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Linda Mann wrote:
> Thought you all might enjoy this. Huge clump of GERALD DARBY,
> "naturalized" in a wet meadow. Weeded by the groundskeeper in the
> photo.
> Linda Mann Tennessee
And fertilizer machine as well I would guess!
Cathy - who used to have a couple of fertilizing machines as well...
Region 19, NJ
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An analysis of blood samples from more than 10,400 children showed that those with vitamin D levels of less than 30 nanograms per milliliter had an almost twofold increased risk of having anemia compared with those who had normal levels of the vitamin. Although more black children than white children in the study had anemia, researchers found that black children's odds of developing anemia did not increase until their vitamin D levels were much lower compared with their white counterparts. The findings were published on the website of the Journal of Pediatrics.
Full Story:U.S. News & World Report

subset: commoncrawl


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Nothing quite tops an outfit like a tiara.
Try though you may, a cloche, a beret, or a fedora do not come close. A scarf, hair band or barrette? Nope. Even fascinators, de rigueur at the royal wedding, simply do not have the cache of a tiara.
Outside of real royal crowns — and those usually require bloodlines, conquerors and all sorts of DNA-fueled history — the tiara that trumps them all is bestowed in New Jersey.
Yes, Miss America is back in Atlantic City, where it all started. The beauty pageant that officials prefer we think of as a scholarship contest, the 2014 Miss America Competition, airs on ABC Sunday, Sept. 15.
Miss America 2013 Mallory Hagan reflected on the year and the fashions of the pageant over the years.
Though Hagan won $50,000 in scholarships and plans to use it to finish her studies in communications at the Fashion Institute of Technology, she won, in part, because she can indeed rock a black bikini.
Here, she wears a Catalina suit, the brand that returned to the pageant last year after a 62-year absence.
The trick to looking this good in a bikini is not so secret. "Eating well and working out," Hagan says. "On stage, it is very important to have a good tan. I love a good spray tan. And mostly, it is just confidence. They say it is won from the neck up. It is more about your energy and connection to the audience and how that confidence shines though. I try to be as confident as possible."
That black bikini, and many smaller ones over the years, have come a long way since these one-piece suits from 1953.
"I think they are actually kind of fun," Hagan says. "Last year, Catalina offered a retro swimsuit as one of our choices, and I thought long and hard if I should go with it. I still love them. Today there is something so enticing about them because they reveal enough, but not too much."
Just in case these don't look hot and itchy enough, remember these suits were wool, some of the women in this photo are wearing wool stockings and even the men are in full suits – on the beach.
"It is just interesting how much the fashion and times have changed since back then," Hagan says. "What we wear today would have been so inappropriate. And Miss America started out as a swimsuit competition. They were there to model the swimsuits."
The tiaras, which have changed over the years, always have four points. They represent service, style, scholarship and success.
Incidentally, Miss America does indeed get to keep the crown, though, oddly she does not wear it all the time.
"It depends on the appearance," Hagan says, adding she has been on the go since being crowned. "I wear it when there are kids around."
Wearing the tiara, "makes me really humbled," Hagan says.


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Barclays swerves Android Pay with smartphone NFC payments launch
Banking giant Barclays has announced the launch of its own mobile contactless on Android, and confirmed to Telecoms.com it will not be joining Android Pay.
Banking giant Barclays has announced the launch of its own mobile contactless on Android, and confirmed to Telecoms.com it will not be joining Android Pay.
Samsung and SK Telecom have both made mobile payment announcements, confirming Korea remains the main source of mobile payment competition to Apple and Google.
South Korean electronics giant LG has taken one step forward and one step back in the wearable technology race.
Korean tech giant Samsung has used the IFA consumer electronics show to showcase its IoT efforts, including the first products of its SmartThings digital home acquisition and a new smartwatch.
A new study has revealed how online commerce will grow as a result of consumers taking to mobile platforms for digital shopping.
Mobile phones will take an increasingly leading role in the payments space over the next five years as a result of technologies that allow safe storage of payment details in smartphones and other security improvements, reports Banking Technology.
US mobile chip giant Qualcomm will integrate NFC and embedded secure element (eSE) technologies from Dutch silicon company NXP in its Snapdragon reference designs.
SMS seems so last decade, but often the simplest technologies provide the easiest solutions. Amdocs has partnered with Norwegian SMS payments outfit Strex to promote this technology and see the rise of mobile wallets from the likes of Apple, Google and Samsung as complementary.
Google has stoked the fire burning underneath the mobile payments industry by announcing its acquisition of "some exciting technology and intellectual property from Softcard to make Google Wallet better." The payment software will come pre-installed as standard on Android phones running KitKat or higher with three of the big four carriers across the USA, AT&T, T-Mobile and Verizon.
A multi-operator capable SIM card included in Apple's latest iPad range will give consumers the flexibility to switch between short-term plans with operators in the UK and USA. So far, AT&T, Sprint, T-Mobile and UK operator EE have confirmed participation with the initiative.
Apple today announced an unprecedented range of additions to its product catalogue, including the iPhone 6, 6 Plus, Apple Pay and Apple Watch. The keynote session in Cupertino, California, saw the unveiling of new NFC mobile payment capabilities to be built as standard into the new models, and the launch of the Apple's foray into the wearable technology space with Apple Watch, as widely anticipated.
India's ICICI Bank is to launch a mobile payments service built by Movida, the Indian joint venture between Visa and mobile money specialist firm Monetise, that will draw on the potential to reach unbanked customers in the country.
Apple has agreed to acquire fingerprint security firm AuthenTec in a deal worth around $356m. AuthenTec's fingerprint technology has been used in mobile phones in Japan for authentication of mobile payments, and Apple is expected to bring those services to more markets.
UK mobile payment technology and services provider Monitise has announced plans to acquire US based counterpart Clairmail, in a bid to create the "world's largest pure-play mobile money company". Monitise will pay a sum of $173m for the acquisition, which is conditional upon US regulatory and shareholder approvals, and the firm expects the acquisition to be completed before the end of the financial year 2012.
Telefónica Digital, the cross sector services arm of the international operator created in September last year, has announced a strategic partnership with mobile commerce provider Sybase 365. The deal will see the two firms collaborating on Telefónica's m-wallet proposition, which will include a range of mobile financial services.
eBay is launching a host of in-store payment processing services for retailers, via PayPal, over the coming months. The services do not rely on the use of near-field communications (NFC) or credit or debit cards.
UK carrier O2 has announced the companies it will be partnering with to deploy its mobile wallet service in the second half of 2011. O2, the UK arm of Spanish incumbent Telefónica, said it would be working with Wave Crest, FIS, Intelligent Environments and Visa Europe.
Mobile payment and payment gateway platform developer Charge Anywhere, has unveiled an Android app that will allow businesses to process credit and debit cards using only a handset. The application turns Google's Nexus-S smartphone into an NFC payment acceptance terminal.
Vodafone, Orange, O2 and T-Mobile have announced their intention to launch NFC mobile payment services in the UK by 2012. Near-field communications (NFC) has been building a head of steam in recent months, with the likes of Google, RIM and Visa announcing their support.
Mobile money transfer and NFC (Near Field Communications) transactions are predicted to account for 50 per cent of the global mobile payment market by 2013. Industry analyst Juniper Research said this week that while the mobile payments market is currently dominated by purchases of digital content such as ringtones, music and games, it will in […]
Will regulators ever be able to catch up with the rate of change in the telco/tech industry?
Total Voters: 48
Red Hat insists EU competition rules do more damage than good https://t.co/Xjz2tpPac7 #regulation #consolidation
01 March 2017 @ 17:15:24 UTC
Competing in the digital economy means owning the smart home - #Accenture https://t.co/d9mBU09mLK
01 March 2017 @ 15:17:11 UTC


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When we first met I was quiet and isolated,
We began to know each others personality.
I learned she loves soccer, and is a whatever person.
I had many adventures and memories with her.
We cried, we laughed, we hugged, and most of we had each other.
She is forever my best friend, no matter how far she lives now,
© Copyright 2017 ezzy. All rights reserved.
Status: Finished
Genre: Memoir
Book / Literary Fiction
Short Story / Non-Fiction
Short Story / Poetry
Paste the link to picture in the entry below:
Paste the link to Youtube video in the following entry:
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OUR SEO OUTSOURCING WORK Has Proven Results
Call Us at: +36 70 629 06 90
Your Success is Our SEO Success at weboldal készítés
Your Success is Our SEO Success at weboldal készítés
Letters is a recipient of the prestigious Mom's Choice Award. The Mom's Choice Awards honors excellence in family-friendly media, products and services.
You might know your pet is immensely talented, but would they be successful in the world of jobs? On this website, you can create a resume for your pet and even apply for fantasy jobs on their behalf.
The mission of the Amelia Island-Fernandina Restoration Foundation is to promote the preservation of the architectural, historical and archaeological heritage of Amelia Island and Fernandina Beach
The sole purpose of business is service. The sole purpose of advertising is explaining the service which your business renders.
Markets change, tastes change, so the companies and the individuals who choose to compete in those markets must change.
Sometimes when you innovate, you make mistakes. It is best to admit them quickly, and get on with improving your other innovations.


