text:
What do you know about riding a motorcycle? What you believe to be true and what is actual fact may surprise you. There is no shortage of myth and misconception surrounding motorcycles, their riders, and their operation. Here are 10 safety myths that you may have bought stock in.
The louder your pipes, the safer you are. According to research, your loud pipes make no difference when it comes to your level of safety. In fact, bikes with modified exhaust systems are involved in more crashes than those without. If you want to be loud, be loud visually with bright helmets and light-colored clothing.
Helmets break necks. It makes sense, in theory, that the heavier your head, the more likely you are to break your neck in an accident. People who wear helmets suffer fewer neck injuries than those who do not because the helmet absorbs force.
Helmets hinder vision and hearing. Wearing a properly-designed, correctly-fitting helmet does not impeded your sense of hearing or vision. There is really nothing else to say.
Helmets do not help in the majority of collisions. Most impacts happen at low speeds. Most helmets are tested at impacts occurring at low speeds. This does not mean, however, that a high-speed impact will cause your helmet to fail. You are more likely to survive a crash wearing a helmet. Period.
You can handle any situation given enough skill. It stands to reason that the more experienced you are, the more likely you are to be able to handle anything the road throws at you. Do not rely on your skill and experience. Doing so can make you behave recklessly on your bike.
Laying it down is safer. You are far better to brake and collide with a vehicle at low speeds than you are to lay it down. When you collide, you may be thrown over the vehicle or even backwards into the air. When you lay it down, you either come to a full and very rapid stop against the vehicle or you become wedged tightly under it.
One drink is okay. No. It's not.
Streets are safer than the highway. In all actuality, highways are safer than streets as all the traffic is traveling in the same direction at a similar speed. You are better off to take the highway when given the option.
Anti-lock brakes are dangerous. Just the opposite. ABS systems can help you in a panic-braking situation more than you think. You are less likely to lock up your bike when you choose one with an ABS system.
Other drivers don't care about you. Yes they do. Many do not think about motorcyclists simply because they do not know anyone. Do not assume, however, that this ignorance equates a lack of care or concern.
If you have been injured in a motorcycle accident, please reach out to our compassionate attorneys. We are here to fight for your rights and get you the compensation that you deserve. Call us today.
MADD fights tirelessly for the rights of victims and their families. The group not only fights to ensure that the rights of victims are protected, but that victims and their families have adequate access to support services. MADD currently has more than 1,000 advocated across the country who are trained to provide support for victims of drugged or drunk driving.
Volunteers staff a 24-hour help line that provides victims with support any time of day or night. The group promises to provide support to victims as long as there are people who need it. In honor of National Crime Victims' Rights Week, MADD has launched two brand new online tools with which survivors and victims of drunk driving can find the support they need.
A new Facebook group has been launched specifically for victims and survivor. The group provides an online space for people to connect, share, and look for the support they need. Any victim of survivor is welcome to join the closed group by clicking here and requesting membership. Those who are not victims are invited to join the Mothers Against Drunk Driving (MADD) Facebook page instead.
The second support service launched by MADD last week is a new online chat feature on their main website. Victims and survivors will receive the same type of support that the hotline provides without the need to make a phone call. Live chat can be located on MADD's homepage or, alternatively, the Victim Services page. The online chat feature is available Monday through Friday during normal business hours.
If you attempt to chat with a volunteer and none are available, leave a message in the chat box. Your query will be answers by email as soon as someone is available to offer assistance. Whether you are a victim or a survivor, MADD hopes that you will find these two new ways to find support effective and useful. Spread the word about these tools freely! The more victims and survivors that MADD can reach, the more impact the group will have.
If you are the victim of a drunk driving accident, we are here to help you fight for your rights. You may be deserving of compensation for your injuries and damages sustained. Our compassionate attorneys are here to assist you. Call us today so that we may discuss the details of your case at no charge to you. Call us now.
An accident involving a school bus and a passenger vehicle has left three people injured in southwest Charlotte earlier this week. Law enforcement officials say that the accident happened on Holabird Lane near West Boulevard at approximately 8:00 a.m. when the car became pinned under the rear of the school bus. Police did not indicate how the accident happened.
Firefighters had to rescue the adult driver who was later transported to an area hospital with what could be life-threatening injuries. Two children who were also in the car had minor injuries at the time of the crash. None of the six students of who were on the bus at the time of the accident were injured. The students were being transported to Myers Park Traditional Elementary School.
When parents send or take their children to school, they are always concerned that their children will be safe while they are away from home. When accidents happen, especially when children are involved, a parent can feel panicked and even devastated if their own child is one of the ones who are hurt.
If you or a loved one has been involved in an automobile accident, having a good legal representative on your side is important. You need an attorney who will fight on your side.
At the Law Offices of Auger & Auger, our attorneys are focused on every aspect of accident and personal liability law. We can do what needs to be done to help you after the accident. Call us today for your free consultation.
Imagine taking the vacation of your life, only to find yourself stranded and unable to return home. This was the reality for a Raleigh woman after she was involved in an ATV accident while on holiday in Aruba. The accident left the woman stranded in the hospital.
Deana Kennedy and Kenya Dukes departed for Aruba intent on celebrating Kennedy's 35th birthday. The two planned on spending four days in Aruba lounging in the sun and soaking up the atmosphere. Unfortunately, that isn't how things played out.
While on the island, the women decided to embark on an ATV tour to see the sights. After just a few minutes on the vehicles, the women's adventure took a disastrous turn. Says Kennedy, "We were probably six minutes into the ride when the steering component got stuck. I was thrown off. I hit my hip on the ground and I rolled."
Not only did Kennedy roll, but she sustained a broken pelvis in the accident and required immediate surgery. But why did the two get stranded?
After surgery, Kennedy was not able to sit up. Her inability to move correctly prohibited her from boarding a plane for home. According to medical professionals, Kennedy will require a ride aboard an air ambulance to return to the United States at a staggering cost: $34,000. Add to that the $22,000 needed to cover the medical bill, and the cost of this vacation has skyrocketed.
Although this situation is extreme, it is not rare for travelers to find themselves in need of medical attention on vacation. Most people's medical insurance will not cover those expenses. Any person who is planning on traveling internationally should seriously consider paying for traveler's medical insurance.
Cost of this type of medical insurance can vary, but it is well worth it should you find yourself faced with a medical emergency. Dukes and Kennedy will be able to return to the United States this week where Kennedy will continue to recover from her injuries.
If you or a loved one has been injured in an ATV accident, you may be entitled to compensation. An experienced attorney can look over your case and help you determine the best course of action. Contact our office as soon as you are able so that we can review your case at no cost to you. Our lawyers are here for you and your family. Call now.
The North Carolina Department of Transportation advises that the month of October is the most common for car versus deer collisions in the state. We may be far removed from October, but spring is well upon us and animals are getting, well…frisky.
Deer are not the only animals that seem to appear out of nowhere and directly in the path of our vehicles. Other forms of wildlife are as happy about the warm weather as we humans are, and they are out in mass numbers. Knowing how to avoid a collision with a deer or other animal can not only save damage to your vehicle, but it can save your life.
Follow these tips to minimize your chances of meeting an animal in the road head on:
Know where animals are common. Understand that you are more likely to see wildlife in heavily wooded areas, near bridges, overpasses, railroad tracks, and bodies of water, no matter how small.
Watch for the signs. Literally. Watch for the signs. The NCDT posts warning signs in areas where animal populations are high or accidents are frequent.
Look out for groups. Deer, specifically, rarely travel alone. If you see one deer, quickly scan your surroundings for others. Where there is one, there are typically many. Other animals like raccoons and opossums tend to travel solo.
Scan your surroundings. Don't get so caught up in driving or so out of focus that you only stare straight ahead. Use your peripheral vision to scan your environment for wildlife.
Make use of your headlights. Turn your headlights on earlier than you think you need to and keep them on longer than you think is necessary. Headlights can reflect in animals' eyes helping you to see them sooner.
Be cautious in low light. You are more apt to have an encounter with a deer or group of them during dawn and dusk. This is when the animals are most active.
Follow the laws of the road. Stay within the posted speed limit, avoid tailgating, and drive responsibly. When you do these things, you are less likely to hit the person in front of you who is unlucky enough to collide with a deer.
