text:
Informed consent for research obtained during the intensive care unit stay
- Catherine Chenaud1Email author,
- Paolo Merlani1,
- Samuel Luyasu1 and
- Bara Ricou1
DOI: 10.1186/cc5120
© Chenaud et al.; licensee BioMed Central Ltd. 2006
Received: 12 July 2006
Accepted: 08 December 2006
Published: 08 December 2006
Patients in the intensive care unit (ICU) may be in an inadequate condition to give their informed consent for research. The aim of this study was to analyse the ability to recall participation in a clinical trial for which ICU patients had given their consent.
The data presented are a two-step observational study: first, a protocolled informed consent procedure was conducted then the informed consent was given by the patient, and second, a patient interview was held 10 ± 2 days later by the same investigator. The primary endpoints were the ability to recall their participation in the clinical trial, as well as its purpose and related risks. As secondary endpoints, we investigated whether asking questions about the clinical trial or reading the informative leaflet was related to the recall. To be included in the study, the patient had to have a Glasgow Coma Scale score of 15, be fully oriented and free of mechanical ventilation, and be judged competent by both the investigator and the attending physician. Patients admitted to the ICU after major surgery or trauma were eligible. However, patients who refused to participate, or those whose next-of-kin gave consent, were excluded.
Of the 44 patients, 35 (80%) recognized, 10 to 12 days after informed consent had been obtained, that they had participated in the clinical trial, but only 14 out of 44 (32%) could recall the clinical trial purpose and its related risks. More patients with complete recall had read the informative leaflet or asked at least one question before signing the informed consent. Asking at least one question was associated with complete recall.
Our results confirm that obtaining informed consent for research during an ICU stay is associated with poor patient recall of participation in a clinical trial and its components (purpose and risk). Whether encouraging reading the informative leaflet and asking questions about the clinical trial improves the informed consent procedure remains to be fully investigated.
Within the past few decades, medicine, especially critical care medicine, has progressed spectacularly as a result of medical research and the participation of patients in clinical trials. The Declaration of Helsinki and international guidelines require that the patient give informed consent before participating in a study. This informed consent is essential to respect the autonomy of patients and protect them against abuse [1–3].
Therefore, to respect the ethical principles of clinical research, informed consent for research demands to be held at a high standard because the patient does not always benefit directly from the research results and might suffer some risks for the good of the community. Keeping with this high standard, informed consent must fulfil three mandatory conditions as described in the Belmont report: adequate information about the study with a complete disclosure of the risks and benefits, the patient's comprehension, and the voluntariness [4–7]. This means that the patient should be able to freely decide their participation in the study without any external pressure and that they could resign from the study at any time without any consequence to their care. To respect this requirement and the principle of autonomy, it is essential that patients comprehend and recall knowledge of the study components as well as their participation in the study. However, patients in the intensive care unit (ICU) may be in an inadequate condition to give their informed consent for a research study because their capacity for comprehension is questionable. However, lighter sedation of ICU patients permits an increasing number of them to remain conscious. These patients seem to be able to understand the information presented and to decide freely if they would like to participate in the study. However, there is no available consensus on the capacity required to give consent [8]. As objective criteria regarding the decision-making capacity of patients are lacking in international and national directives, investigators usually use their clinical judgement and the Glasgow Coma Scale (GCS) as guidance. Previously, we showed that 22% of clinical trial participants could not recall their participation in the clinical trial despite the fact that informed consent was obtained in an ideal situation, namely before their admission to the ICU [9]. Furthermore, 25% of patients were unable to recall the clinical trial purpose and its related risks. In view of these results, we hypothesized that informed consent for research obtained from a patient during their ICU stay is associated with an even worse ability for them to recall their participation in a clinical trial and its components (purpose and risk).
Materials and methods
This investigation on informed consent was an observational substudy of a clinical trial about inflammation, described elsewhere [10]. The present study was designed in two steps: first, a protocolled informed consent procedure was conducted then the informed consent was given by the patient, and second, a patient interview was held 10 ± 2 days later by the same investigator about their participation, the purpose, and the risks related to the clinical trial on inflammation.