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Odakyu Yama No Hotel is located a 5-minute drive from Moto-Hakone Port. Free shuttle service is available. Boasting an extensive garden offering stunning views of Lake Ashi and Mount Fuji, the long-established hotel offers guests a memorable resort experience. Dining options include authentic French and Japanese cuisines. Guests can relax in the modern, large communal bath and open-air hot spring. Western and Japanese-Western style rooms are available. WiFi and wired Internet is available in guest rooms.
- Check-in:
- 15:00
- Last check-in:
- 24:00
- Check-out:
- 12:00
- Closest station:
- From Hakone-Yumoto station, take route bus bound for Hakone-machi and get off at Motohakone-ko bus stop ( 40 min ride ). A direct highway bus runs from Shinjuku Odakyu Halc
- Address:
- 80, Motohakone, Hakone-Machi, Ashigarashimo-Gun, Kanagawa 250-0522, Japan
- Contact information:
Phone number:0460-83-6321
Fax number:0460-83-7419
- Parking:
- 100 Cars / Free


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iPhone - iPad Games
One Spear Savage - Let's Play Trailer for iPhone - iPadHome / iPhone - iPad /
This page contains a "One Spear Savage - Let's Play Trailer" for iPhone - iPad and has been posted or updated on Mar 2, 2014 by EDF_Admin. Check this page periodically for the latest Video Game Trailers and Gameplay Videos.
Boxshot & Details
- Developer: 36peas
- Publisher: 36peas
- Genre: Action
- Release: Feb 27, 2014
- ESRB: Not Set
Video Game Trailers
One Spear Savage - Let's Play Trailer
- Mar 2, 2014, Views: 102
Stuck in this game? Set a specific, clearly defined question and let other gamers answer your question or view answers to previously asked questions.
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A Bookaholic, Pro-life, Pro-Family, Pro-Oxford Comma, Catholic (with Asperger's) who reads and writes as her obsession. I've been reading over 400 books a year lately. These are my ramblings on some of the books I read. To read about all the books I read and comment on, visit me at LibraryThing or Goodreads.
I've been blogging since 2007 and at this point (July 2015) am trying my hand at turning the theme of this blog towards mystery, thriller, and crime, fiction and nonfiction. I have some special interest topics and categories within this broad genre which include (but are not limited to) serial killers, scandi-crime, Victorian history and historicals, history of the criminally insane and asylums, psychopathology, death, funerary practices and burial, corpses, true crime and anything dealing with the real life macabre, or that portrayed in fiction.
I also read a short story a day from various collections, sometimes anthologies othertimes collections of a single author's work. These reviews are also posted here and while they are of mixed genre the mystery, thriller, horror, gothic and macabre often appear within their pages as well.
I also blog about graphic novels and manga on a separate BLOG.
I also blog about graphic novels and manga on a separate BLOG.
Wednesday, December 5, 2012
Short Story: "Long Distance" by Eric Weiner
a short story
Illustrated by Katherine Osborn
from REDBOOK magazine, August, 1981, pg 40
First Sentence: "In an effort to save a dying relationship, Benjamin Katz made long-distance phone calls."
Last Sentence: "That seemed an exceedingly small price to pay"
Author: The short author blurb states that this is the author's first published short story. Research shows there are two famous authors of this name, a children's book writer and an NPR travelogue writer. I can't find a bio of either which states where these authors were born as my info here tells me this short story "Weiner" grew up in Providence, Rhode Island and in 1981 was living in NYC. Of course, it is more likely this is a completely different person, as the name is not all that unique.
This is a short short story taking up 3 columns of one magazine page and does not hold up well to time. It is out-dated and I found it an annoying story. Ben and a girl live together for four months and then she leaves him for her former long-term boyfriend whom she had never gotten over. Ben then proceeds to call her long distance with no result, moves on to calling her mother, some friends (all long distance) and eventually goes through his entire address book starting with "A". Retelling the story each time, it feels fresh and new to him; most people tell him to get over it and move on with his life but all seem willing to listen. By the end, he calls the girl one more time planning to tell her the last thing that should make her come back to him and when she pauses to listen instead of hanging up like usual, he cannot think of anything to say. Instead, he tells her off and says he wouldn't get back together with her even if she wanted. Life goes on until he gets the phone bill, at which point he has an itemized list of his "phone therapy" and he feels the cost was well worth it.
I found Ben annoying, his fixation on a girl he really hardly even knew somewhat creepy and the phone angle out-of-date since most of us have some sort of free long distance plan these days. Perhaps readable at its time but not worth revisiting today.
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Showing 1-24 of 69 items found in Outdoors & Play
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Step back in time a few years and enjoy clean, old-fashioned outdoor fun at Abbey Farms. Unique – no haunting themes, no electronic games, no gimmicks, just clean old-fashioned outdoor fun for everyone. Enjoy three seasons of fun; fresh produce in summer, Pumpkin Daze in fall and U-pick Christmas trees in winter. Shop their fresh bakery goods, cider donuts, and other seasonal delights. Looking for a unique venue for that special occasion? Visit their new rustic-chic barn, the Nagel Emporium.
Acorns Golf Links is located in Waterloo, Illinois featuring 6,701 yards of golf from the longest tees for a par of 72 . The course rating is 72.3 and it has a slope rating of 125. You will not find subdivision golf at Acorns; just nature, beautiful scenery, challenging design, and you. Making Acorns the premier public course to test your game, have fun with good friends, or to get away from your daily hussle and bussle. Acorns features zoysia fairways, five tee boxes; matching every level of golf and large bent grass greens. Designed by William Ebeler, the Acorns golf course opened in 1997.
Two full-sized rinks are open for year-round skating. All Seasons also offers a game room, ballet room, pro shop and party room.
Allerton Park & Retreat Center
Allerton Park was the private estate of Robert Henry Allerton, who donated it to the University of Illinois in 1946. It features 1,500 acres of woodlands, formal gardens and more than 100 sculptures. The park is open to the public for hiking, picnicking, cross-country skiing and leisurely garden strolls.
Amboy Marsh Wildlife Sanctuary
The Amboy Marsh Wildlife Sanctuary is 272 acre of wetlands offering a rare and fragile ecosystem, which includes endangered turtles, many birds and unique plant life. It is located near the intersection of U.S. Route 52 and Mormon Road about 3 miles south of Amboy. Open to the public 7 days a week for walking and bird-watching. No dogs are allowed due to sensitive plant and wildlife.
Find serenity at this beautiful 1700-acre wooded park situated along an old stagecoach route between Galena and Beardstown. Featuring 95-acre Argyle Lake, the park is home to countless beaver dams and more than 200 bird species and 5 miles of hiking and biking trails.
Atkinson Motorsport Campground
Enjoy your stay at the state of the art campground. There are 28 sites that will easily accommodate a 40' motor-home and then some! All sites have electricity and water, while some have sewer. A dump station is at the east end of the campground. There are 6 total shower houses also available: Each room has a shower, toilet, sink and hooks to hang your towel. Enjoy your evenings with a fire in the public use area. This is a great place for getting to know your neighbors and sharing stories about your day of riding and fun!
Atkinson Motorsports Park (Gob Hill)
Looking for an adrenaline rush in Henry County? Experience the thrill of the Hill! Filled with 200 acres of unrestricted trails, undiscovered timber, rugged hills, steep valleys and lakes. Gob Hill is a motorsport enthusiast's dream. More conservative riders can enjoy over four miles of perimeter road riding, with beautiful Midwestern vistas. Gob Hill is also home to a children's dirt track perfect for knee-high dirt trackers. There is also a motocross track.
Ball Fore Family Entertainment Center
Take in all the energy and entertainment available through the abounding opportunities at Ball Fore Family Entertainment Center! Mundane does not exist within the vast array of choices distributed throughout this park. Treat yourself, family, friends, or colleagues to an interactive day at the park. Ball Fore Family Entertainment Center has something for everyone including eight batting cages, an eighteen hole miniature golf course, driving range, sand volleyball pit, archery range, basketball, bags sets, playground, picnic area and concessions.
Just minutes away from the city but a world away, Ballard Nature Center is home to dozens of species of birds and wildlife. Natural prairie, wetlands, butterfly and hummingbird gardens, ponds and creeks round out the outdoor experience.
A tradition for over 25 years. Thousands of hand-pruned, organically grown firs, spruces, and pines in 9 varieties. Free horse-drawn wagon rides & Santa on weekends. Pets welcome
Bicycle/Hiking Trails - Aurora
More than 35 miles of scenic trails, from Aurora to Crystal Lake, pass through scenic landscapes. Active travelers enjoy biking, hiking, jogging and cross-country skiing. Nature-seekers enjoy bird watching and tranquil vegetation. Routes include the Fox River, Virgil Gilman and Red Oak Trails, and the Illinois Prairie Path.
Bill's Friendly Christmas Tree Farm
Cut your Christmas tree in a backwoods setting. We have many trees, including Norway, white spruce and blue spruce. Family owned and operated. Trees up to 23 feet tall.
Boone County Conservation District
The Boone County Conservation District manages over 3,00 acres of prairies, woodlands and wetlands in scenic Boone County, Illinois. Minimum impact recreational opportunities, special events and educational programs are offered to the public throughout the year.
There's more than 200 beautifully landscaped acres to explore at Brookfield Zoo. Highlights include dolphin shows at Seven Seas, ape encounters at Tropic World and the chance for kids to dress up and play veterinarian at the Hamill Family Play Zoo. The zoo also offers an old-fashioned carousel and a wide variety of shopping and dining options.
Byron Forest Preserve District (skating)
The Forest Preserve has one outdoor skating rink and warming shelter - open weekends.
Camp Sagawau Environmental Education Center
Environment Education Center - offers cross country skiing in the winter.
Castle Rock State Park is located three miles south of Oregon on Highway 2. The 2,000-acre park includes rock formations, ravines, and unique northern plant associations. In one valley, 27 different types of ferns have been identified. A sandstone bluff, adjacent to the river, has given the park its name. Picnic area amenities include tables, shelters, grills, toilets, drinking water and playground equipment. Six miles of marked hiking trails have been developed, and a public boat ramp/parking facility is located across from the park's main entrance.
The Chief Keokuk Campground features 70 pads with electrical hook-ups for trailers, plus 25 tent sites. There is a shower building on site. A sanitary dump station is near the camping area. The cabin is located on a slope overlooking Johnson Lake. A fire grill, table and BBQ grill are provided outside. A full-size bed, two sets of bunk beds, a table and benches are provided inside. The cabin has heat and air conditioning as well as two ceiling fans.
Ski along scenic slopes at Galena's Chestnut Mountain Resort, perched high above the Mississippi River. Rated by Ski Magazine as one of the top ski resorts in the Midwest, Chestnut Mountain goes all out with a snowboarding park and night skiing. Stay at the rustic 120-room lodge, which has three restaurants, including the fine-dining Sunset Grille. There are fun non-skiing activities in the summer as well, including boat cruises on the Mississippi Explorer and the exhilarating Alpine Slide, which speeds 2,000 feet down a hillside. Or try the new Segway Mountain Adventure Tours, a three-mile guided ride through rolling terrain.
The Chicago Botanic Garden opened a little more than 40 years ago as a beautiful place to visit, and it has matured into one of the world's great living museums and conservation science centers. Each year, nearly one million people visit the Garden's 26 gardens and four natural areas, uniquely situated on 385 acres of land on and around nine islands. Six miles of shoreline extend along 81 acres of water, including the Great Basin, North Lake, and Skokie River Corridor. The Garden also has a renowned Bonsai Collection.
Conkeytown Christmas Tree Farm
Create a family tradition! Choose and cut your own fresh Christmas Tree. All trees are $30 (tax included) and we'll shake and bale it for free. Open Saturdays and Sundays 8 AM to 4 PM Thanksgiving to Christmas. We have white pine and scotch pine.
Over 45 exhibits of native Illinois wildlife and domestic farm animals; tree-shaded picnic area - seating for 300; "Exclusive Use" facility rentals; private party room; open year-round.
Cross Country Skiing at Rock Spring Center
Trails open whenever there is at least three inches of snow on the ground. Equipment rental available from 9am-2pm.


