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Treatment Efficacy of OMT for Carpal Tunnel Syndrome
|The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
|ClinicalTrials.gov Identifier: NCT00394043
Recruitment Status : Completed
First Posted : October 31, 2006
Last Update Posted : March 16, 2017
- Study Details
- Tabular View
- No Results Posted
- Disclaimer
- How to Read a Study Record
|Condition or disease
|Carpal Tunnel Syndrome
|Procedure: Osteopathic Manipulative Treatment Procedure: Placebo Sub-Therapeutic Ultrasound
|Phase 2
The incidence of Carpal Tunnel Syndrome (CTS) in adults in the U.S. ranges from 15-20% depending on the study, and costs over one billion dollars annually in medical care. Surgery for CTS accounts for much of these costs with up to one third of these patients experiencing re-occurrence of symptoms post-operatively.
The overall goal for this proposed exploratory clinical trial was to evaluate the efficacy of a conservative, manual medicine treatment as an adjunctive therapy to standard care for CTS. This pilot study utilized a prospective, randomized, placebo-controlled clinical trial methodology to examine whether an eight week treatment regimen of osteopathic manipulative treatment (OMT) when used adjunctively to standard therapy would have immediate and lasting positive effects on the symptoms, functional limitations, and physiologic impairment associated with CTS.
Male and female subjects between the ages of 20 and 65 who meet electro-physiologic and symptom/functional inclusion criteria were randomly assigned to one of three study groups, all of which will continue standard medical care with their treating physician/provider; (i) OMT plus standard medical care; (ii) placebo (sub-therapeutic ultrasound) plus standard medical care; and (iii) standard medical care only (no-treat).
Outcome measures were: 1. Median and Ulnar motor and sensory nerve conduction amplitudes and distal latencies, 2. Symptoms and Functional status, 3. Strength, 4. Sensation, 5. Interior dimensions of the carpal tunnel, and 6. Quantification (signal intensity by MRI) of water (edema) in the Median nerve and carpal tunnel. Placebo potency and blinding success will be evaluated. A preliminary investigation demonstrated our ability to recruit subjects and measure these outcomes. Power analysis based upon a decrease in the mean median motor nerve distal latency of 30% identified a minimum number of 42 subjects per treatment group.
It was expected that a significantly greater number of subjects in the OMT adjunctive treatment group would achieve the effective change in nerve latency compared to the other two treatment groups. It was also expected that the OMT adjunctive treatment group would have greater improvement of all physiological and clinical outcome measures than the other two groups.
|Study Type :
|Interventional (Clinical Trial)
|Actual Enrollment :
|138 participants
|Intervention Model:
|Parallel Assignment
|Triple (Participant, Care Provider, Outcomes Assessor)
|Primary Purpose:
|Official Title:
|Treatment Efficacy of OMT for Carpal Tunnel Syndrome
|Study Start Date :
|October 2006
|Actual Primary Completion Date :
|October 2009
|Actual Study Completion Date :
|October 2009
Experimental: Osteopathic Manipulative Treatment
A protocol of specific osteopathic manipulative techniques was applied.
Procedure: Osteopathic Manipulative Treatment
A protocol of specific Osteopathic manipulative techniques was used.
Placebo Comparator: Placebo ultrasound
Sub-therapeutic ultrasound was applied.
Procedure: Placebo Sub-Therapeutic Ultrasound
Sub-therapeutic ultrasound was applied in a standardized method.
No Intervention: Standard Medical care
Subjects did not receive either study treatment, but continued to receive standard medical care.
- Changes in the Median motor and sensory distal latencies.
- Improvement in the patients'self-reported symptoms and functionality scores.
- Strength measured with one grip and three pinch strength tests.
- Changes in sensation as measured by Current Perceptual Threshold.
- Changes in the transverse and anterior/posterior interior diameters and cross-sectional areas of the carpal tunnel.
- Carpal tunnel edema.
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.
|Ages Eligible for Study:
|21 Years to 65 Years (Adult, Older Adult)
|Sexes Eligible for Study:
|Accepts Healthy Volunteers:
Inclusion Criteria:
- Men and women with a self-reported medical diagnosis of unilateral or bilateral CTS, between the ages of 21 and 65 and all races and ethnic groups.
- Median motor nerve distal latency greater than 4.2 ms
- A difference between ipsilateral Median and Ulnar motor nerve distal latency greater than 1.5 ms.
- Median nerve sensory nerve distal latency greater than 2.2 ms
- A difference between Median and Ulnar sensory nerve peak distal latency greater than 0.2 ms
Exclusion Criteria:
- severe CTS that has progressed to muscle atrophy
- pregnancy
- previous wrist surgery on the wrist to be studied
- systemic disease or condition including but not limited to diabetes mellitus, thyroid disorders, rheumatoid disorders, Paget's bone disease, gout, myxedema, multiple myeloma, acromegaly, hepatic disease, dialysis patients, or other diseases or conditions in which peripheral neuropathies are common.
- secondary cause of CTS such as a ganglion cyst, mass, or an accessory muscle shown by an MRI exam of the wrist.
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00394043
|Principal Investigator:
|Scott T Stoll, D.O., Ph.D.
|Osteopathic Research Center University of North Texas Health Science Center
|ClinicalTrials.gov Identifier:
|NCT00394043 History of Changes
|Other Study ID Numbers:
1R21AT002303-01A2 ( U.S. NIH Grant/Contract )
|First Posted:
|October 31, 2006 Key Record Dates
|Last Update Posted:
|March 16, 2017
|Last Verified:
|March 2017
Carpal Tunnel Sydrome
Osteopathic Manipulative Treatment
Osteopathic Manipulative Medicine
Physical Medicine
Carpal Tunnel Syndrome
Pathologic Processes
Median Neuropathy
Peripheral Nervous System Diseases
Neuromuscular Diseases
Nervous System Diseases
Nerve Compression Syndromes
Cumulative Trauma Disorders
Sprains and Strains
Wounds and Injuries


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After a rain delay, the No. 26 University of Redlands women's tennis team hit the courts for a pair of exhibition matches on Saturday against non-Division III foes, Concordia University – Irvine and Westmont College. Although the Bulldogs lost both, they gained solid experience against quality competition.
The Maroon and Gray saw sophomore Karen Kobayashi (Sappora, Japan) prevail in her singles match against Westmont by cruising to a 6-3, 6-3 win at No. 4.
In addition, first-year Halle Martinucci (Burlingame, CA) put up a solid showing in her collegiate debut at No. 1 singles against Concordia and at No. 2 against Westmont. In addition, she teamed up with senior Elizabeth Johnson (Portland, OR) in doubles, as the duo registered scores of 8-5 and 8-4 in the losses.
Redlands heads to UC San Diego on Saturday, February 16, for an 11 a.m. non-conference match against the NCAA Division I opponent.

