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The management of diabetes during terminal illness is complex, with lack of agreement and consensus among physicians and multidisciplinary teams. Despite the plethora of guidelines available for the management of diabetes, there exists no agreed, evidence-based strategy for managing diabetes during terminal illness and at the end of life. A number of physiological factors may influence glycaemic control during terminal illness. These include anorexia, cachexia, malabsorption, renal and hepatic failure. Furthermore, controversy exists on the frequency of blood glucose monitoring, the optimum blood glucose range and how to achieve this. We review the factors influencing blood glucose during terminal illness and provide a suggested approach to managing patients with type 1 and type 2 diabetes during the early and late stages of terminal illness.
Diabetes mellitus is a common and increasingly prevalent condition, with a prevalence of 4–5% in the UK.1 Furthermore, estimates suggest that there is one person with undiagnosed type 2 diabetes (T2DM) for every two patients with a diagnosis.2 The Health Survey for England 2003 suggests that 3.1% of men and 1.5% of women over the age of 35 years have undiagnosed diabetes.3 T2DM, like other chronic conditions, such as degenerative diseases and cancer, becomes more prevalent with age.4–6 In the population over 65 years of age, the prevalence of T2DM is 10%1 and in patients with newly diagnosed cancer the prevalence of T2DM is between 8% and 18%.7 Furthermore diabetes is associated with certain cancer types.8–10 Therefore, it is likely that there will be an increase in the prevalence of diabetes and cancer as the older proportion of the population increases. Traditionally, these two conditions have been managed by different specialities and when both co-exist particularly in the terminal stages of life there is little guidance on the best course of management. Surveys among diabetes and palliative care physicians and diabetes specialist nurses (DSN) show disagreement on best practice.11 In routine clinical practice, the objectives of treating diabetes are firstly to reduce macrovascular and microvascular complications and secondly to reduce osmotic symptoms related to diabetes. Both objectives need to be achieved without treatment-associated side effects, in particular hypoglycaemia. At the end of life, the main reason for managing hyperglycaemia is not to avoid long-term complications,12,13 but to avoid unpleasant osmotic symptoms and at the same time to avoid treatment-associated hypoglycaemia. Within this review, we have examined the available published literature focussing on the management of hyperglycaemia in terminal illness relating to malignant disease and suggest a possible treatment algorithm. Similar principles might also apply to other protracted non-cancer-related terminal illnesses in patients with diabetes. We conducted a full MEDLINE literature search for all relevant articles. Keywords searched for, either individually or in combination were: diabetes, palliative care, end of life, terminal illness, cancer, hospice, insulin, glucose and management. Limits were made to those articles in English, published from 1969 to 2009. Results yielded 21 papers applicable to the search criteria, of which only four were relevant to the management of diabetes at the end of life.11,14–16
Issues relating to managing diabetes with terminal illness
Diabetes during terminal illness may be complex from a physiological, clinical and ethical perspective. Routine diabetes care outside terminal illness aims for meticulous blood glucose control. Specific challenges associated with terminal illness include the frequency and method of monitoring blood glucose and the choice of medication to avoid hypoglycaemia and control osmotic symptoms. Other challenges include the management of pre-existing diabetes, steroid induced diabetes and diabetes developing after cancer diagnosis. Quality of life may be affected by osmotic symptoms when blood glucoses are running high. Clearly each patient has a different threshold for the development of symptoms, but these are inevitably present with a blood glucose >20 mmol/l. Hypoglycaemia may not only be related to therapies such as insulin and oral hypoglycaemia agents (OHA), but hepatic glycogen reserves may be diminished particularly if the patient is malnourished or in the setting of hepatic metastases. There may also be difficulties for the patient and family relating to the more liberal approach to glycaemia in terminal illness. Below we discus other factors which challenge the management of hyperglycaemia in the terminally unwell patient.
Gastrointestinal disturbance
Advanced cancer is associated with the anorexia-cachexia syndrome. Both the anorexia and weight loss complicate diabetes therapy. The doses of insulin and OHA may need to be reduced. Of particular importance metformin is associated with nausea, vomiting and gastrointestinal (GI) disturbance. With respect to long acting sulphonylurea therapy, the risk of hypoglycaemia would also be increased. The mechanism responsible for the anorexia associated with advanced cancer is the result of a chronic inflammatory process associated with elevated levels of cytokines such as tumour necrosis factor alpha and interleukin-6.17 These have profound effects on the hypothalamic control of hunger and food intake. Paradoxically these cytokines may also be associated with insulin resistance within certain tissue such as the liver, skeletal muscle and adipose.17,18 The net effect in patients with diabetes is a complex picture of a reduction in food intake, an increase in basal metabolism and reduced insulin sensitivity. This may be further complicated by inadequate hepatic glycogen reserves and therapy with insulin, sulphonylureas or metformin resulting in hypoglycaemia. Nausea and vomiting in association with anorexia may also be exacerbated by chemotherapy and opiate analgesics.
During terminal illness, disturbance in GI motility may occur due to a neoplastic process per se, for example, bowel obstruction associated with large tumours, or associated with medication use such as opiate analgesics. Malabsorption due to primary GI tumours, previous surgery, bacterial overgrowth or as a result of chemotherapy and radiotherapy will influence the absorption of oral nutrients and medications.
Altered hepatic metabolism
As already described, anorexia and GI disturbance will clearly cause a mismatch between nutrient intake and the action of insulin or OHA in patients with diabetes. Table 1 summarizes the potential problems associated with oral diabetes therapies in the setting of terminal illness. Metformin is not typically associated with hypoglycaemia except in the presence of hepatic dysfunction, for example in association with liver metastases or biliary obstruction. This is likely to be the result of reduced hepatic glycogen reserves associated with anorexia and poor food intake. Similarly, hypoglycaemia is also associated with sulphonylurea therapy and dipeptidylpeptidase-4 (DPP-IV) inhibitors in the setting of hepatic failure. In this setting, consideration may be made to a short acting sulphonylurea such as repaglinide. Thiazolidinediones (TZD) are contraindicated in the presence of hepatic derangement because of the risk of acute hepatic failure.
|Example (s)
|Mechanisms of action
|Main adverse effects
|Increased adverse effect
|Nausea, anorexia, vomiting, abdominal pain
|Long-acting sulphonylurea
|Glibenclamide, Gliclazide, Glipizide
|Short-acting sulphonylurea
|Nateglinide, Repaglinide
|Rosiglitazone, Pioglitazone
|GI disturbance, oedema, anaemia, headache.
|DPP-IV inhibitors
|Sitagliptin, Vildagliptin, Saxagliptin
|Sitagliptin: peripheral oedema, URTI.Vildagliptin: nausea, oedema, headache.
|Example (s)
|Mechanisms of action
|Main adverse effects
|Increased adverse effect
|Nausea, anorexia, vomiting, abdominal pain
|Long-acting sulphonylurea
|Glibenclamide, Gliclazide, Glipizide
|Short-acting sulphonylurea
|Nateglinide, Repaglinide
|Rosiglitazone, Pioglitazone
|GI disturbance, oedema, anaemia, headache.
|DPP-IV inhibitors
|Sitagliptin, Vildagliptin, Saxagliptin
|Sitagliptin: peripheral oedema, URTI.Vildagliptin: nausea, oedema, headache.
Summary of the mechanism of action and potential adverse effects associated with the use of oral hypoglycsemic agents in the treatment of type 2 diabetes in terminal illness.
Altered renal function
Terminal illness and advanced cancer may be associated with impaired renal function. This may relate to the nature of the primary malignancy (e.g. renal outflow obstruction), chemotherapy, radiotherapy, dehydration, renal artery occlusion, hypoalbuminaemia, age and co-existing renal disease. As shown in Table 1, the action of sulphonylurea therapies and insulin are exaggerated in renal impairment. Therefore, hypoglycaemia is a real risk. Caution is required with metformin, sitagliptin, vildagliptin and TZDs as adverse effects related to therapies are more likely.
Iatrogenic diabetes
Not surprisingly the use of corticosteroid therapy to alleviate symptoms of pain, anorexia, raised intracranial pressure or nausea with advanced malignant disease is associated with hyperglycaemia. Hyperglycaemia has been noted in up to 20% of patients taking high-dose corticosteroids.14 This typically occurs in patients with good hepatic function since the mechanism of steroid induced hyperglycaemia is through the hepatic mobilization of glucose from glycogen stores. The use of thiazide diuretics to manage oedema may also be associated with hyperglycaemia.19
Target for blood glucose measurements
Outside terminal illness, targets for capillary blood glucose concentrations are tight, typically below 7 mmol/l. No clear guidance is available on the preferred glucose threshold in terminal illness. Ford-Dunn et al.11 examined this in a postal questionnaire directed to senior members of the Association of Palliative Medicine and to diabetes consultants. There was no consensus agreement from the two groups. Palliative care physicians favoured a blood glucose level between 15 and 20 mmol/l. The diabetes physicians favoured a blood glucose level between 10 and 15 mmol/l. This study highlights the difference in opinion between two groups of clinicians and demonstrates the uncertainty across both specialities. Another publication recommends maintaining blood glucose between 10 and 20 mmol/l.14
Frequency of blood glucose monitoring
There is no agreement in the available literature relating to guidance on the frequency of blood glucose monitoring in terminally unwell patients with days, weeks or months to live. Opinions from palliative care and diabetes specialists range from twice daily, to once every 3 days. However, there is a consensus that patients symptomatic with hypoglycaemia or hyperglycaemia should test more frequently until a safe range is achieved. Authors' comment in the available literature that patients 'suffer' with regular finger-prick testing. Our experience is that most patients have become quite accustomed to this practice, and although this requires some consideration, the frequency of blood glucose testing should be tailored to the wishes of the patient and their families. In general, there may be reluctance to stop capillary blood glucose testing during terminal illness and there are reports where levels are monitored until the day of death.14 Within one study of patients with terminal illness, 29% (12/42) had blood glucose monitoring discontinued and only in a further 10% (4/42) was the frequency of monitoring reduced. Within this study, 76% (32/42) had blood glucose monitored up to and including the day they died. Of interest, patients and carers may be reluctant to reduce or stop glucose monitoring and may even regard a relaxed attitude to blood glucose levels in terminal illness as disinterest or neglect on the part of the medical and nursing staff.15 Within the above study only in 5% (2/42) of cases was there evidence of discussion regarding the change of management of diabetes with the patient or relatives.
With respect to T1DM, there is a general consensus that this is more challenging to manage in relation to glucose testing. Furthermore, although there is no agreement on the frequency of blood glucose monitoring; there is a consensus that this should be minimized to reduce discomfort associated with finger-prick testing.11 With respect to T2DM treated with OHA during the early phase of terminal illness, there is an overwhelming agreement that stopping blood glucose monitoring is a preferred course of action.11 With respect to the later stages of terminal illness, there is general consensus that blood glucose monitoring should be discontinued,11,16 but this is not always easily implemented.14
Managing glucose control
Outside the setting of terminal illness the treatment of diabetes typically follows well-defined algorithms [e.g. National Institute if Clinical Excellence (NICE) guidance in the UK]. However, treatment choices are dependent on many other factors such as age, co-existing morbidity, food intake, carer support and risk of hypoglycaemia. T1DM always requires insulin therapy, however, only when a significant reduction in beta cell function occurs do patients with T2DM require insulin therapy. The key aims of managing hyperglycaemia are to reduce osmotic symptoms in the short-term and to reduce macrovascular and microvascular complications in the long-term. Meticulous control to avoid long-term complications is not required with terminal illness. With respect to the long-term comorbidities, patients are often treated with other therapies such as statins, ACE inhibitors and other antihypertensive agents, and aspirin. Consideration should be made to stopping these agents.
During terminal illness the management of diabetes will not only depend on the type of diabetes, but also on prognosis, oral intake and the presence of co-existing disease such as renal and hepatic impairment. One approach is to stratify patients into two distinct groups; those with constitutional symptoms associated with terminal illness, and those entering the later stages of terminal illness.15 There is no agreed consensus in the available literature in relation to the optimum blood glucose control, but anecdotally clinicians do not intervene with a blood glucose level up to 20 mmol/l. There is a clear balance between the risks of inducing hypoglycaemia in patients who are anorexic, cachectic, and generally unwell, against accepting a higher blood sugar level without unpleasant osmotic symptoms of thirst, lethargy and polyuria. A difficulty that commonly arises is precisely establishing the cause of symptoms in terminally ill patients. Distinguishing whether symptoms of fatigue are due to hyperglycaemia or advanced terminal illness can be complex. Given that the emphasis of treatment in the palliative setting is symptom-control it is important for the physician to not over-interpret these signs, and investigate beyond what is ethically and morally deemed acceptable.
Type 1 diabetes and Type 2 diabetes treated with insulin
During terminal illness the aim of therapy should be avoid symptoms relating to hypoglycaemia and hyperglycaemia with a minimum number of injections. Patients with T1DM who are otherwise well should continue on their previous insulin regimens, but if there is reduced appetite then a dose reduction might be appropriate. To reduce the frequency of injections and potential treatment-associated post-prandial hypoglycaemia, long acting insulin analogues such as glargine or detemir may be appropriate,20 but there are no studies examining this in patients with terminal illness. There is also an argument to avoid the use of long-acting preparations especially when appetite may be suppressed and there is little regular food intake. The management of T1DM during the later stages of terminal illness differs between specialists in palliative care and diabetes. Palliative care physicians are more likely to use 'as required' short-acting soluble insulin or rapid-acting human insulin analogues (aspart or lispro), whereas diabetes physicians favour the use of premixed and long-acting preparations.11 It may be that a flexible combined approach is required, for example, in patients with anorexia and vomiting a change to short-acting insulin may be initially required and subsequently a change to long-acting once a day insulin when symptoms have improved.
Type 2 diabetes
For patients with T2DM treated with oral agents, if there is hypoglycaemia, an obvious approach is to reduce the dose of the sulphonylurea. (e.g. 50% reduction). Metformin therapy may need to be stopped in this setting as they may contribute to anorexia. An alternative approach is to use a short-acting sulphonylurea (e.g. repaglinide, nateglinide). The shorter half-life of ∼1 h of these agents may provide an advantage in that they may be administered if the patient is eating and withheld if the patient is unable to eat. In this way, the agents would be administered in a similar manner to a rapidly acting insulin analogue. Although there is no published literature on the use of such agents in the terminal phase of illness, this might be useful. For T2DM treated with OHA with blood glucose levels >15 mmol/l, then insulin therapy may be required. No consensus is available on the type of insulin, but twice-daily regime of short-acting insulin may be appropriate.
Education for patient and carer
The importance of patient education must not be overlooked, especially during the end of life. The role of the DSN is essential in this respect. The DSN may have already formed a bond with the patient and relatives during many years of outpatient care or during their hospital stay. The key role of the DSN is to provide support, education and advice in hospital or in the community to patients, relatives and health-care staff. They provide an important link with practice nurses, chronic conditions nurses and community and hospital palliative care staff. Their expertise with insulin delivery devices and home glucose monitoring is essential.
Patients and their relatives will have been previously educated to aim for good glycaemic control throughout the duration of the diabetes and may find it difficult to alter the practice. Furthermore, patients and relatives may also wish to follow the familiar routine. Sensitive discussion between familiar medical and nursing staff, the patient and family should occur to ensure that the avoidance of long-term complications is not the aim of diabetes management during terminal illness. This may, therefore, reduce the medication burden relating to both achieving glycaemic control and also to prevent other complications such as ischaemic heart disease and nephropathy. It may be necessary to provide education on the symptoms, detection and treatment of hyperglycaemia and hypoglycaemia. The range of acceptable blood glucose measurement will need to be explained to the patient and carer and a clear explanation of the reasoning behind this. Carers especially may need to be aware of the difficulty in balancing the risks of inducing hypoglycaemia against accepting a higher blood glucose level without unpleasant osmotic symptoms such as thirst, lethargy and polyuria. Dietetic advice and support may be essential particularly if enteral or parenteral feeding regimes are in use. The family and patients need to be aware that some concomitant medicines such as corticosteroids may increase blood glucose.
A proposed management algorithm
There is a clear paucity of guidelines and protocols available for managing patients with diabetes during the early and late stages of terminal illness. As already described there is also lack of agreement between medical specialists. Any algorithm for managing diabetes in terminal illness must differentiate between patients who are in the final terminal stages of an illness and those with weeks or months to live. Consideration is also required to the location of the patients, the carers, family nursing and medical staff.
We would suggest that all dietary restrictions relating to diabetes are relaxed or removed from the early stage of terminal illness. In both T1DM and T2DM, glucose monitoring should be reduced to an acceptable minimum. In the case of a patient treated with insulin, this may be 2–3 times per week and for a patient treated with oral agents blood glucose could be monitored 1–2 times per week, unless a circumstance arises that necessitates more frequent monitoring. This may include: hypoglycaemia, poor food intake, nausea and vomiting, enteral or parenteral feeding or corticosteroid use. We would recommend a target blood glucose range between 10 and 15 mmol/l in the early stage of terminal illness with a more liberal range of 5–20 mmol/l in the later stages. The clear aim is to avoid hypoglycaemia and osmotic symptoms and other acute unpleasant problems such as oral or genital candida.
A proposed treatment algorithm for T2DM is shown in Figure 1. Early education, multidisciplinary planning with the patient and relatives are clearly important. The plan should be clearly explained to the patient and family and documented in the medical and nursing notes. Primary care and community palliative team involvement may also be crucial. A review of concomitant medication is essential with particular focus on the need for therapy with corticosteroids, statins, antihypertensive and aspirin. Metformin and TZD are best avoided due to potential adverse effects. During the early phase of terminal illness, the patient should be assessed in relation to the risk of hypoglycaemia. In those at high risk consider the use of a short acting SU or a DPP-IV inhibitor. There are no clinical trials or other studies looking at the use of any of oral agents or insulin in the management of diabetes with terminal illness. As with any medication, these agents should be avoided if there are contraindications to use.
A proposed algorithm for the management of T1DM is shown in Figure 2. Patients should be grouped by duration of terminal illness and hypoglycaemia risk. If there is a low risk then the current insulin treatment may be continued or a once a day long-acting preparation considered. If the patient is at high risk of hypoglycaemia, then consideration should be made to a reduction in the insulin dose or a switch to short-acting insulin analogue or soluble insulin with meals. An intravenous infusion of insulin would be best avoided.
The management of diabetes with terminal illness will become more common practice as the ageing population increases. There is a lack of consensus between physicians and this portrays a difficult and complex management dilemma. This results due to the lack of clinical research and clinical trials within this area of medicine. Much of the available literature is based on personal experience and peer opinions from specialists within palliative care and diabetes. We have reviewed the available published literature and suggest a set of treatment algorithms which are relatively simple, achievable and written as a collaborative effort between palliative care and diabetes. Underpinning these guidelines is the importance of tailoring treatment to individual patient needs. This requires flexibility, ongoing reassessment and full involvement of the patient and family throughout the process. The suggested algorithms are based on personal experience and views rather than evidence. They have been developed on current treatment strategies available in the literature, providing an up to date and easily useable aid to clinicians managing this group of patients. We acknowledge the limitations associated with such an approach, and encourage further research into approaching the management of diabetes at the end of life.
Conflict of interest: None declared.


