text:
If you are a subscriber to the JCSM (including members of the AASM), please login to access the journal.
Click here to Subscribe:
$75/volume year for individuals or $140/volume year for institutions to access all current articles and archives published in JCSM.
Click Here to DOWNLOAD the article*:
$20 to access a PDF version of a specific article from the current issue of JCSM.
*Purchase of an electronic download of JCSM provides permission to access and print the issue/article for personal scholarly, research and educational use. Please note: access to the article is from the computer on which the article is purchased ONLY. Purchase of the article does not permit distribution, electronic or otherwise, of the article without the written permission of the AASM. Further, purchase does not permit the posting of article text on an online forum or website.
Subscribers can download and print full articles from current and past issues of the JCSM
Login to JCSM
Join the American Academy of Sleep Medicine and receive a subscription to JCSM with your membership
Numerous studies have demonstrated that sleep promotes memory consolidation, but there is little research on the effect of hypnotics on sleep-dependent memory consolidation. We compared bedtime administration of zolpidem-ER 12.5 mg (6- to 8-h duration of action), middle-of-the-night administration of zaleplon 10 mg (3- to 4-h duration of action), and placebo to examine the effect of different durations of hypnotic drug exposure on memory consolidation during sleep.
Twenty-two participants with no sleep complaints underwent 3 conditions in a counterbalanced crossover study: (1) zolpidem-ER 12.5 mg (bedtime dosing), (2) zaleplon 10 mg (middle-of-the-night dosing), and (3) placebo. Memory testing was conducted before and after an 8-h sleep period, using a word pair association task (WPT; declarative memory) and a finger-tapping task (FTT; procedural memory).
ANOVA revealed a significant condition effect for the WPT (p = 0.025) and a trend for the FTT (p = 0.067), which was significant when sex was added to the model (p = 0.014). Improvement in memory performance following sleep was lower with bedtime dosing of zolpidem-ER compared to placebo and middle-of-the-night dosing of zaleplon. There were no differences between placebo and zaleplon.
The results suggest that in some circumstances hypnotics may have the potential to reduce the degree of sleep-dependent memory consolidation and that drug-free sleep early in the night may ameliorate this effect.
Hall-Porter JM; Schweitzer PK; Eisenstein RD; Ahmed HAH; Walsh JK. The effect of two benzodiazepine receptor agonist hypnotics on sleep-dependent memory consolidation. J Clin Sleep Med 2014;10(1):27-34.
A growing body of evidence demonstrates that sleep promotes memory consolidation in healthy individuals.1–3 Numerous studies using various designs and memory tasks have consistently found that memory consolidation (i.e., improvement on a given memory task from initial training/test to retest) is significantly greater after a period of sleep than a period of wake. This is commonly referred to as sleep-dependent memory consolidation (SDMC).4 For example, improvements on a procedural memory finger-tapping task were observed after a night of sleep but not after 4-, 8-, or 12-hour daytime periods without sleep.5,6 Studies examining declarative memory consolidation, such as with a word pair association task, also demonstrate improvements in performance after sleep.7 In addition to improvements in memory following overnight sleep, memory consolidation is also enhanced during naps as short as 45 minutes. Improvements in procedural8,9 and declarative10 memory occur with naps, but not following similar durations of wakefulness. These findings suggest that memory consolidation that occurs during wakefulness is enhanced during sleep.
Synaptic plasticity, which refers to structural or functional neural changes in response to stimuli,2 is thought to be the cellular substrate underlying the processes of memory formation and consolidation.11 Sleep has been found to enhance plasticity in animals,12 which is consistent with the idea that sleep enhances memory consolidation. In humans, fMRI studies have shown that sleep-dependent learning of a motor skill task is accompanied by changes in multiple brain areas, indicative of large-scale plastic reorganization of memory.13 There is evidence that some sleep-promoting medications may affect corticoplasticity negatively. Frank and colleagues found that zolpidem 10 mg/kg (although not triazolam 1-10 mg/kg or ramelteon 0.1-1 mg/kg) reduced cortical plasticity in rats by approximately 50%.14 They also demonstrated that trazodone 10 mg/kg (but not zaleplon 10 mg/kg or eszopiclone 1-10 mg/ kg) impaired sleep-dependent plasticity.15 Although not all hypnotics studied significantly impaired corticoplasticity, low sample sizes and variable potency might have influenced the results. The finding that plasticity may be negatively affected by hypnotics suggests that hypnotics may also lead to impairments in SDMC.
Current Knowledge/Study Rationale: Few studies have investigated the impact of hypnotic medication on sleep-dependent memory consolidation. This study compared the effect of differing time of exposure to two hypnotics on the sleep-dependent consolidation of declarative and non-declarative memory.
Study Impact: This study contributes to the research surrounding sleep-dependent memory and hypnotics, indicating that hypnotic exposure during most of the night may reduce sleep-dependent memory consolidation; whereas hypnotic exposure only during the second half of the night appears to have no effect.
Because 10%-20% of the population is estimated to have insomnia16–18 and hypnotics remain a commonly used treatment, it is important to determine if memory consolidation during sleep is negatively affected by these drugs. Few studies have investigated the effect of hypnotics on sleep-dependent memory in humans. Melendez et al. reported no effect of either zolpidem immediate release (10 mg) or triazolam (0.25 mg) on SDMC in normal sleepers.19 However, subjects were trained to 100% on the memory tasks prior to the sleep period precluding a demonstration that the tests used were sensitive to SDMC with placebo. Other investigators found that zopiclone (7.5 mg), but not brotizolam (0.25 mg), impaired SDMC in normals.20 The small sample (N = 8) may have been insufficient to detect an effect with brotizolam. Finally, Morgan et al. reported significant impairment of sleep-dependent memory on a motor task with triazolam (0.375 mg), but not with zolpidem immediate release (10 mg).21 However, the dose of triazolam is rather high and the detected effect may be a direct influence of drug on motor performance during the morning testing period, rather than interference with SDMC. Additionally, the small sample (N = 12) may have provided insufficient power to detect an effect with the dose of zolpidem employed.
In sum, these studies provide some evidence that hypnotic drugs may impair SDMC, but further investigation is clearly needed to confirm these findings and assess possible contributing factors. One such factor may be duration of drug exposure. Given that memory consolidation improves after sleep periods (without medication) that are as brief as 1-2 hours,8-10 limiting drug exposure to a portion of the sleep period may result in less interference with SDMC, compared to drug exposure for the majority of the sleep period.
The objective of the present study was to determine the effect of different durations of hypnotic drug exposure on SDMC. To do this, we used hypnotics with different durations of action and administered them at different times of the night. We compared the effects of bedtime administration of zolpidem extended-release (zolpidem-ER) 12.5 mg, middle-of-the-night administration of zaleplon 10 mg, and placebo on procedural and declarative memory consolidation. The two hypnotics have similar mechanisms of action, both binding preferentially to the α-1 benzodiazepine receptor subunit,22 although their durations of action differ. Zolpidem-ER has an estimated duration of action of 6-8 h, with a t1/2 of 2.8 h and a tmax of 1.5 h.23 In contrast, zaleplon has an estimated duration of action of 3-4 h due to rapid absorption and elimination, with t1/2 and tmax both approximately one hour.24 These doses were chosen because, at the time of study, they were the recommended therapeutic doses for treatment of insomnia. In addition, residual morning sedation has not been detected with either drug at these doses when administered at bedtime,25,26 or with zaleplon 10 mg when administered as little as 4 h before wake time (middle-of-the-night dosing).27,28 Normal subjects were studied to avoid potential influence of the inherent sleep disruption of insomnia patients.
We predicted that SDMC would be impaired following a period of sleep with drug activity during most or all of the night, but not after a period during which approximately half of the sleep is drug-free. Specifically, we hypothesized that bedtime administration of zolpidem-ER 12.5 mg would result in lower SDMC—measured as the percent change in memory performance from before sleep to after sleep—compared to placebo and middle-of-the-night zaleplon 10 mg. In addition we predicted that SDMC would not be lower following zaleplon 10 mg compared to placebo.
Healthy individuals with no sleep complaints were recruited via media advertisements and telephone contacts. Participants were required to have a Pittsburgh Sleep Quality Index29 global score ≤ 5 and report nightly total sleep time between 7 and 10 h with time in bed between 7 and 10.5 h. Exclusionary criteria included the presence of any clinically significant unstable medical condition; a DSM-IV axis-I psychiatric disorder during the past 2 years; a prior diagnosis of, or symptoms suggesting risk for, sleep apnea, restless legs syndrome, or other sleep disorder; a history of substance abuse in the past year; use within the prior 2 weeks of prescription hypnotic medication, over-the-counter sleep aid, or any psychotropic medication; a history of adverse reaction to benzodiazepines or similar medications; and a body mass index ≥ 36. In addition, participants could not be night or rotating shift workers; consume ≥ 700 mg per day of xanthine-containing food or beverages; consume > 14 units of alcohol per week; or smoke ≥ 1 pack of cigarettes per day, use chewing tobacco > 3 times per day, or be unable to refrain from smoking or chewing without distress or discomfort while in the sleep laboratory. Female subjects could not be pregnant or nursing and were required to use adequate contraceptive procedures throughout the study.
The protocol was approved by the Institutional Review Board of St. Luke's Hospital. All subjects provided written informed consent and were compensated for their participation.
A randomized, counterbalanced, double-blind, placebo-controlled, crossover design was used to compare overnight memory consolidation during three drug conditions:(1) zolpidem-ER 12.5 mg (bedtime dosing), (2) zaleplon 10 mg (middle-of-the-night dosing), and (3) placebo (Figure 1). To provide blinding, capsules containing drug or placebo were administered twice each night: 30 min before bedtime and 3.5 h after bedtime during a brief experimental awakening. Thus placebo was given in the middle of the night during the zolpidem-ER condition, before bedtime in the zaleplon condition, and at both times in the placebo condition. Subjects were randomly assigned to a study condition sequence using a Latin Square design and had a 1- to 2-week interval between visits to allow for adequate wash-out.
Each subject underwent three conditions with order counterbalanced: zolpidem-ER (bedtime dosing), zaleplon (middle-of-the-night dosing), and placebo. Capsules containing drug or placebo were administered twice each night: 30 min before bedtime and 3.5 h after bedtime. Placebo was administered in the middle of the night in the zolpidem-ER condition, before bedtime in the zaleplon condition, and both times in the placebo condition. Memory tests were conducted 90 min before bedtime and 60 min after wake time. Time in bed (dark bar) was 8 h with bedtime at the subject's usual bedtime.
Study design. Each subject underwent three conditions with order counterbalanced: zolpidem-ER (bedtime dosing), zaleplon (middle-of-the-night dosing), and placebo. Capsules containing drug or placebo were administered twice each night: 30 min before bedtime and 3.5 h after bedtime. Placebo was administered in the middle of the night in the zolpidem-ER condition, before...
(more ...)
Declarative memory and procedural memory tasks were administered 90 min before bedtime (60 min before drug administration) and 60 min after wake time, with the time between testing held constant at 10.5 h. The order of the tasks was counterbalanced within each study condition and held constant across conditions for each subject. Ninety minutes was chosen for the evening interval to allow time for memory testing and electrode placement prior to drug administration which occurred 30 min before bedtime. Sixty min was chosen for the morning interval so that testing occurred at a time when drug levels were undetectable or minimal. Thus morning testing occurred 9.5 h after zolpidem-ER dosing and 5.5 h after zaleplon dosing which is approximately 1.5 h after drug should have been eliminated based on pharmacokinetic data.23,24 Both time intervals are consistent with prior studies of SDMC involving overnight sleep.5,6
Polysomnography (PSG) was conducted at each of the 3 overnight visits with bedtime at the subject's reported typical bedtime and time in bed held constant at 8 hours. Sleep was recorded and scored according to standard criteria,30 using C3-A2 or C4-A1 EEG derivations by experienced staff blind to the experimental condition.
Subjects were instructed to cease caffeine consumption at 12:00 p.m., and to refrain from napping and consuming alcohol, on the days they were scheduled to arrive in the laboratory for overnight testing. In addition, use of nicotine products was prohibited while subjects were in the laboratory. Subjects were studied in private rooms without access to other subjects. During brief periods when testing was not conducted, subjects were permitted to engage in quiet activities such as reading or watching television. Breakfast was provided in the morning after awakening.