subset: commoncrawl


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Over the summer, when the Israeli government wanted to demonstrate just how little respect they had for laws and the lives of the others, there was a jaw dropping moment listening to KPFA, when one person (we'll be kind and won't name the individual) felt the need to praise Sabrina Tavernise for her reports. Now we've praised Tavernise here for her reporting in Iraq, we've also slammed her reporting. But the idea that anyone, any reporter, at the New York Times, did anything praise worthy . . .
When the Times reports (or 'reports') on anything involving Israel, there is nothing praise worthy. Their reporting is reflexive and filtered through their Israel-has-to-do-whatever-it-has-done narrative. That's the only narrative they have. Whether Palestinians are involved or Lebanese, it's always Israel did what it had to. Always was the narrative, always will be the narrative.
An individual at the paper can do a better job than is usually done but they will never do anything that resembles a "good job" except by comparison to others at the paper. It's in the structure of the paper, it's in the system. And anyone who leaves the paper or leaves the coverage of that region will discuss this imposed-from-above structure either publicly or privately. "Israel good, others bad." That's how it plays out year after year, that's how it's always played out and always will.
So hearing Tavernise praised for her coverage of the region was a shocker. If her name was mentioned at all, it should have been to note that the Times had no business pulling any reporter covering Iraq out of Iraq to go elsewhere at a time when the UN would announce that an estimated 100 Iraqis were dying a day. It should have been noted that the Times' committment (as it were) to covering the Middle East was (as always) laughable and that the decision to pull reporters from Iraq (and Tavernise wasn't the only one) while people continued to earn checks from London and other European countries (for penning stories that read like they just sat in front of their TVs jotting down notes from whatever SKY TV broadcast the evening before) was one more indication of how thoroughly the paper fails the region.
Tavernise has returned to the Green Zone and today pens the only article from that heavily fortified region of Iraq, "Qaeda Operative, An Escapee in '05, Is Killed In Iraq." Her reporting today demonstrates how damaging it is for any reporter at the paper to attempt to cover Israel in any manner. She's had her bad moments before but she's never come off so stupid. And make no mistake, she's an idiot in print today. How awful?
Dexy's departs from the Green Zone and she comes off as determined to out Dexy anyone.
And she succeeds.
With regard to her Iraq reporting, her finer moments have always been what the Dexys would see as the "small moments." They'd see it that way both because, like Paul Bremer, they spent all that time in Iraq without having any interest in the country or the people and because they were they saw their purpose as printing up whatever the US military told them to. Tavernise, in her finer moments, found a way to report on Iraq in a way that didn't spit out the MNF press releases or appear to rely upon what officials told her was happening around her, but what she (or a stringer -- and yes, people are still smarting over Dexy's disclosures) could see.
Apparently heady from demonstrating just how well she could toe the company line, she returns to Iraq, to the Green Zone, and files the absolute worst piece that her name has ever been attached to. So, naturally, it makes the front page and, naturally, it's short on Iraqis and heavy on puff (sorely in need of editing). But when you've proven your bonafides by sweeping reality under the rug with regards to Israel, you do get the front page no matter how poor your writing is. Working from official sources and an MNF press release, Tavernise tells a tale that, if you read closely, will have you scratching your head.
For instance, there's this:
Bush administration officials said in 2002 that he had given them information about an impending Qaeda attack in the region that year, not long before a bomb blast on the Indonesian island of Bali killed more than 180 people.
Does anyone grasp that tidbit or do they just repeat it? If true, we're talking about the October 12, 2002 nightclubs attack. October 12, 2002 -- over a year after 9-11. Impending? A real reporter would be writing about that "impending". A real reporter would be interested in knowing what the "officials" did with that impending knowledge. After the public remarks of Coleen Rowley, a real reporter might wonder.
A real reporter might mention the name Abu Bakar Ba'asyir but Tavernise probably has no idea of that name because that would require work and it's so much easier just to type up what 'officials' tell you.
Which is what Tavernise does, often without any attribution. Here's opinion (of others) presented as fact:
Though Iraq is awash with insurgents who identify themaselves as members of Al Qaeda, the most senior Qaeda leaders have rarely been Iraqi.
Based on what? Based on what 'officials' tell her. The Times knows nothing about the resistance and nothing about al Qaeda in Iraq. Early into the illegal war, they had an interview scheduled with the resistance. It was a big coup for them, such a big coup that Dexy couldn't refrain from shooting his mouth off (no surprise) and that led to displeasure from the US military and the interview was killed. (And this has been spoken of publicly, in public forums, by other reporters. Do your own research if you're a visitor -- we've covered it before.) That was when there was slight mobility in Iraq (though most chose to Green-Zone-it even then unless they were embedded with the military on one of their missions). So where is Tavernise's 'knowledge' coming from? Where's the attribution for that evaluation presented as fact but little more than conventional wisdom from the mouths of official sources?
You may remember the name Rita Katz. She was a Dexy fave. She's a joke (and she may be the source of that bit of 'wisdom' included by Tavernise) and the paper's rightly stayed away from her in recent months. Katz is discredited -- most recently in the pages of The New Yorker. That should have put an end to Katz as a source but here she is talking about Iraq and being cited by Tavernise. (Maybe we're supposed to take comfort in the fact that Katz's 'wisdom' now gets printed with her actual name attached and no fake nose used for filming?)
From Benjamin Wallace-Wells' "PRIVATE JIHAD" (The New Yorker):
SITE's detractors have also questioned the quality, or, rather, the possible slant, of SITE's translations--an especially troubling issue given the shortage of alternatives. "An Arabic word can have four or five different meanings in translation," Michael Scheuer, the former C.I.A. analyst, said. SITE, in his view, always picks the "most warlike translation."
Which is why, though Katz has been to Iraq since she was a child (even her ever changing tales of her life haven't, thus far, included a return trip to Iraq) she fits right in at the New York Times. But she gets government monies and it probably didn't take much prodding on the part of officials to get Tavernise to quote her. (It never took much prodding from them to get Dexy to quote her either.)
This is an embarrassing article for so many reasons. It's embarrassing because prior to leaving Iraq, Tavernise was actually one of the stronger reporters for the paper in Iraq. There was usually some effort to note Iraqis in her articles. In nearly thirty paragraphs today, there's really not. She does the official dance for paragraph after paragraph and then stumbles across Rita Katz (without noting the group's funding), then she goes to "Ali" (who was offered to many reporters by the US government Monday -- those with sense turned down the offer -- Tavernise clings to him with her life).
I'm counting thirty paragraphs of text exactly (check my math). Yesterday, when I got off the plane and the phone started ringing, those calling about Iraq were laughing about "Ali" and wondering who would be stupid enough to go with him? Since Dexy was out of the Green Zone, I honestly didn't think anyone at the Times would be. I was wrong, I often am. When you're a new 'big time' reporter the way Tavernise is now, you don't share credit in the byline. If she was duped by a stringer, tough. Her name's on the piece and it's an embarrassing one. In paragraph 28, she notes the Iraqi parliament, in paragraph twenty-nine she notes Iraqi deaths on Monday (she goes with "at least eight" -- we'll come back to that) and then in paragraph thirty she tosses out that a US soldier died on Monday. I don't use the pyramid form here. But the Times does. And the form is inverted -- you pile your most important information at the top because most readers don't read all the way through. Or that's the assumption. (Bad writing causing them to move on more than anything else.)
Now if Damien Cave, Paul von Zielbauer, Edward Wong, James Glanz or Richard A. Oppel Jr. had written today's piece, if nothing else, it would have noted in one of the two opening paragraphs that a US soldier died. But when you're fresh off your star turn apparently that's not news. Apparently that death is so unimportant that you don't even mention it until paragraph thirty.
Paragraph thirty. You think the friends and family of that man appreciate that? You think, regardless of their stance on the war, they pick up the paper today, trudge through twenty-seven paragraphs of official and official-endorsed crap and, if they get to the last paragraph, think, "Thank God, the New York Times noted ___'s death."?
They won't. They won't think that. He mattered to some people. His death matters to some people. But it doesn't matter Tavernise today and the why of that goes to the crap reporting she did all summer long when she learned to reduce people to nothing. And that's what noting the man's death in a hastily written paragraph thirty does -- reduces him to nothing. He gave his life serving in Bully Boy's (illegal) war but he doesn't matter. Nothing matters as much to Tavernise as writing down the official line. She's got time to quote the laughable Rita Katz in paragraph twelve (check my math) -- Katz who hasn't been to Iraq in decades and knows nothing about it and has a hatred for the region due to her own personal history.
Katz interjecting herself into something she knows nothing about is "news" -- paragraph twelve "news." An American soldier dies and he's reduced to paragraph thirty.
At her best, prior to leaving Iraq, Tavernise's byline usually meant some form of humanity was in the story, some interest of what it was like in Iraq for the average Iraqi or American. That's gone. She lost her interest in humanity while fitting into the paper's Israel narrative all summer long. That's why she can write "at least eight" Iraqis died on Monday when the number was higher than that before she had lunch yesterday.
When you grasp the Israel narrative, internalize it, there's no need for people anymore, just officials. Tavernise returns to the Green Zone with an interest in nothing but sucking up to DC. Congratulations to her, she's accomplished her task. She's nothing resembling a reporter -- she has no interest in Iraqis, she has no interest in Americans. She's pursuing that special off-breed, "officials." She is the future Cokie Roberts (and may she inherit the jowels as well -- you really do get the face you deserve after forty).
It takes her thirty paragraphs to mention, briefly, that an American soldier died. Her t-shirt reads: "I COVERED LEBANON ALL SUMMER AND LOST MY HUMANITY."
Martha notes Amit Paley's "Al-Qaeda Figure Killed in Raid In Basra, British Military Says" in the Washington Post. Since the Times is its own nasty breed, let me note that Paely covers the death in the final paragraph as well. But that's paragraph sixteen, not paragraph thirty. (Take note before you e-mail.) And Paley's not quoting the laughable Rita Katz or the US military endorsed "Ali." Paley also covers, in four paragraphs, what it takes the wordy Tavernise to do in twenty-six. Paely also notes that at least 13 Iraqis died yesterday. (And that's the one and only compare/contrast I intend to make. That's been noted before and why.)
I can already read the e-mail coming in, about how brave the Times article is, how Tavernise notes that the British troops, according to "Ali," put a bag over an inncoent's head and that someone other than the 'Qaeda Operative' may have died. Brave? One person who turned down "Ali" yesterday was then told, by 'officials,' that tidbit and how "Ali" was willing to talk about that. Why? The thought was to take the heat off allegations of American abuses (no need to worry, the Times goes with a tiny portion of the AP story on three of the Pendleton eight facing the death penalty if found guilty of murder). Call it the Coaltion of the Backstabbers. Or maybe the Coalition of the Willing Backstabbers. But if anyone wants to attempt to justify Tavernise's nonsense this morning on the basis that she's offering that allegation, note that she treats it as a tidbit and uses it to end her 'Qaeda' narrative, not open with it.
The first you learn of it is paragraph 26, where, out of the blue, a major is quoted saying, "It's regrettable that as a result of an exchange of fire he died." He? Who?
Then in paragraph 27, Tavernise writes: "Ali said that he heard sounds of a scuffle and that the British soldiers shouted at someone to stop. A man's voice answered 'God is great' in Arabic." And then Tavernise is done with her tidbit. (She's so unitnerested in her own tidbit that she doesn't do the usual "Shouted 'Allah Akbar'," which translates as 'God is great.'")
It's treated as a tidbit and possibly it should be (any tale involving the supposed Arabic cry of "God is great," should be treated as a fabricated story, as Australian community members know only too well). But if you're including it, you don't do so in a manner that leads readers to wonder if there were two men dead in paragraph 26 because for 25 paragraphs you've had nothing to say.
There are a number of ways a reporter could have handled this story. They could have tackled the intel angle, they could have tackled the allegation of the death of an apparently innocent man, but it takes a real Cokie to do nothing but repeat official sources. If this is any indication of what Tavernise has to offer now that she's returned to Iraq, someone pass on to Steve Roberts that there's a new Cokie in town.
The headline that should have run with this piece is, "Tavernise Returns to the Green Zone Determined to Out-Dexy Dexter Filkins." That's truly the only thing she achieves in thirty long paragraphs. (Where was Bill Keller screaming 'shorter!' on this? Star 'reporters' are rarely edited. Or, as Cokie's career demonstrates, fact checked.) A little less love of self, love of their own voice, eagerness to please officials and a little more actual interest in the topics they're reporting on would serve the readers but star 'reporters' exist to serve their own egos. (Even "officials" take a back seat to their own egos.)
FYI, this is a dictated entry. The e-mail address for this site is email@example.com.
Added: A link turned this into alphabet soup -- if you read this earlier in the morning. It's been fixed. And for those who wondered why the Times' "story" on yesterday's hearing wasn't noted, it wasn't worth noting. Kate Zernike hops in her taxi and does another hit in a few paragraphs (Carl Hulse is her fare for the day) that dismiss the hearing. There's a reason for that and anyone late to the game on Zernike should inform themselves by studying her hit on John Kerry this summer. Thanks to ___ for taking dictation.
the new york times
sabrina tavernise
dexter filkins
the washington post
amit r. paley
the new yorker
benjamin wallace-wells


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- Glenna Jean
- >
- Secret Garden
- >
- Secret Garden 3 Piece Set
Secret Garden 3 Piece Set
per item
Secret Garden is a beautiful and classic design for your little girls nursery. Lavishly opulent skirt features layers upon layers of luxurious fabrics. Underskirt of crushed white taffeta has a 22" drop. A middle layer of gathered tulle (like a tutu) adds volume. A sheer overskirt is embellished with richly embroidered roses trailing on a picket fence. The same sheer embroidery is found on the quilt which is lined with white pintuck taffeta. Quilt back is super soft fabric, and is the perfect size to wrap baby in cozy comfort (34x42). Trimmed with pink piping. Gorgeous silk-like fabrics have a subtle sheen for a lustrous play of light. Petal pink sheet is fully elasticized for a secure fit that won't slip. Made in USA. Machine washable. Quality fabrics last longer.