This study was performed in a 20-bed surgical ICU of a tertiary-university-affiliated teaching hospital receiving 1,600 patients per year.
Type of participants
Patients admitted to the ICU after a major surgery or trauma were eligible. To give their consent to participate in the clinical trial on inflammation, patients had to present with a GCS score of 15, be fully oriented and free of mechanical ventilation, and judged competent by both the investigator and the attending physician. Patients who refused to participate, met any of the exclusion criteria for the clinical trial on inflammation, and those whose next-of-kin gave consent were not considered for the present study. Furthermore, incompetent or non-French-speaking patients, and those with psychiatric disorders, senile dementia or other intellectual disabilities were not included.
The informed consent procedure
A protocoled procedure detailing how to obtain informed consent was developed to ensure that the two investigators contributing to the study obtained consent in an identical manner. The investigators were physicians who were not caring for the patients enrolled in the study. Informed consent was obtained on the ICU admittance date, after a 20-minute individual oral presentation. During this presentation, the investigator explained the clinical trial on inflammation, emphasizing two clinical trial components: the purpose and its related risks. The defined keyword for the clinical trial purpose was inflammation. The clinical trial risk for the patient was that 10 ml of their blood would be drawn daily for the first five days of their ICU stay, and a final blood draw would be required at day 28. The investigator told the patient that the risk was minimal.
The patient then received a one-page informative leaflet. At the end of this procedure, the investigator asked the patient if he had any questions about the clinical trial before signing the informed consent form. The investigator noted whether the patient asked any questions and/or if he read the informative leaflet in his presence. These two attitudes of the patient (asking one or more questions and reading the informative leaflet) were defined a priori in the consent procedure. No other attitudes of the patient were recorded or tested.
This informed consent procedure conforms to recommendations on the ethical conduct of clinical research involving patients in the ICU [11].
Data collection
Patient age, gender, history of daily alcohol intake type of admission and diagnosis, as well as Simplified Acute Physiological Score second version (SAPS II) [12] were recorded on admission to the ICU. The lengths of mechanical ventilation and ICU stay were also noted.
When informed consent was obtained, clinical and laboratory values, the Sequential Organ Failure Assessment (SOFA) score [13], and medical treatment given within the 24 hours before and after the consent procedure were assessed.
At 10 ± 2 days (range), the investigator met the patient to plan the blood sampling to be performed on day 28. At this time, the investigator assessed whether the patient could recall participation in the clinical trial and/or any of the clinical trial components.
The primary endpoints were the ability of the patient to recall participation in the clinical trial, as well as the purpose and related risks of the clinical trial. As secondary endpoints, we investigated whether asking questions about the clinical trial or reading the informative leaflet was related to the recall.
Patients who could report their participation in the clinical trial on inflammation, the clinical trial purpose and the related risks were assigned to the 'complete recall' group. Patients lacking one or more components were assigned to the 'incomplete recall' group.
Ethical issue
The clinical trial on inflammation itself, as well as the informative leaflet and the consent form, were approved by the Ethical Committee for Human Research of our institution. Specific informed consent had not been sought for this study. The educational status of the patient, that was the sole data not available in the dataset of the clinical trial, was subsequently retrieved from the administrative file.
Statistical analysis
StatView for Windows version 5.0.1 (SAS Institute Inc., Cary, NC, USA) was used for statistical analysis. Patients were stratified as having either complete or incomplete recall; these data were compared separately by using a two-tailed Fisher's exact test, an unpaired t test or a Mann–Whitney U test, as deemed appropriate. We also assessed the sensitivity, specificity, the positive predictive value, the negative predictive value and the likelihood ratio of factors that were statistically significant on the basis of the univariate analysis performed to predict complete recall of the clinical trial. Odds ratios with 95% confidence intervals were calculated to estimate the effect size of risk factors associated with complete recall. All tests were two-tailed; p < 0.05 was considered significant.
Of the 44 patients, 35 (80%) recognized they had participated in a clinical trial; 14 of the 44 patients (32%) could recall their clinical trial participation as well as the clinical trial components, namely the clinical trial purpose and the related risk (Figure 1). These 14 patients were assigned to the 'complete recall' group.