Don't try to miss the animal. It is unfortunate, but sometimes an animal being injured is better than a human being injured or killed. It is ultimately safer to strike the animal than swerve to avoid hitting it.
Not all accidents with wildlife can be avoided, but you can reduce your chances of running into one. If you or a loved one has been injured in an accident, contact our compassionate attorneys for assistance today.
If you are in the market for a new car, it only makes sense that you consider safety when choosing your make and model. New technology has made cars safer, but what if you aren't looking for a new model? Not all car buyers shop new.
The Insurance Institute for Highway Safety issues a report outlining the most dangerous vehicles and the safest ones, based upon death rate. Vehicles in the report are all of the model year 2011. If you are shopping for a used car, consider your options carefully.
Between 2008 and 2011, vehicle fatalities dropped 41 percent from 48 fatalities per million registrations to just 28 per million. It is a huge improvement, but car shoppers should still consider the following information when choosing the next vehicle they will be using to hit the open road.
The Kia Rio may be one of the worst choices that you can make with 149 fatalities for every million registrations. The Rio was followed closely by the Nissan Versa sedan at 130 fatalities per million registrations and the Hyundai Accent at 120 fatalities per million registrations. Several other small cars also made the list.
When it comes to the safest cars on the list, nine separate models had a fatality rate of zero: Volvo XC90 4WD, Toyota Highlander Hybrid 4WD, Toyota Sequoia 4WD, Subaru Legacy 4WD, Mercedes-Benz GL-Class 4WD, Lexus RX 350 4WD, Kia Sorento 2WD, Honda Odyssey, and Audi A4 4WD.
Just eight years ago, IIHS conducted the same study and discovered that no make or model had a zero death rate.
A complete elimination of traffic fatalities is something that is decades away, but vehicle improvements are making the risk less. In 2013, 32,719 people were killed in car accidents, a number down from the 33,561 people who were killed in 2012. While the study examined data through the end of 2012, it only concentrated on drivers. Passenger deaths were not included.
So what do you look for? Larger cars are safer than smaller ones. "Mini" cars are the most dangerous of all. Four wheel drive is always a viable option and a safe choice. No matter what you choose, be sure to conduct a fair amount of research before you plunk any money down.
If you or a loved one has been injured in an auto accident, please contact our attorneys as soon as possible. We are here to assist you and your family today.
An accident involving a Megabus that was traveling from Chicago from Atlanta left 19 people injured on Monday.
According to the Indiana State Police, at approximately 5:30 a.m. on Monday morning a southbound bus travelling on Interstate 65 crashed about 35 miles southeast of Indianapolis when it rear ended a semi-truck that had been stopped for construction. The bus pushed the 18-wheeler into the back of two passenger vehicles.
Authorities say that the bus, operated by Megabus, was carrying a total of 63 passengers at the time of the accident. The 19 passengers who were injured were taken to area hospitals with only minor injuries.
Megabus officials said in a statement that they are fully cooperating with authorities while the accident is under investigation by the National Highway Traffic Safety Administration.
There have been other recent crashes involving the low-cost carrier, Megabus. Authorities have ruled out alcohol as a factor in Monday's accident.
Many people depend upon mass transit, such as traveling by bus in order to get to where they want to go at a more reasonable cost. Accidents, however, can happen. Injuries resulting from bus accidents can be serious or even deadly. Even when a company follows all safety laws and regulations, the worst can happen.
Most accidents happen because someone was careless. When fault is determined, it's the insurance company of the person or company responsible that has to pay for the cost of injuries and damages after the accident.
If you or someone you love has been injured in an accident, it is important to speak to someone that understands the laws. If a company has a history of accidents, then negligence can be a factor. Establishing negligence and legal liability is the first step in any personal injury claim.
At Auger & Auger, we understand how accidents can affect people's lives. Don't go it alone. Get legal help in your corner that will fight for every dollar you are entitled to. Call us for a free consultation today.
Three Senators in North Carolina have introduced legislation that would expand current interlock ignition laws to include all people convicted of drunk driving.
In the state, current law requires the installation of interlock ignition devices for repeat offenders, those who refuse to take a chemical alcohol test, and anyone who has a BAC of greater than 0.15.
SB 619, proposed by Senators Josh Stein, Bill Rabon, and E.S. Newton would strengthen the current law. All drunk driving offenders with a BAC of 0.08 and above would be required to have the devices installed on their vehicles. Twenty-four states already have a similar law on the books, including Virginia and Tennessee.
MADD is in full support of this initiative in North Carolina. According to LaRonda Scott, Executive Director of MADD North Carolina, "We can't erase tragedies North Carolina has experienced, but we can prevent others from happening."
In 2013, one-third of deaths on state roadways were caused by a drunk driver. During that year, 371 people were killed in the state.
One of MADD's largest campaigns is to pass similar legislation in all 50 states. According to the CDC, ignition interlock devices are effective in reducing the incidence of drunk driving by 67% been compared to license suspension alone. Other states in the nation have seen similar outcomes.
The federal government has grants available for any state that passes this type of legislation. If passed, North Carolina would be in line for $574,000 in funding to kick-off and support the installation of these devices.
If you or someone you love has been injured in a car accident due to a driver choosing to operate a vehicle while intoxicated, you have rights. Contact our offices immediately for assistance in getting the compensation you deserve.
As proud supporters of MADD and the group's various initiatives, we invite you to visit MADD's website to learn more about this organization and how they work to promote sober driving throughout the state of North Carolina.
RALEIGH, N.C. – While local police agencies are fighting to keep drunk drivers off of the streets in the interest of public safety, court systems are experiencing a back log. Local courts are finding it difficult to keep up with the number of new cases as North Carolina police amp up their efforts.
It is not unusual to see DWI checkpoints set up around local counties. Road blocks are set up and drivers are stopped. If you are intoxicated, plan on being arrested.
In Raleigh alone, federal grant money topping half a million dollars supports department efforts to man a DWI squad. During just one checkpoint early on a Saturday morning, Raleigh police arrested 18 people for drunk driving in a matter of two and a half hours.
Between January and November last year, police made close to 3,000 DWI arrests. Those numbers were up from 2013 when arrests totaled under 2,000.
Chief Justice Mark Martin is seeking to increase funding for a struggling court system that sees a backlog of DWI cases dating a year or more.
Martin is after $30 million to cover operating costs and increase salaries. Since 2008, operating funds have dropped more than 40 percent. 500 positions have been eliminated throughout the local court systems, and other positions have simply been left empty.
In 2013, courts saw more than 5,500 DWI cases and that number is on the rise.
Although cases continue to pour into the courts, there has been no added manpower and no increase in operating funds. People are doing what they can with limited resources, but the backlog is jamming up the system.
The backlog may be frustrating, but it is proof of one thing: Local police are doing everything in their power to make sure the streets are safe for everyone. If you make the decision to drink and drive, you can expect to get caught at some point. Luck is not on your side.
If you or a loved one has been injured at the hands of an intoxicated driver, you deserve compensation. Call our experienced attorneys for a free consultation as soon as you are able to do so. We are here and ready to work for you. Our attorneys will review your case and determine the best way to move forward. We want you back on your feet. Call us now.
Golf carts are a popular way to get around cities in North Carolina. From gated communities to campgrounds, from sporting events to college campuses, these handy little vehicles make getting where you need to go a breeze. As golf carts become increasingly popular, so do golf cart accidents. When not driven with proper safety in mind, these machines can be just as dangerous as a sedan.
Originally made to carry golfers and their gear, the design of the cart has changed over the years to accommodate different purposes. What carts all have in common, however, is their ability to carry passengers short distances while never reaching speeds over 15 mph. In North Carolina, anyone 15-years and older can legally drive a golf cart.
Unfortunately, the number of injuries and deaths incurred in golf cart accidents tells us that these four-wheeled vehicles are not the safest choice. Injuries sustained in accidents include burns, lacerations, fractures, spinal injuries, and paralyzing injuries. Although people of any age are susceptible to golf cart accidents, one-third of those injured are children.
There are 10 causes of golf cart accidents that are most prevalent:
When people are killed in golf cart accidents, there are five injuries that are typically to blame:
Golf carts seem like toys to many. Their diminutive size and relatively low speeds make people forget that they are driving a vehicle. If you and your friends or family decide to utilize a golf cart, never forget that you are driving a powerful piece of machinery.
When you keep this in mind, it can mean the difference between a wonderful vacation or a tragic one. If you are driving a golf cart, keep safety rules in mind. If you are the passenger in a golf cart, do not behave out of sorts. No matter your position in the cart, you share in the responsibility of ensuring that everyone has a safe ride.
If you have been injured in a golf cart accident, please contact us immediately. We are here to fight for your rights and get you back on your feet. Call us today for a free consultation.