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Today is MY Friday
Randy and I are going out of town for the weekend, so today is our Friday. Jodie and Devin will be in charge tomorrow. I know they are looking forward to all the Halloween Festivities.
I made a few orders last week and had some new things arrive today. Below is our new marker holder. I have went through hundreds of markers since the beginning of the year from caps left off, so we are going to try this wooden holder. The cap stays in the wooden piece and the kids pull the marker out. I am hoping this solves our missing lid problem. To demonstrate how it works today we traced a pumpkin. 🙂
It was a good day!


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How I ever managed to snatch up "whitneyjohnson" as my username on instagram before anyone else did will always remain a mystery to me. Seems like my name is fairly common, especially when dealing with a social media platform of such grandeur like instagram...but either way, I'm taking full advantage. At this rate I should have about a million little square photos of Wyatt by the time he's 10 years old. He'll thank me when he's older.
You can follow along HERE.


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8 Comments
Adam Levine: Calling 'Voice' Co-Star Christina Aguilera Ignorant?
Adam wrote a thinly-veiled Tweet which we totally think is a diss to Christina, with whom he's engaged in a bitter feud behind the scenes of the show!
Adam Levine and Christina Aguilera have been fighting on The Voice all season, and Adam seems to have taken another swipe at her via Twitter!
Adam, 33, took to Twitter on May 9 to write, "Ignorance has this unique way of making me want to both laugh AND cry simultaneously…"
We DEFINITELY think this is a jab at Christina, 31 — perhaps trying to provoke her into quitting the show!
Do YOU think Adam is attacking Christina, HollywoodLifers?
— William Earl
More 'Voice' News:


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NCC seeks police collaboration on protection of telecoms infrastructure
• IGP makes proposal for better use of CCTV cameras
Inspector-General of Police, Solomon Arase, is proposing a legislation that would make installation of CCTV cameras part of approval plan for public buildings like supermarkets and housing estates, stressing that such measures remain the best way to police the nation's space.
The IGP said that the Nigerian Police Force is working to migrate from analogue to digital technology knowing that that is the best way that the force can go.
Speaking when the Executive Vice-Chairman of the Nigerian Communications Commission, Prof Umar Danbatta visited him yesterday in Abuja, Arase noted that the numeric strength of the force is not enough to police the country's security space as the Nigerian Police have only 317,000 personnel in its workforce.
He observed that modern policing is predicated on technology adding that since he assumed duty, he has been trying to migrate from analogue to digital technology.
According to him, "there is no way we can be everywhere and you will also recall too that we are in the forefront of fighting the ZHT product that we burst because as the president said if we are going to fight crime you must be able to put the police on a technological platform that will be able to match our effectiveness and since I came board the first thing I did is to make sure that the police is accountable to the public they serve because I know that we cannot do it alone."
He said: "I am excited at what you are doing, we shall key into it like the issue of kidnapping for example, is one area where this GSM has really aided the system. And with what you are doing and our principal stand on the MTN platform was such that we cannot allow things like this degenerate in our country because there is no country in the world where you pick up a SIM card without registering it, as people must know this thing and how it works."
Apart from the people who are benefitting from selling this card they also pay tax to the country.
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We Are Five! Happy Birthday To Forge.
We're five years old! That's to say, Ormiston Forge Academy opened five years ago. I'm delighted with the progress that we've made in this time.
Our celebration this morning was quite a low-key affair. It's a training day. There was cake, pictured! We're going to save the main celebration for Prize Giving, where we celebrate our students, it seems right that we combine the two as they go hand-in-hand.
For the staff, I led a visioning session today. Before we finished for the Christmas break I asked everyone to provide some structured reflection on the last five years, it made for an inspiring read. The commitment and aspiration the staff at Forge show makes me very proud. It is also encouraging to read that staff echoed many themes and with such a large body of staff, having people on the same page means that we'll reach our goals quicker and with less friction.
We started our visioning session by looking at the journey and my remarks from five years ago when I first started. We've come so far and we weren't far off the mark in our aspirations. We wanted to be good, all day, every day! In 2016 Ofsted told us that we were!
Now we need to be VERY good, all day, every day. I make no secret of the fact that I want us to be Outstanding. It's what our students deserve and I know that my staff are committed to delivering. However, it's more than that. As we plan for the next five years we all need to be involved in what this school will look like. To this end, I'll be inviting parents, stakeholders and, most importantly, students into visioning sessions to reflect on the past and build for the future.
This is the best fifth birthday present I can deliver. We will build on the firm foundations we have, plan for the future and ensure that this school inspires and serves generations of young people from Cradley Heath and beyond. There will be candles at Prize Giving, I'm sure they'll be a rousing chorus of Happy Birthday too but what matters is that this school pushes on, that we keep improving exam results and our student get the best education and the best start in life that they can possibly have.
Andrew Burns


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Here's Why Your Stomach Makes So Much Noise When You Are Hungry
Outside of our mouths, our stomachs might be the loudest part of our bodies. How often have you found yourself having to apologize not for something you said but your rumbling stomach did as you secretly prayed for lunch to come?
The team over at SciShow decided to look into "Why does your stomach make noises?" You can watch for yourself, but it's basically because our digestive system has to move things around, and sometimes it refuses to do so quietly—especially when there's air in there. The air moving through your digestive tract makes those embarrassingly loud sounds when your stomach muscles contract.
Take a look.
[h/t Laughing Squid]
Related: The U.S. Dietary Committee Approves of Your Coffee Habit
Many Juices Contain More Sugar Than Sodas
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text:
Law of gravity
This essay introduces a realistic look at our laws of gravity, and the effects thereof, and it goes beyond to reveal how and by what gravity comes about in the fundamentals of nature upon which the earth and all spheres rest.
Copyright (c) 2019 Leonard Van Zanten
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors retain the copyright of their manuscripts, and all Open Access articles are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided that the original work is properly cited.


text:
IPG Photonics Appoints Veeco Instruments CEO John Peeler to Board of Directors
IPG Photonics Appoints Veeco Instruments CEO John Peeler to Board of Directors
OXFORD, Mass.--(BUSINESS WIRE)-- IPG Photonics Corporation (Nasdaq: IPGP) today announced that John R. Peeler, Chairman and Chief Executive Officer of Veeco Instruments, Inc. (Nasdaq: VECO) , has joined the IPG Photonics Board of Directors. The addition of Mr. Peeler, who will serve on IPG's Compensation Committee, temporarily expands the IPG Board to 10 members until the 2013 annual meeting of shareholders. The Company also announced that William F. Krupke, Ph.D. will not stand for reelection at the 2013 annual meeting of shareholders.
"The addition of John will further diversify the outstanding talents and wide-range of experience of our current Board," said Dr. Valentin Gapontsev, IPG's founder and Chief Executive Officer. "John has deep experience in managing high-growth technology companies and a wealth of knowledge about the service needs of customers in demanding markets, including semiconductor capital equipment. We look forward to working with John as we continue to expand the presence of our products and technology around the world. On behalf of the entire Board, I also want to thank Dr. Krupke for his 12 years of service, guidance and dedication to the Company and its stockholders."
Mr. Peeler joined Veeco as CEO in July 2007 and was named Chairman of the Board in May of 2012. Veeco is a global market leader in MOCVD, Molecular Beam Epitaxy, Ion Bean and other advanced thin film technologies, and its equipment is used to manufacture LEDs, power electronics, hard disk drives and wireless semiconductors. Mr. Peeler spent his early career in engineering, marketing and product development in the communications test equipment industry. He became President and CEO of TTC in 1992, and through organic growth and a series of acquisitions, he grew the company into the largest global provider of field service communications test products. The company evolved into Acterna, which was acquired by JDSU in 2005. Mr. Peeler earned a B.S. and Masters Degree in Electrical Engineering and graduated with high distinction from the University of Virginia.
About IPG Photonics Corporation
IPG Photonics Corporation is the world leader in high-power fiber lasers and amplifiers. Founded in 1990, IPG pioneered the development and commercialization of optical fiber-based lasers for use in diverse applications, primarily materials processing. Fiber lasers have revolutionized the industry by delivering superior performance, reliability and usability at a lower total cost of ownership compared with conventional lasers, allowing end users to increase productivity and decrease operating costs. IPG has its headquarters in Oxford, Massachusetts, and has additional plants and offices throughout the world. For more information, please visit www.ipgphotonics.com.
Sharon Merrill
David Calusdian, 617-542-5300
Executive Vice President
KEYWORDS: United States North America Massachusetts


text: Orlando Bloom#1: ORLANDO BLOOM Age: 34 Other than the Lord of the Rings and Pirates of the Caribbean movies, we dare you to name one other Orlando Bloom project. Give up? Don't feel bad. If not for somehow joining two of the biggest film franchises ever, the English actor's resume would be as uneventful as that of any bitter C-lister. It's easy to understand why: He's too much of a frail pretty-boy to command the screen on his own, and too mediocre of a thespian to act as more than an ensemble player. With one year left until he hits the big 3-5, he'd be better off spending all his time in the company of supermodel wifey Miranda Kerr. We can't imagine a better retirement plan.Previous SlideListsMoviesTV