Double-blind study drug was prepared by a compounding pharmacy (Foundation Care, St. Louis, MO). Zolpidem-ER and zaleplon were over-encapsulated in identical #000-sized white opaque capsules and back-filled with an excipient (lactose). Identical placebo capsules contained only lactose. A dissolution test documented that there was less than a two-minute difference in dissolution of the outer capsule between the two active drug preparations.
Declarative memory was assessed with a word pair association task (WPT), modeled after that of Plihal and Born.31,32 Approximately 90 min prior to bedtime, 46 word pairs (23 related and 23 unrelated word pairs) were presented on a computer screen, one pair at a time for 3 sec each. Immediately following presentation of all 46 word pairs, an initial test of recall (WPT-Pre) was conducted. Participants were presented with the first (cue) word of each pair, one at a time and in a different order, and were asked to recall the second (target) word for each cue word. Immediately after each response, the correct word pairing—both cue word and target word—was displayed on the computer screen for 2 sec, regardless of whether the response was correct. Approximately 60 min after wake time, a second recall test (WPT-Post) was conducted during which subjects were again presented with the cue words, one at a time in yet a different order, and asked to recall the target words. Three unique versions of the test were utilized, with a different version administered during each of the 3 overnight conditions. Order of the test versions was randomly assigned and counterbalanced. SDMC was measured as the percent change in the number of correctly recalled word pairs from WPT-Pre to WPT-Post.
Procedural memory was assessed with a finger-tapping task (FTT), a test frequently used to demonstrate sleep-dependent memory.5,21 In this test, subjects are asked to type a 5-digit number sequence as quickly and as accurately as possible with the fingers of the nondominant hand by pressing 4 adjacent numeric keys on a standard computer keyboard. Subjects are instructed to look at the number sequence displayed on the computer screen while typing. No feedback on performance is given. Each test consists of twelve 30-sec tapping trials alternating with twelve 30-sec rest periods. The FTT was administered approximately 90 min prior to bedtime (FTT-Pre) and approximately 60 min after wake time (FTT-Post) using the same number sequence. Three versions of the test were utilized (2-4-3-1-2, 3-1-4-2-3, and 4-2-3-1-4), with a different version administered during each condition. Order of the test versions was randomly assigned and counterbalanced across conditions. SDMC was measured as the percent change in the number of correctly typed sequences from FTT-Pre (mean of the last 3 trials) to FTT-Post (mean of the first 3 trials).
Residual morning sedation was evaluated with the Digit Symbol Substitution Task (DSST), a measure of information processing, psychomotor performance, visuomotor coordination, and concentration. This test is commonly used as an indicator of psychomotor impairment and residual sedation following administration of hypnotics.33 The 90-sec test requires subjects to substitute digits (between 0 and 9) with different nonsense symbols according to a key which links symbols and digits. The DSST was administered 60 min after wake time and just prior to the FTT-Post and WPT-Post. Three unique versions of the test were utilized, with a different version administered each morning and order randomly assigned and counterbalanced. The primary performance measure was the number of correct substitutions.
Statistical analyses were conducted with SYSTAT 13, using repeated-measures ANOVAs followed by paired comparisons to examine condition differences. Age was used as a covariate for WPT analyses because it has been shown to affect declarative memory performance.34,35 PSG measures were examined for the entire 8 h, the first 3.5 h of the night, and the last 4.5 h of the night.
Twenty-six individuals gave written informed consent and were randomized to the study. Two subjects withdrew due to scheduling conflicts, and 2 subjects were excluded from data analysis because of unusual sleep patterns while on placebo (one subject's total sleep time was 263 min; one subject's percent of REM sleep was 41%). The final sample (N = 22) consisted of 14 females and 8 males, with a mean age of 29.4 ± 6.7 years. Subjects had mean body mass index of 25.4 ± 4.3, and reported consuming an average of 1.0 ± 0.8 caffeinated beverages per day and 1.9 ± 1.7 alcoholic beverages per week. All but one of the subjects were nonsmokers; that subject consumed an average of 8 cigarettes per day. Two extreme outliers (≥ 3 standard deviations from the mean) were noted on the WPT and excluded from analyses involving this task. This sample (N = 20) consisted of 14 females and 6 males, with a mean age of 30.1 ± 6.6 years.
Polysomnography data in minutes and percents are shown in Table 1. Because time in bed was constant at 8 h, comparisons are similar for minutes and percents. Significant differences in the paired comparisons for both measures are presented in the table but data in minutes are reported here.
Polysomnography data for each condition (N + 22)
Comparing zolpidem-ER and placebo conditions, several predictable differences of minor magnitude reached statistical significance. For the entire night, zolpidem-ER had a shorter latency to persistent sleep (p = 0.007), less wake after sleep onset (WASO; p = 0.026) and stage 1 (p = 0.003), as well as more total sleep time (TST; p = 0.010), stage 2 (p = 0.012), and slow wave sleep (SWS; p < 0.001). Most of these differences occurred in the first 3.5 h, with zolpidem-ER demonstrating less WASO (p = 0.001), stage 1 (p = 0.001), and REM (p = 0.005), as well as more TST (p = 0.004), stage 2 (p = 0.035), and SWS (p = 0.001) during this time period. During the last 4.5 h the only difference was less stage 1 with zolpidem-ER (p = 0.015).
Sleep architecture was similar between the zaleplon and placebo conditions. Comparisons between these conditions showed only one significant difference, an increase (by 10.5 min) in SWS in the zaleplon condition for the entire night (p = 0.003). There were no other differences for the entire night, the first 3.5 h (when placebo was present during both conditions), or the last 4.5 h (following middle-of-the-night dosing).
Because zolpidem-ER was taken at bedtime and zaleplon was dosed in the middle of the night, we performed comparisons between these conditions for the entire night as well as the last 4.5 h. In addition, the first 3.5 hours were compared to demonstrate that the sleep architecture differences between zolpidem-ER and zaleplon conditions were parallel, as expected, to the differences between the first 3.5 h of the zolpidem-ER and placebo conditions. Comparisons between the two active drug conditions for the entire night demonstrated less WASO (p = 0.022) and stage 1 (p = 0.005), as well as more TST (p = 0.006) and stage 2 (p = 0.003) with zolpidem-ER compared to zaleplon. For the first 3.5 h when placebo was present in the zaleplon condition, zolpidem-ER had less WASO (p = 0.001), stage 1 (p = 0.001), and REM (p = 0.031), as well as more TST (p = 0.008), stage 2 (p = 0.023), and SWS (p = 0.004), consistent with the zolpidem-ER/placebo comparisons for the same time period. During the last 4.5 h, zolpidem-ER had more stage 2 (p = 0.016) than zaleplon.
The DSST means (number of correct substitutions) were: zaleplon = 67.4 ± 11.7, placebo = 68.0 ± 11.9, and zolpidem-ER = 64.5 ± 11.1. Repeated-measures ANOVA indicated a trend for a condition effect (F(2,20) = 3.095, p = 0.067. Follow-up paired comparisons showed lower DSST scores with zolpidem-ER compared to placebo (p = 0.029) and a trend for lower scores compared to zaleplon (p = 0.052). Correlational analyses were thus conducted to determine if residual sedation might be responsible for poorer SDMC in the zolpidem-ER condition. These analyses revealed no significant correlations between DSST and memory measures.
Pre-sleep learning (the number of correctly-recalled word pairs on the WPT-Pre) was similar among the conditions: zaleplon = 24.5 ± 8.9, placebo = 25.1 ± 6.9, and zolpidem-ER = 25.8 ± 8.1 (F(2,17) = 1.725, p = 0.208). There was evidence of an overnight improvement in memory for each condition, measured as raw score change in correctly recalled word pairs from WPT-Pre to WPT-Post (zaleplon: 4.15 ± 3.6, placebo: 4.20 ± 3.8, and zolpidem-ER: 3.35 ± 3.7). Repeated-measures ANOVA, including age as a covariate, demonstrated a significant effect of condition for the percent change from WPT-Pre to WPT-Post (F(2,17) = 4.619, p = 0.025; Figure 2). Pairwise comparisons revealed significantly lower overnight improvement on WPT in the zolpidem-ER condition compared to both the placebo (p = 0.015) and zaleplon (p = 0.031) conditions. There was no difference between zaleplon and placebo (p = 0.58).
WPT: Mean percent change from pre-sleep (WPT-Pre) to post-sleep (WPT-Post). Means and standard deviations are adjusted for age. *placebo vs. zolpidem-ER, p = 0.015; ‡zaleplon vs. zolpidem-ER, p = 0.031.
Pre-sleep learning (the average number of correctly typed number sequences on the FTT-Pre) was similar among conditions: zaleplon = 19.3 ± 5.2, placebo = 20.0 ± 5.4, and zolpidem-ER = 20.2 ± 6.2 (F(2,20) = 1.52, p = 0.243). There was evidence of an overnight improvement in memory for each condition, measured as raw score change in correctly typed sequences from FTT-Pre to FTT-Post (zaleplon: 2.77 ± 2.0, placebo: 2.59 ± 3.0, and zolpidem-ER: 1.53 ± 2.8). Repeated measures ANOVA showed a trend towards a condition effect for the percent change from FTT-Pre to FTT-Post (F(2,20) = 3.097, p = 0.067). Pairwise comparisons revealed significantly lower overnight improvement on FTT for zolpidem-ER compared to placebo (p = 0.035), a trend for less improvement with zolpidem-ER compared to zaleplon (p = 0.057), and no difference between zaleplon and placebo (p = 0.78). Because plots of the data indicated sex may have differentially affected performance on the FTT, we added sex to the ANOVA model for a secondary analysis of percent change. This analysis revealed a condition effect (F(2,19) = 5.446, p = 0.014) and a trend for a condition by sex interaction (F(2,19) = 3.028, p = 0.072). Paired comparisons revealed significantly lower overnight improvement on FTT for zolpidem-ER compared to both placebo (p = 0.014) and zaleplon (p = 0.012), and no difference between zaleplon and placebo (p = 0.88; Figure 3).
FTT: Mean percent change from pre-sleep (FTT-Pre) to post-sleep (FTT-Post). Error bars are standard errors. *placebo vs. zolpidem-ER, p = 0.035; ‡zaleplon vs. zolpidem-ER, p = 0.057.
Exploratory correlation analyses were conducted for each condition to determine if improvements in memory were related to specific all-night PSG measures (TST, Stage 1%, Stage 2%, SWS%, and REM%). In the placebo condition, WPT percent change was positively correlated with REM% (r = 0.520, p = 0.019) and FTT percent change was negatively correlated with stage 2% (r = -0.432, p = 0.044). In the zolpidem-ER condition, WPT percent change correlated negatively with SWS% (r = -0.524, p = 0.018).
The objective of the present study was to determine the effect of different durations of hypnotic drug exposure on SDMC. We compared bedtime administration of zolpidem-ER 12.5 mg (6- to 8-h duration of action) with middle-of-the-night administration of zaleplon 10 mg (3 to 4-h duration of action) and placebo. ANOVAs revealed a significant condition effect for the WPT and a trend for the FTT, which was significant when sex was added to the model. The results suggest that bedtime administration of zolpidem-ER reduces the magnitude of SDMC while middle-of-the-night dosing with zaleplon does not.
One interpretation of these data is that the 3.5-h drug-free period of sleep prior to zaleplon ingestion was sufficient to allow SDMC to occur to the same degree as in the placebo condition, whereas having drug active in the brain for most of the sleep period, as in the zolpidem-ER condition, reduces SDMC. Observations from nap studies that as little as 45 minutes of sleep allows SDMC to occur is consistent with this interpretation.8,10 Our data do not address whether the timing of drug-free sleep is important. Similar results with zaleplon administered at bedtime (allowing a period of drug-free sleep in the latter part of the night) would suggest that some minimal period of drug-free sleep any time of night is sufficient to maximize SDMC. On the other hand, a decrement in SDMC in this circumstance would suggest that drug exposure early in the sleep period is a critical factor in diminishing SDMC.
Alternative explanations include differences specific to the two drugs or to the doses employed (affecting peak plasma and duration of action). Zaleplon and zolpidem-ER have different chemical structures. However, both are GABAA receptor agonists with preferential binding to the α-1 subunit, which is believed to be responsible for the drugs' sedative properties as well as for anterograde amnestic effects.36
We do not believe residual sedation accounts for the reduced SDMC with zolpidem-ER 12.5 mg. since testing was done 9.5 hours post-dose and studies of this drug as a hypnotic indicate no residual sedation 8.5 to 9.5 hours post dosing.25,26,37 Although DSST scores with zolpidem-ER were slightly lower than those with zaleplon and placebo, follow-up correlational analyses between DSST and WPT/FTT performance showed no significant findings, indicating that any residual sedation present in the zolpidem-ER condition did not predict performance on the memory tests. We also visually examined the data to determine if residual sedation was more likely to occur in females, since the FDA has recently lowered the recommended dosage of zolpidem-ER for women based on reports that some women eliminate zolpidem more slowly than men.38 Our females did have lower DSST scores in the zolpidem-ER condition than in the other conditions, while males showed equivalent DSST scores in all three conditions. However, these scores were not correlated with WPT/FTT performance. In fact, males (in contrast to females) appeared to perform more poorly on the memory tests in the zolpidem-ER condition than in the other conditions.
It is important to note that although SDMC was reduced in the zolpidem-ER condition, memory improvement across the sleep period was present in all three conditions. The overnight percent change in FTT performance in the zaleplon and placebo conditions (14.4% to 15.4%) is similar to the improvement seen in published studies using the same test with overnight sleep ranging from 3.5 to 7.5 hours (14% to 18%).5,39 In comparison, the percent change with zolpidem-ER was only 8%. It is difficult to compare the WPT data (which show overnight improvements of 16% to 19%) with published studies because of variability of methodology, particularly in type and number of word pairs used in those studies. Nonetheless, these data suggest that sleep with a hypnotic does not prevent SDMC from occurring, but may reduce its magnitude.
