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Archived Story
Mingo's lung injury called 'mysterious'Published 1:27am Thursday, August 22, 2013
BEREA (AP) — Barkevious Mingo's injury has gone from maybe serious to mysterious.
Cleveland's rookie linebacker remains sidelined with a bruised lung, a "freakish" injury the first-round pick believes he sustained nearly a week ago on the opening kickoff of an exhibition against Detroit.
Mingo was hospitalized for two days with the injury, which he said caused him to twice spit up blood and gave him shortness of breath before he was taken out of last Thursday's game. Mingo said he has been symptom free since last week, but it's still not clear when he was injured.
Mingo will not play in Saturday's preseason game at Indianapolis, and it's likely he will be kept of the final exhibition against Chicago as well.
On Wednesday, Mingo was seen taking a nap while lying across several chairs in the locker room. After he woke up, he told reporters that he has improved, but that doctors still aren't allowing him to practice. He reiterated that he does not think the injury occurred before last week's 24-6 win over the Lions, and said he had never had those symptoms before experiencing them on the sideline.
"Everything is feeling good," Mingo said. "Everyone is happy with the progress and now we're just waiting to see what the doctors say, so we can get back."
Mingo was last seen by doctors and had more tests on Tuesday, but the No. 6 overall pick has not been cleared to practice and hasn't been told when he'll be able to return to the field. For the moment, he's only allowed to observe practice, and doctors have discouraged him from doing any running.
Mingo was joined on the sideline by starting outside linebacker Jabaal Sheard, who was held out with an unspecified knee injury. Browns coach Rob Chudzinski did not mention Sheard as one of the players who would miss practice when he was asked for a list earlier in the day. During practice, a team spokesman said Sheard is day-to-day.
The sight of Mingo and Sheard standing side-by-side on the sideline with towels draped over their heads had to be concerning to the Browns, who are counting on the pair to rush the quarterback. With Sheard out, Quentin Groves worked with Cleveland's first-team defense on the opposite side of Paul Kruger.
The Browns will wait for Mingo's bruise to heal completely before he's allowed back on the field. He's promised he'll try to be a patient patient.
"I'm listening to the doctors, listening to the coaches," he said. "That's all I know."
Chudzinski didn't provide much of an update on Mingo.
"The timeline nobody really knows exactly," he said. "It is just a matter of how quickly his body heals."
Mingo doesn't recall being hit on the opening kickoff last week or remember any significant impact that may have caused his unusual injury. As he waits for medical clearance, Mingo is doing all he can to stay sharp. He's asking veteran teammates for pointers and offering encouragement as they go through drills without him.
He said it's not difficult to stay upbeat while watching.
"This is what we do as football players," he said. "We listen to our coaches and if they say we want you to run down there and hit that guy on the play, you go down there and hit the guy on the play. If you've got to sit out for a couple weeks or whatever, you sit out and then you come out ready to go."
Mingo, who last month signed a four-year, $16.35 million contract with a team option for a fifth year, could only remember missing one game because of injury. He said it's weird having to watch.
"That's one thing they (doctors) were talking about," he said. "You feel great but you're not going to be (great), so you might as well rest up."
NOTES: DE Brian Sanford was back after his trade to the Seahawks was rescinded when guard John Moffitt failed his physical with the Browns. Sanford flew to Seattle, took a physical and thought he was starting a new NFL chapter when he was told to head back to Cleveland. It was a strange 24 hours. "Experiences like these, you should soak in, because in this league you never know where you're going to be or what's going to happen," he said. "I'm just gonna play as hard as I can and hope I can continue my career playing football." … Chudzinski named Tashaun Gipson the club's starting free safety alongside T.J. Ward. … Chudzinski said Cleveland's starters will play most of three quarters on Saturday against the Colts, but running back Trent Richardson and others coming off injuries may play less. … Rookie CB Leon McFadden intercepted two passes during practice.


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Software Development Intern Interview Questions
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"Give me 5 different ways of finding the median (middle element) of a linked list. For the sake of simplicity, assume the list has odd number of ints. Also mention the runtime for each. Follow up..."
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We are a handmade tile and polymer clay art showroom/studio located in Northeast Minneapolis Art District. We are a husband and wife team both creating our art work in different types of clay. Josh Blanc makes handmade ceramic tile and Layl McDill creates polymer clay sculptures with her "Silly Millies" (polymer clay millefiore canes).
Clay Squared to Infinity is also a tile showroom that carries local and national contemporary tile artists and reproductions from seven historic tile companies from the Victorian, Arts & Crafts and Mid-century periods 1890's to 1950's. Come in and view our beautiful showroom and meet our friendly knowledgeable staff and we will help you with your tile projects. Take classes and discover Clay Squared to Infinity's amazing work.
Using classic subway 3x6 running bond tile it created quite balance of expressive strokes to create this Asian inspired Arts & Crafts kitchen. Click here to check out more photos of this project.
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Ages 8 to 98 will learn magical techniques with colorful oven baked clay. Roll, flatten, wrap and then slice to reveal amazing designs like stars, flowers and swirls. Then take your slices and cover anything you choose from the collection of objects including- frames, jars, boxes, utensils and pins. Or make a creature like a frog or owl! You'll be amazed what you can do!
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Select Local Merchants
Little Caesars St. PaulRead MoreMore than 50 years go, Mike Ilitch was poised for major-league glory. An up-and-coming shortstop for the Detroit Tigers, his baseball finesse was blossoming when an injury derailed his sports career. But although the wound stunted his athletic aspirations, it steered him toward a new path, and on May 8, 1959, he and his wife opened the first Little Caesars location, a then-unheard-of carry-out-only joint. The career shift and novel technique eventually proved triumphant. Today, the pizzeria's iconic, toga-clad mascot adorns storefronts on five continents. In each shop, staffers forge the signature Hot-N-Ready pizza, a freshly baked pizza designed for instant pickup, and warm, garlicky Crazy bread. With a storied half-century under their belt, Mike Ilitch and his family strive to give back, supporting local organizations and creating their own charitable programs.1688 White Bear Ave.Maplewood, MN US
Pizza RanchRead MoreEase your appetite with delicious bites from Pizza Ranch in Saint Paul. Save money on a sitter — kids are welcome to join the table at Pizza Ranch. If time is of the essence, Pizza Ranch's take-out option may be a better fit. Fed up with difficult parking? At Pizza Ranch, you will find easy nearby parking and good eats.1845 County Road DSaint Paul, MN US
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Papa Murphys Take n BakeRead MoreA well-known restaurant in Saint Paul, Papa Murphys Take n Bake on 10th St N is the perfect location for terrific pizza and tasty pub food. It's a culinary destination for those that want great food. If you're in a hurry, you can call ahead and take advantage of the convenient take-out offerings. Or, if you just want to stop by for a drink, the restaurant has a good selection at its bar. One of the better pizza chains in the area, Papa Murphys Take n Bake stands out, no matter how you slice it. Don't worry about trying to find a spot on the street, as visitors to the restaurant do have access to a private parking lot nearby.7017 10th St NSaint Paul, MN US
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Pino's PizzaRead MoreTake a break with a hot slice at Pino's Pizza — this casual pizza joint is a favorite in Saint Paul's Woodbury community. Keep your diet in check at Pino's Pizza, a local restaurant with gluten-free and low-fat menu items. Have a few picky young eaters in the family? Not a problem at Pino's Pizza, where the food and ambience are perfect for family dining. Place an order for pickup or schedule a delivery — the pizzeria makes it easy to enjoy your meal from anywhere. The pizzeria has catering services as well. Diners at Pino's Pizza will be happy to know that free parking is always available. Pino's Pizza is a mid-priced establishment, with the average meal costing under $30. Early risers and night owls alike can enjoy Pino's Pizza since it offers breakfast, lunch, and dinner.2110 Eagle Creek LaneSaint Paul, MN US


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Video: Partying at Nixon Sandbar on Fourth of July
On weekends and holidays Miami-area sandbars like Nixon and Haulover frequently transform into some of the area's hottest water party spots. But policing the areas is exceedingly difficult, and after a spate of high-profile accidents at Nixon -- including the May 4 death of 23-year-old Ernesto Hernandez, who was killed after being sucked into the running propellers of a boat operated by DJ Laz -- the Key Biscayne Village Council has moved to block off the area from motorboats as a safety initiative.
See also: DJ Laz and the Dinner Key Boating Disaster: Too Many Watery Deaths
The night of the Fourth saw more tragedy on Biscayne Bay. Just before 10:40 p.m. a 32-foot Contender with five young people on board smashed into a boat carrying a family of eight, then careened into another vessel. Four were killed and three seriously injured, making the crash the area's bloodiest boating accident in recent memory. But in South Florida, where a culture of permissive partying has long coincided with famously lax boating regulations, it was far from the first.