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Friday, June 5, 2009
Please visit The Tammy and Mandy Doggie Bag for occasional Tammy/Mandy/Courtney/Misty photo postings with limited text. To submit a photograph for the site, please email me at firstname.lastname@example.com.
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Friday, May 8, 2009
They Will Return Again Someday
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Thursday, May 7, 2009
Tuesday, May 5, 2009
Misty and "Friend"
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Everyone as an Awkward Amateur Model
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Monday, May 4, 2009
Friday, May 1, 2009
Anyone Can Do It
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How to Spot a Mandy: Adult Braces
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Wednesday, April 29, 2009
Comprehensive Decimation
I used to think the end of the world would involve multiple car crashes and the guitar solo in November Rain, but it turns out the apocalypse already secretly happened in Courtney's basement sometime in 1994.
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Pick Your Favorite and Name Her
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In a message dated 1/12/01 9:41:53 AM Eastern Standard Time, firstname.lastname@example.com
<< Heavenly Tiara sure looks alot like Grand Prize which is a tiara from
what I have heard and it also looks like Pilgrim's Progress. Just
thought I would mention that. >>
Bob, you would know that there would be a payoff to uploading all those
thousands of hosta images. Thanks, I like to keep it simple so I am going to
say that price will rule here.
Does anyone else have an opinion? N.
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for Men Exfoliating Tonic
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Item #14576U