Demographic, anamnestic characteristics and intensive care unit data of the two groups of patients
Complete recall
Incomplete recall
Demographic and educational data
Age, years (mean ± SD)
54 ± 22
54 ± 21
> 0.99b
Male/female, n
Educational status
Up to junior high school, n (percentage)
6 (43)
Intermediate (college), n (percentage)
6 (43)
16 (53)
Academic level or more, n (percentage)
1 (7)
1 (3)
Not available, n (percentage)
1 (7)
2 (7)
Daily alcohol intake, n (percentage)
1 (7)
8 (27)
ICU and hospital data
Admission diagnosis, n (percentage)
Abdominal surgery, n (percentage)
7 (50)
10 (33)
Cardiovascular surgery, n (percentage)
3 (21.5)
8 (27)
Trauma, n (percentage)
3 (21.5)
9 (30)
Other, n (percentage)
1 (7)
3 (10)
Emergency admission/elective admission, n
> 0.99c
Admission SAPS II (mean ± SD)
16 ± 10
20 ± 9
Length of mechanical ventilationa, hours (median (range))
0 (0–15)
0 (0–64)
Length of ICU stay, days (median (range))
3 (2–9)
4 (2–25)
Data at the time of informed consent and the attitude of the patients
Complete recall
Incomplete recall
Data at the time of informed consent
GCS (mean ± SD)
15 ± 0
15 ± 0
> 0.99a
SOFA score (median (range))
2 (1–5)
2.5 (0–9)
Temperature, °C (mean ± SD)
37.0 ± 0.5
37.2 ± 0.7
Glycemia, mmol/l (mean ± SD)
7 ± 2
7 ± 3
Creatinin, μmol/l (mean ± SD)
80 ±± 25
105 ± 78
Bilirubin, mmol/l (mean ± SD)
13 ± 6
15 ± 6
24 hours before informed consent
Morphine, n (percentage)
2 (14)
11 (37)
Benzodiazepines, n (percentage)
1 (7)
5 (17)
Vasopressors, n (percentage)
0 (0)
0 (0)
24 hours after informed consent
Morphine, n (percentage)
8 (57)
18 (60)
> 0.99c
Benzodiazepines, n (percentage)
1 (7)
3 (10)
> 0.99c
'Attitude' of the patients
Read leaflet before consent, n (percentage)
11 (79)
17 (57)
Asked at least one question before consent, n (percentage)
8 (57)
6 (20)
Read or asked, n (percentage)
13 (93)
18 (60)
Read and asked, n (percentage)
6 (43)
5 (17)
Value of 'asking one question' and 'reading the informative leaflet or asking one question' to recall the clinical trial
OR, complete versus incomplete recall
Positive predictive value
Negative predictive value
Likelihood ratio
Asked one question
5.3 (1.3–21)
0.57 (0.29–0.82)
0.80 (0.61–0.92)
0.57 (0.29–0.82)
0.80 (0.61–0.92)
Read leaflet or asked one question
8.7 (1.0–75)
0.93 (0.66–1.00)
0.40 (0.23–0.59)
0.42 (0.25–0.61)
0.92 (0.64–1.00)
Patient characteristics, rate of recall and attitude of the patients during the informed consent procedure according to the two investigators.
Investigator 1
Investigator 2
p value
Age of the patients, mean (SD)
48 (22)
56 (20)
Sex of the patients, male/female
SAPS II of the patients
20 (9)
18 (10)
Patients with Complete recall, n (percentage)
3 (20)
11 (38)
Patients with recall of study participation, n (percentage)
10 (67)
25 (86)
Patients with recall of the study purpose, n (percentage)
4 (27)
16 (55)
Patients with recall of the study risk, n (percentage)
Attitude of the patients before consent, n (percentage)
Read leaflet
8 (53)
20 (69)
Asked at least one question
6 (40)
8 (28)
Read or asked
10 (67)
21 (72)
Read and asked
4 (27)
7 (24)
A great majority of ICU patients who had consented to participate in a clinical trial during their ICU stay recalled their clinical trial participation after 10 ± 2 days. Other studies, including those on patients with acute myocardial infarction, have reported clinical trial participation recall rates similar to ours [14–16]. Our rate is also similar to the rate we found in a study in which informed consent was obtained in an ideal situation, namely before ICU admission [9].
