text:
Radial head subluxation: How long do children wait in the emergency department before reduction?
Philippe Toupin;* Martin H. Osmond, MD, CM;†‡ Rhonda Correll, HBScN, RN;† Amy Plint, MD, MSc†‡
From the *School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ont., the †Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ont., and the ‡Departments of Pediatrics and Emergency Medicine, University of Ottawa, Ottawa, Ont.
Objective: To describe the current emergency department (ED) wait times and treatment characteristics of children with radial head subluxation (RHS).
Methods: We performed a 2-year retrospective medical record review (April 1, 2004, to March 31, 2006) of all children who presented to our tertiary care pediatric ED with a discharge diagnosis of RHS, pulled elbow, dislocated elbow or nursemaid's elbow.
Results: We identified 501 cases of RHS in 427 children over a 2-year period. The mean age was 2.4 years (range 22 d-9.7 yr) and the injury was caused by a pull in 314 (62.8%) cases, a fall in 91 (18.2%) cases and a twist in 20 (4.0%) of the cases. The median time from triage to physician assessment was 1.3 hours, with 112 (23.5%) patients waiting > 2 hours and 33 (6.9%) waiting > 3 hours. The median time from triage to ED discharge was 1.7 hours, with 193 (41.2%) staying > 2 hours, 85 (18.1%) staying > 3 hours and 30 (6.4%) staying > 4 hours. Overall, 490 (99.2%) of these injuries were reduced in the ED: 98 (19.8%) were reduced prior to physician assessment and 309 (89.6%) were reduced on the first attempt. The technique used was pronation in 138 (52.7%), supination in 100 (38.2%), and pronation and supination in 24 (9.2%) cases.
Conclusion: This large cohort indicates that children with RHS often have long ED waits before reduction and discharge. The majority of children with RHS are treated successfully with 1 reduction attempt. The data from this study will be used in planning a prospective study to shorten ED visits for patients with RHS.
Objectif : Décrire les temps d'attente actuels à l'urgence et les caractéristiques de traitement des enfants qui ont subi une subluxation de la tête radiale (STR).
Méthodes : Nous avons procédé à une étude rétrospective sur deux ans (du 1er avril 2004 au 31 mars 2006) des dossiers médicaux de tous les enfants qui se sont présentés à notre urgence pédiatrique de soins tertiaires et chez lesquels on a diagnostiqué au congé une STR, une subluxation du coude, une luxation du coude ou une pronation douloureuse.
Résultats : Nous avons repéré 501 cas de STR chez 427 enfants sur une période de deux ans. Les enfants avaient en moyenne 2,4 ans (intervalle de 22 j-9,27 a) et le traumatisme avait été causé par une traction dans 314 (62,8 %) cas, par une chute dans 91 cas (18,2 %) et par une torsion dans 20 cas (4,0 %). La période écoulée entre le triage et l'évaluation par le médecin a été en moyenne de 1,3 heure; 112 (23,5 %) patients ont attendu plus de 2 heures et 33 (6,9 %), plus de 3 heures. La période médiane écoulée entre le triage et le congé de l'urgence a été de 1,7 heure; la durée du séjour a été de plus de 2 heures pour 193 (41,2 %) patients, de plus de 3 heures pour 85 (18,1 %) patients et de plus de 4 heures pour 30 (6,4 %) patients. Dans l'ensemble, on a réduit 490 (99,2 %) de ces traumatismes à l'urgence : 98 (19,8 %) avant l'évaluation par le médecin et 309 (89,6 %) à la première tentative. On a utilisé comme technique la pronation dans 138 (52,7 %) cas, la supination dans 100 (38,2 %) cas et la pronation et supination dans 24 (9,2 %) cas.
Conclusion : Cette cohorte importante indique que les enfants qui ont subi une STR doivent souvent attendre longtemps à l'urgence avant que l'on réduise la luxation et qu'ils reçoivent leur congé. La majorité des enfants qui ont subi une STR sont traités avec succès au premier essai de réduction. Les données tirées de cette étude serviront à planifier une étude prospective visant à raccourcir la durée de la visite à l'urgence pour les patients qui ont subi une STR.
Radial head subluxation (RHS), also known as pulled elbow, dislocated elbow or nursemaid's elbow, is one of the most common upper extremity injuries in young children1 and a common reason for an emergency department (ED) visit. The injury usually occurs when forceful longitudinal traction is applied to an extended and pronated arm.2 While children may sustain this injury up to about 7 years of age, typically they are between the ages of 1 and 3 years.3-5 Children with RHS are usually easily recognized by their clinical presentation and rapidly treated by a simple reduction technique involving pronation, supination, or both pronation and supination of the injured arm.3,6-9
Despite the relative ease of diagnosis and treatment of RHS, it has been our experience that children with this condition often wait several hours in a pediatric ED for a reduction that takes only a few minutes. While many factors are associated with parental and patient satisfaction in the ED, it appears that early treatment10 and short waiting times correlate with both patient and parent satisfaction.11 Currently, wait times in the pediatric ED for children with RHS are unknown.
The objective of our study was to determine the wait times that children with RHS experience in a pediatric ED. We also sought to describe the characteristics and treatments used for this group of patients. Our long-term plan is to investigate whether triage nurses can be trained to identify RHS and reduce the dislocation thus shortening ED length of stay for such patients, compared with standard physician-delivered treatment.
We conducted a retrospective medical record review of all patients presenting to a tertiary care pediatric ED with RHS over a 2-year period between April 1, 2004, and March 31, 2006. This review was conducted at the Children's Hospital of Eastern Ontario (CHEO), in Ottawa, Canada. CHEO serves a population of approximately 1.5 million people in eastern Ontario and western Quebec, and has approximately 55 000 ED visits per year. The CHEO Research Ethics Committee approved the study protocol.
We reviewed the charts of all patients discharged from the hospital ED with a diagnosis of RHS, pulled elbow, dislocated elbow or nursemaid's elbow. Cases were identified using the injury section of the International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10-CA). All cases with a final ED discharge diagnosis consistent with RHS were included in the study; cases of elbow dislocation and/or fracture were excluded.
To improve accuracy and minimize inconsistencies in the chart review, we incorporated medical record review strategies recommended by Gilbert and colleagues.12 The review was performed by one of the investigators using a standard data abstraction form to extract the following variables: age, sex, ED times, time of injury, history of RHS, mechanism of injury, arm injured, ED investigations, ED treatment and recommended follow-up. If there was no record of these variables, they were recorded as being "not documented." All variables on the data abstraction form were discussed and defined by the study team prior to the chart review. A second investigator reviewed all data abstraction sheets for accuracy and thoroughness.
Ten percent of the charts were randomly selected and reviewed by a second trained chart abstractor to evaluate interrater agreement. To maintain consistency, regular meetings were held to discuss and resolve any problems.
Data analysis was performed using SPSS 14.0 for Windows (SPSS Inc., Chicago, Ill.). Descriptive statistics and frequencies were used to analyze the variables. In addition to the first 20 data abstraction sheets, 10% of the data abstraction sheets were randomly chosen and reentered in SPSS to ensure the precision of the data entry. Kappa statistics were generated to determine the interrater reliability of the data abstraction.
During the 2-year study period, there were 546 patients with a discharge diagnosis of RHS, pulled elbow, dislocated elbow or nursemaid's elbow. On review of these patient records, we identified 501 cases of RHS in 427 children. Of the remaining 45 patients, 25 (55.6%) were diagnosed with a dislocated elbow, 4 (8.9%) with a fracture, and 10 (22.2%) with a dislocated elbow and a fracture; 3 (6.7%) patients presented no clinical indications of RHS, 2 (4.4%) left the ED without being seen by a physician, and 1 chart could not be located.
Figure 1 shows the age distribution of the study cohort of 501 patients. The mean age was 2.4 years with a range of 22 days to 9.7 years. Table 1 shows the characteristics of the children in the study; 56.9% of all RHS patient visits were for females. The majority of patients had a pull (62.8%) or fall (18.2%) as the mechanism of injury, and the left elbow was injured most frequently (61.8%).
|No. (and %) of patients
|285 (56.9)
|216 (43.1)
|Time from injury to ED presentation, h (n = 292)
|< 6
|228 (78.1)
|19 (6.5)
|36 (12.3)
|> 24
|9 (3.1)
|History of RHS (n = 213)
|134 (62.9)
|79 (37.1)
|Mechanism of injury (n = 500)
|314 (62.8)
|91 (18.2)
|20 (4.0)
|Arm struck
|7 (1.4)
|60 (12.0)
|8 (1.6)
|Arm injured (n = 495)
|306 (61.8)
|189 (38.2)
|RHS = radial head subluxation.
|*Mean age of patients = 2.4 years (standard deviation 1.2); range 0.06–9.7.
The ED waiting times of children with RHS are shown in Figure 2. The median waiting time from triage to physician assessment was 1.3 hours (interquartile range [IQR] 0.7-2.0), with 23.5% (n = 112) waiting more than 2 hours and 6.9% (n = 33) waiting more than 3 hours. The median waiting time from triage to discharge from the ED was 1.7 hours (IQR 1.1-2.6), with 41.2% of children (n = 193) waiting more than 2 hours, 18.1% (n = 85) waiting more than 3 hours and 6.4% (n = 30) waiting more than 4 hours.
Table 2 shows the management and disposition of patients with RHS. The ED outcome was documented for 494 subjects with RHS. The large majority of pulled elbows (99.2%) were reduced during the ED visit. A radiograph was performed on approximately one-quarter of the subjects and 6.3% of radiographs showed a joint effusion. On discharge, 8 patients (1.6%) were provided with either a sling (n = 5) or a splint (n = 3) as treatment. Physician follow-up was advised for 8 patients; 4 to their family doctor and 4 to an orthopedic surgeon.
|No. (and %) of cases
|Reduction attempted in the ED (n = 494)
|Successful reduction in the ED
|490 (99.2)
|- Reduced prior to MD assessment
|78 (15.8)
|- Reduced by MD
|387 (78.3)
|- Reduced in radiology department
|25 (5.1)
|Unsuccessful reduction in the ED
|4 (0.8)