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Smyrna Real Estate
Smyrna is located in Delaware. Smyrna, Delaware 19977 has a population of 10,065. Smyrna 19977 is more family-centric than the surrounding county with 33.24% of the households containing married families with children. The county average for households married with children is 31.02%.
The median household income in Smyrna, Delaware 19977 is $51,681. The median household income for the surrounding county is $55,786 compared to the national median of $53,046. The median age of people living in Smyrna 19977 is 32.7 years.
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The average high temperature in July is 87 degrees, with an average low temperature in January of 26.3 degrees. The average rainfall is approximately 44.6 inches per year, with 15.2 inches of snow per year. No weather information available.
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California pizza kitchen
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Thai Chicken Pizza (California Pizza Kitchen copycat) #Majestic #Pizza #BuffaloBucksCoffee
Thai Crunch Salad... the reason I am addicted to California Pizza Kitchen. Can't wait to try this copy cat version to see how it rates!
Recipe for Copycat California Pizza Kitchen Mac and Cheese - It's the most ridiculously simple, delicious, creamy macaroni and cheese recipe ever. It calls for just three ingredients, and it's simply amazing.
This copycat roasted garlic chicken pizza reminds me of my favorite California Pizza Kitchen pizza. So full of garlic flavor and ready in just 30 minutes.
Chicken Chipotle Pizza - California Pizza Kitchen copycat
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Avocado Club Egg Rolls. (California Pizza Kitchen) A fusion of East and West with fresh avocado, chicken, tomato, Monterey Jack cheese and applewood smoked bacon, wrapped in a crispy wonton roll. Served with ranchito sauce and our herb ranch dressing.
Deliciously spicy and sweet, this Kung Pao Chicken Spaghetti is a fan favorite and all time best seller from California Pizza Kitchen that you can make at home and with my adjustments enjoy it with about half the calories and ALL the taste!
California Pizza Kitchen BBQ Pizza Copycat Recipe | Taste and Tell
California Pizza Kitchen White Corn Guacamole


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Paget Brewster net worth and salary: Paget Brewster is an American actress who has a net worth of $3 million dollars. Paget Brewster was born in Concord, Massachusetts, and was originally focused on a career in design. She went on to attend Parsons School of Design in New York City after graduating from high school. However, her acting career began to take off, and she eventually had to drop out of school. After hosting a short-lived talk show for a local network in San Francisco, she gained national attention with a recurring role on "Friends" as Chandler Bing's girlfriend. From there she went on to steady film and television work. She has since appeared in such film projects as "Desperate But Not Serious", "The Adventures of Rocky and Bullwinkle", "The Specials", "Eulogy", "Man of the House", "Unaccompanied Minors", and "Sublime". She has appeared on such television shows as "Raising Dad", "Two and a Half Men", "Stacked", "Law & Order: Special Victims Unit", "Modern Family", and "Community". She is most widely recognized for her co-starring roles on "Huff" and "Criminal Minds". She is also a prolific voice over actress.
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Paget Brewster
Date of Birth
Mar 10, 1969 (47 years old)
Actor, Voice Actor, Photographer, Model
United States of America
5 ft 8 in (1.73 m)
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Skillet Penne and Sausage Supper
Total Time
Prep 10 mins
Cook 20 mins
Try this recipe if you're looking for something quick and easy with great flavor. The pasta cooks right in the skillet so there's no need for extra pots. Don't make this without the sun-dried tomatoes because it will not have as much flavor. My DH recently told me that this is his favorite of the pasta dishes I cook. Recipe is from America's Test Kitchen.
Ingredients Nutrition
- 1 tablespoon olive oil
- 1 onion, minced
- salt
- 1 lb sweet Italian turkey sausage or 1 lb hot Italian turkey sausage, casings removed
- 3 garlic cloves, minced
- 1⁄2 cup sun-dried tomato packed in oil, rinsed and chopped fine
- 8 ounces penne (can also use ziti) or 2 1⁄2 cups penne (can also use ziti)
- 2 cups low sodium chicken broth
- 1 cup milk
- 1 (5 ounce) bag Baby Spinach
- 1 ounce parmesan cheese, grated or 1⁄2 cup parmesan cheese
- pepper, to taste
- Heat olive oil in a 12-inch nonstick skillet over medium heat until shimmering. (Be sure to use at least a 12-inch size skillet to hold all ingredients.) Add the onion and 1/2 teaspoon salt and cook until softened, about 5 minutes.
- Stir in the sausage and cook, breaking it up with a wooden spoon, until no longer pink, about 4 minutes.
- Stir in the garlic and cook until fragrant, about 15 seconds. Sprinkle the sun-dried tomatoes and penne evenly over the sausage. Pour the broth and milk over the pasta. Cover and bring to a simmer. Reduce heat to medium-low and continue to simmer, stirring occasionally, until the pasta is tender, about 10 minutes.
- Stir in the spinach a handful at a time and cook until wilted, about 2 minutes. (It may seem like a lot of spinach, but it will wilt considerably.) Stir in the Parmesan and season with salt and pepper to taste.
- Note: You can use Italian pork sausage, but you may have to spoon some of the fat off before adding the pasta.
Most Helpful
This was rich and creamy yet so easy! We used hot Italian pork sausage and drained the fat before adding the garlic. The only other sub we made was using kale instead of spinach. We are definitely adding this to our regular line up and can't wait to try it with regular Italian sausage too. Thanks for sharing! *****Update - made it again with spinach and a 50/50 blend of hot and regular Italian sausage....still delish!
DH said this was awesome! This was so awesome. Easy!! I increased the garlic, used 1/2 cream 1/2 milk and threw in about 4 ounces of tomato paste. This will be made again and soon!
Wow! I thought this was a great recipe. I use a little extra milk and chicken broth to be sure I had plenty of sauce. I was surprised at how flavorful it was. Left overs were pretty good the next day too. Thanks!