Although this may seem very encouraging, only 32% of the patients who gave consent during their ICU stay recalled clinical trial components; this is in contrast to our 'ideal situation' previous study in which 75% of patients had a complete recall [9]. The low rate of complete recall in the present study could be explained by the difficulty of some ICU patients to process information given the stress of the acute phase and possibly experiencing feelings of dependence and anguish [17]. Our routine clinical evaluation might not detect this potential cognitive defect [18]. The reasons why some patients are able to recall whereas others cannot therefore remain unclear.
The severity of disease, the neurological status of the patients, and the medications received in the ICU when informed consent was obtained and during the 24 hours after the informed consent procedure were similar in both groups of our patients.
Inadequate information disclosure to some patients that could explain our results can reasonably be excluded because the information procedure was well standardized. In contrast with previous reports, we found that neither age nor educational status influenced the ability to recall clinical trial components [19, 20]. This might reflect the fact that the information presented was not difficult to understand.
If the informed consent satisfies the three criteria specified by international guidelines, the consent is deemed valid [1, 2, 21]. However, if the clinical trial has already begun and the patient is unaware of the purpose, related risks, and their participation in the clinical trial, they are obviously unable to decide mindfully whether to continue in the clinical trial or to withdraw from it at any time. In this case, we might question the respect of the participant's autonomy offered by the informed consent. This leads us to view the informed consent as a process rather than a simple procedure. The informed consent process requires, to our mind, multiple conversations on several occasions while the research is conducted.
We found simple but important factors associated with complete recall of the clinical trial components. We tried to identify factors that were easy to observe by an investigator such as 'asking questions' and 'reading the informative leaflet'. In our previous study, we found that more patients who were able to mention all clinical trial components had read the leaflet and had asked at least one question. 'Asking questions' increased the chance of recall in critically ill patients. We could speculate inversely that asking no questions could increase the potential for poor initial comprehension of the clinical trial components.
Our results are in line with Flory and Emanuel's findings [22], which concluded that person-to-person interaction with clinical trial participants may be the most effective way of improving their understanding.
This finding revives the debate about informed consent for research in the ICU. In the past, deferred consent [23] or waiving of consent for research in the emergency setting [24, 25] was considered acceptable in particular research situations. However, during the past few years, legislation has tried to enhance protection for incompetent patients. Barriers to the inclusion of ICU patients in research studies have increased, especially across Europe [2, 26]. We fully support the idea that oversight is necessary to ensure the uniform application of ethical standards [11], but the most dependable safeguard for the research subject is investigator understanding and respect of the ethical requirements of clinical research.
Our study presents some limitations. First, the small number of patients enrolled was dependent on the clinical trial. This might have impeded the detection of other potential factors that could influence the recall of the clinical trial. In addition, the small clinical trial size precluded the possibility of a multivariate analysis. Second, we did not investigate the recall of patients who had refused to participate in the clinical trial on inflammation primarily because there was no consent to investigate. Perhaps the degree of recall might have been different in patients who had refused participation. Third, we did not assess patients' cognitive capacity. There is good evidence that the cognitive capacity of ICU patients, or even sick patients in general, is impaired [27, 28]. However, spending more time with patients to test their cognitive capacity, and interacting with them for much longer than for a 'standard' informed consent procedure, would have biased our results. It is for this same reason that we did not measure the patients' memory. Fourth, scores of severity of illness and laboratory values may suggest that patients with incomplete recall were more ill than those with complete recall. Although not statistically significant, these results do not allow for the possibility that the severity of the disease might act on recall. However, the fundamental message remains that a poor rate of recall of a clinical trial is present in ICU patients. Finally, as our patients were presumed fully competent, the study faced the best possible situation in ICU patients. We are aware that these patients do not represent the majority of ICU patients and our results may therefore not be generalizable. However, it is reasonable to speculate that the rate of recall may be even worse in usual patients in the ICU.