text:
Beginning June 2008 transcripts of court proceedings in the Northern District of Illinois will be available on the PACER system
IF 90-days or less has passed since the transcript was ordered
THEN only the party that ordered that transcript may view it
IF 90-days or more has passed since the transcript was ordered
THEN any PACER user may view the transcript
Attorneys bear the responsibility for identifying personal information that might need to be redacted from the transcript, and for providing the court reporter with notice of same. The court reporter is responsible to follow up on those instructions.
The fee cap of $2.40 will not apply to transcripts viewed on the PACER system.
For more information see Policy Regarding Availability of Court Proceedings or the Court's website at www.ilnd.uscourts.gov

subset: commoncrawl


text:
Class 11 (2016-17)
Hello, we would like to welcome you to Class 11. In our class we have 6 pupils, all boys and a mix of Year 1 and 2. We have two teachers, Helen and Leanne, and a teaching assistant, Jennifer.
We are a small class, in a small classroom, but we have BIG ideas and explore different learning environments!
We especially like to go to our outdoor Discovery Park, ICT suite, splat zone, ball pool and trips on the school bus.
Please look below to find out more about what we get up to...


text:
Come Get Your AppAdvice Fix: We're Back Online
Over the past 48 hours, have you found yourself twitiching because your weekend plans were ruined? Did you not get to catch up on "Mad Men" on Netflix? Instagram your cat playing Magic the Gathering? Pin that adorable ewok outfit to Pinterest?
We're right there with you. In case you haven't heard, there was a terrible storm in northern Virginia. Our thoughts are with those who had to endure the storm firsthand, and also with those continuously enduring it because they still have no power.
This storm not only did some real life damage, it damaged some of us digitally as well. It caused outages for many Amazon Web Service (AWS) data centers — not only for the above mentioned services, but many others across the Webiverse, including your favorite source for all things iOS, us.
Amazon is ruining lives right now…LIVES!!!!1— Jamie Young (@atjamie) June 30, 2012
We're still in fisticuffs with Amazon — but, don't worry, we brought our brass knuckles — trying to straighten everything out and get all of our content back. So, please continue to bear with us. We've been burning the midnight oil to ensure all of our content is secure, and that we can get our new content out to you as soon as possible.
We're slowly rolling everything out and getting back on track, but we are back. And we missed you. So, resume your app addict ways. We insist on it.


text:
|Opa en kleinzoon met een zak confetti (en speelgoedgeweren...)
In het blog van dezelfde dame (the Venice Experience) las ik ook dat de traditie begonnen is met het strooien van gesuikerde korianderzaadjes, de coriandoli, zoals confetti in het Italiaans nu nog genoemd wordt. Wat zij confetti noemen daarentegen, zijn gesuikerde amandelen, die ook met carnaval gebruikt werden maar nu vooral bij trouwerijen, dopen en diploma uitreikingen.
Volgende keer weer het "serieuze" werk met prachtige handmarmers. :-) Veel papier plezier!
Apart from the papier-maché masks there appears to be another important paper part in the celebration of carnival in Venice: confetti! When I was walking though the city in january I saw confetti in all kinds of places, especially on bridges and stairs. It intrigued me and I even took some photographs.
I thought they were remains of wedding parties; maybe it's easier to do an unhindered photo shoot in the relative peace of january? But I also found that somewhat odd; surely most weddings will take place in spring with (hopefully) nice weather...
In the blog of an American lady living in Venice I found the answer! They are the first signs of the coming carnival that started this year at January 31st. In the shops it is already for sale in abundance and children will cheerfully start trowing it around. At some point I did indeed meet a little boy with his nonno who were bombarding other children and the merry-go-round with a big bag of confetti. :-)
In the same blog (the Venice Experience) I also read that the tradition began with the scattering of sugared coriander seeds, the coriandoli, as confetti is still called in Italian. What they call confetti are sugared almonds which were also used at carnival, but now mainly at weddings, baptisms and graduations.
Next time a more "serious" post about beautiful hand marbled papers. :-) Have fun!


text:
The King's Cross Central redevelopment area will soon have another array of flats within it for the rich set to keep as standby crash pads should a meeting overrun and they miss their flights back to Dubai, with a developer turning several old Victorian gasholders into your standard glass-fronted flats that no one normal can afford.
Architect Wilkinson Eyre is behind this part of the scheme to redevelop another bit of London into something unrecognisable, with 145 flats -- or apartments as the brochure might say -- starting at a ludicrous £785,000 currently nearing completion and the pages of Rightmove.
The site will use the restored framework of three of the listed 1860s gasholders that currently sit there, which are officially known as Gasholders 10, 11 and 12 according to the naming convention of the Imperial Gas, Light and Coke Company that had them built. They've been restored off site, to ensure no future rich people scratch themselves on their rusted exteriors; and a fourth one will be a park, where inhabitants can sit and look at their houses while drinking an expensive drink, thinking about how life turned out OK thanks to that massive inheritance.
If you think you might have access to £785,000 in the mid-term future, interest can be registered here. [Standard]
Want more updates from Gizmodo UK? Make sure to check out our @GizmodoUK Twitter feed, and our Facebook page.


text:
Lisa Loeb first hit the airwaves in 1994 with "Stay (I Missed You)", which is quite impressive for someone who didn't have a recording contract at the time. Since then she has worked in children's recordings and has done voice-over work for film and television. In addition to raising two children, Loeb is currently working on a new eyewear line, Lisa Loeb Eyewear (in partnership with Classique Eyewear); her second children's book "Lisa Loeb's Songs for Moving and Shaking" out April 2, 2013. On January 29th, she released her seventh album No Fairy Tale. She collaborated with Chad Gilbert from the pop-punk band, New Found Glory, to record a pop-punk/rock album.
The elements of the late 90s and early 2000s pop punk sound are definite, yet this CD also seems to be a rehash of Lisa's early 90s sound. It's listenable, but it lacks the depth, like most music of today. A few songs are catchy, of course, but it's nothing memorable. It's certainly not the kind of CD I'll rush out to get, even though she recorded two songs with identical twin sister singing duo, Tegan and Sara. She has also collaborated with a few artists (that I've never heard of), such as Hello Goodbye, Morgan Taylor, Maia Sharp, and Marvin Etzioni.
Bottom Line: I admire Lisa Loeb for her talent, her collection of nerdy, yet cute and chic glasses, and our equal obsession with Hello Kitty. However, I feel like this isn't the best she can do, not even by a long shot. Unfortunately, this CD doesn't capture the talented artist that she is.
1. No Fairy Tale
2. The 90's
3. Weak Day
4. Walls
5. A Hot Minute
6. Sick, Sick, Sick
7. Matches
8. Married
9. Swept Away
10. He Loved You So Much
11. Ami, I'm Sorry
12. The Worst
Prize(s): Three winners will receive Lisa Loeb's "No Fairy Tale" CD.
Disclosure: This review was made possible by Double Duty Divas and Lisa Loeb. I was provided the featured product free of charge to facilitate my review, but all opinions are 100% mine.


text:
I wonder why he has not said one word about Israel and the khazars that also constitute the bankers, and their role in creating, funding and arming the ISIS, and other such bogus terrorist groups. That has disappointed me tremendously. Now I believe he may well be owned by the khazars. But I do like what he said he wanted to do to the bankers. Looks like things may get pretty hot in London if he wins the election. For that I applaude him. You watch and listen and you decide.
Video: George Galloway Wants To Jail All Bankers As Mayor Of London
Galloway pledges to fight crime in the belly of the beast if elected as mayor of London, targeting the bankers, who have engaged in destructive neoliberalism encouraged tightened austerity measures, and have proven themselves to be driven by an imperialist war machine. Could the UK see a similar fate as Greece?
Transcript:Hey everyone, I'm Mnar Muhawesh. Welcome to another episode of MintPress News's Behind the Headline.
Athens is in flames as cash-strapped Greek protesters flood the streets in the wake of the nation's destructive austerity measures. And while the average citizen can barely put food on their table, bankers are yet again asking for billions of dollars in bailouts.
Protesters accuse international creditors including the European Commission, European Central Bank and the International Monetary Fund, of destroying the Greek economy in the first place.
And as creditors continue to rake in millions of dollars in salaries, Greece is set to impose even more wage and pension cuts to meet the terms of the $315 billion bailout.
Stealing from the poor to give to the rich has never been more obvious.
But one Robin Hood in a nearby European nation hopes to hold these same creditors accountable as the UK veers onto the same austerity path that could eventually lead to major riots.
George Galloway has stuck out his neck for years as Member of Parliament, and now he's running for mayor of London under the Respect Party.
Galloway pledges to fight crime in the belly of the beast if elected, targeting the bankers who he says are bleeding Londoners dry and walking free, while those who commit petty crimes sit in prison for years.
He is courageously taking on the most powerful elite, who have engaged in destructive neo-liberalism encouraged tightened austerity measures, and have proven themselves to be driven by an imperialist war machine.
Joining me from London, I talk to Galloway about his platform and how he plans to hold these institutions accountable before England succumbs to the fate plaguing Greece.
Watch the exclusive MintPress interview with George Galloway:
The article is reproduced in accordance with Section 107 of title 17 of the Copyright Law of the United States relating to fair-use and is for the purposes of criticism, comment, news reporting, teaching, scholarship, and research.