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You will develop mobile apps for iOS projects. As Mobile Dev you will be responsible for the creation of the architecture of mobile projects and convince the team with your ideas and decisions.
The "Mobile Revolution" has radically changed perspectives. It has enabled the User to be constantly connected to the world through one single device.
We are looking for an advocate for this Revolution. You will support your team in the definition of technical data and requirements, and you will define the most effective paths to follow that will lead to the most successful results. Your team is made up of people from different backgrounds - the perfect blend for successful mobile projects. We are talking about impactful apps and mobile platforms of innovative service and high-quality content that are going to be used by millions of users.
Specifically, you will carry out the following tasks:
You will report to the CTO.
This is what we are looking for. There are crucial sets of skills and fundamental traits that we will go through together, while under "nice to have" we have listed some qualities we consider a plus, but not required.
We commit to treating people the best way we can, with respect and a professional approach. What follows is our offer. We do not want you to commit to an offer that does not fit you. What you see here is what you get, no secrets.
Caffeina is a Creative Digital Agency. Technology, Design, Creativity, and Marketing are in our genes. Our headquarters is located in Parma, a city only one hour away from Milan and Bologna. Parma has a good work/life balance and a fair cost of living.
The work environment is informal and young (the average age here is 28 years old). Most of all, we value what you can do and how well you do it. We work as a team, we help each other and we grow together, project after project.
Our work philosophy is all about merging well-established, effective solutions with new, experimental pathways. Personal input and suggestions are always highly appreciated, as we consider them to be vital for our growth.
Each job application is evaluated one by one. We use a tool to help us manage the selection process and to communicate with all candidates. Unfortunately, every now and then our answers are filtered as Spam: remember to check that folder as well!


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Automated email action
Hi there,
ve connect magento to openerp 7 with "connector". Its working great, but now i want to use openerp to send automaticly my invoice email (with pdf) when a order is imported(from magento). Its no problem to do this manualy, but i want to do it automaticly. I
ve made a serveraction to make it automaticly, but the problem is that i cant attach the pdf invoice with this. Does anyone has an idee how to do this? Thanks in advance!
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|Asked: 2/5/14, 5:22 AM
|Seen: 736 times
|Last updated: 3/16/15, 8:10 AM


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I have beeen scouring the net for some riser bars for less than $20. Anyone know of any deals. Also is it normal to cut bars down to a shorter size? I have been seeing a lot of bars that are way longer than what I am used to.
Thanks Everyone
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Rob Chesnut, a former federal prosecutor from Virginia who helped put away CIA turncoat Aldrich Ames, leads the anti-fraud team at eBay. "My job is to keep everybody in the eBay community on the right side of the law," Chesnut says.
But while Chesnut joined the company in 1999, it wasn't until January of last year that the eBay's stance shifted from reactive to proactive. That month, Chesnut became the head of a newly formed department called Rules, Trust and Safety. Later in 2002, the company launched a software system called FADE (Fraud Automated Detection Engine.) Its objective was to try to spot signs of fraudulent auction activity before money changed hands.
Though eBay continues to add capabilities to FADE and other anti-fraud software, Chesnut won't say much about what, exactly, the systems do to prevent fraud on the site. "Every company, like Visa and MasterCard, has anti-fraud engines, but they don't talk about how they work," he says. "Keeping that information secret is the key to [the software's] success."
But even after the introduction of FADE, and the establishment of the Trust and Safety Department, unscrupulous sellers still operate on the site. An Arizona couple suspected of swindling 510 would-be buyers out of more than $100,000 ran auctions on eBay between January and March of this year. (While they were at large in Colorado, the husband committed suicide; the wife eventually turned herself in to authorities.) David Steiner, a frequent eBay buyer and seller who also runs the Web site AuctionBytes.com, says it sometimes takes eBay too long to suspend suspicious sellers, even after the company gets complaints from buyers.
eBay has to perform a deft balancing act when it comes to battling scammers. The company doesn't want to get overly involved in trying to sniff out prospective fraud because it would seem intrusive to honest buyers and sellers - and because it could render eBay legally liable for every transaction that takes place on its site.
One area where eBay has gotten consistently high marks is in collaborating with law enforcement.
"We treat law enforcement [agencies] like a customer," Chesnut says. "We make sure that they get the information they need to fully and fairly investigate cases." And eBay leverages its experience with serial auction fraud - like the Jay Nelson case - to try to figure out how it can prevent future occurrences.
"Resting on our laurels isn't something that crosses my mind," Chesnut says. "I'd sure like to have the reputation of being the worst place on the Internet to commit fraud, because we're going to come after you, and you will go to jail."
Don't miss the main article: Catch Me If You Can.
A version of this article appeared in the August 2003 issue of Fast Company magazine.


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Newegg.com - A great place to buy computers, computer parts, electronics, software, accessories, and DVDs online. With great prices, fast shipping, and top-rated customer service - once you know, you Newegg.
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This review is from: OLYMPUS TG-830 iHS Blue 16 MP 5X Optical Zoom Waterproof Shockproof Wide Angle Digital Camera HDTV Output
Pros: It feels very solid. Quite easy to setup. Picture quality are okay. Not too bad for taking pictures at night.
Cons: When recording videos, there were some clicking noises recorded in the video. The noise is not very loud, but you can definitely hear it. I was looking at some other reviews and discovered that this problem was known to the manufacturer. It was caused by the focus lock inside the camera. And there is no plan to fix it or recall it for this camera. They are going to fix it in the next version. That's bad!
Also, there are some video skipping when you playback the video. Not sure what's causing it, but you can see it.
Overall for video, it's pretty bad!
Other Thoughts: The manufacturer should recall or disclose the noise problem up front. That's bad business for hiding the problems!READ FULL REVIEW


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Ciaobino: I Hated Selling Girl Scout Cookies
I hated selling Girl Scout cookies when I was a kid; really, REALLY hated it. And that was back when we thought nothing of going door to door by ourselves. I'd sell my minimum requirement as quickly as I could and then spend the rest of the year dreading the next sale. So now I buy a couple of boxes - from the kids, never from the pushy parents at work - because I remember how hard it can be for a shy little girl to go up to total strangers, smile and put herself out there like that/Ciaobino.
Question: Did you dread selling cookies, candy, etc., as a kid for various school and organizational fund-raisers?
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MOUNT WASHINGTON - Bullitt County Public School superintendent Keith Davis knows that the funds generated by increasing property tax rates could be wisely utilized for student learning.
But, he also knows that the efficient spending of the district could allow for the school board to vote for the compensating tax rate, which would be the same rate as this year.
The public will have its opportunity to voice its opinion on the school tax rates. The public hearing will be held on Monday, Sept. 22, at 5:30 p.m. at the central office.
SHEPHERDSVILLE - Rob Campbell said Shepherdsville could be "proactive" in updating its city sewer system.
The representative from QK4 discussed two potential sewer system upgrade plans with the Shepherdsville CIty Council.
The two projects included sewer improvements along Highway 44 West and the elimination of a pump station along W. Blue Lick Rd.
See the latest scams and bad business in BBB's September 2014 Hot Topics!
1. If you receive a call from a "Sergeant Carlson" who says he is with the Jefferson County Motor Division, hang up! The "Sergeant," who is calling local residents, claims a traffic camera on a local highway caught them speeding. The "speeder" is asked to pay the ticket with a prepaid money card. This is a SCAM!
SHEPHERDSVILLE - Anyone in Bullitt County can have any lab test done in Bullitt County now.
A new Any Lab Test Now facility is open for business in Shepherdsville at the Shepherds Crossings Shopping Center on Adam Shepherd Parkway.
"We're excited to serve the SHepherdsville area," said owner Woodie Hippler. "We're proud to give this part of the community an alternative choice in lab testing."
MOUNT WASHINGTON - An old pastime is making way for a new one.
A Lasting Staple
At the end of June, Bullitt East Bowling Center in Mount Washington closed its doors after more than 30 years of business, said owner Bill Whelan.
He said health reasons and the "down swing" of bowling lead to the decision.
"Open bowling has really dropped off. It's due to a lot of things—gas, economy, more outside sports for kids to play," said the Cox's Creek resident.
SHEPHERDSVILLE - The economic picture in Bullitt County continues to grow.
And so does the need for space by the Bullitt County Economic Development Authority.
Having utilized free rental space from Bullitt County government since its inception, the authority has now found some bigger digs.
The authority signed a 24-month lease last week to lease space in the Porter and Associates office complex on South Buckman Street.
The lease will include monthly rent of $800 plus a flat $300 per month for all utilities.
MOUNT WASHINGTON -- City officials are another step closer to enacting its new policy regarding solicitation.
At a recent city council meeting, City Attorney Matthew Lemme said a few council members had been contacted by citizens concerned about "aggressive solicitation."
Last month the council heard from Mount Washington resident Don Judd who said he had to call the police after a solicitor refused to leave his property.
Lemme said the proposed changes also had the elderly population in mind as far as safety's concerned.
CLERMONT - Residents and businesses in the Clermont area consider themselves members of a full-time community.
The U.S. Postal Service, however, doesn't seem to agree.
As of Aug. 25, the Clermont Post Office officially changed to part-time open hours for customers, from noon to 4 p.m. weekdays and 8-10 a.m. Saturdays.
The change was part of a two-year plan implemented by USPS in 2012 to keep smaller community post offices and zip codes in place.
SHEPHERDSVILLE - For the past seven years, Bullitt County Judge/Executive Melanie Roberts has been advocating the creation of the position for financial officer.
With a population nearing 80,000 and with a budget of over $22 million, Roberts said county government should be run like a business.
After getting the position funded in the 2014-15 budget, Roberts cleared the final hurdle on Tuesday.
Despite repeated opposition in the past, Bullitt Fiscal Court voted unanimously to hire Keith Griffee as the new finance officer.
SHEPHERDSVILLE - The Shepherdsville Fire Department is finally one step closer to getting their main truck back in working order.
Chief Layne Troutman informed the city council that the Seagrave company approved a contract to repair the 2007 truck model damaged at a working accident scene on Interstate 65 in 2013.
According to Troutman, the estimated total cost for repairs was set at $97,698.28. City attorney Joe Wantland said the Kentucky League of Cities had offered to pay up to $83,000 in insurance.
Copyright © 2017
The Pioneer News Online is your source for local news, sports, events and information in Bullitt County and Shepherdsville, KY, and the surrounding area.