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HOUSTON, Feb. 28 /PRNewswire/ -- US Oncology Holdings, Inc. ("Holdings" or the "Company"), the parent company of US Oncology, Inc. ("US Oncology"), one of the nation's largest cancer services companies, reported revenue of $771.6 million, EBITDA of $51.3 million, Adjusted EBITDA of $58.0 million, net loss of $14.8 million and operating cash flow of $74.2 million for the quarter ended December 31, 2007. For the year ended December 31, 2007, the Company reported revenue of $3.0 billion, EBITDA of $190.7 million, Adjusted EBITDA of $218.7 million, net loss of $35.0 million and operating cash flow of $164.7 million.
The results of Holdings include those of US Oncology, its wholly-owned
subsidiary, through which all operations are conducted. The results of
operations and financial position of Holdings are substantially identical
to those of US Oncology, with the exception of nominal administrative
expenses and items related to the capitalization of Holdings. For the
quarter ended December 31, 2007, US Oncology reported EBITDA of $51.2
million, Adjusted EBITDA of $58.0 million, net income of $0.3 million and
operating cash flow of $74.6 million. For the year ended December 31, 2007,
US Oncology reported EBITDA of $203.7 million, Adjusted EBITDA of $218.8
million, net income of $7.2 million and operating cash flow of $198.0
million. Differences between the results of Holdings and US Oncology, as
well as selected balance sheet data, are reconciled in this press release.
US Oncology Holdings Fourth Quarter and Fiscal Year Results
-- Adjusted EBITDA for the fourth quarter of 2007 was $58.0 million,
compared to $59.5 million for the fourth quarter of 2006 and
$50.5 million for the third quarter of 2007. Adjusted EBITDA for
fiscal 2007 was $218.7 million compared to $250.0 million in 2006.
-- In 2007, physicians affiliated under comprehensive service agreements
provided care to over 590,000 patict of management fee reductions and lower utilization of supportive care drugs. The results of fiscal year 2007 also include restructuring and impairment charges of $15.1 million, a debt extinguishment loss of $12.9 million and an unrealized loss of $11.9 million related to our interest rate swap, for which cash flow hedge accounting was discontinued during 2007. In addition, interest expense increased $20.4 million due to higher borrowings outstanding during 2007.
The company currently anticipates that EBITDA for fiscal year 2008 will be approximately $220 million to $230 million. This estimate is a forward-looking statement and is subject to uncertainty including the results of the scheduled March 13, 2008 meeting of the Oncology Drug Advisory Committee of the FDA. The reader should refer to the Company's cautionary advice regarding forward-looking statements appearing elsewhere in this news release and in the Company's filings with the Securities and Exchange Commission.
Cash Flow
During the quarter ended December 31, 2007, operating cash flow provided was $74.2 million, compared to $3.9 million used in operations in the third quarter of 2007 which reflects lower regularly scheduled interest payments and increased receivable collections in the fourth quarter.
The Company generated operating cash flow of $164.7 million during 2007, compared to $20.5 million in 2006. The increase in operating cash flow was primarily due to working capital investments of $113.0 million during the first quarter of 2006, principally for inventory and accounts payable at the Company's distribution center as well as increased receivable collections during the current year.
On November 30, 2007, the company amended its senior secured credit facility to increase the maximum leverage and decrease the minimum interest coverage ratios required under the facility. The amended terms provide flexibility as the company responds to the adverse impact of reduced ESA reimbursement experienced during 2007. In addition, the amendment increases the company's ability to invest in future growth by increasing capital available for practice affiliations and other investments, as well as making other revisions necessary to support diversification into additional service offerings. In connection with the amendment, the LIBOR spread on outstanding borrowings increased from 225 basis points to 275 basis points and consenting lenders were paid an amendment fee of 25 basis points or $1.5 million. During 2007, our capital expenditures were $90.9 million.
As of February 26, 2008, the Company had $122.7 million of cash and investments, and availability under the revolving credit facility of $133.7 million.
One of the Company's ongoing objectives is to expand our network by affiliating with practices in new or existing markets, recruiting physicians into existing affiliated practices and entering into joint ventures. In the fourth quarter of 2007, our network grew by 35 physicians, net of retirements and other separations. During the fourth quarter of 2007, agreements were signed with 64 physicians to begin practicing in our network.
Broussard also stated, "With the addition of 190 physicians though comprehensive and oncology pharmaceutical service agreements, 2007 was a successful development year. The momentum of 2007 has continued into 2008 when, in January, we executed a comprehensive service agreement with Advanced Medical Specialties, a 47 physician practice in Miami, Florida, representing the largest single practice to affiliate with the company. This transaction demonstrates not only the financial benefits of affiliation, but also the attractiveness of the network's mission to advance the delivery of cancer care through collaboration, improved clinical and operational processes, establishment of evidence-based treatment protocols and participation in clinical trial research."
Contingencies and Risks
During the fourth quarter of 2005, we received a subpoena from the United States Department of Justice's Civil Litigation Division ("DOJ") requesting a broad range of information about us and our business, generally in relation to our contracts and relationships with pharmaceutical manufacturers. We are cooperating fully with the DOJ in responding to the subpoena. At the present time, the DOJ has not made any allegation of wrongdoing on the part of the Company. We cannot, however, provide assurance that such an allegation or litigation will not result from this investigation.
On April 18, 2006, the Company terminated its net revenue model comprehensive service agreement with a practice in Oklahoma, as a result of alleged breaches of that agreement by the practice. The practice accounted for 4.6 percent and 2.3 percent of the Company's revenue and EBITDA, respectively, for the first quarter of 2006. The Company remains in litigation with this practice regarding termination of its service agreement. As a result of the practice's alleged breaches of that agreement and the litigation, we were unable to collect payments on receivables owned by us and other amounts owed by the practice on a timely basis. At December 31, 2007, the total amount owed to us for those receivables of $22.5 million is reflected on our balance sheet as other assets. We intend to pursue the claims we incurred as a result of terminating this service agreement. We also intend to defend against the practice's allegations that we breached the agreement and that the agreement is unenforceable. As with any complex litigation, the process necessary to resolve this claim may take several years.
During March 2007, the Company became aware that it and one of its affiliated practices are the subject of allegations that the practice may have engaged in activities that violate the Federal False Claims Act. These allegations are contained in a qui tam complaint, commonly referred to as a "whistle-blower" lawsuit. The details of this suit are not publicly available or disclosable at the current time since qui tam complaints are filed on a confidential basis with a United States federal court. The DOJ has not made a decision on the merits of the whistle-blower's claim. The Company intends to continue to investigate and vigorously defend itself against this claim. Based upon its present understanding of the nature and scope of the claim and investigation, the Company does not expect this claim to have a material adverse effect on its operations or financial condition, however our expectation could change as we receive more information.
On July 30, 2007, CMS issued a national coverage decision ("NCD") establishing criteria for reimbursement by Medicare for ESA usage which is expected to continue to lead to a significant decline in utilization of these drugs by oncologists, including those affiliated with US Oncology. The NCD is expected to continue to adversely impact the revenues and operating income of the Company, particularly in its medical oncology segment, as well as reduce cash flow available for debt service and capital expenditures. Because the NCD relates to specific clinical determinations in connection with administration of ESAs and we do not make clinical decisions for affiliated physicians, analysis of the financial impact of the NCD is a complex process and continues to be closely monitored. As part of the Company's evaluation of the impact of the NCD, management evaluated the recoverability of certain management service agreement intangible assets and goodwill. Management's analysis did not result in an impairment of these assets in 2007. As the financial impact of the NCD continues to evolve, additional assessments may be necessary in subsequent quarters. In addition, the Oncology Drug Advisory Committee of the FDA ("ODAC") is scheduled to meet on March 13, 2008, to further consider the use of ESAs in oncology. A number of scientific articles, including several released since last year's actions by FDA and CMS, have concluded that ESAs may in certain situations increase certain side effects and mortality risk due possibly to stimulation of the growth and/or survival of cancer cells in cancer patients. It is possible that determinations by ODAC at this meeting may result in further changes to ESA labeling including either further restrictions in labeled indications for ESA use or the complete elimination of the chemotherapy-induced anemia indication. During the fourth quarter of 2007, $10.7 million of the Company's EBITDA was attributable to utilization of ESAs by our network physicians.
The Company's Senior Secured Credit Facility (the "Facility") includes covenants that are applied quarterly, based on the prior four quarters' EBITDA (as defined by the Facility), and become more restrictive over time. Based upon its current estimates, the Company believes it can maintain compliance with these restrictive covenants through December 31, 2008. As previously discussed, the Company amended the Facility during the fourth quarter of 2007 to address the current year changes in healthcare reimbursement.
The Company and US Oncology will broadcast the 2007 fourth quarter and year end financial results by conference call on Thursday, February 28, 2008 at 9:00 A.M. Central Standard Time. The archived replay of the event will be available through the news center on the Company's Web site (http://www.usoncology.com).
About US Oncology, Inc.
US Oncology, headquartered in Houston, Texas, supports one of the nation's largest cancer treatment and research networks. US Oncology provides extensive services and support to its affiliated cancer care sites nationwide to help them expand their offering of the most advanced treatments and technologies, build integrated community-based cancer care centers, improve their therapeutic drug management programs and participate in many of the new cancer-related clinical research studies. US Oncology is affiliated with 1,199 physicians operating in 461 locations, including 88 radiation oncology facilities in 39 states.
This news release contains forward-looking statements, including statements that include the words "believes," "expects," "anticipates," "estimates," "intends," "plans," "projects," or similar expressions and statements regarding our prospects. All statements other than statements of historical fact included in this news release are forward-looking statements. Although the Company believes that the expectations reflected in such statements are reasonable, it can give no assurance that such expectations will prove to have been correct. Such expectations are subject to risks and uncertainties, including the Company's reliance on pharmaceuticals for the majority of its revenues, the Company's ability to maintain favorable pharmaceutical pricing and favorable relationships with pharmaceutical manufacturers and other vendors, concentration of pharmaceutical purchasing and favorable pricing with a limited number of vendors, prescription drug reimbursement, such as reimbursement for ESAs, and other reimbursement under Medicare (including reimbursement for radiation and diagnostic services), reimbursement for medical services by non-governmental payers and cost-containment efforts by such payers, including whether such payers adopt coverage guidelines regarding ESAs that are similar to Medicare coverage, other changes in the manner patient care is reimbursed or administered, the Company's ability to service its substantial indebtedness and comply with related covenants in debt agreements, the Company's ability to obtain amendments to its credit facility financial covenants on terms acceptable to it, the Company's ability to fund its operations through operating cash flow or utilization of its existing credit facility or its ability to obtain additional financing on acceptable terms, the Company's ability to implement strategic initiatives, the Company's ability to maintain good relationships with existing practices and expand into new markets and development of existing markets, modifications to, and renegotiation of, existing economic arrangements, the Company's ability to complete cancer centers and PET facilities currently in development and its ability to recover investments in cancer centers, government regulation and enforcement, increases in the cost of providing cancer treatment services and the operations of the Company's affiliated physician practices. Please refer to the US Oncology Holdings, Inc. filings with the Securities and Exchange Commission, including its Registration Statement on Form S-4/A filed on October 9, 2007, and subsequent filings, for a more extensive discussion of factors that could cause actual results to differ materially from the Company's expectations.
Discussion of Non-GAAP Information
In this release, the Company uses the term "EBITDA" and "Adjusted EBITDA". EBITDA is earnings before interest, taxes, depreciation and amortization (including amortization of stock compensation), minority interest expense and other income (expense). EBITDA is not calculated in accordance with accounting principles generally accepted in the United States of America ("GAAP"). Adjusted EBITDA is EBITDA before loss on early extinguishment of debt and impairment and restructuring charges. These measures are derived from relevant items in the Company's GAAP financial statements. A reconciliation of EBITDA to net income (loss) and operating cash flow is included in this release.
The Company believes EBITDA is useful to investors in evaluating the
value of companies in general, and in evaluating the liquidity of companies
with debt service obligations and their ability to service their
indebtedness. Management uses EBITDA as a key indicator to evaluate
liquidity and financial condition, both with respect to the business as a
whole and with respect to individual sites in the US Oncology network.
Adjusted EBITDA is useful to investors as it eliminates certain amounts
that are unusual in nature and not currently expected to be part of the
Company's ongoing operational performance. The Company's senior secured
credit facility also requires that it comply on a quarterly basis with
certain financial covenants that include Adjusted EBITDA as a financial
measure. Management believes that EBITDA and Adjusted EBITDA are useful to
investors, since they provide investors with additional information that is
not directly available in a GAAP presentation.
As a non-GAAP measure, EBITDA and Adjusted EBITDA should not be viewed as alternatives to the Company's GAAP financial statements, but should be read as a supplement to, and in conjunction with, the Company's GAAP financial statements.
Q4 Q4 % Q3 % Fiscal Fiscal %
2007 2006 Change 2007 Change 2007 2006 Change
oncologists 705 686 2.8% 714 (1.3)% 705 686 2.8%
oncologists 146 146 - 149 (2.0) 146 146 -
oncologists 52 47 10.6 52 - 52 47 10.6
Total CSA
physicians 903 879 2.7 915 (1.3) 903 879 2.7
physicians 296 188 57.4 249 18.9 296 188 57.4
physicians 1,199 1,067 12.4 1,164 3.0 1,199 1,067 12.4
visits (1) 10,224 9,918 3.1 10,045 1.8 10,028 9,793 2.4
scans(2)(4) 3,680 3,522 4.5 3,622 1.6 3,642 3,530 3.2
Daily Same
visits (1) 10,024 9,815 2.1 9,785 2.4 9,750 9,500 2.6
scans(2)(4) 3,463 3,425 1.1 3,457 0.2 3,436 3,373 1.9
(3)(4) 88 91 (3.3) 91 (3.3) 88 91 (3.3)
PET systems 34 33 3.0 36 (5.6) 34 33 3.0
New patients
enrolled in
research studies
during the
period 809 790 2.4 769 5.2 3,050 2,723 12.0
receivable days
outstanding 33 38 (13.2) 36 (8.3) 33 38 (13.2)
Notes to Key Operating Statistics:
(1) Medical oncology visits include information for practices affiliated
under comprehensive service agreements only, and do not include the
results of OPS practices.
(2) Represents technology-based treatments, including IMRT treatments
and diagnostic scans, provided through our integrated cancer
(3) The fourth quarter of 2007 includes 77 integrated cancer centers and
11 radiation-only facilities while the third quarter of 2007
includes 80 integrated cancer centers and 11 radiation-only
facilities. The fourth quarter of 2006 includes 80 integrated
cancer centers and 11 radiation-only facilities.
(4) Radiation treatments/diagnostic scans and facilities do not include
cancer centers operated by unconsolidated joint ventures in which
the Company or an affiliated practice has a financial interest.
(in thousands)
Three Months
Three Months Ended Ended
December 31, September 30,
2007 2006 2007
Product revenue $509,914 $462,184 $488,017
Service revenue 261,656 259,400 255,797
Total revenue 771,570 721,584 743,814
Cost of products 497,290 460,725 478,628
Cost of services:
Operating compensation and benefits 122,100 114,341 121,289
Other operating costs 73,755 70,256 73,177
Depreciation and amortization 18,569 17,854 19,215
Total cost of services 214,424 202,451 213,681
Total cost of products and services 711,714 663,176 692,309
General and administrative expenses 20,668 17,488 20,210
Impairment and restructuring charges 6,771 - 960
Depreciation and amortization 4,887 3,806 4,024
744,040 684,470 717,503
Income from operations 27,530 37,114 26,311
Other income (expense):
Interest expense, net (36,913) (29,547) (34,414)
Minority interests (1,743) (660) (539)
Other income (expense) (11,573) - (312)
Income (loss) before income taxes (22,699) 6,907 (8,954)
Income tax benefit (provision) 7,869 (3,654) ents, including approximately
250,000 new patients.
-- Operating cash flow for the year ended December 31, 2007 was
$164.7 million, compared with $20.5 million in 2006. The increase in
operating cash flow is primarily due to working capital investments
for the Company's distribution center made during the first quarter of
-- During 2007, 190 physicians began practicing as part of the US
Oncology network. For the same period, 58 physicians separated from
the network, including 45 who retired or otherwise left practices that
remain affiliated with the company and 13 at former OPS practices who
separated due to disaffiliation of their practice from our network.
In the fourth quarter of 2007, our network grew by a net of 35
physicians, which represents the sixth consecutive quarter of net
-- As of December 31, 2007, 32 physicians had executed agreements to join
the US Oncology network under CSA and OPS agreements and are expected
to begin practicing under these agreements in 2008. Subsequently, an
agreement with a 47 physician practice affiliating with the Company
under a comprehensive service agreement was signed, with the
affiliation effective January 1, 2008. Also, at December 31, three
integrated cancer centers were under construction and are expected to
begin providing patient care in 2008.
Bruce Broussard, president and chief executive officer stated, "We
continue to focus on efforts in expanding our local presence, improving the
network's quality of care and driving more efficient cancer treatments. In
that context, during fiscal 2007 we made great advances in our strategic
initiatives, including:
-- We launched our cancer-specialized disease management program. This
program of nursing outreach to patients4,760
Net income (loss) $(14,830) $3,253 $(4,194)
(in thousands)
Year Ended
December 31,
2007 2006
Product revenue $1,970,106 $1,822,141
Service revenue 1,030,672 989,242
Total revenue 3,000,778 2,811,383
Cost of products 1,925,547 1,753,638
Cost of services:
Operating compensation and benefits 479,177 458,006
Other operating costs 293,677 274,665
Depreciation and amortization 73,159 69,351
Total cost of services 846,013 802,022
Total cost of products and services 2,771,560 2,555,660
General and administrative expenses 84,423 77,180
Impairment and restructuring charges 15,126 -
Depreciation and amortization 16,172 13,983
2,887,281 2,646,823
Income from operations 113,497 164,560
Other income (expense):
Interest expense, net (137,496) (117,088)
Minority interests (3,619) (2,388)
Loss on extinguishment of debt (12,917) -
Other income (expense) (11,885) -
Income (loss) before income taxes (52,420) 45,084
Income tax benefit (provision) 17,447 (18,926)
Net income (loss) $(34,973) $26,158
(in thousands)
Year Ended
December 31,
2007 2006
Cash flows from operating activities:
Net cash provided by operating activities $164,677 $20,517
Cash flows from investing activities:
Proceeds from sale of property and equipment 750 9,261
Acquisition of property and equipment (90,850) (82,571)
Acquisition of business, net of cash acquired - (31,378)
Investment in subsidiaries (4,745) (2,450)
Payments in practice affiliation transactions (134) (3,630)
Distributions from minority interests 254 -
Proceeds from contract separation 1,555 -
Net cash used in investing activities (93,170) (110,768)
Cash flows from financing activities:
Proceeds from senior floating rate PIK toggle notes,
net of issue costs 413,232 -
Proceeds from term loan - 100,000
Proceeds from other indebtedness 1,323 4,522
Repayment of senior floating rate notes (256,766) -
Repayment of term loan (7,487) (1,000)
Repayment of other indebtedness (2,761) (5,051)
Proceeds from issuance of common stock - 99,274
Proceeds from issuance of preferred stock - 50,726
Payment of dividends on preferred stock (25,000) -
Payment of dividends on common stock (323,580) -
Debt financing costs (1,575) (714)
Offering costs - (608)
Distributions to minority interests (1,925) (2,320)
Contributions from minority interests - 1,015
Proceeds from exercise of options 521 337
Net cash provided by (used in) financing activities (204,018) 246,181
Increase (decrease) in cash and equivalents (132,511) 155,930
Cash and equivalents:
Beginning of period 281,768 125,838
End of period $149,257 $281,768
(in thousands)
December 31, December 31,
2007 2006
Current assets:
Cash and equivalents $149,257 $281,768
Accounts receivable 318,976 341,306
Other receivables 120,285 105,544
Prepaid expenses and other current assets 26,544 21,139
Inventories 82,822 78,381
Deferred income taxes 7,428 4,268
Due from affiliates 71,021 66,674
Total current assets 776,333 899,080
Property and equipment, net 399,621 393,318
Service agreements, net 223,850 240,100
Goodwill 757,270 757,870
Other assets 79,299 76,126
$2,236,373 $2,366,494
Current liabilities:
Current maturities of long-term indebtedness $38,613 $9,397
Accounts payable 242,172 198,978
Dividends payable - 190,000
Due to affiliates 170,432 146,683
Accrued compensation cost 30,045 26,854
Accrued interest payable 24,949 30,965
Income taxes payable - 1,842
Other accrued liabilities 37,763 32,565
Total current liabilities 543,974 637,284
Deferred revenue 8,380 8,337
Deferred income taxes 23,289 33,520
Long-term indebtedness 1,456,569 1,319,664
Other long-term liabilities 39,492 8,032
Total liabilities 2,071,704 2,006,837
Minority interests 13,217 14,148
Preferred stock Series A, 15,000 shares authorized,
13,939 shares issued and outstanding, respectively 308,174 312,749
Preferred stock Series A-1, 2,000 shares authorized,
1,948 shares issued and outstanding, respectively 53,431 50,797
Total stockholders' deficit (210,153) (18,037)
$2,236,373 $2,366,494
(in thousands)
Reconciliation of Holdings Net Loss to US Oncology Net Income (Loss):
Three Months Ended Year Ended
December 31, 2007 December 31, 2007
Holdings Net Loss $(14,830) $(34,973)
Add back: General and administrative expense (21) 97
Other (income) expense 11,573 11,885
Loss on extinguishment of debt - 12,917
Interest expense 12,765 42,154
Effective tax rate differential (9,185) (24,894)
US Oncology Net Income $302 $7,186
Reconciliation of Selected Balance Sheet Data:
December 31, 2007
entries and
US Oncology eliminations Holdings
Total assets $2,208,650 $27,723 $2,236,373
Total liabilities 1,641,110 430,594 2,071,704
Preferred stock - 361,605 361,605
Stockholders' equity (deficit) 554,323 (764,476) (210,153)
(in thousands)
Three Months Three Months
Ended Ended Year Ended
December 31, September 30, December 31,
2007 2006 2007 2007 2006
Net income (loss) $(14,830) $3,253 $(4,194) $(34,973) $26,158
Add back:
Interest expense,
net 36,913 29,547 34,414 137,496 117,088
Income tax
provision (7,869) 3,654 (4,760) (17,447) 18,926
Depreciation and
amortization 23,456 21,660 23,239 89,331 83,334
Amortization of
stock compensation 277 746 15 753 2,149
Minority interest
expense 1,743 660 539 3,619 2,388
Other expense 11,573 - 312 11,885 -
Loss on
of debt - - - 12,917 -
Impairment and
charges 6,771 - 960 15,126 -
Adjusted EBITDA 58,034(1) 59,520(1) 50,525(1) 218,707(1) 250,043(1)
Changes in assets
and liabilities 45,954 29,394 (14,787) 77,708 (97,934)
Deferred income
tax provision
(benefit) (699) 1,414 (10,017) (11,689) 4,422
expense, net (36,913) (29,547) (34,414) (137,496) (117,088)
Income tax
(provision) 7,869 (3,654) 4,760 17,447 (18,926)
Net cash provided
by (used in)
activities $74,245 $57,127 $(3,933) $164,677 $20,517
(1) US Oncology Holdings incurs certain general and administrative costs
that are incremental to the amounts incurred by US Oncology. During
the quarter and year ended December 31, 2007, these expenses were
$(21) thousand and $97 thousand, respectively, and are not included in
the determination of US Oncology Adjusted EBITDA of $58.0 million and
$218.8 million, respectively, for these periods.between visits is
complementary to our evidence-based clinical pathways that have been
adopted by approximately 90 percent of practices affiliated under
comprehensive service agreements and form the foundation of an
integrated Care Management model.
-- We added 190 physicians to our network and, in January 2008, executed
a comprehensive services agreement with a 47 physician practice that
represents our largest practice affiliation.
-- The Company continued to match affiliated practices with economic
models that both align our economic interests and acknowledge the
varied scope of services that our customers seek. During the fourth
quarter, two practices previously affiliated under comprehensive
agreements chose to affiliate under our OPS model.
-- We ended the year with over 600 providers implemented on our
electronic medical record, an increase of over 70% since
December 31, 2006.
-- From the end of 2006, our accounts receivable days outstanding
decreased by 5 days to 33 days as of December 31, 2007.
-- We strengthened our management team through the addition of Glen
Laschober as chief operating officer and through the expansion of our
regional leadership team to enhance the support of our existing
practice operations and the integration of new practices into our
Results of Operations
The Company operates and manages its business through four operating
segments. The table below compares the results of the fourth quarter of
2007 and fiscal year 2007, to the results of the corresponding period of
the prior year and the preceding quarter (in millions).
Q4 Q4 % Q3 % Fiscal Fiscal %
2007 2006 Change 2007 Change 2007 2006 Change
services $529.4 $524.5 0.9 $514.1 3.0 $2,088.2 $2,080.4 0.4
services 87.1 81.8 6.5 89.1 (2.2) 349.9 323.9 8.0
services 599.7 520.0 15.3 568.2 5.5 2,282.8 1,995.7 14.4
other 12.3 12.5 (1.6) 11.9 3.4 51.2 53.2 (3.8)
tions(1) (456.9) (417.2) (9.5) (439.5) (4.0) (1,771.3) (1,641.8) 7.9
Total $771.6 $721.6 6.9 $743.8 3.7 $3,000.8 $2,811.4 6.7
services $19.3 $25.2 (23.4) $15.6 23.7 $79.7 $124.5 (36.0)
services 20.1 19.2 4.7 22.9 (12.2) 87.7 77.5 13.2
services 28.1 20.2 39.1 21.6 30.1 90.9 79.8 13.9
and other (0.3) 0.4 nm(4) (0.8) (62.5) (0.8) - nm(4)
costs (2) (32.9) (27.9) (17.9) (32.0) (2.8) (128.8) (117.2) (9.9)
and rest-
charges(3) (6.8) - nm(4) (1.0) nm(4) (15.1) - nm(4)
Total $27.5 $37.1 (25.9) $26.3 4.6 $113.6 $164.6 (31.0)
services $19.3 $25.2 (23.4) $15.6 23.7 $79.7 $124.4 (35.9)
services 29.9 28.9 3.5 32.9 (9.1) 126.8 116.0 9.3
services 29.4 21.5 36.7 22.9 28.4 96.1 83.7 14.8
and other (0.2) 0.6 nm(4) (0.7) (71.4) (0.3) 0.9 nm(4)
costs(2) (20.3) (16.7) (21.6) (20.2) (0.5) (83.6) (75.0)(11.5)
Loss on
(3) - - - - - (12.9) - nm(4)
charges(3) (6.8) - nm(4) (1.0) nm(4) (15.1) - nm(4)
Total $51.3 $59.5 (13.8) $49.5 3.6 $190.7 $250.0 (23.7)
Net income
(loss) (14.8) 3.3 nm(4) (4.2) nm(4) (35.0) 26.2 nm(4)
cash flow 74.2 57.1 29.9 (3.9) nm(4) 164.7 20.5 nm(4)
(1) Eliminations represent the sale of pharmaceuticals from our
distribution center (pharmaceutical services segment) to our
practices affiliated under comprehensive service agreements (medical
oncology segment).
(2) Corporate costs relate primarily to general and administrative
expenses in support of our network.
(3) Impairment and restructuring charges and the loss on debt
extinguishment are excluded from Adjusted EBITDA. During the fourth
quarter of 2007, these charges consisted of $0.9 million related to
the medical oncology segment, $1.2 million to the cancer center
services segment and $4.7 million to corporate costs. During 2007,
$1.6 million related to the medical oncology services segment,
$4.2 million to the cancer center services segment and $9.3 million
to corporate costs.
(4) Not meaningful.
Medical Oncology Services
In the fourth quarter of 2007, medical oncology services revenue increased $4.9 million, or 0.9 percent, and EBITDA decreased $5.9 million, or 23.4 percent, compared to the fourth quarter of 2006. The revenue increase reflects an increase in daily visits due to growth in our network of affiliated medical oncologists which was partially offset by reduced utilization of supportive care drugs. The EBITDA decrease is due primarily to reduced utilization of supportive care drugs and management fee revisions discussed below.
Compared to the third quarter of 2007, medical oncology services revenue increased $15.3 million, or 3.0 percent and EBITDA increased $3.7 million, or 23.7 percent, both reflecting an increase in daily visits. Also contributing to the medical oncology EBITDA improvement from the third quarter of 2007 was an increase in management fees to reflect a redistribution of amounts retained by an affiliated practice between its medical oncology and cancer center services. These increases were partially offset by a higher management fee reduction under our program to promote continued support of initiatives in our pharmaceutical services segment (as discussed below).
During calendar 2007, medical oncology services revenue increased $7.8 million, or 0.4 percent, while EBITDA decreased $44.7 million, or 35.9 percent. The revenue increase reflects an increase in the average number of daily visits due to the growth in affiliated medical oncologists in the current year. Partially offsetting the revenue growth, and contributing to the EBITDA decline, were reduced utilization of supportive care drugs, reductions to management fees paid by affiliated practices (as discussed below) and the elimination of payments by Medicare to oncologists for providing certain patient care information (the "Medicare Demonstration Project") effective January 1, 2007.
The company's management fees are comprised of reimbursement for expenses we incur in connection with managing a practice, plus a fee that is typically a percentage of the affiliated practice's earnings before income taxes. Our agreements also provide for performance-based reductions in our percentage-based fee that are designed to encourage disciplined use of capital and efficient pharmaceutical ordering and management practices. Certain management agreements have been amended to provide a platform for long-term financial improvement of the practices' results, improve consistency with other agreements and to encourage practice growth and efficiency.
In addition, a program to promote continued support of initiatives in our pharmaceutical services segment became effective July 1, 2006. As of that date, we began reducing management fees paid to the Company by affiliated practices based upon compliance with distribution efficiency guidelines established by the Company and the profitability of the pharmaceutical services segment. For the third and fourth quarters of 2007, the management fee reduction amounted to $6.4 million and $7.8 million, respectively. For the fourth quarter of 2006, the management fee reductions amounted to $4.6 million. For the year, the management fee reduction amounted to $24.6 million in 2007 and $8.9 million for the six months ended December 31, 2006. The benefit of the efficiency performance is reflected in the operating results of the pharmaceutical services segment.
Cancer Center Services
Cancer center services revenue in the fourth quarter of 2007 was $87.1 million, an increase of $5.3 million, or 6.5 percent, and EBITDA was $29.9 million, an increase of $1.0 million, or 3.5 percent, over the fourth quarter of 2006. These increases reflect a 4.5 percent increase in radiation treatments and diagnostic radiology procedures over the same period in the prior year. Both revenue and EBITDA increased at a rate greater than treatment volumes as a result of expanding services in advanced targeted radiation therapies, such as image guided radiation therapy ("IGRT") and brachytherapy administered by network physicians, which are reimbursed at higher rates than conventional radiation therapy.
Fourth quarter cancer center services revenue decreased $2.0 million, or 2.2 percent, and EBITDA decreased $3.0 million, or 9.1 percent from the third quarter of 2007 reflecting the redistribution of management fees at an affiliated practice between its medical and radiation oncology divisions as discussed above.
During calendar 2007, cancer center services revenue increased $26.0 million, or 8.0 percent, and EBITDA increased $10.8 million, or 9.3 percent, over the prior year. Similar to the quarterly comparison, the increase reflects the use of technologically advanced radiation therapies and a 3.2 percent increase in radiation treatments and diagnostic radiology procedures per day.
Pharmaceutical Services
Pharmaceutical services revenue in the fourth quarter of 2007 was $599.7 million, an increase of $79.7 million, or 15.3 percent, over the fourth quarter of 2006. The revenue increase is primarily due to the net addition of 132 physicians affiliated through comprehensive service and oncology pharmaceutical services ("OPS") agreements since the close of the fourth quarter of 2006. Pharmaceutical services EBITDA was $29.4 million for the fourth quarter of 2007, an increase of $7.9 million, or 36.7 percent, over the fourth quarter of 2006, which reflects the revenue increase discussed previously as well as distribution performance fees earned during the quarter.
Pharmaceutical services revenue in the fourth quarter of 2007 increased $31.5 million, or 5.5 percent, and EBITDA increased $6.5 million, or 28.4 percent, over the preceding quarter. The revenue and EBITDA increases are due to the net addition of 47 physicians affiliated under OPS agreements during the quarter and increased earnings from services provided to manufacturers.
For 2007, pharmaceutical services revenue was $2.3 billion, an increase over 2006 of $287.1 million, or 14.4 percent, and EBITDA was $96.1 million, an increase over 2006 of $12.4 million, or 14.8 percent, for the reasons discussed previously in the quarterly comparisons.
Corporate Costs
Corporate costs, which represent general and administrative expenses, excluding stock-based compensation, were $20.3 million in the fourth quarter of 2007, compared to $16.7 million in the fourth quarter of 2006 due primarily to higher personnel costs, which reflect annual merit increases and personnel investments made to support our expanded regional infrastructure. Compared to the third quarter of 2007, corporate costs were essentially flat.
During calendar 2007, corporate costs were $83.6 million, an increase of $8.6 million from 2006. The increase is due to higher 2007 personnel costs (as discussed previously), as well as increased marketing costs to support our marketing efforts and expenses associated with an upgrade of the company's financial information system.
Impairment and Restructuring Charges
We continue to align our agreements with the service needs and maturity of our affiliated practices. During December 2007, eleven physicians from a practice previously affiliated under a comprehensive service agreement entered into a binding agreement to convert to an oncology pharmaceutical services agreement effective December 31, 2007. The company recognized an impairment charge of $6.5 million related to this practice, which relates primarily to a $4.7 million write-off of our service agreement intangible asset that was terminated in connection with the conversion.
Net Income (Loss)
Net loss for the fourth quarter of 2007 was $14.8 million, a decrease of $18.1 million from net income of $3.3 million the fourth quarter of 2006 and a decrease of $10.6 million from the third quarter of 2007. When compared to the fourth quarter of 2006 and the third quarter of 2007, the decrease resulted from the impairment charges described previously, increased interest expense reflecting additional borrowings and a loss on an interest rate swap.
For calendar year 2007, the net loss was $35.0 million, a decrease of
$61.2 million compared to fiscal year 2006 net income of $26.2 million.
Excluding impairment and restructuring charges, income from operations
decreased $35.9 million due primarily to the impa
|SOURCE US Oncology Holdings, Inc.
Copyright©2008 PR Newswire.
All rights reserved