text:
We crowdsource PowerObjects's maternity, paternity and parental leave policies, based on PowerObjects's employee reviews and anonymous tips from PowerObjects employees.
PowerObjects Maternity and Paternity Leave Policies
PowerObjects offers. This information is based on anonymous tips submitted by employees.
Information Services: Technology Maternity and Paternity Leave
How many weeks of paid maternity, unpaid maternity, paid paternity and unpaid paternity leave do employers in the Information Services: Technology industry offer?


text: Another thread reminded me I have this quesition. A lot of 8 ohm speakers have 4 ohm kits available. So say you had a simple (no tweeters, crossovers, at that) blown 8 ohm cab and you wanted to recone 4 ohm. Would it function equally in that cab or would the increase output blow the cab parameters all to ............wherever.


text:
Oil on Linen Mounted on Board
Jen models for my Monday life drawing group. This time around she wore a white satin wedding kimono but dropped it off her shoulders. The little painting is only 6" X 8" but it carries a bigger impact. To check out the auction at www.dailypaintworks.com, click here.


text:
Ken O'Brien
There is a widely held belief that liberals favor a nanny state.
Well, I don't believe that. In fact, I believe that there is a fundamental and natural convergence of values between libertarians and liberals.
I start from the premise that anyone who makes an objective evaluation of history will conclude that the basic difference between conservatives and liberals is as follows; the primary concern of conservatives is property values: the primary concern of liberals is human values.
Liberals, Conservatives and Libertarians all proclaim their devotion to freedom.
But freedom toward what end?


text:
Jennifer has starred on stage and screen in projects domestic and international. She can be seen in the Emmy Award-winning Netflix series Master of None in the acclaimed ASL sequence as the mom in the shop shouting in sign language after overhearing a couple's sex talk.
She recently starred as Sister James in John Patrick Shanley's Pulitzer Prize-winning play DOUBT with the Long Island Repertory Co. at Theater 294 for which she received stellar reviews. Previously she appeared in the premiere of LEMON TREE written by Theater for the New City playwright-in-residence Claude Solnik at TNC and Theater 294.
She has made appearances on The Daily Show with Jon Stewart (Comedy Central), The Chris Kepford Show (Funny or Die), Z: The Beginning of Everything (Amazon), and Kevin Can Wait (CBS) as Nancy.
Jennifer voiced the commanding yet playful anime character of Misato in an English version of The End of Evangelion, the penultimate film in the Neon Genesis Evangelion series. She played Vicki the robot from Small Wonder in the indie comedy Mission Idiot and portrayed Kathleen Kennedy, sister of JFK, in "A Kennedy Family Story" on the Japanese TV series Gyoten Astonishing News. While residing in Australia, she lent her voice to the Emmy Award-winning CGI-animated series Animalia (BBC) and filmed Suing the Devil starring Malcolm McDowell on location in Sydney.
A New York native with a prolific theatrical presence across Long Island and NYC, she is especially noted for her roles in INTO THE WOODS as the Baker's Wife and Cinderella in three separate productions. Other highlights: MARY POPPINS (Mary Poppins), LI'L ABNER (Daisy Mae), THE WIZARD OF OZ (Dorothy), GREASE (Patty Simcox), COMPANY (Susan), and Jephthah's Daughter in the NYC premiere of SACRIFICES with Original Binding Productions.
In the spring of 2015 she took on the role of Associate Producer having helped produce a concert featuring Oxford University's a cappella group Out of the Blue with special guest artist Broadway's Kristy Cates at the renowned Feinstein's/54 Below in New York City.
She is a graduate of Hofstra University where she trained classically as a mezzo-soprano. She earned a B.A. in Liberal Arts with specializations in Music, Philosophy, and Sociology and studied at the New York Conservatory for Dramatic Arts and the Actors Centre Australia in Sydney.
Jennifer is a member of SAG-AFTRA and AEA and is currently based in New York. ✧


text:
It's been like 6 months since I played this round so please bear with me if I forget who everyone is. Anyway it's time for the gen 2 sims to start coming of age 😀 hopefully there's much more drama to come.
Linn finally managed to unlock gardening :D. They get two fruit trees and if all goes well in a few seasons they'll have garden plots.
Taleh gets together with Ember which is great and all except he's also a heir -.- I believe he's a family sim though so if he falls for her and rolls the want to marry/get engaged to her he has the option of leaving his family to move in with her. It's not like the Edan family is short on heirs at the moment.
Ash looks pretty pissed off at becoming besties with Laleh XD.
Don't know what this was. 90% sure it was inappropriate.
Taleh and Reef Kai (not a heir but already a baby daddy) got together as well. Great she's going for all the guys she can't have. At least they didn't head straight for the bedroom.
Who me? I had nothing to do with her sudden interest in baskets.
That night Taleh grew into an adult.
What was the first thing she did upon becoming an adult?
Roll the want to fall in love with the father of one of her boyfriends
This was the second thing she did -.- romance sims.
Speaking of weirdness I found this in Linn's memories. Is Laleh not his kid or something?
No idea what was going on here XD
Aven's ghost made a brief appearance to scare Lark Rayfe (I think). All in all she's a pretty well behaved ghost.
Laleh all made over
The trees finally bore fruit 😀
This means they've progressed to a proper garden.
Ember had his first kiss with Laleh.
Ahh no -.- not again
Luckily Ember was on his best behavior.
Linn and Laleh (heir)


text:
Invert WordPress Theme is a multipurpose agency theme from Sketch Themes. This theme is best suitable for any types of website like agencies, portfolios and business website. It has easy customization options with option to setup a perfect business theme in a few minutes.
Invert WordPress Theme includes revolution slider plugin. Highlight your important post, page, excerpt and services on front page. invert is a visually amazing constructed style with sectional design. show 4 column filterable portfolio with mouse hover effects. 3 icon boxes on to showcase main features of your business.
Download Invert WordPress Theme
Invert theme is build with powerful SketchBoard Framework. It gives tons of customization options. Show client feedback about your service via testimonials section. Ideal to present what users have to say about your business. Multiple homepage layouts offers great flexibility to select your own homepage. Invert theme has 9 home page variations.
Advance theme option panel to change your website looks & layout, without editing the coding. Upload logo, favicon, add social media links, write custom CSS and much more. Awesome parallax section to display key features in an attractive way.
Invert WordPress Theme has responsive and retina ready design. Add vibrant color, crisp and High Definition images and razor sharp text. It automatically adapts any screen resolution such as desktop, tablet or mobile. Show your team member with their designation and social media profile. Useful custom page template like about, services, 404 page error, FAQ, sitemap etc.
Features of Invert WordPress Theme :
- Responsive design – Supports desktop, laptop, mobile or smartphones devices
- Ideal for business, corporate, portfolio and magazine website
- Retina ready – Support high definition images
- Works with powerful SketchBoard Framework
- Glamours, chick and Elegant theme design
- Advance theme option panel – Change your website looks, layout and feels
- Child theme support
- Featured revolution slider on homepage with touch support
- Limitless color option
- Show team member brief information and social media profile
- Most popular WooCommerce Compatible to sell your product online
- Multiple layout – Choose homepage from 9 different layout
- Customizable navigation menu
- Threaded comment support
- Custom logo or Favicon image upload
- Easily translate in any language
- Awesome parallax section
- Built in Theme Backup/Restore options
- Custom widgets support in sidebar or footer
- All basic post format support including Standard, Video and images
- Show your client or partner logo on homepage
- Google Analytics code support
- Useful page template – About, services, FAQ, 404 error etc.
- Beautiful filterable portfolio with 4 column layout
- Custom Shortcodes – Buttons, Google map, Pricing table etc.
- Cross browser tested – IE8+, Firefox, Safari, Opera, Chrome and etc.
- Invert WordPress Theme is fully compatible with latest WordPress 3.9.1+ version
For Invert WordPress Theme Pro Version: $49