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Dragon's Lair 3D: Return to the Lair
Title Data
- Genre:
- Action Adventure > Linear
- Developer:
- Dragonstone Software
- ESRB Descriptor(s):
- Mild Violence
- Number of Players:
- 1 Player
Release Data
Data and credits for this game contributed by Mookiethebold, halo824, Blk_Mage_Ctype, bcks, and BartSmith.
Know Something We Don't?
You can submit or update game data or submit game credits to help us keep our data up-to-date.


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Country Life, Chromium Picolinate, 50 Veggie Caps (Discontinued Item)
Shipping Weight:?0.25 lbsSwitch to Metric units
- Product Code: CLF-01678
- UPC Code: 015794016786
- Package Quantity: 50 Veggie Caps
1.6 x 1.6 x 2.7 in, 0.15 lbsSwitch to Metric units
- Specialty Supplements
- Biologically Active Chromium
- Dietary Supplement
- Certified Gluten-Free
- Kosher Parve
- Certified Vegan AVA
- GMP Certified
Suggested Use
Adults take one (1) capsule daily with food or as directed by a health care professional. As a reminder, discuss the supplements and medications that you take with your health care providers.
Other Ingredients
Cellulose, cellulose (capsule shell), silica.
No: Yeast, corn, wheat, soy, gluten, milk, salt, sugar, preservatives or artificial color.
This product has been manufactured at an NSF GMP Registered facility.
If you are pregnant, nursing, diabetic, hypoglycemic, taking medication or planning a surgery, consult your doctor before using this product. Do not use if you have gastric or duodenal ulcers. If any adverse reactions occur, stop taking the product and consult your doctor.
Do not accept if seal is broken.
Store between 59º-86º F. Keep out of the reach of children.
|Supplement Facts
|Serving Size: 1 capsule
|Amount Per Serving
|% Daily Value
|Vitamin B-6 (as pyridoxine hydrochloride)
|2 mg
|Chromium (from 1.7 mg chromium picolinate)
|200 mcg
|18 mg
|*Daily Value not established.


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The Fundamentals of EU Law Revisited
Assessing the Impact of the Constitutional Debate
Edited by Catherine Barnard
Format: Hardback
Normal Price: $204.95
Your Price: $184.45 AUD, inc. GST
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Availability: Available to Backorder, No Due Date for Supply
Fundamentals of EU Law Revisited by Catherine Barnard
Book DescriptionWith the rejection of the Constitutional Treaty in French and Dutch referenda, the European Union received a severe blow. This precipitated a period of reflection and soul searching. How far should the fundamental principles that shape the Union be re-assessed in the light of the Constitutional debate? Can the Constitutional Treaty be rescued from failure? If not, what other options for constitutional reform are available? Does the Treaty's rejection signal the failure of the Union's goal of democratic governance? The essays in this volume examine the impact of the debate surrounding the future of the European Constitution on the development of core areas of EU law and policy. Opening with a discussion of the shifting conceptions of European democracy, the volume proceeds to look at key areas of substantive law against the backdrop of the Constitutional Treaty, from Foreign Relations to Fundamental Rights, Social Policy to Justice and Home Affairs. The book concludes with an examination of potential solutions to the constitutional crisis, and models for future constitutional reform.
Buy Fundamentals of EU Law Revisited book by Catherine Barnard from Australia's Online Bookstore, Boomerang Books.
Book DetailsISBN: 9780199226214
(240mm x 160mm x 24mm)
Pages: 328
Imprint: Oxford University Press
Publisher: Oxford University Press
Publish Date: 22-Mar-2007
Country of Publication: United Kingdom
Other Editions...
Books By Author Catherine Barnard
Substantive Law of the EU, Paperback (August 2016)
Widely acclaimed and respected, this is the leading text on the four freedoms of the European Union. Unparalleled coverage of the subject area is paired with expert author insight and presented in a concise and user-friendly format, accompanied by engaging case studies and diagrams.
European Union Law, Paperback (June 2014)
Written by experts this innovative new textbook offers students a relevant, case-focused account of EU law. Under the experienced editorship of Catherine Barnard and Steve Peers, the text draws together a range of perspectives on EU law designed to introduce students to the key debates and case law which shape this vast subject.
Cambridge Yearbook of European Legal Studies, Hardback (December 2013)
The Yearbook provides a forum for the scrutiny of significant issues in EU Law, the law of the European Convention on Human Rights, and Comparative Law with a 'European' dimension.
EU Employment Law, Paperback (August 2012)» View all books by Catherine Barnard
The new edition of this major work is a must-buy for all students studying EU employment law. It offers comprehensive coverage of an increasingly complex subject, tackling both case law and legislation, and provides detailed analysis of the EU's Directives and their impact on employment law.
» Have you read this book? We'd like to know what you think about it - write a review about Fundamentals of EU Law Revisited book by Catherine Barnard and you'll earn 50c in Boomerang Bucks loyalty dollars (you must be a member - it's free to sign up!)
Author Biography - Catherine Barnard
Catherine Barnard is Fellow of Trinity College, Reader in European Union Law and Jean Monnet Chair of European Law, University of Cambridge
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C.M.I. - Control and Monitoring Interface
The C.M.I. is an interface for convenient system monitoring, remote control, data logging and visualisation of all controllers with DL or CAN bus.
We are proud to announce, that our C.M.I. has been awarded at the prestigious Plus X Award in the categories Innovation, Ease of Use and Functionality.
Operation - access
C.M.I. App for Android™
With this C.M.I. App for Android the access to the schematic of the C.M.I. is even easier.
The free app is available on Google Play™ immediately.
Available interfaces
Article numbers and prices
This list prices do not include VAT.
The power unit is required if...


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Beautiful Children's Wall Art Prints and Decor
Welcome to Sprout and Sparrow. We absolutely adore designing wall art prints for children's bedrooms, playrooms and nurseries.
We also create bright and cheery greeting cards and gift tags (handy for the kids' parties you go to every weekend!)
Have a look around and grab some inspiration to brighten up your kids' spaces! xox
Absolutely awesome
From $20.00
Be wild
From $20.00
From $35.00
Berry sweet
From $20.00
Best kid ever


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Results 1 to 5 of 5
- 02-07-2014, 05:22 AM Thread Author #1
HTC One: App updates cause apps to move from created folders in app menu.
Hey guys,
I've notice after a big list of app updates, all apps that were once in folders have now dropped beneath the folders in the app menu.
I've not notice this happen before, just wondered you guys knew of a way to sort this out please?
Many thanks!
Posted via Android Central App
- 02-09-2014, 02:38 PM Thread Author #2
- Posts
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- 02-10-2014, 09:19 AM Thread Author #4
Re: HTC One : App updates cause apps to move from created folders in app menu.
Fair enough! I'll simplify as best I can... I'm updating apps through the app store, but after these are updating, they're causing the app shortcuts to move from the folders in the app drawer to just the app drawer/menu (I think that's what it's called). I.e. it's losing it's folder structure after updating apps.
- Posts
- 1,770 Posts
- Mentioned
- 0 Post(s)
- Tagged
- 0 Thread(s)
Re: HTC One : App updates cause apps to move from created folders in app menu.
I'm sorry but I think ram has hit the nail on the head. I see you only have 7 posts 3 of which are in this thread. Meanwhile the app drawer is the center grid button at the bottom of your home screen. There is no way to group or put apps into folders in this view. On your home screen you can create folders and and group apps. Now if that is what you're talking about my next question is are you using stock folders? I'm using an app called Application Folder and have not had this happen regardless of how many apps update. That could be your answer to how to prevent this from happening. There are tons of 3rd party apps to create folders at the Play Store. Beautiful Widgets is one that is very popular but there are others as well. If you are wanting folders for your home screen and the stock folder system is failing you that would be where I'd look. If I'm/we're still not getting it try posting a screen shot of it so that we can better see what you are talking about.
To take a screen shot Press and hold the power button and then press the Home button before the options show up. You can post pics from your phone if you are connected to a pc with a USB.
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[FREE APP] Love Meter - Valentines Day SpecialBy cinq labs in forum Android AppsReplies: 1Last Post: 02-07-2014, 10:07 AM


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The Legal Form Of Labour Conflicts And Their Time Persistence: An Empirical Analysis With A Large Firms' Panel
Using a panel of large firms from Spain, the authors check the relative time persistence of different types of labour conflicts such as strikes, collective conflicts, lockouts and other conflicts with lost working hours but without the previous stated legal forms for labour conflicts. They present random-effects probit estimations comparing observations with each type of conflicts with the same set of observations without any type of conflict. The results show that no legal form labour conflicts do not have long-term persistence (persistence is only in the short-term, from quarter to quarter), and the other types of conflicts suffer short and long-term persistence of confliction at the firm level, corresponds to strikes the higher size of both types of persistence.


