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Being a better driver means giving your vehicle the tender loving care it needs - regular oil changes and a thorough cleaning, for example. But learning a little bit more about the weather can also make an impact on your daily driving habits and how you respond to conditions on the road. Unpredictable weather - especially between winter and spring - can pose plenty of driving challenges. Here's what you need to know about the weather and your drive.
Rain + Freezing Temps = Slick Roads
This combination can transform roads from dry to slippery in just minutes. Bridges and overpasses may present particular dangers.
Driving strategy: If it starts to drizzle during your drive, take precautions. Turn on headlights to increase visibility and increase your driving distance between cars to six seconds rather than three. Avoid sudden braking to prevent skids. Avoid slamming on the brakes or abruptly correcting your steering. If your vehicle begins to hydroplane, ease off the gas pedal and steer straight until you regain control.
Warm Days + Overnight Freezing = Black Ice
When snow melts during a warm winter day but freezes again overnight, something termed black ice can form. It's not actually black - just a very thin, shiny-looking sheet of ice that's often difficult to detect.
Driving strategy: If possible, delay driving until temperatures warm. Otherwise, drive at slower-than-posted speeds and increase your following distance.
Gusty Winds + Temperature Drop = Road Instability
As cold fronts move in, winds often pick up speed. Strong gusts can affect how your car handles, even if you're driving at normal speeds. Especially after a snowfall, blustery conditions can result in fallen branches, poor visibility, and downed power lines.
Driving strategy: Slow down so it's easier to brake and handle your car. In addition, choose parking spots away from potential hazards.
Moisture That's Low in the Atmosphere + a Cold Ground = Dense Fog
In near-freezing temps, the moisture from dense fog can create slick spots on the road and bring visibility to zero.
Driving strategy: Glare from high beams and other lights on the road can make it difficult to spot dangers on the road. Switch on your low-beam or fog headlights to make your own vehicle more visible. Drive slowly and pay attention to make sure you're driving in one lane.
Recent or Ongoing Snow + Heavy Traffic = Slick Roads
Lots of traffic can turn roads slick, especially if road crews haven't yet cleared or deiced surfaces. Sharp turns, over-correcting, and slamming on the brakes may all lead to skidding or swerving.
Driving strategy: Increase the distance between you and other drivers, particularly on hills. Allow more time to stop at intersections. Never pass snowplows or sand trucks.
Tip: Skip the cruise control during difficult weather conditions so you can respond more quickly to changing road conditions.


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The Elevation Dock for the iPhone is a classic Kickstarter story. An indie designer develops a better mouse trap, raises $1.4 million, and of course, delivers the product to backers, very, very late. These delays created a serious problem when they overlapped with Apple's announcement of the iPhone 5 and its new Lightning connector.
London-based software engineer and 3D-printer enthusiast Mike Hellers sums up the situation: "I actually received mine the day before I received the iPhone 5. Couldn't have been worse, really, as it meant that I used the dock with the 30-pin connector for exactly one day before it became a useless paperweight."
Unlike most backers, Hellers saw the incompatibility between his gadgets as a challenge instead of an inconvenience. He opened up Tinkercad, a web-based 3D-modeling program, fired up his MakerBot, and got busy designing an adapter. He says, "Designing the adapter was fairly straightforward and quick. I printed four or five iterations ... since it is such a small piece. The printing of those revisions was very quick, only a couple of minutes each time." He posted his design to Thingiverse, set up a Shapeways shop for those without access to a 3D printer, and helped 12,521 downloaders bring their products back to life.
The story doesn't end there, though. Metafilter founder Matt Haughey saw the adapter on Thingiverse and thought there was room for improvement. He and friend Michael Buffington printed out some samples and discovered that they didn't hold the charging cable flat and allowed the adapter to be pushed out. They designed a second part that solved both problems, printed it, tested it, and returned the design to the community on Thingiverse. Haughey says "It only took a couple hours of tinkering through two existing designs to meld the best parts of each into something that worked better than previous designs."
Makers armed with 3-D printers had a solution in hours, by comparison it took Elevation Labs over a month.They first posted on September 12th that an official solution would be coming soon, but didn't post an image of the adapter in production until October 20th. A five week turnaround time is really impressive in the world of hardware manufacturing, but an eternity in the world where people are armed with 3-D printers. Elevation Labs moved as fast as it could, but technology and the market is moving much faster.
This begs an interesting question — Will customer service phone lines be replaced with at home 3-D printers that can print replacement parts and upgrades? In the future will companies like Elevation Labs issue physical "patches" until a proper replacement can be produced? Haughey thinks so and writes "Any industry that involves physical objects and small parts is ripe for 3D printing becoming a huge thing (and a problematic thing for stakeholders involved). I know friends that can rapidly produce any part of a R/C (remote-controlled) car or plane that breaks, which is cool for them, and problematic for the manufacturers of R/C parts."
High resolution 3-D printers will create new industries, but their biggest value may be fixing old ones.

subset: commoncrawl


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Mariners finish off sweep of Twins
Twins drop fifth consecutive
SEATTLE — Michael Saunders homered, helping Blake Beavan and the Seattle Mariners beat the Minnesota Twins 5-1 Sunday for their fifth straight victory.
Seattle completed a three-game sweep and has won 12 of its last 13 at Safeco Field. Minnesota lost its fifth in a row.
Saunders's two-run shot was his career-high 11th homer. He connected in the seventh inning after Dustin Ackley doubled off reliever Jeff Gray, putting Seattle ahead 4-1.


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What route should we take to work today, Brain?
Same route we take every day, Pinky.
There were bikes on every block and lines of cyclists along many stretches of road and it would seem remarkable, but I've grown accustomed to it. The logic (and joy) of bicycle commuting seems to have taken root and there's no part of my ride where there's anything resembling a lack of bicyclists. I suppose I have the benefit of riding through the downtown core, but I predict that on a day like today, most roads will have seen at least a few bike commuters and hopefully those few bike commuters saw each other and maybe smiled or winked or high fived. The bike-to-bike high five is not something I've ever set out to do, much less accomplish, but one of these days I'll make it happen, hopefully with the consent of the other fiver so it's just not assault.
Felt a little bit heavy on the bike today. Maybe I was just carrying more stuff than usual, including a weird ceramic 'coat of arms' all hanging that I bought in a post-wine tasting fog in Eger, Hungary in 2003. It's hideous and that's why it's now in my office instead of in my home. I submit for your disapproval:
I also brought my lunch in glass containers, which I prefer to plastic containers, but are considerably heavier. Also, why did I bring rocks for lunch? Just kidding about the rocks- that's for dinner. Maybe it wasn't my slightly heavier than usual bag that slowed me down, but instead my not riding to work yesterday. Consistency is important for exercise and also the hobgoblin of little minds, which I think means that Emerson didn't belong to a gym.
Wore my new Road Holland today. It's the best. Go buy some. (I am not a paid endorser of this product. But I would be!)
East Capitol to Penn to 11th to R to Massachusetts. Construction on R Street led to a situation in which the roads were unambiguously temporarily closed to car traffic, but not really to bike traffic, or at least the gentlemen managing the traffic didn't seem to think so. Or at least one of them didn't and maybe the other one said "Oh shit, we were supposed to stop them" as me and another cyclist found ourselves biking towards the path of a reversing crane truck. It was fine- I was on a bike, so I could just move over a little and avoid the truck and so I did and crossed New Hampshire before there was even another truck doing some other kind of traffic pirouette, which was also avoidable. It's sort of easy to get around a city when you're not encased in a multiton vehicle. The idea that we think it should be just as easy to do things when in a car has always struck me as odd.
There's a statue of St. Jerome outside of the Croatian Embassy. "Greatest Doctor of the Church" it proclaims. That's pretty braggadocious and I'm sure that the St. Ambrose fans (to say nothing of what the supporters of the Eastern
Sloggy the rest of the way. A BMW driver stopped for me at a crosswalk. General feelings of contentment upon arriving at work after another great bike commute.


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This medication is typically used for human immunodeficiency virus (HIV).
This medication is typically used only once a day. However, your doctor or pharmacist may have suggested a different schedule that is more appropriate for you. Important: Follow the instructions on the label. Do not use more of this product, or more often, than prescribed.
It must be used regularly and continuously to maintain its beneficial effects. Be sure to keep an adequate supply on hand. If you forget a dose, take it as soon as you remember -- unless it is almost time for your next dose. In that case, skip the missed dose. Do not double the next dose to catch up.
This medication may be taken with or without food.
In addition to its desired action, this medication may cause some side effects, notably:
Each person may react differently to a treatment. If you think this medication may be causing side effects (including those described here, or others), talk to your doctor or pharmacist. He or she can help you to determine whether or not the medication is the source of the problem.
As with most medications, this product should be stored at room temperature. Store it in a secure location where it will not be exposed to excessive heat, moisture or direct sunlight. Do not allow it to freeze and keep it out of reach of young children. Make sure that any leftover portion is disposed of safely.
A treatment with this medication requires regular monitoring by a doctor. Be sure to see your doctor for all regularly scheduled appointments.
It is important to tell the health professionals you consult:


