD years
|54.1 ± 12.7
|Women, no. (%)
|37 (58)
|Disease duration, median (IQR) months
|6.0 (4.0–8.0)
|RF positivity, no. (%)
|42 (66)
|CRP level, median (IQR) mg/liter
|22.0 (7.3–49.3)
|7.5 (5.0–17.8)
|DAS28, mean ± SD
|5.85 ±1.11
|3.33 ± 1.44†
|HAQ score, median (IQR)
|1.38 (0.88–1.63)
|1.00 (0.38–1.59)
|RAQoL score, median (IQR)
|17 (7–18)
|11 (4–20)
As shown in Table 2, more patients had loss of BMD that exceeded the SDC over the first year in their hands than in the lumbar spine or femoral neck (66%, 28%, and 17%, respectively). In comparison, the proportion with a negative 1-year change in BMD at the hands, lumbar spine, and femoral neck was 67%, 63%, and 50%, respectively. Similarly, between baseline and final followup, more patients had BMD loss exceeding the SDC in their hands compared to the lumbar spine or femoral neck (82%, 29%, and 42%, respectively), while a negative change in BMD was now seen in 82% in the hands, 59% in the lumbar spine, and 74% in the femoral neck. During the first year there was no association between change in disease activity and hand BMD loss (▵CRP level ρ = 0.136, ▵SJC ρ = −0.081). Furthermore, at 12 months neither the TJC68 (ρ = −0.108, P = 0.394), SJC66 (ρ = −0.162, P = 0.200), nor VAS for disease activity (ρ = −0.007, P = 0.955) was related to first-year hand BMD loss. However, CRP level was weakly associated (ρ = −0.316, P = 0.016). Final followup CRP level was not substantively related to change in BMD from baseline to final followup (ρ = −0.050, P = 0.692), but showed a weak relationship with radiographic change over the same period (ρ = −0.328, P = 0.008).
|12-month change
|Followup change
|Hand BMD, mean ± SD gm/cm2
|0.431 ± 0.071
|−0.164 ± 0.024
|−0.034 ± 0.035 (n = 50)
|No. (%) > SDC
|42 (66)
|41 (82)
|Spine BMD, mean ± SD gm/cm2
|1.199 ± 0.163
|−0.023 ± 0.058
|−0.029 ± 0.099 (n = 51)
|No. (%) > SDC
|18 (28)
|15 (29)
|Right femoral neck BMD, mean ± SD gm/cm2
|0.966 ± 0.129
|−0.005 ± 0.054
|−0.050 ± 0.072 (n = 50)
|No. (%) > SDC
|11 (17)
|21 (42)
Radiographic progression.
Baseline erosion score was 1.55 (interquartile range [IQR] 0–4.53) compared with a followup score of 2.85 (IQR 0.13–8.54). Similarly, the total score progressed from 2.73 (IQR 0–6.08) to 4.40 (IQR 0.63–16.74). Seventy-five percent of patients had deterioration in their erosion score and 78% had deterioration in their total radiographic score (Table 3).
|Followup change
|Erosion score
|1.55 (0–4.53)
|2.85 (0.13–8.54)
|Deterioration, no. (%)
|48 (75)
|JSN score
|0 (0–1.91)
|0.48 (0–5.49)
|Deterioration, no. (%)
|32 (50)
|Total score
|2.73 (0–6.08)
|4.40 (0.63–16.74)
|Deterioration, no. (%)
|50 (78)
Relationship between BMD and radiographic progression.
When the patients were grouped according to their change in BMD in the first year (loss or no loss exceeding SDC), there was an association between hand BMD deterioration and progression of erosions. Only 12 (55%) of 22 of those with no hand BMD loss had erosion progression versus 36 (86%) of 42 of those with hand BMD loss (χ2 = 7.48, P = 0.006). However, baseline radiographs showed a similar strength of association. Of 21 patients who had no radiographic erosions present at baseline, 12 (57%) became erosive at followup, compared to 36 (84%) of 43 patients with erosions at baseline who had an increased erosion score (χ2 = 5.32, P = 0.021). When BMD loss and erosions at baseline were entered into a binary logistic regression model of the odds of erosion progression, although the model as a whole was significant (χ2 = 8.52, 2 df, P = 0.014), neither variable made a statistically significant contribution independently of the other, and the odds ratios (ORs) for each were comparable (BMD loss OR 3.53, 95% confidence interval [95% CI] 0.93–13.48; P = 0.065 and baseline erosion OR 2.21, 95% CI 0.58–8.45; P = 0.249). Erosion progression was not associated with first-year BMD loss in the lumbar spine (33 [71.7%] of 46 versus 15 [83.3%] of 18; χ2 = 0.93, P = 0.336) or femoral neck (39 [73.6%] of 53 versus 9 [81.8%] of 11; χ2 = 0.57, P = 0.566).
Patient-reported outcomes.
HAQ and RAQoL at followup were not substantively associated with first-year BMD loss at any site (all Spearman's ρ = <|0.2|).
Medication effects.
At followup, 25 patients were receiving MTX monotherapy, 5 were receiving SSZ, 1 was receiving leflunomide, 1 was receiving hydroxychloroquine, 18 were receiving combination therapy including any of the above, 1 was receiving the MTX-CSA original combination, and 8 were receiving anti-TNF agents. Five were receiving no DMARDs. Of those taking combination therapy, 6 were receiving prednisolone between 5 and 7 mg/day. Four (6%) had bisphosphonates and 6 (9%) had hormone replacement therapy (HRT). There were no differences in loss of BMD from 1 year to followup for those taking prednisolone, anti-TNF agents, bisphosphonates, or HRT; however, the numbers were very small and no firm conclusions can be made. Table 4 shows the medication use at followup according to hand BMD loss during the first year. The use of HRT, monotherapy, biologic therapy, and no need for DMARDs was similar. The number of patients requiring combination treatment was also comparable; however, more patients in the hand bone loss group included prednisolone in their therapy. This was parallel with more prescriptions of bisphosphonates in the same group.
|BMD loss <SDC
|BMD loss >SDC
|Monotherapy, no. (%)
|11 (50)
|21 (50)
|Combination therapy, no. (%)
|5 (23)
|8 (19)
|Combination therapy including prednisolone, no. (%)
|1 (5)
|5 (12)
|No DMARDs, no. (%)
|2 (9)
|3 (7)
|Biologic therapy, no. (%)
|3 (14)
|5 (12)
|HRT, no. (%)
|2 (9)
|4 (10)
|Bisphosphonate, no. (%)
|0 (0)
|4 (10)
In this study we have identified an association between hand BMD loss in the first year of RA and the likelihood of radiographic progression at followup. This would suggest that those patients whose BMD deteriorates over the first year of disease have a high chance of subsequent radiographic progression. There is no doubt about the need for good reliable prognostic tools for RA at the time of presentation to guide treatment decisions and help utilize the expensive biologic therapies more cost effectively. DXA is a simple, reproducible, and widely available technique. However, DXA performed just marginally better than baseline radiographs alone. Eighty-four percent of those with erosions at baseline had radiographic progression at followup. Our cohort had a high percentage of patients with erosions at baseline compared with the average early RA population. This is explained by the fact that more than one-half of the patients had been recruited to studies that selected patients for bad prognosis (8, 10). However, this may overestimate the ability of the baseline radiographs to predict the followup radiographic progression. Equally, the results of this study may not be applicable to patients with milder disease at presentation. While it has been documented that radiogrammetry performs better than DXA when detecting hand bone loss in RA (11), this study did not include a comparison of these techniques.
Deodhar et al reported a group of 40 patients with early RA who were followed up for 5 years with serial radiographs and DXA (12). They found no association between bone loss in the first 6 months and final Larsen radiographic score; however, patients with high bone loss at 6 months had a worse functional status as assessed by the Duruoz Hand Index compared to those with low bone loss. Our data do suggest an association between early hand bone loss and radiographic progression, and this discordance may be due to the different sample size, disease characteristics, or therapeutic approaches. Their cohort had less functional disability at baseline (HAQ score 1.1 versus 1.38 in our group); however, they had a higher inflammatory response (CRP level 43.5 versus 22.0 mg/liter, respectively). Other measures of disease are not comparable. Proportionally, Deodhar et al reported less use of MTX or combination therapy and there were no patients receiving anti-TNF agents. This may represent a milder disease cohort.
There was no association between initial BMD loss, function, and quality of life outcomes (HAQ, RAQoL). Similarly, Deodhar et al found no association with the HAQ. Although clearly the HAQ is related to structural change in the long term, there are suggestions that other aspects such as inflammation may influence the scores, especially early in the disease course (13). It is important to note that a proportion of patients did progress radiographically without an initial BMD loss. This suggests that there may be a "threshold" effect of inflammation on measurable bone loss.
The main limitations to this study are the size of the cohort and the lack of first-year radiographs. The followup radiographs include the progression in the first year, and this may overestimate the value of DXA in the first year by taking into account a damage that could have been measured simply by a radiograph at 1 year. Moreover, the true predictive value of DXA would address the radiographic progression from 1 year to the final followup, excluding the radiographic progression in the first year. Additionally, an ideal prognostic tool would be able to provide the required information within a much shorter frame of time. BMD loss over the first few months of the disease may provide more helpful results. Furthermore, it may be relevant to investigate its prognostic ability to predict progression from undifferentiated inflammatory arthritis to RA. The relationship between bone loss and disease course was not examined in this study as serial disease activity measures over the long-term followup period were not available.
In summary, there is an association between hand bone loss in the first year of RA, as assessed by DXA, and long-term radiographic progression; however, this tool performs just marginally better than baseline radiographs and, based on these results, it does not add to the management of early RA.
All authors were involved in drafting the article or revising it critically for important intellectual content, and all authors approved the final version to be published. Dr. Conaghan had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Study conception and design. Bejarano, Green, Haugeberg, Brown, Emery, Conaghan.
Acquisition of data. Bejarano, Green, Brown, Buch, Emery, Conaghan.
Analysis and interpretation of data. Bejarano, Hensor, Green, Haugeberg, Brown, Emery, Conaghan.
- 1Refining the complex rheumatoid arthritis phenotype based on specificity of the HLA–DRB1 shared epitope for antibodies to citrullinated proteins. Arthritis Rheum 2005; 52: 3433–8., , , , , , et al.
- 2
- 3How do you diagnose rheumatoid arthritis early? Best Pract Res Clin Rheumatol 2001; 15: 49–66., , , .
- 4Cortical hand bone loss after 1 year in early rheumatoid arthritis predicts radiographic hand joint damage at 5-year and 10-year follow-up. Ann Rheum Dis 2009; 68: 324–9., , , , , , et al.
- 5Hand bone densitometry: a more sensitive standard for the assessment of early bone damage in rheumatoid arthritis. Ann Rheum Dis 2007; 66: 1513–7., , , , , , et al.
- 6The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 1988; 31: 315–24., , , , , , et al.
- 7Assessment of rheumatoid arthritis using a modified scoring method on digitized and original radiographs. Arthritis Rheum 1998; 41: 1583–90., , , , , .
- 8Treatment of poor-prognosis early rheumatoid arthritis: a randomized study of treatment with methotrexate, cyclosporin A, and intraarticular corticosteroids compared with sulfasalazine alone. Arthritis Rheum 2000; 43: 1809–19., , , , , , et al.
- 9Elucidation of the relationship between synovitis and bone damage: a randomized magnetic resonance imaging study of individual joints in patients with early rheumatoid arthritis. Arthritis Rheum 2003; 48: 64–71., , , , , , et al.
- 10Can very high-dose anti–tumor necrosis factor blockade at onset of rheumatoid arthritis produce long-term remission? [letter]. Arthritis Rheum 2002; 46: 1971–2., , , , , .
- 11Hand bone loss as an outcome measure in established rheumatoid arthritis: 2-year observational study comparing cortical and total bone loss. Arthritis Res Ther 2007; 9: R81., , .
- 12Hand bone densitometry in rheumatoid arthritis, a five year longitudinal study: an outcome measure and a prognostic marker. Ann Rheum Dis 2003; 62: 767–70., , , , .
- 13Patients with rheumatoid arthritis in clinical care. Ann Rheum Dis 2004; 63: 221–5., .