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Movie Review: American Wine Story
This past weekend, I had the opportunity to view a screening of American Wine Story. This highly anticipated film chronicles a group of people who take their unexplained passion for wine to another level. In the spirit of similar documentaries … Continue reading
Serpent Ridge Vineyard, Westminster, MD – September 20th, 2014
If you are anything at all like me, after a while the fast pace of living gets to you. It's something almost all of us have to deal with, and I'm as guilty as the next guy of contributing to … Continue reading
Posted in Personal Experience, Winery Visits Tagged cabernet franc, Festival, Maryland, Maryland wine, Serpent Ridge, Seyval Blanc, Westminster 1 Comment
Black Ankle Vineyards, Mt. Airy, MD – October 18th, 2013
Right on the heels of my Linganore visit, was a stop by nearby Black Ankle Vineyards after a short, ten minute drive. A long, winding lane snakes through scenic rows of Syrah vines on either side before emptying out in … Continue reading
Posted in Personal Experience, Winery Visits Tagged Black Ankle Vineyards, Crumbling Rock, Frederick County, Lu & Joe's, Maryland wine, Passegiata, Syrah 2 Comments
Linganore Winecellars, Mt. Airy, MD – October 18th, 2013
Northern Maryland, Day 1. The plan was to head south from Westminster to nearby Mount Airy to visit two local producers today. The first stop would be Linganore Winecellars, by far the biggest on my list. It holds the title … Continue reading
Posted in Food Pairings, Personal Experience, Winery Visits Tagged Anthony Aellen, Bacioni, Frederick County, Linganore, Maryland, Mt. Airy, Red Skins 3 Comments


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Congratulations to Mrs. Garbriella McEachern, fourth grade teacher who was voted as our Teacher of the Year for 2016 - 2017!
Congratulations to Mrs. Shontay McNeill, kindergarten teacher assistant who was voted as our Teacher Assistant of the Year for 2016 - 2017!
WHK's first fundraiser for the 2016-2017 school year is a Krispy Kreme Doughnut sale. The money raised will go toward funding many activities that are planned for our students. LAST DAY to turn in fundraiser money is October 4, 2016. Thank you all for your participation and patronage with this fundraiser.
Half Day for Students/Half Day Required Teacher Workday on Friday, September 23rd. Students will be dismissed at 12:30pm.
Title I Family Night/PTO - September 29, 2016
5:30pm-7:00pm Dinner will be served!
Progress Reports will be sent home with students on September 30, 2016.


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Newegg.com - A great place to buy computers, computer parts, electronics, software, accessories, and DVDs online. With great prices, fast shipping, and top-rated customer service - once you know, you Newegg.
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This review is from: YAMAHA RX-V565 7.1-Channel Home Theater Receiver
Pros: Sounds great with Klipsch HD 500 speakers!
Cons: Had lots of issues with the HDMI passthrough.**I may be incorrect.** I was unable to change the surround audio presets while using my blu-ray player. I tried everything in the settings for the player and the receiver with no success.
Other Thoughts: I got around this problem by hooking all components to my TV and then using a fiber optic cable from the TV to the receiver.READ FULL REVIEW
This review is from: Klipsch HD 500 5.1 High Definition Theater system
Pros: Loud with great sound. Paired up with a 630w 7.1 Yamaha RX-565 and a 52" B750 series Samsung LCD. I lo\/e watching Rambo on Blu-Ray!!!
Cons: -NO WIRES??!?! I had to buy my own wires at Radio Shack and crimp connectors on them.
-Price...look somewhere else on google.
-Spring clips on the back of the satellites. Cheap mo\/e by klipsch.
Other Thoughts: I found these o\/er 6 months ago for less than 5 hundo on some small name electronics site based in Las \/egas. Can't remember the name of it, but I bartered with someone through email. Google them.
Sorry about the \/s, my keyboard just started to act up on me.
This review is from: Rosewill RHB-210 USB 3.0 4 Ports Hub with Anti-dust Design
Pros: Is two fried mice a pro? How about an external hard drive?
Cons: Read the pros.
Other Thoughts: It was free with a combo deal, but it killed about 220 bucks worth of stuff. Sweet!!!READ FULL REVIEW


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Bring your bucks and your biceps over to Roberta's backyard this weekend for the Second Flex: Ladies Arm Wrestling competition. Eight decked-out lady wrestlers will compete in a round-robin style tournament to see who's the strongest, and who plays the dirtiest. Outrageous costumes and betting? They're strongly encouraged. Even better? The event is free, and net proceeds go to support Providence House — a not-for-profit organization founded by the Sisters of St. Joseph that helps transform the lives of homeless, abused, and formerly incarcerated women and their children – one family at a time.
The Five Borough Ladies Arm Wrestling league is a part of a national network of ladies arm wrestling league. We sat down with the last bout's champion, Jackie O'Nasty, and organizer Kate McNeely to get their take on what makes a champion.


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Port Wine Sauce For Ham
|Port wine
|1⁄2 Cup (8 tbs)
|Minced shallots
|1 1⁄2 Teaspoon
|Thyme sprig
|Bay leaf
|1⁄2 Small
|Orange juice
|3 Fluid Ounce (Juice Extracted From 1 Orange)
|Lemon juice
|1⁄2 Tablespoon (Juice Extracted From 1/2 Lemon)
|Grated orange peel
|1⁄4 Teaspoon
|1 Cup (16 tbs)
|1 Tablespoon
Combine the port, shallots, thyme, and bay leaf, and simmer until the liquid is reduced by half.
Stir in the orange juice, lemon juice, and orange peel.
Mix a little of the consomme with the flour to make a paste.
Add the rest of the consomme to the saucepan, heat, and stir in the flour paste to thicken the sauce slightly.
Simmer 2-3 minutes before serving.
Recipe Summary
Rate It
Nutrition Rank
Nutrition Facts
Serving size: Complete recipe
Calories 237 Calories from Fat 3
% Daily Value*
Total Fat 0.41 g0.63%
Saturated Fat 0.07 g0.33%
Trans Fat 0 g
Cholesterol 0 mg
Sodium 681.5 mg28.4%
Total Carbohydrates 29 g9.6%
Dietary Fiber 1.2 g4.6%
Sugars 8.6 g
Protein 8 g16.5%
Vitamin A 8% Vitamin C 91.3%
Calcium 5% Iron 14.2%
*Based on a 2000 Calorie diet


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B&B Al Convento
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Wego searches multiple travel sites so you can find and compare the best rates.
B&B Al Convento Hotel Reviews
Based on reviews from across the web.
B&B Al Convento Hotel Details
Check-in: 14:00
Check-out: 11:00
Lombardi 11 is located in the heart of the historical Matera centre, famous for its ancient town Sassi di Matera. It offers self-catering accommodation. Each studio comes with a kitchenette, sofa and a TV. The private bathroom features a hairdryer and free toiletries. Ferrovia Lucana Train Station is 600 metres from Lombardi 11. The Murgia Materana Regional Park is a 20-minute away.
Please let the property know your expected arrival time in advance. You can use the Special Requests box when booking or contact the property. Please note that the property is in a restricted traffic area, which is operational on Saturday and Sunday. Please note that full payment is due on arrival.