|Reduction technique used (n = 262)
|Pronation only
|138 (52.7)
|Supination only
|100 (38.2)
|Pronation and supination
|24 (9.2)
|Number of reduction attempts (n = 345)
|309 (89.6)
|33 (9.6)
|3 (0.9)
|Radiograph of elbow (n = 128)
|120 (93.8)
|Joint effusion
|8 (6.2)
|Discharge treatment (n = 501)
|493 (98.4)
|5 (1.0)
|3 (0.6)
|Follow-up advised (n = 501)
|None or "PRN"
|493 (98.4)
|Family doctor
|4 (0.8)
|4 (0.8)
|ED = emergency department; PRN = as circumstances may require.
There were 4 patients who were unable to have their RHS successfully reduced in the ED. They were discharged with either a splint or a sling. Three were scheduled to follow-up with an orthopedic surgeon, and the fourth patient was told to return to the ED if his arm did not return to normal. None of the 4 patients returned to the ED or attended their scheduled follow-up appointment with orthopedics. Three of the 4 children had normal radiographs and the fourth was never imaged.
The concordance rate for interobserver reliability between the chart reviewers showed extremely high interrater agreement on all variables (kappa statistics ranging between 0.82 and 1.00), with the exception of 1 variable (number of reduction attempts) that showed a moderately high interrater agreement (κ = 0.73).13
To our knowledge, this is the largest study of RHS published to date, and the first study to specifically examine the ED wait times of patients with RHS. We found that children often have a long wait in the ED before reduction and discharge by a physician. The time to discharge is over 2 hours in almost one-half of the children, and is frequently greater than 3 hours. The majority of children with RHS had a pull as the mechanism of injury and were successfully treated with 1 reduction attempt by a physician.
Although previous studies have found that patients with RHS range in age from 0.2 to 7 years,5-7,14-16 we found that children as young as 22 days and as old as 9.7 years are diagnosed with RHS. The highest incidence of RHS was observed between the ages of 1 and 2 years (35%). Similar to other studies,6,7,15 the majority of children in our study had a pull (62.8%) or fall (18.2%) as the mechanism of injury.
Virtually every case of pulled elbow (99.2%) was successfully and easily reduced in hospital. Of the cases identified, 15.8% had spontaneously reduced before physician assessment. If the child required a reduction, only 1 attempt by the physician was required in 89.6% of cases. Other studies have found that 8%-10% of all RHS cases spontaneously reduce14,17 and that 74%-88% of reductions are successful on the first attempt.1,6-8,18 These findings demonstrate that the great majority of pulled elbows are easily reduced in the ED setting.
We found that children presenting to the ED with RHS often have a long wait before treatment and discharge. Over one-third (41.2%) of all patients diagnosed with RHS had to wait more than 2 hours before being treated and discharged. In some cases, children had to wait more than 5 hours in the ED before receiving treatment. Once assessed by a physician, the median time to discharge was 24 minutes. In EDs using the Canadian Triage and Acuity Scale (CTAS), children with RHS would typically score 4 out of 5 and would appropriately be in the "less urgent" category, unless significant pain was present, which could result in an up-triage to a score of 3.19 Hence, such children will often wait for long periods of time despite the relative ease and rapidity of the diagnosis and treatment. We believe that there may be an opportunity to improve wait times for children with RHS by training nurses to recognize and treat RHS soon after presentation to the ED, and we intend to pursue further research initiatives with this in mind.
While no studies that examine the success of nurse initiated treatment of RHS have been published, there are many reasons to believe that this would be feasible. We are aware of at least 2 Australian children's hospitals where reduction of RHS is routinely provided by a nurse soon after presentation at triage (Dr. Matthew O'Meara, personal communication, 2005). In addition, parents whose children frequently experience RHS are often taught how to reduce a pulled elbow at home should it recur in the future. A recently published case series reports 2 children whose physician diagnosed RHS over the phone and successfully instructed the caregivers (who had no medical experience) to reduce this injury.20 The use of nurse initiated treatments or "critical care pathways" is common within many EDs. Several studies have demonstrated that nurse-initiated treatments can be beneficial in the management of ED patients.21-26 Furthermore, patient satisfaction appears to be unchanged or improved when ED care for minor injuries is provided by nurse practitioners rather than physicians.27,28 While many factors are associated with parental and patient satisfaction in the ED, it appears that early treatment10 and short waiting times are correlated with patient and parent satisfaction.11 Before adopting a practice change, however, a prospective study is required to examine whether ED nurses can successfully and safely diagnose and reduce RHS .
In the setting of a convincing history and typical physical examination, radiographs are not required to diagnose or manage a patient with RHS. The medical literature indicates that the number of patients with RHS who are evaluated radiographically varies between 24% and 61%.1,7,15,16 In our study, 26% of RHS patients were imaged, with only a small number (n = 8) demonstrating a joint effusion. None of these patients had their care altered as a result of undergoing radiography.
Owing to the retrospective methodology, the information extracted from the medical charts was limited by missing or incomplete data in some cases. Another limitation is that our study only describes the circumstances that exist at a single location. Although our findings are consistent with the existing literature, ED wait times of patients with RHS have not previously been studied and may vary institutionally.
This large study demonstrates that children with RHS often have long waits in the ED before reduction and discharge. The majority of children with RHS have a pull as the mechanism of injury and are treated successfully with 1 reduction attempt by a physician. The data collected from this study will assist in planning and implementing a prospective study to shorten ED visits for patients with RHS.
- Schutzman SA, Teach S. Upper extremity impairment in young children. Ann Emerg Med 1995;26:474-9.
- Salter R, Zaltz C. Anatomic investigation of the mechanisms of injury and pathological anatomy of pulled elbow in young children. Clin Orthop Relat Res 1971;77:134-43.
- Quan L, Marcuse EK. The epidemiology and treatment of radial head subluxation. Am J Dis Child 1985;139:1194-7.
- Teach SJ, Schutzman SA. Prospective study of recurrent radial head subluxation. Arch Pediatr Adoles Med 1996;150:164-6.
- Jongschaap HCN, Young GG, Beattie TF. The epidemiology of radial head subluxation ("pulled elbow') in the Aberdeen city area. Health Bull (Edinb) 1990;48:58-61.
- Macias CG, Bothner J, Wiebe R. A comparison of supination/ flexion to hyperpronation in the reduction of radial head subluxations. Pediatrics 1998;102:e10.
- Schunk JE. Radial head subluxation: epidemiology and treatment of 87 episodes. Ann Emerg Med 1990;19:1019-23.
- McDonald J, Whitelaw C, Goldsmith LJ. Radial head subluxation: comparing two methods of reduction. Acad Emerg Med 1999; 6:715-8.
- Taha AM. The treatment of pulled elbow: a prospective randomized study. Arch Orthop Trauma Surg 2000;120:336-7.
- Chan B, Schull M, Schultz S. Emergency department services in Ontario. Toronto (ON): Institute for Clinical Evaluative Sciences; 2001.
- Bursch B, Beezy J, Shaw R. Emergency department satisfaction: What matters most? Ann Emerg Med 1993;22:586-91.
- Gilbert EH, Lowenstein SR, Koziol-McLain J, et al. Chart reviews in emergency medicine research: Where are the methods? Ann Emerg Med 1996;27:305-8.
- Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977;33:159-74.
- Amir D, Frankl U, Pogrund H. Pulled elbow and hypermobility of joints. Clin Orthop Relat Res 1990; 257:94-9.
- Choung W, Heinrich SD. Acute annular ligament interposition into the radiocapitellar joint in children (nursemaid's elbow). J Pediatr Orthop 1995;15:454-6.
- Sacchetti A, Ramoska EE. Glascow C. Nonclassic history in children with radial head subluxations. J Emerg Med 1990; 8: 151-3.
- Snyder HS. Radiographic changes with radial head subluxation in children. J Emerg Med 1990;8:265-9.
- Green DA, Linares M, Garcia Peña BM, et al. Randomized comparison of pain perception during radial head subluxation reduction using supination-flexion or forced pronation. Pediatr Emerg Care 2006;22:235-8.
- Beveridge R, Clarke B, Janes L, et al. Canadian Emergency Department Triage and Acuity Scale: implementation guidelines. Can J Emerg Med 1999;1(Suppl 3). Available: www.caep.ca.
- Kaplan RE, Lillis KA. Recurrent nursemaid's elbow (annual ligament displacement) treatment via telephone. Pediatrics 2002; 110: 171-4.
- Fry M, Holdgate A. Nurse-initiated intravenous morphine in the emergency department: efficacy, rate of adverse events and impact on time to analgesia. Emerg Med (Fremantle) 2002;14:249-54.
- Klassen TP, Ropp LJ, Sutcliffe T, et al. A randomized, controlled trial of radiograph ordering for extremity trauma in a pediatric emergency department. Ann Emerg Med 1993;22:1524-9.
- Tambimuttu J, Hawley R, Marshall A. Nurse-initiated x-ray of isolated limb fractures in the emergency department: research outcomes and future directions. Aust Crit Care 2002;15:119-22.
- Wilmshurst P, Purchase A, Webb C, et al. Quinn T. Improving door to needle times with nurse initiated thrombolysis. Heart 2000; 84:262-6.
- Salt P, Clancy M. Implementation of the Ottawa Ankle Rules by nurses working in an accident and emergency department. J Accid Emerg Med 1997;14:363-5.
- Karpas A, Hennes H, Walsh-Kelly CM. Utilization of the Ottawa Ankle Rules by nurses in a pediatric emergency department. Acad Emerg Med 2002;9:130-3.
- Cooper MA, Lindsay GM, Kinn S, et al. Evaluating emergency nurse practitioner services: a randomized controlled trial. J Adv Nurs 2002;40:721-30.
- Rhee KJ, Dermyer AL. Patient satisfaction with a nurse practitioner in a university emergency service. Ann Emerg Med 1995; 26: 130-2.
Dr. Martin Osmond, Division of Emergency Medicine, Children's Hospital of Eastern Ontario, 401 Smyth Rd., Ottawa ON K1H 8L1; firstname.lastname@example.com