Previous research has shown that certain aspects of sleep architecture may be associated with SDMC,31 although there is inconsistency among studies. In our exploratory analyses (subject to type 1 error given the number of tests performed) we found only three significant correlations. In the placebo condition, FTT improvement correlated negatively with stage 2%. This conflicts with prior reports linking performance on this task with increased stage 2 or spindling.6,9,40 Also unexpected was the positive correlation between WPT improvement and REM%, as this task has been associated with SWS and/or stage 2.7,31,41,42 The single significant correlation in the drug conditions was a negative correlation between WPT percent change and SWS% in the zolpidem-ER condition, which also conflicts with previous findings that increases in SDMC are associated with increases in SWS.31,42,43 Perhaps the increase in SWS with zolpidem-ER does not have the same functional benefit as naturally occurring SWS. The fact that zolpidem increases slow wave activity only in frequencies ≤ 1 Hz44,45 provides some indication that the functional effect of increased SWS with zolpidem-ER may be different than naturally occurring SWS. The inconsistencies among studies suggest that many variables influence SDMC, so that there does not appear to be a simple relationship between gross measures of sleep and SDMC. Spectral analysis of the EEG may provide more insight into whether there is a relationship between sleep stages and memory consolidation with these hypnotics. Spindle detection analysis may also be beneficial since spindles have been linked with declarative7,46 and procedural memory.6,9,40,47
Our findings, if confirmed, may have implications for the treatment of insomnia. If hypnotics negatively affect SDMC, cognitive-behavioral treatment should be considered instead of or prior to pharmacological treatment of chronic insomnia, assuming no other compelling reasons to favor pharmacotherapy. When pharmacological treatment is considered, there may be an advantage for pro re nata treatment of insomnia, rather than prophylactic treatment in anticipation of sleep disturbance. In other words, taking a drug routinely to prevent insomnia might be less preferable than intermittent use so that SDMC can be optimized on nights when drug is not needed. Similarly, short-acting drugs, which allow some drug-free sleep to occur, may interfere less with SDMC than longer-acting drugs. Use of short-acting drugs or a drug with delayed release could be particularly advantageous for patients with sleep maintenance insomnia, the most frequent insomnia phenotype, with a population prevalence reported to be 16.1% to 23.5%.18,48 However, a much better understanding of SDMC in insomnia patients is needed before making such recommendations. A modest amount of evidence suggests that SDMC may be impaired in primary insomnia.49,50 Whether use of hypnotic medication in this population worsens this impairment is unknown. The clinical significance of SDMC impairment, whether caused by insomnia, hypnotic use, or their combination must also be taken into consideration. Understanding the effects of hypnotics on SDMC in normal individuals without sleep problems or medical comorbidities is an important first step in this evaluation.
In conclusion, the findings of this study advance our knowledge of the effects of hypnotics on SDMC, an area with little research to date. The results suggest that in some circumstances hypnotics may have the potential to reduce the degree of SDMC and that drug-free sleep early in the night may ameliorate this effect. Future studies of SDMC would benefit from comparisons of specific drugs administered at different doses and times as well as study of drugs with different mechanisms of action in individuals with insomnia as well as normal controls.
The research was funded by the American Sleep Medicine Foundation, Strategic Research Award. Research support has been provided to the Sleep Medicine and Research Center at St. Luke's Hospital by the following companies: Apnex, Merck, Respironics, Somnus, Vanda, and Ventus. Dr. Walsh has provided consulting services to Eli Lilly, GlaxoSmithKline, Merck, Pfizer, Respironics, Somnus, Transcept, Vanda, Ventus, and Vivus. Dr. Schweitzer was a member of the Speakers Bureau for Somaxon. Work was performed at the Sleep Medicine and Research Center, St. Luke's Hospital, Chesterfield, MO. The other authors have indicated no financial conflicts of interest.
analysis of variance; statistical test
Digit Symbol Substitution Task
extended-release drug
finger-tapping task
number of correctly-typed number sequences on the FTT test given before each sleep period
number of correctly-typed number sequences on the FTT test given after each sleep period
sleep-dependent memory consolidation; the improvement in memory from pre-sleep to post-sleep
slow wave sleep
total sleep time
wake after sleep onset
word pair task
number of correctly-recalled word pairs on the WPT test given before each sleep period
number of correctly-recalled word pairs on the WPT test given after each sleep period
Stickgold R, author. Sleep-dependent memory consolidation. Nature. 2005;437:1272–8. [PubMed]
Walker MP, Stickgold R, authors. Sleep, memory, and plasticity. Annu Rev Psychol. 2006;57:139–66. [PubMed]
Diekelmann S, Wilhelm I, Born J, authors. The whats and whens of sleep-dependent memory consolidation. Sleep Med Rev. 2009;13:309–21. [PubMed]
Walker MP, Stickgold R, authors. Sleep-dependent learning and memory consolidation. Neuron. 2004;44:121–33. [PubMed]
Walker MP, Brakefield T, Seidman J, Morgan A, Hobson JA, Stickgold R, authors. Sleep and the time course of motor skill learning. Learn Mem. 2003;10:275–84. [PubMed]
Walker MP, Brakefield T, Morgan A, Hobson JA, Stickgold R, authors. Practice with sleep makes perfect: sleep-dependent motor skill learning. Neuron. 2002;35:205–11. [PubMed]
Schabus M, Gruber G, Parapatics S, et al., authors. Sleep spindles and their significance for declarative memory consolidation. Sleep. 2004;27:1479–85. [PubMed]
Backhaus J, Junghanns K, authors. Daytime naps improve procedural motor memory. Sleep Med. 2006;7:508–12. [PubMed]
Nishida M, Walker MP, authors. Daytime naps, motor memory consolidation and regionally specific sleep spindles. PLoS One. 2007;2:e341. [PubMed Central][PubMed]
Tucker MA, Hirota Y, Wamsley EJ, Lau H, Chaklader A, Fishbein W, authors. A daytime nap containing solely non-REM sleep enhances declarative but not procedural memory. Neurobiol Learn Mem. 2006;86:241–7. [PubMed]
Bliss TV, Collingridge GL, authors. A synaptic model of memory: long-term potentiation in the hippocampus. Nature. 1993;361:31–9. [PubMed]
Benington JH, Frank MG, authors. Cellular and molecular connections between sleep and synaptic plasticity. Prog Neurobiol. 2003;69:71–101. [PubMed]
Walker MP, Stickgold R, Alsop D, Gaab N, Schlaug G, authors. Sleep-dependent motor memory plasticity in the human brain. Neuroscience. 2005;133:911–7. [PubMed]
Seibt J, Aton SJ, Jha SK, Coleman T, Dumoulin MC, Frank MG, authors. The nonbenzodiazepine hypnotic zolpidem impairs sleep-dependent cortical plasticity. Sleep. 2008;31:1381–91. [PubMed]
Aton SJ, Seibt J, Dumoulin MC, Coleman T, Shiraishi M, Frank MG, authors. The sedating antidepressant trazadone impairs sleep-dependent cortical plasticity. PLoS One. 2009;4:e6078. [PubMed Central][PubMed]
Roth T, Coulouvrat C, Hajak G, et al., authors. Prevalence and perceived health associated with insomnia based on DSM-IV-TR, ICD-10, and RDC/ICSD-2 criteria: Results from the America Insomnia Survey (AIS). Biol Psychiatry. 2011;69:592–600. [PubMed]
Leger D, Guilleminault C, Dreyfus JP, Delahaye C, Paillard M, authors. Prevalence of insomnia in a survey of 12,778 adults in France. J Sleep Res. 2000;9:35–42. [PubMed]
Ohayon MM, author. Prevalence of DSM-IV diagnostic criteria of insomnia: distinguishing insomnia related to mental disorders from sleep disorders. J Psychiatr Res. 1997;31:333–46. [PubMed]
Melendez J, Galli I, Boric K, et al., authors. Zolpidem and triazolam do not affect the nocturnal sleep-induced memory improvement. Psychopharmacology. 2005;181:21–6. [PubMed]
Silva A, Collao A, Orellana M, Melendez J, Caviedes P, Cardenas AM, authors. Zopliclone, but not brotizolam, impairs memory storage during sleep. Neurosci Res. 2003;47:241–3. [PubMed]
Morgan PT, Kehne JH, Sprenger KJ, Malison RT, authors. Retrograde effects of triazolam and zolpidem on sleep-dependent motor learning in humans. J Sleep Research. 2010;19:157–64. [PubMed]
Doble A, author. New insights into the mechanism of action of hypnotics. J Psychopharmacol. 1999;13:S11–20. [PubMed]
Weinling E, McDougall S, Andre F, Bianchetti G, Dubruc C, authors. Pharmacokinetic profile of a new modified release formulation of zolpidem designed to improve sleep maintenance. Fundam Clin Pharmacol. 2006;20:397–403. [PubMed]
Greenblatt DJ, Harmatz JS, von Moltke LL, et al., authors. Comparative kinetics and dynamics of zaleplon, zolpidem, and placebo. Clin Pharmacol Ther. 1998;64:553–61. [PubMed]
Blin O, Micallef J, Audebert C, Legangneux E, authors. A double-blind, placebo- and flurazepam-controlled investigation of the residual psychomotor and cognitive effects of modified release zolpidem in young healthy volunteers. J Clin Psychopharmacol. 2006;26:284–9. [PubMed]
Roth T, Soubrane C, Titeux L, Walsh JK, authors; Zoladult Study Group. Efficacy and safety of zolpidem-MR: a double-blind, placebo-controlled study in adults with primary insomnia. Sleep Med. 2006;7:397–406. [PubMed]
Danjou P, Paty I, Fruncillo R, et al., authors. A comparison of the residual effects of zaleplon and zolpidem following administration 5 to 2 h before awakening. Br J Clin Pharmacol. 1999;48:367–74. [PubMed]
Walsh JK, Pollak CP, Scharf MB, Schweitzer PK, Vogel GW, authors. Lack of residual sedation following middle-of-the-night zaleplon administration in sleep maintenance insomnia. Clin Neuropharmacol. 2000;23:17–21. [PubMed]
Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ, authors. The Pittsburgh Sleep Quality Index (PSQI): a new instrument for psychiatric research and practice. Psychiatry Res. 1989;28:193–213. [PubMed]
Rechtschaffen A, Kales A, editors. A Manual of Standardized Terminology, Techniques and Scoring System of Sleep Stages in Human Subjects. 1968. Los Angeles, CA: Brain Information Service/Brain Research Institute, University of California.
Plihal W, Born J, authors. Effects of early and late nocturnal sleep on declarative and procedural memory. J Cogn Neurosci. 1997;9:534–47. [PubMed]
Plihal W, Born J, authors. Memory consolidation in human sleep depends on inhibition of glucocorticoid release. NeuroReport. 1999;10:2741–7. [PubMed]
O'Hanlon JF, author. Residual effects on memory and psychomotor performance of zaleplon and other hypnotic drugs. Primary Care Companion. J Clin Psychiatry. 2002;4 suppl 1:38–44.
Mitchell DB, Brown AS, Murphy DR, authors. Dissociations between procedural and episodic memory: effects of time and aging. Psychol Aging. 1990;5:264–76. [PubMed]
Provyn JP, Sliwinski MJ, Howard MW, authors. Effects of age on contextually mediated associations in paired associate learning. Psychol Aging. 2007;22:846–57. [PubMed Central][PubMed]
Stahl S, author. Stahl's Essential Psychopharmacology: Neuroscientific Basis and Practical Applications. 2008. 3rd ed. New York, NY: Cambridge University Press.
Greenblatt DJ, Legangneux E, Harmatz JS, et al., authors. Dyamics and kinetics of a mofified-release formulation of zolpidem: comparison with immediate-release standard zolpidem and placebo. J Clin Pharmacol. 2006;46:1469–80. [PubMed]
U.S. Department of Health & Human Services. U.S. Food and Drug Administration. FDA Drug Safety Communication: Risk of next-morning impairment after use of insomnia drugs; FDA requires lower recommended doses for certain drugs containing zolpidem (Ambien, Ambien CR, Edluar, and Zolpimist). Accessed January 11, 2013. http://www.fda.gov/Drugs/DrugSafety/ucm334033.htm.
Tucker MA, Fishbein W, authors. The impact of sleep duration and subject intelligence on declarative and motor memory performance: how much is enough? J Sleep Res. 2009;18:304–12. [PubMed]
Morin A, Doyon J, Dostie V, et al., authors. Motor sequence learning increases sleep spindles and fast frequencies in post-training sleep. Sleep. 2008;31:1149–56. [PubMed]
Schmidt C, Peigneux P, Muto V, et al., authors. Encoding difficulty promotes postlearning changes in sleep spindle activity during napping. J Neurosci. 2006;26:8976–82. [PubMed]
Molle M, Marshall L, Gais S, Born J, authors. Learning increases human electroencephalographic coherence during subsequent slow sleep oscillations. Proc Natl Acad Sci USA. 2004;101:13963–8. [PubMed]
Marshall L, Molle M, Hallschmid M, Born J, authors. Transcranial direct current stimulation during sleep improves declarative memory. J Neurosci. 2004;24:9985–92. [PubMed]
Monti JM, Alvarino F, Monti D, authors. Conventional and power spectrum analysis of the effects of zolpidem on sleep EEG in patients with chronic primary insomnia. Sleep. 2000;23:1075–84. [PubMed]
Walsh JK, Deacon S, Dijk DJ, Lundahl J, authors. The selective extrasynaptic GABAA agonist, gaboxadol, improves traditional hypnotic efficacy measures and enhances slow wave activity in a model of transient insomnia. Sleep. 2007;30:593–602. [PubMed]
van der Helm E, Gujar N, Nishida M, Walker MP, authors. Sleep-dependent facilitation of episodic memory details. PLoS One. 2011;6:e27421. [PubMed Central][PubMed]
Fogel SM, Smith CT, Cote KA, authors. Dissociable learning-dependent changes in REM and non-REM sleep in declarative and procedural memory systems. Behav Brain Res. 2007;180:48–61. [PubMed]
Walsh JK, Coulouvrat C, Hajak G, et al., authors. Nighttime insomnia symptoms and perceived health in the America Insomnia Survey (AIS). Sleep. 2011;34:997–1011. [PubMed]
Nissen C, Kloepfer C, Nofzinger EA, Feige B, Voderholzer U, Riemann D, authors. Impaired sleep-related memory consolidation in primary insomnia. Sleep. 2006;29:1068–73. [PubMed]
Backhaus J, Junghanns K, Born J, Hohaus K, Faasch F, Hohagen F, authors. Impaired declarative memory consolidation during sleep in patients with primary insomnia: influence of sleep architecture and nocturnal cortisol release. Biol Psychiatry. 2006;60:1324–30. [PubMed]