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Lupus is a disease that is caused by something going wrong with the immune system . That is the part of the body that fights off invaders, such as viruses, bacteria, and other germs. Typically, B cells in our immune system produce proteins called antibodies that protect the body from these invaders.
In a person with lupus, some B cells, called autoreactive B cells, react against your own body. The autoreactive B cells produce a type of protein called an autoantibody. Unlike normal antibodies, which react against foreign invaders, the autoantibodies attack your own body. In lupus, this can lead to inflamed body tissue.
Who does lupus affect?
Lupus fact: Lupus affects more women than men. About 90% of people living with lupus are women. While nobody knows for certain what causes the disease, lupus appears to have a genetic component and can run in families.
What triggers lupus?
Lupus fact: A number of factors may potentially trigger the disease, including infections, toxins, and environmental factors. Ultraviolet light, such as sunlight, has been shown to trigger lupus disease activity in up to 70% of people living with lupus.
Diagnosing lupus
Lupus fact: Lupus affects everyone differently. Symptoms are wide-ranging and can change over time. This unpredictability can make lupus difficult to diagnose. An accurate diagnosis can take months or even years to determine.
The start of lupus may be acute, appearing like an infection, or it may be a succession of vague, or seemingly disconnected, symptoms over time. Because the symptoms come and go and vary for each person, evaluation by a healthcare professional well-acquainted with lupus?most often a rheumatologist?is critical for an accurate diagnosis. This evaluation may include a physical examination, laboratory tests, and a complete medical history.
For additional information about lupus, please visit these sites or contact these organizations.
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Lupus information from the US government.
Lupus Foundation of America
The largest national non-profit voluntary health organization dedicated to the lupus community, research and support.
Lupus Research Institute
Information on new research and scientific efforts to prevent, treat, and cure lupus.
The web sites listed are external to GSK. GSK does not have control over the content or the information provided on these web sites and therefore does not warrant the accuracy or completeness of any content or information on these sites.
Handout on Health: Systemic Lupus Erythematosus
This publication is for people who have systemic lupus erythematosus, commonly called SLE or lupus, as well as for their families and friends and others who want to better understand the disease. The publication describes the disease and its symptoms and contains information about diagnosis and treatment, as well as current research efforts supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) and other components of the U.S. Department of Health and Human Services' National Institutes of Health (NIH). It also discusses issues such as health care, pregnancy, and quality of life for people with lupus. If you have further questions after reading this publication, you may wish to discuss them with your doctor.
- Defining Lupus
- Understanding What Causes Lupus
- Symptoms of Lupus
- Diagnosing Lupus
- Treating Lupus
- Lupus and Quality of Life
- Pregnancy and Contraception for Women With Lupus
- Research Highlights
- Hope for the Future
- For More Information
Information Boxes
- Common Symptoms of Lupus
- Diagnostic Tools for Lupus
- Warning Signs of a Flare
- Preventing a Flare
- Tips for Working With Your Doctor
Defining Lupus
Lupus is one of many disorders of the immune system known as autoimmune diseases. In autoimmune diseases, the immune system turns against parts of the body it is designed to protect. This leads to inflammation and damage to various body tissues. Lupus can affect many parts of the body, including the joints, skin, kidneys, heart, lungs, blood vessels, and brain. Although people with the disease may have many different symptoms, some of the most common ones include extreme fatigue, painful or swollen joints (arthritis), unexplained fever, skin rashes, and kidney problems.
At present, there is no cure for lupus. However, lupus can be effectively treated, and most people with the disease can lead active, healthy lives. Typically, lupus is characterized by periods of illness, called flares, and periods of wellness, or remission. Understanding how to prevent flares and how to treat them when they do occur helps people with lupus maintain better health. Intense research is underway, and scientists funded by the NIH are continuing to make great strides in understanding the disease, which may ultimately lead to a cure.
Two of the major questions researchers are studying are who gets lupus and why. We know that many more women than men have lupus. Lupus is two to three times more common in African American women than in Caucasian women and is also more common in women of Hispanic, Asian, and Native American descent. African American and Hispanic women are also more likely to have active disease and serious organ system involvement. In addition, lupus can run in families, but the risk that a child or a brother or sister of a patient will also have lupus is still quite low. It is difficult to estimate how many people in the United States have the disease, because its symptoms vary widely and its onset is often hard to pinpoint.
There are several kinds of lupus:
- Systemic lupus erythematosus (SLE) is the form of the disease that most people are referring to when they say "lupus." The word "systemic" means the disease can affect many parts of the body. The symptoms of SLE may be mild or serious. Although SLE usually first affects people between the ages of 15 and 45 years, it can occur in childhood or later in life as well. This publication focuses on SLE.
- Discoid lupus erythematosus is a chronic skin disorder in which a red, raised rash appears on the face, scalp, or elsewhere. The raised areas may become thick and scaly and may cause scarring. The rash may last for days or years and may recur. A small percentage of people with discoid lupus have or develop SLE later.
- Subacute cutaneous lupus erythematosus refers to skin lesions that appear on parts of the body exposed to sun. The lesions do not cause scarring.
- Drug-induced lupus is a form of lupus caused by medications. Many different drugs can cause drug-induced lupus. They include some antiseizure, high blood pressure, and thyroid medications; antibiotics and antifungals; and oral contraceptive pills. Symptoms are similar to those of SLE (arthritis, rash, fever, and chest pain), and they typically go away completely when the drug is stopped. The kidneys and brain are rarely involved.
- Neonatal lupus is a rare disease that can occur in newborn babies of women with SLE, Sjögren's syndrome, or no disease at all. Scientists suspect that neonatal lupus is caused in part by autoantibodies in the mother's blood called anti-Ro (SSA) and anti-La (SSB). Autoantibodies ("auto" means self) are blood proteins that act against the body's own tissues. At birth, the babies have a skin rash, liver problems, and low blood counts. These symptoms gradually go away over several months. In rare instances, babies with neonatal lupus may have congenital heart block, a serious heart problem in which the formation of fibrous tissue in the baby's heart interferes with the electrical impulses that affect heart rhythm. Neonatal lupus is rare, and most infants of mothers with SLE are entirely healthy. All women who are pregnant and known to have anti-Ro (SSA) or anti-La (SSB) antibodies should be monitored by echocardiograms (a test that monitors the heart and surrounding blood vessels) periodically during pregnancy. It is important for women with SLE or other related autoimmune disorders to be under a doctor's care during pregnancy. Doctors can now identify mothers at highest risk for complications, allowing for prompt treatment of the infant at or before birth. SLE can also flare during pregnancy, and prompt treatment can keep the mother healthier longer.
Understanding What Causes Lupus
Lupus is a complex disease, and its cause is not fully understood. Scientists are making progress in understanding lupus, as described here and in the "Research Highlights" section of this publication.
In studies of identical twins, when one twin has lupus, the other twin has a 24-percent chance of developing it. This and other research suggests that genetics plays an important role, but it also shows that genes alone do not determine who gets lupus, and that other factors play a role. Some of the factors scientists are studying include sunlight, stress, hormones, cigarette smoke, certain drugs, and infectious agents such as viruses. Studies have confirmed that one virus, Epstein-Barr virus (EBV), which causes mononucleosis, is a cause of lupus in genetically susceptible people.
Scientists believe there is no single gene that predisposes people to lupus. Rather, studies suggest that a number of different genes may be involved in determining a person's likelihood of developing the disease, which tissues and organs are affected, and the severity of disease. Researchers have begun to make headway in identifying some of those genes, which could eventually lead to better ways to treat and perhaps even prevent lupus.
In lupus, the body's immune system does not work as it should. A healthy immune system produces proteins called antibodies and specific cells called lymphocytes that help fight and destroy viruses, bacteria, and other foreign substances that invade the body. In lupus, the immune system produces antibodies against the body's healthy cells and tissues. These antibodies, called autoantibodies, contribute to the inflammation of various parts of the body and can cause damage to organs and tissues. The most common type of autoantibody that develops in people with lupus is called an antinuclear antibody (ANA) because it reacts with parts of the cell's nucleus (command center). Doctors and scientists do not yet understand all of the factors that cause inflammation and tissue damage in lupus, and researchers are actively exploring them.
Common Symptoms of Lupus
- Painful or swollen joints and muscle pain
- Unexplained fever
- Red rashes, most commonly on the face
- Chest pain upon deep breathing
- Unusual loss of hair
- Pale or purple fingers or toes from cold or stress (Raynaud's phenomenon)
- Sensitivity to the sun
- Swelling (edema) in legs or around eyes
- Mouth ulcers
- Swollen glands
- Extreme fatigue.
Symptoms of Lupus
Each person with lupus has slightly different symptoms that can range from mild to severe and may come and go over time. However, some of the most common symptoms of lupus include painful or swollen joints (arthritis), unexplained fever, and extreme fatigue. A characteristic red skin rash—the so-called butterfly or malar rash—may appear across the nose and cheeks. Rashes may also occur on the face and ears, upper arms, shoulders, chest, and hands and other areas exposed to the sun. Because many people with lupus are sensitive to sunlight (called photosensitivity), skin rashes often first develop or worsen after sun exposure.
Other symptoms of lupus include chest pain, hair loss, anemia (a decrease in red blood cells), mouth ulcers, and pale or purple fingers and toes from cold and stress. Some people also experience headaches, dizziness, depression, confusion, or seizures. New symptoms may continue to appear years after the initial diagnosis, and different symptoms can occur at different times. In some people with lupus, only one system of the body, such as the skin or joints, is affected. Other people experience symptoms in many parts of their body. Just how seriously a body system is affected varies from person to person. The following systems in the body also can be affected by lupus.
- Kidneys: Inflammation of the kidneys (nephritis) can impair their ability to get rid of waste products and other toxins from the body effectively. There is usually no pain associated with kidney involvement. Most often, the only indication of kidney disease is an abnormal urine or blood test; however, some patients may notice dark urine and swelling around their eyes, legs, ankles, or fingers. Because the kidneys are so important to overall health, lupus affecting the kidneys generally requires intensive drug treatment to prevent permanent damage.
- Lungs: Some people with lupus develop pleuritis, an inflammation of the lining of the chest cavity that causes chest pain, particularly with breathing. Patients with lupus also may get pneumonia.
- Central nervous system: In some patients, lupus affects the brain or central nervous system. This can cause headaches, dizziness, depression, memory disturbances, vision problems, seizures, stroke, or changes in behavior.
- Blood vessels: Blood vessels may become inflamed (vasculitis), affecting the way blood circulates through the body. The inflammation may be mild and may not require treatment or may be severe and require immediate attention. People with lupus are also at increased risk for atherosclerosis (hardening of the arteries).
- Blood: People with lupus may develop anemia, leukopenia (a decreased number of white blood cells), or thrombocytopenia (a decrease in the number of platelets in the blood, which assist in clotting). People with lupus who have a type of autoantibody called antiphospholipid antibodies have an increased risk of blood clots.
- Heart: In some people with lupus, inflammation can occur in the heart itself (myocarditis and endocarditis) or the membrane that surrounds it (pericarditis), causing chest pain or other symptoms. Endocarditis can damage the heart valves, causing the valve surface to thicken and develop growths, which can cause heart murmurs. However, this usually doesn't affect the valves' function.
Diagnosing Lupus
Diagnosing lupus can be difficult. It may take months or even years for doctors to piece together the symptoms to diagnose this complex disease accurately. Making a correct diagnosis of lupus requires knowledge and awareness on the part of the doctor and good communication on the part of the patient. Giving the doctor a complete, accurate medical history (for example, what health problems you have had and for how long) is critical to the process of diagnosis. This information, along with a physical examination and the results of laboratory tests, helps the doctor consider other diseases that may mimic lupus, or determine if you truly have the disease. Reaching a diagnosis may take time as new symptoms appear.
No single test can determine whether a person has lupus, but several laboratory tests may help the doctor to confirm a diagnosis of lupus or rule out other causes for a person's symptoms. The most useful tests identify certain autoantibodies often present in the blood of people with lupus. For example, the antinuclear antibody (ANA) test is commonly used to look for autoantibodies that react against components of the nucleus, or "command center," of the body's cells. Most people with lupus test positive for ANA; however, there are a number of other causes of a positive ANA besides lupus, including infections and other autoimmune diseases. Occasionally, it is also found in healthy people. The ANA test simply provides another clue for the doctor to consider in making a diagnosis. In addition, there are blood tests for individual types of autoantibodies that are more specific to people with lupus, although not all people with lupus test positive for these and not all people with these antibodies have lupus. These antibodies include anti-DNA, anti-Sm, anti-RNP, anti-Ro (SSA), and anti-La (SSB). The doctor may use these antibody tests to help make a diagnosis of lupus.