For more read this week's feature story on the tragedies and Florida's lax boating regulations.
Video by Adam Hendel.
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Study: Mobile Internet Use in 2012
Pew Internet & American Life Project has revealed new statistics that could have a profound impact on how websites are built in the near future.
Pew Internet & American Life Project has revealed new statistics that could have a profound impact on how websites are built in the near future.
Cell Internet Use 2012 Study
According to new data from a recent study, 88 percent of adults in the United States own a cell phone and 55 percent of them are using their handsets to go online. Pew points out that this is a 24 percent increase over the 31 percent of cell phone owners that admitted to doing so three years ago.
Given the proliferation of touch-enabled smartphones with generous screen sizes in recent years, plus network speeds that are slowly creeping ever upward, Pew's findings are revelatory, if not shocking. Furthermore, there is one surprising statistic that points to a new breed of mobile die-hards. Read more about the Cell Internet Use 2012 study on Datamation.
Stay up to date on the latest developments in Internet terminology with a free weekly newsletter from Webopedia. Join to subscribe now.
From wacky alarm clocks to lecture hall tools and after class entertainment, these Android apps are a good fit for a student's life and budget. Read More »Sharing Threat Intelligence
A growing number of startups make the sharing of threat intelligence a key part of their solutions. Read More »Smiley Faces and Symbols
A text smiley face is used to convey a facial expression or emotion in texting and online chat conversations. This Webopedia guide shows you how... Read More »
The Open System Interconnection (OSI) model defines a networking framework to implement protocols in seven layers. Use this handy guide to compare... Read More »Network Fundamentals Study Guide
Networking fundamentals teaches the building blocks of modern network design. Learn different types of networks, concepts, architecture and... Read More »Computer Architecture Study Guide
This Webopedia study guide describes the different parts of a computer system and their relations. Read More »


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View Record Details
|Pub. Type
|Conference Proceedings
|Cumulative Environmental Advantage and Children's Achievement: A Mediation Analysis of the Effects of an Employment Support and Antipoverty Program
Walker, J.T.
Huston, A.C.
|Conference/Meeting Name
|Annual Meeting of the Society for Research in Child Development (SRCD)
|Conference/Meeting Date
|Apr 2009
|Conference/Meeting Sponsor
|Place of Conference/Meeting
|Denver, CO
Related Studies
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Are you smarter than your computer? What about a robot? Explore the science of artificial intelligence.
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It has been postulated that atypical and melancholic depression subtypes exist in depressed fibromyalgia (FM) patients, yet no study has empirically tested this hypothesis. The purpose of this study is to determine whether major depressive disorder (MDD) with atypical features and MDD with melancholic features occurs in a FM sample and to describe their demographic, clinical and diagnostic characteristics.
An observational cohort study using a descriptive cross-sectional design recruited a convenience sample of 76 outpatients with FM from an academic Rheumatology clinic and a community mental health practice. Diagnoses of FM were confirmed using the 1990 ACR classification guidelines. Diagnoses of MDD and diagnostic subtypes were determined using the DSM-IV-TR criteria. Clinical characteristics were measured using the Fibromyalgia Impact Questionnaire, Structured Interview Guide for the Hamilton Depression Rating Scale with Atypical Depression Supplement and other standardized instruments. Odds ratios were computed on subtype-specific diagnostic criteria. Correlations assessed associations between subtype diagnoses and diagnostic criteria.
Of the 76 subjects with FM, 11.8% (n = 9) were euthymic, 52.6% (n = 40) met diagnostic criteria for MDD with atypical features and 35.6% (n = 27) for MDD with melancholic features. Groups did not differ on demographic characteristics except for gender (p = 0.01). The non-depressed and atypical groups trended toward having a longer duration of FM symptoms (18.05 yrs. ± 12.83; 20.36 yrs. ± 15.07) compared to the melancholic group (14.11 yrs. ± 8.82; p = 0.09). The two depressed groups experienced greater severity on all clinical features compared to the non-depressed group. The atypical group did not differ clinically from the melancholic group except the latter experienced greater depression severity (p = 0.001). The atypical group demonstrated the highest prevalence and correlations with atypical-specific diagnostic criteria: (e.g., weight gain/ increased appetite: OR = 3.5, p = 0.02), as did the melancholic group for melancholic-specific criteria: (e.g., anhedonia: OR = 20, p < 0.001).
Depressed fibromyalgia patients commonly experience both atypical and melancholic depressive features; however, in this study, atypical depression was 1.5 times more common than melancholic depression. This finding may have significant research and clinical implications.
Fibromyalgia (FM) is a common, chronic and often debilitating rheumatologic disorder which presents in 7% of all primary care visits [1]. FM is characterized by widespread musculoskeletal pain (100%), specified tender points (100%), fatigue (96-100%), sleep disturbances (86%-98%), and co-morbid mood disorders (29%) [2]. While the lifetime prevalence rate of major depressive disorders in the general population is 10% to 25% for women and from 5% to 12% for men [3], 74% of FM patients report at least one major depressive disorder (MDD) episode in their lifetime [4]. Depression is known to worsen FM symptom severity including pain, functional impairment, sleep quality and quality of life [5-7]. Of grave concern is suicide is the leading cause of premature mortality in those with FM. People with FM have been reported to have a nine-fold increased risk of death from suicide during depressive episodes [8]. It is important to further elucidate the biological and psychological underpinnings of depression in FM, as the successful treatment of depression has been shown to significantly improve FM symptomatology [9].
While several subtypes of MDD have been discussed in the literature, only three have specific diagnostic criteria defined in the Diagnostic and Statistical Manual, 4 th edition, Text Revised (DSM-IV-TR) [10]: MDD with psychotic features, MDD with atypical features and MDD with melancholic features. Full diagnostic criteria can be viewed in an additional file (#1).Combined, the atypical and melancholic subtypes represent approximately 60% of all MDD cases [11] and have been postulated to represent the two main subtypes of depression in FM [12], thus are the focus of this study.
Additional file 1. DSM-IV-TR mood disorder episode specifiers for melancholic features and atypical features. Lists the specific mood disorder diagnostic features for melancholic and atypical depression subtypes.
Format: PDF Size: 8KB Download file
This file can be viewed with: Adobe Acrobat Reader
Major depressive disorder, with atypical and melancholic features, has been methodically investigated in depressed populations: yet there is still some debate as to the validity of the subtype-specific criteria, especially for atypical depression [13]. While several researchers have critiqued the current DSM-IV-TR criteria, as yet a viable alternative has not been agreed upon [14]. Therefore, for the purpose of this study, the current prevailing criteria as per the DSM-IV-TR were used. Gold and Chrousos [15] postulated that atypical depression would be more prevalent in FM patients compared to melancholic depression due to the shared biological underpinnings of atypical depression and FM. Specifically, there is a blunting of hypothalamic-pituitary-adrenal (HPA) axis functioning as evidenced by low to normal levels of plasma cortisol following dexamethasone suppression testing. This blunting is secondary to glucocorticoid receptor desensitization as a result of chronic over secretion of cortisol. However, there are no studies to date that have evaluated Gold and Chrousos' assertions. Thus the first aim of this study was to test the hypotheses that atypical depressive episodes (ADE) and melancholic depressive episodes (MDE) occur in FM patients with ADE being the predominant subgroup. A secondary aim was to describe the demographic and clinical characteristics and diagnostic features of depression subgroups in people with FM to determine if they exhibited the same symptom clusters as those in depressed, non-FM samples.
Sample and data collection
Subjects were recruited from an academic medical center in the Pacific Northwest and a local community mental health clinic. A multi-step recruitment protocol was used to invite subjects to enter the study [16]. Males and females 18 years old or older who were diagnosed with FM as per the 1990 American College of Rheumatology criteria [17] for ≥ 2 years were eligible to participate in the study. Subjects also needed to speak and read English at a 6 th grade level. Exclusion criteria, designed to decrease risk to subjects and potential confounding variables, excluded subjects who were acutely ill, pregnant, currently lactating or planning to conceive within 90 days. Additional exclusion criteria included a Beck Depression Inventory score greater than 31 (extreme depression), any medical disorder that altered the HPA axis, suicidal ideation, abnormal thyroid stimulating hormone levels (less than 0.28 uIU/ml or greater than 5.00 uIU/ml), weight change greater than 15 pounds during the prior three months and subjects who did not meet diagnostic criteria for one of the three FM groups, i.e.: non-ADE or non-MDE (n = 1). Subjects on medications that could potentially alter the HPA axis were also excluded (e.g.: prednisone, opioids, corticosteroids, carbamazepine, etc.). Those on anti-depressants were not excluded, as research has shown the presence or absence of antidepressants while depressed, type of antidepressant or number of antidepressant trials previously used did not affect HPA axis perturbations or cortisol levels (unless depression symptoms had resolved) following the combined dexamethasone suppression/ corticotrophin-releasing hormone (DEX/CRH) test [18]. Thus depressed subject's plasma cortisol levels, which are associated with subtype-specific symptom expression, would still be expected to reflect MDD subtype variations. Approval of the protocol was obtained from the university's Investigational Review Board. Data was collected from 01/07/2006 to 10/18/2006.