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AEGD Clinic
AEGD stands for Advanced Education in General Dentistry, a one or two year training program for experience in more advanced and complex dental procedures.
Patient Care Services
Patients with treatment needs or medical histories that are too complex for the dental student are referred to the AEGD Clinic. Treatment is provided by residents (dentists getting additional training) under the supervision of licensed faculty dentists. Almost all general dentistry procedures are provided in the clinic - root canals, crowns, implants, dentures, extractions, esthetic dentistry such as teeth whitening and veneers, and deep cleanings.
Clinic Hours and Appointments
The AEGD Clinic is open 10:00am to 1:00pm and 2:00pm to 5:00pm, Monday through Friday. It is closed for major holidays and at other times throughout the year for conferences, meetings and academic related events and breaks.
The AEGD clinic accepts referrals from private dentists and from within the School of Dentistry. For more information please call the AEGD Clinic at (313) 494-6873. Due to the high demand for treatment in this clinic there will be periods of time the AEGD clinic is closed to new patients. Patients can request to be placed on the waiting list to become a new patient.

subset: commoncrawl


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Proud to be a Democrat – Humor
Gun Control via Executive Order?
I hate to say I told you so, but well, I told you so. Not YOU, personally, probably, unless you happen to be the person-in-denial I told, but well, you get my drift. The point is, I DID say it was coming and several deniers protested the thought that *gasp* Obama was going to even attempt a gun grab.
Damn. I hate it when I'm right. And not even a heartfelt apology from said deniers will make that sorrow dissipate. It's almost too late, you see.
Joe Biden (Viceroy of Ogling) was quoted earlier today stating Obama is weighing Executive Order gun control options. via The Weekly Standard:
"The president is going to act," said Biden, giving some comments to the press before a meeting with victims of gun violence. "There are executives orders, there's executive action that can be taken. We haven't decided what that is yet. But we're compiling it all with the help of the attorney general and the rest of the cabinet members as well as legislative action that we believe is required."
Biden said that this is a moral issue and that "it's critically important that we act."
Biden talked also about taking responsible action. "As the president said, if you're actions result in only saving one life, they're worth taking. But I'm convinced we can affect the well-being of millions of americans and take thousands of people out of harm's way if we act responsibly."
More interpolation at Townhall: Obama to Use Executive Order on Gun Control
Obama is coming for your guns. Incrementally of course, but don't be like my friend living in Egypt on the river with his head buried in the desert. It's time to realize Obama is taking aim at the Second Amendment, along with Eric (We must brainwash people against guns) Holder, Senator Feinstien, the ATF and Janet (I-shoulda-been-a-man with a gun-ban) Napolitano.
We're SAVED! Feinstein unveils sweeping gun-control agenda
Too Many Taking the Bait
A.F Branco brings us another light hearted look at the serious situation in which we find ourselves.
Don't take the bait!
Weekend Roundup – Why Obama Must Go
Obama's Unprecedented Record of Failure on Jobs - IBD
U.S. Shed 9,000 Mining, Energy Jobs in October, 17,000 Since May – Foundry
Warped WaPo World: Rising Unemployment Rate Is Good News For Dear Leader – MCT
OMG!… Obama Administration Was Warned 3 Hours Before Benghazi Attack – Did Nothing (Video) – GP
Bracken: Did Obama Withhold Cross-Border Authority? – WRS
FAST AND FURIOUS IN BENGHAZI: Timing of Attack Hints at Double-Cross of White House Gun-Running Operation by Turkey – DR
Fred Thompson Makes News With Benghazi Comments at AFP Event – TOM
Benghazi clear as mud? – Spellchek
Obama: "We leave nobody behind". Unless your name is Stevens, Smith, Doherty or Woods – WyBlog
FBI Spends Measly 3 Hours Investigating Benghazi, Overlooks documents – AP
When you head to the polls … A couple of things to remember: – Blackfive
Romney Responds to Obama's 'Revenge' with 'Love' – Breitbart
Romney's powerful new ad:
Hey, What's Obama's Real Second Term Agenda? – PC
A Betrayal of Public Trust – WFA
Conservative Bloggers Unite To Defeat Obama – KS Chimes in.
This is an election about an idea – WWTFT
So our choices are: elect President Romney, or learn to live with SCOTUS Justices Holder, Clinton, and Frank – Trog
Hurricane Sandy: Don't let the moment cloud your judgment…judge President Obama based on his record – SJ
Still Undecided? Watch This Video About Obama's Record – CH2.0
(VIDEO) Democrat Congressman Nick Lampson Gets Physical with Reporter in TX when Questioned about Voting with Pelosi – TCRN
Constitutional Scholar To Speak On Legality Of Independence at Texicon2012 – TNM
Texas woman blocked from voting for wearing Christian t-shirt – Examiner
Gov. Rick Perry rocks Friendswood for Randy Weber – Chron blog
TNM Denounces Racist Flyers Distributed At Churches – TNM
Texas Attorney General warns United Nations election observers could be arrested – Examiner
Right Jabs For November 3, 2012 – More links from Political Clown Parade
Frank Marshall Davis And Obama – TCotS
Stupid On Steroids! Are Green Taxes In Our Future? – CoF
Obama: "Ich Bin Ein Bullslinger!" – CHWaCD
Dung Beetle Award goes to… – TLC
It's Saturday… – Adrienne has more worthy links
Vote wisely, my friends.
Breaking: Supreme Court Resurrects Obamacare Challenge
It's Alive!
The challenge to Obamacare, that is.
Did the Chief Justice have a change of heart? Did he finally remember where he placed that wooden stake?
I'm not holding my breath. But it is an interesting development.
via CDN: Supreme Court shocks life into Obamacare challenge.
Just two days prior, the U.S. Supreme Court revived hope – long thought dead – that Obamacare, the president's signature achievement, might yet be ruled unconstitutional. The High Court shocked the legal community by opening its new term with an order giving the Obama Justice Department just 30 days to respond to Liberty Counsel's petition for rehearing. Liberty Counsel filed the petition on behalf of Liberty University and two private individuals.
An appeals court in Richmond, Va., ruled that the Anti-Injunction Act, or AIA, barred the court from addressing the merits in Liberty Univ., Inc. v. Geithner, which challenged the individual mandate (Section 1501) and the employer insurance mandate (Section 1513) of Obamacare.
In addition to the constitutional arguments that Congress lacked authority to pass the law, the suit also raised the Free Exercise of religion claim because of the forced taxpayer funding of abortion.
Homeland Security Watchdog
Another spot-on cartoon by Antonio F. Branco.