Some tests are used less frequently but may be helpful if the cause of a person's symptoms remains unclear. The doctor may order a biopsy of the skin or kidneys if those body systems are affected. Some doctors may order a test for anticardiolipin (or antiphospholipid) antibody. The presence of this antibody may indicate increased risk for blood clotting and increased risk for miscarriage in pregnant women with lupus. Again, all these tests merely serve as tools to give the doctor clues and information in making a diagnosis. The doctor will look at the entire picture—medical history, symptoms, and test results—to determine if a person has lupus.
Diagnostic Tools for Lupus
- Medical history
- Complete physical examination
- Laboratory tests:
- Complete blood count (CBC)
- Erythrocyte sedimentation rate (ESR)
- Urinalysis
- Blood chemistries
- Complement levels
- Antinuclear antibody test (ANA)
- Other autoantibody tests (anti-DNA, anti-Sm, anti-RNP, anti-Ro [SSA], anti‑La [SSB])
- Anticardiolipin antibody test
- Skin biopsy
- Kidney biopsy.
Other laboratory tests are used to monitor the progress of the disease once it has been diagnosed. A complete blood count, urinalysis, blood chemistries, and the erythrocyte sedimentation rate test (a test to measure inflammation) can provide valuable information. Another common test measures the blood level of a group of substances called complement, which help antibodies fight invaders. A low level of complement could mean the substance is being used up because of an immune response in the body, such as that which occurs during a flare of lupus.
X rays and other imaging tests can help doctors see the organs affected by SLE.
Treating Lupus
Diagnosing and treating lupus often require a team effort between the patient and several types of health care professionals. Most people will see a rheumatologist for their lupus treatment. A rheumatologist is a doctor who specializes in rheumatic diseases (arthritis and and other inflammatory disorders, often involving the immune system). Clinical immunologists (doctors specializing in immune system disorders) may also treat people with lupus. As treatment progresses, other professionals often help. These may include nurses, psychologists, social workers, nephrologists (doctors who treat kidney disease), cardiologists (doctors specializing in the heart and blood vessels), hematologists (doctors specializing in blood disorders), endocrinologists (doctors specializing in problems related to the glands and hormones), dermatologists (doctors who treat skin disease), and neurologists (doctors specializing in disorders of the nervous system). It is also important for people with lupus to have a primary care doctor—usually a family physician or internist (internal medicine specialist)—who can coordinate care between their different health providers and treat other problems as they arise.
The range and effectiveness of treatments for lupus have increased dramatically in recent decades, giving doctors more choices in how to manage the disease. It is important for the patient to work closely with the doctor and take an active role in managing the disease. Once lupus has been diagnosed, the doctor will develop a treatment plan based on the patient's age, sex, health, symptoms, and lifestyle. Treatment plans are tailored to the individual's needs and may change over time. In developing a treatment plan, the doctor has several goals: to prevent flares, to treat them when they do occur, and to minimize organ damage and complications. The doctor and patient should reevaluate the plan regularly to ensure it is as effective as possible. Medications used in the treatment of lupus include the following:1
1All medicines can have side effects. Some side effects may be more severe than others. You should review the package insert that comes with your medicine and ask your health care provider or pharmacist if you have any questions about the possible side effects.
NSAIDs: For people with joint or chest pain or fever, drugs that decrease inflammation, called nonsteroidal anti-inflammatory drugs (NSAIDs), are often used.2 Although some NSAIDs, such as ibuprofen and naproxen, are available over the counter, a doctor's prescription is necessary for others. NSAIDs may be used alone or in combination with other types of drugs to control pain, swelling, and fever. Even though some NSAIDs may be purchased without a prescription, it is important that they be taken under a doctor's direction.
2Warning: NSAIDs can cause stomach irritation or, less often, they can affect kidney function. The longer a person uses NSAIDs, the more likely he or she is to have side effects, ranging from mild to serious. Many other drugs cannot be taken when a patient is being treated with NSAIDs because NSAIDs alter the way the body uses or eliminates these other drugs. Check with your health care provider or pharmacist before you take NSAIDs. Also, NSAIDs sometimes are associated with serious gastrointestinal problems, including ulcers, bleeding, and perforation of the stomach or intestine. People age 65 and older, as well as those with any history of ulcers or gastrointestinal bleeding, should use NSAIDs with caution.
Antimalarials: Antimalarials are another type of drug commonly used to treat lupus. These drugs were originally used to treat malaria, but doctors have found that they also are useful for lupus. A common antimalarial used to treat lupus is hydroxychloroquine. It may be used alone or in combination with other drugs and generally is used to treat fatigue, joint pain, skin rashes, and inflammation of the lungs. Clinical studies have found that continuous treatment with antimalarials may prevent flares from recurring.
Corticosteroids: Corticosteroids, such as prednisone, hydrocortisone, methylprednisolone, and dexamethasone, are related to cortisol, which is a natural anti-inflammatory hormone. They work by rapidly suppressing inflammation. Corticosteroids can be given by mouth, in creams applied to the skin, by injection, or by intravenous (IV) infusion (dripping the drug into the vein through a small tube). Because they are potent drugs, the doctor will seek the lowest dose required to achieve the desired benefit.
In an effort to minimize side effects associated with corticosteroids, researchers are working to develop ways to limit or offset the use of corticosteroids. For example, corticosteroids may be used in combination with other, less potent drugs, or the doctor may try to slowly decrease the dose once the disease is under control.
Immunosuppressives: For some patients whose kidneys or central nervous systems are affected by lupus, a type of drug called an immunosuppressive may be used. Immunosuppressives, such as cyclophosphamide and mycophenolate mofetil, restrain the overactive immune system by blocking the production of immune cells. These drugs may be given by mouth or by IV infusion. The risk for side effects increases with the length of treatment.
BLyS-specific inhibitors: Belimumab, a type of agent referred to as a B-lymphocyte stimulator (BLyS) protein inhibitor, was approved by the U.S. Food and Drug Administration (FDA) in March 2011 for patients with lupus who are receiving other standard therapies, including those listed above. Given by IV infusion, belimumab may reduce the number of abnormal B cells thought to be a problem in lupus.
In studies conducted so far, African American patients and patients of African heritage did not appear to respond significantly to belimumab. An additional study of this patient population is planned to evaluate belimumab further in this subgroup of lupus patients. However, this difference in response to a treatment may be another indicator of the various ways that the disease affects different patients.
Other therapies: In some patients, methotrexate, a disease-modifying antirheumatic drug, may be used to help control the disease. Other treatments may include hormonal therapies such as dehydroepiandrosterone (DHEA) and intravenous immunoglobulin (proteins derived from human blood), which may be useful for controlling lupus when other treatments haven't worked.
Working closely with the doctor helps ensure that treatments for lupus are as successful as possible. Because some treatments may cause harmful side effects, it is important to report any new symptoms to the doctor promptly. It is also important not to stop or change treatments without talking to the doctor first. In addition to medications for lupus itself, in many cases it may be necessary to take additional medications to treat problems related to lupus such as high cholesterol, high blood pressure, or infection.
Alternative and complementary therapies: Because of the nature and cost of the medications used to treat lupus and the potential for serious side effects, many patients seek other ways of treating the disease. Some alternative approaches people have tried include special diets, nutritional supplements, fish oils, ointments and creams, chiropractic treatment, and homeopathy. Although these methods may not be harmful in and of themselves and may be associated with symptomatic or psychosocial benefit, no research to date shows that they affect the disease process or prevent organ damage. Some alternative or complementary approaches may help the patient cope or reduce some of the stress associated with living with a chronic illness. If the doctor feels the approach has value and will not be harmful, it can be incorporated into the patient's treatment plan. However, it is important not to neglect regular health care or treatment of serious symptoms. An open dialogue between the patient and doctor about the relative values of complementary and alternative therapies allows the patient to make an informed choice about treatment options.
Lupus and Quality of Life
A diagnosis of lupus can have a significant impact on quality of life, including the ability to work. Research on work loss associated with lupus, funded in part by the NIAMS, estimated that almost three-quarters of the study's 982 participants would stop working before the usual age of retirement, and that half of those who had jobs when they were diagnosed (during their mid-thirties, on average) would no longer be working by the age of 50. The researchers determined that demographics and work characteristics (the physical and psychological demands of jobs and the degree of control over assignments and work environment) had the most impact on work loss.
Despite the symptoms of lupus and the potential side effects of treatment, people with lupus can maintain a high quality of life overall. One key to managing lupus is to understand the disease and its impact. Learning to recognize the warning signs of a flare can help the patient take steps to ward it off or reduce its intensity. Many people with lupus experience increased fatigue, pain, a rash, fever, abdominal discomfort, headache, or dizziness just before a flare. Developing strategies to prevent flares can also be helpful, such as learning to recognize your warning signals and maintaining good communication with your doctor.
It is also important for people with lupus to receive regular health care, instead of seeking help only when symptoms worsen. Results from a medical exam and laboratory work on a regular basis allow the doctor to note any changes and to identify and treat flares early. The treatment plan, which is tailored to the individual's specific needs and circumstances, can be adjusted accordingly. If new symptoms are identified early, treatments may be more effective. Other concerns also can be addressed at regular checkups. The doctor can provide guidance about such issues as the use of sunscreens, stress reduction, and the importance of structured exercise and rest, as well as birth control and family planning. Because people with lupus can be more susceptible to infections, the doctor may recommend yearly influenza vaccinations or pneumococcal vaccinations for some patients.
Women with lupus should receive regular preventive health care, such as gynecological and breast examinations. Both men and women need to have their blood pressure and cholesterol checked on a regular basis. It is reccommended that people who take corticosteroids or antimalarias have regular eye exams to screen for and treat eye problems.
People with lupus should also be aware of their increased risk of premature cardiovascular disease. This makes healthy lifestyle choices such as eating well, exercising regularly, and not smoking particularly important for people with lupus.
Warning Signs of a Flare
- Increased fatigue
- Pain
- Rash
- Fever
- Abdominal discomfort
- Headache
- Dizziness.
Preventing a Flare
- Learn to recognize your warning signals.
- Maintain good communication with your doctor.
Staying healthy requires extra effort and care for people with lupus, so it becomes especially important to develop strategies for maintaining wellness. Wellness involves close attention to the body, mind, and spirit. One of the primary goals of wellness for people with lupus is coping with the stress of having a chronic disorder. Effective stress management varies from person to person. Some approaches that may help include exercise, relaxation techniques such as meditation, and setting priorities for spending time and energy.
Developing and maintaining a good support system is also important. A support system may include family, friends, medical professionals, community organizations, and support groups. Participating in a support group can provide emotional help, boost self-esteem and morale, and help develop or improve coping skills. (For more information on support groups, see the "For More Information" section at the end of this publication.)
Tips for Working With Your Doctor
- Seek a health care provider who is familiar with SLE and who will listen to and address your concerns.
- Provide complete, accurate medical information.
- Make a list of your questions and concerns in advance.
- Be honest and share your point of view with the health care provider.
- Ask for clarification or further explanation if you need it.
- Talk to other members of the health care team, such as nurses, therapists, or pharmacists.
- Do not hesitate to discuss sensitive subjects (for example, birth control, intimacy) with your doctor.
- Discuss any treatment changes with your doctor before making them.
Learning more about lupus may also help. Studies have shown that patients who are well-informed and participate actively in their own care experience less pain, make fewer visits to the doctor, build self-confidence, and remain more active.
Pregnancy and Contraception for Women With Lupus
Although pregnancy in women with lupus is considered high risk, most women with lupus carry their babies safely to the end of their pregnancy. Overall, women with lupus have a higher rate of miscarriage and premature births compared with the general population. In addition, women who have antiphospholipid antibodies are at a greater risk of miscarriage in the second trimester because of their increased risk of blood clotting in the placenta. Lupus patients with a history of kidney disease have a higher risk of preeclampsia (hypertension with a buildup of excess watery fluid in cells or tissues of the body). Pregnancy counseling and planning before pregnancy are important. Ideally, a woman should have no signs or symptoms of lupus and be taking no medications for several months before she becomes pregnant.
Some women may experience a mild to moderate flare during or after their pregnancy; others do not. Pregnant women with lupus, especially those taking corticosteroids, also are more likely to develop high blood pressure, diabetes, hyperglycemia (high blood sugar), and kidney complications, so regular care and good nutrition during pregnancy are essential. It is also advisable to have access to a neonatal (newborn) intensive care unit at the time of delivery in case the baby requires special medical attention.