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A former bookkeeper accused of embezzling more than $65,000 over five years from Lodi Physical Therapy was arraigned in San Joaquin County Superior Court on Friday.
Felicia Wendy Caulfield, 48, of Stockton, faces felony charges of falsifying corporate books and grand theft over $950.
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A group in an introductory hand-drum class plays a rhythm, and it gets recorded by a portable cassette recorder with ...
Group plays a rhythm in an introductory hand drum class. Intentionally bad quality from cassette over 20 years old, for ...
automated announcement recorded in Cercanías Málaga-Fuengirola (Spain).
The second of three Harley Owner's Groups (HOGs) passes from left to right.
First test with the mopho desktop, spiced up with beat made with blofeld waves. Still need to explore the synth...
Custom drum loop made with Battery2 and Nuendo4 and quite some fx.
Pitched down & normal voices uttering "blah, blah, blah" rhythmically recorded on 1/4" tape and physically looped (loop it)
Personal file
undanceable beats used as demo sounds for my website.
automated announcement for next stop
Recorded with a Soundman OKM Microfone plugged to an old portable Sony MD-Recorder 2008 in Berlin
Deportación de ciudadano africano en un vuelo de Air France African citizen deportation on a flight from Air France
Korg Polsix with a bad chip


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Child & Family Partners is a not-for-profit organization dedicated to empowering and supporting children, adults and families with bilingual social, mental health and education services. At CFP, we treasure the beauty and potential of every child and believe that strong families offer children their greatest opportunity to shine. We appreciate the uniqueness of every individual and the importance of providing client-centered services that are relevant to specific needs. We are committed to providing quality services and delivering them with excellence.
Child & Family Partners bases all programs and services on the following core values:
• The uniqueness of every individual should be revered and preserved.
• Children are the hope for the future. They must be protected and empowered.
• We strengthen our community by strengthening families.
• Service must be value-centered and provided with fairness, love and compassion.
• Service to others and our community is a responsibility.
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text:
Iowa Pitches Its Way Past Rutgers, 6-3, In Big Ten/BIG EAST Baseball Challenge Opener
Scarlet Knights to Face Northwestern Saturday
ST. PETERSBURG, Fla. (February 26, 2010) – Down 6-3, Rutgers brought the tying run to the plate with two outs in the ninth and denied a complete-game bid by Iowa starter Jarred Hippen but the Scarlet Knights could not close the gap anymore with a groundout against Hawkeye reliever Kevin Lee in an opening-game loss in the Big Ten/BIG EAST Baseball Challenge at Al Lang Stadium Friday morning in St. Petersburg, Fla.
Rutgers (0-4) and Iowa (2-1), who faced each other during the 2008 season three hours north for a spring break series in Deland, Fla., met in the opening game of the second annual tournament in St. Petersburg, pitting members of the Big Ten Conference against members of the BIG EAST Conference.
A leadoff triple by Zach McCool set the table for a sacrifice fly from Ryan Durant to give Iowa an early 1-0 lead in the opening frame.
The Scarlet Knights countered with a leadoff triple of their own in the second as junior Jaren Matthews (Teaneck, N.J.) found the gap in right-center field and a Jarred Jimenez (Monroe, N.J.) groundout got him home on the next play to tie it up.
RU threatened to take the lead in the top half of the third after junior Brandon Boykin (Teaneck, N.J.) led off the frame with a double and later stole third with one out, but the Scarlet Knights couldn't get him home.
McCool once again set the table for a run for the Hawkeyes with a leadoff single in the bottom half of the third. Mike McQuillan followed with a single to right field to put runners on first and second and McCool scored two plays later as Durant and Dallas Burke hit into a fielder's choice as RU got the out at second on consecutive plays.
Both teams were retired in order in the fourth and the Scarlet Knights and Hawkeyes traded single runs, each with two outs, in the fifth as Iowa held on to the one-run advantage.
Both teams were retired in order in the sixth as Rutgers starter Casey Gaynor (Toms River, N.J.) and Hippen worked into the seventh inning.
After a 1-2-3 frame for Hippen in the seventh, Iowa got a leadoff double from Trevor Willis and moved him over to third on a sacrifice bunt. After a strikeout, Rutgers went to its bullpen for Dan O'Neill (Garfield, N.J.) and with runners on second and third, the freshman induced a pop out and got a big strikeout to deny the Hawkeyes a run in the inning.
Hippen continued to hold the Scarlet Knights at bay with a pair of strikeouts in the eighth and Iowa put a pair of runners on with one out in the bottom half of the frame. Veteran reliever Kevin Lillis (Fair Haven, N.J.) came in for his 77th career appearance – the mark is tied with Matt Pustay (2003-06) for third-most all-time. Iowa's Chett Zeise singled to left field to bring a run home and with two outs in the frame, Kurt Lee found the gap in left-center field for a two-run double to stretch the Hawkeye's lead to 6-2.
Rutgers put runners on first and second with two outs and Hippen's complete-game bid was denied as the Hawkeyes went to their bullpen for Kevin Lee. Senior Jayson Hernandez (Belmar, N.J.) greeted Lee with an RBI single back up the middle to make it 6-3 and RU brought the tying run to the plate with pinch hitter Ryan Kapp (Toms River, N.J.) but the Scarlet Knights could not get any closer as Lee got out of the jam with a groundout to preserve the victory.
Hippen (1-0) earned the win, coming just short of the complete-game with 8.2 innings of work and eight strikeouts with just three runs allowed on six hits. Gaynor (0-2) took the loss despite a solid 6.1 innings with five strikeouts and three runs allowed. Lee posted the one-out save for his second save of the season for the Hawkeyes.
Gaynor's five strikeouts gave him 176 strikeouts for his career and moved him past the late Darrin Winston (175 from 1985-88) for third place on the Rutgers career strikeout list. Gaynor's 6.1 innings brought his career inning total to 230.2 which moved him past Neil Ioviero (230.1 from 1991-94) for seventh place on the Rutgers all-time innings pitched list. Friday was the senior hurler's 39th career start which is the second-most in school history, one behind senior teammate Matt Giannini (Millington, N.J.).
Rutgers returns to action in the Big Ten/BIG EAST Baseball Challenge tomorrow with a 10 a.m. game against Northwestern at Raymond Naimoli Complex. Senior lefty Dennis Hill (Hillsdale, N.J.) will be on the mound for the Scarlet Knights against sophomore righty Francis Brooke for the Wildcats.