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Wego.com.sg recently found 3 hotels in Westwego, United States. Find a range of accommodation in Westwego at great prices. Book luxury Westwego hotels or find last minute accommodation. Save more on cheap hotels in Westwego with affordable room rates.
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Follow the trend and make your very own shamballa bracelets! Make them as a gifts. Your friends will love them!
Thank you for visiting Style Me Up Shambala Style Bracelets Kit on shoppingfind.co.uk
We bring the products from many websites to one website for you to search, save and compare.


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Huckleberry Bar
Brooklyn, NY 11211
- Sun 2pm-2am, Mon-Thu 5pm-2am, Fri 5pm-4am, Sat 2pm-4am
- $$
- Patio/Sidewalk Dining
- Late Night
- Full bar
- No Parking
- Reservations Accepted
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This is your resource to discuss support topics with your peers, and learn from each other.
I have an AT&T user in China who is having an issue
Tourch 9800
Everything is in Chinese accept his corporate mail (exchange). Texting and web surfing all in Chinese, his corporate mail is not. All other users in China (who are on same exchange box and BES box as this user) are workig fine. Seems this is the only device with issues and the only device that is v6.
Vendor said it was a BES issue.
Do we need to upgrade the OS...can we do it wirelessly?
Thanks for the help!
Solved! Go to Solution.
He can't upgrade wirelessly, sweet AT&T has not released any 9800 OS upgrade past 188.8.131.52, but he can upgrade manually IF he has a PC.
1. Any change he as Chinese set as a language? Options > Typing & Input > Languages. (I know he can read his BES emails in English, but it's worth looking, and you didn't state he had looked at this).
2. If he has not do so already, please instruct him to do a reboot in THIS matter: With the BlackBerry device POWERED ON, remove the battery for FIVE minutes, and then reinsert the battery to reboot. A reboot in this manner is prescirbed for most gltiches and operating system errors, and you will lose no data on the device doing this.
I don't know that an OS upgrade would fix this. And I don't know about it being a BES issue... I am not a BES expert.
PIN: C0001B7B4 Display/Scan Bar Code
PIN: C0005A9AA Display/Scan Bar Code
forgot to post fix..vendor AT&T had user flash ROM and this fixed problem.