For women with lupus who do not wish to become pregnant or who are taking drugs that could be harmful to an unborn baby, reliable birth control is important. Oral contraceptives (birth control pills) were once not an option for women with lupus because doctors feared the hormones in the pill would cause a flare of the disease. However, a large NIH-supported study called Safety of Estrogens in Lupus Erythematosus National Assessment (SELENA) found that severe flares were no more common among women with lupus taking oral contraceptives than those taking a placebo (inactive pill). As a result of this study, doctors are increasingly prescribing oral contraceptives to women with inactive or stable disease.
Research Highlights
Lupus is the focus of intense research as scientists try to determine what causes the disease and how it can best be treated. Some of the questions they are working to answer include: Why are women more likely than men to have the disease? Why are there more cases of lupus in some racial and ethnic groups, and why are cases in these groups often more severe? What goes wrong in the immune system and why? How can we correct the way the immune system functions once something goes wrong? What treatment approaches will work best to lessen lupus symptoms? How do we cure lupus?
To help answer these questions, scientists are developing new and better ways to study the disease. They are doing laboratory studies that compare various aspects of the immune systems of people with lupus with those of other people both with and without lupus. They also use mice with disorders resembling lupus to better understand the abnormalities of the immune system that occur in lupus and to identify possible new therapies.
The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) has a major focus on lupus research in its on-campus program in Bethesda, Maryland. By evaluating patients with lupus and their relatives, researchers at the National Institutes of Health (NIH) are learning more about how lupus develops and changes over time.
The NIAMS also funds many lupus researchers across the United States. To help scientists gain new knowledge, the NIAMS sponsored the development of a Lupus Registry and Repository that gathers medical information, as well as blood and tissue samples from patients and their relatives. This gives researchers across the country access to information and materials they can use to help identify genes that determine susceptibility to the disease.
The NIAMS also helped establish a registry to collect information and blood samples from children affected by neonatal lupus and their mothers. Information from the registry forms the basis of family counseling and tracks important data such as recurrence rates in subsequent pregnancies. The hope is that the registry will facilitate improved methods of diagnosis, as well as prevention and treatment for this rare condition.
In 2003, the NIH established the Lupus Federal Working Group (LFWG), a collaboration among the NIH Institutes, other Federal agencies, voluntary and professional organizations, and industries with an interest in lupus. The Working Group is led by the NIAMS and includes representatives from all relevant U.S. Department of Health and Human Services (HHS) agencies and other Federal departments having an interest in lupus.
In 2014, the NIH, pharmaceutical companies, and nonprofit organizations together created the NIH Accelerating Medicines Partnership (AMP). The goal of the AMP is to increase the number of new diagnostics and therapies for select diseases, including lupus, and to reduce the time and cost of developing them.
Here are some recent major advances in different areas of lupus research:
Identifying genes that play a role in the development of lupus or lupus severity is an active area of research.
The NIAMS intramural and extramural investigators have established that a variant in a gene called STAT4, which is associated with lupus susceptibility, is more specifically associated with disease characterized by severe symptoms such as disorders of the kidney. This finding may allow doctors to determine which patients are at risk of more severe disease and may lead to the development of new treatment for patients at greatest risk of complications.
A number of other genes associated with lupus risk and severity have been discovered. Some are linked to patient populations at high risk for lupus, including African American and Hispanic individuals.
Biomarkers are another significant area of lupus research. Biomarkers are defined as molecules that reflect a specific biological or pathological process, consequence of a process, or a response to a therapeutic intervention. Simply put, they can let the doctor know what is happening in the body—or predict what is going to happen—based on something reliably measurable in tissues, cells, or fluids. NIAMS-supported researchers identified anti-double-stranded DNA antibodies and complement C3a—both of which can be found in blood tests—as biomarkers for flares, meaning they can predict that a flare will occur. They also showed that moderate doses of prednisone can prevent flares in people having these biomarkers.
In separate research, NIAMS-supported investigators identified a list of proteins in the urine of people with renal disease caused by lupus. These biomarkers can be used to indicate the type and severity of renal disease in these patients, as well as the extent of damage to the kidney. Such biomarkers could form the basis of clinical tests to help doctors establish an effective treatment plan for these patients without putting them through repeated kidney biopsies. Further studies are needed to determine whether urine protein analysis could replace the use of biopsies to assess kidney damage in lupus.
Other recently identified biomarkers include C-reactive protein (CRP), a protein made by the liver, which correlates with disease activity and cardiovascular disease risk factors, and C4d, a protein in the blood that may indicate lupus disease activity or kidney involvement.
The Disease Process
One NIAMS-supported study found that the disease process of lupus—including the development of certain autoantibodies and some symptoms of the disease—begin before the disease is diagnosed. Because lupus is different in different people and is characterized by autoimmunity in various systems of the body, the initial presentation can be unpredictable. Many symptoms come and go over time, often delaying diagnosis and the start of therapy.
Seeking to identify patterns among early clinical events in lupus, as well as to assess whether the presence of lupus-associated autoantibodies precedes clinical manifestations, investigators looked back at the charts of 130 lupus patients, analyzing 633 serum samples taken at different times and noting when the criteria for a lupus diagnosis were fulfilled. To be classified as having lupus, a person needs to meet at least 4 of 11 criteria. They found that in 80 percent of the patients, at least one clinical criterion for SLE appeared before SLE was diagnosed. Eighty-four percent developed antinuclear antibodies (ANAs). Discoid rashes and seizures were the earliest observed symptoms, with a mean onset of 1.74 years and 1.70 years prior to diagnosis, respectively. Oral ulcers tended to appear only after diagnosis, making this a less useful diagnostic tool. Among SLE patients with renal disease, anti-double-stranded DNA antibodies appeared before or at the same time as American College of Rheumatology (ACR)-defined renal disorder in the majority of patients who had both the autoantibodies and the renal disorder.
Researchers are also making strides in understanding how the disease process affects different organs. One NIAMS investigator reported that a subset of antibodies to DNA can be found in the blood and the brain of lupus patients with cognitive problems. These anti-DNA antibodies bind to specific receptors (NMDA [N-methyl-d-aspartate] receptors) on nerve cells in the brain. In the culture dish, binding of these anti-DNA antibodies to nerve cells results in the death of the cells. In subsequent studies involving mice, the researchers found that these antibodies affect the nervous system only when the blood-brain barrier was broken, allowing the antibodies access to the brain. Where the blood-brain barrier was broken, antibodies bound to the neurons in a specific area of the brain that helps regulate emotion and memory. Tests for cell death in that area of the brain were positive. Behavioral tests on the mice also revealed impaired cognitive function and memory. Perhaps more important was the finding that the nerve cell binding and its damage could be prevented with a drug that inhibits the NMDA receptor. Researchers say the findings suggest that such drugs may eventually be a useful therapy for people with lupus.
Understandably, identifying and developing better treatments for lupus—and ensuring that patients receive the best treatments—are among the primary goals of lupus research. A 2005 study of 17 adults with lupus that was clinically active despite treatment, found that just one injection of the cancer drug rituximab eased symptoms for up to a year or more. Several participants were able to reduce or completely stop their regular lupus medications. Rituximab works by lowering the number of B cells—white blood cells that produce antibodies—in the body. It is approved by the U.S. Food and Drug Administration (FDA) for a type of cancer called lymphoma, as well as for rheumatoid arthritis. Further research is needed to better understand its effectiveness and safety and to better determine its role in lupus treatment.
Studies from the NIH Intramural Research Program determined that treatment with immunosuppressive drugs (cyclophosphamide and prednisone) can prevent or delay kidney failure caused by nephritis, one of the most serious and life-threatening complications of lupus. Other NIH-supported research has shown that lupus patients treated with hydroxychloroquine were less likely to develop severe kidney disease, had lower disease activity, and used less steroid medication.
Other research is examining barriers that keep certain populations from complying with their prescribed medical treatment, which could contribute to worse disease outcomes, including disability and death in those populations. One NIAMS-supported study of economically disadvantaged and ethnically diverse people with rheumatoid arthritis or lupus identified the fear of side effects, including long-term damage, as a major reason people failed to take prescribed medications for their disease. Other factors identified included belief that medicines are not working, problems with the health system such as navigating Medicaid requirements and a lack of continuity with the same doctor, and medication cost.
More information on research is available from the following resources:
- NIH Clinical Research Trials and You was designed to help people learn more about clinical trials, why they matter, and how to participate. Visitors to the website will find information about the basics of participating in a clinical trial, first-hand stories from actual clinical trial volunteers, explanations from researchers, and links to how to search for a trial or enroll in a research-matching program.
- ClinicalTrials.gov offers up-to-date information for locating federally and privately supported clinical trials for a wide range of diseases and conditions.
- NIH RePORTER is an electronic tool that allows users to search a repository of both intramural and extramural NIH-funded research projects from the past 25 years and access publications (since 1985) and patents resulting from NIH funding.
- PubMed is a free service of the U.S. National Library of Medicine that lets you search millions of journal citations and abstracts in the fields of medicine, nursing, dentistry, veterinary medicine, the health care system, and preclinical sciences.
Hope for the Future
With research advances and a better understanding of lupus, the prognosis for people with lupus today is far brighter than it was in the past. It is possible to have lupus and remain active and involved with life, family, and work. As current research efforts unfold, there is continued hope for new treatments, improvements in quality of life, and, ultimately, a way to prevent or cure the disease. The research efforts of today may yield the answers of tomorrow, as scientists continue to unravel the mysteries of lupus.
For More Information
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Information Clearinghouse
National Institutes of Health
1 AMS Circle
Bethesda, MD 20892-3675
Phone: 301-495-4484
Toll Free: 877-22-NIAMS (877-226-4267)
Fax: 301-718-6366
Email: firstname.lastname@example.com
Website: http://www.niams.nih.gov
Other Resources
American College of Rheumatology
Website: http://www.rheumatology.org
Alliance for Lupus Research, Inc.
Website: http://www.lupusresearch.org
American Autoimmune-Related Diseases Association, Inc.
Website: http://www.aarda.org
Arthritis Foundation
Website: http://www.arthritis.org
Lupus Clinical Trials Consortium, Inc.
Website: http://www.lupusclinicaltrials.org
Lupus Foundation of America
Website: http://www.lupus.org
Lupus Research Institute
Website: www.lupusresearchinstitute.org
SLE Lupus Foundation
Website: http://www.lupusny.org
The NIAMS gratefully acknowledges the assistance of the following individuals in the preparation and review of the original version of this publication: Jill P. Buyon, M.D., Hospital for Joint Diseases, New York, NY; Patricia A. Fraser, M.D., Brigham and Women's Hospital, Boston, MA; John H. Klippel, M.D., The Arthritis Foundation, Atlanta, GA; Michael D. Lockshin, M.D., Barbara Volcker Center for Women and Rheumatic Disease, Hospital for Special Surgery, New York, NY; Rosalind Ramsey- Goldman, M.D., Dr.P.H., Northwestern University Medical School, Chicago, IL; George Tsokos, M.D., Uniformed Services University of the Health Sciences, Bethesda, MD; and Elizabeth Gretz, Ph.D., Barbara Mittleman, M.D., Susana Serrate-Sztein, M.D., and Peter E. Lipsky, M.D., NIAMS, NIH. Special thanks also go to the many patients who reviewed this publication and provided valuable input. An earlier version of this publication was written by Debbie Novak of Johnson, Bassin, and Shaw, Inc.
The mission of the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), a part of the U.S. Department of Health and Human Services' National Institutes of Health (NIH), is to support research into the causes, treatment, and prevention of arthritis and musculoskeletal and skin diseases; the training of basic and clinical scientists to carry out this research; and the dissemination of information on research progress in these diseases. The NIAMS Information Clearinghouse is a public service sponsored by the NIAMS that provides health information and information sources. Additional information can be found on the NIAMS website at www.niams.nih.gov.
For Your Information
This publication may contain information about medications used to treat the health condition discussed here. When this publication was produced, we included the most up-to-date (accurate) information available. Occasionally, new information on medication is released.
For updates and for any questions about any medications you are taking, please contact:
U.S. Food and Drug Administration
Website: http://www.fda.gov
Toll free: 888-INFO-FDA (888-463-6332)
For additional information on specific medications, visit Drugs@FDA at www.accessdata.fda.gov/scripts/cder/drugsatfda. Drugs@FDA is a searchable catalog of FDA-approved drug products.
For updates and questions about statistics, please contact:
Centers for Disease Control and Prevention, National Center for Health Statistics
Website: http://www.cdc.gov/nchs
Toll free: 800–232–4636
This booklet is not copyrighted. Readers are encouraged to duplicate and distribute as many copies as needed.
Additional copies of this booklet are available from
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Information Clearinghouse
National Institutes of Health
1 AMS Circle
Bethesda, MD 20892-3675
Phone: 301-495-4484
Toll Free: 877-22-NIAMS (877-226-4267)
Fax: 301-718-6366
Email: email@example.com
Website: http://www.niams.nih.gov
NIH Publication No. 15–4178