The first visit was held at the University's School of Nursing in a town hall meeting format. All subjects gave written informed consent after an explanation of the study's purpose and procedures was given. Screening information for depression, demographic data, current medications and medical history were obtained and inclusion/exclusion criteria were assessed. In an attempt to decrease the possibility of estrogen fluctuations affecting symptom presentation, (e.g., fatigue, amotivation, hyperphagia and hypersomnia), menstruating females who continued to meet criteria were encouraged to schedule and attend the second visit during their next luteal phase (14 days after the first day of their last menstrual cycle), when estrogen levels would theoretically be at their highest. Menstrual phase was determined from subjective reports of the number of days from the first day of the last menstrual period. All other subjects were scheduled within 30 days of their first assessment.
At visit 2, subjects completed self-report instruments plus interviewer-administered evaluations. To decrease inter-rater reliability issues, the principal investigator (PI) completed all physical examinations and interviewer-administered questionnaires for all subjects. The following instruments, chosen specifically for their psychometric properties and appropriateness for use in an FM population, were used to assess depression severity, subtype-specific diagnostic criteria, overall FM symptom severity, pain severity, functional impairment, quality of life and sleep quality.
Primary measures
The 2003 version of the Structured Interview Guide for the Hamilton Depression Rating Scale with Atypical Depression Supplement (SIGH-ADS) was used to assess overall depression severity and severity of subtype-specific diagnostic features. This interviewer-administered questionnaire is based on the 21-item Hamilton Depression Rating Scale (HAM-D) plus includes an 8-item addendum to assess atypical depressive episode (ADE) features [19]: social withdrawal, increased appetite, increased eating, weight gain, carbohydrate craving or eating, hypersomnia, fatigability and pattern of depression symptoms being worse in the afternoon. It also includes two un-scored questions regarding difficulty awakening and temperature discomfort that are indicative of ADE. The HAM-D also includes seven items that assess features of melancholic depressive episode (MDE) features as per the DSM-IV-TR [10]: loss of appetite, weight loss, terminal insomnia, guilt, agitation, psychomotor retardation and pattern of depression symptoms being worse in the morning. Scores range from 0 to 88 with lower scores reflective of lower depression severity. Reliability for scale items of the SIGH-ADS as measured by Cronbach's alpha was established to be 0.87 in this sample.
To insure instrumental validity of the SIGH-ADS, a patient self report version was used to verify the interviewer-obtained responses. The Structured Interview Guide for the Hamilton Depression Rating Scale, Seasonal Affective Disorder- Self Report Version (SIGH-SAD-SR)[20] includes the same questions as the SIGH-ADS and has the same scoring matrix. After the SIGH-ADS was administered, the self-report questionnaire was reviewed by the PI. If responses differed by two or more points on any question, the PI clarified the question with the subject and rescored it accordingly. Reliability for scale items of the SIGH-SAD-SR as measured by Cronbach's alpha was established to be 0.78 in this sample.
The DSM-IV-TR diagnostic criteria for MDD with atypical features and MDD with melancholic features [10] were used to diagnose depressive subtypes. Based on these criteria, subjects were divided into three groups: A. non-depressed FM patients, B. FM patients with a current ADE and C. FM patients with a current MDE. As only one depressed FM subject did not meet diagnostic criteria for either ADE or MDE (non-ADE/non-MDE, n = 1), this data could not be used for group comparisons, thus was excluded from all statistical analyses.
The Fibromyalgia Impact Questionnaire(FIQ) was used to measure clinical features of FM, including pain severity, functional impairment, fatigue and depression. The FIQ was developed to measure the components of health status believed to be most affected by FM symptom severity, impact on functionality and response to treatment and outcomes in interventional studies [21]. Total FIQ scores range from 0 to 100, with higher values indicating a more negative impact of FM. The test-retest reliability has been documented to range from 0.56 on the pain score to 0.95 for physical function [22]. Internal consistency as measured by Cronbach's alpha has been established to range from 0.72 to 0.93 in seven translated versions of the FIQ. Reliability for scale items of the FIQ as measured by Cronbach's alpha was established to be 0.85 in this sample.
Three instruments were used to measure pain dimensions: the FIQ visual analogue scale (VAS) for pain, the number of tender points and the cumulative myalgic score (CMS). The 100-mm VAS for pain rated the participant's perception of pain intensity over the previous 7 days. The CMS is an eighteen-item scale that diagnoses FM as per the 1990 ACR criteria plus rates the amount of pain associated with 4-kilograms of pressure applied to 18 tender points commonly found in FM. The number of non-zero scores out of 18 determined the total tender point count. Tenderness and pain severity were measured by observing subject's reactions to 4-kg pressure on a 0-3 scale (0 = no pain, 1 = some pain, 2 = verbal exclamation (e.g. "ouch"), 3 = flinches/ moves away). Higher scores indicate more pain, with a total possible range of 0 to 54. The PI performed all tender point evaluations. Reliability for scale items of the CMS as measured by Cronbach's alpha was established to be 0.90 in this sample.
The Flannigan Quality of Life Scale (QOLS) is a16-item Likert-type scale that assesses multiple areas of well-being and life satisfaction [23]. Quality of life is measured on a continuum where 1 = terrible and 7 = delighted. The possible range of scores is from 16 to 112, with higher scores indicating better well-being and quality of life. It has been validated in an FM sample with an internal consistency reliability alpha equaling 0.82 to 0.88 and test-retest reliability of 0.84. Reliability for scale items of the QOLS as measured by Cronbach's alpha was established to be 0.92 in this sample.
The Jenkins Sleep Scale was used to assess sleep quality. It is a 4-item scale divided over 5 equal time periods during the preceding month that measures the quality of sleep obtained [24].The scale has a possible range of scores from 0 to 20, with higher scores indicating poorer overall quality of sleep. The internal consistency coefficient for the scale was 0.79. Reliability for scale items of the Jenkins Sleep Scale as measured by Cronbach's alpha was established to be 0.80 in this sample.
Secondary measures
The Demographic Data Form, an investigator-designed questionnaire, was used to screen for inclusion/exclusion criteria (past medical history, review of systems, current medications) and to obtain demographic information including age, gender, ethnicity/race; educational level; marital and employment status; number of years with FM; and body mass index (BMI). Body weight and height were measured in kilograms and meters using a calibrated standing model scale (Detecto, Brooklyn, New York). A standard formula of weight in kilograms divided by height in meters squared was used to calculate BMI.
The Beck Depression Inventory-II-1973 Revision (BDI-II-R) was used to screen for eligibility based on overall depression severity and confirm the diagnosis of MDD. The BDI-II-R is a 21-item scale that assesses intensity of depression in clinical patients and in healthy controls and has a reliability of 0.92 [25]. It has been widely used in depression research and has been adapted for use in FM by removing three items from the total score: fatigue, sleep disturbance, and effort to get things done. These symptoms correspond to FM symptomatology and therefore do not correlate well with MDD and overestimate the level of depression. This adaptation, the BDI-A, has better sensitivity (74% - 85%) and specificity (45% - 65%) in a FM population than the original [26]. A score of 13 or higher indicates a moderate level of depression, while scores above 21 are fairly specific for MDD in FM patients [26]. Reliability for scale items of the BDI-A was determined to be a Cronbach's alpha of 0.87 in this sample.
Statistical analyses
Data analyses were conducted using the Statistical Package for Social Sciences version 15.0 (SPSS, Chicago, Illinois, USA). Significance levels were set at an alpha of ≤ 0.05 and used a 2-tail distribution. Chi-square (χ2) tests were used to determine if there were differences between groups on nominal and ordinal level variables and also to determine if diagnostic groups differed statistically on prevalence of subtype-specific diagnostic criteria. To measure the differences among diagnostic groups on interval level variables, analysis of variance (ANOVA) with Bonferroni post-hoc tests were conducted with an adjusted alpha of 0.01 for multiple comparisons. To assess the association between depression subtypes and diagnostic criteria, multivariate analyses using logistic regression with odds ratios were used. Relationships between each criterion and each MDD subtype (ADE vs. MDE) were further examined using Spearman's Rho correlation coefficients.
Demographic characteristics
Convenience sampling identified 118 potential subjects who were assessed for eligibility. Of those, 95% (n = 77/118) met inclusion criteria, signed an informed consent and completed Visit 1. One subject's data was later excluded due to not meeting depression subtype group inclusion criteria; thus the total sample consisted of 76 subjects. Ten subjects were unable to complete Visit 2; therefore analyses for clinical characteristics were conducted on the 66 subjects who completed all evaluations. See Figure 1 for full recruitment and enrollment details. All subjects (n= 63) were tested within an average of 17 (SD ± 20.43) days from the first assessment. Both premenopausal and post-menopausal females were seen an average of 14 days after their first assessment (Premenopausal: SD ± 12.82; Postmenopausal: SD ± 14.53).