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|Home | About | Journals | Submit | Contact Us | Français
Abstract Background: Vancomycin-resistant enterococci represent an increasingly important cause of nosocomial infections. Minimizing vancomycin use represents a key strategy in preventing the spread of these infections.
Objective: To determine whether a structured ordering intervention using computerized physician order entry that requires use of a guideline could reduce intravenous vancomycin use.
Design: Randomized controlled trial assessing frequency and duration of vancomycin therapy by physicians.
Participants and Setting: Three hundred ninety-six physicians and 1,798 patients in a tertiarycare teaching hospital.
Intervention: Computer screen displaying, at the time of physician order entry, an adaptation of the Centers for Disease Control and Prevention guidelines for appropriate vancomycin use.
Main Outcome Measures: The frequency of initiation and renewal of vancomycin therapy as well the duration of therapy prescribed on a per prescriber basis.
Results: Compared with the control group, intervention physicians wrote 32 percent fewer orders (11.3 versus 16.7 orders per physician; P = 0.04) and had 28 percent fewer patients for whom they either initiated or renewed an order for vancomycin (7.4 versus 10.3 orders per physician; P = 0.02). In addition, the duration of vancomycin therapy attributable to physicians in the intervention group was 36 percent lower than the duration of therapy prescribed by control physicians (26.5 versus 41.2 days; P = 0.05). Analysis of pharmacy data confirmed a decrease in the overall hospital use of intravenous vancomycin during the study period.
Conclusion: Implementation of a computerized guideline using physician order entry decreased vancomycin use. Computerized guidelines represent a promising tool for changing prescribing practices.
Since the first report of their isolation in 1988, 1,2 vancomycin-resistant enterococci (VRE) have become a major health threat in hospitals throughout North America and Europe. 3,4 The Centers for Disease Control and Prevention reported that VRE already constituted 7.9 percent of national enterococcal isolates in 1993. 5. The emergence of VRE clearly represents a problem in itself, as no established antimicrobial therapy currently exists. 6 Even more alarming, however, is the possibility that vancomycin resistance will emerge among staphylococci, the most common of nosocomial pathogens. Demonstration of the transfer of plasmid-mediated resistance to staphylococci has already occurred in the laboratory setting, 7 and isolation of intermediately resistant clinical strains has recently been described.8,9
Expert recommendations cite more prudent use of vancomycin as the key strategy in containing the problem of VRE.10 Clinicians and researchers have considered different means of limiting inappropriate and excess antibiotic use at least since the 1970s, because of cost considerations as well as concern over the emergence of resistant organisms.11,12 Strategies have included specialized ordering forms,13 individualized feedback,14 performance feedback,15 and continuing education.16 In the case of vancomycin in particular, restriction and monitoring of drug ordering by members of the pharmacy and infectious diseases departments have been tried.4,17 However, these approaches have yielded mixed results and, even when successful, require continued resources of time and money to maintain.
A promising alternative approach to changing physicians' prescribing behavior is offered by physician computer order entry, in which orders are written online and decision support can be provided at the time the orders are written.18,19 With such an approach, the guidelines for use of a particular drug can be displayed when the drug is ordered, and these guidelines are immediately available to all providers. We undertook a randomized controlled trial using the provider order-entry system at our hospital to display guidelines for the appropriate use of intravenous vancomycin. Our goal was to determine whether this intervention would reduce vancomycin ordering.
Brigham and Women's Hospital (BWH) is a 720-bed university-affiliated hospital with approximately 35,000 admissions per year. In 1995, there were 78 new cases of VRE at the hospital, 49 of which were obtained from specimens collected for clinical indications; the rest were detected through surveillance cultures in response to index cases (unpublished data from Infection Control at BWH).
Physicians at BWH write orders using a computerized provider order-entry application, which has been described previously.20 Interns and residents enter the vast majority of all patient orders, as only housestaff, along with fellows and a small number of attendings in surgery and obstetrics and gynecology, can write orders that do not require cosignature. The order-entry system accepts orders for all aspects of patient care, including laboratory and radiologic tests as well as all medication orders. This same computer system allows all providers (not just those writing orders) access to clinical data on patients, including laboratory results, reports from diagnostic studies, discharge summaries, and notes from ambulatory visits in most of the clinics associated with the hospital.
The study was a randomized controlled trial comparing the use of vancomycin by physicians randomly assigned to the intervention group with the use of vancomycin by a control group of providers who had no exposure to the intervention. It was possible that physicians in the control group could learn of the intervention from physicians in the study group, but as discussed later, any such cross-over exposure would be expected to bias the study toward the null hypothesis. The study was approved by the hospital's institutional review board.
Nonphysicians who were authorized to enter orders that required eventual signing off by physicians were also randomized. These nonphysicians consisted mostly of nurses entering verbal orders from physicians, but also some pharmacists likewise entering verbal orders and a few physician assistants. In total, this group contributed only 10 percent of all vancomycin orders, and the vast majority of members of this group contributed only a single order for vancomycin. Thus, we excluded these data because of their small contribution to the overall vancomycin orders and because these users were generally not in a position to make independent prescribing decisions.
All users of the clinical computer system at BWH have a sequentially assigned internal identification number that remains unknown to them. Randomization was performed using the even or odd character of this number, which has no connection with any provider characteristics such as department affiliation, seniority, or level of training. Other studies conducted at BWH use this same method of randomization, but assignment to the experimental group does not consistently involve either the even or odd identification numbers.
The intervention consisted of showing computerized guidelines for vancomycin ordering at the time of initial vancomycin ordering and after 72 hours of therapy. The initial screen presented () contained an adaptation of the indications for vancomycin use developed by the Centers for Disease Control10 and approved by the BWH Pharmacy and Therapeutics Advisory Committee and Infection Control Committee. This screen appeared whenever a clinician in the intervention group initiated an order for intravenous vancomycin. Providers were required either to enter an indication or to abort the order. The "other" category required the user to enter free text describing their indication. Any response in the "other" category was accepted.
Previous work has shown that vancomycin is often prescribed for inappropriately long periods of time.21 Thus, we also displayed a screen asking providers their indication for continuing vancomycin use after 72 hours of therapy. Physicians in the intervention group were presented with the guidelines screen shown in , whereas the control physicians encountered only the usual computer prompt to renew or discontinue the order after 72 hours of therapy.
The primary outcomes of the study consisted of the number of vancomycin orders and duration of vancomycin therapy prescribed by providers in the intervention and control groups. The global utilization of vancomycin in the hospital constituted a secondary outcome for the study. Adjusting for monthly changes in the hospital census, we compared the number of patients who received vancomycin and the amount of vancomycin dispensed before and after the intervention. One would expect any change in the vancomycin utilization suggested by this comparison to represent approximately half the true effect, since the pharmacy data make no distinction between the control and intervention groups. However, we hoped to provide some external corroboration that a real effect on vancomycin utilization had occurred, if the physician order entry data showed a positive impact of the intervention.
We recorded each vancomycin order in a computer log containing the service on which the patient received treatment, the department affiliation and study status of the ordering provider (intervention or control), as well as the indication selected for vancomycin use by providers exposed to the guidelines screens. To estimate the amount of vancomycin prescribed by each provider, we used the dates and times of the orders from this computer log and calculated the duration of vancomycin therapy attributable to each provider.
We obtained data from the pharmacy system on the monthly utilization of vancomycin in the hospital. These data contained the number of patients who received at least one dose of vancomycin as well as the amount (in units and grams) of vancomycin dispensed. We also obtained census information for the study and comparison periods in connection with the analysis of the pharmacy data.
Results for the numbers of orders and ordering rates are reported as means with standard deviations as well as medians with 25- and 75-percent quartiles because of the non-normality of the results and the expectation that far outliers would have an important influence on the overall amount of vancomycin used. The primary univariate comparisons between the control and intervention groups were made using the Wilcoxon rank-sum statistic, since the data were not normally distributed. For the secondary outcomes of global vancomycin utilization before and after the intervention, we performed univariate comparisons as above but also used piecewise linear regression22 to analyze the trend in monthly vancomycin utilization. With this technique, the effect of the intervention can be detected either by a change in the vertical intercept if the change is abrupt or by a change in the slope if providers learned gradually from the intervention.
From June 20, 1996, through March 30, 1997, 396 physicians wrote 5,536 orders for vancomycin for 1,798 patients. The distribution of the physicians by department between the control and intervention groups was nearly balanced (). Since the use of vancomycin tends to cluster among patients on particular services and patients with lengthy hospitalizations, we checked the average length of stay for the patients of physicians in both groups as well as the services of the patients for whom they ordered vancomycin. There were no significant differences between the intervention and control group physicians with respect to the average length of stay of their patients or the services on which the patients received their care.
Comparison of the numbers of orders by type in the two groups () showed that the number of initial orders per physician in the intervention group was 29 percent lower than the number of the control group (6.8 ± 9.5 compared with 9.6 ± 14.5 orders per physician; P = 0.03). Physicians in the intervention group also wrote 36 percent fewer renewal orders compared with physicians in the control group (4.5 ± 11.3 compared with 7.0 ± 16.2 orders per physician; P = 0.16). We hypothesized that the renewal guidelines might have less impact on services on which long courses of vancomycin are common, specifically the hematology-oncology and bone marrow transplant services. However, analysis of the ordering data excluding patients from these services left the results for the renewal orders unchanged. Overall, though, the total number of orders for physicians in the intervention group was 32 percent lower than in the control group (11.3 ± 19.9 compared with 16.7 ± 29.2 orders per physician; P = 0.04).
The initiation and renewal of vancomycin therapy are not necessarily linked, as one physician might renew an order that another had initiated. Also, a physician might write multiple renewal orders on a single patient requiring a prolonged course of vancomycin. Thus, we also compared the total number of patients for whom each physician had written either an initiation or renewal order for vancomycin. As shown in , physicians in the intervention group prescribed vancomycin for 28 percent fewer patients than did control group physicians (7.4 ± 11.4 compared with 10.3 ± 15.1 patients; P = 0.02). When we compared the duration of vancomycin therapy ordered per physician (also shown in ), we found that physicians in the intervention group prescribed vancomycin for 36 percent fewer days than physicians in the control group (26.5 ± 47.6 compared with 41.2 ± 76.7 days; P = 0.05). The number of days of vancomycin per course of treatment was also lower for the physicians in the intervention group, with a mean of 1.8 ± 1.1 days compared with 2.0 ± 1.1 for the control group (P = 0.05).
After the randomized trial began, the percentage of patients in the entire hospital who received vancomycin at least once during their hospitalization decreased by 15 percent compared with the months immediately prior to the study (P < 0.01; ). The average amount of vancomycin in grams dispensed per month also decreased by 15 percent (P = 0.01; ). However, the small decrease in the amount of vancomycin dispensed on a per patient basis was not statistically significant. To evaluate whether or not these reductions in the hospital-wide use of vancomycin could be attributed to the intervention, we used piecewise linear regression. The analysis of the percentage of hospitalized patients who received vancomycin at least once () shows that both the slope and vertical axis intercept changed significantly (P = 0.04 and P = 0.01, respectively) after the intervention. In , the amount of vancomycin dispensed per month corrected for hospital census shows a steady decrease (i.e., a negative slope), but this decrease was not significantly affected by the intervention. Last, while the analysis in suggests a small but statistically significant decrease of 10 percent in the amount of vancomycin dispensed per patient, this small change was not statistically significant in the piecewise analysis.
We also evaluated the frequencies of the indications entered for initiation and renewal of vancomycin therapy (Tables and ). We do not have a measure of the accuracy of the indications entered, although in other domains accuracy has been high.23 Also, physicians could enter any free text they chose under the "other" category, decreasing the chance that users would deliberately enter inaccurate indications. Only approximately 10 percent of orders were entered as "other." For the initiation orders, no single category accounted for a large proportion of these orders, but for the renewals, the vast majority of "other" indications related to fever in patients on the hematology-oncology or bone marrow transplantation services.
The annual hospital costs for vancomycin have been just under $300,000 per year for the past three years at our institution. Thus, this intervention has a projected savings of as much as $90,000 per year from decreased vancomycin utilization. However, in many instances, a different antibiotic may be chosen instead of vancomycin, so that these projected savings will be partially offset by increased purchases of first-generation cephalosporins and penicillinase-resistant penicillins. The daily cost of vancomycin at 2 g per day is approximately $12/day in our hospital, whereas the cost of a first-generation cephalosporin such as cefazolin at 3 g per day is approximately $9/day. Thus, if cefazolin were substituted for vancomycin in all cases in which providers chose not to order vancomycin, the cost savings of the intervention would consist of 25 percent of the $90,000 figure above, i.e., a savings of $22,500/yr.
In this study, a computerized ordering guideline resulted in a significant change in antibiotic ordering practice. Physicians exposed to the intervention ordered approximately 30 percent less vancomycin than physicians in the control group in terms of frequency of ordering, numbers of patients on vancomycin, and duration of vancomycin therapy prescribed per patient. The study took place against a background of a general 15 percent reduction in vancomycin use, as measured by grams of vancomycin dispensed per month adjusted for monthly census, in our hospital during the study period. However, because of the randomized controlled design of the study, the observed 30 percent decrease in frequency and duration of vancomycin therapy represents an effect beyond that attributable to this background historical trend. Also, piecewise linear regression analysis of the pharmacy data confirmed that our intervention had an effect on reducing vancomycin use independent of the secular trend of reduced vancomycin ordering during the study period. For this reason, the computerized guidelines for vancomycin ordering were generalized to all users of the order entry system and have been left in place since completion of the study.
Researchers at LDS Hospital in Utah have described an elegant decision support system for treatment of infections and have demonstrated that this system has substantially improved the quality of the prescribing practices of physicians and reduced antibiotic costs at that institution.24,25 This decision support system presents data available from the computerized patient records relevant to antibiotic prescription and even presents a recommendation for antibiotic selection to the physician users. The type of system in place at LDS Hospital will undoubtedly find application at other hospitals in conjunction with the implementation of computer order entry systems. However, the complexity of the system will likely delay widespread availability for some time. In contrast, the approach used in the present study is much simpler and more readily generalizable to computer order entry systems in the short term.
Anglim et al. published a study evaluating the impact of a computerized ordering guideline for vancomycin26 and reported a 50 percent decrease in vancomycin use, a larger reduction than we observed. However, there are several important methodologic differences between the two studies. The intervention these authors describe was implemented without a control group of providers for comparison, so the effect of the intervention itself cannot be separated from general changes in ordering practice that may have occurred. At our hospital there was a secular trend of decreasing vancomycin use before the study began. Thus, the 50 percent reduction in vancomycin orders observed by Anglim et al. could represent the combined effect of the computer intervention and general changes in ordering practice occurring during the study period, as a result of heightened awareness of the problem of VRE and other infection control strategies.
These authors also report a reduction in the prevalence of VRE isolates detected by their surveillance program after their intervention went into effect. We observed a similar marked decrease in the isolates of VRE at our institution (both clinical isolates and surveillance cultures) during our study. We did not report further on this outcome because the decrease seemed merely to reflect the fact that an outbreak of VRE had occurred shortly before the study began. Control of the outbreak by general infection control measures presumably resulted in the observed decrease in VRE before any microbiologic effect of reduced vancomycin use could reasonably have been expected to occur. Because the study by Anglim et al. was undertaken in response to an outbreak of VRE at their institution, the reduction in monthly incidence of VRE isolates they observed could reflect regression to the mean. Nonetheless, decreasing vancomycin use represents the key strategy in containing the spread of VRE, and Anglim's data as well the data presented here both suggest that computerized guidelines may provide a powerful tool for changing prescribing practice.
In general, physician practice has proved difficult to change. Systematic review of educational strategies for changing physician behavior reveals that traditional strategies such as continuing medical education conferences produce little long-term benefit in terms of physician performance or health care outcomes,15 although they may alert physicians to the need for a specific change in practice. Multifaceted interventions and educational outreach interventions have been more successful, although such interventions require more resources to implement and often still have only moderately favorable results.15 A recent study of a computerized decision support system for aiding clinicians in the outpatient management of diabetic patients showed a two-fold increase in compliance with established clinical practice guidelines for physicians exposed to the intervention.27 However, this positive effect on the practice of the intervention group physicians corresponded to an absolute compliance with the practice guidelines of only 32 percent, underscoring the magnitude of the task often facing investigators hoping to modify physician behavior. In our study, a simple intervention, requiring a relatively small investment both to implement and to maintain, resulted in a significant impact in the behavior of interest, namely, parenteral vancomycin ordering.
The major limitations of our study are that we did not gather data on appropriateness or on adverse outcomes. The study from the University of Virginia by Anglim et al.,26 discussed above, and an earlier study of vancomycin use at the University of Iowa20 documented remarkably similar values of 61 percent and 63 percent, respectively, for the proportion of vancomycin orders deemed inappropriate by the investigators. We did not formally audit appropriateness in this study, but were recently participants in a Massachusetts Peer Review Organization (MassPRO) study, in which charts from 1995 were audited by MassPRO reviewers. The hospital's guideline-supported vancomycin use rate using the Centers for Disease Control guidelines was 42 percent (range among hospitals, 33%-53%), exactly the mean rate for the six hospitals sampled (unpublished data, D. Yokoe). These data suggest that the appropriateness of vancomycin use at our institution is similar to that in other hospitals.
Regarding this intervention and appropriateness, it is our impression that improvement occurred but that many of the orders remain inappropriate according to the Centers' guidelines. It is also possible that the intervention resulted in the decision not to use vancomycin in cases in which its use would have been appropriate. Because no therapeutic equivalent exists for vancomycin, it is possible that adverse outcomes could have resulted. However, the guidelines screens we used were, if anything, more liberal than the original CDC guidelines, and these guidelines have been developed by panels of experts specifically to improve antibiotic ordering practice without compromising patient outcomes. Other potential criticisms of our study might include contamination of the control group through awareness of the intervention as a result of communication among the physicians in both groups. Also, a Hawthorne effect might have produced reductions in vancomycin ordering in both groups independent of the intervention itself. However, in both these cases, the expected effect would be a bias toward the null, suggesting an underestimate by our study of the true effect of the intervention.
In conclusion, implementation of a computerized ordering guideline resulted in a reduction in vancomycin use at a tertiary-care hospital with a prevalence of VRE close to national averages. The intervention was readily incorporated into the existing computer order entry system at our institution and required negligible resources to maintain. The intervention also facilitates further improvements in vancomycin use by allowing us to target specific indications and providers. In general, the process of having a follow-up review of the orders entered using computer guidelines may provide an effective adjunct in the effort to control the use of drugs that should be prescribed sparingly, such as vancomycin and imipenem.
This work was supported by grant R01-HS08927 from the Agency for Health Care Policy and Research.
PubMed Central Canada is a service of the Canadian Institutes of Health Research (CIHR) working in partnership with the National Research Council's national science library in cooperation with the National Center for Biotechnology Information at the U.S. National Library of Medicine(NCBI/NLM). It includes content provided to the PubMed Central International archive by participating publishers.