text:
March 2007 Journal of Geoscience EducationVolume 55, Number 2
Conceptions of the Greenhouse Effect and Global Warming among Elementary Students from Diverse Languages and Cultures
Okhee Lee, University of Miami
Benjamin T. Lester, University of Miami
Li Ma, University of Miami
Julie Lambert, Florida Atlantic University
Melissa Jean-Baptiste, University of Miami,
URL for this article: http://www.nagt.org/nagt/jge/abstracts/mar07.html#v55p117
Teaching Geology in the Field: Significant Geoscience Concept Gains in Entirely Field-based Introductory Geology Courses
Joe T. Elkins and Nichole M.L. Elkins, Bowling Green State University
URL for this article: http://www.nagt.org/nagt/jge/abstracts/mar07.html#v55p126
FossilPlot, an Excel-based Computer Application for Teaching Stratigraphic Paleontology Using the Sepkoski Compendium of Fossil Marine Genera
Leif Tapanila, Idaho State University
URL for this article: http://www.nagt.org/nagt/jge/abstracts/mar07.html#v55p133
Box Diagrams to Assess Students' Systems Thinking about the Rock, Water and Carbon Cycles
Duncan F. Sibley, Charles W. Anderson, Merle Heidemann, John E. Merrill, Joyce M. Parker, and David W. Szymanski, Michigan State University
URL for this article: http://www.nagt.org/nagt/jge/abstracts/mar07.html#v55p138
Using Mobile Mapping to Determine Rates of Meander Migration in an Undergraduate Geomorphology Course
Kirsten Menking and Meg E. Stewart, Vassar College
URL for this article: http://www.nagt.org/nagt/jge/abstracts/mar07.html#v55p147
A Redesigned Geoscience Content Course's Impact on Science Teaching Self-efficacy Beliefs
Tracy J. Posnanski, University of Wisconsin-Milwaukee
URL for this article: http://www.nagt.org/nagt/jge/abstracts/mar07.html#v55p152
Teaching the Nitrogen Cycle and Human Health Interactions
Margaret Townsend, University of Kansas
Audrey C. Rule, State University of New York at Oswego
Mary Ann Meyer, Thomas M. Cooley High School, Detroit Public Schools
C. Jolene Dockstader, Jerome School District, Jerome, Idaho
URL for this article: http://www.nagt.org/nagt/jge/abstracts/mar07.html#v55p158
Introducing Medical Geology to Undergraduates as a Critical Thinking and Risk Assessment Tool
Anne Taunton and Mickey Gunter, University of Idaho
URL for this article: http://www.nagt.org/nagt/jge/abstracts/mar07.html#v55p169
A Professional Engineering Degree in Petroleum Geoscience to Satisfy Caribbean Industry
Richard A. Dawe, Brent Wilson, and Winston Rajpaulsingh The University of the West Indies
Faced with industrial growth but an aging community of petroleum geoscientists, the petroleum industry in Trinidad and Tobago needs an injection of locally-grown graduates trained to the highest international standards to fill professional positions. To address this requirement, an undergraduate program in Petroleum Geoscience was introduced into the Faculty of Engineering at the University of the West Indies' Trinidad Campus in September 2001. This was done at the request of the Geological Society of Trinidad and Tobago (GSTT), the Government, and the major upstream petroleum companies, all of whom assisted in the development of the unique, 3-year program by forming an industry advisory committee (the JIAAC). The program was taken through all its committee stages during May-July 2001. Subsequent progress has been phenomenal. All student intakes (limited to about 15 and comprising local citizens) have had excellent qualifications and have included some of the best science-based school performers. Industry has already assimilated three cohorts of students, totalling 43 graduates. Some have either been posted abroad by their companies for career development, or are abroad for further study, often sponsored by their company. A further 46 are currently progressing through the program.
This paper describes this undergraduate program in petroleum geoscience and engineering. It is one of the few university geoscience programs worldwide that (a) was created through a partnership of academia, government and industry, (b) focuses on the Petroleum Sector, and (c) has the potential to be recognized globally as an ideal setting for the recruitment of quality geoscientists for petroleum exploration, development and engineering. The partnership between industry, higher education, government, and professional bodies provides for prime development of human resources, which is the key investment in developing the next generation of local professionals.
URL for this article: http://www.nagt.org/nagt/jge/abstracts/mar07.html#v55p181