text:
In the world of machining very small parts, what you get isn't necessarily what you can see. Many of the parts being manufactured for medical, electronics and aerospace are too small to be accurately discerned by the human eye.
That lack of visual reference hasn't stopped the development of a machining niche for prototype and production grinding workpieces from wire stock. It's a growing segment of the precision machining market.
Featured Content
For many years, Swiss-type lathes have been successfully used to turn very small parts for the watch industry. By using a sliding headstock for longitudinal movement, with a guide bushing for support, parts with high length to diameter ratios can be machined.
Key to this technology is the position of the cutting tool relative to the face of the headstock, which contains the guide bushing. The cutters move perpendicular to the workpiece and engage it as it emerges from the guide bushing.
Cutting forces are therefore focused on the most supported point of the workpiece. Traversing the work across the cutters, using the moving headstock, allows long thin shafts to be machined without deflection.
This same concept of the moving headstock has been applied to a new grinding machine developed by Glebar, Inc. (Franklin Lakes, New Jersey). Called the model CAM SXE-B, it is designed to produce custom parts from wire stock with projecting features, flats and other geometric forms that were traditionally created using multiple machining steps across several machine tools. The working range for this machine is 0.125 to 0.002 inch diameter wire stock. Unlike conventional centerless grinding processes, which can impart profiles only within the width of the grinding wheel, this new design is able to machine unrestricted profile lengths.
Targeted initially at the medical industry, the new machine is designed to increase the precision and flexibility of producing standard and custom guidewires used for a variety of minimally invasive surgical procedures. The use of CNC on all machine axes makes setup of production volumes of higher precision standard guidewires and prototypes significantly faster than other processes.
For short run and prototype work, the designer simply draws the wire profile at a CAD station then downloads it to the machine. Any necessary edits can be performed at the machine. According to the company, a part can be running in minutes.
Glebar's machine is a full CNC six-axis grinder. The wheel head carries a 12-inch diameter grinding wheel with superabrasive capability, if dictated by the workpiece material. Wheel widths from 0.010 inch to 1 inch can be accommodated. A machine mounted, two-axis CNC dresser can profile the grinding wheel in process for plunge grinding or dress the wheel straight for traversing.
The headstock holds the workpiece in a collet system and has linear in-feed (toward the grinding wheel) and C-axis rotary axes capabilities. Its speed range is 0-5,000 rpm. The work can be rotated against the grinding wheel or held stationary for OD work.
In the centerless operating mode, a regulating wheel is located across from the grinding wheel and acts as a steady rest to provide additional support for the workpiece. This setup helps the machine achieve its accuracies and productivity on very thin wire. Length accuracy, in the centerless mode, is 0.001 inch with diameter accuracy of 0.0001 inch.
As applications within the medical, aerospace, electronic and other industries demand higher production, lower costs and tighter tolerances, a look at this new grinding machine and process should be considered.


text:
The Department of Planning and Construction manages a six-year capital program which
includes systemic renovations, additions, new construction, school modernizations,
and the purchase and movement of portable classrooms. Reports are provided to advise
the Board on current and timely issues and as an overview of the program status.
On September 5, 2017, the remainder of the two story portion of the school, known as Area "D", opened for staff and students.
The site around the new school has been complete with sod, as well as the storm water management features. The final paving and stripping of the parking lots is complete.
The single story portion of the school, known as Areas "E" and "F" which consists of 3rd, 4th and 5th grade classrooms opened for staff and students on November 6, 2017. The salvage and demolition process of the Intermediate Building is complete, with the parking lot and storm water features construction on going until late May early June. This is the final phase of the project.
Final Phase – November 6, 2017
The first link indicates the rooms complete for the start of the 2017-18 school year in yellow, and the rooms completed and occupied on November 6, 2017 in blue, red and green.
The second link indicates the construction area where the Intermediate Building currently sits, with the completed bus loop and new parking lot. This will be complete in Spring 2018.
Updated Floor Plan
Updated Site Plan
Planning and Construction develops school facilities that meet student population and educational program requirements and is responsible for managing resources that are organized to provide a variety of project management related services in the areas of school planning, design and construction for the purposes of modernizing, renovating and improving educational facilities.
Through the management of in-house staff and out-sourced contracted services Planning and Construction will effectively and efficiently manage the delivery of services associated with the Capital Improvement Program. The department utilizes demographic information, educational specifications, procurement practices, architectural and engineering parameters, and budget data to deliver planning and construction related services in support of High Student Achievement.
Maryland State Rules, Regulations, and Procedures for the Administration of the School Construction Program require that Harford County Public Schools (HCPS) and each Local Education Agency (LEA) annually submit an amended copy of the Educational Facilities Master Plan (EFMP) by July 1st.
Each year, HCPS reviews and analyzes the capital needs of the school system. A capital budget is recommended by the Superintendent to the Board of Education (Board) for approval. The Board adopts a capital budget prior to October 1st.
The EFMP is a planning tool that addresses the LEA's projected facility needs. The information, analysis, and conclusions validate the priorities for the Capital Improvement Program (CIP). In order to develop a capital program, HCPS must consider:
Each year the Board of Education, school staff, and community, review and analyze the Capital Improvement Program (CIP) for the Board to establish priorities as it secures County and State funding for capital improvements and program requirements. Projects may be funded over several years and allocations may be carried forward over multiple years until a project or initiative is completed. In the development of the CIP HCPS must consider:
Bel Air High School Scope Study
Homestead-Wakefield Elementary Scope Study
John Archer School Scope Study
William Paca/Old Post Road Elementary Scope Study
Joppatown High School Scope Study
Youth's Benefit Elementary School Scope Study
Joppatowne High School Limited Renovation Request for Qualifications for Construction Management Services
Joppatowne High School Scope Study
Joppatowne High School Limited Renovation Educational Specifications DRAFT
Joppatowne High School Overall Floor Plans
Aberdeen Middle School Comprehensive Roof Replacement
North Harford Middle School Pool Repairs Phases 2 & 3
Fallston Middle School Chiller Replacement - Bid Tab Results
102 South Hickory Avenue Bel Air, MD 21014 | (410) 838-7300


text:
Contact Media Relations 614-293-3737
Chair, Department of Neurological Surgery
I specialize in:
- Neurosurgery
Topics: brain injuries; sports-related head injuries
Contact Media Relations 614-293-3737
Topics: brain injuries; sports-related head injuries
Get tips from Ohio State experts right to your inbox.
We'll be in touch every so often with health tips, patient stories, important resources and other information you need to keep you and your family healthy. Welcome to our online community here at the Ohio State Wexner Medical Center!