text:
Santhigram Wellness's premier center in New York City was formally opened on October 4, 2018, by K. Devadasan Nair, Consul, Community Affairs, Consulate General of India in New York, in the presence of invited guests, including George Abraham, former Chief Technology Officer at the United Nations.
The New York Center, located at 30 East 40th Street, Suite 607, is an authentic Kerala Ayurvedic and Panchakarma Therapy Center for providing Ayurvedic consultation and holistic treatments for alleviating various chronic ailments, and life style consultation and preventive and rejuvenation therapies.
The Center has Consultation Room, separate treatment Rooms for both male and female clients equipped with Ayurveda equipment and fixtures imported from Kerala, India to ensure genuine Kerala Ayurveda therapy is imparted as per the ancient treatise of Kerala Ayurveda.
The Center is staffed with qualified and experienced Ayurveda doctors and Panchakarma Technicians and specialist Consultation with our Chief Holistic Consultant Dr.Ambika Nair is also available at this location with prior appointment.
With the on boarding of the Manhattan Center in a prime location just one block from the famous Grand Central Station on the Park Avenue, Santhigram has fulfilled the long standing demand of many of our clients in Manhattan translating into more convenient access from the five boroughs of New York City, Long Island, Upstate New York, Connecticut and Jersey City.
The Chief Guest Mr. K. Devadasan Nair expressed the view during his inaugural speech that the unique services brought by Santhigram to Manhattan will definitely help many people who are looking for holistic remedies for treating their various chronic health issues. Mr. George Abraham and other dignitaries who spoke on the occasion applauded the Ayurvedic services being provided by Santhigram which had already been benefiting hundreds of people in East Coast and Midwest where Santhigram is operating nearly a dozen Centers for the last more than 10 years.
Dr. Gopinathan Nair, Founder and Chairman of Santhigram Ayurveda Group, has taken the opportunity to once again thank our Patrons for the support extended to Santhigram over the years and expressed confidence to serve the US populace with renewed dedication in the days ahead.