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To say Brian Grubb has wakeskated all over the world isn't an exaggeration — in fact, it's a bit of an understatement. From skipping through rice pools and shredding snow in Bosnia and Herzegovina to grinding ice in Cape Cod, the wakeskater is constantly on the hunt for new spots to shred.
The latest? The famous Cleopatra Pool in Pamukkale, Turkey, which is a man-made pool fed by natural hot springs and filled with ruins dating back to the seventh century, when Turkey was part of ancient Greece.
During the day it's open for people to bathe and enjoy the "champagne water," but Grubb and friends got special permission to shred the spot before opening hours, and it was quite the session. Check out the video below to see what went down.
"I look at spots with water around them differently than most people," says Grubb. "I'm always looking for new places to ride and a lot of times those are fountains and spillway drops. As wakeskaters we're ideally trying to find natural spots that have drops or ledges so we can do skateboard-style tricks down them."
The pool is pretty shallow
But the Cleopatra Pool would need some work. "It was a very shallow pool with pillars and rocks just below the surface," says Grubb. "Getting the rail built and then set up every day was probably the biggest obstacle we faced."
Now, you may be worried that the rail the guys are hitting is in fact a priceless piece of ancient history. Never fear, as that was not the case.
"The column rail we set up was made for this project. We wrapped it to look like a pillar that would be there already," says Grubb. "It's a pretty basic rail to wakeskate on, but having it in such a small location and shallow water made it more challenging."
Once the rail was set up, however, it worked. "The pool was just big enough to get the speed to hit the rail and then stop on the other side. The electric winch helped to get us to speed quickly. We knew where the rocks and pillars were just under the surface, and once we got the rail in we had a pretty good line to ride with a deep landing!"
What's next for Grubb? He's not letting on, but he promises that in 2016 he'll have a few projects that will catch our eye. We can't wait!
Follow Brian Grubb on Instagram and Red Bull Adventure on Facebook for more.