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Leapers UTG 5th Generation Quick Detachable Picatinny-Style Double Rail Mount AK-47 Matte
Product #: 990185 Leapers #: MNT-978 UPC #: 4712274522336
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This picatinny-style double rail mount allows for a scope to be mounted on an AK-47. It is constructed of machined aluminum and is adjustable to fit the majority of side rail variants. It features a quick detach lever for simple installation and removal.
Technical Information
Side mount with quick detach lever
Adjustable to fit most side rail variants
Machined aluminum, STANAG dimension and 12 slots on top rail, 8 slots on side rail
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- Maglula LULA Magazine Loader and Unloader AK-47, Galil... $26.95 Available


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Nature enthusiast and fibre artist Leigh Martin has been hard at work on an awesome project entitled 52 Forms of Fungi for which she is knitting beautiful and impressively realistic pieces of fungi each week. They look particularly wonderful photographed in natural settings.
"It's no secret that I have an affinity for fungi, and that I am also a slightly obsessed knitter. I've decided to challenge myself this year (because after all, what is the New Year for if not for challenges) to take my favorite combo (knitting and fungi) to the next level by knitting 52 different forms of fungi in 2013."
Click here to follow Leigh's progress on her blog.
[via Neatorama]


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The city is full of the them. And they're open(ing), with the peak expected from March 20-23 (which is a bit early, but it's been in the 70s here for a week). Chris (in Paris) is coming on Tuesday for the week, so he and I are going to go down to the Tidal Basin (by the Jefferson Memorial) to check out the blossoms with the throngs. DC really is at its best in springtime.
Sasha and I spent the day, yet another prematurely nice day in the 70s, with my friends Matt and Damian hanging out in Matt's yard.


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The TempoTuner eliminates the erratic timing in your golf swing and replaces it swith smooth, even tempo. First, DOWNLOAD a TempoTuner program to your MP3 player, iPod, or smartphone. Then, listen and swing to the music while key words gently guide you through the movements of your swing. Instantly, you experience the "smoothing effect" of the soundtrack. You feel relaxed, less anxious, and your natural instinct is to swing in sync with the program.
The result: a smooth swing and a solid golf shot.


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The American Association of Oral and Maxillofacial Surgeons sponsors two exhibitions annually.
- The AAOMS Annual Meeting, held in the Fall, attracts more than 3,200 members and more than 5,500 registrants.
- The Dental Implant Conference, held in early December, attracts more than 1,200 dental specialists and general dentists.
For more information on AAOMS exhibition opportunities, please contact Valerie Wolf, Exhibition Manager, at 800-822-6637 x4316.
Corporate Support Opportunities
Increase your visibility with AAOMS members and their staff by supporting an AAOMS meeting or event. For further information, please contact Robert Rinaldi, PhD, CAE, Executive Director, at 800-822-6637 x4311 or send a request online.
Exhibitor News
Reminder, onPeak is the AAOMS official housing partner. Hotel Poacher Alert! While other hotel resellers may contact you offering housing for your trip, they are not endorsed by or affiliated with the show.
Exhibition Opportunities
AAOMS 97th Annual Meeting
AAOMS 97th Annual Meeting, Scientific Sessions and Exhibition in conjunction with the Canadian Association of Oral and Maxillofacial Surgeons
September 28 - October 3, 2015
Washington, DC
Space Draw: 2015 Annual Meeting Exhibitor Application
VXH Exhibit Hall Floor Plan
Scientific Sessions and Exhibition in Conjunction with
the Japanese Society and Korean Association of Oral and Maxillofacial Surgeons
September 8 - 13, 2014
Honolulu, HI
2014 Annual Meeting Exhibitor Prospectus
2014 Annual Meeting Exhibitor Application
VXH Exhibit Hall Floor Plan
Items of Interest
Exhibitor Service Manual
Exhibitor Booth Services Order Form
Exhibitor Show Stoppers
Service Manual - Online Ordering
Exhibitor Show Floor Suite Application
Giveaway and Drawing Approval Form
Exhibitor Space Request
New Exhibitor Spotlight Application
Excursion Game Prize Commitment Form
AAOMS Mailing List Order Form
Webinar Slides presented by AAOMS,GES, and Hawaii Convention Center - June 18, 2014
Exhibitor Lunch Order Form - Deadline August 22
OnPeak, the AAOMS official housing partner suggests...
Dental Implant Conference
December 4th - 6th, 2014
Sheraton Chicago Hotel and Towers
Chicago, IL
VXH Exhibit Hall Floor Plan
2014 Dental Implant Conference Exhibitor Prospectus
2014 Dental Implant Conference Exhibitor Application
Items of Interest
Function Space Request
2013 Virtual Exhibit Halls
Dental Implant Conference
December 5-7, 2013
Chicago, IL
AAOMS 95th Annual Meeting
October 7-12, 2013
Orlando, FL
Questions? Contact the Exhibits team at email@example.com or 847/678-6200 or 800/822-6637