Figure 1. Enrollment Flowchart
Subjects were on average 54 years old (± 12.7 yrs.) and had experienced FM symptoms for an average of 18 years-Table 1. Nine of the total sample of 76 FM subjects (11.8%) did not meet diagnostic criteria for MDD, 40 (52.6%) met criteria for ADE, and 27 (35.6%) for MDE. The total sample reflected the expected predominance of females (96%) versus males (4%) [27]. No significant differences existed between groups on demographic variables except on gender (p = 0.01). Symptom duration approached significance (p = 0.09) with the ADE subgroup reporting FM symptoms an average of 6 years longer (20 years ± 15.1) than the MDE subgroup (14 years ± 8.8). The duration of symptoms in the non-MDD group, (18 years ± 12.8), did not differ statistically from the ADE group.
Table 1. Comparison of demographic data by diagnostic group: count (%), mean (±SD) and X2 values
Clinical characteristics
As depicted in Table 2, groups differed on all clinical characteristics except for number of tender points and stiffness. All significant analyses of clinical features remained significant at an adjusted Bonferroni alpha level of 0.01 with the exceptions of physical impairment (p = 0.02) and pain severity as measured by the cumulative myalgic score (p = 0.02). Pain as evidenced by the FIQ VAS was highly significant (p < 0.001). Irrespective of subtype, non-depressed subjects were generally less symptomatic as measured by the total FIQ score (non-MDD vs. ADE: p < 0.001; non-MDD vs. MDE: p < 0.001), had a better quality of life (non-MDD vs. ADE: p < 0.001; non-MDD vs. MDE: p < 0.001) and quality of sleep (non-MDD vs. ADE: p = 0.007; non-MDD vs. MDE: p = 0.012) compared to subjects with MDD.
Table 2. Comparison of clinical characteristics for total sample and by diagnostic group: mean (± SD)
Comparisons of the ADE subgroup versus the MDE subgroup revealed depression severity was significantly higher in the MDE group compared to the ADE group as measured by the HamD-17 embedded in the SIGH-ADS (p < 0.001). No significant differences in overall impact of FM symptoms on daily life (p = 0.44), quality of life (p = 0.49), sleep quality (p = 1.0), pain severity (p = 0.2), or tenderness (p = 1.0) existed between groups.
Subtype-specific criteria
As expected, the prevalence rates of the subtype-specific diagnostic criteria for MDD with melancholic features as per the DSM-IV-TR (Table 3) were found to be highest in the MDE group and the criteria for MDD with atypical features (Table 4) were highest in the ADE group.
Table 3. Prevalence rates of melancholic depressive episode-specific diagnostic criteria by diagnostic group
Table 4. Prevalence rates of atypical depressive episode-specific diagnostic criteria by diagnostic group
Atypical Depressive Episode-specific criteria
While groups exhibited predominant symptom patterns respective of their diagnostic classification (ADE vs. MDE), some individual symptoms overlapped between groups. In our sample, all subjects in the ADE group reported mood reactivity, a mandatory criterion for ADE, while 74.1% of the MDE and 44.4% of the non-MDD groups also experienced this symptom. Over 67% of the ADE group experienced weight gain or increased appetite. Interestingly, 37% of the MDE group also reported weight gain, while only 33% reported significant anorexia or weight loss, which is the MDE-specific criterion. The symptom of hypersomnia was highest in the ADE group (35%) followed by the MDE group (18.5%). Over 71% of the ADE group and 48.1% of the MDE group reported interpersonal rejection sensitivity. Of interest, the majority of the total sample reported leaden paralysis irrespective of diagnostic subgroup, with 100% of the ADE group, 96.3% of the MDE group and 44.4% of the non-MDD group reporting this ADE-specific criterion. Groups differed significantly on chronicity of depression as measured by the number of episodes of depression [χ2 (2, n = 51) = 67.84, p = 0.007], with the ADE group having the most episodes. Although groups did not differ on the number of times suicide was attempted [χ2 (2, n = 61) = 4.16, p = 0.13], the highest prevalence of attempts were made by the ADE group (38.1%; n = 8/21), followed by the MDE group (15%; n = 3/20). None of the non-depressed group had ever attempted suicide.
Melancholic Depressive Episode-specific criteria
The prevalence rate of anhedonia was 74% in the MDE group while 12.5% of the ADE group also met this MDE-specific criterion. Over 29% of the MDE group and 11.1% of the ADE group reported lack of reactivity to usually pleasurable stimuli. A distinct quality of depressed mood was present in 100% of the MDE group; but 85% of the ADE group also experienced this symptom. Depression was regularly worse in the morning in 63% of the MDE group and 32.5% of the ADE group. Early morning awakening was highest in the MDE group (88.9%), but almost half of the ADE group and over a third of the non-MDD group also reported this symptom. Marked psychomotor retardation or agitation was highest in the MDE group (70.4%), yet 32.5% of the ADE group also endorsed it. Excessive or inappropriate guilt was highest in the MDE group (85.2%), compared to 40% in the ADE group.
Odds ratios
The presence of the MDE-specific criteria of lack of reactivity to usually pleasurable stimuli and distinct quality of depressed mood predicted the diagnosis of MDE. Likewise, leaden paralysis and mood reactivity predicted the diagnosis of ADE. However, while the associations of the diagnostic subtypes with the above features were very sensitive (the diagnosis of ADE was associated 100% of the time with leaden paralysis) it was not very specific (leaden paralysis was associated with the diagnosis of MDE 47% of the time). As odds ratios cannot be computed on items that perfectly predict each other, the above four criteria were removed from further analyses.
All other odds ratios were positive, indicating subtype-specific diagnostic criterion were highly associated with their respective subtype. As seen in Table 3, the MDE group was 20 times more likely to endorse anhedonia (p < 0.001); 3.5 times more likely to endorse depression being worse in the mornings (p < 0.02); 10.8 times more likely to endorse early morning awakening (p = 0.001); 4.9 times more likely to endorse psychomotor agitation or retardation (p = 0.003); 6.2 times more likely to endorse anorexia or weight loss, (p = 0.01); and 8.6 times more likely to endorse excessive or inappropriate guilt (p = 0.001) than the ADE group. In contrast, Table 4 shows the ADE group was more likely to endorse the ADE-specific criteria of weight gain/ increased appetite (OR = 3.5, p = 0.02) and interpersonal rejection sensitivity (OR = 2.6, p = 0.06) compared to the MDE group.
The correlation matrix of the diagnosis of ADE versus MDE with all five of the ADE-specific diagnostic features and eight MDE-specific diagnostic features can be viewed in an additional file (#2). In brief, there was a weak relationship between the diagnosis of ADE and significant weight gain/ hyperphagia (r = 0.30, p = 0.013) and a moderate relationship with mood reactivity (r = .42, p < 0.001). However, no significant associations existed between the diagnosis of ADE and hypersomnia (r = .18, p = 0.15), leaden paralysis (r = .15, p = 0.23) nor interpersonal rejection sensitivity (r = .23, p = 0.06).
Additional file 2. Correlations among diagnostic subtype and atypical and melancholic episode specifiers using Spearman's Rho with p values. Displays the correlation matrix for the diagnoses of ADE versus MDE with all five of the ADE-specific diagnostic features and all eight of the MDE-specific diagnostic features.
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For the MDE-diagnosed group, there was a strong relationship between the MDE-specific criteria anhedonia (loss of pleasure in all, or almost all, activities) (r = 0.62, p < 0.001), and moderate relationships with lack of reactivity to usually pleasurable stimuli (r = 0.45, p < 0.001), early morning awakening (r = 0.47, p < 0.001) and excessive or inappropriate guilt (r = 0.45, p = < 0.001). Weak relationships existed with marked psychomotor retardation or agitation (r = 0.37, p = 0.002), significant anorexia or weight loss (r = 0.33, p = 0.006), depression worse in the morning (r = 0.30, p = 0.013) and distinct quality of depressed mood (r = 0.26, p = 0.035).