text:
Bowen as subject of my Master's Thesis
Elizabeth said that in writing "shape is possibly the important thing". She is a writer whose atmospheric descriptions of place, other-worldly perceptions, hyperaesthetic responses to shifts of mood, ligt, pace, mass make one characterise her as an impressionist. And yet there is this inexorability with which she brings her characters towards their fate; and her endings are seldom ambiguous – in the novels, as opposed to the stories, they are often unequivocally violent.
(Victoria Glendinning in Elizabeth Bowen: A Biography)
"Tears, idle tears, I know not what they mean,
Tears from the depth of some divine despair
Rise in the heart, and gather to the eyes,
In looking on the happy Autumn-fields,
And thinking of the days that are no more."
When she was asked by interviewers in 1959 what the relation of writing to the world was, Bowen replied: "Just as in an air raid, if you were a warden, which I was, you stump up and down the streets making a clatter with the boots you are wearing, knowing you can't prevent a bomb falling, but thinking, 'At any rate I'm taking part in this, I may be doing some good.'"
- What is the main theme of her writings?
- How did WWII influence her work?
- Why is there often an open ending to her short stories?
- "Identity at Risk": how does that show in her writings?
Elizabeth Bowen Presentation 11-12-2008
The Demon Lover
"The Demon Lover" is a short story by Anglo-Irish novelist Elizabeth Bowen. It was first published in 1945 in a book titled The Demon Lover and Other Stories.
The story was referred to in The New Yorker magazine after its publication as "a completely successful explanation of what war did to the mind and spirit of the English people".
Some students have captured their versions of the story on film:
A realistic version: http://www.youtube.com/watch?v=wi1sHTWzOMY&feature=related
Two free interpretations: http://www.youtube.com/watch?v=XTSDQuQPqFs
A hilarious interpretation: http://www.youtube.com/watch?v=2nxqTQ_OQ1Q&NR=1
Course stories + Biography
"Fate is not an eagle, it creeps like a rat."
Week 13: Elizabeth Bowen, 'The Back Drawing Room', 'The Cat Jumps', 'Her Table Spread', 'The Demon Lover', 'Mysterious Kor', 'Ivy Gripped The Steps', 'Summer Nights', and 'The Happy Autumn Fields', from Collected Stories (Vintage).
Elizabeth Dorothea Cole Bowen (1899-1973)
Anglo-Irish Novelist and short story writer. Born in Dublin, she spent much of her childhood at the family home in Co. Cork which she inherited in 1930 and described in Bowen's Court (1942). In 1923 she published her first collection of short stories, Encounters, and married Alan Cameron. They lived for ten years in London, vividly evoked in many of her works; her skill in describing landscape, both urban and rural, and her sensitivity to changes of light and season are distinguishing features of her prose. Her novels include The Hotel (1927), The Last September (1929), The House in Paris (1935), A World of Love (1955), and Eva Trout (1969). The best known are probably The Death of the Heart (1938) and The Heat of the Day (1949).
The war inspired many of Elizabeth Bowen's best short stories, including 'Mysterious Kôr. A. Wilson in his introduction to her Collected Stories (1980) praised her as one of the great writers of the blitz. Other stories (e.g. the title story of The Cat Jumps, 1934) reveal subtle deployment of the supernatural. She writes most confidently of the upper middle and middle classes, but within that social range her perceptions of change are acute; her works already strike the reader with a powerful sense of period, through their accurate detail and keen response to atmosphere.


text:
Family Development Minister
From the new Family Development Minister – Debbie Godsell
We are delighted to announce Debbie is our new Family Development Minister. Debbie writes -
One of my favourite quotes is by Albert Einstein:
"Everybody is a genius. But if you judge a fish by its ability to climb a tree, it will live its whole life believing that it is stupid."
We can't all be good at everything! Everyone has different and unique gifts and talents. Our bodies are a good example of this. Every part of our body plays a vital and yet very different role in helping our bodies to not just survive but to get the very best out of life. In the Bible, 1 Corinthians 12 tells us about the unity and yet diversity of the body.
When I asked my teenager children which part of the body they thought that they were they both said "The stomach because we love to eat". This got me thinking that this is true of most teenagers and in fact most children. Children have a continuous need to be fed and will happily eat whenever they are given the opportunity. They need this food to help them to grow and without food their energy quickly fades.
As Christians, we should be feeding ourselves constantly with the word of God. We should be more like hungry children constantly wanting the sweet taste of His good news. We do not feed our bodies just once a week on a Sunday and so we should strive to find sometime during the day to feed our minds and get close to God.
It is true that we can't all be good at everything and life would be very boring if we were all good at the same things. However, we should all be striving to be the same in one way – Being more like Jesus. Most of us lead extremely busy lives but we are called to be one body and to spend time together as a church and as individuals worshipping God. Children are a vital part of the Body of the Church and should be respected and welcomed into the church. We have a lot to learn from children's openness, honesty and thirst for knowledge.
As the new Family Development Minister, I would like to take this opportunity to say that I am excited about what lies ahead for the West of Severn Benefice. It would be great to discuss ways in which we, as a church, can help families to deepen their faith and share fellowship with one another.
Please feel free to email me email@example.com or phone me 07784 875186
| Printable Version


text:
"I find that good thoracic mobility plays a very important role in the body's force production. I have been looking for a simple piece of equipment to analyze the body in order to understand and increase the rotational movement of the upper torso. I find that the TE3 Mobility Testing Stick is a great tool for professional trainers and athletes to improve their performance."
Marko Yrjovuori, Performance Specialist, NBA and NHL Trainer
"TE3 Mobility Testing Stick is an easy to use professional measuring tool to measure the rotational mobility of the hip and the spine. It is also a perfect tool to use incorporated in the mobility training."
Hero Mali, Physiotherapist, Strength & Conditioning Coach, Jokerit Hockey Club Oy
"TE3 group training is very good – the class is perfect for those who train actively, though everybody should do these exercises. Those who work in an office and sit most of the day can say that this class is necessary and functional. I believe that TE3 will help me with my neck and shoulder problems. And what's more, the class is fun!"
Sonja Lauren, Erimover Oy Ab
"My joint mobility has dramatically increased after I started using the TE3 Mobility Training Stick even though I am over 50 years old. Now I am able to perform many difficult techniques without doing a long warm-up and they work even better than 20 years ago."
Master Jean Feller, 7th Dan in Taekwondo (seventh-degree black belt)
"The TE3 Mobility Station is a great exercise tool for work. It´s always available and it´s easy to use while working and during breaks. The vibration gives you feedback and helps you to correct your movement and challenges you to continue"
Oili Kettunen, Doctor of Philosophy, Expert of Occupational Well-Being, The Sport Institute of Finland
"A good day starts with the TE3 Mobility Training Stick. In ski jumping, lines and posture must be straight in order to gain an optimal take-off and flight position. The TE3 Mobility Stick is a great solution for fixing those problems. The TE3 stick is also a real medicine against rounded shoulders and the so called ʽtext neck'. The TE3 technology meets sports in the best possible way."
Pekka Niemelä, Head Coach, Turkish Ski Jumping National Team (Previous Head Coach of Finnish and French National Teams. His teams have won two Olympic medals and seven world championship medals)
"Powerful tool to open and calibrate your body before golf rounds. TE3 Mobility Training Stick will also give valuable data after exercise which can be used planning your training program of the day."
Oscar Stark, European Tour and Challenge Tour golfer
"The TE3 Mobility Station offers several benefits in gym use for different customer segments: our personal trainers can use TE3 with new customers, beginners, and as a tool to better identify, and demonstrate, the problems srelated to one's body control. It also helps to demonstrate how regular exercise, can improve body control and posture, even after just a few weeks. The benefits of using the TE3 Mobility Station are numerous, only our imagination sets the limits."
P-C Nordensved, CEO Fit1 Fitnessclub