text:
'Highest calibre' talent sought for new tourism roles
Following its bold decision to overhaul New South Wales regional tourism by creating six new Destination Networks, the NSW Government is seeking "applicants of the highest calibre" for the jobs.
It want skills-based, professional boards for the six new Destination Networks.
NSW Minister for Tourism and Major Events, Stuart Ayres, said the Board of Destination NSW, the State Government's tourism and major events agency, is seeking applicants for the positions of chair and board members at each of the six networks being set up as part of the reforms announced by this week.
"I'm very pleased to be travelling across NSW this week visiting a number of regions and talking to local operators about the reforms we are undertaking to provide a further boost to tourism across our fantastic state," Ayres said.
"We are now seeking applicants for these exciting new roles, and I encourage those with relevant experience to join our new skills-based, professional boards that will focus on attracting even more visitors to our regions.
"Regional tourism is an important driver in meeting the NSW Government's goal of doubling overnight visitor expenditure by 2020."
The new Destination Networks are Riverina Murray, Southern NSW (including the Snowy Mountains and Far South Coast), North Coast (from the Mid Coast to Tweed Heads including Lord Howe Island), Country and Outback NSW, Sydney Surrounds North (including the Blue Mountains, Central Coast and the Hunter), and Sydney Surrounds South (including Southern Highlands, Wollongong and Shoalhaven).
Applicants with expertise in a number of the following are encouraged to apply:
- Leadership, strategic planning and business management
- Tourism/marketing/publicity expertise
- Community and/or Local Government participation
- Regional service delivery
- Working with multiple stakeholders and/or government
- Legal/audit, financial control and reporting/risk management
- International business/legal experience
- Asset management/market research
- Event management or promotion
- Working with Aboriginal groups and communities and/or Local Government.
For more information on the roles go to dnsw.com.au/dns-applications.
MEANWHILE, the Tourism and Transport Forum Australia (TTF) has congratulated the NSW Government on the tourism overhaul.
The NSW Government will invest AUD 43 million over the next four years in the six new Destination Networks.
"NSW is more than just Sydney – it is a State of exciting and diverse experiences that visitors, particularly international visitors, are increasingly craving and we need to be getting the message out on what regional and rural NSW has to offer," TTF chief executive, Margy Osmond, said.
"Regional and rural NSW does very well in attracting domestic overnight visitors with more than double the number visiting Sydney – 19.5 million visitors to regional NSW in 2015 compared to 9.3 million to Sydney in the same period.
"However in the lucrative international visitor market regional NSW attracted 689,700 tourists in 2015 compared to the 3.2 million that visited Sydney. This is why encouraging and facilitating regional dispersal is particularly important for our regional communities, which rely on tourism to support their local and regional economies."
Edited by Peter Needham