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Homemade Pasta is not nearly as daunting as it might seem. As a person that uses store-bought pie crust and boxed cakes mixes, I'm definitely not an 'everything from scratch' purist - by any stretch. But when Mike and I went to Italy on our honeymoon, we discovered fresh pasta. When we came back home, the only way we could get the authentic pappardelle and tagliatelle pasta we had had was to make it ourselves.
For most of our special occasions, instead of heading out to a restaurant we spend the evening with a bottle of wine and our pasta rolling machine. This year for our 1st Anniversary I was 8 months pregnant and we had a snow storm headed our way in New England. Going out was not an option... not a fun sounding one, anyway. We stayed in, started a fire, Mike opened a bottle of wine (for himself) and I got out the pasta roller.
This is our pasta roller machine - it was around $60 from Williams-Sonoma. It is very simple to use!
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Homemade Pasta Recipe
easier than you think!
2 cups of flour
3 eggs
Start with a KitchenAid mixer fitted with the dough hook. Dump in the flour, then top with the eggs. Put the mixer on medium and let the ingredients roll together until they form a ball.
*You may need to add a little bit (1-3 tablespoons?) of water or flour if the dough is too wet or too dry. After a ball is formed, let the dough 'knead' on low-medium in the mixer for 5-7 minutes until the dough is elastic. Cover it with plastic wrap and let it sit for 20 minutes.
When it is finished kneading, turn the dough out onto a floured board and kneed it by hand a couple of times.
From this stage, you can roll it out by hand with a rolling pin (or bottle of wine!), or put it through a pasta rolling machine. Either way is pretty simple. I've recently invested in this pasta machine that was very inexpensive. If you plan to make a lot of pasta in the future it can make things a little easier.
Separate the dough into 6 pieces. Flour the machine and dough well to keep it from sticking. Feed it through the rolling/flattening part of the machine starting on the largest setting and progressing to a smaller setting each time you feed the dough through. I find that flouring it each time helps to keep it from sticking. After it has gone through the smallest (or 2nd to the smallest) setting, lay it flat.
Attach the tagliatelle (small square cut long pasta, pictured above) cutting attachment. Feed the long flat sheets through, creating long strands of spaghetti type pasta. Set aside in a dry area until ready to cook in boiling water.
Cook in a large pot of boiling salted water for 30 seconds, until the pasta is light in color and floating.
Truffle Cream Sauce
easy indulgence, serves 6
2 cups of heavy cream
6 ounces of white truffle butter (or 3 oz. truffle oil)
black pepper
Prepare a large pot of water to cook pasta. Add salt.
In a saucepan, heat cream for 5 minutes on medium - until slightly bubbling. When the cream is bubbling, reduce heat to low. Add truffle butter, stir to melt.
Add pasta to the boiling water. After 30 seconds, remove the pasta from the water (with tongs) and place it immediately into the truffle cream sauce. Toss and stir to coat. Add a small amount of black pepper. Serve immediately!
We love a simple, seared steak along side our truffle pasta. For the step-by-step directions for how to perfectly sear a steak in a skillet, click here.