subset: commoncrawl


text:
Young Punxsy collector finds himself a new fancy
PUNXSUTAWNEY — One of Punxsy's most well-known collectors is back at it, and this time around he's putting a new spin on an old trick.
After collecting a license plate from each state from cars, Douglas Bartlebaugh, a 17-year-old Punxsutawney Area High School student, decided it might be time to start collecting a miniature version of one of his old favorites: motorcycle license plates.
"My uncle gave me a Pennsylvania motorcycle plate, and I already had all the states for the cars, so I figured it was time to start something new," Bartlebaugh said.
Bartlebaugh said that his time spent tracking down the car plates has led him to a place where he knows how to find them, but he did admit that sometimes, he has to resort to the Internet.
"I've picked some up at flea markets in Ohio; I got one at a yard sale last year; and then some of them, I've had to buy on eBay," he said.
Bartlebaugh's family said he's been a collector ever since he was a youngster, citing his habit of peeling license plates off of cars at the family's junkyard when he was just 3 years old.
Fourteen years later, Bartlebaugh's knack for collecting continues, and he has his eyes set on the new prize of rounding out another collection with a bit of hard work.


text:
Two Dads, Many Roots
I am adopted from Paraguay and have two dads from very different backgrounds–one is white and only has one family member; the other is Asian-American and has a huge family scattered all across the West Coast.
With that side of my family, there is always something going on. We follow a tradition where we honor our ancestors a few times a year by taking chicken, incense, and paper money to the cemetery. We lay everything out in front of the gravestones, light the incense and burn the paper money. Then we bow three times before each of our ancestors to show our respect. My grandparents teach us Chinese calligraphy, showing us new ways to communicate and connect with our family roots.
I remember little about my birthplace or my family. But two years ago, I went to visit my mother for the first time in Paraguay. We went to my aunt's house where I met my mother and although I had never seen her before, I knew that we were related somehow. It amazed me that something so different can suddenly feel so close and similar.
Throughout my life, the thing that has kept me feeling safe and care-free is my community and friends. I spent most of my life in a cohousing community on Bainbridge Island, Wash., and went to school with a core group of friends from kindergarten through eighth grade—an experience I've only recently come to fully appreciate. My friends and I have learned about the world together.
In fifth grade, we went on a field trip to the San Juan Islands just north of Seattle, where we camped and learned about the wildlife in the local ecosystem. Discovering the wilderness with friends—and learning how humans are a part of the whole natural system—was wonderful. We had a great time learning and formulating ideas together. I remember camping on the beach and realizing how much nature can entertain you if you just allow it.
When I was in the 7th grade, my family moved to Costa Rica for a year of language and cultural immersion. It was a time of excitement, fear, and uncertainty. I had to adjust to a new life, a new house, a new school, and new friends. At first, my brother and I did not meet many people. But as soon as school started I made friends quickly. I realized that there were so many aspects of the world that I did not understand and was not exposed to in the United States. I became interested in learning more about the world and especially about how people communicated with each other.
Being a seventh-grader with two dads was not as unique as I thought. I learned that everyone has a different family, and mine was just one among many kinds.
Video: A mother-daughter interview about one family's immigration to the United States.
Now that I live in Seattle, I see how helpful living in a small community was when I was young. It gave me the time to think about the world, develop opinions, and create strong relationships. Having the same friends from kindergarten through eighth grade was probably the biggest influence on my feeling of community. I have told many people about being adopted and having two dads. It isn't hard or embarrassing because everyone is "different" in some way.
My family not only supports, but encourages me to make a difference in the world, and my real passion is working to make this society a better place. Being able to understand a lot about the world that I live in helps me to feel not only supported but confident that my family will have my back no matter where I am or what I do.
16-year-old Rafael Regan wrote this article for What Happy Families Know, the Winter 2011 issue of YES! Magazine. Rafael lives in Seattle and hopes to pursue his interest in urban planning, the environment, and social justice in the future.
More Family Stories
|My New Sisters
|How I Fight For
My Family
|Two Dads, Many Roots
|Sex Without Jealousy,
Love Without Ownership
|Did I Ever Tell You
The Story ... ?
|The Child We
Never Had
Grandpa's Love
- More stories from , the Winter 2011 issue of YES! Magazine
- :
9 progressive policies to support our families.
- :
A celebration of friendship, family, love, and laughter.


text:
British playwright Polly Stenham is still in her mid-20s, but she has received the kind of attention from the London theater power brokers — commissions, awards and lavish praise — that most emerging playwrights in the cash-poor world of American fringe theater can only dream about. Her debut, "That Face," penned when she was just 19, pushed her to the forefront of a new generation of British female playwrights.
I didn't see "That Face" in its local premiere last year at Redtwist, but Stenham's follow-up, "Tusk Tusk," is now in its U.S. premiere with Piven Theatre. As a showcase for teen actors — quite a few of whom Piven has trained during the past 40 years — it's a powerhouse, as one might expect from a writer close in age to the characters. Director Jennifer Green's production has a decidedly grungier edge than one usually sees at this venerable story-theater outpost. But frankly, it's just not a very good play, and at two hours, it takes too long to tell us nothing particularly new about abandoned kids.
Eliot (Bryce Lunsky) and Maggie (Olivia Cygan) are 16 and 14, respectively. Their mentally ill mother has taken off for parts unknown, as she has so many times in the past. Terrified that they, along with their 7-year-old brother, Finn, (Gabriel Stern) will be put "in care" (the British foster system) and split up, they hide out in their filthy London flat, waiting like teenage versions of Beckett's tramps for their Godot-like mum to return.
"Tusk Tusk" takes its title from David McKee's allegorical children's book about black and white elephants that war against each other. But the literary antecedents for Stenham, which she references in neon, are Peter Pan and Maurice Sendak's "Where the Wild Things Are." Eliot — with his increasingly desperate belief that he can outwit the adults and his appetite for making time with his own version of Tiger Lily, the lovely Cassie (Austin Moore) — is obviously meant to be Peter. Pragmatic and increasingly anguished Maggie plays Wendy to her lost boys. And adorable Finn imagines himself as Max from Sendak's book.
The insularity of the world created by Stenham tends to be suffocating (and repetitive, and occasionally pitched at high volumes), so that when outsider Cassie does enter, one wonders why she doesn't quickly grasp that something is amiss with the siblings and call the proper authorities. Stenham also can't make a convincing case for why Maggie in particular, who we learn was always the responsible caretaker for their screwed-up mother, doesn't grab Finn and leave once Eliot's behavior starts shading into dangerous territory.
Kids growing up too soon and raising their younger siblings because of absent parents can be rich territory, as the Gallagher clans in both the British and American versions of the television series "Shameless" demonstrate. And in its more playful moments, Stenham's script convinces us of the fierce bond these three have forged. But as the melodrama heats up, the believability fizzles out. These bold and brave young actors deserve a better showcase.
When: Through Oct. 7
Where: Piven Theatre at the Noyes Cultural Arts Center, 927 Noyes St., Evanston
Running time: 2 hours
Tickets: $25 at 847-866-8049 or piventheatre.org


text:
Venom di Leopoldo La Ciura
Web site texts and images, © 2014 Panini S.p.A., all rights reserved. Marvel Comics and all related images and logos are © 2014 MARVEL (marvel.com). All other images are © and TM their respective owners.
All copyrighted material is used only for journalistic and promotional purposes.
Format "Marvel made in Italy" © 2007/2014 and created by Matteo Losso.