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The Real Housewives Of New York City Recap: Daddy To The Rescue
September 24, 2012 07:14 PM by Megan Thompson
The Real Housewives Of New York City is all new tonight on Bravo. The feud between Aviva and Ramona is still raging and both women refuse to back down. But George, yes Aviva's horny dad, demands that Ramona apologizes to his baby girl. Yeah, that didn't go over so well with Ramona.
Aviva is cleaning out the vitamin shop with her dad, who is visiting the city for a couple of days. Of course, George is going on about some woman he is flying in and how much sex he is going to have. He even tries to plan a visit with Carole, but Aviva isn't having it.
The romantic rendezvous that Sonja had envisioned in her head with her ex, didn't happen at all. A teary-eyed Sonja can't believe that her ex-husband wouldn't even see her; he would only deal with the lawyers. The trip was an epic fail both financially and emotionally. "I can't keep my house," Sonja cries to her interns. Thankfully, Ramona calls so Sonja can complain about suing her ex's ass off.
Sonja invites LuAnn over to help remove the painting of her ex-husband from her wall. "I'm learning to let go of attachments," Sonja tells the cameras. It's emotional for Sonja and she feels LuAnn will understand her situation better than Ramona would. In a dramatic moment, Sonja has a professional come over and remove the painting for storage. The past is hard to let go of, but Sonja feels she is doing the right thing. The scene ends with LuAnn hugging Sonja and telling her everything is going to be okay.
A furious Aviva has set up a breakfast meeting to discuss some issues she has with Ramona. There is absolutely no small talk; Aviva goes right in for the kill. "I was disgusted by you," Aviva tells Ramona about her actions in St. Barth's. But Ramona lets Aviva know that she ruined the trip for everyone. The breakfast is more like a boxing match; the women are verbally punching each other. Aviva is slamming Ramona for her drinking and Ramona lets Aviva know she has a big stick up her ass. "I love the way I am," Ramona says as she storms out of the restaurant. Let's take a look at this hot mess breakfast:
The Ramona pinot is flowing at Ramona's charity event for women who have dealt with domestic abuse. All the ladies show up to support Ramona, but Aviva is nowhere to be seen. That's not the shocker; the shocker is that Aviva sends her dad! Yes, George is the only man at the event. George wants Ramona to apologize to Aviva, but Ramona tells him that his daughter said horrible things to her. As Ramona is trying to get away from George, he grabs her arm. "The last thing you want to do is grab a woman's arm at a domestic abuse charity," Sonja jokes to the cameras. George is basically escorted out of the event, but not before he asks Carole out for dinner. "That trailer terd kicks me out of her party," George says as he is leaving the party.
So do you think Ramona drinks too much or that Aviva has a stick up her ass? Let us know what you thought of tonight's RHONY episode, leave us a comment below.
Want more? Follow our tweets on Twitter and "like" us on Facebook! Click here for more information about The Real Housewives Of New York City. For other great Reality TV News, please feel free to check out SirLinksALot: The Real Housewives of New York City.
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8 Responses to "The Real Housewives Of New York City Recap: Daddy To The Rescue"
Taya Says:
September 24th, 2012 at 8:12 pm
Aviva & George!! Disguisting.. What a White Trash Old Man..he's a damn Pig, ad his Daughter Aviva should be Very Very Ashamed of her Sick Father, & he's Sober..Aviva U r No Dive,& Repulsive Dad, How r u not Ashamed if that.. All I can say is Your a sick woman drinks, or no Drinks..Seriously hope u Do Read since your do Damn Smart, Please Stop doing the show & Just Focus on your Fears & anxieties, Do it for your children, sooo many R Worried Bout Your Children, U need to Stop thinking u r above All, you r Nothing really, but a Daughter , Wife, & Mother.. Most important not money$$ Nothing..but a Mother to those Precious children.. So Smart u Say, Yet soo Very Stupid..
lee Says:
September 25th, 2012 at 5:42 am
Romona and Sonja both white trash..
Xwhyzee Says:
September 25th, 2012 at 7:46 am
Good 4 Aviva to stand up to that crazy-eyed woman and set boundaries where she should be made aware that her self righteousness (she likes her self so much?)don;t have to be tolerated.
Enoff of her's&sonja's old-woman-gone-wild partying in national TV. Really? it puts 'TRASH' to it's stinky form.
c meikle Says:
September 25th, 2012 at 10:11 am
Aviva is such a self rightous bitch .Why is she always in Ramona's face about her behavior when she is worst than Ramona
When her dad is making rude sexual remarks she is all smiles, however when Ramona throws him out of her event he is an 80 yr old man. Keeeo the dirty 80 yr old off the show and let Ramona and Sonja party naked it is none of your bussines .
April Says:
September 25th, 2012 at 11:24 am
Avia's dad IS white trailer terd trash-going on national t.v. talking so lewdly about sex and dis respecting the single women he meets! Avia is an idiot smiling as if this is "cute" behavior for an 80 year old! NO CLASS AT ALL. As far as Ramona, she is irritating and acts low class a lot, but I'd rather see her having fun and partying then watch Avia's constant preaching. Ramona should NOT have refused the donation to her charity from Avia. That only showed how self absorbed Ramona is, putting her feelings before a generous donation for a good cause.
Jessica Says:
September 26th, 2012 at 9:11 am
Well it makes for good reality TV…don't it?
It's a group of people that ARE NOT friends thrown together (say maybe it should be called "Thrown Together" watch what happens!). Maybe get a grudge match or something together. Ramona & Sonja in a mud battle? I heart Caroline would love to hang with her.
Suzanne Says:
September 26th, 2012 at 4:06 pm
I think that Aviva is a judgmental, condescending, diva brat. It is absolutely none of her business who sleeps with whom, or how late grown women stay out, or how much they drink. I am SO appalled at her behavior that I would like to see her leave the show. Caroline needs to watch a few reruns of the show to understand what she missed. LuAnn was the direct cause of the whole thing escalating. And I don't even LIKE Ramona but Aviva's behavior was far worse than anything Ramona has ever done. Aviva needs to grow up. And apologize to ALL the women for ruining their vacation.
joan Says:
September 26th, 2012 at 10:05 pm
Does anyone seriously believe these women would be friends if they weren't thrown together on this show. It is comedy at its'best. It must have something going for it because we watch it.
Maybe it is a good lesson in that money doesn't make you happy; they all seem to have so much, but competing with everyone else must be very stressful, so they have to drink a lot to handle it. Just when I think one of them has some smarts, she does something really stupid. If a girl's week-long vacation can't handle one night when two husbands go out with their wives, something is terribly amiss. Bitch, bitch, bitch.