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An elderly California woman accused of trying to cut off her husband's penis during oral sex was ordered to stand trail on felony charges Friday.
After an hour-long preliminary hearing in Indio, Calif., a judge ruled there was enough evidence for 70-year-old Virginia Valdez to stand trial on one count each of spousal abuse and assault with a deadly weapon, John Hall, spokesman for the Riverside County District Attorney's Office, told The Huffington Post. Valdez is pleading not guilty to both charges.
On Dec. 3, in Palm Springs, Valdez was "massaging the intimate areas of the victim such as his testicles and inner thigh" when she told her husband that she was going to get up to brush her teeth, according to the arrest warrant. Instead, she grabbed a pair of scissors and cut her unsuspecting husband's penis and "disfigured the victim's genitals."
"The victim got up in a panic and screamed in pain," the warrant reads. He went to the bathroom, retrieved some towels, applied direct pressure to his penis and drove himself to Desert Regional Medical Center. The husband, who was 62, also called 911 and said to the police, "Bitch tried to cut my dick off." He then received four stitches to his penis.
Officers arrested Valez, who walked out of the house willingly. Soon after, she was released on $100,000 bail and ordered to refrain from having any contact with her husband, CBS reported.
Valdez and her husband have been married for 30 years and share two children.
According to Hall, the victim has hired attorney Gloria Allred, who is famous for taking high-profile cases, particularly those defending the rights of women. Allred is also currently representing a former girlfriend of Rudy Eugene, the alleged Miami cannibal.
The motivation for Valdez's alleged attack is unclear. She has no other criminal record in Riverside County, and the defense has not filed any motions regarding her mental health, Hall told HuffPost. If convicted as charged, she will face nine years in prison.
Caught in the act: mugshots of other dumb criminals.
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Lolita, 50th Anniversary Edition (original 1955; edition 1989)
by Vladimir Nabokov
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Lolita by Vladimir Nabokov (1955)
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Let me be brief. The audiobook version performed / read by Jeremy Irons may well be the best audiobook performance I have ever had the pleasure of reading.
He renders this controversial and brilliant novel so skillfully, so seductively (appropriate considering the subject matter) that he elevates the book into an entirely new category of something like "literary performances".
Read the audiobook for its emotional power but not to study the book which is much too dense to be fully understood via the audiobook form. Iron's narration, especially toward the end can zip along so quickly that much of the symbolism of this complex novel will be lost.
As an emotional experience however, it is unparalleled and I recommend it highly.
Nabokov hated Humbert. And rightly so, because Humbert is not the romantic, tragic figure he wanted himself to be viewed. He is an incestuous, rapist pig and a murderer, plain and simple. He took advantage of a young girl. A twelve-year-old girl. Sure, she fooled around at summer camp, but a lot of young girls start discovering sex at that age. That doesn't give adults pretext to rape them, and if you have that mentality, you're screwed up. It's easy to get seduced by the prose, but you have to remember what Humbert is.I read this last year and while I was blown away by the prose, I managed to keep my head and remember Humbert is not the victim. Dolores is. To quote one of my favourite movies, Hard Candy (which, funny enough, also dealt with paedophilia): "It's just so easy to blame a kid, isn't it? Just because a girl knows how to imitate a woman does NOT mean she's ready to do what a woman does!"
I love this book. I don't know what that says about me. I mean, I know the subject matter is atrocious, but I was super amazed by how much I got into the story. The writing style is the absolute most interesting I've known. Especially for something written so very long ago, the words were super fresh. The imagery, metaphors and just words used in ways that haven't been used before. This is a book that will stay with me forever.
Normally, I would think of a child being nothing after the fact to a child molester, and in turn, the effects of what happened overshadowing the child forever. In this he's so madly in love with her, and to her he's just a blip she passed over.
I love how morose he is, and his crazy ridiculous love is so weird.
So for whatever reason, this book just is a hit for me.
FangirlMoments and My Two Cents
The story of Humbert Humbert, a pedophile who is telling his own story. He is a nutcase, so he writes all over the place. He is deluded, thinking he is perfectly fine and doing the best for Lolita. So it is obvious that you, the reader, cannot take at face value what the writer, Humbert, is writing. Overall, a disgusting book that gives more weight to the idea of simply killing all pedophiles instead of sending them to jail.
Despite the critical acclaim, rave reviews and high placement on most must-read lists, I avoided reading Lolita for decades, mostly because of the subject matter. What can I say? My philosophy of universal tolerance doesn't extend to Pedophiles. But when I read another Nabokov book, Despair, I realized that this was a unique author. His ability to tell a story through the eyes of an unsavory character, simultaneously expressing his twisted belief in his innocence while subtly revealing to readers the vile truth of his character, is unparalleled. Vladimir Nabokov is an absolute master of the unreliable narrator. When I realized this, I had my first inkling that Lolita might be something more than just a story about a pervert.
Now that I have read it I find myself in a bit of a pickle. By my rating scale, for me to give a book five stars I must believe it must pass the 'If it ain't broke, don't fix it' test. There should be no room for improvement. That's not the case. I reached a point about midway through the book where I grew very tired of Humbert Humbert, the less-than-humble narrator, and his efforts to maintain control of his step-daughter Dolores, aka Lolita. Many will argue and I won't disagree that Nabokov used this time to subtly and relentlessly build the case against Humbert. Humbert's greatest crime, as revealed via subtle clues and references revealed from his own pen, is that he took a 12 year-old girl and stole from her not only her childhood but her entire life. While I did find it painful to read at times, I cannot deny that it was masterfully done.
Other arguments favoring a high rating include Nabokov's skill at creating new English words when none exist that meet his needs. Some, such as the word 'nymphet' have jumped from his pen into the current lexicon. His mordant sense of humor also put him in a class above most authors. One wouldn't expect to find humor in a book about pedophilia but a careful reading will reveal quite a bit. I particularly enjoyed a scene when he talked about the fate of his first wife after she left him.The couple had somehow got over to California and had been used there, for an excellent salary, in a year-long experiment conducted by a distinguished American ethnologist. The experiment dealt with human and racial reactions to a diet of bananas and dates in a constant position on all fours. My informant, a doctor, swore he had seen with his own eyes obese Valechka and her colonel, by then gray-haired and also quite corpulent, diligently crawling about the well-swept floors of a brightly lit set of rooms (fruit in one, water in another, mats in a third and so on) in the company of several other hired quadrupeds, selected from indigent and helpless groups. I tried to find the results of these tests in the Review of Anthropology; but they appear not to have been published yet.Another point in the book's favor is his ability to portray complexity. Almost all of us see the subject of pedophilia in black and white. It's not something to which we apply gradation. To those of us who see the world thusly, Nabokov asks 'But what if you have two pedophiles? Is a victim better off with one of them than the other?'
Bottom line: This is not a very pleasant book to read but it is brilliant and I recommend it highly. It is more mystery than romance although, since it is told to us by a sexual predator, his passion for his victim is a big part of it. What I find most fascinating is Nabokov's ability to tell a story using a deranged individual's words. He simultaneously shows us how twisted his protagonist is and how he can obliviously view himself as something almost noble. There is one word that describes this skill that Nabokov has that many authors lack; 'depth'.
FYI: On a 5-point scale I assign stars based on my assessment of what the book needs in the way of improvements:
*5 Stars – Nothing at all. If it ain't broke, don't fix it.
*4 Stars – It could stand for a few tweaks here and there but it's pretty good as it is.
*3 Stars – A solid C grade. Some serious rewriting would be needed in order for this book to be considered great or memorable.
*2 Stars – This book needs a lot of work. A good start would be to change the plot, the character development, the writing style and the ending.
*1 Star - The only thing that would improve this book is a good bonfire.
Brilliantly written ... a disquietingly sombre exposure of a pervert's mind, and finally dreadfully moral in its almost melodramatic summing up pf the wages of this particular sin.
Massive, unflagging, moral, exqusitely shaped, enormously vital, enormously funny - Lolita iscertain of a permanent place on the very highest shelf of the world's didactic literature.
A scarifying indictment of the kind of perversion with which it deals.
I am sure that the future will exonerate Lolita from the charge of pornography as compleately as we have exonerated Ulysses.
Some readers may find Lolita offensive. It is a strange combination of roman noir and hot-potato. But more accurately it is an authentic work of art which compels our immediate response and serious reflection _ a revealing and indispensable comedy of horrors.
Is contained in
Novels 1955-1962: Lolita / Pnin / Pale Fire by Vladimir Nabokov
Five novels (Collins collector's choice) by Vladimir Vladimirovich Nabokov
Has the adaptation
References to this work on external resources.
Wikipedia in English (4)
Amazon.com Amazon.com Review (ISBN 0679723161, Paperback)Despite its lascivious reputation, the pleasures of Lolita are as much intellectual as erogenous. It is a love story with the power to raise both chuckles and eyebrows. Humbert Humbert is a European intellectual adrift in America, haunted by memories of a lost adolescent love. When he meets his ideal nymphet in the shape of 12-year-old Dolores Haze, he constructs an elaborate plot to seduce her, but first he must get rid of her mother. In spite of his diabolical wit, reality proves to be more slippery than Humbert's feverish fantasies, and Lolita refuses to conform to his image of the perfect lover.
Playfully perverse in form as well as content, riddled with puns and literary allusions, Nabokov's 1955 novel is a hymn to the Russian-born author's delight in his adopted language. Indeed, readers who want to probe all of its allusive nooks and crannies will need to consult the annotated edition. Lolita is undoubtedly, brazenly erotic, but the eroticism springs less from the "frail honey-hued shoulders ... the silky supple bare back" of little Lo than it does from the wantonly gorgeous prose that Humbert uses to recount his forbidden passion:
She was musical and apple-sweet ... Lola the bobby-soxer, devouring her immemorial fruit, singing through its juice ... and every movement she made, every shuffle and ripple, helped me to conceal and to improve the secret system of tactile correspondence between beast and beauty--between my gagged, bursting beast and the beauty of her dimpled body in its innocent cotton frock.Much has been made of Lolita as metaphor, perhaps because the love affair at its heart is so troubling. Humbert represents the formal, educated Old World of Europe, while Lolita is America: ripening, beautiful, but not too bright and a little vulgar. Nabokov delights in exploring the intercourse between these cultures, and the passages where Humbert describes the suburbs and strip malls and motels of postwar America are filled with both attraction and repulsion, "those restaurants where the holy spirit of Huncan Dines had descended upon the cute paper napkins and cottage-cheese-crested salads." Yet however tempting the novel's symbolism may be, its chief delight--and power--lies in the character of Humbert Humbert. He, at least as he tells it, is no seedy skulker, no twisted destroyer of innocence. Instead, Nabokov's celebrated mouthpiece is erudite and witty, even at his most depraved. Humbert can't help it--linguistic jouissance is as important to him as the satisfaction of his arrested libido. --Simon Leake
(retrieved from Amazon Thu, 12 Mar 2015 18:11:34 -0400)
The most controversial classic novel of the 20th century, Lolita tells the story of Humbert Humbert, a middle-aged man who is aroused to erotic desire only by a young girl. Awe and exhilaration--along with heartbreak and mordant wit--abound in Lolita, Nabokov's most famous and controversial novel, which tells the story of the aging Humbert Humbert's obsessive, devouring, and doomed passion for the nymphet Dolores Haze. Lolita is also the story of a hypercivilized European colliding with the cheerful barbarism of postwar America. Most of all, it is a meditation on love--love as outrage and hallucination, madness and transformation.… (more)
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Brooks Rehabilitation will be hosting its seventh annual Challenge Mile on Saturday, March 11 at 10 a.m. as part of the Gate River Run. The Challenge…
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At Brooks, we're dedicated to offering the most advanced therapies and techniques for all of our patients. We offer more types and more hours of therapy than any area rehabilitation system.