text: Squamous Cell Carcinoma: A Review of Etiology, Pathogenesis, Treatment, and VariantsShulstad, Raymond M.; Proper, StevenJournal of the Dermatology Nurses' Association: January-February 2010 - Volume 2 - Issue 1 - p 12-16 doi: 10.1097/JDN.0b013e3181cb5165 FEATURE ARTICLES Free CE Abstract Author InformationAuthors Article OutlineOutline Article MetricsMetrics There are a multitude of malignant neoplasms that can, with the right genetic predisposition and exposure, affect the human body. The most common of these malignancies are the nonmelanoma skin cancers. There are two main forms of nonmelanoma skin cancer, basal cell carcinoma and squamous cell carcinoma. Of the two, squamous cell carcinoma is the second most prevalent but is potentially more devastating and life-threatening form of nonmelanoma skin cancer. This article describes the incidence, genetics, and etiology of squamous cell carcinoma. Also, this article defines squamous cell carcinoma stages of progression from precancerous to malignant and the various treatment modalities that are used in each stage of development. Finally, this article discusses the various forms of squamous cell carcinoma and the physiological changes that occur within the skin because of this malignancy. Raymond M. Shulstad, ARNP-C, BC, DNC, Center for Dermatology and Skin Surgery, Spring Hill, Florida. Steven Proper, MD, MPH, Center for Dermatology and Skin Surgery, Spring Hill, Florida. Correspondence concerning this article should be addressed to Raymond M. Shulstad, ARNP-C, BC, DNC, 5060 Commercial Way Dr, Spring Hill, FL 34606. E-mail: email@example.com Abstract OBJECTIVES BACKGROUND ETIOLOGY AND PATHOGENESIS SQUAMOUS CELL CARCINOMA: DEVELOPMENT, VARIANTS, AND TREATME... Actinic Keratosis Squamous Cell Carcinoma In Situ Invasive Squamous Cell Carcinoma CONCLUSIONS NURSING IMPLICATIONS References There are a multitude of malignant neoplasms that can, with the right genetic predisposition and exposure, affect the human body. The most common of these malignancies are the nonmelanoma skin cancers. There are two main forms of nonmelanoma skin cancer, basal cell carcinoma and squamous cell carcinoma. Of the two, squamous cell carcinoma is the second most prevalent, but it is potentially more devastating and life threatening. Back to Top | Article Outline OBJECTIVES The following are the objectives of the study: Describe the prevalence, genetics, and etiology of squamous cell carcinoma. Define the stages of progression of squamous cell carcinoma from precancerous to malignant and the various treatment modalities that are used in each stage of development. Discuss the various forms of squamous cell carcinoma and the changes that occur within the skin because of this malignancy. Back to Top | Article Outline BACKGROUND The prevalence of cutaneous squamous cell carcinoma in lightly pigmented individuals is 58.25 per 100,000, and for darker pigmented skin colors, it is 3.09 per 100,000. The head and neck region is the most commonly affected, comprising 67% of the cases. Although rare, squamous cell carcinoma is the most common form of cutaneous malignancy among darker pigmented populations. The mortality rates are low for squamous cell carcinoma, but they are higher in men and increase with age. For lightly pigmented men, the mortality rate is 0.38 per 100,000, and for lightly pigmented women, the rate is 0.23 per 100,000. The most common primary site that contributes to mortality is the ear (Miller & Moresi, 2003). Back to Top | Article Outline ETIOLOGY AND PATHOGENESIS The exact genetic alterations and numbers of mutations needed for malignant transformation are as yet unknown. The most readily accepted theory involves the transformation of the epidermal p53 gene clones by ultraviolet (UV) exposure to the precursors of squamous cell carcinoma. Early p53 mutations are believed to inhibit apoptosis of abnormal cells, allowing them to expand at the expense of normal presenting cells. Alterations of the p53 gene are the most common presenting malformation in all stages of squamous cell carcinoma, starting at the precancerous lesion and advancing to the invasive and potentially metastatic forms. Typically, this presents with one allele (DNA sequence) containing a missense point mutation with a UV signature, and the remaining allele is deleted (Ponten & Lundeberg, 2003). The pathogenesis of squamous cell carcinoma is multifactorial and includes many extrinsic and intrinsic factors. The most important extrinsic factor is generally recognized as UV sunlight exposure. As lifetime UV exposure increases, so does the incidence of squamous cell carcinoma (Marks, 1996). In fact, for every 8- to 10-degree decrease in latitude (e.g., Washington, DC to Tampa, FL), there is a doubling of the incidence of squamous cell carcinoma. Patients treated with psoralen with ultraviolet A are 30 times more likely to develop squamous cell carcinoma than the general population (Lohmann & Solomon, 2001). The human papillomavirus type 16 is present in many of the genital and periungal forms of squamous cell, but human papillomavirus types 5, 8, 9, 18, 31, 33, 35, 39, 40, and 51-60, have all been isolated from squamous cell tumors (Wolff, Johnson, & Suurmond, 2005). Other extrinsic factors that are related to the development of squamous cell carcinoma are industrial carcinogens, such as pitch, tar, crude paraffin oil, fuel oil, creosote, lubricating oils, arsenic, and nitrosoureas (Wolff et al., 2005). Intrinsic factors associated with squamous cell carcinoma include age, lighter skin pigmentation, scars, and dermatoses associated with photosensitivity (chronic cutaneous lupus), ulcerations, and lichen planus (Lohmann & Solomon, 2001). There are two hereditary conditions that increase the risk of developing squamous cell carcinoma. Xeroderma pigmentosa is an autosomal recessive condition leading to an inability to repair UV-induced DNA damage. Oculocutaneous albinism results in insufficient melanin production, thereby decreasing the body's defense against UV damage (Miller & Moresi, 2003). Immunosuppressed individuals, whether by AIDS or organ transplant, have shown not only an increased incidence of squamous cell carcinoma but also a tendency to develop more aggressive tumors (Lohmann & Solomon, 2001). Back to Top | Article Outline SQUAMOUS CELL CARCINOMA: DEVELOPMENT, VARIANTS, AND TREATMENT The prototypical invasive squamous cell lesion can be identified with relative ease by its appearance. Most commonly, they are indurated papules, plaques, or nodules, with thick adherent scale or hyperkeratosis (Wolff et al., 2005). Fortunately, many squamous cell carcinomas move through multiple stages before reaching the invasive presentation. If these precursors are identified, more conservative treatments can be utilized. Back to Top | Article Outline Actinic Keratosis The actinic keratosis is the first observable precursor to an invasive squamous cell carcinoma (Figure 1). Histologically, an actinic keratosis is defined by atypical keratinocytes, arising in the stratum spinosum, which extend up to but do not involve the stratum corneum (Figure 2). These keratinocytes are enlarged and crowded and show loss of polarity (Miller & Moresi, 2003). Clinically, acitinic keratoses present as less than 1 cm, tan-brown, red, or skin-colored, rough, sandpaper-like patches (Figure 2). Cutaneous horns can develop in lesions that produce excess keratin (Murphy, Sellheyer & Mihm, 2005). The most common sites of occurrence are the face, ears, and dorsum of the hands and arms (Wolff et al., 2005). These precancerous lesions can be treated conservatively and successfully with cryosurgery, electrodessication and curettage, chemotherapeutic creams, or topical immune modulators (Chang, Madkan, Cook-Norris, Sra, & Tyring, 2005; Marks, 1996). Without treatment, it is generally believed that a percentage of these lesions will spontaneously resolve, but some can continue to mutate and form squamous cell carcinoma in situ. FIGURE 1 FIGURE 2 Back to Top | Article Outline Squamous Cell Carcinoma In Situ Clinically, squamous cell carcinoma in situ presents as a well-demarcated, scaling, or hyperkeratotic macule, papule, or plaque (Figure 3). They can be nearly indistinguishable from actinic keratoses to the naked eye. Evidence of erosion and, at times, evidence of bleeding should increase clinical suspicion (Wolff et al., 2005). Histopathologically, squamous cell carcinoma in situ involves the entire thickness of the epidermis with pleomorphic (multiple sizes and shapes) keratinocytes, and involves the adnexal epithelium (Figure 4). No evidence of invasion into the dermis is observed (Miller & Moresi, 2003). Like their precursors, squamous cell carcinoma in situ may be treated with cryosurgery, electrodessication and curettage, chemotherapeutic creams, excision, and topical immune modulators (Chang et al., 2005; Marks, 1996). Without timely and appropriate treatment, these lesions can advance to form invasive squamous cell carcinoma. FIGURE 3 FIGURE 4 Back to Top | Article Outline Invasive Squamous Cell Carcinoma The common invasive squamous cell carcinoma (Figure 5) is a malignancy of the keratinocytes from the epidermis that invade the dermis. Having transversed the basement membrane, these malignancies have the potential to invade fat, muscle, bone, and cartilage and to metastasize to regional lymph nodes and distant sites (Miller & Moresi, 2003). The cells of an invasive squamous cell carcinoma resemble those of an actinic keratosis. They have enlarged and irregularly contoured nuclei, increased numbers of nucleoli, and irregular mitotic figures (Figure 6). The important clinical distinction is that there is invasion into the dermis, which necessitates more aggressive treatment to prevent further damage to the surrounding cutaneous and underlying structures, and metastasis. Surgical excision is the treatment of choice for all invasive tumors. Usually, treatment is performed under local anesthesia with a 3- to 4-mm margin taken. For high-risk lesions, such as those on the face, ears, and lips, as well as recurrent tumors and tumors larger than 2 cm, Mohs