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CUE with many weak instruments and nearly singular design
This paper analyzes many weak moment asymptotics under the possibility of similar moments. The possibility of highly related moments arises when there are many of them. Knight and Fu (2000) designate the issue of similar regressors as the "nearly singular" design in the least squares case. In the nearly singular design, the sample variance converges to a singular limit term. However, Knight and Fu (2000) assume that on the nullspace of the limit term, the difference between the sample variance and the singular matrix converges in probability to a positive definite matrix when multiplied by an appropriate rate. We consider specifically Continuous Updating Estimator (CUE) with many weak moments under nearly singular design. We show that the nearly singular design affects the form of the limit of the many weak moment asymptotics that is introduced by Newey and Windmeijer (2009a). However, the estimator is still consistent and the Wald test has the standard χ2 limit.
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Volume (Year): 170 (2012)
Issue (Month): 2 ()
Pages: 422-441
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- Frank Kleibergen, 2002. "Pivotal Statistics for Testing Structural Parameters in Instrumental Variables Regression," Econometrica, Econometric Society, vol. 70(5), pages 1781-1803, September.
- Abadir,Karim M. & Magnus,Jan R., 2005. "Matrix Algebra," Cambridge Books, Cambridge University Press, number 9780521537469, October.
- John Chao & Norman Swanson, 2004.
"Consistent Estimation with a Large Number of Weak Instruments,"
Departmental Working Papers
200421, Rutgers University, Department of Economics.
- John C. Chao & Norman R. Swanson, 2005. "Consistent Estimation with a Large Number of Weak Instruments," Econometrica, Econometric Society, vol. 73(5), pages 1673-1692, 09.
- Chao, John Chao & Norman R. Swanson, 2003. "Consistent Estimation with a Large Number of Weak Instruments," Cowles Foundation Discussion Papers 1417, Cowles Foundation for Research in Economics, Yale University.
- John C. Chao & Norman Rasmus Swanson, 2004. "Consistent Estimation with a Large Number of Weak Instruments," Yale School of Management Working Papers ysm374, Yale School of Management.
- Holtz-Eakin, Douglas & Newey, Whitney & Rosen, Harvey S, 1988.
"Estimating Vector Autoregressions with Panel Data,"
Econometric Society, vol. 56(6), pages 1371-1395, November.
- Tom Doan, "undated". "RATS program to demonstrate IV estimation of VAR in panel data," Statistical Software Components RTZ00185, Boston College Department of Economics.
- Carrasco, Marine & Chernov, Mikhail & Florens, Jean-Pierre & Ghysels, Eric, 2007. "Efficient estimation of general dynamic models with a continuum of moment conditions," Journal of Econometrics, Elsevier, vol. 140(2), pages 529-573, October.
- Joshua D. Angrist & Alan B. Keueger, 1991.
"Does Compulsory School Attendance Affect Schooling and Earnings?,"
The Quarterly Journal of Economics,
Oxford University Press, vol. 106(4), pages 979-1014.
- Joshua D. Angrist & Alan B. Krueger, 1990. "Does Compulsory School Attendance Affect Schooling and Earnings?," Working Papers 653, Princeton University, Department of Economics, Industrial Relations Section..
- Joshua D. Angrist & Alan B. Krueger, 1990. "Does Compulsory School Attendance Affect Schooling and Earnings?," NBER Working Papers 3572, National Bureau of Economic Research, Inc.
- repec:cup:cbooks:9780521822893 is not listed on IDEAS
- Carrasco, Marine & Florens, Jean-Pierre, 2000. "Generalization Of Gmm To A Continuum Of Moment Conditions," Econometric Theory, Cambridge University Press, vol. 16(06), pages 797-834, December.
- Mehmet Caner, 2005.
"Nearly Singular Design In Gmm And Generalized Empirical Likelihood Estimators,"
0509019, EconWPA.
- Caner, Mehmet, 2008. "Nearly-singular design in GMM and generalized empirical likelihood estimators," Journal of Econometrics, Elsevier, vol. 144(2), pages 511-523, June.
- Andrews, Donald W. K., 1987.
"Asymptotic Results for Generalized Wald Tests,"
Econometric Theory,
Cambridge University Press, vol. 3(03), pages 348-358, June.
- Donald W.K. Andrews, 1985. "Asymptotic Results for Generalized Wald Tests," Cowles Foundation Discussion Papers 761R, Cowles Foundation for Research in Economics, Yale University, revised Apr 1986.
- Chirok Han & Peter C. B. Phillips, 2006.
"GMM with Many Moment Conditions,"
Econometric Society, vol. 74(1), pages 147-192, 01.
- Chirok Han & Peter C.B. Phillips, 2005. "GMM with Many Moment Conditions," Cowles Foundation Discussion Papers 1515, Cowles Foundation for Research in Economics, Yale University.
- Peter C. B. Phillips & Chirok Han, 2004. "GMM with Many Moment Conditions," Econometric Society 2004 Far Eastern Meetings 525, Econometric Society.
- Caner, Mehmet, 2009. "Lasso-Type Gmm Estimator," Econometric Theory, Cambridge University Press, vol. 25(01), pages 270-290, February.
- Whitney Newey & Richard Smith, 2003.
"Higher order properties of GMM and generalised empirical likelihood estimators,"
CeMMAP working papers
CWP04/03, Centre for Microdata Methods and Practice, Institute for Fiscal Studies.
- Whitney K. Newey & Richard J. Smith, 2004. "Higher Order Properties of Gmm and Generalized Empirical Likelihood Estimators," Econometrica, Econometric Society, vol. 72(1), pages 219-255, 01.
- Hansen, Lars Peter & Singleton, Kenneth J, 1982. "Generalized Instrumental Variables Estimation of Nonlinear Rational Expectations Models," Econometrica, Econometric Society, vol. 50(5), pages 1269-1286, September.
- Knight, Keith, 2008. "Shrinkage Estimation For Nearly Singular Designs," Econometric Theory, Cambridge University Press, vol. 24(02), pages 323-337, April.
- Stock, James H & Wright, Jonathan H & Yogo, Motohiro, 2002. "A Survey of Weak Instruments and Weak Identification in Generalized Method of Moments," Journal of Business & Economic Statistics, American Statistical Association, vol. 20(4), pages 518-529, October.
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I unveiled my rankings of the Big 12 nonconference schedules earlier this offseason, and one thing was clear: The league's scheduling out of conference this year is pretty awful, to put it mildly.
CBSSports' Bruce Feldman released his rankings of the top 10 easiest schedules in college football, and guess who checked in at No. 1?
1. Texas Tech: The Red Raiders are coming off a dismal 2011, but should get off to a 3-0 start (they did open 4-0 last fall). They begin with FCS Northwestern State, who they essentially swapped on the schedule in place of Nevada, which has won 20 games the past two seasons. In Week 2, the Red Raiders visit Texas State, who Tech beat 50-10 last year. TSU is now in the WAC after going 6-6 at the FCS level last year and losing to its two FBS opponents by a combined score of 95-20. Then Bob Davie's New Mexico Lobos visit Lubbock. The Lobos have won three games combined the past three seasons and they're probably the closest thing to a test in the nonconference for Tech.
Tech's nonconference schedule is indeed an embarrassment, but Baylor checked in at No. 5 on Feldman's list, with SMU headlining a schedule that also features FCS Sam Houston State and struggling Sun Belt member Louisiana-Monroe.
The Big 12 wasn't done. West Virginia made it to No. 6 on that list for scheduling James Madison and an awful Maryland team, along with in-state rival Marshall.
That gave the 10-team Big 12 three teams on the list.
The Oklahoman's Berry Tramel also ranked each of the 68 major conference schedules, which obviously included the Big 12.
Not a single Big 12 team made the top 25. My pick for the Big 12's toughest schedule was the same as Tramel's: Oklahoma. The Sooners didn't make an appearance on the list until No. 27 for scheduling Notre Dame, UTEP and Florida A&M.
Here's where the rest of the Big 12 checked in.
29. Iowa State: Tulsa, at Iowa, Western Illinois
31. Kansas State: Missouri State, Miami, North Texas
38. TCU: Grambling State, Virginia, at SMU
51. Texas: Wyoming, New Mexico, at Ole Miss
52. Oklahoma State: Savannah State, at Arizona, Louisiana-Lafayette
56. West Virginia: Marshall; James Madison at Landover, Md.; Maryland
63. Baylor: SMU, Sam Houston State, at Louisiana-Monroe.
66. Kansas: South Dakota State, Rice, at Northern Illinois
68. Texas Tech: Northwestern State (La.), at Texas State, New Mexico
No big qualms about any of those picks. Feldman and Tramel disagree on Kansas and West Virginia, but they're both pretty rough schedule.
The Big 12 has 30 nonconference games between 10 total teams, and seven of those are against teams from major conferences (including the Big East!). That's awful.
I get it. Moving to nine conference games means things are going to be tougher for teams in the Big 12, especially those trying to scrape for bowl games. Still, though, for the league as a whole, this is embarrassing. The Pac-12 plays nine games and it had seven members in the top 25 of the toughest schedules.
Eight of the 10 members are in the bottom half of college football's top teams when it comes to nonconference schedules.