text:
Hot Reality TV
Which Surprising Bravolebrity Is Besties with #RichKids of Beverly Hills' Star Jonny Drubel?
Have you caught E!'s new hit reality show #RichKids of Beverly Hills yet? If not, it's time to get involved — these spoiled and fabulous 20-somethings are pretty fascinating to watch, if only to imagine what it would be like to live in a world where $488,680.50 shopping sprees are the norm.
One thing that keeps us tuning in to #RichKids is the totally endearing Jonny Drubel. The 25-year-old singer/songwriter won us over when he told Wetpaint Entertainment exclusively that, as a gay man, "I'm not trying to represent the gay community as a whole. I'm just trying to be myself." What a great attitude!
And though Jonny is new to our TV screens, this breakout star has a pretty interesting connection to another major Bravolebrity. Can you guess which reality star from the E! sister network is a longtime BFF of Jonny? Click through to find out the answer!


text:
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Historical Dictionary of LesothoScarecrow Press 2013; US$ 164.99
This second edition of Historical Dictionary of Lesotho covers the full scope of Lesotho?s ancient, colonial, and independence eras. It gives greater emphasis to the more recent period and brings the book fully up-to-date. This is done through a chronology, an introductory essay, appendixes, and an extensive bibliography. The dictionary section... more...
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Hauptbeschreibung Die hier vorgelegte Sammlung von Studien umfa�t eine Auswahl kleinerer Schriften zur Autobiographie, die seit den siebziger Jahren bis heute die gr��eren Arbeiten G�nter Niggls zu dieser Gattung begleiten. Er�ffnet wird die Sammlung von zwei einf�hrenden Aufs�tzen �ber literarische Zweckformen allgemein, ihre Einordnung ins Literatursystem... more...
Tunisia Since the Arab ConquestGarnet Publishing (UK) Ltd 2012; US$ 14.57
This comprehensive history of Tunisia covers an essential period in the country's development, from the Arab conquest of the seventh century to the Jasmine Revolution and the fall of Ben Ali's regime in 2010. Tunisia since the Arab Conquest describes the evolution of the Tunisian state, its place in the Mediterranean basin and its contacts with the... more...
Among The FaithfulEland Publishing 2012; US$ 14.57
Dahris Martin, a young American in search of sun, arrived in the holy city of Kairouan in the late 1920s. Befriended by the roguish Kalifa, she is welcomed into his circle of friends and family. Among the Faithful is a unique portrait of traditional Tunisian society. It tells of barefoot pilgrims and bedouin, the deflowering of virgin brides, spirit... more...
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Botswana has been portrayed as a major case of exception in Africa-as an oasis of peace and harmony with an enduring parliamentary democracy, blessed with remarkable diamond-driven economic growth. Whereas the "failure" of other states on the continent is often attributed to the prevalence of indigenous political ideas and structures, the author argues... more...
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Adorning the north-west staircase in the British Museum is a group of brightly coloured figured mosaic pavements. Most were excavated for the Museum between 1856 and 1859 at Carthage, in what is now Tunisia, by a dilettante called Nathan Davis; the work was funded by the Foreign Office of the British Government. This book recounts for the first time... more...
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The CarthaginiansTaylor and Francis 2010; US$ 41.95
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This book gives a concise yet comprehensive overview of Tunisia?s political and economic development from the mid-nineteenth century to the present. Written specifically for a non-specialist audience, the book examines the factors that make Tunisia one of the Arab world?s most stable and prosperous countries and one of its hardiest authoritarian orders.?The... more...
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From the mists of Basotho legendfrom the time of King Moshoeshoe. The tiny country of Lesotho is entirely surrounded by South Africa, yet it remains one of the most remote and unexplored areas in the region. The reason for this isolation is the mountainsrow upon row of serrated peaks make this the country with the highest low point... more...