text:
WASHINGTON (Reuters) - U.S. national security adviser Susan Rice returned to center stage on Monday to deliver a forceful call for limited U.S. military strikes in Syria, nearly a year after her comments about another foreign crisis turned her into a target for Republican anger.
In her first major speech since the former U.S. ambassador to the United Nations started her White House job in July, Rice said Washington had to respond to the "atrocity" and "outrage" of chemical weapons use in Syria.
President Barack Obama's administration intended to return to a diplomatic track to try to resolve the Syria conflict, but this would be following "any limited (military) strikes" to degrade that country's chemical weapons capabilities, Rice said.
"This most recent atrocity is particularly gut-wrenching," she said in a speech at the New America Foundation in Washington, as part of Obama's push to persuade Congress and a doubtful public to support military strikes against Syria.
She described the "hellish chaos and terror" of the August 21 chemical weapons attack, with "those little children, laying on the ground, their eyes glassy, their bodies twitching." The Obama administration says more than 1,400 people were killed, including 400 of them children.
"This cannot stand," Rice said. "As the one indispensable leader in the world, the United States of America can and must take action - carefully, responsibly, purposefully - to reduce the chances of such an outrage happening again."
It was the kind of blunt language Rice was known for before criticism of comments she made about a militant attack on a U.S. diplomatic compound in Benghazi, Libya last year forced her off the public stage to take more of a behind-the scenes foreign policy role.
Last September, while still serving as U.S. ambassador to the United Nations, Rice said the attack that killed four Americans at the U.S. mission in Benghazi, was the work of a spontaneous crowd, instead of Islamic militants.
When this proved false, Republican lawmakers charged Rice had been trying to protect Obama during his re-election campaign, which the White House disputed.
Rice eventually withdrew her name from consideration to be nominated as Obama's second-term secretary of state and former Senator John Kerry got the job. Instead, Rice was appointed national security adviser, which does not require Senate confirmation.
She has been relatively quiet since beginning her new duties at the White House. Syria is her most serious challenge so far and she has occasionally tweeted her views on the importance of holding President Bashar al-Assad accountable for the chemical weapons attack.
On Monday, Rice asserted there was no doubt who was responsible for the chemical weapons attack and said Assad had used chemical weapons on a small scale several times before.
"The intelligence we've gathered reveals senior (Syrian) officials planning the attack and then afterwards, plotting to cover up the evidence by destroying the area with shelling," she said. Assad has denied he was behind it and said in an interview with CBS that evidence was not conclusive there had been such an attack.
Rice did not say what she thought of Russia's proposal that Syria's chemical weapons be put under international control, or a suggestion by U.N. Secretary General Ban Ki-moon that the Security Council could demand Damascus move its chemical arms stocks to a place where they could be safely destroyed.
However, she declared that past U.N. behavior on Syria had been "shameful," especially the actions of Russia and China, which opposed Security Council resolutions condemning the Syrian government. She also threw cold water on the idea that the council would now uphold an international ban against the use of chemical weapons with sanctions or an authorization of force.
"Let's be realistic. It's just not going to happen now," Rice said. "Believe me. I know. I was there for all of those U.N. debates and negotiations on Syria. I lived it. It was shameful."
(Additional reporting by Deborah Charles and Steve Holland.; Editing by Alistair Bell and Christopher Wilson)


text:
Now proudly part of the Sun Communities family.
Stay up to date with all the latest community news and important announcements with the community newsletter. Click the button on the right to download the PDF.
It can be hard to keep track of all the fun events and activities happening in Country Lakes, so this calendar puts all the information you need in one place. Want to learn even more about your community? The newsletter has a thorough list of the activities available in and around Little River, SC. If you'd like to learn more about a particular event, just click the name in the calendar above. Have a suggestion of an event we should organize for the residents of Country Lakes? Reach out to us today to let us know!


text:
Episode 217: Co-hosts B.L. Ochman and David Erickson discussed the Guggenheim Museum's punking of Donald Trump with a golden toilet; the Finnegans beer augmented reality Super Bowl commercial; one-star Paris reviews; how Burger King educated consumers about Net Neutrality with Whopper Neutrality PSA ad; get out the vote postcards; Elton John's 360 retirement tour trailer; Budweiser's Big Data focus; Facebook's newsfeed fail; the Super Bowl America deserves; the Twitter follower factory; plus great new apps and stats you should know…and much, much more.
Home » vintage movie posters


text:
Copyright (C) 1999-2015 eZ Systems AS. All rights reserved.
This file may be distributed and/or modified under the terms of the "GNU General Public License" version 2 as published by the Free Software Foundation and appearing in the file LICENSE included in the packaging of this file.
Licencees holding a valid "eZ Business Use License" version 2.1 may use this file in accordance with the "eZ Business Use License" version 2.1 Agreement provided with the Software.
This file is provided AS IS with NO WARRANTY OF ANY KIND, INCLUDING THE WARRANTY OF DESIGN, MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE.
The "eZ Business Use License" version 2.1 is available at http://ez.no/Products/About-our-Software/Licenses/eZ-Business-Use-License-Agreement-eZ-BUL-Version-2.1 and in the file PROFESSIONAL_LICENCE included in the packaging of this file. For pricing of this licence please contact us via e-mail to email@example.com. Further contact information is available at http://ez.no/About-eZ/Contact-Us.
The "GNU General Public License" (GPL) is available at http://www.gnu.org/copyleft/gpl.html.
Contact eZ Systems if any conditions of this licencing isn't clear to you.


text:
While Ellen DeGeneres is known for hilariously scaring her show's guests, sending them to a haunted house is taking it to a whole new level.
The victims this time around were her producer Andy Lassner and "Modern Family's" Eric Stonestreet. Together they braved twists and turns stocked with droves of mutilated zombies leaping out in front of them. And "The Ellen DeGeneres Show's" cameras were there capturing their every ridiculous reaction. Seriously, you have to see this video.
PHOTOS: Eek! Peep these celebs' creepy Halloween pics
While we get that it's in celebration of the Halloween season, we would rather eat a Vaseline-frosted cupcake with cockroach sprinkles than partake in said festivity. Is it even considered festive if all you're doing is screaming and hating life for the duration of the experience?
Whatever, we're just going to stick to a rousing night of trick-or-treating in our "Hotline Bling" girl costume.
PHOTOS: Check out how these other stars are celebrating Halloween


text: POLITICS President Obama's Campaign Trashes '2016: Obama's America' 9:49 AM PDT 9/11/2012 by Paul Bond FACEBOOK TWITTER EMAIL ME Filmmakers call it "the movie the White House doesn't want you to see." Apparently, they're right. Perhaps the president was hoping 2016: Obama's America would come and go unnoticed like so many other political documentaries. But seven weeks after its opening, the film is still going strong, prompting Barack Obama to finally respond, which he has done through a lengthy entry at his campaign's website that calls the movie "a deliberate distortion" of his "record and world view." EXCLUSIVE AUDIO: '2016: Obama's America' Filmmaker Calls White House Attack 'Clumsy,' 'Bizarre' The entry at BarackObama.com quotes from several negative reviews of the film and claims Dinesh D'Souza, who stars in the film based on his book, The Roots of Obama's Rage, has a "long history of attempting to add a veneer of intellectual respectability to fringe theories, conspiratorial fear-mongering and flat-out falsehoods." The entry is dated Sept. 5, just ahead of the weekend in which 2016: Obama's America became the second-highest-grossing political documentary in history, behind only Fahrenheit 9/11, and the sixth-biggest documentary of any kind. The movie has earned $26 million domestically since opening July 13. VIDEO: 'Obama's America' Filmmaker Lashes Out at Media Among the movie's inaccuracies, according to BarackObama.com: "D'Souza falsely claimed that President Obama said he didn't believe in American Exceptionalism." "D'Souza falsely asserted that President Obama funded $2 billion in Brazilian oil exploration even though numerous fact checkers and reporters have noted that President Obama had nothing to do with the loan." "D'Souza falsely charged that President Obama backed Scotland's release of the Lockerbie bomber only weeks after the Obama administration had put out a statement opposing Scotland's decision." "D'Souza even claimed that President Obama passed the bank bailouts when the facts clearly show that it was President Bush who signed the Troubled Asset Relief Program into law in October 2008." The film, which its marketers dubbed, "the movie the White House doesn't want you to see," was in 2,017 theaters during the weekend and is expected to be on the same number this coming weekend. PHOTOS: 20 Biggest Political Players in Hollywood For good measure, the website entry also bashes some of Obama's harshest critics: Tea Partiers. "It should say enough about D'Souza's credibility that a movie catering to the Tea Party attacks someone for allegedly 'anti-colonial' views," the entry reads. "His attempts to hide his lies behind pseudo-scholarly presentation and glossy production values cannot withstand basic scrutiny. The facts show that 2016: Obama's America is nothing more than an insidious attempt to dishonestly smear the President by giving intellectual cover to the worst in subterranean conspiracy theories and false, partisan attacks." Email: firstname.lastname@example.com FACEBOOK TWITTER EMAIL ME Paul Bond firstname.lastname@example.com @thr


text:
My Shopping CartCart
Close Recently added item(s)
You have no items in your shopping cart.
Product Review (submitted on October 16, 2017):
Beautiful colors that match the fabrics so well!
We use cookies to enhance your experience on our website. To learn more about cookies please see our privacy policy for more information. By continuing or clicking accept you accept the use of cookies.Accept
Please wait...
My Cart Summary


text:
Wooden Framed Advertising Poster Decoration Porcelain Tile Made
Model Number: ISFP 005
Material: picture/ wooden frame
Reference size: 110X70X2cm
Certification: CE, UL , ROHS
MOQ: 500 pcs
OEM&ODM and Customized Brands are welcome
Technics: CYMK printing
Features: Combination of decoration tiles and wooden frame, to be beautiful indoor poster and display Brand
Application: Bar /club / promotion /advertisement
OEM design is welcome, we can make this kind of products according to customers' specification
About Ideal Sign
Started from 2002 in the POS areas, we help you design, develop and implement innovative solutions for alcohol and drinks brand promotion. We are your creative and reliable partner in the fulfillment of your very initial ideas to the finished products. We are mainly focus on liquor bottle display, led ice bucket, slim light sign, illuminated pub sign, indoor led signs, bar top bottle opener, advertising board, wine packaging & racks and bar related products with clients including Coca Cola, Heineken, Budweiser, Chivas, Corona Extra, etc.