To respect the principle of autonomy in the informed consent procedure, patients should be able to decide freely without any external pressure whether they agree to continue to participate in a clinical trial at any time. In concordance with our previous paper, about 80% of ICU patients are able to recall their clinical trial participation. However, as hypothesized, the rate of recall of the clinical trial components is very low. We presume that it could be much lower than in patients informed before being admitted to the ICU. Our results reinforce the importance of viewing informed consent as a process and the need for revisiting informed consent several times during an ongoing clinical trial. We suggest that investigators, while the research is conducted., repeatedly repeat clinical trial information to the participants even after their ICU stay. We therefore propose to reassess regularly whether continued participation in a clinical trial is desired by the patient, as recommended previously [11]. Whether encouraging patients to read the informative leaflet and ask questions about the clinical trial improves the informed consent procedure remains to be fully investigated.
Key messages
The rate of recall of the clinical trial components (purpose and risks) in patients informed after being admitted to the ICU is very low. It is presumably much lower than in patients who gave their informed consent outside the ICU setting.
More patients who could recall their clinical trial participation and the clinical trial components had read the informative leaflet or had asked at least one question before signing the informed consent.
Reconsidering the informed consent procedure repeatedly during an ongoing clinical trial could be useful to respect patients' rights.
Informed consent to participate in a clinical trial should be considered an ongoing process rather than a single procedure.
Glasgow Coma Scale
intensive care unit.
Support was provided solely from institutional and/or departmental sources. This paper was presented in part at the annual congress of the American Thoracic Society (ATS), May 2003, in Seattle, WA, USA.
Authors' Affiliations
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Provision of sponsorships and awards to inspire students to soar to greater heights.
© CPE/UEN: 200504979ZRegistered: 4 June 2016 - 3 June 2022


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Thin Pasta With Shrimp Red Peppers And Pine Nuts
|1⁄2 Pound
|White wine
|3⁄4 Cup (12 tbs)
|Chopped onion/Shallots
|1⁄4 Cup (4 tbs)
|4 Tablespoon
|Olive oil
|2 Tablespoon
|Medium shrimps
|8 Ounce, peeled and deveined
|Toasted pine nuts
|1⁄3 Cup (5.33 tbs)
|Garlic clove
|1 Large, crushed
|Red pepper
|1 Large, sliced thin
|Chopped oregano/1/2 teaspoon dry
|1 Tablespoon
|Chopped basil/1/2 teaspoon dry
|1 Tablespoon
|Chopped parsley
|1 Tablespoon
Cook in boiling water until al dente (firm to the bite).
Drain and set aside.
Meanwhile, prepare sauce.
Boil approx. 5 minutes.
Remove from heat.
Whisk into above slowly, until all is incorporated.
Heat in skillet.
Add ingredients and saute just until shrimps turn pink, about 2 minutes.
Set aside.
Add pasta to shrimp mixture along with wine mixture and toss well.
Sprinkle over pasta, toss
Rate It
Nutrition Rank
Nutrition Facts
Serving size: Complete recipe
Calories 2142 Calories from Fat 1004
% Daily Value*
Total Fat 118 g181.9%
Saturated Fat 39.2 g195.9%
Trans Fat 0 g
Cholesterol 540.4 mg180.1%
Sodium 381.9 mg15.9%
Total Carbohydrates 162 g54%
Dietary Fiber 17.6 g70.3%
Sugars 13.9 g
Protein 84 g168.1%
Vitamin A 179.4% Vitamin C 334.2%
Calcium 51.7% Iron 122.9%
*Based on a 2000 Calorie diet


text:
Glancing For The Beautiful Plate For Professional Hair?
LaPiega Italia is a pioneering hair beauty brand, born and operates in Italy in 2015 and soon expanding to Spain (available soon at http://lapiega.es) and UK. Considering today's rebellious, multi-tasking and modern women, the brand is offering high quality plates for smooth hair.