The results reported herein provide evidence for the occurrence of atypical and melancholic subtypes of depression in FM subjects. Furthermore, these subjects exhibited similar clinical features of ADE and MDE as has been reported in other depressed non-FM populations [13,28,29]. Interestingly, the ADE prevalence rate of 52.6% is approximately twice that of the 30% reported in population studies of depressed people without FM. This finding is consistent with ADE being more prevalent in women and may be associated with the neuroendocrine underpinnings of the preponderance of women versus men (9:1) with FM [30]. The prevalence rate of MDE was 35.6%, which is more consistent with previous studies in depressed non-FM populations which demonstrated a prevalence of approximately 30% [31,32]. Demarcation of MDD subtypes is a novel area of research in FM. Prior to completing this pilot study, it was not known if subtype prevalence in an FM sample would be consistent with the prevalence of MDD subtypes previously identified in the general population. We speculate the over-representation of ADE is likely due to the above and ADE being more prevalent in females in addition to the long-term effect of chronic stress blunting HPA axis functions resulting in lower cortisol levels. It is unclear as to why only one subject out of 77 was identified with the non-ADE/non-MDE subtype. It is possible this finding was associated with self selection bias, differences in symptom presentation of MDD co-morbid with FM versus MDD alone, or the possibility the subject was transitioning from MDE to ADE. A larger study is needed to better characterize depression subtypes and their clinical features to determine if the above finding is reproducible. Our team plans to investigate this issue in future studies.
Clinical features of FM more severe in depressed groups
Our data substantiates previous reports that associate a diagnosis of MDD in FM patients with more pain [33], poorer sleep quality [34], poorer quality of life [35] and greater functional impairment [36]. However, in the current study, the specific subtype of MDD (ADE vs. MDE) did not affect the intensity of the clinical characteristics of FM with the exception of greater depression severity in the MDE group.
Overlap of diagnostic criteria between subtypes
While conceptually, MDD subtype-specific criteria are exclusive to their respective diagnostic subtype with no overlap between subgroups, ours and other study data [13,37] indicate diagnostic features that differentiate ADE versus MDE do commonly overlap. Benazzi provides an in-depth discussion of the concept of depressive subtype symptom overlap in depressed non-FM populations and presents the hypothesis of mood disorders representing a continuum of overlapping disorders with common underlying biological pathways versus being absolute categorical definitions [38]. Consistent with our findings, Angst and colleagues [39] found in their 20 year prospective study that depressed non-FM subjects with pure melancholic and atypical depression exhibited many similar characteristics, as evidenced by no significant differences between groups on psychomotor retardation/agitation, weight gain or feelings of excessive or inappropriate guilt. In a large trial of 579 depressed non-FM patients (ADE, n = 130; Non-ADE, n = 449) ADE symptoms were reported in both groups, with the ADE group having the highest prevalence of mood reactivity (100% vs. 77.7%), hypersomnia (36.2% vs. 16.8%), hyperphagia (53.1% vs. 21.8%), leaden paralysis (60.8% vs. 28%), and interpersonal rejection sensitivity (75.4% vs. 40.9%) [13]. In line with Thase and colleagues [40], we found that mood reactivity, a mandatory criterion for ADE, was reported by the majority of the MDE group and almost half of the non-MDD group; which is also congruent with the observations of Henkel and colleagues [41]. We cautiously speculate the overlap in depressive subtype symptoms is likely due at least in part to dysfunction of the HPA axis as well as other neuroendocrine (e.g., serotonin and norepinephrine) and neuroimmune (e.g., pro-inflammatory cytokine response) systems. Although Juruena and Cleare [42] reviewed symptom overlap between ADE and other MDD subtypes in populations similar to FM including chronic fatigue syndrome, to our knowledge this study was the first to evaluate ADE and MDE specific diagnostic criterion in an FM population. Therefore, these findings need to be replicated in a larger sample before any conclusive assumption regarding the causes of the symptom overlap can occur.
One final example of the non-specificity of diagnostic criteria in our study was the finding that 100% of the ADE group endorsed experiencing "leaden paralysis"; while three-fourths of the MDE group also experienced this symptom. As the reported prevalence of leaden paralysis is significantly higher than reports from depressed non-FM populations [37], we hypothesized there may be an etiological link between leaden paralysis and the symptom of stiffness, a common complaint of FM subjects [43]. However we only found a week association between these symptoms (r = 0.26, p = 0.03) indicating there may be a mediating or moderating variable accounting for this clinical observation.
Possible temporal association between length of time with FM and MDD subtypes
A non-significant (p = 0.09), yet potentially interesting finding was a trend among MDD subtypes to differ in the number of years that FM symptoms were present. Similar to Wallace's findings [44], the ADE and non-MDD groups had symptoms of FM for approximately six years longer than the MDE group. It has been reported that non-FM patients with ADE have a longer duration of symptoms versus non-FM patients with MDE [39]. Gold and Chrousos [15] have hypothesized that new onset FM is generally associated with a hyperactive HPA axis characterized by elevated levels of CRH and cortisol (a characteristic of MDE), and that, over time, persistent stress results in blunting of the HPA axis response (a characteristic of ADE). Our data supports this notion, and we postulate that this finding may explain disparities in previous reports of HPA axis studies in FM [45-48], as both the duration of FM symptoms and depression subtype might be expected to influence HPA axis functioning.
Certain groups were excluded to decrease risk to vulnerable individuals (children, severely depressed people, people with suicidal ideation) and to eliminate potential confounding variables (persons with co-occurring rheumatic and pituitary disease, therapy with medications known to alter HPA axis function), thus result may not generalize to such individuals. Varying estrogen levels across the menstrual cycle presents a potential confounding variable in this study and necessitates more in-depth measurement via standardized biochemical assays in future studies. Furthermore, the sample was recruited from patients seen at a tertiary care facility for FM consultation and short-term management and an outpatient mental health clinic specializing in mood disorders with concurrent chronic pain, thus their symptoms may have been more severe than patients managed in primary care clinics. As the sample size was relatively small, these findings need to be confirmed in a larger sample from a more diverse population. The age of onset (before vs. after 20 years old), duration of symptoms (less than vs. greater than 2 years) and chronicity of depression (number of lifetime episodes) needs to be evaluated in future studies, as these are proposed additions to the DSM-V diagnostic criteria for depression with atypical features and may add sensitivity and specificity to the diagnosis [49].
Future directions
There is much contemporary interest in trying to understand psycho-neuro-endocrine dysfunction in relation to the etiology of FM and chronic pain. Currently these studies have yielded non-consistent and often contradictory findings. We deduce that failure to distinguish between depressive subgroups could have led to confounding results in studies that have measured HPA activity, as the HPA axis in ADE is purported to be relatively hypo-cortisolemic compared to the HPA axis in MDE. For instance, recent research has reported that interpersonal rejection sensitivity and the associated fear of negative social evaluation is associated initially with a hypercortisolemic response consistent with melancholic depression and then later in life with hypocortisolemic states such as atypical depression [50]. Thus both the duration of a stressor and the nature of an associated mood disorder are potentially important confounding variables to consider in any HPA axis study in chronic disease.
The results of this study confirm that depressed FM patients commonly experience both atypical and melancholic depressive features. In this study, atypical depression was 1.5 times more common than melancholic depression. Furthermore, while the melancholic group exhibit greater depression severity, those with atypical depression appear to have fibromyalgia symptoms an average of six years longer than those with melancholic depression. The presence of depression subtypes in depressed FM patients may have significant research and clinical implications. In research, a failure to account for depression subgroups may lead to regression towards the means in some studies of HPA function. Classic research provides evidence that the successful pharmacologic treatment of ADE differs from the treatment for MDE [51,52] and is proposed to be due to differing biological dysfunction of the HPA axis, locus ceruleus-noradrenergic system and the physiological stress systems. Thus, depression subtypes need to be addressed in future studies and clinical practice to eliminate the possibility of making erroneous conclusions from the data.
Competing interests
The authors declare that they have no competing interests.
Authors' contributions
RLR was involved in study design, acquisition of data, data analyses, interpretation of data, had full access to all data in this study and takes responsibility for the integrity of the data and accuracy of the analyses. RLR was the primary author of the manuscript and finalized it after comments from the other authors. KDJ participated in study design, interpretation of data and development and editing of the manuscript. RLW carried out the regression analyses and assisted in writing the odds ratio section. LJW commented on drafts of the manuscript. RMB constructed the FIQ, participated in study design and interpretation of data, made critical suggestions for the development of the manuscript as well as significant contributions to the final manuscript. All authors have read and approved the final manuscript.
This study was supported by funding from the National Institutes of Health in Bethesda, Maryland, USA (NINR T32NR07061; NRSA F31NR009472); Oregon Health & Science University School of Nursing - Portland, Oregon, USA (Deans Dissertation Award) and the Oregon Clinical and Translational Research Institute - Portland, Oregon, USA (OCTRI Award); the University Club Foundation - Portland, Oregon, USA (Fellowship Award); and by the Fibromyalgia Information Foundation - Portland, Oregon, USA (Research Award). These funding bodies did not have an active role in the conduct of the study or in manuscript preparation. We would like to thank Christine Nelson for her invaluable assistance with revisions and final preparation of the manuscript. We would especially like to thank the volunteers participating in the study for their valuable time and altruism.