micrographic surgery should be employed to ensure the highest possible cure rate (Marks, 1996). Failure to treat or insufficient treatment can lead to recurrence and metastasis. FIGURE 5 FIGURE 6 There are many factors that contribute to the aggressiveness, recurrence rate, and metastatic potential of squamous cell carcinomas. Tumor size is a major determinant. For lesions larger than 2 cm, the recurrence rate doubles and the metastatic rate triples to 30%. Tumors with rapid growth rates also have a higher metastatic potential. Tumors originating in burn scars have a 30% metastasis rate. The rate for metastatic disease increases the closer a tumor is to the oral cavity. Recurrent tumors also have a greater metastatic rate, especially on the lips and ears, where the rate is 32% and 45%, respectively (Lohmann & Solomon, 2001). Metastasis from squamous cell carcinoma appears most commonly in the regional lymph nodes, followed by the lungs and liver (Marks, 1996). Squamous cell carcinoma would be relatively easy to diagnose and treat if the common variety were all that existed. There are, however, multiple variants of this disease, including spindle cell, acantholytic, verrucous, lymphoepithelioma-like, desmoplastic, adenosquamous, cystic, and keratoacanthoma (Miller & Moresi, 2003). Each of these variants differs in histology and prognosis, but the treatment is identical to the more common form. Spindle cell carcinoma is a rare variant in which the neoplastic keratinocytes infiltrate the dermis as single cells with elongated nuclei (Miller & Moresi, 2003). Associations with previous trauma or radiation have been reported. These tumors are most often found on the face or other sun-exposed regions of older persons. Due to a lack of keratinization, these lesions are difficult to detect and diagnose (Lohmann & Solomon, 2001). In addition, because differentiation is minimal in these lesions, recurrence and metastatic rates are high (Miller & Moresi, 2003). Acantholytic squamous cell carcinoma is identified histologically by the cells being arranged in cords and nests, with clefts produced by acantholysis of cells leaving spaces resembling glands. These lesions usually present as ulcerations or nodules on the head and neck of men in their fifth to sixth decades (Lohmann & Solomon, 2001). It is believed that this variant is more aggressive and poses a greater risk of metastasis (Miller & Moresi, 2003). Verrucous squamous cell carcinoma is a low-grade variant that is typified by well-differentiated keratinocytes lacking significant atypia (Miller & Moresi, 2003; Figure 7). These are not believed to have a metastatic risk and are identified by their location. The three main forms are oral, plantar, and Buschke-Loewenstein tumors (Lohmann & Solomon, 2001). FIGURE 7 Lymphoepithelioma-like carcinoma is a rare form of squamous cell carcinoma, recently classified by the World Health Organization. Its histogenesis is as yet uncertain. Due to the presence of sebaceous, eccrine, and trichilemmal differentiation within these neoplasms, it is widely believed that they originate in adnexal structures. These tumors have also been identified in the nasopharynx, salivary glands, thymus, lung, stomach, uterine cervix, and vagina. Therefore, when lesions are found on the skin, metastasis from another primary site must be considered. These tumors are composed of infiltrating cords and islands of pale epithelial cells that lack epidermal or adnexal connections (Miller & Moresi, 2003). Desmoplastic squamous cell carcinomas are another subtype that has an increased risk of recurrence and metastasis. The most common site for these tumors is the ear. Histologically, these tumors are characterized by infiltrating cords of neoplastic keratinocytes with a dense sclerotic stroma that comprises at least one third of the tumor. Perineural invasion and cytological atypia are often present (Miller & Moresi, 2003). Adenosquamous carcinoma is a form of squamous cell carcinoma that has the cytological features of both a keratinocyte-derived epidermal tumor and a gland-derived epithelial tumor. Its architecture is identical to the common squamous cell carcinoma except for the presence of deeply invasive nests and gland-like cystic spaces with areas of mucin production (Miller & Moresi, 2003). Cystic squamous cell carcinoma is a variant that typically occurs in older persons on the lower extremities and the dorsal aspects of the hands. This histological subtype closely resembles the common squamous cell carcinoma with the addition of large, intradermal keratin-filled cysts. Superficial sampling of these tumors may result in the misdiagnosis of an epidermoid cyst (Miller & Moresi, 2003). Keratoacanthomas are a distinct and interesting subtype of squamous cell carcinoma. The debate still rages as to whether this is a form of squamous cell and if it should be treated as a malignancy at all. Histologically, these tumors resemble the common squamous cell carcinoma and at the early stages are nearly indistinguishable (Figure 8). In the mature tumor, there is a crateriform squamous proliferation with a central core of compact hyperkeratosis (Figure 9). These tumors evolve rapidly over weeks to months, and then many will spontaneously resolve. There are many factors associated with the development of these lesions, including solar radiation, trauma, genetics, and possible viral etiologies (Sarabi, Selim, & Khachemoune, 2007). There are various forms of keratoacanthomas including Grzybowski, Ferguson-Smith, and Witten and Zak (Wee, 2004). FIGURE 8 FIGURE 9 Back to Top | Article Outline CONCLUSIONS In conclusion, this article has discussed the etiology, stages of development, treatment, and multiple forms of squamous cell carcinoma. This is a diverse disease with many cytological and clinical variants. It is important to note that, as with all cancers, early diagnosis and treatment is the key to survival. The advantage of skin cancer is that we can see the tumor as it develops; one only has to look and be equipped to recognize the changes it manifests in the skin. Back to Top | Article Outline NURSING IMPLICATIONS It is imperative that dermatology nurses and advanced practice dermatology nurses understand the developmental aspects of the diseases that face them everyday in practice. Knowing the etiology, pathogenesis, treatment options, and variants of squamous cell carcinoma can improve the rate of diagnosis and the selection of treatment options, patient outcomes, and ongoing patient education and care.Back to Top | Article Outline References Chang, Y. C., Madkan, V., Cook-Norris, R., Sra, K., & Tyring, S. (2005). Current and potential uses of imiquimod. Southern Medical Journal, 98, 913-919. Cited Here... | CrossRef Lohmann, C. M., & Solomon, A. R. (2001). Clinicopathologic variants of cutaneous squamous cell carcinoma. Advances in Anatomic Pathology, 8, 27-36. Cited Here... | View Full Text | PubMed | CrossRef Marks, R. (1996). Squamous cell carcinoma. Lancet, 347, 735-738. Cited Here... | View Full Text | PubMed | CrossRef Miller, S. J., & Moresi, S. J. (2003). Actinic keratosis, basal cell carcinoma, and squamous cell carcinoma. In J. L. Bologna, J. L. Jorizzo, & R. P. Rapini (Eds.), Dermatology (pp. 1677-1696). New York: Mosby. Cited Here... Murphy, G. F., Sellheyer, K., & Mihm Jr., M. C. (2005). The skin. In V. Kumar, A. K. Abbas, & N. Fausto (Eds.), Robbins and Cotran pathologic basis of disease (pp. 1227-1271). Philadelphia: Elsevier Saunders. Cited Here... Ponten, F., & Lundeberg. (2003). Principles of tumor biology and pathogenesis of BCCs and SCCs. In J. L. Bologna, J. L. Jorizzo, & R. P. Rapini (Eds.), Dermatology (pp. 1663-1676). New York: Mosby. Cited Here... Sarabi, K., Selim, A., & Khachemoune, A. (2007). Sporadic and syndromic keratoacanthomas: diagnosis and management. Dermatology Nursing, 19, 166-170. Cited Here... | View Full Text | PubMed Wee, S. A. (2004). Multiple eruptive keratoacanthomas, de novo. Dermatology Online Journal, 10(3). Retrieved November 6, 2007, from http://dermatology.cdlib.org/103/NYU/case_presentations/042004n11.html Cited Here... Wolff, K., Johnson, R. A., & Suurmond, D. (2005). Fitzpatrick's color atlas & synopsis of clinical dermatology. New York: McGraw-Hill. Cited Here... For more than 57 additional continuing education articles related to cancer, go to NursingCenter.com\CE.Keywords:Squamous Cell Carcinoma; Pathogenesis; Treatment © 2010 Lippincott Williams & Wilkins, Inc. Article Outline Abstract OBJECTIVES BACKGROUND ETIOLOGY AND PATHOGENESIS SQUAMOUS CELL CARCINOMA: DEVELOPMENT, VARIANTS, A... Actinic Keratosis Squamous Cell Carcinoma In Situ Invasive Squamous Cell Carcinoma CONCLUSIONS NURSING IMPLICATIONS References Source Squamous Cell Carcinoma: A Review of Etiology, Pathogenesis, Treatment, and Variants Journal of the Dermatology Nurses' Association2(1):12-16, January-February 2010. Full-Size Email + Favorites Export View in Gallery Email to a Colleague Colleague's E-mail is Invalid Your Name: (optional) Your Email: Colleague's Email: Separate multiple e-mails with a (;). Message: Thought you might appreciate this item(s) I saw at Journal of the Dermatology Nurses' Association. Send a copy to your email Your message has been successfully sent to your colleague. Some error has occurred while processing your request. Please try after some time. Email to a Colleague Colleague's E-mail is Invalid Your Name: (optional) Your Email: Colleague's Email: Separate multiple e-mails with a (;). Message: Thought you might appreciate this item(s) I saw at Journal of the Dermatology Nurses' Association. Send a copy to your email Your message has been successfully sent to your colleague. Some error has occurred while processing your request. Please try after some time. Add Item(s) to: An Existing Folder A New Folder Folder Name: Description: The item(s) has been successfully added to "". Thanks for registering! Be sure to verify your new user account in the next 24 hours, by checking your email and clicking the "verify" link. This article has been saved into your User Account, in the Favorites area, under the new folder "". Related Articles