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gmp Architects von Gerkan, Marg and Partners wants to provide you with the best possible service. To do that, we store information about your visit using so-called cookies. By continuing to use this site, you agree to our use of these cookies. Detailed information about the use of cookies on this website can be found by clicking on "More information". There you can also disagree with the use of cookies and adjust your browser settings accordingly.
An ecologically designed city quarter for living and working is currently being developed in China's Qingdao, on the coast of the Yellow Sea, to plans by architects von Gerkan, Marg and Partners (gmp). The foundation stone will be laid on 6 December by Ernst Burgbacher, Parliamentary State Secretary of the Federal Ministry of Economics and Wang Chao, the Chinese Vice-Minister of Economics.
After a construction period of two and a half years, von Gerkan, Marg and Partners Architects (gmp) have completed the Tianjin West Railway Station in China. The new intersection, which is located about 130 kilometers south-west of Beijing, serves as a stop on the high-speed line between the Chinese capital and Shanghai.
The inauguration of the new Palacongressi di Rimini conference center will take place on 15 October 2011. The center, which was designed by von Gerkan, Marg and Partners Architects (gmp), who had already designed the Rimini exhibition center, was completed in 2010.
Following their success in winning first prize in an international competition, the architects von Gerkan, Marg and Partners (gmp) have been commissioned to realize a tower block complex of ten buildings in Nanjing. The design by gmp is or a financial enterprise center on a site of about 80,000 square meters in this large eastern Chinese metropolis.
To mark the occasion of the Universiade, which will take place from 12th to 23rd August 2011, the Universiade sports center and Bao'an stadium will be opened tomorrow in Shenzhen, southern China.
The twenty-storey Jiaming Center office block designed by Architects von Gerkan, Marg and Partners has been awarded gold-standard LEED certification by the U.S. Green Building Council (USGBC).
The sports complex was designed and built by architects von Gerkan, Marg and Partners (gmp), who won the competitive bidding in 2008, and constructed it in under two and a half years.
Architects von Gerkan, Marg and Partners will be represented by Cape Town Stadium/South Africa at the 2011 São Paulo Architecture Biennale, as part of the German contribution.
The German Lighting Design Prize 2011 was awarded in Cologne on 5th May 2011. The lighting design for the Moses Mabhida Stadium in Durban was awarded first prize in the International Project category. The lighting design was the work of the lighting-design firm Conceptlicht.
Four years after the foundation stone was laid, the Chinese National Museum in Beijing opens its doors to the public on 1st April 2011. The rebuilding and extension scheme to plans by architects von Gerkan, Marg and Partners (gmp) combines the former Chinese History Museum and Chinese Revolutionary Museum.
Architects von Gerkan, Marg & Partners (gmp), in consortium with landscape architects Bernard & Sattler, have won the competition for the reconstruction of the Federal Environmental Office building in Bismarckplatz in Berlin.
The planned utilization scheme for the building drawn up under the direction of Prof. Meinhard von Gerkan means that this special location will once again be accessible to public cultural life.
Worms's new Culture and Conference Center — designed and built by architects von Gerkan, Marg and Partners (gmp) — along with the efurbished Spiel- und Festhaus theater will open with a special festival week marking the end of nearly three years' construction.
As part of the event "The importance of public spaces in urban development", Meinhard von Gerkan will speak on the subject of "the importance of public spaces in urban development".
As part of the Sofia Architecture Week 2012, gmp-Partner Stephan Schütz will talk on the subject "Cultural Buildings - Stages for Urban Life" in Sofia, Bulgaria.
The South Tyrol Architecture Foundation organises regular lectures with well known speakers. On Friday 16 November 2012 Prof. Meinhard von Gerkan will speak on the subject "Architecture: meaning and message".
On Wednesday 14 November 2012, Magdalene Weiss will speak at the international symposium "Design for All – Space Design on Roads" in Seoul, Korea.
On Tuesday 13 November 2012, the "American Jesus Suite" concert will take place at the Berlin office: a composition by Stefan Wurz for Quartet PLUS 1, inspired by Michael Jackson's pop songs.
The focus of Siegener Bautag 2012 is on exploring the boundaries between construction, technology, economy, ecology and form. Hence the event runs under the motto "To go to the limits…and beyond". As part of the event Prof. Dr.-Ing. h.c. Volkwin Marg will speak on the subject "Architecture as a synthesis of function, construction and interpretation" on Friday 9 November 2012.
Nicolas Pomränke will give the keynote speech on the 5th ForumMIRO in Dresden, Germany. He will speak on the subject "The architect's personal pride determines the character of the building".
gmp-Partner Hubert Nienhoff will be talking on Tuesday 6 November 2012 on the topic "Stadiums for the 2014 FIFA World Cup".
On the 1st of November, the Hanse Viertel arcade in Hamburg celebrates the completion of extensive conversion . Hamburg's traditional shopping arcade was technically upgraded and brought up to current environmental standards. As part of the press reception, which runs under the slogan "The Hanse-Viertel with a new, vibrant look", Volkwin Marg will give a talk on the architecture and the original design ideas for the shopping arcade.
In the context of the "Sustainability of buildings for mega-events - Transfer of knowledge" conference in Munich (29 to 30 October), Markus Pfisterer (gmp Director) will speak on the subject of "Functionality of mega-event buildings – Examples: FIFA World Cup South Africa 2010 and 2012 UEFA European Football Championship".
The exhibition OrgaTec will host high-profile speakers such as Prof. Meinhard von Gerkan. On 23 October 2012 there will be several lectures, one of them a keynote address by Meinhard von Gerkan under the heading "Architecture: meaning and message".
As part of the "Global Economic Symposium (GES)" in Rio de Janeiro, Ralf Amann (Director at gmp) will take part in the round table discussion on the subject "Challenges encountered in the organisation of mega events".
On Thursday 11 October, the "Chamber music with different ensembles" Musitecture concert will take place at Völckersstrasse, Hamburg.
On Friday 28 September 2012, Nicolas Pomränke will take part in the second annual 'juniors' conference by the OAV (German Asia-Pacific Business Association) in Berlin and will be moderating the workshop entitled "Asian Megacities – challenges of urbanisation".
On Thursday 20 September 2012, Hubert Nienhoff will give a workshop lecture in Gelsenkirchen as part of the North Rhine-Westphalia VFA group members evening.
Katharina Glös and Rahel Bader come together for this concert and will be presenting 18th century solos and duets in our intimate and stylish setting.
At the 23rd VitrA Project workshop, which takes place on 6 September 2012, Nikolaus Goetze will talk on the subject of "Building in China and elsewhere" under the heading "Expat(riate)s: on building in foreign lands".
On the first day of the conference "SPONSORS Sports Venue Summit", Markus Pfisterer (gmp Director) will speak on the subject "Brazil, Russia, Qatar: can German stadiums be models for large international projects?" as part of the "Sustainability" forum.
The CHINA TIME initiative (9 to 25 August 2012) by the Hamburg Senate showcases, for the fourth time since 2006, Hamburg's comprehensive expertise as a trading partner with China with about 200 events in the Hamburg region.
As part of the II Syposium "German Desk Latin America", Ralf Amann (Director gmp do Brasil) will speak in Rio de Janeiro about "Infrastructure Projects in Rio de Janeiro". He will talk on the gmp stadia, which are currently on the occasion of the Soccer World Cup 2014 under construction.
The association Architekturpreis Berlin e.V. extends an invitation to a debate on the subject of "What does the future hold for Tegel airport?" at the KutscherHaus, Kurfürstendamm, Berlin on 14 August 2012. Together with other well-known speakers, Stephan Schütz will be discussing the future of Tegel airport.
As part oft he Exhibition "Choreography oft the mass", which will be shown in Berlin from 6 June – 12 August 2012, Hubert Nienhoff will talk on the subject "Expression and Construction".
As part of the specialist conference "Medical facilities of the next generation, 2012" at the Japan Center, Frankfurt, Martin Bleckmann (gmp Director) will speak about the 1st Prize in the "City of Karlsruhe Medical Centre" architectural competition within the "Sustainable and innovative hospital project" theme section.
The "MEXCON 2012 Meeting Experts Conference" – the main professional congress of the Meeting and Events industry – will take place at the ICC Berlin from 18 to 20 June 2012.
As part of the lecture series "At home abroad? Reports from Germany and Brazil", Ralf Amann (gmp Director) will speak at the Goethe Institute in Rio de Janeiro about the stadiums for the 2014 FIFA World Cup.
As part of the annual conference organised by Architecture Technique (AT) magazine, Nikolaus Goetze will give a public lecture at Tongji University, Shanghai on Thursday 14 June 2012.
As part oft he Exhibition "Choreography oft the masses", which will be shown in Berlin from 6 June – 12 August 2012, Prof. Dr. Volkwin Marg will talk on the subject "Choreography and Identity".
As part of the "World Stadium Congress 2012" (3 to 7 June 2012) in Doha, Qatar, Martin Glass will speak about stadium projects carried out by gmp.
As part of the "ArchitekTour 2012 – Higher, faster, bigger? - Architecture, sport + entertainment", Hubert Nienhoff will speak about the Arena da Amazônia, Manaus, Brazil, on Tuesday 5 June 2012, in Berlin.
At the 35th study conference "Action for a city worth living in", the discussion will focus on the steps we need to take in order to allow for sustainable urban development that is fit for the future. Johann von Mansberg (gmp Director) will talk on the subject "New values in architecture – three examples from China".
Johann von Mansberg (gmp Director) has been invited as a guest speaker by the "bridge to the future" in China and, on 15 May, will present outstanding gmp projects in China and Germany.
The exhibition "At ours, next door – Building and living in Altona" presents an important chapter in the urban history of Altona.
Architects gmp are represented at the Stadia Design & Technology Expo 2011 in Los Angeles.
On Thursday 3 May 2012, gmp invites the Boulanger Trio to give a concert which will take place at the Völckersstrasse office in Hamburg.
The poet Heinrich Heine, one of the most important German writers of the 19th century, is the focus of the programme featuring Marianne Kaiser (recitation), Philipp Jekal (baritone) and Thomas Benke (piano). The recital will take place in gmp's Berlin office.
Markus Pfisterer (Director gmp) will be talking about "Dynamic Facade Lighting of the Arena National Stadium Warsaw". The talk will be part of the "Media Facade Summit" at the Städelschule in Frankfurt.
As part of the "2018 FIFA World Cup Russia: Developing country through football" event in Moscow, Hubert Nienhoff will speak on "gmp - Stadia for the FIFA World Cup".
During the "fensterbau frontale 2012" trade exhibition, which takes place in Nuremberg from 21 to 24 March, Prof. Meinhard von Gerkan will talk in the Architect's Area on the subject of building in China.
On Tuesday 20 March, 2011, Prof. Volkwin Marg will take part in a debate on "Hamburg's townscape": a debate between Jörn Walter, Volkwin Marg and Till Briegleb.
On Thursday 1 March 2012, Prof. Volkwin Marg will speak on the subject "The Krakow Aviation Museum and the proposal for an aviation and space-travel museum at Tempelhof Airport" as part of the "Berlin hebt ab!" (Berlin takes off) lecture series.
The 13th annual exhibition organised by the Berlin Architects' Chamber is called "da! Architecture in and from Berlin" and shows a total of 69 projects by Berlin architects. Exhibits include the State Ballet School, Berlin by gmp as well as other exemplary projects.
Paulo Ferreira is a famous young genius who plays the modern bassoon. His style is completely unconventional and he plays this instrument solo with great radiance and virtuosity. An absolute must for those keen on musical exploration!
On Tuesday 21 February 2012 the "Textile Construction" event will take place at the Kutscherhaus, Berlin. The lecture series is organised by "Architekturpreis Berlin e.V".
gmp director, Martin Glass, will speak at the "Membrane constructions for the energy efficiency upgrade of buildings" symposium on the subject "Membrane projects by gmp Architects – experiences and outlook".
Subject of the round table discussion at the Dresden State Theatre: "Which cities do we want to live in? Historic buildings or contemporary design".