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Tops M, Riese H, Oldehinkel AJ, Rijsdijk FV, Ormel J: Rejection sensitivity relates to hypocortisolism and depressed mood state in young women.
Psychoneuroendocrinology 2008, 33:551-559. PubMed Abstract | Publisher Full Text
West ED, Dally PJ: Effects of iproniazid in depressive syndromes.
Br Med J 1959, 1:1491-1494. PubMed Abstract | Publisher Full Text | PubMed Central Full Text
Klein DF, Davis JM: The drug treatment of depression.
JAMA 1970, 212:1962-1963. PubMed Abstract | Publisher Full Text
Pre-publication history
The pre-publication history for this paper can be accessed here:


text:
Mobile-Phone Use May Affect Brain Activity, Researchers Find
Feb. 22 (Bloomberg) -- Using a mobile phone for 50 minutes stirs brain metabolism, although the health consequences are unknown and need to be studied further, U.S. researchers said.
When mobile phones were on and held against the ear, brain glucose metabolism, a marker of brain cell activity, was about 7 percent higher in areas closest to the antenna than when phones were off, a study in today's Journal of the American Medical Association found. The study, the first to show the effects of mobile-phone use on brain metabolism, was done by researchers from the National Institutes of Health in Bethesda, Maryland, and Brookhaven National Laboratory in Upton, New York.
Studies, including a report last year from the World Health Organization's International Agency for Research on Cancer, have produced conflicting results over the health dangers of mobile phones, particularly their link to cancer. Today's finding shows that human brain metabolism is sensitive to the effects of radiofrequency-electromagnetic fields, a form of radiation, from mobile phones.
"We need to investigate this carefully so that we can send a clear-cut message that is as unequivocal as possible," said Nora Volkow, director of the National Institutes of Health's National Institute on Drug Abuse, in a Feb. 18 telephone interview. "We don't know the clinical significance. In principle, increasing brain glucose metabolism is not a bad thing. You don't need to stop using your cell phones. If you are concerned, use a wire ear piece or use your speaker phone mode."
There were almost 293 million wireless accounts in the U.S. as of June 2010, according to CTIA-The Wireless Association, a Washington-based trade group that represents carriers, phone makers and suppliers. The number of U.S. households that only have wireless phones was about 25 percent, the group said.
Industry Response
"The peer-reviewed scientific evidence has overwhelmingly indicated that wireless devices, within the limits established by the FCC, do not pose a public health risk or cause any adverse health effects," John Walls, vice president of public affairs for CTIA, said in a Feb. 18 e-mail. "The leading global health organizations such as the American Cancer Society, National Cancer Institute, World Health Organization and the U.S. Food and Drug Administration all have concurred that wireless devices are not a public health risk."
The researchers from the National Institutes of Health and Brookhaven National Laboratory included 47 people in the study. They placed mobile phones on the right and left ears of participants and then measured brain glucose metabolism once when the phone on the right side was on but muted for 50 minutes and a second time when both cell phones were off. After 50 minutes, the patients had their brain activity measured using a positron emission tomography, or PET, scan.
Affected Brain Regions
Researchers found that only the regions closest to the antenna, the orbitofrontal cortex and the temporal pole, saw a rise in brain metabolism when the mobile phone was on. The orbitofrontal cortex plays a role in decision making and reward and punishment, and the temporal pole is involved in social and emotional processes.
Henry Lai, who wrote an accompanying editorial in the journal with Lennart Hardell from University Hospital in Orebro, Sweden, said the results of today's study add to information about the possible effects of emissions from wireless phones on the brain.
"It is an intriguing discovery and it certainly adds to the concern that cell phone use is not completely safe," said Lai, a bioengineering researcher at the University of Washington in Seattle, in a Feb. 20 e-mail. "Before we understand the impact of the results of this study, people who use cell phones should limit their exposure to the radiation, particularly to the head."
Health stories from the U.S.: {TNI US HEA BN <GO>} Top stories about science: {TNI SCIENCE WWTOP <GO>} Today's most popular health-care stories: {MNI HEA <GO>} Bloomberg Drug Database: {BDRG <GO>} Top health stories: {HTOP <GO>} News about medical research: {NI MEDICAL <GO>}
To contact the reporter on this story: Nicole Ostrow in New York at firstname.lastname@example.com.
To contact the editor responsible for this story: Reg Gale at email@example.com


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Stainless Steel Wax Melter 65 lb.
Maximize productivity and profitability with a CandleScience wax melter. This wax melting pot quickly produces a uniformed heating area ideal for use with soy and paraffin waxes. Designed specifically for candle making, the stainless steel construction of our wax melter allows for easy mixing of dyes and fragrances into the melted wax inside the pot.
View our wax melter instructions for additional tips and suggestions on proper use and care of your stainless steel wax melter.Wax Melter Features:
- Direct Heat - no need to fill with water!
- Dual zone heating control (12 amps, 120v, 1440 watts)
- Heated spout
- Lifetime warranty on the tank, 1 year on the heating element.
- 304 stainless steel inside and out
- Tight fitting stainless steel cover
- Standard 110v power plug
- Rust Proof - Stainless Steel construction will not rust!
- Melts entire case of soy or paraffin wax
Melting times vary depending on the type of wax and heat setting.
|50° to 250°F
|20 inches
|17.75 inches
Customer Reviews
Submitted on 2015-10-05 WT
Are you all adding the fragrances and dyes into the melter itself to do large batches? Or, are you filling your pouring pitchers first then adding the fragrance and dyes at that point? I typically do that method right now (although not using a large wax melter right now) but my issue is keeping the wax the right temp when adding fragrance and dye and then pooring temp once its been transferred to pooring temperate. Hard to control temp at that point.
Submitted on 2015-01-26 Kerry
I purchased this last year. This is the best ever. I have a small candle business. This absolutely saved me I was staying up till 1 and 2 in the morning making candles. It usually took me 8 days to make one set of 6 jars of each scent.. It takes me 2 days to make them now. I can make one candle scent at a time. If I don't need all the wax just shut it off and reheat later.. THIS IS A GOD. IF you are worried . DONT>. I have had it a year.. ABSOLUTLY NO PROBLEMS AT ALLL!!!!!!!
Submitted on 2013-09-15 Jessica Larson
My candle business is small and I worried about purchasing an expensive piece of equipment but this is a lifesaver! I live in a warm climate and I am thrilled at how little heat this emits. I heat the wax and pour it into my regular melting pots 4lbs at a time. I set the temp slightly higher than 185 so I just let it cool slightly before adding fragrance and color. I don't know how I lived without this!


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Official music video for the track I Got You (I Feel Good) [Round 1] by James Brown.
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Survey Brief: Political Independents and Health Care
With the 2008 presidential race well underway, some analysts believe that political independents will play a key role in the final vote. In July 2007, The Washington Post, the Kaiser Family Foundation, and Harvard University released a Survey of Political Independents exploring the views and priorities of these voters on…Poll Finding Read More
USA Today/Kaiser Family Foundation/Harvard School of Public Health Survey: The Public on Prescription Drugs and Pharmaceutical Companies: Summary and Charts
This document provides key findings from a USA Today/Kaiser/Harvard survey examining Americans' views on, and experiences with, prescription drugs and the pharmaceutical industry, including drug costs, advertisements, safety issues, government regulation and medical research. Summary and Charts (.pdf)Poll Finding Read More
Toplines: National Survey of Households Affected by Cancer
These toplines provide the complete survey questions and findings from the National Survey of Households Affected by Cancer conducted jointly by USA Today, the Kaiser Family Foundation and the Harvard School of Public Health by telephone between Aug. 1 and Sept. 14, 2006. The survey provides an in-depth look at…Poll Finding Read More
Seniors and the Medicare Prescription Drug Benefit
The survey, which assessed seniors' views of and experiences with the Medicare drug benefit, was conducted November 9-19 by the Kaiser Family Foundation and the Harvard School of Public Health. It included a nationally representative sample of 718 seniors, including 275 who reported being enrolled in a Medicare drug plan.…Poll Finding Read More
NPR/KFF/HSPH Survey: Public Views on SCHIP Reauthorization: Summary
This summary provides an overview of the results of an October 2007 survey conducted jointly by NPR, the Kaiser Family Foundation, and the Harvard School of Public Health on the public's views and opinions of the State Children's Health Insurance Program and the pending legislation surrounding its reauthorization. Summary (.pdf)Poll Finding Read More
NPR/Kaiser/Harvard Survey — Children's OTC Cold Medicines: The Public, and Parents, Weigh In
This survey from NPR, the Kaiser Family Foundation, and the Harvard School of Public Health examines the public's views of over-the-counter children's cold and cough medications in the wake of recent concerns regarding their safety and effectiveness. The poll was conducted after an FDA advisory panel recommended that children under…Poll Finding Read More
Washington Post/Kaiser Family Foundation/Harvard Survey of African-American Men
Washington Post/Kaiser Family Foundation/Harvard African-American Men SurveyThe Washington Post, the Kaiser Family Foundation and Harvard University have released a new, comprehensive survey looking at how African-American men view their lives in the United States and their outlook for the future. The survey gauges the views and experiences of African-American men…Poll Finding Read More
Toplines: The Public's Health Care Agenda
These toplines provide the complete survey questions and findings from The Public's Health Care Agenda for the New Congress and Presidential Campaign, conducted jointly by the Kaiser Family Foundation and the Harvard School of Public Health between November 9 and 19, 2006. The survey looks at the public's priorities and…Poll Finding Read More
Massachusetts Health Reform Tracking Survey
This survey finds that, with a July 1 implementation milestone approaching, most Massachusetts residents support a new state law to provide health coverage to almost all residents, including the individual mandate that requires residents to obtain coverage or pay a penalty. The poll, conducted by the Kaiser Family Foundation, the…Poll Finding Read More
Toplines: Massachusetts Health Reform Tracking Survey
These toplines provide the detailed results from the June 2007 Kaiser/Harvard/BCBSMA Foundation poll of Massachusetts residents on the new health reform law. Toplines (.pdf)Poll Finding Read More


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NBAA 2000 Image Gallery # 1, Picture 22
Just as medical reform appears to be almost within sight, the House melts into a dysfunctional blob and an untimely death in a cockpit provides more ammo for the antis. More
Allen Macbean of American Fork, Utah serves up our latest "Picture of the Week." Click through for a better look and for more breath-taking reader-submitted photos.