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Archive for September 21st, 2014
Lenovo IdeaPad U330 2267-58U 13.3-inch Laptop – $500 Shipped
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BlackBerry Tour 9630 Black for Verizon Wireless – $0 Shipped
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Amazon Deals
Onkyo TX-SR607 7.2-Channel A/V Surround Home Theater Receiver – $379 Shipped
Amazon has the Onkyo TX-SR607 7.2-Channel A/V Surround Home Theater Receiver for $379 + free shipping = $379 shipped! This receiver has a 7.2 channel surround sound, 90 watts per channel, 1080p video processing, Deinterlacer wi...
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Sony Bravia V-Series KDL-40V5100 40-Inch LCD Flat Panel HDTV & Sony BDP-N460 Blu-ray Disc Player – $853 Shipped
Electronics Expo, via Amazon has the Sony Bravia V-Series KDL-40V5100 40-Inch LCD Flat Panel HDTV & Sony BDP-N460 Blu-ray Disc Player for $853 + free shipping = $853 shipped! This TV has a 1920x1080 resolution, built-in HD ...
Samsung SL502 12MP Black Digital Camera – $108 Shipped
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Beach Camera Deals
Toshiba 42ZV650U 42-inch LCD TV – $759 Shipped
BeachCamera carries the Toshiba 42ZV650U 42-inch LCD TV at the bottom of the price barrel. Features include a 1920x1080 resolution, 240hz refresh rate for reduced motion blur (120hz doubled), PixelPure 5G 14-Bit Internal digit...
BuyDig Deals
Samsung LN55B650 55-inch LCD TV – $1,574 Shipped
Buydig.com has a super low on the Samsung LN55B650 55-inch LCD TV, though it's not the cheapest they've ever had it. This TV has a 1920x1080 resolution, 120hz refresh rate, 100,000:1 dynamic contrast ratio, 4ms response time an...
Nokia E63 Red Smartphone (unlocked) – $160 Shipped
Dell has a coupon deal for the Nokia E63 Red Smartphone (unlocked). This cell phone has a GSM connectivity, Bluetooth, microSD card slot, 2 megapixel sensor, 2GB storage, QWERTY keyboard, FM radio, media player, WiFi b/g, Blue...
BuyDig Deals
Canon PowerShot A480 Red Digital Camera – $90 Shipped
I've never seen a lower price for the Canon PowerShot A480 Red Digital Camera. It has a 3x optical zoom, 10 megapixel sensor, SD card slot, 2.5-inch LCD and more. It's (more…)
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Garmin nuvi 265/265T 3.5-Inch Bluetooth Portable GPS Navigator with Traffic – $124 Shipped
Buy.com, via Amazon $329.99 - $206 instant savings + $0 shipping = $123.99 shipped! This GPS has traffic, a 3.5-inch touchscreen, City Navigator for North America, Bluetooth for hands free calling, photo viewer, text to speech ...
Amazon Deals
CyberPower CP1000AVRLCD UPS – $107 Shipped
Price drop alert! Buy.com, via Amazon now carries the CyberPower CP1000AVRLCD UPS for $99.95 + free shipping = $99.95 shipped! This system can power your computer in the case of a power failure, has 600 watts of power, 9 outle...
Acer X223WDbd 22-inch Widescreen LCD Monitor – $140 Shipped
Newegg has the Acer X223WDbd 22-inch Widescreen LCD Monitor for a great deal. This monitor has the following specs: 1680x1080 resolution, 250 cd/m2 brightness, 1000:1 contrast ratio, 5ms response time and VGA/DVI inputs. It's...


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Crystallize Meets Elements - Lindsey Stirling Original (Samuel Lin 5 Instruments Cover) ft. Junoflo
I had the honor of being featured on this epic track for a remix contest that my talented buddy Sam Lin just entered. Ain't no instrument he can't play. Recorded & filmed everything in 2 days on our campus, UCSD. Enjoy!


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See and share Beautiful Nature Photos and amazing photos of interesting places
"The harder you work, the luckier you get."
Gary Player
Below is the poem entitled Penn Avenue Blues which was written by poet
Harrison. Please feel free to comment on this poem. However, please remember, PoetrySoup is a place of encouragement and growth.
Read Poems by
Marie Harrison
Penn Avenue Blues
Forever I roam
I have no home
And I'm alone
My heart is cold
And my bones grow mold
My soul has been transposed
Love doesn't glow between my toes
I've had too much blow up my nose
My life is about to close
I'm a clone of a ghost
I need a strong cup of French Roast