Now, looking up for the professional plate hair straightener is not at all a big problem. Women understand the importance of healthy and shiny hair and for guarding the same; we are providing professional hair straighteners made up with titanium and ceramic.
Explore A Plate Made Up Of Ceramic And Titanium With Several Benefits For Professional Hair
As used by our valuable customers, the E-Professional hair straighteners plate is not only the best to use but is worthy enough and provides good value for the money. The benefits of using them are as follows.
- Silky, smooth and healthy hair in few minutes
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Less than 2.5 cm designed plate for extremely fine, narrow and thin hairMore than 3.5 cm designed plate for thick and long hair We suggest you that even a plate in between 2 and 3.5 cm can be used for all types of hair providing great ease and flexibility with the crease.
Why purchase a plate made up of ceramic and titanium?
Selecting the plate material is always been one of the most significant things to consider for. Over the last few years, technology has emerged a lot used in hair straighteners. For a good and beautiful hairstyle, it is still possible to look for the plates made up of advised and friendly materials that will not damage your hair like those are made up of alluminium does. LaPiega proffers plates for hair made up of ceramic and titanium as the perfect blend of two lends great advantages in the hair treatment and allows a perfect fold. Titanium is known to be a very light element that not only keeps heat in a uniform way but also let to warm up quickly the entire surface of the plates and that too without thermal shock making it simpler to style down hair fast, safely and efficaciously. On the other side, ceramic slips on the hair making them shinier and healthier without any damage. Both elements have negative ions present, are excellent heat conductors and good for making hair healthier, smoother and shinier.
What is the meaning of Ionic technology?
Our newly introduced Ionic technology in our e-professional hair straighteners allow clients to smooth down their hair less aggressively as compared to the normal plates available in the market. Helping in protecting the natural moisture of the hair, Ionic technology annihilates static electricity making it simpler and convenient to smooth down hair in a natural way. As compared to conventional plates available, our offered plates does not dry due to the negative ions of ceramic and titanium available, thus cutting down frizz and providing shine and volume to hair. The end result is shiny, smooth, hydrated and soft hair.
What is the temperature variation at which I should iron my hair?
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The E-Professional hair straightener proffered by LaPiega lets you to adjust the temperature in an easy way backed with an LCD screen for the display. Moreover it is a pre-set model adjusted with a safe optimal temperature that could not be exceeded. And it is nearly impossible to damage or burn your hair in such setting. Though, we recommend:
For Fine Hair – Max 150 ºC For Normal Hair – Max 180 ºC For Large Hair – Max 200-200 ºC Your hair care and protection is the uttermost essential thing for us.
How long smooth and shiny effect of plate prevails?
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Can I use E-professional hair straightener of LaPiega every day?
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It is advised as per the council that the daily cuts should be done within a temperature range of 80-100 degrees.
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We understand that in this techno savvy era, it is simple to purchase anything on web but still who are not very much comfortable with the online platform, LaPiega assures to make everything simple, secure and as convenient as could be possible.
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Two Year Assurance and Warranty on our Italian Products:
LaPiega promises providing high quality products. We simply relish what we do, and serve our unique clientele an exclusive brand items. In all, if our clients are happy and contended, so are we.


text:
- Anonymous
- France, Male, 31-40
- Novice Nomad
- 9 reviews
Nice house at the feet of the upper town with possibility to park your car. Host is quite friendly. Definitiely a good place to stay to visit Bergamo
- monikabartz4004
- Poland, Couple, 31-40
- Novice Nomad
- 9 reviews
Great place! Italian atmosphere, family like. Location in between Ciita Alta and Bassa is very convenianat.
Hostelworld Mobile Apps
Book on the go with the new Hostelworld mobile apps.