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Have Legal Questions? Ask a Lawyer Now.
Do you know the date the person changed the name?
Legal name changes are made in superior court. You can go to the clerk of courts and look up the superior court cases on that day. A general search by name by the clerk will cost a small fee.
The son can be tracked through the school system. Have your detective check with the schools.
Actually, its a bit devious, but if you contact the child and depended services and lodge an inquiry that you fear for the safety of the child, they will track down your grandchild.
It will not be frivalous or a lie. It sounds to me that you do fear for thier safety.
DISCLAIMER: Answers from Experts on JustAnswer are not substitutes for the advice of an attorney. JustAnswer is a public forum and questions and responses are not private or confidential or protected by the attorney-client privilege. The Expert above is not your attorney, and the response above is not legal advice. You should not read this response to propose specific action or address specific circumstances, but only to give you a sense of general principles of law that might affect the situation you describe. Application of these general principles to particular circumstances must be done by a lawyer who has spoken with you in confidence, learned all relevant information, and explored various options. Before acting on these general principles, you should hire a lawyer licensed to practice law in the jurisdiction to which your question pertains.
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Pleasant Room in Eco Village
Size13 m²
Floor No.1
- Kitchen
- Breakfast
- Washer/dryer
- Balcony/terrace
- Towels
- Internet/WiFi
- Dishwasher
|Understensvägen, 12153 Johanneshov, Sweden
|Property type
|Private room
|Property ID
|Acceptance rate
|Response time
|A few hours
|Calendar updated
The room itself has two comfortable single beds. Guests have access to the toilet and a separate shower next door, bathroom with a washing machine downstairs, the living room, the outdoor patio and the fully equipped kitchen. Coffee, tea, hot chocolate, and cooking oil are always available. Simple fishing equipment is available as well as cross-country skis and boots in the winter.
In 7 minutes on foot and another 12 by metro, guests can reach Stockholm's Old Town (Gamla Stan). By bike, it can be reached in 30 minutes. Many kilometres of forested trails start 200 metres from the house in a large nature reserve. See www.nackareservatet.se/bilder/nackareservatet_72dpi.jpg
Fifteen minutes' walk away there is a lake, which is a great place for swimming, fishing, and canoeing. In 30 minutes guests can reach a sauna open year round at another lake. The house is built with ecology in mind, with solar panels and natural decor.
Host Nils is always happy to help with anything guests might need. On prior arrangement he offers a real Swedish meal made with elk from his forest.
No smoking indoors. Smoking is permitted on the patio.
The host is happy to accommodate special diets (gluten-free, vegetarian, vegan, etc.).
Keep noise to a minimum at night.
We follow the Swedish custom of taking off our shoes when entering the house. Slippers available.
Children sleeping in their parents' bed are free.
Various equipment like computer printer, hairdryer, umbrellas, iron and ironing board are for guests to use.
Pickup anywhere in the Stockholm region can sometimes be arranged by the host with his car for a fee. E.g Arlanda airport 500 SEK.
Cars are not allowed in the Ecological Village. There is free parking on the street 100 metres from the house and the host will be glad to help guests with the luggage. If you have a lot of luggage you can drive up to the house to leave it
On request, the host will give you detailed information about how to get to the house and on travel with the public transportation system in Stockholm.
|Weekly rate for 1 guest
|Monthly rate for 1 guest
|Price for > 1 guests
|$ 19 US per guest/night extra
|Check-in after
|Check-in before
|On arrangement
|Check-out before
|Cancellation Policy
Our trip to Stockholm was amazing. Nils was very welcoming and friendly. The house is cozy and warm, which invites you to come home after a long and active day. All facilities needed are available; tv, good shower and bath, nice comfy kitchen and a comfortable bed.
We enjoyed walking in the closeby national park with its beautiful lakes and forests. Also Stockholm city provides many different views and subcultures - each island gives a different experience. We especially loved Sodermalm.
Thank you Nils, for your hospitality and pleasants chats :)
Ha sido una experiencia maravillosa, Nils y su hijo son unas personas muy agradables dispuestas a ayudarte en todo, vivir en su casa es como estar en tu propio hogar, ni te enteras cuando esta por la casa, la cual esta siempre muy limpia y esta ubicada en mitad de la naturaleza muy cerca de unos campos de futbol y pistas de atletismo y un "gymnasio" al aire libre. el metro tambien esta cerca a menos de 5 min. Sin duda una gran eleccion si vas a Estocolmo
I have lived here for three days in mid-September. The hosts are very hospitable and attentive people.
The area is quiet and clean. The house is located in a forested area and is surrounded by pine trees. Clean air and tranquility are guaranteed. Near the house is a magnificent park with bicycle and jogging paths. The owner graciously offers bicycles for trips. The kitchen has everything you need to cook a meal. Metro station is just five minutes from the house, and to the old town of all 7 stops. Near the metro is inexpensive grocery store. In the house you have a fast Internet connection.
I liked Stockholm and the house in which I lived.
Igor from Russia
We had a pleasant stay. The house in the green residential area was very nice and cozy. Unfortunately the landlord was even absent all week and his son, the house and guest services operated only very minimal. It was therefore more like an apartment with other guests.
Wir hatten einen angenehmen Aufenthalt. Das Haus in der grünen Wohnsiedlung war sehr schön und gemütlich. Leider war der Hausherr selbst die ganze Woche abwesend und sein Sohn hat die Haus- und Gästebetreuung nur sehr minimal betrieben. Es war deshalb eher wie in einer Ferienwohnung mit anderen Gästen.
Nils is a very nice and friendly host, who knows much about the world (because he travels a lot and likes to meet people); we had some great, interesting talks with him. He also offers some tourist guide books and brochures etc. on what to do in Stockholm for his guests to borrow.
From our room (cosy, bright room in a homely, wooden house) we had a nice view on the forest. We saw deer in the evening, heard birds in the morning, and had quiet and restful nights.
There's a 10-minute walk to the nature reserve, with great hiking trails and lakes to swim in; and a 10-minute walk to the T-bana station for trips into the city (with a supermarket, small restaurants, and a medical treatment station along the road).
We used to have breakfast with the other guests of the house and chat about our plans for the day.
It was a great holiday, we loved our accomodation and we'd go back there at any time :)
Wir hatten einen tollen Aufenthalt in Stockholm. Trotz der langen Dauer wurde uns nicht langweilig. Die Lage von Nils Haus ist perfekt: Auf der einen Seite ein schöner Wald, auf der anderen Seite nur 10 Minuten Fußweg zur Metro. Die Zimmer sind hübsch eingerichtet. Nils und sein Sohn Emil sind sehr bemüht, auf die Wünsche der Gäste einzugehen und bei Problemen zu helfen. Vielen Dank!
Wir hatten eine tolle Zeit in Stockholm- nicht zuletzt aufgrund der gemütlichen und naturnahen Unterkunft bei Nils. Es ist schön, auf diesem Wege Stockholmer und Gäste aus anderen Ländern kennenzulernen und sich über die Erfahrungen und Erlebnisse in der Stadt auszutauschen. Der tägliche Sprung in den nahegelegenen See war eine perfekte Ergänzung zu den vielfältigen Möglichkeiten in der Stadt. Der richtige Weg, Stockholm zu erleben!
Staying in this beautiful place was a real pleasure for us. It's really near the center of Stockholm in a silent area, Nils is a very nice and helpful person. For breakfast we could choose between many different breads, mueslis and so on. We'd definitely come again and whoever likes staying in a typical Swedish house in a green place should do so as well!
In diesem wunderschönen Haus zu wohnen, war eine tolle Erfahrung für uns. Es befindet sich unweit des Stadtzentrums in ruhiger Lage. Nils ist sehr zuvorkommend und hilfsbereit. Beim Frühstück blieben keine Wünsche offen, wir konnten zwischen verschiedenen Brot- und Müslisorten etc. wählen, alles super. Wir würden definitiv wiederkommen und empfehlen diese Unterkunft all jenen, die gerne in einem typischen schwedischen Haus im Grünen und dennoch in Stadtnähe leben möchten.
Abitare per alcuni giorni in questa bellissima casa ci è piaciuto tanto. Si trova vicino al centro di Stoccolma, in un posto silenzioso in mezzo al verde. Nils è molto gentile e vi aiuterà sempre.. Per colazione c'era proprio di tutto, vari tipi di pane, muesli, caffé... proprio perfetto! Verremo definitivamente di nuovo e possiamo raccomandare questo alloggio a tutti quelli che vogliono vivere in una casa tipica svedese al verde ma non lontana dal centro.
Lovely bedroom in a very nice house, located in a very quiet park, close to a lake... just amazing ! The last but not the least, Nils is a very nice, warm host, always with the desire to please his guests ! And, as there are several bedrooms to rent, I appreciated to talk also with the others guests... I'll add that Stockholm is definitely one of my favorite city... In conclusion, I highly recommend this renting !
We loved staying here! Nice room, incredibly nice host and the perfect surroundings! Quiet yet close to the city! Absolutely recommendable!
- Quality assured accommodation
- Every host is verified by telephone
- Secure payment via SSL encryption


text:
Book your room at Hotel America
Get an overview of this hotelMilan hotel in Porta Vittoria, near Piazza del Duomo
Collect 200 points
Simply enter your Nectar card number when prompted. Your points will be credited 30 days after you return from your trip.*Offers may apply
Located in Porta Vittoria, this hotel is within 2 mi (3 km) of Parco Marinai d'Italia, Piazza del Duomo, and Cathedral of Milan. Galleria Vittorio Emanuele II and Teatro alla Scala are also within 2 mi (3 km).
Hotel Features
A bar/lounge, a 24-hour front desk, and a front-desk safe are available at this hotel. Full breakfast is free.
Room Amenities
All 12 rooms offer free WiFi and free wired Internet, plus minibars and digital TV. Other amenities available to guests include room service, safes, and phones.Would you like to give us feedback? Share it! Opens in a new window
Hotel AmericaCorso XXII Marzo 32 Milan MI 20135
Hotel Amenities
Hotel Amenities
A bar/lounge is on site where guests can unwind with a drink. Guests can enjoy a complimentary breakfast each morning. This Milan hotel also offers a safe deposit box at the front desk and an elevator (lift).
- 24-hour front desk
- Total number of rooms - 12
- Babysitting or childcare
- Bar/lounge
- Free breakfast
- Elevator/lift
- Luggage storage
- Safe-deposit box at front desk
- Free parking nearby
Family Friendly Amenities
- Family Hotel
- Free Wi-Fi
- Babysitting or childcare
Available in all rooms: Free WiFi , Free wired high-speed Internet
Free parking nearby
Room Amenities
- Air conditioning
- Phone
- Minibar
- Private bathroom
- Hair dryer (on request)
- In-room safe
- Desk
- Digital TV service
- Free WiFi
- Free wired high-speed Internet
- Room service
Where to Eat
A complimentary full breakfast is served each morning between 8:00 AM and 10:00 AM.
Room service is available.
Hotel Policies
Check-in time starts at 1:00 PM
Check-out time is 11:00 AM
Payment types
- Pets allowed
You need to know
Extra-person charges may apply and vary depending on hotel policy.
Government-issued photo identification and a credit card or cash deposit are required at check-in for incidental charges.
Special requests are subject to availability upon check-in and may incur additional charges. Special requests cannot be guaranteed.
- No onsite parking is available.
- A tax is imposed by the city: EUR 2 per person, per night, up to 14 nights. This tax does not apply to children under 18 years of age.
Hotel Name
- America Milan
- Hotel America Milan
We should mention
Cash transactions at this property cannot exceed EUR 2999.99, due to national regulations. For further details, please contact the property using information in the booking confirmation. Children 8 years old and younger stay free when occupying the parent or guardian's room, using existing bedding.


text:
Just a couple of days ago, a series of Lumia 928 pictures have been exposed via @evleaks Twitter account, which looks very similar to Nokia Lumia 920, but with Verizon logo on top. These leaked photos fit in the previous report, indicating the existence of Nokia Lumia 928.
Luckily, Etrade Supply once again get the part of Nokia Lumia 928 before release. Here are some photos we've taken and let's see what improvements Nokia has made to its new phone.
At the first glance of these two different digitizer and LCD screen assembles, you will find that the Lumia 928′s digitizer and LCD screen assembly looks slimmer than Lumia 920, cause it's 5 mm taller than 920′s digitizer and LCD screen assembly. Though Lumia 928′s screen is taller, the display area is still the same as Lumia 920, a 4.5 inches display. Another difference you can figure out is that the microphone phone of Lumia 928 is at the bottom of the screen, while that on Lumia 920 is at the bottom side of the phone.
when we turn the assembles around, we can easily find out the main difference of these two screens. The LCD screen of Nokia Lumia 920 is and LCD screen, while the LCD screen of Nokia Lumia 928 is and AMOLED screen made by Samsung. We don't know why Nokia quits the IPS screen they used for Lumia 900, but what we know is that the AMOLED screen is much lighter and thinner than IPS screen, which means the space left can be used for larger battery.
As the release date of Nokia Lumia 928 is just around the corner, We will keep an eye on that and share the latest parts and news with you.