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GFOA is always on the lookout for news items that will be useful for finance professionals, research that might help you do your job better, and legal and regulatory updates you need to know about. Check the GFOA news page for the updates and any relevant GFOA announcements, and see the GFOA Newsletter archive for back issues of our weekly electronic newsletter.
GFOA Issues Alert on Rule G-42
The new G-42 rule from the Municipal Securities Rulemaking Board (MSRB) becomes effective June 23, 2016. Rule G-42, or Duties of Municipal Advisors, stems from the Dodd Frank Act and the SEC's subsequent municipal advisor rule. This rule does not establish any responsibilities for issuers, but it does create numerous responsibilities for the municipal advisors that are hired by state and local governments.
GFOA Alert: MCDC Initiative Settlement Terms for Issuers
The information contained in this document was developed to educate members about the SEC MCDC Initiative and should not be construed as legal advice.
GFOA Issues Alert on MCDC Initiative Settlement Terms for Issuers
Issuers that self-reported under the SEC's Municipalities Continuing Disclosure Cooperation (MCDC) initiative can expect to receive settlement offers containing standard provisions to which they must consent in the near future. The SEC is requesting an extraordinarily short turn-around for the settlement—5 to 10 days—but has indicated that it will extend the settlement offer upon request.
GFOA's 2016 Awards for Excellence in Government Finance
The Government Finance Officers Association of the United States and Canada (GFOA) announced the winners of its 2016 Awards for Excellence in Government Finance. GFOA's most prestigious awards recognize contributions to the practice of government finance that exemplify outstanding financial management. The awards stress practical, documented work that offers leadership to the profession and promotes improved public finance.
New President, President-elect, Executive Board Members of Government Finance Officers Association for 2016−2019
Marc Gonzales, Director, Department of Finance, Clackamas County, Oregon, became the new president of the Government Finance Officers Association of the United States and Canada (GFOA) at the association's annual business meeting on May 24, 2016. During the past year, Gonzales served on the Executive Board as president-elect. He has been a member of the Executive Board since 2012. Gonzales accepted the gavel from 2015-2016 President Heather A. Johnston, City Manager, City of Burnsville, Minnesota.
Patrick J. McCoy Becomes GFOA President-Elect
Patrick J. McCoy, Director of Finance, Metropolitan Transportation Authority, New York, New York, was elected as president-elect of the Government Finance Officers Association of the United States and Canada (GFOA) on May 24, 2016. The election was held at the association's annual business meeting in Toronto, Ontario, Canada.
Marc Gonzales Becomes GFOA President
Marc Gonzales, Director, Department of Finance, Clackamas County, Oregon, became president of the Government Finance Officers
Association of the United States and Canada (GFOA) on May 24, 2016. The gavel was passed at the association's annual business meeting in Toronto, Ontario, Canada.
New Executive Board Elected
Marc Gonzales, director, Department of Finance, Clackamas County, Oregon, became GFOA's new president at the association's annual business meeting in Toronto, Ontario, Canada, May 24, 2016. Gonzales accepted the gavel from 2015−2016 President Heather A. Johnston, city manager, City of Burnsville, Minnesota. Also at the business meeting, the association's members elected a new GFOA president-elect and five new members-at-large, who will each serve a three-year term beginning immediately.
The Perils of "Benefit Bonds" and Social Impact Bonds
At "Just Say No: Financial Products and Strategies to Avoid," a Tuesday session at GFOA's annual conference, the panelists discussed the pitfalls of newer, more "innovative" financial instruments that local governments have access to.
A CFO's First 100 Days
At the Tuesday GFOA conference session, "A CFO's First 100 Days," Yousef Awwad, chief financial officer of Portland Public Schools, and Marion M. Gee, finance director at the Metropolitan St. Louis Sewer District, discussed strategies for getting a successful start in a new financial leadership role.
Most people starting out as as financial leader have came from the ranks of financial management. Hence, the new leader needs to recognize the difference between leadership and management. Here are some of the key ways to become a leader:
Bruce Tulgan Examines the Changing Workplace
Bruce Tulgan, who studies leadership and performance management in the workplace, addressed delegates during Monday's opening general session. His research, based on 23 years of interviews with employers and employees, leads to a key finding: "The workforce is changing."
Urbanist Richard Florida Suggests New Role for Local Governments
Tuesday's general session featured Richard Florida, the urbanist perhaps best known for his concept of the "creative class," which posits that metropolitan regions with high concentrations of technology workers, artists, musicians, and other creative groups exhibit a higher level of economic development. Florida explained that though the creative class makes up a relatively small portion of the total workforce, it creates a disproportionate amount of economic growth. For example, the creative class comprises about 30% of the workforce but produces about 75% of disposable income in the U.S.
School Districts Discuss Aligning Resources with Student Achievement Goals
For the second year in a row, GFOA hosted a luncheon for school districts to discuss GFOA's best practices in budgeting for school districts. This year's event featured four school districts – Portland Public Schools, Dayton City Public Schools, Upper Moreland Township School District, and Atlanta Public Schools – that have been on the journey toward optimizing the alignment between their limited resources and their student achievement goals.
Land Use Policy: Do the Math!
Have you considered how you can use data to look at your city in a different way – to find out what it's really worth? In his Monday conference presentation, "The Financial Impacts of Land Use Policy," Joe Minicozzi, principle of Urban3, a consulting firm created by a real estate developer, discussed the importance of data modeling to determine your real potential for increasing tax revenues. His advice is, in short, "Do the math!"
Next Generation of Public Finance Officers Takes Broad Outlook
At GFOA's Tuesday afternoon "Next Generation Roundtable" discussion, people in the early stages of a career in public finance exchanged views on a variety of topics.
For example, when it came to how they got into public finance, there was a diverse range of experiences. For some participants, it was a public administration degree program, while others came from private-sector employers (and were, in fact, surprised to learn that public finance was a viable career path).
Helping Citizens Extract Information from Data
The general public has neither the time nor the technical expertise for using highly detailed financial information—they need guidance on how to extract information from your data. For example, terms that are commonplace for government finance officers are often completely foreign to most citizens. Therefore, the titles, labels, and other descriptors picked up from your financial system may need to be changed to more citizen-friendly terminology, according to "Helping Citizens Extract Information from Data," as session at GFOA's May 2016 annual conference in Toronto.
Understanding the Flaw of Averages
Central to understanding risk is a concept called the "flaw of averages"—the idea that a single average number obscures the variation in the data. In "A Financially Resilient Organization is a Risk-Aware Organization," a session at today's annual conference in Toronto, Process Omprovement Specialist with the City and County of Denver's Peak Performance Initiative Melissa Files and Executive Director of ProbabilityManagement.org Sam Savage discussed uncertainty in financial planning.
Austin and San Francisco Navigate the Sharing Economy
The "sharing economy" is a business model that allows providers and consumers to share resources and services, from housing to vehicles and more. Well-known examples include Uber and AirBnB. Cities like Austin, Texas, and San Francisco, California, are at the forefront of the challenge that sharing economy business poses to traditional municipal regulation and taxing regimes.
GFOA Encourages Members to Contact the IRS
On Friday, September 20, GFOA filed comments to the IRS on Proposed Regulations that would redefine Political Subdivisions for the purposes of tax exempt bonds. The Proposed Regulations set forth a new, three-part federal test to define political subdivisions qualified to issue tax-exempt debt. Every entity would have to meet all three tests to be considered a political subdivision.
GFOA Alert: Bank Loan Disclosure
Over the past five years, the municipal securities market has witnessed a dramatic increase in the use of bank loans by municipal issuers as a tool to finance capital improvements as well as refund outstanding debt. Bank loans, which may be structured with fixed or variable interest rates and with defined maturities or flexible payment provisions, may offer a number of potential advantages over a public offering of municipal securities.
Pension Resource Center Added to Federal Government Relations Page
Continued scrutiny of state and local government retirement plans is expected to last into 2016. GFOA will continue to educate members of Congress about the true fiscal condition of public pension systems, consider whether proposed initiatives provide the flexibility the public sector needs to provide retirement security to its employees, and oppose congressional proposals that undermine state and local governments' authority to effectively govern and finance their pension plans.
A Somewhat New Strategy: Marketplace Fairness and a Case for the SCOTUS
GFOA, along with Big Seven members of the State and Local Legal Center (SLLC), have filed amicus briefs in every stage of Direct Marketing Association v. Brohl, a Colorado law requiring remote sellers to provide Colorado purchasers with an annual summary of their purchases and to send the same information to the Colorado Department of Revenue. Each amicus brief has cited the devastating impact that the 1992 Quill Corp.
GFOA Appoints New Director of Federal Liaison Center
Emily S. Brock has been appointed as the new director of GFOA's Federal Liaison Center. She replaces Dustin McDonald, who left GFOA to pursue a government relations position in the marijuana industry.
GFOA Awards Frank L. Greathouse Government Accounting Scholarship
The Government Finance Officers Association (GFOA) has announced the recipients of its 2016 scholarships. The GFOA's mission is to enhance and promote the professional management of governments. Among the ways GFOA accomplishes its mission is through education, training, and leadership.
The recipients of the two awards for the Frank L. Greathouse Government Accounting Scholarship are Jean Iannuzzi and Cassandra J. Roush. Each will receive $8,000.
GFOA Awards 2016 Scholarships
The Government Finance Officers Association (GFOA) has announced the recipients of its 2016 scholarships. GFOA's mission is to enhance and promote the professional management of governments and the awarding of scholarships is one of the ways the GFOA accomplishes its mission.