text:
US headliners Little Charlie & The Nightcats (left) and The Holmes Brothers are two of the most engaging live acts currently treading the boards. The Nightcats, fronted by diminutive guitar whizz Little Charlie Baty and larger-than-life vocalist and harmonica virtuoso Rick Estrin, are - with their witty take on the always lively jump blues idiom and tight stage act - the more obviously entertaining. Who, after all, can ignore an outfit that can come up with a title like "My Next Ex-Wife"? But The Holmes Brothers - Sherman and Wendell, with cohort Popsy Dixon - have, over the years, made a speciality of bringing together R'n'B, gospel and even country to make an irresistible soul-blues stew. Nor is this just stuff for the roots purist - the latest record features versions of Lennon and McCartney's "And I Love Her" and Tom Waits's "Train Song".
Earlier, the "non-stop all-dayer" - as tomorrow's event at Watermans Art Centre is billed - features another performer who can turn his hand to a pop tune, DJ, actor and former Manfred Mann frontman Paul Jones who takes the stage with Blues Band colleague Dave Kelly. And the currently in-vogue acoustic blues style receives a nod with the appearance of Michael Roach, a finger-picking guitarist who continues the East Coast country blues tradition.
With a barbecue, record stall - not to mention a number of other acts to keep the music flowing - all the organisers need is a good dose of sweltering heat to replicate the feel of the dozens of open-air festivals that punctuate the American summer every year.
Blue Sunday, Watermans Arts Centre (0181-568 1176), tomorrow 2pm to 12 midnight
- More about:
- Arts
- Blues
- Festive Events (including Carnivals)
- Tom Waits


text:
1491: New Revelations of the Americas Before Columbus
Vintage Books, 2006 - History - 541 pages
This book presents a study that radically alters our understanding of the Americas before the arrival of the Europeans in 1492. Traditionally, Americans learned in school that the ancestors of the people who inhabited the Western Hemisphere at the time of Columbus's landing had crossed the Bering Strait twelve thousand years ago; existed mainly in small, nomadic bands; and lived so lightly on the land that the Americas was, for all practical purposes, still a vast wilderness. But as Charles C. Mann makes clear, archaeologists and anthropologists have spent the last thirty years proving these and many other long-held assumptions wrong. In a book that startles and persuades, Mann reveals how a new generation of researchers equipped with novel scientific techniques came to previously unheard-of conclusions. Among them - In 1491 there were probably more people living in the Americas than in Europe. Certain cities - such as Tenochtitlán, the Aztec capital - were far greater in population than any contemporary European city. Furthermore, Tenochtitlán, unlike any capital in Europe at that time, had running water, beautiful botanical gardens, and immaculately clean streets. The earliest cities in the Western Hemisphere were thriving before the Egyptians built the great pyramids. Pre-Columbian Indians in Mexico developed corn by a breeding process so sophisticated that the journal Science recently described it as 'man's first, and perhaps the greatest, feat of genetic engineering'. Amazonian Indians learned how to farm the rain forest without destroying it- a process scientists are studying today in thehope of regaining this lost knowledge. Native Americans transformed their land so completely that Europeans arrived in a hemisphere already massively 'landscaped' by human beings. Mann sheds clarifying light on the methods used to arrive at these new visions of the pre-Columbian Americas and how they have affected our understanding of our history and our thinking about the environment. His book is an account of scientific inquiry and revelation.
What people are saying - Write a review
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Review: 1491: New Revelations of the Americas Before ColumbusUser Review - Thomas - Goodreads
I thought this was a really excellent book, it reminded me a little of Guns, Germs, and Steel: The Fates of Human Societies but I think I liked it better actually. Mann really gets into what the ... Read full review
All 2 reviews »
Review: 1491: New Revelations of the Americas Before ColumbusUser Review - Al - Goodreads
The author presents very interesting evidence about the state of the 'New World' prior to the entry of the Europeans in 1492 and thereafter. He presents significant data that contradicts much of what has been written in the past. Read full review


text:
Ask Your Health Question and Get an Answer ASAP
This could be cardiac related, and it is very important that you have that ruled out. Chest tightness and sweating, with dizziness means you could be having a heart attack.
Please go to the ER now, and don't drive yourself.
Also, take one aspirin as soon as you can.