text:
Every woman who loves diversity has certainly got a pair of broken jeans in her wardrobe. Because they are very stylish, original and comfortable, they give you an air of chic look. If you do not know how to wear them and what to match them, follow the tips below.
The ruffled jeans are a clothing detail for all silhouette types. It is important that when you dress them, you know how to match them so that you can hide the defects and highlight your qualities.
– Girls with thick thighs are recommended straight cut jeans. Try to choose a model with fewer holes in vertical direction. This will make you look taller.
– Weak girls can choose any pattern of broken jeans. But they will look best in skinny jeans with some cuts around the thighs and knees.
– Low girls need to avoid cuts and holes in the bottom of the jeans, they give a look distorted to the silhouette.
If you want to add a little bit of color to your picture, choose the bright-colored jeans. You can choose neon or even acidic colors. The rest of the garment must have a neutral, pastel shade to create a balance of look.
You must know that the extravagance of ruffled jeans is to make smoky feet, so it is recommended to wear them on the naked foot.
First of all, whether they're broken or not, a pair of jeans must come perfectly to you. If you go to a more relaxed look, a boyfriend ripped jeans pair is a good idea. For an arranged, well-arranged look, look for a pair of perfectly molded jeans (but not so much that you can not move in them).
Are you afraid your jeans will reveal too much skin? Look for a pair of jeans that have a layer of cotton cloth underneath the holes or with damaged, red, but not broken.
For a casual outing, a walk in the park or a coffee with your girlfriends, you can match the ruffled jeans with a vaporous and warm top. Make the most of the layers and put on top a thin blazer. Fill in everything with a pair of ballerinas and a vintage inspiration bag. Are you a fan of accessories? Jewelry and earrings will do well if they take over the classic retro style, so you can even call your mother's box to fill your look.
Sexy, in orange. Have you ever imagined that such jeans can fit well with a pair of heeled shoes and an elegant bag? Assort them with an asymmetrical blouse, possibly colorful bold, and use accessories to give the look a sexy and stylish air.