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………..You know that moment when your husband comes home from work and he drinks a glass of wine at the middle of the night. That tells you something. He had it rough. AND SO HAVE I WITH THIS MOVIE. OMG. THIS. MOVIE. SUUUUUUUCCKKKKSSSS. WHO DIRECTED THIS IN THE FIRST PLACE?? WHY JANUARY? WHY HATH FORSAKEN US MOVIE REVIEWERS. But this is my solo standpoint. I had to see it with my lil sis and my family because this was for her and I didn't want to make her feel bad. But NOW I CAN Express my feelings over this hunk of junk. So the story talks about this squirrel named Surly, who's reckless/selfish actions has left his fellow park animals in jeopardy with no food. So he is banished to the streets with no friends until one day he comes across a nut store that is run by mobsters planning a heist. What does he find there, a treasure cove of nuts. Now Surly must redeem himself by throwing away his selfishness and give the nuts to every animal friend at the park. To be honest that's what this whole movie is about. Its really predictable, I'm not saying its good or bad its meh. Theres a-ok actors in this one but the script is crap and humorless. The animation is terrible. The soundtrack is so 3 years ago (I'm talking about you Gangnam style). Need I say more. With family I say sure go ahead your kid will laugh. But solo…na-uh. I just had a headache from this movie and I wish to make it go away. I hope the Lego Movie can be better than this.
-Ok Actors
-Horrible Script
-Late Music
-Bad Animation


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You can access thousands of recipes by subscribing to WeightWatchers.com.Learn more
I used organic spinach.Didnt add the sour cream and it still tasted good.
Awesome! Brought to a "healthy" themed potluck at school and everyone loved it! Even used canned chicken.
My son who hates spinach loves this. I often made a double batch since my husbad loves taking this for lunch the next day. Poaching chicken breast in stock prior to shredding it gives it a richer flavor.
This was very good. I thought I would get tired of the taste, but I didn't. I highly recommend it.


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Transfer Center
Special Transfer Programs
Pasadena City College has many programs that facilitate transfer to four-year institutions. Here are some to explore:
Special Transfer Programs for PCC Students:
CLAVE - Chicanos/Latinos Advancing in the Values of Education. Advancing from PCC to the University for Chicano/Latino Transfer Students.
ROPE - Rights of Passage In Education Transfer Program. Passage from PCC to the Universitiy for African American Transfer Students.
Puente Project - A one-year transfer program open to all students. The content of the Puente Project focuses on Mexican American/Latino authors and issues.
Fast Track - A program designed for students to begin attending Pasadena City College while still in high school. Students follow a structured format of courses that, upon successful completion of the courses, accelerates transfer from PCC to a four-year college or university in advanced class standing by one or more semesters.
Transfer Admission Guarantee - Guaranteed Admission is a commitment that selected colleges and universities make to PCC students who meet basic transfer requirements. Students who complete an agreed upon sequence of classes in general education and a selected major with a stated minimum GPA can apply to the four-year institution within a prescribed time-frame and be "guaranteed admission."
Honors Program - The PCC Scholars Program provides highly motivated students with an intellectually challenging educational experience designed to prepare them for a successful transition from community college to university.


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Click on a thumbnail to go to Google Books.
To Paint Her Life
by Mary Lowenthal Felstiner
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Amazon.com Product Description (ISBN 0520210662, Paperback)
Charlotte Salomon was a German-Jewish artist who created a stunning visual diary of her life as a young artist in Nazi Berlin and as a refugee in France; she died in Auschwitz at age twenty-six.To Paint Her Life tells the story of Salomon's extraordinary life and death.
(retrieved from Amazon Thu, 12 Mar 2015 18:03:47 -0400)
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Wiki says, Warm Bodies is the debut novel of author Isaac Marion. The book was described as a "zombie romance" by the Seattle Post Intelligencer, and makes allusions to William Shakespeare's Romeo and Juliet. The author, based in Seattle, originally wrote a short story entitled "I am a Zombie filled with love" that attracted a wide internet audience… like you folks visiting the Zombie Channel and Slice of SciFi!
Buy "The New Hunger" here: Zola Books: The New Hunger


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Have Legal Questions? Ask a Lawyer Now.
Good evening! I can help you out with your legal question tonight. I'm sorry to hear about your husband's dimentia.
Do you have a doctor's note or report that supports the fact that he has dimentia.
he was diagnosed with in 2011
I understand. You should make a copy of that letter and take out the personal information other than his name and then write a letter to the dealership. Return the motorcycle and in the letter, write that if they sue, then you will counter sue for damages and attorney fees.
If you know an attorney, it will mean more if he/she writes the letter and attaches the doctor's evaluation.
Basically you are returning the motorcycle and writing a letter with your position. Then if they sue him, he can counter sue for damages and request attorney fees.
I understand
That is mostly all you can do, and then that sets you up to win fees if you get sued pursuant to the purchase contract.
Did you have any other questions?
If they don't except the offer. How long will it take if it goes to court do you estimate?
It just depends, they have years in which to bring a suit against him. They likely won't do anything if they don't move in the first 3 months though.
When we brought the back back to the dealership that same day and explained the situation, mental state and all, they said there was nothing they could do. We left the bike at the dealship and Ill bring the letter from doc tomorrow.
Yes, they are not legal, so there is nothing they can do. They will talk with their lawyers though and your letter will help avoid litigation.
Oh I see.
I think that's it then.
I would suggest mailing a letter via certified mail and attach the doctor letter that way. Then if a suit begins, you can show the court you already told them of his dementia and inability to contract.
Ok have a great night and please leave me feedback before you go. Take care!
DISCLAIMER: Answers from Experts on JustAnswer are not substitutes for the advice of an attorney. JustAnswer is a public forum and questions and responses are not private or confidential or protected by the attorney-client privilege. The Expert above is not your attorney, and the response above is not legal advice. You should not read this response to propose specific action or address specific circumstances, but only to give you a sense of general principles of law that might affect the situation you describe. Application of these general principles to particular circumstances must be done by a lawyer who has spoken with you in confidence, learned all relevant information, and explored various options. Before acting on these general principles, you should hire a lawyer licensed to practice law in the jurisdiction to which your question pertains.
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Colorful Coatings From Jet-Hot at SEMA 2012Written by Thom Taylor on November 2, 2012
Jet-Hot Performance Coatings in Burlington, NC, has been busy reorganizing, as well as improving their pick-up and drop-off capabilities, but more interesting to us is they are developing some exciting new processes. Check out their 1300-degree coatings in customizable patterns and colors. Jet-Hot head honcho Gordon McGilton was telling us that virtually anything you can print can now be part of the thermal coating they provide. To go along with that colors are available for the first time, whether you want a solid coating or a pattern of your own making. Who knows, color coordinating your engine compartment may soon require an interior decorator. Interestingly there is no step or separation of the coating surface between color changes. They can also provide higher thermal coatings that can withstand 2000-degrees, albeit in the more subdued gray, silver or charcoal. Check them out at www.jet-hot.com.