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Bits, Bytes & Bots is a home-based computer enrichment company.
|Bits, Bytes & Bots
|Bits, Bytes & Bots Makes Learning About Technology An Adventure
|Bits, Bytes & Bots Computer Adventures
|Technology In Action, Complete (8th Edition)
|Alan R. Evans, Kendall Martin and Mary Anne Poatsy
|In today's technological age, computer literacy is important for everyone, and now learning the basics is easier than ever. A Computer Concepts Text Focused on Today's Student,Technology in Action engages students by combining a unique teaching approach with rich companion media. The eighth edition has been updated to reflect the latest developments in computer technology. New interactive learning tools have also been added to enhance student engagement. Student CD is included with every text, containing: · Sound Bytes: Multimedia lessons that demystify computer concepts with audio and video presentations. · Sound Byte Podcasts: The Sound Bytes are now also available as podcasts. · Active Helpdesk Calls: Highly interactive, engaging, almost game-like media that places the student in the role of a helpdesk staffer answering computer technology questions from callers. Why Computers Matter to You: Becoming Computer Literate; The History of the PC; Looking at Computers: Understanding the Parts; Using the Internet; Ethics; Application Software: Programs That Let You Work and Play; Using System Software: The Operating System, Utility Programs, and File Management; Understanding and Assessing Hardware; Networking and Security: Hackers and Viruses; Protecting Your Computer and Backing Up Your Data; Mobile Computing; Digital Entertainment; System Hardware With an array of fun and engaging learning tools, Technology in Action teaches students computer fundamentals, from learning Microsoft Office to setting up their own home network.
|Handbook of Informatics for Nurses and Healthcare Professionals (4th Edition)
|Toni Lee Hebda and Patricia Czar
|This useful handbook introduces nurses and other health care professionals to the most current application of computer-related technology in the health care environment. Included are the various forms of electronic communication and ways to use it more effectively. New coverage of web-based technology, search tools, and evaluation criteria for online material are presented along with regulatory and accreditation requirements, such as HIPAA. Completely updated, the fourth edition offers a clearly written overview of informatics, as well as practical applications of computer-based education for day-to-day use.
|Discovering Computers, Brief: Your Interactive Guide to the Digital World (Shelly Cashman Series)
|Gary B. Shelly and Misty E. Vermaat
|Students are guided through the latest trends in computer concepts and technology in an exciting and easy-to-follow format. Updated for currency, DISCOVERING COMPUTERS: BRIEF provides the most up-to-date information on the latest technology in today's digital world.
|The Internet Book: Everything You Need to Know About Computer Networking and How the Internet Works (4th Edition)
|Douglas E Comer
|Internet Book, The: Everything You Need to Know About Computer Networking and How the Internet Works, 4/e utilizes a non-technical perspective to explain the technology of how computers communicate, what the Internet is, how the Internet works, and what the Internet can do for people. This book works to fully connect readers to the "big picture" by presenting a solid overview of networking and the Internet, rather than burying them with details. Comer assumes no prior background in computer networking or the Internet. Introduces computer communication system concepts and technology, reviews the history of the Internet and its growth, describes basic Internet technology and capabilities, and describes services currently available on the Internet and how to use them. For anyone interested in learning how to navigate the Internet to its full potential.
|Your Guide to Operating A Computer-Based Business at Little or No Cost!
|LaDonna D. Vick
|This book gives you step-by-step instructions on how to start your Computer-Based Business absolutely FREE. It is a comprehensive guide that will take you step-by-step on how to operate your computer-based business at little or no cost. It will tell you the "rules of the road" for a mail order business, what the top product and service oriented home businesses are, how to obtain a FREE host for your website, how to gain FREE Internet access, how to develop a low cost/FREE marketing strategy, how to accept credit cards with NO set-up or monthly fees, basically everything you need to know to start and run your computer-based business today and much, much more.
|Computer System Architecture (3rd Edition)
|M. Morris Mano
|Dealing with computer architecture as well as computer organization and design, this fully updated book provides the basic knowledge necessary to understand the hardware operation of digital computers. Written to aid electrical engineers, computer engineers, and computer scientists, the volume includes: KEY FEATURES: the computer architecture, organization, and design associated with computer hardware • the various digital components used in the organization and design of digital computers • detailed steps that a designer must go through in order to design an elementary basic computer • the organization and architecture of the central processing unit • the organization and architecture of input-output and memory • the concept of multiprocessing • two new chapters on pipeline and vector processing • two sections devoted completely to the reduced instruction set computer (RISC) • and sample worked-out problems to clarify topics.
|The Laptop Repair Workbook: An Introduction to Troubleshooting and Repairing Laptop Computers
|Morris Rosenthal
|This book will help you troubleshoot your laptop problem and take the most cost effective approach to repairing it, getting it repaired, or replacing it. But the troubleshooting process depends on your observations of the symptoms and your willingness to keep your mind open to solutions other than your first impression, or those suggested by friends who say they had "exactly the same problem." If the laptop is still usable but acts up, pay close attention to when and where it acts up, whether the problem always occurs after the laptop has been moved, or shut-down for the night, or running all day. Even the weather plays a part in troubleshooting some problems, so try to read through all of the general troubleshooting sections, just to get a feel for the things that go wrong with different components. If it doesn't make you into a laptop hypochondriac, it will make you a stronger diagnostician.You may notice we don't talk about the razzle-dazzle technology of computer components in this book. The reason is simple. You can't upgrade or repair your laptop by using the latest technology available, nor can you save money by repairing it with older technology rescued from a random laptop at the recycling center. You have to use the exact parts your laptop was engineered to work with. Hard drives and memory are the only replaceable parts that are often compatible between models of a similar vintage. For some readers, the lack of an illustrated discussion on how hard drives store data bits will take some fun out of the book, but that knowledge can't help you when it comes to troubleshooting. There are plenty of books with beautiful color illustrations that try to explain basic computer technology, but they do so at the expense of helping you solve real laptop problems.Two final notes about using this workbook. First, if your laptop is in warranty, it doesn't make any sense to take it apart in hopes of fixing something yourself. This book can still help you troubleshoot the problem to determine if it's a software setting or incorrect use, which may save you sending the laptop out for repair. Second, feel free to cut out the twelve flowcharts in the second half of the book and staple them together. This will save on page flipping as you read the expanded explanations of the decision symbols. It's a workbook, not English literature.The Laptop Repair Workbook includes twelve full page troubleshooting flowcharts for laptop hardware troubleshooting and explanatory text for every decision point. The book begins with an introduction to basic laptop terminology, troubleshooting procedures, and cost decisions. Supplementary illustrated tests and procedures are available on the publisher's website and an ebook version is also available direct from the publisher.
|Technology In Action, Complete Version (7th Edition)
|Alan R. Evans, Kendall Martin and Mary Anne S. Poatsy
|For introductory courses in computer concepts or computer literacy often including instruction in Microsoft Office.A Computer Concepts Text Focused on Today's Student! Technology in Action engages students by combining a unique teaching approach with rich companion media.The seventh edition has been updated to reflect the latest developments in computer technology.
|Discovering Computers - Fundamentals 2011 Edition (Shelly Cashman)
|Gary B. Shelly and Misty E. Vermaat
|Students are guided through the latest trends in computer concepts and technology in an exciting and easy-to-follow format. Updated for currency, this book and the robust Online Companion provide students with the most up-to-date information on the latest technology in today's digital world.
|Hackers and Painters: Big Ideas from the Computer Age
|Paul Graham
|"The computer world is like an intellectual Wild West, in which you can shoot anyone you wish with your ideas, if you're willing to risk the consequences. " --from Hackers & Painters: Big Ideas from the Computer Age, by Paul Graham We are living in the computer age, in a world increasingly designed and engineered by computer programmers and software designers, by people who call themselves hackers. Who are these people, what motivates them, and why should you care? Consider these facts: Everything around us is turning into computers. Your typewriter is gone, replaced by a computer. Your phone has turned into a computer. So has your camera. Soon your TV will. Your car was not only designed on computers, but has more processing power in it than a room-sized mainframe did in 1970. Letters, encyclopedias, newspapers, and even your local store are being replaced by the Internet. Hackers & Painters: Big Ideas from the Computer Age, by Paul Graham, explains this world and the motivations of the people who occupy it. In clear, thoughtful prose that draws on illuminating historical examples, Graham takes readers on an unflinching exploration into what he calls "an intellectual Wild West." The ideas discussed in this book will have a powerful and lasting impact on how we think, how we work, how we develop technology, and how we live. Topics include the importance of beauty in software design, how to make wealth, heresy and free speech, the programming language renaissance, the open-source movement, digital design, internet startups, and more.
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American Idol Season 10 Winner – Scotty McCreeryMay 25, 2011 by Popstarbiz | Filed under American Idol, Television.
The Result : Scotty McCreery Wins American Idol 2011!
Scotty McCreery, 17, wins American Idol Season 10 on Thursday, May 25, 2011. Congratulations Scott!
Performance Spoilers :
Lauren Alaina duet with Carrie Underwood
Scotty McCreery duet with Tim McGraw
Casey Abrams duet with Jack Black
James Durbin duet with Judas Priest
Haley Reinhart duet with Tony Bennett
Beyonce performing with Top 13 girls (We run the world! Girls!)
Tom Jones performing with Top 13 guys
Steven Tyler might sing 'Dream On'
Jennifer Lopez might perform as well
Watch American Idol Finale Red Carpet – Here
We'll give you live updates here :
– Get ready!← Previous
Tags: american idol 10 live, american idol 10 performances, american idol 10 red carpet, american idol 10 update, American Idol 10 Winner, lauren alaina wins american idol, scotty mccreery wins american idol


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"Interviews with interrogators"
Vaughan Bell over at Mind Hacks posted a bunch of fantastic links of interviews with interrogators (CIA, U.S. Army, MI5, MI6, and British Intelligence Corps) that were used for the book Brainwash by Dominic Streatfeild.
If you are familiar with the Science of the KGB interviews, then this will be up your alley.
Bet we'll find Occultist rummaging through the bins.
(via WCBS 880)
Bet we'll find Occultist rummaging through the bins.
(via WCBS 880)
pro tip: just buy and go. don't ask questions. they hate that. and no side eye. trust me.
This site complies with the HONcode standard for trustworthy health information: verify here.
Scaffold theme by Mike Harding.