text:
Hesser Handcrafted is a state of the art architectural woodworking and millwork facility located in downtown San Diego, CA. Our company uses the latest in woodworking technology to produce the highest quality veneer products, doors, cabinets, and furniture. We specialize in high-end residential and commercial work. We offer custom exotic and domestic wood veneer panels and hardwood and veneered furniture involving hand joinery, precious inlays, and world-class finishes. Each piece is meticulously constructed by expert, award-winning craftsmen. Attention to detail, a commitment to excellence, and a passion for crafting are found in each individual piece of furniture.
Using a state-of-the-art facility, with all of the advantages of modern tooling, each craftsman blends the hand techniques of the past with a vision of the future. Hesser Handcrafted combines the balance and symmetry of Asian furniture with the exotic materials of the art-deco period to create a unique and harmonious style. Whether developed from outside or in-house designs, each piece is guaranteed to become a family heirloom.
Custom staircases, hardwood floors, fireplace mantels, cabinets, and furniture are all within our ability. Clients may choose from over 500,000 square feet of exotic veneers to create their functional piece of art.
We welcome the most technically challenging pieces of custom furniture being designed and built in the country today. Hesser Handcrafted is not limited by geography or range of style. Pieces can be shipped worldwide and custom installations are available.
Please also check out the video showcasing the owner's work featured at the Mingei International Museum - Forms in Wood and Fiber show.
|©2012 Hesser Handcrafted Inc. All rights reserved.


text:
Category: Stock Graphic, Illustrations
Stock Graphic >> Illustration - Watercolor Spring Flowers 12450 by Angie Makes @ CreativeMarket
File Size: 28.03 MB; DPI: 300 DPI.
These pretty spring flowers would be just lovely in your next design project. Perfect for blog headers, invitations, and more. This listing includes 64 300dpi PNG images with transparent backgrounds. Some styles and colors not shown.
Leaves, stems, and flowers come separate so that you can create your own floral combinations.
Keywords: watercolor, watercolor flowers, watercolor floral clip art, floral watercolor, floral watercolor clip art, floral watercolor clipart, watercolor flower clip art, watercolor flower clipart, spring flowers, pretty flower clip art, wedding, wedding invitation.


text:
If you tuned in to our last episode you know that we just celebrated our son's 7th birthday. Now that he's getting older and about to start 1st grade, I've been a little sentimental.
Today, for our quick and brief 3 Minute Thursday episode, I read to you a blog article I came across recently. It's written by a well-know blogger by the name of Rachel Marie Martin.
Her blog is at FindingJoy.net. If you're a crazy busy mom like me, you should really check it out.
Links Mentioned in this Show:
Rachel's Blog: FindingJoy.net
Share this Episode: CarlaRaeArneson.com/episode96
Share this Podcast: LifeMadeSimplePodcast.com
Simplicity University: SimplicityU.com
Free Guide: "9 Ways to Simplify Your Life"
Or send a text to 44222 with the word 9SIMPLIFY
Free Download: "5 Steps to Organizing Your Home"
Or send a text to 44222 with the word ORGANIZE
Website: CarlaRaeArneson.com
Facebook: Facebook.com/CarlaRaeArneson
Submit Questions: CarlaRaeArneson.com/AskCarlaRae


text:
Magazine article Newsweek
Brazil Fights Warming One Leaf at a Time
Article excerpt
Byline: Stefan Theil
The Copenhagen climate talks may have been a flop, but there was one piece of good news: a plan for rich states to pay the developing world to stop destroying tropical forests. That's key because deforestation represents about 15 percent of annual greenhouse gas emissions--more than all the world's cars, trucks, planes, trains, and ships combined. While countries couldn't agree on binding targets, it was the first time they had made halting deforestation central to the fight against climate change.
The agreement followed new evidence showing that deforestation can actually be slowed and, in some cases, reversed--which runs counter to longstanding predictions that nothing could stop the process and that eradication of the world's tropical forests was all but inevitable. In 2009 Brazil, long the world's worst offender, saw its pace of jungle-clearing plummet to a third of its historical rate. That's due in part to the recession, as falling commodity prices made clear-cutting for timber or soybean farms less profitable. But Brazil has also stepped up protection efforts, and is reaping the benefits of socioeconomic change and rising living standards, which have led to a decline in subsistence farming. As the bulk of destruction shifts to big agro, not millions of individual farmers, it has become easier for governments and NGOs to target perpetrators--just what Brazil has done. After they became the focus of a global protest campaign last year, Nike and Wal-Mart stopped sourcing their leather from Amazon cattle farmers. …


text:
New products are coming soon!
The historic Pike Place Market has been our home for over 40 years. Decorative Light Switch Covers are our specialty as well as many other ceramic designs to fit your home needs!
All of our work is made by hand with care and precision. If you are curious, ask us how we do it!
Singles, Doubles, Triples, and more!
Sign up to hear from us about specials, sales, and events.
We love our customers, so feel free to come say hi down at the historic Pike Place Market.
Pike Place, Seattle, Washington 98101, United States


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have joint together for a challenge
The Stampotique hostess this week, Monique has challenged the team to use a technique on their creation. So Stampotique turned to Pat Huntoon of the Technique Junkie Newsletter and together they decided that the team of the Technique Junkies joint in and they chose to use the Faux Barnwood Technique of the latest Newsletter. Now even if you are not a member of the Technique Junkies you can use this link to the Faux Barnwood technique or or any of the techniques Pat uses on her website to make a card for the Stampotique Febuary Challenge.
Please make sure to link within your post which technique you are using.
What are you playing for this week? Oh…..good question! How about we give away 2 prizes this week along with 2 winners??? Pat Huntoon has been very gracious and is giving away one of the Fancy Folds and Motions CDs PLUS a two year, online only subscription (2010 and 2011 issues) for one winner and the other winner will be receiving a $30 gift certificate towards stamps to the Stampotique store. We will randomly draw 2 winners for the prizes before our next challenge on March 9th.
Make sure to stay tuned to the website as both the Stampotique design team AND the Technique Junkies design team participated in this challenge and we will be sharing some wonderful creations using the Faux Barnwood technique over the next 2 weeks here.
So, what are you waiting for????? Get out some papers, some inks, some stamps and join us!
Please remember the following rules when entering this challenge:
1. This is a STAMPOTIQUE ONLY stamps week
2. You must LINK to the Faux Barnwood Technique or a technique from Technique Junkies that you chose to use within your blog post
3. Please link directly to your challenge post, not to your general blog
4.. Contest will close at March 8th at 5 p.m. EST
For my contribution as a member of the Technique Junkie Designteam I choose to use Relaxin' (one of the stamps by Daniel Torrente &Jill Penney). I did some paper piecing technique on this stamp as you can see. This is a technique from the Feb 2003 Newsletter.
I used the Faux Barndoor technique, yes on the barndoor! The grass is stitched on with some embroidery floss. Hope you are inspired to give it a try too!


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Parter International, Inc.
About Us
Our Services
Why Parter
Alan Parter
Elaine Mancini
Mark White
Robert Manasse
Michael Rubinger
Richard Kilner
Tadashi Hattori
Ann Willets
Mitch Arnowitz
Edyta Juda
Strategic Alliances
Where We Work
Our Expertise
Case Studies
Economic Development
Tourism Strategic Planning
Trade Promotion
Kawasaki Delegation
Investment Attraction
Marketing and Communications
US Market Entry
US Start-Up Package
Legal Services
Philanthropic Program
UK Department of Trade & Industry
This project had two parts: developing a program for joint ventures and strategic alliances and participating in the writing of the book entitled Trading with the US: A Practical Guide to Doing Business in the United States (Sterling Publications Limited, UK).
For the first part of the project, Parter International, Inc. developed the strategic alliance programs for the UKDTI to help British and American firms establish partnerships useful both in investment and trade. The program helped to match British small and medium sized enterprises (SME's) with American firms, which could use each other's technical know-how, product expertise, marketing savvy, or financial support. The UKDTI adopted many of our proposals
and developed a three-year effort to assist their small and medium sized enterprises. A couple of million pounds sterling, together with substantial manpower, were devoted to this effort by the UKDTI.
For the second part of the project, Alan Parter authored sections on market entry strategies, conducting market research, getting the product ready for the market and getting the market ready for the product in the aforementioned book. He explained how companies should gather information, segment the market, utilize primary data, consult secondary data, access government data, and hire consultants.


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Sir Alex Ferguson has revealed Manchester City's shock defeat to Southampton yesterday persuaded him to pick a stronger Manchester United team than he had originally planned for today's 2-0 win over Everton.
With Wednesday's Champions League trip to Real Madrid to consider, United boss Ferguson had been expected to field a weakened side against the Toffees.
However, Wayne Rooney and Robin van Persie were among the starters in Ferguson's XI, with Rio Ferdinand and Michael Carrick the only regulars on the bench.
Goals from Ryan Giggs and Van Persie earned the three points as United stretched their lead over champions City at the top of the Premier League to 12.
Asked if City's 3-1 loss had prompted a rethink on who to pick to face Everton, Ferguson said: 'Yeah it did. I thought I'd make about seven changes, but when I saw the result yesterday, I knew how important the game today would be for us and we can make more changes later on in the season.'
'We have to win our games anyway, it doesn't matter what happened with City yesterday,' the Scot continued. 'That's the way we should look at it, to concentrate on our own game and we will be OK.'
Giggs' 13th-minute opener means he has scored in 23 successive top-flight seasons – including all 21 Premier League campaigns.
Ferguson said of the Welsh veteran: 'His legacy lives on, he is a fantastic human being. He's up and down that pitch all day and has shown fantastic energy for the game, it is wonderful to see.'
Everton boss David Moyes said he was proud of his team's dogged display.
'The goal just before half-time made it difficult, but full credit to our lads, we stuck at it,' said Moyes. 'We didn't give in and I am a bit disappointed we didn't get the goal in the game.'
Madrid boss Jose Mourinho, meanwhile, was at Old Trafford to check out his European opponents. Mourinho's troops warmed up for the last-16 clash with a 4-1 thumping of Sevilla, with former United star Cristiano Ronaldo grabbing a hat-trick.
And Ferguson added: 'I had a chat with him [Mourinho], they had a regret result yesterday. It will be a fantastic match on Wednesday.'