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Apple gets Microsoft, Oracle, Intel as allies against Samsung in iPhone ban
The Business Software Alliance, which includes the likes of Microsoft, Oracle and Intel, has come out in support of Apple (NASDAQ: AAPL) in its iPhone patent battle with Samsung before the U.S. International Trade Commission, the Wall Street Journal is reporting.
As FierceMobileIT reported last month, the ITC ruled that a number of iPhone and iPad models sold by AT&T infringed Samsung's patents and should be subject to a U.S. import ban. The specific models were the iPhone 4, 3GS, and 3, as well as the iPad 3G and iPad 2 3G. Peter Cohan, a contributor to Forbes, predicted that the U.S. import ban, if imposed, could cost Apple $1 billion in revenue.
The ITC's decision is subject to a 60-day presidential review period, which expires on Aug. 4. Pressure is mounting from U.S. companies, particularly AT&T (NYSE: T), as well as from within the administration to reverse the ITC's ruling, although an ITC ruling has not been vetoed since 1987, noted the Journal. At issue are "standard essential patents"--patents that cover technology that is incorporated into industry-wide standards. Usually, holders of these patents are required by law to license them on reasonable terms.
In its defense, Apple said it offered to pay a "reasonable" licensing fee for the technology covered by the Samsung standard, but that Samsung was not willing to agree to the terms. Apple is arguing that imposing an import ban on the mobile devices at issue would enable other companies holding standard essential patents to demand excessive licensing fees, according to the newspaper.
Samsung is disputing Apple's charges. "Samsung has never offensively used its patents, essential or not, to keep competitors out of the market," it said in a filing with the U.S. Trade Representative. The ITC agreed, ruling that Samsung's licensing terms were reasonable, the Journal noted.
Apple and Samsung have been engaged for years in patent battles over smartphone technology. Last year, Apple won a $1 billion award from a jury in a patent infringement case against Samsung, which is appealing the award. Earlier this year, a judge vacated $450 million of the award and ordered a new trial on the patents covered by that amount.
For more:
- read the Wall Street Journal article
- check out the ITC notice
Related Articles:
ITC decision could result in US import ban on some iPhones, iPads
Strike two for Apple at the US Patent and Trademark Office
In legal dispute with Samsung, Apple says it wants Android source code
Judge slices $450M off $1B Apple-Samsung patent award


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An enchilada
Mex: Kraft Spaghetti.
Originally Posted by Star
Then we will dye easter eggs and watch stupid horror movies until she pisses her pants and I die.
Im growing impatient with these malevolent slithering reptiles on this bloody aircraft.
- Snakes on a Plane (As if spoken by a proper Englishman)
Forum Rules


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What an Obamanation
Campaign 2008
The Clinton campaign machine is sucking wind like a Hoover vacuum cleaner, now that Hillary's passive-aggressive, race-oriented attacks against Obama clearly backfired. Hillary's huge loss in Georgia, where the Democratic base is largely black, sends the Clintons a strong message: Many black Democrats don't like you after all. Hillary does not own the so-called "black vote."
Although Obama won several states, he still trails in pledged delegates. Obama's strongest wins were in his home state of Illinois and Georgia, where he'll receive a significant share of the 288 delegates in those states.
Obama also won North Dakota, Missouri, Kansas, Minnesota, Alabama, Alaska, Colorado, Connecticut, Delaware, Idaho, and Utah with 278 delegates up for grabs.
Clinton won her home state of New York and somehow managed to confuse Democrats in New Jersey and Massachusetts by winning in those states. Clinton has also duped Democrats in Tennessee, Arkansas, Oklahoma and Arizona, and has won a sizable share of the 235 delegates in those states.
With very little ideological difference between Clinton and Obama it seems that Democrats cannot decide if they want a half-African as president or a woman.
The Republicans, on the other hand, are in the midst of an obvious identity crisis. Republican strategists are likely hoping that Clinton wins the Democratic nomination (which will probably happen) because a short, 71-year-old white guy doesn't stand a chance against Obama if the Republicans choose McCain.
Conservatives understand why Dobson, Coulter, Limbaugh, and others are against McCain. Many wonder if he's actually a conservative. "John McCain is not only bad for Republicanism, which he definitely is - he is bad for the country," says Ann Coulter.
Additionally, it seems that America is ready for something different than a white male in the White House. Why are Republicans so incapable of producing a non-white male or female electable candidate for the office of president? Alan Keyes is totally unelectable, too quirky, and should never be encouraged to run for public office ever again. Moreover, the passing-over of J.C. Watts while he was in the House was truly scandalous.
As a result of Republican's inability to construct a cohesive message and cultivate candidates that represent a changing America, a decisive loss should be expected in November, especially if Obama emerges as the Democrat's choice.


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It might seem tempting, but do NOT follow this diet trick!
File this under Advice That Should Be Obvious: Ingesting a live tapeworm is not the best way to lose weight.
Somewhere in Iowa recently, a patient told her doctor that she had bought a tapeworm on the internet and ingested it. The physician called the Iowa Department of Public Health to ask what to do for her. The department's medical director, Dr. Patricia Quinlisk, advised to prescribe an anti-worm medication.
Quinlisk recounted the incident Thursday in a weekly email to public-health workers around the state. She noted that websites have been selling tapeworms as a weight-loss tool, and she warned against the practice.
"Ingesting tapeworms is extremely risky and can cause a wide range of undesirable side effects, including rare deaths," she wrote. "Those desiring to lose weight are advised to stick with proven weight loss methods; consuming fewer calories and increasing physical activity."
Tapeworms are parasites that can live in the intestines of animals and humans. They can be accidentally ingested in undercooked meat. Quinlisk said that a century ago, hucksters often sold tapeworm eggs in pill form as a weight-loss aid.


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About every 35 years or so, as if by congressional decree, the football teams from Hawaii and Washington get together as they will again...
About every 35 years or so, as if by congressional decree, the football teams from Hawaii and Washington get together as they will again Saturday night in Honolulu.
And for schools that have very little history, there is actually quite a history. The series features:
• What is probably the only time a Huskies team practiced on a ship.
• What might be the biggest upset ever suffered by Washington.
- Seattle fifth-graders will get their camp trip, but teachers refuse to go
- Designed in Seattle, this $1 cup could save millions of babies
- Five things to watch as Seahawks begin OTAs Monday
- What the national media are saying about Robinson Cano and the Mariners' hot start to the season
- Ivar's looks to sell, lease back two venerable restaurant sites
Most Read Stories
• And the first start for an African-American quarterback at UW.
The workout-by-sea happened in late 1937 as the Huskies headed to Honolulu to play Hawaii in something called the Pineapple (Poi) Bowl, though to consider it a bowl by today's definition wouldn't be quite right. Hawaii was 2-5, having played mostly local alumni teams, and typically ended its seasons by inviting a big-name West Coast team to play.
The Huskies, according to school archives, already had stored their gear for the offseason when the invitation came. Coach Jimmy Phelan took a vote, players unanimously agreed to go, and the Huskies left from Vancouver, B.C., for a weeklong trip, practicing on deck along the way.
The game, played Jan. 1, 1938, was a rout with UW taking a 26-0 lead before the hosts had a first down. The Huskies won 53-13, and still include the game in their official bowl record. (The Huskies also beat the Honolulu Townies five days later, 35-6.)
In 1973, it was Hawaii coming to Seattle for the season opener for what then was a rare visit by the Rainbows (known now as the Warriors) to the mainland. Hawaii at the time was an independent team that typically played at home. They would come to the mainland for just a couple games.
The game at Washington was part of Hawaii's attempt to begin upgrading its schedule a bit — Hawaii had lost 34-2 at Tennessee the year before.
But few thought Hawaii had a chance against UW — the school's official history claims it was a 50-point underdog.
Some of that spread was based on the fact UW was coming off two 8-3 seasons. But those were with Sonny Sixkiller at quarterback, and he was gone by 1973.
Washington entered the Hawaii game with a somewhat unsettled quarterback situation, with three players rotating, and coach Jim Owens gave the start to James Anderson, a sophomore from Fresno, Calif., making him the first African American to start at that position for the Huskies, according to school officials.
Anderson, however, didn't last long, suffering muscle spasms after a hard hit on the second series. He was replaced by junior Denny Fitzpatrick, who promptly led the Huskies to a touchdown with the expected rout apparently on.
Instead, UW never scored again, in large part due to five turnovers and two missed field goals, indicative of a sloppy effort throughout.
"We were just not passionate and hungry enough to take them really, really serious," said Fitzpatrick, now general manager at the Beverly Hilton Hotel.
Hawaii grabbed a 10-7 lead in the third quarter, but Washington drove inside Hawaii's 23-yard line three times in the fourth quarter.
Twice, the Huskies lost fumbles, the other time — with less than four minutes left — they went for a first down rather than try a tying field goal and were intercepted.
"Personally, I'd rather tie than lose," said a surprised Hawaii coach Dave Holmes afterward.
Hawaii's media notes this week refer to the game as "one of the biggest upsets in school history."
Owens said afterward, "I think we all were embarrassed," and the game was not "indicative of our team."
Unfortunately for UW, it was. The Huskies finished the season 2-9 overall and 0-7 in Pac-8 play, the first winless conference season since World War II.
Anderson played sparingly the rest of the season, finishing the year 3 of 13 passing. He was later moved to receiver, though he played a few more games at quarterback, rushing for 102 yards against Oregon State in 1975. And his status as the first African American to start a game at quarterback for the Huskies is generally forgotten, most figuring it was Warren Moon.
"It got a lot of attention at the time," said Fitzpatrick, calling Anderson "a very talented quarterback. He was very, very fast and quick on his feet."
Fitzpatrick, however, said it was an odd season, with a lot of uncertainty over the future of Owens.
"There were so many questions in many minds that it affected our psyche," he said, adding that the loss to Hawaii "felt like the beginning of the end, so to speak."
Owens, however, lasted one more year, retiring after the 1974 season, which was highlighted by Fitzpatrick's 249-yard rushing game against Washington State. Fitzpatrick rushed for 697 yards, which until this year was the most for a UW quarterback.
Coincidentally, Fitzpatrick was at Stanford last month when Jake Locker broke his record, having simply picked that game to attend with friends as part of an annual outing. He said he intentionally didn't tell anyone he was there, wanting to keep the attention on Locker.
He'll try to watch again Saturday on television when UW and Hawaii renew acquaintances, hoping for another upset.
Bob Condotta: 206-515-5699 or firstname.lastname@example.com