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Sunset Cottage Rentals
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- Free parking
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Day 6
Blue ridge parkway in the smoky mountains. Rode a stretch that was so narrow and as tight as anything on the dragon. Kent started the day with his shirt on backwards! Ha!! Cool up in the mountains , had to pull out a jacket! Great day! Heading out tomorrow back to Kentucky starting ...
Longer day than expected
Hi friends,
I know im behind and yet again writing from my phone so please, lets keep this like planet fitness and not judge lol.
On Saturday we started our 7 and half hour journey to Gatlinburg! We ended up being in the car for 11 hours! It was a long day!! We did stop and write the last post and I just had to pull over and take a nap at a truck stop, which added some time to the trip.
Some things I've realized...
1) ...
Day 11 - Hiking, wasps, and cinema
... get a few more wasp stings.
Jeanny counts 11, Robin 3, Fiona 3, Emily (the new friend) 2, Papa: NONE! (lucky).
Luckily the kids forget the pain quicky after the return, as they jump into the pool.
In the afternoon we take Emily with us to Newport into the cinema to see "Inside out".
Day 10 - Quiet day at the farm
Well, it's Sunday after 4th of July. We are a little tired, and just hang out, and finally have some real rest - exactly what we needed!
The kids leave in the morning and aren't seen for the whole day, except checking in when hungry...
There are ...
Day 9 - 4th of July on an Appalachian Farm
... The farm crew, a few neighbor families, and us - there couldn't have been a better way spending the 4th of July day! The kids enjoyed performing songs and skits with their new friends.
Oh, by now we found out ...


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Leelawadee Park & Hotel
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Travel Blogs from Phitsanulok
One Day Stop
... around the lines. Coming up onto the platform looking for food. They were very big! Biggest we had seen and they were not scared of human activity either.
Time passed quickly (the local lady putting the football on a tiny tv in her little stall helped) and finally 30 minutes late the train arrived. We was so eager to get on and get some sleep.
It had been a long but fun day and Phitsanulok was worth the stopover!
Next Stop: BANGKOK!
Nathan & India x
Phitsanulok & Sukothai
... fit Dave's feet, but since Thai people are significantly smaller, Dave eventually had to settle for some size elevens. Mission accomplished, we could finally explore the Ancient City. Established in the 13th Century and the centre of rule for over 150 years before being superseded by Ayutthaya, Sukothai is credited with instigating much of what is now seen as the Thai identity. Although prior to the rise of Sukothai the Khmer empire had extended its influence ...
... the outside of it got cleaned by an army of people scrubbing, rinsing and then mopping. Once inside it got even better. We had airline style seats in a clean, comfortable, air conditioned carriage. An hour in we even got treated to noodle soup, green chicken curry with rice and a doughnut to finish! Now this was travelling :). Phitsanulok itself was not much to write home about really, the best thing about it was probably the night market which was ...
Phitsanulok pit stop
... her a good day of rest. Mission successful, and at £12 was hardly breaking the bank, it was time to put Liz to bed. Feeling better come evening we had time to raid Seven-11 for cheese toasties before having an early night. Next morning Liz feeling close to 100%25 we hopped in a tuk tuk to the bus station and boarded a bus for the remainder of the journey to Chiang Mai. For some reason in SE Asia bus travel is faster than ...
Week 2 - Phitsanulok - Day 11
Day 11 - 10/06/11 - Phitsanulok With the extended day in Phitsanulok (extended as it is a great town for a random non-Itinerary visit) we decided to visit the main temple in town. �It has the 2nd most revered images of Buddah in Thailand. �I can see why, with shoes off we went inside and saw a huge gold Buddah surrounded by a ton of kneeling Thais rattling sticks of some sort. �It was more bling than a drab wooden crucifix. �Buddah 1 - Jebus 0. �You have ...


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Joined by legislative representatives and school board members
Following the classroom visit there was a press conference at which both Secretary Duncan and Governor Dayton stressed the importance of investing in early learning.
"The North St. Paul Maplewood Oakdale Schools have been champions in providing quality early learning opportunities for students'" said Jenna Peters, Richardson Principal, "and it is an affirmation of our good work to be chosen as a site visit for U.S. Secretary of Education Duncan and Governor Dayton."
Click here to see photos and links to the media coverage of the event.
Richardson Elementary School
2615 First Street North
North St. Paul, MN 55109
School Hours: 9:15am - 3:45pm
Office Hours: 8:00am – 4:00pm
Phone: 651-748-6900
Attendance Line: 651-748-6945
Fax: 651-748-6991
Principal Jenna Peters, 651-748-6910
Administrative Support
Principal's Secretary Susi Weldon, 651-748-6901
Receptionist Stephanie Woodbury, 651-748-6912
Health Office
Health Education Assistant Miranda Johnson, 651-748-6915
Student Services
Social Worker Judy Aubrecht, 651-748-6907
Psychologist Chris Church, 651-748-6907
Adventure Connection Site Supervisor
Parent Involvement Coordinator
Staff Directory
You may search for Richardson staff by last name or title. Choose from either of the lists below and click on the submit button.
Welcome to Richardson Elementary School. We appreciate you taking the time to visit our school website. Richardson is a school rich in history and tradition. It is also a school moving forward to prepare its students for the future. Our staff, parents, and community volunteers work together to meet our goal of high achievement in a safe, learning environment.
Communication and collaboration with families is important to us and to the learning process. You can expect regular communication from us regarding learning and behavior expectations and school events. Please do not hesitate to contact your child's teacher if you have a question or concern.
Richardson Elementary is nestled in a residential area of North St. Paul, Minnesota and houses approximately 500 students in pre-kindergarten through fifth grade.
Our staff works hard to instill pride, responsibility and a love of learning in each of our students. We teach our students to function independently and responsibly in the community.
We will:
Richardson Elementary School Rules
7:00 AM - 6:00 PM Conferences & Book Fair
8:45 AM - 9:45 AM Coffee with the Principal
6:00 PM - 8:00 PM Saints North Roller Skating


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L'Oreal Voluminous Waterproof
649 reviews
65% would repurchase
Package Quality: 3.8
Price: $$
Package Quality: 3.8
Price: $$
INGREDIENTSisodecane - aqua (water) - cera alba (beeswax) - disteardimonium hectorite - carnauba wax - paraffin - alcohol denat. - allyl stearate/va copolymer - propylene carbonate - oryza sativa (rice) starch - polyvinyl laurate - peg/ppg-17/18 dimethicone - synthetic wax - dimethicone - propylparaben - 2-oleamido-1,3-octadecanedio - dimethiconol - sodium dna. May contain [ /- ci 77492, ci 77499, ci 77491 / iron oxides - ci 77007 / ultramarines - ci 77891 / titanium dioxide - mica - ci 75470 / carmine - ci 77288 / chromium oxide green - ci 77510 / ferric ferrocyanide]
on 4/29/2007 4:50:00 PM
Age: 25-29
Skin: Combination, Other, Not Sure
Hair: Brunette, Other, Other
Eyes: Hazel
Ug, I hate this stuff! I'm glad it worked for many, but it sure didn't on me. I threw it out after one use. I've never used a mascara so clumpy and disappointing. It was like black glue sticking my lashes together, and nothing would separate them. There was no lift, and it took a long time to dry. No thanks!