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The Art of BRYN TERFEL 4790494
. . . [Schubert: "Erlkönig"]: Terfel almost creates that poem about a young boy dying on a journey through the night -- it is like sitting in Schubert's mind while he was composing it. I think Schubert himself would have been thrilled if he had heard this interpretation.


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Branding and design - bringing ideas to life.
* All vehicle images and car descriptions on this site are for illustration and reference purposes only and are not necessarily an accurate representation of the vehicle on offer.
Butlers Vehicle Solutions Ltd
3 Chillington Way
Norton Heights
Stoke on Trent
Registered Office : 3 Chillington Way, Norton Heights, Stoke on Trent ST6 8GJ
| Registered in England & Wales with company number : 6157611 | Data Protection No : Z9983101 | VAT No : 906 6494 05 | BVRLA No : 2174 |
Butlers Vehicle Solutions Ltd are a credit broker and not a lender, we are authorised and regulated by the Financial Conduct Authority. Registered No : 690569
Copyright © 2020 Butlers Vehicle Solutions Ltd, All rights reserved.


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UBC Homes & Vancouver MLS® Map Search
The University of British Columbia (UBC) offers a full range of housing options in five distinct neighbourhoods to provide a unique opportunity to live, work and learn in a truly integrated campus community. Search Vancouver & UBC Properties from Map.
Lord Byng Secondary School Houses for Sale
Data was last updated April 1, 2020 at 09:05 PM (UTC)


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- Want to post a mini-Eloquent Woman on your website? Lots of libraries, speaker coaches, universities and companies do--it's an easy way to make sure your readers see our updates. Just go to the Eloquent Woman widget and follow the easy download instructions.
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While you're at it, don't forget to enter our contest 15 Weeks to Step Up Your Speaking by July 31--and share the information with other female colleagues. It's a great chance for one lucky would-be speaker to win a Flip Mino HD camera and 15 weeks of coaching right here on the blog!


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BestNewBands.Com necesitaba un nuevo diseño de logotipo y lanzó un concurso de diseño en 99designs.
Un ganador ha sido elegido entre 235 diseños de 46 diseñadores freelance.
We are a video based music blog that introduces the best emerging recording artists to the world.
Our site ( http://www.bestnewbands.com ) has the following features:
Main Stage: The artists featured on our Main Stage play the best traditional clubs in the country and have current releases on the market. We use 4 cameras and multi-track audio, to capture these exclusive, live performances.
Second Stage: Our Second Stage features any bands, any where as shot by fans with a video camera, cell phone or still camera.
Artists-In-Residence: Here we present a more in-depth look at artists we like; on the road, in the studio or just having fun.
Blog: Our Blog features reports, and frequently videos from live shows around the country.
We are looking for a logo that's both artistic and professional and that complements the existing look of the site. It should evoke what the site is about, i.e. new artists and live music, while conveying a sense of energy and excitement.
Please feel free to be creative, not only with the design but also with both the color and the font.
We consider the ".com" to be an important part of our name. Please include a (TM) symbol after the name.
Our site appeals to a broad audience of people who love music and go to shows. Indie, Pop or Rock.
Please include our tag line: "Where Live Music lives" in the design.
The logo should be delivered in Vector format with a standard array of JPG's. We'd also like a second version of the logo with the word "Beta" added to the design delivered in Vector format.
Please provide the names of the fonts used in the logo.
Descubre cómo funciona un concurso de diseño u obtén más información sobre nuestros servicios de diseño de logo.


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Birthdays Direct To Your Door In Powder Springs
Game Cave Atlanta is the #1 birthday direct to your door in Powder Springs, GA. Our birthday party service is the most requested and most referred video game truck in the metro area.
We have successfully directed over 2,000 birthday parties for families all over Powder Springs. Our customer service record is renowned and our business comes 90% from customer referrals so our availability for weekend parties are always competitive - plan in advance!
Why waste your time coordinating your event at some Powder Springs location that mass produces birthday parties without the the personal touch that your birthday VIP deserves?
Our video game theater will travel the a location of your convenience where you control exclusiveness your event. That means no shared tables, no cattle call to eat your pizza & cake, and your event will be in a 100% clean environment.
If you are looking for a stress-free party where you will be asking yourself what to do with your time then fill out the information box to the right to get started. We will take care of the details for you and you can take care of the finer details of your birthday VIP's big day.
For birthdays direct to your door in Powder Springs, GA call 877-426-3007.
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Moxibustion is a technique used in Traditional Chinese Medicine (TCM) as an addition or alternative to acupuncture and cupping. Small cones of cigarette-shaped cylinders of artemisia (a type of wormwood) are burnt while being held just above the skin at specific points. The technique seems to have emerged in China around the 200s - 400s CE.
A moxibustion manual was first printed in China around 1050, forming a kind of companion to the manuals accompanying the bronze man statues explaining acupuncture. It included diagrams of moxibustion points on the body - these are normally, but not exclusively, the same as acupuncture points.
Moxibustion is used as a prophylactic, or preventative treatment, within TCM, and is often included in first-aid kits. It is generally used for ongoing, chronic conditions, while acupuncture is used for acute illness, but the two techniques are frequently used together.
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