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By Tim LinscottManaging Editor Using a smart phone may not be smart while driving. The proof of this folly is being seen in Perkins County as the accident total for the year is on a record pace. The vast majority of the accidents this year have been due, in part, to cell phone usage and/or texting. The trend the last 30 years, according to Don Softley, Grant fire chief, has been an average of eight vehicle accidents a year. In 2013, there have been 12 accidents as of Nov. 1. "In years when we have an above average year, by October we'd have eight to nine accidents. We are already way above that," Softley said. "When the first or second ice storm hits you get an accident or two, but this is already above that pace." The accidents appear to be more serious as well. On average the local fire and rescue department uses the Jaws of Life twice a year. Already in 2013 the Jaws of Life have been used six times. "We've used them to get a door open on a vehicle or separate the roof to give more passenger space or simply extrication," Softley said. In half of the cases the Jaws of Life were used simply to pry the hinges off of a door to get to an accident victim. The use of these tools are from the way the accidents are happening. Many of the accidents have been involving texting or cell phone usage. "We are not in the investigation business but when you are in the fire and rescue business, it appears cell phone involvement has been a contributing factor," Softley said. The certain types of accidents indicates a cell phone has been in use, where the driver has been distracted or not paying attention to road conditions. A recent accident north of Grant was a prime example of how a cell phone can be a detriment while driving. Softley explained that while sheriff's deputies and fire and rescue crews were cleaning up the scene and were diverting traffic, a woman drove past deputies and fire and rescue officials while texting, driving with her elbows the entire way through the detour. "She wound up slamming on her brakes and about rear-ended a cattle trailer," Softley said. "It is so dangerous, we about had another accident right there." Teens have nationally been statistically susceptible to accidents while driving and texting, but Softley reports that the accidents this year involving text messaging have been a gambit of age ranges. "It is not one age demographic that has had an accident," Softley said, mentioning only one accident this year involved a teen. "We all need a reminder to be aware of our surroundings and not text and drive." Ways to avoid texting and driving are simple, according to AT&T: • Put the phone in a glove box or under the seat, using an 'out of sight, out of mind' mentality. • Put the phone on silent mode to avoid even hearing the chime of a text coming in or incoming call ring tone. • Do not send a text to someone you know is driving. Wait to call when you know they are at their destination. • If you must answer or send a text, pull off to the side of the road safely, take care of sending or receiving the text or call and then put the phone away. Being a defensive driver is also essential to preventing an accident. Be aware of drivers texting and driving approaching on the highway or in front or behind a vehicle.
Texting and Driving-The Statswww.textanddrivingsafety.com
• In 2011 at least 23 percent of auto collisions involved cell phones, equalling 1.3 crashes. • Five seconds, the minimal time it takes away your vision from the road while texting, driving at 55 miles per hour, equals driving blindly for the length of a football field. • A total of 13 percent of all drivers ages 18-20 involved in a wreck said they were texting or talking on a cell phone at the time of the accident. • A total of 77 percent of young adults claim they are 'very' or 'somewhat very' comfortable that they can text safely and drive. • A total of 55 percent claim it is easy to drive and text. • A total of 27 percent of adults have sent or received a text while driving. • Thirty-nine states, Nebraska included, prohibit drivers from texting while driving. However, in Nebraska it is a secondary offense, meaning law enforcement officials cannot pull someone over for simply texting and driving. • Thirty-two states, including Nebraska, prohibits novice drivers from cell phone use while driving. • Annually 1.6 million accidents are caused while drivers are texting, which is 25 percent of all vehicle accidents in the U.S. ~ National Safety Council • Eleven teens a day die from texting and driving. ~Insurance Institute for Highway Safety Fatality Facts • Texting and driving is six times more likely to cause an accident than driving intoxicated. ~ National Highway Transportation Safety Administration • Driving and texting is the same as driving after four beers for reaction time. ~ National Highway Transportation Safety Administration • Texting and driving slows brake reaction speed by 18 percent. ~Human Factors/Ergonomics Society


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Definition: 'Pathology'
pathologyType: Term
Pronunciation: pa-thol′ŏ-jē
1. The form of medical science and specialty practice concerned with all aspects of disease, but with special reference to the essential nature, causes, and development of abnormal conditions, as well as the structural and functional changes that result from the disease processes.
The definition information for pathology is provided by Stedman's. You can search our medical dictionary here.
Stedman's, part of Lippincott Williams & Wilkins, provides a comprehensive line of health-science publications for healthcare professionals and medical students.
Medical Dictionary Copyright © 2006 Lippincott Williams & Wilkins. All rights reserved.


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All research activities at the Wyoming Department of Health must have prior approval by the Investigational Review Board (IRB) prior to implementation. Specifically, all research will be conducted within the parameters of the Code of Federal Regulations and its sections 45 CFR and 38 CFR 15, and, where applicable, 21 CFR 50 and 56. These regulations are referenced in the WDH IRB Policies and Protocols below.
WY IRB Policies and Procedures
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WDH IRB Instructions for Application for Use of Existing Data or Biological Materials
WDH IRB Application for Use of Existing Data or Biological Materials (fillable format)
IRB Review for WDH Research Studies
*Any project meeting one or more of the following criteria should be submitted to the IRB to determine if review is needed:
*Research protocols that require review by an institutional review board and have been reviewed and approved by another IRB still are required to be reviewed and approved by WDH IRB if:
*Research projects being performed by interns or employees of the agency to fulfill the requirements of educational activities, including university or college degrees or course of study projects, must be sponsored by the individual's immediate supervisor and the corresponding division administrator if the investigator represents themselves as an employee of the agency and the project will collect information either through direct contact of human subjects or use of existing WDH data on file.


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Maddave replied to AdamC11's topic in Ford Fiesta ClubLooking good mate B) B) Were they very expensive?
Poll on Fiesta Mk7 Colour Choice
Maddave replied to DanGull's topic in Ford Fiesta ClubB) B) :) :)
Wing mirror
Maddave replied to Beermonster's topic in Ford Fiesta ClubUpdate:- Well after a visit to main dealer and numerous calls from ford customer services. Apparently the overtaking mirror on passenger side IS to European spec for this vehicle , and NOT a design fault , which I find very strange . I then enquired if I they did a plain mirror for nearside and apparently there is no such part. available. So not at all pleased , as I find the overtaking mirror on the nearside irritating to say the least.
Maddave started following Coolant Leak
Maddave started following Tyre Speed Ratings
New Member
Maddave replied to mikey40's topic in New Member IntroductionsHello there ;)
Air Con Not Cold
Maddave replied to Fiesta-tom's topic in Ford Fiesta ClubI had similar problem with st170 I had , turned out it needed new clutch on AC. :(
Washer Jets Leaking Fluid Down The Bonnet
Maddave replied to bluewatch's topic in Ford Fiesta ClubI did have this on an 08 Focus , first I was told that the Halfords screen wash I had been using was too strong a mix , eventually they replaced jets on bonnet and that seemed to cure it.Well didn't leak quit so often.
The Fiesta(2008+) Mk7 Review Topic
Maddave replied to Jason Tierney's topic in Ford Fiesta ClubThanks for the links , enjoyed watching them. ;)
Hello From Cornwall
Maddave replied to Silverbow's topic in New Member IntroductionsHi there my "ansome" lol ;) I'm from Cornwall as well , what part matey?