text:
Journal Article
© Jan 2008 Volume 5 Issue 4, Editor: Charles Despres, pp347 - 550
Look inside Download PDF (free)
This paper reports from an interpretive case study conducted in a multinational company that operates in the . marine insurance industry. The study focuses on how structural diversity influences knowledge work activities performed by participants who are members of distributed networks of practice (DNoPs). In this paper, a DNoP is defined as a loosely knit, geographically dispersed group of participants who share knowledge with the purpose of solving business problems and improve daily work practices within an organization. The paper takes the view that dimensions of structural diversity such as geographical dispersion, business functions and business divisions define internal organizational boundaries. Thus, knowledge sharing in structurally diverse networks may be less efficient due to the barriers that these internal boundaries may cause. Structural diversity, however, may also enhance creativity and innovation where radical new insights arise from different perspectives introduced by the participants. Consequently, diversity and its potential boundaries embed a duality of contradictory features. The interviewees who participated in this study regarded diversity as a valuable resource. Different perceptions of business concepts, however, caused misunderstanding and conflicts between participants who worked at different business divisions and thus were geographically dispersed. Interesting findings demonstrated that the DNoPs under study went through an evolution where participants enacted through boundary spanning activities to overcome the barriers that structural diversity caused. The role of knowledge brokers and the use of boundary objects were crucial in these activities. While some boundary objects acted as obstacles, unexpected and illogical objects emerged from practice and became the most efficient boundary objects in use. Different communication media such as video‑ and teleconferences, email and intranet supported the boundary spanning processes. This paper brings the insight that networks were transformed by the influence of diversity, and that knowledge practices within the networks supported a shift as the networks evolved through cross‑network interactions.
Keywords: Network of practice, knowledge sharing, structural diversity, boundary object, boundary spanning, knowledge broker
Share |


text:
We have an exciting opportunity for an experienced Magento Project Manager to join an industry leading Magento Digital Agency based in Pompano Beach, FL.
The ideal candidate must have 1+ year experience working as a Magento Project Manager.
The position offers excellent benefits including: Health, Vision, Dental, 401k, Bonus, Company paid meals including breakfast and lunch, Salary reviews every 6 months, and Paid certifications.
If you are interested, please apply today!


text:
Books, Movies, Music
JCPL Catalog
Reading programs and Book Groups
Kids & Teens
Kids Zone
Teens Only
For Parents and Teachers
Student Portal
Main Content
What are you going to do with 2014?
According to hash tags, 2013 was a year of natural disasters, celebrity deaths and blurred social lines. Maybe some of things are better left in the past, but each year as we look back on what happened, we can choose to remember what we want.
What will you choose to make the highlights of the year? What will you choose to remember as 2014 goes by?
One way to remember those important thoughts: make a memory jar. Clean a glass jar after the next pasta night and decorate with markers or paint. Every time something memorable happens, such as a movie date with friends, or that perfect moment, write it down and stick it in. At the end of the year, pull them all out and read them, save them, scrapbook them, or just dump them out like happy dandelion fluff and start all over. Whatever fits your style.
Maybe social media is your thing. You could go around retexting buzz like everyone else, or you could do something a little crazy. What would happen if every day you decided to tweet one nice thing about someone? Maybe lots of nice things about lots of someones? Check out this video from the Today show about some students in Iowa who tried just that.
According to a 2005 study, the most important factor in being happy in life is gratitude. Showing you are grateful for someone, or something, makes you happy. Taking a moment to appreciate the things that make life worthwhile makes them all the sweeter.
Here's hoping there are many sweet moments in your coming year and more!


text:
Had enough of reading Shakespeare? Sit back and listen to Shakespeare audio books instead! Listening to Shakespeare gives an alternative way to interact with The Bard, and is a different experience to watching or reading Shakespeare. We've scoured the internet for the best deals on Shakespeare audio books. Below is a list of our favorite Shakespeare audiobook picks:
Having problems viewing the above Shakespeare audiobooks? View Shakespeare audiobooks directly on Amazon >>


text:
COLUMBUS: Several companies including Kroger Co. have won approval to receive job creation tax credits for their proposals in Ohio.
The Ohio Tax Credit Authority on Monday approved assistance for 11 projects expected to create 410 jobs and retain another 874 positions statewide.
Kroger plans to add 23 full-time jobs in Columbus, generating $1.5 million in additional annual payroll.
Air Transport International Inc. is creating 65 full-time positions as a result of the company�s new location project in Wilmington in southwest Ohio. The company flies passenger and cargo aircraft.
Robert Rothschild Farm in Urbana will add 25 full-time positions as part of an expansion project at the gourmet foods manufacturer.


text:
jul 5
Swim in crystal clear waters, then bike and run through the heart of Carinthia and Klagenfurt.
OpenRegister ▻
*Click here for the full list of the 2018 IRONMAN Athletes' Choice Award winners.
Every year IRONMAN Austria attracts 3,000 athletes from over 60 countries to compete in what has been described as the perfect triathlon landscape. Known as one of the most beautiful races in the world, IRONMAN Austria has become legendary among athletes. They enjoy being part of one big IRONMAN Austria family and rave about one of the most emotional finish lines in the sport. Fans cheer on every athlete until the very last one has achieved their goal.
Klagenfurt is situated at one end of the beautiful Lake Wörthersee with an average temperature of 22° C. After swimming, the athletes bike through the scenic landscape of Carinthia. The bike course, which has a Tour de France atmosphere, with two steep climbs on each loop. The run course along the lakeside and through the city is mainly flat and shaded.
2020 IRONMAN Austria-Kärnten offers 40 qualifying slots for the 2020 Vega IRONMAN World Championship in Kailua-Kona, Hawai'i.


text: Hennig Olsen Is AS, Norway - Constructor Group Pallet Racking Reference Hennig Olsen Is AS founded 1924 by Sven Hennig-Olsen. The factory in Kristiansand was built in 1960 and has been in continuous development since. Today the factory is an ultra-modern producer of ice cream. Due to a constant flow of new products, and a regular increase of output, the warehouse for labels and packaging required more space. Solution: The solution was to replace the existing racking with MOVO - mobile pallet racking. This increased the number of pallet spaces by 70%. Capacity: Pallet spaces: 1934 palletsLength of trolley: 15 metreHeight: 6.5 metreNo in height: 5 pallets


text:
Get to the Chopper!
DUNEDIN, Fla. — An Arnold reference there in honor of today's events at Knology Park. After a light, breezy, Spring Trainingy workout at the Jays' home ballpark — miles away from where the "B" squad was taking on the Twins in Fort Myers — Alex Rios came out of the clubhouse with a gasoline-powered, remote-control, four-foot long helicopter.
Rios and Jeremy Accardo set the thing up in the warning track in right field and Rios manned the controls, taking the helicopter for a spin around the park. When they were setting it up, Aaron Hill and David Eckstein headed up to the pitchers deck behind the right-field wall to watch — safely behind netting.
"It's a little dangerous down there," said Hill, when Lyle Overbay walked out and gave a look of curiousity as to why the middle infielders were watching from above.
Shawn Camp came out to run some laps along the warning track and stopped when he saw the players setting up the helicopter.
"Jeremy, am I going to be in the hot zone running here?" Camp asked.
"You know he's going to chase you with that thing," Hill quipped.
Rios flew the chopper for a bit, making it climb high, dive quick, nearly do a flip and steering it near the light towers, giving the local ospreys a scare. Roy Halladay — known flying remote control helicopters and planes inside the Rogers Centre — manned the controls for a bit and took the thing a lot higher than Rios was willing to go.
Rios started this hobby in November and has three such helicopters now — two smaller than the one he brought out on Sunday. He said the large one ran him about $2,300 and he noted that Halladay's helicopter is even bigger.
Oh, baseball, right. They did have a workout thingy today, too, where players played catch, took batting practice and did some fielding work. Reliever Armando Benitez also threw for roughly 10 minutes in the bullpen and is scheduled to throw a live BP session on Tuesday before the Jays begin working him into a game.
Frank Thomas stood in as a mock batter for Benitez's session and he walked away very impressed with the life on the pitcher's slider, splitter and sinker.
"I'm telling you guys," Thomas said as he walked back on the field, "he's ready to go. It's the same guy I've seen over the years. I thought he was behind. Wow."
Later, in the clubhouse, Thomas expanded, saying, "If we can keep Armando healthy, he's going to be someone who can surprise a lot of people. He's hungry right now and he's a little frustrated with the system, closing in on 300 saves and he doesn't have a job. He's always been one of those guys that pitch well under pressure and that adds something to this team."
Bullpen coach Bruce Walton didn't have a radar gun on Benitez, but simply from his years of experience, Pappy estimated that the pitcher was hitting around 91-92 mph. I stood behind the bullpen for the session and was especially impressed with the late movement on his sinker.
I talked to Thomas some about the hitting slump he's going through this spring and you can read that feature later today on bluejays.com. Here's a few leftover quotes that didn't make the cut:
"Right now, I just feel a little off. I'm a little jumpy. I just haven't hit enough balls in the sweet spot. Guys have predominantly stayed out of the zone, so it's been tough. But I've been through this plenty of times in the spring. I just take it for what it's worth. You take your at-bats and try to get your timing right, because that's all I can do right now.
"For me, right now, yeah, I'm not happy. I'm not getting any hits, but you're going to have those periods. It's Spring Training and once the lights turn on it's a different ballgame and I have to be prepared like I'm always prepared."
Players heading to Bradenton for tomorrow's tilt against the Pirates include: Thomas, Rios, Hill, Eckstein, Overbay, Zaun, Barajas, John McDonald, Scott Rolen, Marco Scutaro, Reed Johnson, Vernon Wells, Matt Stairs, Shannon Stewart, Jeremy Accardo, Brandon League, B.J. Ryan and A.J. Burnett, among others.
Catch you all tomorrow.
3 Comments
Tough draw for the Spartans. Temple is tough, just won the A-10 tournament. If the Spartans can get by Temple, that game can go either way. The Spartans might make a run again. Izzo is all about adjustments. What is Izzo's record in the 2nd. rd.? I'm sure it is outstanding. Good luck Jordan.
Temple is no joke and Pitt is a tough possible assignment in the second round. I was thrilled MSU was seeded fifth, but they have a tough road ahead. If they make Sweet 16 I'll be ecstatic — anything more and I might just dance a jig a la Bruce Willis in the Last Boyscout.
Hey Jordan, I have been reading your blogs and post ups for years and thought I create an account and finally get in the action. You're doing an excellent job, keep it up!
I was wondering something about Benitez. Will he be considered as a closer at all at some point, considering he is only eleven saves away from 300?