on 4/28/2007 4:48:00 PM
Age: 19-24
Skin: Dry, Fair-Medium, Not Sure
Hair: Brunette, Other, Other
Eyes: Brown
I've used the regular version of this years ago. The overall performance wasn't bad and it did a decent job at thickening, considering the price, but it smudged badly which I couldn't tolerate. I've been using Lancome Definicls and then Hypnose for many years, and recently started the search for a good drugstore mascara. First tried the Maybelline Volum Express Waterproof (see my review for it if you wanna compare), thought it was wonderful but shortly after discovered all the shortfalls. Then, bought L'Oreal Voluminous Waterproof due to all the positive reviews here. This is indeed a great mascara. Not 100%, and not as amazing as my beloved Lancome Hypnose, but quite close, and definitly better than Maybelline Volum Express. It gives noticeable volume after one coat, and can really help achieve "big lashes" by three coats (my lashes are not short but sparse). Doesn't clump for a good 2 months and by the time it starts to clump, it's around time to toss it away anyway. Occasionally the tips (and only the tips) of my lashes would get messy after application --- get weighed down or stick toward different directions --- and I find it's solved when I wait till the first coat is dry and then apply the second and third coat. I use black and I think the black is more true and glossy than Maybelline Volum Express as well. However, it does still smudge a bit, after a long day of more than 10 hours. But on a regular day it's just fine, and I don't normally wear my makeup for more than 10 hours anyway, so it works out I guess. It's very inexpensive so the performance is well worth every penny and deserves 5 lipsticks on its own. But to rate it relative to other mascaras, I'll give it a 4.
on 4/2/2007 12:17:00 AM
Age: 25-29
Skin: Combination, Other, Not Sure
Hair: Brown, Other, Other
Eyes: Brown
I love this stuff! Really won't budge in the water, after surfing for a couple hours, wiping face many times etc..It gives the fullest, longest prettiest lashes and it holds a curl so well! I wish I could wear it everyday, but I have a feeling wearing waterproof mascara daily might be bad for the lashes but...wow...LOVE. Oh...but you do have to make sure you replace...when it gets old, it flakes like mad!!!
on 3/30/2007 8:15:00 AM
Age: 19-24
Skin: Sensitive, Fair, Neutral
Hair: Black, Straight, Fine
Eyes: Green
I bought this a couple months ago and I'm really liking it. It clumps a tiny bit but that's understandable with volume mascaras and it's really not that bad. I haven't had to use an eyelash brush or comb with it so far. The brush is nice. I can still comb through my lashes with it after a couple coats have already dried. It still continues to separate. The brush is also a nice size. Not too big but not too small either. I would describe the formula as very wet. You can really plaster the stuff on when doing several coats. Before putting my makeup away in the morning, I have to keep adding "Just one more coat..." because it builds up so nicely. It's hard to remove but I use a fair bit of it so that's to be expected. It's one one of the few mascaras that I can get that false eyelash look with when I care to. I like it.
Update: 2 out of 2 cosmeticians as well as 1 pharmacy staff member I had asked yesterday told me that their favourite mascara is Voluminious. I also figured out a faster way to build up the layers. The result isn't quite as neat and perfect as if you did one thin layer at a time, but it's quicker. I do coats on both the right and then the wrong (backside) of my top lashes to make the mascara go on really thick and wet. As soon as you brush the lashes down to get the other sides, you have to quickly brush them back up (on the right side) to prevent them from drying in that position. Also, there may be a little more clumping because you're applying a lot more at once, but it's fixable with a few quick swoops of the brush. It saves me time in the morning using this method but I will take the time to do more thin coats if I'm going somewhere special.
Update 03/29/11: I recently tried using this again because my HG mascara, GOSH Lift 'N Shape WP was discontinued. This is not at all like I remember it. It goes on so wet and heavy and pulls out my curl, and it doesn't apply evenly at all. It makes my lashes messy, clumped in some spots and separated in others, and unevenly curled. It also crumbles off of the tips of my lashes throughout the day, which looks very weird. Not cool.
on 3/22/2007 8:17:00 PM
Age: 25-29
Skin: Combination, Fair-Medium, Neutral
Hair: Black, Straight, Medium
Eyes: Brown
Holds a curl quite well and does not smear or flake. Definitely not nearly as volumizing as the regular Voluminous. This formula thickens a little bit, but gets clumpy if you apply even one coat, so make sure you have your lash comb handy. "Takes" to my heated lash curler (Panasonic--love!) well, too, which has not been the case with most other L'Oreal mascaras. The "Very Black" is very black indeed and the texture is pretty well balanced between wet and dry/waxy.
This is my favorite L'Oreal mascara, just because it actually holds a curl (important because I have fine, stick-straight lashes that go down under the weight of mascara pretty easily). Otherwise, doesn't come close to unseating my Maybelline Full & Soft (also waterproof) as my HG everyday mascara. I'll use up my tube but I doubt I'll repurchase--it's a decent mascara by my standards, but not great.
continued >>
on 3/22/2007 12:09:00 AM
Age: 18 & Under
Skin: Combination, Tan, Not Sure
Hair: Brunette, Curly, Coarse
Eyes: Blue
Doesn't pump as much volume into my lashes as the original formula, definetely goes on differently.. but once dry, totally waterproof! I used this mascara when I had swim meets and it didn't budge through the whole session. I don't use it on a daily basis but I reccommend it for anyone hitting up the beach or public pool and wants their mascara to stay put.
on 3/13/2007 4:50:00 AM
Age: 25-29
Skin: Combination, Other, Not Sure
Hair: Red, Other, Other
Eyes: Brown
My favorite mascara, hands down. Regular mascara burns my eyes, and this one is the only thing I can use. It gives me transvestite lashes...which I sometimes tame with a metal lash rake thingy. People always ask me what mascara I use. Even my sister, and I always say...the same thing I have been using since 5th grade. About drying your lashes out- whatever. I use waterproof eye makeup remover (Clinique, Lancome or Paula's Choice). It's kinda oily, so it conditions them when I take the mascara off. Best mascara ever.
on 3/12/2007 10:36:00 PM
Age: 25-29
Skin: Combination, Fair, Not Sure
Hair: Black, Straight, Coarse
Eyes: Brown
No, no, no! This mascara didn't deliver the volume it promised! I know I applied 3 coats but my lashes looked no thicker than with regular mascara. Very disappointing!!! It also took the curl out of my lashes. It didn't make them completely droop/point downwards (there was still a slight lift), but they didn't look perky and curled as they usually do. However, there was limited smudging and no flaking at all and didn't seem at all clumpy.
on 3/8/2007 11:15:00 PM
Age: 19-24
Skin: Normal, Medium, Cool
Hair: Black, Wavy, Fine
Eyes: Brown
I tried this because even though Maybelline's Full and Soft is the best mascara on earth, it was causing me lash loss. So I thought I'd try this on MUA's recommendation. However, this doesn't hold up a candle to Full and Soft. It's clumpy, flakey, and just totally messes up my lashes. I tried this about 3 times, gave up, and returned it. I'd rather lose some lashes than use this mascara! Maybelline's Full and Soft is still the best thing around!
on 2/25/2007 4:05:00 PM
Age: 25-29
Skin: Other, Other, Not Sure
Hair: Other, Other, Other
Eyes: Other
I really wanted to like this mascara based on all the good reviews, but I have to say it was a huge disappointment. After a week, I realized that this was what was causing my bloodshot eyes (I had thought it was just stress from planning my wedding, but the irritation and redness ended once I stopped using this). Also, after applying the mascara, I ended up with thick black clumps on my contacts after a few hours. I've been a devotee of Maybelline Full n' Soft, but I think I'm going to try MF Lash Perfection next. Bottom line, use L'Oreal Voluminous mascara at your own risk!!
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Call of Duty: Modern Warfare 2
Question from MRFTBALL84
How do i create that clan tag that looks like a little hand gun?
I see it all the time online, its an
6 years ago
Seriously! nobody seems to know, or want to tell, but i see it all the time online and even remember it on cod 4...... i was thinking it has to do with changing language or hex editing, but i see it so often that i doubt all of them hex edited it !
6 years ago
Top Voted Answer
its the mexican e with the little dash on top of it then a degree symbol then Quotes 2 of them "" and thats all the e with dash of it can be slanted either way too.
6 years ago
I wanna know too. So cool...
6 years ago
Add me on xbox live i will show you how. My gt is whit3trash101.
6 years ago
%*** I think
6 years ago
First go to symbols then lowercase E with diagonl line pointing top right then do the tiny o, to finish click right trigger and to quoteations hope this helped.
6 years ago
e*"" Tada!
e - lowercase 'e' with an accent on it
* - small 'o' (not actually an asterisk)
" - quotation mark
" - quotation mark
6 years ago
This question has been successfully answered and closed
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