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Films about youth
Feature Film
PBS Premiere: Oct. 31, 2016
Inside the very first girls' school in a small Afghan village, education goes far beyond the classroom as the students discover the differences between the lives they were born into and the lives they dream of leading. A co-production of ITVS.
Short Film
PBS Premiere: Oct. 10, 2016
An intimate portrait of a gender-nonconforming child growing up in conservative rural Florida.
Feature Film
PBS Premiere: Sept. 12, 2016
Accompany two African-American teens from the South Side of Chicago on their journey to achieve their dream of graduating from college. A co-production of American Documentary | POV; Part of American Graduate: Let's Make It Happen, made possible by the Corporation for Public Broadcasting.
Feature Film
Encore Broadcast: Aug. 29, 2016
An extraordinary look into a internet addiction rehab in Beijing, China, the first country in the world to classify this evolving diagnosis. Official Selection of the 2014 Sundance Film Festival.
Digital Project
Digital Premiere: April 14, 2016
Whiteness Project is a multi-platform investigation into how Americans who identify as "white" experience their ethnicity. The latest installment, "Intersection of I," examines a cross-section of white millennials from Dallas, Texas, sharing their views on race, racism, family, friends, perceptions and privilege.
Short Film
Digital Premiere: April 13, 2016
Storm Reyes found hope the day a bookmobile arrived at her migrant camp near Tacoma, Washington in the 1960's.
Short Film
Digital Premiere: Feb. 1, 2016
Since 2010, POV and StoryCorps have brought over 30 animated shorts to PBS and online audiences.
Feature Film
PBS Premiere: Sept. 21, 2015
In a community where silence is seen as necessary for survival, immigrant activist Angy Rivera joins a generation of Dreamers ready to push for change in the only home she's ever known — the United States. A co-presentation with Latino Public Broadcasting.
Feature Film
Digital Premiere: Sept. 11, 2015
Since 2010, POV and StoryCorps have brought over 30 animated shorts to PBS and online audiences.
Feature Film
PBS Premiere: Aug. 17, 2015
One teacher prepares his students for their new life in Switzerland as they struggle to learn a new language, prepare themselves for employment and reveal their innermost hopes and dreams.
Feature Film
PBS Premiere: July 20, 2015
A look behind the barricades of the besieged Syrian city of Homs, where, for 19-year-old Basset and his ragtag group of comrades, the audacious hope of revolution is crumbling like the buildings around them. Winner of the first George Polk Documentary Film Award.
Short Film
Digital Premiere: Nov. 10, 2014
In 2005, Specialist Justin Cliburn deployed to Iraq with the Oklahoma Army National Guard. While serving in Baghdad, Justin formed an unlikely friendship with two Iraqi boys who lived nearby. At StoryCorps, Justin speaks with his wife, Deanne, about the lasting impression the boys left on his life.