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Mars One is an initiative to migrate small groups of people to Mars, using currently available technologies. The current schedule is to land the first group of four on Mars in 2023, with an additional crew landing every two years.
The design team has been working on the planning in 2011 and has recently sought publicity for their plans in order to secure funds. The power of this mission concept is that it uses technologies which are available today or in the near future, such as the falcon heavy and life support that is currently in use in the ISS.
With ambassadors as Prof. dr. Gerard 't Hooft (nobel prize winner), Mary Roach (writer) and Prof. dr. ir. Ambrosius (chairman of Delft Technical University's Astrodynamics and Space Missions faculty) the group aims to be both visionary and feasible.
I wish them the best of luck. I hope to hear more from them soon. Go check out their website: http://www.mars-one.com/
Brutal Simplicity Theme


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Army denies rumor that Tomás Borge has died.
Said the Commander is recovering in the intensive care unit of the Military Hospital "Alejandro Dávila Bolaños' after a lung operation.
Borge is Nicaragua's Ambassador to Peru.
He entered the military hospital several days ago as confirmed this afternoon by Rosario Murillo, coordinator of the Communication and Citizenship Council
Murillo said that she and President Daniel Ortega are in constant communication with the medical team treating Borge.
The First Lady said that "virtually every half hour" they are receiving reports "in terms of his improvement and the process he is going through after he underwent surgery last Friday," she said.
On Sunday, President Ortega visited and talked with Borge in the hospital.
Borge is almost 82 years old.
- Juanno's blog
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Another piece of history gone.
What I remember about him is that he forgave his torturer.
Rebecca Brown
is that a joke?
Wow, what a great man! He "forgave his torturer".
And then became one himself.
When asked what three men he admired most, Yoda replied:
"First, Fidel Castro. Second, Fidel Castro. Third, Fidel Castro. Fourth, Fidel Castro. Fifth, Fidel Castro."
One can only hope there is a Hell and that this evil little dwarf is roasting!
Fidel Castro is the True President of the US
Ask Lawrence Ferlinghetti.
Rebecca Brown
Most feared
He was, arguably, the most feared Sandinista – and not just because he controlled the secret police, prison system, media, foreign intelligence, clandestine prisons, divine mobs, special operations, tribunals, etc., as Interior Minister for more than a decade.
Are you're confusing him with Lenin Cerna?
Son of two communists, head of intelligence, and rumored to have skinned people alive. Can't remember where precisely I read that, but the State Department's paper up on Wikimedia has a run-down on all the players. http://en.wikisource.org/wiki/Nicaraguan_Biographies/Name_Index; also http://en.wikisource.org/wiki/Nicaraguan_Biographies/Inner_Circle#16 The State Department is pushing their case here, so not utterly reliable on all the details, but that's not the only place where I've read about Cerna.
Friend of mine here said that his father hid Borge during the revolution. Didn't get any sense from him that Borge was in the same league, reputation-wise as Cerna, from what I've been reading.
Rebecca Brown
you are so right man
Cerna learned everything he's become from Borge,thou IMO borge was smarter about it,more political sometimes, where as the cerna is more bully .
Good advise
Rebecca, this is really good advise, Juanno hit the nail on the head. Listen to what the people are saying here, do not repeat it, just listen. I have found that doing just this you will hear what they are really saying - and it's always the same people saying the same thing.
Probably shouldn't have repeated it
Mheh. I trust my eyes and senses far more than anyone else's.
South Carolina and much of the rest of the US South were mild police states when I was growing up, perhaps not so mild if you were black -- women not allowed to serve on juries; blacks hardly allowed to vote. Yet most people just lived their lives. I don't think political conditions, absent being Jewish in Nazi Germany and not working for Leica or being Stalin's political rivals, matter as much as we've been led to believe. Religions are all about encouraging people to accept less now for the big future posthumous pay off.
And blacks wouldn't tell white anything, but the body language was pretty telling. I don't see that kind of body language here.
Whatever things were like the 1980s, I don't know. They were fighting the US, which, however well it does or doesn't run its internal politics, tends to be a bully internationally.
Rebecca Brown
They were not fighting the US
They were fighting their fellow Nicaraguans, starting with the Sandinistas who spun off from the frente to fight against the leftist clique that ran it. In the immediate post-Vietnam era, the US was too confused and defeatest to do much of anything. Only Ronald Reagan had a clue what was going on in the Soviet camp, and the will to act. At the time I thought he was nuts, but history proved him right.
"You can avoid reality, but you cannot avoid the consequences of avoiding reality." Ayn Rand
Um, and the social democrats were in charge all along
The biographer of Carlos Fonseca was extremely upset that the third faction had not been really interested in anything other than a mixed economy.
I was telling my brother recently that it's amusing living in a place where Socialist is a meaningless buzz word with good connotations rather than the silliness in the US where Socialism is a meaningless buzz word meaning "OMG, we have a Negro president."
Rebecca Brown
You also might try reading the local press, social media, and other internet fora. Of course these are in Spanish. You might try taking classes. Amazing how anyone can live here without knowing the language.
Lenin Cerda - er, Cerna - is in a league of his own. Even the Stasi were impressed with his utter disregard for humanity and his brutal repression tactics. And he worked for whom???
Yoda was an evil man. Anyone who dared speak ill of the F$LN was an "enemy of the revolution" and oppressed. He implemented the CDC to be the "eyes and ears" of the revolution -- brought in from Fidel by the thousands of Cuban "advisors". Of course Fidel got the idea from the Stasi who got it from Stalin who got it from Lenin.
The evil dwarf's idea of a free press was stolen directly from Goebbels. He personally censored La Prensa on innumerable occasions and shuttered it twice. On one occasion he threatened to throw their presses into the Gates of Hell (that would be Volcan Masaya) and the editorial directors in after them (note that one of those people was Violeta Chamarro, widow of the martyr, and former fellow National Junta member).
And since you live on the border of the indigenous communities, find an old Mayanga man or woman and ask them about the burning of their villages, the forced relocation of other villages, the wholesale clear cutting of old growth forests on indigenous lands by the Bulgarians ("our fraternal socialists brothers" [sic]{and sick}).
And especially ask ANY indigenous person about Navidad Roja.
The man (term used loosely) was a thug cut from the same cloth as Che, Fidel, Stalin, Mao, the endless Kim family, et al. Zeus only knows why the leftists cherish and praise these pond scum.
The evil dwarf is dead. Good riddance.
Knowing the language is not an either/or thing
And conditions on the ground anywhere are more complex than ideologues seem to believe.
People who think in either/or categories simply don't have enough information.
I've never understood the rights' fascination with Reagan, either.
Rebecca Brown