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Quebec City, Canada: Flowers, Frontenac, Food, and Fun
It's freezing rain in Boston right now, and I'm seized with an urge to write a new article about the best place our family traveled last year: Quebec City, Canada during the summer! In this article, I've compiled 31 of my most beautiful photos from Old Quebec for your escapist pleasure.
Quebec City is a destination that epitomizes the word "charming." It is worth at least three days of unstructured wandering and restaurant-hopping through its cobblestoned streets, should you be wise enough to schedule a visit.
In these photos, you'll see the four "Fs" listed in the article's title. First, flowers abound in the city in summer, spilling out of window boxes in exuberant rainbow waterfalls. My all-time favorite Quebec flower photo is below, captured after I asked my husband one too many times to pose for me. Bwhaha!
Next, you will see food, because Quebec is famous for its delicious, French-inspired fare. We dined on outdoor patios almost every meal, and our little traveling toddler enjoyed the al fresco meals, too.
Third, Chateau Frontenac features prominently in many of these pictures, because the fancy hotel reminds me of a fairy tale castle, and makes a gal happy to look at. Paired with Old Quebec's historic 17th century buildings (a UNESCO World Heritage Site), it's all a romantic feast for the eyes. Want to sleep inside this castle? Click to see current deals on this remarkable hotel, as it's surprisingly affordable!
Finally, these photos show fun. From river-side walking paths, to fresh markets, to joyful public art, Quebec City made our family smile with its color and joie de vivre. Despite the fact that I was in my first trimester of pregnancy during the trip and nauseous as heck, I still had a good time, and that says a lot!
Without further ado, let us explore Quebec City through some more luscious photographs! I'm curious to find out: Which ones call out to you the most? Which surprise you? Which make you want to find that exact spot and sip an espresso in front of its glory? Let's see!
So, did you enjoy this stroll through delightful Quebec City? I hope so, because I loved photographing it! Do leave your impressions or experiences with the city in the comments section, below. I look forward to hearing your thoughts! If you enjoyed this article and are still planning your trip, click here for an easy link to Quebec City hotel deals, and here for cheap flights to Quebec City, as it will give a small commission to help support this site at no cost to you. Have a great trip!
14 Responses to "Quebec City, Canada: Flowers, Frontenac, Food, and Fun"
I come from Quebec city! Thank you so much for the good words about my city! I you ever want to come back… during the winter, at Christmas time is the perfect choice! Every shop, every corner is decorated with lights! You can even visit the Chateau Frontenac … it is very special when they decorate for Christmas.
Wow! Thank you for your article and awesome photos. Your family are so sweet.
As for me, Quebec is a favourite city among others. We travelled there with my gf about 8 months ago. Quebec is one of North America's oldest and most magnificent settlements. The city's compact size makes it ideal for walking, and it shines brightest when you slow down. There's more than a glimmer of Old Europe in its classic bistros, sidewalk cafes and manicured squares. I think Quebec must be in everyone's bucket list.
One of my favorite cities in the world. I agree with you totally. Quebec is so wonderful even in the winter. Great pictures.
Every time I see your photos of Quebec, it reminds me to put it on my list of places to travel in the near future. Stunning shots!
Such lovely pictures. The buildings, the art work, the colors, OH MY! Honestly, Quebec City wasn't even on my radar, but it is now!
This looks so charming and definitely like my kind of city!
Very inspiring. I'm loving with the city now.
No, but really – how beautiful! And that salad (can you tell it's dinner time where I live…?)!
Gorgeous. This is one of my favorite cities, too – it's so beautiful there!


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Hotels in Holzkathen
Hotel reservation
Hotel rooms in Holzkathen
There are not so many hotel rooms in Holzkathen, just 6, still everyone can find an offer to suit his choice. The most common offers in this city are apartments, they count 4 out of 6, and their prevalent location is central district. According to our practice, it is the most profitable to book a hotel in the north of Holzkathen, as it is the location of the hotels with optimal cost and quality offers along with the cheap hotels. Taking into account the small size of the city, there is no need to dwell hotel reservation on the location: the road to the city center would take less then half an hour, so one can book a hotel in any district of Holzkathen. The most populated with hotels district of Holzkathen is the center, 83% of cheap hotel rooms are concentrated here. Holzkathen is a truly multifaceted city, here everyone can find a hotel of his choice: a business person, a young couple or a family with little children. Take a look at our selection of the cheap hotel rooms in Holzkathen to make a well-informed choice for your reservation!
Holzkathen cheap hotels
Guest Houses
All cheap hotels in Holzkathen
Best hotels in Holzkathen
Hotels in Holzkathen are spread around the city within the distance of 1.3 kilometers, while 5 hotels are located directly in the city center. The most popular accommodations in Holzkathen is
Studio Pod D?bem 2
located in a 0.3 kilometers from the city center.
The best hotels are here and now. Try them!
All cities in Poland


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Category:Palo Verde National Park
From Wikimedia Commons, the free media repository
English: Palo Verde National Park is a National Park of Costa Rica, part of the Tempisque Conservation Area, that contains much of the area of the valley of the Tempisque River.
Español: Parque Nacional Palo Verde
Media in category "Palo Verde National Park"
The following 6 files are in this category, out of 6 total.
- PaloVerdeRocaview.jpg 198 KB


text: Barrett-Jackson: People Spend a Lot at the BJRay Wert1/19/08 5:08pmFiled to: Barrett-jackson2008 Barrett-Jackson ScottsdaleAuctionsbarrettBarrett-Jackson AuctionBarrett-Jackson ScottsdaleJacksonScottsdale8EditPromoteShare to KinjaToggle Conversation toolsGo to permalink So far today the big B-J auction's brought in a total of $9,010,000. Not too shabby if you ask us. Not for enthusiasts looking to buy on the cheap, but certainly for the Barrett-Jackson people and the folks looking to sell. With about half of the lots already sold, we've got the top five money-makers so far below the jump. We'll have more from the auction shortly — including some pretty amazing one-off stuff that'll blow your mind — live from our couches Barrett-Jackson in Scottsdale. Advertisement 5.) 1970 Chevy Chevelle LS6 SS - $177,500 4.) 1953 Buick Skylark - $155,000 3.) 1970 Hemi Cuda - $245,000 2.) 1956 Chevy Bel Air - $255.000 1.) 1932 Ford Custom Competition "Rollin Stone" - $320,000Reply8 repliesLeave a reply


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Season 2 of the Overtime podcast is here! Listen to the first episode with Meg Robichaud now.
I'm working on a design for Sequential.co to replace the current, buggy theme. This is what I've got so far.
Please follow @Jeremy Blazé for updates.
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1991 BMW 525i Repair and Maintenance Costs
A guide to repairs, service, and maintenance costs for your 1991 BMW 525i
Never overpay. Check prices with our estimator
Ask a mechanic in our community
Our experts translate recalls into plain English
1991 BMW 525i ProblemsLoosness in the Front Suspension Due to Worn Tension Strut Bushings
The front thrust rod bushings—also referred to as tension strut bushings—are known to fail occasionally. The oil-filled rubber mounts weaken and crack over time, causing a mushy road feel and shuddering in the steering wheel when going over bumps. These worn bushings should be replaced.
A creak or squeak can be heard from the top of the front or rear doors. This noise is most noticeable when the windows are fully up. The noise is caused by the decay of the flocking material on the door seals. New door seals, Teflon tape, special lube, or a combination of all of these may be needed to eliminate the noise.
The low coolant light may illuminate and/or the engine may overheat as a result of a coolant leak from the water pump. The leaking pump will require replacement and the entire cooling system should be inspected for leaks as it is not uncommon to find multiple leaks on higher mileage vehicles.
Overheating can cause severe engine damage. If the engine begins to overheat it is recommended to stop at the first available location and have your vehicle towed to a repair shop.
1991 BMW 525i QuestionsWhat would it cost for a tensioner pully (1 answer)
Greg's Auto...Question about total check of coolant system outlined yesterday in my request for help...I replied today to your suggestion about hydracarbons in system...I ment to
ask you about the lack of heat up to the system's Rad return
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The case of a juvenile accused of two armed robberies of mopeds in New London in July has been transferred to the adult docket and will be tried in the major crimes court.
Peter Gibson-Huff, of 53 Prest St., who has turned 18 since the July 13 incident, is being held at the Manson Youth Institution in lieu of a $150,000 bond on charges of first-degree robbery, fifth-degree larceny and fourth-degree larceny. Gibson-Huff appeared Wednesday before Judge Hillary B. Strackbein, who granted prosecutor David J. Smith's motion to transfer the case from juvenile court to the adult docket due to the serious nature of the charges.
Attorney Kevin C. Barrs from the public defender's office is representing Gibson-Huff, who has pleaded not guilty. His next court date is Oct. 10.
According to a police report, a male victim and passenger were driving a scooter on Ashcraft Road at about 12:40 a.m. on July 13 when an SUV began following them "extremely closely." The scooter driver pulled over twice to let the vehicle pass, but the vehicle continued following them and pulled up next to them.
Gibson-Huff got out of the back seat of the SUV, walked in front of the scooter and pulled a silver revolver from his waistband, according to the report. He demanded that the scooter riders get off the bike, climbed on it and fled.
A short time later, Gibson-Huff and two others allegedly robbed two men of another moped at the Wendy's restaurant on Colman Street. The victims said that after they refused a request to let the teens ride their scooters, one of the males — later identified by police as Gibson-Huff — pulled out what appeared to be a silver revolver and started yelling at them to give them their scooters. One of the victims complied, while the other pretended he couldn't start his scooter.
New London police arrested all three men within a short time of the incident.
The cases of Hassan Foster-Carney, 18, of 320 Central Ave., Norwich, and Dwayne Miller, 18, of 26 Jefferson Ave., New London, also are pending in the major crimes court. They are both free on bond.
— Karen Florin
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