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Lake Buchanan Adventures
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Back Home and a little R & R
... and maker shops are still the original buildings from that era. They've been painted up, fixed up and a little face lift but the same buildings the post office, bars, stores, etc. that made up the nucleus of Ingram. That big diesel pusher in the background is my closest neighbor. There are only 23 spots in the whole park and are full hookups, cable and wifi for one money. Very quiet and peaceful. Unless something major develops, I think this will be ...
God Bless Williamson County Cowboy Church
... for a reason....I didn't know she was going to be there, outside of the church, when I completely lost it and needed someone to hold me. I was thinking about my Daddy big time for some reason among various other things........if only everyone could feel this love from our Almighty God.
Next time I go in a couple weeks, I will take pics of the whole congregation .....this place was packed and I know why....
Marble Falls, Tx , a great place to land
... Home Depot in a town of population 7,000. I like this area....for a population of 7,000 there is a tremendous amount of traffic coming through from other little cities. For economics, the primary traffic is 60,000 and Secondary is 100,000. That is a lot for a small town. Seems traffic is flying through there though and gaulking at sites is not an option...they will scare the **** out of you flying up on your tail and ...
Beautiful Texas Hill Country!
After searching online for 2 weeks and getting a little frustrated, I think I finally found an RV park that actually has some space between Rv's, is in the country, is around water activities, hiking and biking places, will take my dogs, and is located central to everywhere I want to adventure. 3 hours to Fort Worth, 3 hours to the Gulf, 2 hours to San Antonio, 3 hours east to the national forests. Whewwww!!! Very in depth search....Coldwater Creek ...
Getting Ready
... prevent that from happening, but it doesn't. The large awning has an area where it has rubbed, so I put some repair tape over it to reinforce it. While I was up there, I cleaned the awning. That was on the outside, meanwhile on the inside, I washed and dried 4 loads of clothes. Tonight we joined Ronny & Linda for their "date night". Ronny is ...


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- 1saying what somebody/something is like; describing something the descriptive passages in the novel The term I used was meant to be purely descriptive (= not judging).
- 2 (linguistics) saying how language is actually used, without giving rules for how it should be used opposite prescriptive Word Origin mid 18th cent.: from late Latin descriptivus, from descript-
BrE BrE//dɪˈskrɪptɪv//; NAmE NAmE//dɪˈskrɪptɪv//
Check pronunciation: descriptive


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Don't beat yourself up. You did everything you could for the other kitty.
Most folks wouldn't have bothered to care so much.
I do agree that while it may be something minor with your new kitten, as
soon as it is safe to do, I'd take him/her to the vet anyway to be on the
safe side. We have always done that with any new furred family member
a sneezing hamster that was allergic to dust!) It will make you feel
better. I'm with Jesse...say those prayers until you can easily pick
him/her up and into your safe keeping.
Bonnie (SW OH - zone 5)
-----Original Message-----
From: firstname.lastname@example.com [mailto:firstname.lastname@example.com] On
Of Daryl
Sent: Tuesday, June 06, 2006 4:40 PM
To: email@example.com
Subject: Re: [CHAT] Kitten
I worry because the last kitty that tried to adopt us turned out to have
pneumonia. He'd been thrown out of a car, and when we took him to the vet
because his leg was broken, he died on the operating table. :-( It was
years ago and I still feel bad about it.
To sign-off this list, send email to email@example.com with the
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When South Africa came back into the fold
10 November 1991 is a historic and one of the most emotional days in cricket history because it was when South Africa played their first international match for 21 years, against India in Calcutta. South African cricket had been ostracised since 1970, but four months after rejoining the ICC they began a speedily arranged tour with this one-dayer. India won the match by three wickets and the series 2-1; however this was one of those situations when the enormity of the occasion dwarfed the scoreline. For the record, there were over 90,000 spectators at the Eden Gardens to welcome South Africa back into the international cricket fold. South Africa captain Clive Rice, whose only official internationals, came in this short series said after the Calcutta match: "I know how Neil Armstrong felt when he stood on the moon."
- AFG won by 106 runsvs. AFGZIM5th ODISun, Feb 26, 2017Harare, ZimbabweAfghanistan in Zimbabwe OD...
- AUS won by 333 runsvs. AUSIND1st TestThu, Feb 23, 2017Pune, IndiaAustralia in India, 4 Test...
- SA won by 159 runsvs. SANZ3rd ODISat, Feb 25, 2017Wellington, New ZealandSouth Africa in New Zealan...
- No live matches are in progress.
- vs. SANZ4th ODIWed, Mar 01, 2017Wed, Mar 01, 2017Hamilton, New ZealandSouth Africa in New Zealan...
- vs. IREUAE1st ODIThu, Mar 02, 2017Thu, Mar 02, 2017To Be Confirmed, IndiaIreland vs United Arab Emi...
- vs. ENGWI1st ODIFri, Mar 03, 2017Fri, Mar 03, 2017Antigua, West IndiesEngland in West Indies ODI...
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Necesito urgente este ejercicio
Complete the paragraph below with the correct form of the verbs in brackets:
Every year I ________(go) on holiday to york with my family. We usually stay there for 3 weeks. I like going cycling. My sister _________(go) shopping and my parents ___________(love) going to museums. I ______________(not/like), we _______________(have) a great time there. We ___________(go) to a fancy dress party, wearing Viking's clothes. While we _______________(dance) we____________(hear) a strange noise. When we _________(turn) round, we ____________(see) a ghost screaming.
It ___________(be) an actor. He ___________(try) to frighten the guests.


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Publication Name: Circular To Bankers
Location: London, Middlesex
Pages Available: 12,035
Years Available: 1828 - 1853Learn More About This Publication
Circular To Bankers (Newspaper) - October 31, 1828, London, Middlesex . J * t. * 1 > 4 �nd'jdlVdr9 issue notes upon unstamped paper, under the Composition Act, he may continue to issue his old notes upon stamped wanted in that manufacturing sirai lar trade might, we should think, be forced adv^htctgeotikly are worn out: but he cannot obtain fresh by other bankers the towns of thtt mining stamps to issue new notes upon stamped paper, after once manufacturing districts, by their drawing bills at fourteeii issuing composition notes. twenty-one days date on their London banker i ex- The mode of reckoning the amount of notes in circula- tion, upon which to pay the composition duty, is just and to the Bankers who issue them :-The duty is to be change for cash. The persons who want the sovereigns and silver for wages pay the banker's co mission charged upon those notes only that are in actual circula-tion; and all notes in the drawers of the issuers, or in the Nothing is more common than to find precisely opposite , ver- Wh en hands of their London agents, are not to be included in interpretations of the same act of the amount of notes chargeable with duty. Some Bankers bally, by different functionaries at the Stamp-o have formed a different opinion of the tenor of the act, however, a formal opinion is given, in writing, by the on considering merely its strict literal.signification. But Commissioners, we may pretty safely conclude that that We have the best this interpretation of it is that which the secretary of the opinion will remain the rule of action, the Commissioners of Stamps has given in a formal reason for asserting that the 10th clause of the 7th of manner. George IV. (see Circular, p. 46) is at the All Bankers who compound for their notes, and have Stamp-office to mean, that notes must be paid by Bankers several Branch Establishments, are exempted from, the where they are originally made and issued. paying for more than four licenses, although compel them to pay those notes at necess the number of their banks exceed four. It does not any Branch Bank, or Several of those Bankers who have compounded for stamps, have done so solely because they are enabled by week tpr th it to issue bills at not exceeding twenty-one days' date, in the disjunct the same manner as the Bank of England, and have no - No. 15. at any office which is occasip business at a market fair for banki 7 if t-i # * mone r nv, or "had been and/' and the clause had stood ;


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Dr. Chin graduated from the Medical College of Georgia School of Medicine in 1984. He works in Augusta, GA and 2 other locations and specializes in Endocrinology, Diabetes & Metabolism and Internal Medicine. Dr. Chin is affiliated with Augusta University Medical Center.
Endocrinology, Diabetes & Metabolism, Internal Medicine
Medical School: Medical College of Georgia School of Medicine; Graduated 1984
Please verify insurance information directly with your doctor's office as it may change frequently.
*This physician has multiple office locations. See Office Information for details.
1220 W Wheeler Pkwy Ste B
Augusta, GA 30909
465 N Belair Rd Ste 3A
Evans, GA 30809
4321 University Pkwy Ste 101
Evans, GA 30809


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Argenta Caleta
CTRA. BENICARLO / PEÑISCOLA S/N - Peniscola, Peniscola, Castellon 12598, Spain
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[hotel-description]Centrally located and directly on the beach Peñiscola, the complex is only a few minutes away from the resort centre. Near is a commercial area with all kind of shops, cafeterias, restaurants, etc.[/hotel-description][location]Information not available.[/location]
CTRA. BENICARLO / PEÑISCOLA S/N - Peniscola Peniscola, Castellon 12598, Spain