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Word: 飼い猫
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飼い猫 = Pet cat
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Millions of people with heart burn eventually can't eat any foods, because the medicines to prevent acid reflux stop working.
"I couldn't lean down to get something out of the cabinet, because even that would trigger my acid reflux, I was in constant pain. It was miserable," said Diane Picket, who was desperate for a surgical solution.
Through research Diane Picket found Dr. Gopal Grandhige, a leading expert in the surgical treatment of gastro-esophageal reflux disease, or GERD.
Dr. Grandhige is one of the few doctors in the state of Florida performing the a minimally invasive procedure to implant an FDA breakthrough medical device called LINX®, in those patients suffering with acid reflux, who no longer feel relief from over-the-counter or prescription drugs.
"It's laparoscopic, but the procedure heals pretty well, 30 minutes to an hour depending on a person's surgical history. But we encourage them to start eating regular foods that night," Dr. Grandhige said.
LINX®, is a small flexible band of magnetic beads that is placed around the esophagus. The magnetic attraction helps the sphincter stay closed to prevent reflux.
After having the procedure, patient Diane Pickett, can eat whatever foods she wants, and is off medications related to acid reflux.
"It's like I have my life back," Pickett said.
Dr. Grandhige practices in Brandon with Suncoast Surgical Associates.
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Just bought another tube at about $30 with tax....and it's worth it. Just can't beat the volume and length that this gives underneath ANY mascara. It's a fabulous primer, however, I don't think it does much as far as actually growing lashes longer; it didn't for me anyway.
1 out of 1 people found this review helpful. Did you? Yes No
Nothing beats my Shiseido mascara base which holds curls, nourishes, adds length and volume....this Diorshow primer was no exception. I'm sure it'd work great for someone that doesn't have short, stick-straight, downward-pointing, Asian lashes like me cuz it did add volume, but did not hold a curl for the kife of me. Steep price point and the brush was too big for my small eyes. Don't get me wrong, it is a high quality formula...just not for me. I look for length and most importantly the ability to hold a curl and this just didn't give it to me.
More reviews by LittlePrincessJasmine
I love this product, definately the best maximizer. I have tried MUFE lash maximizer, It works good, but it dries white. The Dior one dries clear and that makes a big difference. Worth the price.
1 out of 1 people found this review helpful. Did you? Yes No
I absoloutley love this serum! I already have long eyelashes, so I honestly got this more for keeping my eyelashes in good condition & have less lash fall out. This serum goes on white, but dries to almost invisible, but there's still some traces of white left over. I was skeptical of this actually working, but I decided to buy it anyways. & wow I'm glad I did. This not only adds incredible length, volume, & holds a curl....but this also defines each lash perfectly. I've never seen anything like it. This is super buildable & makes applying any mascara a breeze. This makes my mascara application faster. I wouldn't use this right before applying mascara, because it can make your eyelashes clumpy. I put this on at night before I go to bed, & it still gives my lashes an amazing effect when I do my make up in the morning. This is pretty expensive...It's $28-$30. But, the tube is pretty big & comes with a lot. I haven't been using this that long, so I will update on if this makes my lashes grow in better & how long this tube lasts me to see if this is really worth the money. Overall, I love this & I'm happy with my purchase. This really blows all other lash serums out of the water.
**UPDATE:** I've been using this for a while now & I've come to a few conclusions. 1) This does NOT make your eyelashes miraculously grow, like the bottle says. This is only a primer & the reason it extends lashes to make them "appear" longer is because this contains fibers which extend your lashes, but temporarily. I'm not a fan of false advertising, so that's why I'm changing my 5 star review to a 4 star. The bottle should not say this makes your eyelashes grow, when they clearly know it doesn't. 2) This works best if you apply at night, not directly before applying mascara. You still can apply this before mascara, but I would only use a little bit or this will make your lashes clump easier. 3) This does help with the durability of my eyelashes. I do notice less lash fallout when I wash my eye makeup off at the end of the night, which is a major PLUS.
In conclusion, because there are more "pros" than "cons", I will probably still buy this again. Overall, what this basically does is prime your eyelashes to make your mascara go on smoother, thicken your lashes with the serum, & extend your lashes with the fiber. But, that's honestly all I was looking for this to do, so I'm good with that. Although, I will admit, I was still a little dissapointed that this did not make my lashes grow in longer/better. But then again, this is not doctor prescribed latisse. & I do agree with the other reviewers that said this is just a clear mascara. If this came in the color black, this would be a normal mascara. So, this is basically a $30 clear mascara...but it's a good one:)
1 out of 1 people found this review helpful. Did you? Yes No
this is UMAZING. today i woke up and thought i was still wearing mascara. upon poking my eyelashes, i discovered my eyelashes are NATURALLY CURLING. um, WHAT?
fyi: i have notoriously short, black, stumpy asian eyelashes.
i have been wearing this on and off for the past few months, not sure if it's this or the fish oils or biotin or what i've been taking but my eyelashes are definitely 2x as long as before. as someone who has used the revlon store dupe and revitalash or whatever, this is the only thing that has EVER made any sort of noticiable effect on my eyelashes.
bonus - also makes it look like i'm wearing falsies when i do have it on. LOVE! the tube / packaging is totes cute as well. :D
2 out of 2 people found this review helpful. Did you? Yes No
This product is amazing. Sadly I will not buy it again because it's so expensive. This product really conditions your lashes and actually makes it grow longer and thicker if you use this product religiously. It makes my eyelashes so much longer and it lifts up my eyelashes. I love this product.
3 out of 3 people found this review helpful. Did you? Yes No
First of all I want to write that I did not purchase this to achieve longer or thicker lashes. Im one of those lucky ones that has naturally long, thick lashes with a curl. I purchased the serum for better mascara results. I do like this serum but only paired with certain mascaras and it just happens to be that Lancome's Hypnose Drama is the perfect mascara for this lash maximizer. I also own Lancome's Cils booster which I like just a bit better than Dior's because Lancome's works with most of my mascaras including their own (Hypnose and Doll Lashes)
I know it sounds crazy but for some reason I noticed Dior's booster works better on volumizing mascaras while Lancome's is great on all mascaras but works best on defining and those more natural looking mascaras like Chanel's Inmitable original or intense or Lancome's Defincils (which I hate) Overall this is a great product I would recommend highly. Dior's serum and Lancomes are both excellent its a personal preference and it depends on what kind of mascaras a person uses. If it came down to it I probably would go with Lancome.
3 out of 3 people found this review helpful. Did you? Yes No
I've been using this product for about 6 months. I apply it before using my mascara and it makes my lashes longer and fuller. I also have noticed that my natural lashes have grown longer....my lashes are usually short and straight. Although quite expensive...I love it and will continue to buy.
2 out of 2 people found this review helpful. Did you? Yes No
I had your basic short Asian lashes until I started using generic Latisse. Now I have long straight lashes. I was getting them permed, but that's such a hassle, and I also thought it might be harming my lashes. So I let them go straight and checked out Dior's Lash Plumping Serum. Yowza! They don't curl my lashes but kind of push them up and extend them even longer, yet they don't get spidery at all. If they clump after mascara, I comb them with this great eyelash comb I got on Amazon. The final effect is gorgeous and ohhhhhh so worth it.
2 out of 2 people found this review helpful. Did you? Yes No
first of I'd like to say I'm a person who doesn't believe in primers regardless of where on the face you are supposed to apply them.
add to that the fact that this tube costs $40 over here made me really hesitate to try it. however I finally caved in and gave it a go.
this primer applies white which can be annoying if you make a mistake but lets you know that there is something on your lashes so you're doing it right.... after a coat of this I applied my usual Mascara and the difference was really dramatic!!!! my lashes looked thicker and longer, the curls held! my Mascara isn't flakie so I can't comment on that but there was ALOT less clotting and my lashes didn't end up in the sink when I remove my make up later in the evening.
this tube is pretty expensive but it actually gives noticeable results, I'd recommend it fore Mascara lovers!
2 out of 2 people found this review helpful. Did you? Yes No