text:
Making a website: Work with a professional
Not everyone has the time or desire to build their own website. Watch this video to learn about two GoDaddy services that can connect you to the expert help you need.
Video transcript
Your small business needs a new website, or a website upgrade, and you want to hire a pro to do the work. But who?
Learn how GoDaddy can help you find just what you're looking for. When it comes to website experts, GoDaddy is connected - and can help you find the right pro through either its Professional Web Services or Pro Connect program.
First we'll look at Professional Web Services, GoDaddy's in-house staff of experts who can get you online fast.
Your first step is a free, no-commitment phone consultation. You can either call Professional Web Services at your convenience or request that they call you.
A consultant will explain the four plans and help you determine which option makes the most sense for your business.
Once you purchase a plan, you provide information about your business and website requirements in a brief phone or online interview.
Then your GoDaddy Pro goes to work creating your site, using the text, images, and logos you provide.
Don't have images? Your pro will insert professional photos and graphics that fit your site's look, feel, and messaging.
And if you need a logo, GoDaddy can create one for an affordable one-time fee.
To make sure your site is visible on popular search engines like Google, Bing, and Yahoo, your web pro will add search engine optimization tags to every page.
Before you know it - possibly as few as 7 business days - your site will be ready for your review. Once you approve it, your new site is published live on the web.
Now to GoDaddy's Pro Connect program - a great way to find an experienced website designer or developer to create, modify, or maintain your custom website. Pro Connect is a great resource if you need a completely customized site.
Pro Connect professionals are independent freelancers and agency partners located throughout the U.S. And most are entrepreneurs like you!
The free Pro Connect website allows you to browse or search for web designers and developers based on your budget, location and the type of pro you want to work with.
Each professional has a profile that includes details about their experience, links to their own website, a portfolio of their work, and customer reviews.
A handy "Contact me" button makes it super easy to send a no cost, no obligation request to pros that interest you.
Your website is an integral part of your business, so getting it right is important. GoDaddy Professional Web Services and Pro Connect are a couple of great ways to find and partner with a pro.
More info
- Plan Your Website
- Build Your Website
- Learn more about Website Design Services
- Learn more about Pro Connect Services


text:
Seniors make up nearly 18% of the population in the City and have unique housing needs. Over the past several years senior living facilities and programs have been developed to cater to this growing demographic group. Below are senior programs offered in the City.
Handyworker Program
The Handyworker Program provides minor home repair, accessibility and security improvements to low income renters and homeowners in both single and multi-family units. The program is administered by Michael Baker International at no cost to the occupant. Most maintenance issues and home repairs not requiring a permit are eligible, including: exterior/interior painting, minor plumbing, handicapped ramps, stair railings, floor and window repairs, grab bars. Contact Elizabeth Davis at (213) 407-4146 or email firstname.lastname@example.com for more information.
Senior Case Management Program
The City contracts with Jewish Family Services to provide case management and ongoing support to elderly residents (age 55+) who need assistance to remain independent in their homes. An on-site case worker (English and Farsi) is available on Mondays from 9-12 at the Community Center in Roxbury Park. Contact (310) 285-1006 for more information.
Senior Homesharing Program
Alternative Living for the Aging (ALA) provides a free shared housing program which matches older people with others (younger and older) interested in sharing their homes. Housing counselors at ALA interview potential roommates and obtain references, leaving the decision to the potential roommates whether to make a match. Contact (323) 650-7988 for more information.


text:
Mattress Cleaning Wacol – Contact professional Fresh mattress cleaners and get the expert mattress steam cleaning, mattress dry cleaning, bed sanitising & anti allergic treatment services. Book us for Mattress Dust Mite & Odour Removal. Guaranteed Immaculate Mattress Cleaning Results!
- Single Sized Mattress Cleaning
- Double Sized Mattress Steam Cleaning
- Mattress Sanitisation Services
- Mattress Stain Removal
- Cot Mattress Cleaning.
- Non Toxic Mattress Steam Cleaning Chemicals
- Mattress Bug Removal
- Express Mattress Cleaning Service
- Same Day Mattress Steam Cleaning
- Emergency Mattress Cleaning
- Anti Allergic Mattress Treatment
- Vomit Cleanup
- Stain Removal
Did you know you spend more time on your mattress than any other place in your home?
Because of this little fact, mattresses accumulate dust, allergens and bacteria faster than any other furniture item around. Without regular mattress cleaning, you literally sleep in a plethora of skin cells and dust mites, which can affect your health and well-being.
Mattress Sanitisation Wacol
Mattress Sanitisation is most important part of the the home. Our mattress sanitisation process involve cleaning of both sides of themattress. Cleaners are expert in removing dust mite eggs, excrement, larvae and dust mites.
Our Mattress cleaning & Mattress Sanitisation benefit you and your family in many ways. Sound and restful night sleep, no sneezing, no more itchy eyes, no more coughing and no more allergies.
Have you gone six months without a clean? You need to contact the experts in mattress cleaning Wacol. We model ourselves on an unbeatable customer service that has built its name in the cleaning industry.
Locally owned and operated, we have established ourselves as a family professional business with an eye for detail. We will follow up on each and every customer request so that you can sleep easy in a peaceful mattress environment.
Mattress Steam Cleaning Wacol
When it comes to deep cleaning your mattress, steam cleaning is one of the most widely used methods. The professional experts of our team are very well-known throughout Wacol for delivering the best mattress steam cleaning. With the help of quality cleaning tools and solutions, we bring you a completely restored mattress. We, first of all, inspect your mattress, for the pre-treatment of stain, then carry out the cleaning process. Once the cleaning is done, we also quick dry and deodorise your mattress for a fresh and revived look.
Mattress Dust Mite & Stain Removal Wacol
Empirical studies have shown that inside your mattress is an ecosystem of living dirt and bacteria. Resting in one place for more than a few hours causes a build up of shed skin cells and dust mites. Without intensive regular cleans using specialist equipment and knowledge, you can be sleeping in an environment which breeds disease.
- Anti Allergic Mattress Treatment
- Bed Bug Removal Service
- Dust Mite Sanitation & Removal
- Vomit Odor Removal from Mattress
- Sweat stains from Mattress
- Dead Skin Particles Removal Service
- Blood Stain & Spot Removal
- Dog & Cat Urine Smell & Stain Cleaning
- Hidden Germs & Mould Removal From your mattress
- Healthy Mattress Steam Cleaning Method
Why scheduled Mattress Cleaning is Important?
Have you had a bad service experience with a cleaning company? Have they showed up unannounced one day, or not attended a scheduled visit? We dont do any of that. With our mattress cleaning services in Wacol, you will never have surprise visits or unexpected delays.
- Reduce Allergies & Skin problems
- Get better overnight sleep
- Add beauty to your home
- Peace of Mind when sleeping
- No bad or stinky odour
- Improve air quality
- Sound sleep gives you better output at work
Same Day Mattress Cleaning Wacol
With access to bio-friendly, industry standard cleaning solutions our business can assist you to make sure you never have a bad nights sleep again. With same day convenience, we can arrive at your home and take care of everything for you.
Imagine the feel of a freshly pressed mattress. You can unlock that feeling again when our experienced team of certified cleaners arrive at your door. We have a flexible schedule that can complement even the busiest schedule and we never double book.Pick up the phone and call us on 1300 223 762 to commission the more affordable, cost effective service in Wacol.
Our Other Services
- Tile and Grout Cleaning Wacol
- Blinds Wacol
- Duct Cleaning Wacol
- Carpet Cleaning Wacol
- Upholstery Cleaning Wacol
Our Mattress Cleaning Team in Wacol
We are a team of expert, specialized, and experienced mattress cleaners. At Fresh Mattress Cleaning, our main intention is to make sure that our customers are thoroughly satisfied and happy with our cleaning job. Our cleaners love across Wacol so as to offer instant mattress cleaning services.
- Sean works as the manager of the Southern suburbs on behalf of Fresh Mattress Cleaning.
- Blake is responsible for providing ultimate mattress cleaning services to our clients in the Eastern suburbs.
- Cody manages all mattress cleaning requests from the people of the Western suburbs.
- Andrew is answerable to our clients' needs of mattress cleaning across the Northern suburbs of Wacol.
Fresh and Clean Mattresses
A mattress is where you spend 8 hours a day sleeping. And more than that, you do a lot of other stuff on your bed – playing with your kids/pets, watching TV, reading a book, or just sipping a cup of coffee. Your mattress absorbs everything – human fluids (perspiration, oil), human and pet dead skins, spillages, and what not. All these things make your mattress conducive for the growth of harmful bacteria, mould, and other dangerous contaminants. Fresh Mattress Cleaning Wacol help you keep your mattresses clean and bedding healthy with our complete mattress care solutions.
- It adds to the overall look of your house
- Reduces the risk of breeding of allergens inside your house
- It removes dust and dirt
- Removes mites and bed bugs
Mattress Cleaning Process of Fresh Mattress Cleaning
We have qualified, experience, and trained technicians to provide absolute mattress cleaning services at most affordable prices. Our process involves:
- An effective mattress cleaning begins with removing all the dry particles from the mattress including soil and contaminants. We have strong vacuuming machines for this purpose.
- Once the dry dust is removed, it is important to kill all types of germs and contaminants. We do using special eco-friendly sprays that do not have any effect on humans and pets. And these are safe for the environment as well.
- When the mattress cleaning is done, we use anti-bacterial sprays to save it in future from bacterial and mould growth.
- Finally, our expert mattress cleaners perform mattress sanitization to ensure that you get healthier bedding.
Mattresses need to be professionally cleaned regularly even if you are cleaning them by home vacuum cleaners. Even if you feel your mattress doesn't seem dirty, they are. Sometimes you become so habitual of it that you don't realize when it changes colour. And at times the dirt and contaminants are residing deep within the fabric to cause serious health hazards to you and your family.Call us today and switch to cleaner and safer mattresses!
Location: Wacol, QLD, Australia


text:
Get out of your head and into our writer's group! The fortress of solitude can blind a writer to the magic of inspiration. Or at least, to the helpful perspective of some fellow writers. In this group we will follow a syllabus of works by various writing teachers to better see our work objectively, and to guide inspiration's hand to our page. We'll begin our focus with Brooke Berman's Nine Juicy Weeks to a Wonderfully Imperfect First Draft, the Zen Buddhist perspective of Natalie Goldman's Writing Down the Bones, and Writing From the Senses – an inspired set of exercises by Laura Deutsch. This group is for professional writers, aspiring writers, and those who have yet dared to put word on paper. All genres and perspectives welcome.
When: Every Monday, from 6-8
Where: The Head & The Hand Press Writers' Workshop
2012 Sepviva St, Philadelphia, PA 19125
Cost: This workshop is currently full. Please email email@example.com for wait-list info.