text:
Hall nissan of virginia beach for sale on US's largest classifieds sites (81 results)
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2007 Cadillac DTS
What a price for an 07! Here it is! Tired of the same tedious drive? Well change up things with this outstanding-looking 2007 Cadillac DTS. J.D. Power and Associates gave the 2007 DTS 5 out of 5 Power Circles for Overall Dependability. There are plenty of miles left on this car so you dont have to wor
2012 Buick Enclave AWD Premium
** LOCAL TRADE **, ** CLEAN CARFAX **, ** ONE OWNER **, ** LOADED WITH EVERY OPTION! **, And ** AWD **. Dont let the miles fool you!Previous owner purchased it brand new! Want to save some money? Get the NEW look for the used price on this one owner vehicle. Dont let the drumming of road noise
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text:
The Clinical Research Core (CRC - Resource Core 1) of the Wake Forest University Older Americans Independence Center (WFU OAIC) provides the critical infrastructure and investigator resources essential to the successful conduct of clinical research focusing on physical function and disability in older adults. The CRC is well-integrated with the other OAIC Resource Cores (Biolmaging, Integrative Biology and Biostatistics Cores). With them, the CRC will support externally funded studies, OAlC-funded Pilot and Research Development Projects, and other externally-funded projects related to the WFU OAIC research theme: Integrating pathways affecting physical function for new approaches to disability treatment and prevention. A high priority for the CRC will be to support clinical trials translating basic research discoveries into human population studies;clinical research targeting sarcopenia and adiposity-related decline in physical function and disability in older adults;and trials of novel interventions related to these risk factors. The CRC will also assist the Leadership and Administrative Core (LAC), the Pilot and Exploratory Studies Core (PESC), and the Research Career Development Core (RCDC) in identifying promising new investigators and programs positioned to help to address the mechanisms and prevention of physical disability. The CRC will provide 'turn-key'resources critical for successful clinical research studies, including: 1) expertise related to experimental study design and conduct, including selection of appropriate outcome measures;2) highly efficient and effective participant recruitment 3) a standardized physical function assessment battery;4) procurement (with the Integrative Biology Core) of muscle and adipose tissue and blood samples;5) maintenance (in concert with the Biostatistics Core) of a uniform outcomes database;6) assisting junior investigators with IRB and other regulatory filings (in concert with the PESC and RCDC). In the present cycle, provision of these key resources has been integral to our timely completion of clinical studies, publication of results, competition for new independently-funded grant awards, and development of new investigators
The Wake Forest OAIC Clinical Research Core provides research support (assessment tools, staff, space, recruitment support, etc.) for scientists interested in developing new understanding about the causes and prevention of older adults'loss of ability to live independently in their communities.
|Tyrrell, Daniel J; Bharadwaj, Manish S; Van Horn, Cynthia G et al. (2015) Respirometric Profiling of Muscle Mitochondria and Blood Cells Are Associated With Differences in Gait Speed Among Community-Dwelling Older Adults. J Gerontol A Biol Sci Med Sci 70:1394-9
|Wrights, Abbie P; Fain, Christie W; Miller, Michael E et al. (2015) Assessing physical and cognitive function of older adults in continuing care retirement communities: who are we recruiting? Contemp Clin Trials 40:159-65
|Beavers, K M; Beavers, D P; Newman, J J et al. (2015) Effects of total and regional fat loss on plasma CRP and IL-6 in overweight and obese, older adults with knee osteoarthritis. Osteoarthritis Cartilage 23:249-56
|Murphy, Rachel A; Reinders, Ilse; Register, Thomas C et al. (2014) Associations of BMI and adipose tissue area and density with incident mobility limitation and poor performance in older adults. Am J Clin Nutr 99:1059-65
|Buford, Thomas W; Hsu, Fang-Chi; Brinkley, Tina E et al. (2014) Genetic influence on exercise-induced changes in physical function among mobility-limited older adults. Physiol Genomics 46:149-58
|Pamukoff, Derek N; Haakonssen, Eric C; Zaccaria, Joseph A et al. (2014) The effects of strength and power training on single-step balance recovery in older adults: a preliminary study. Clin Interv Aging 9:697-704
|Kitzman, Dalane W; Nicklas, Barbara; Kraus, William E et al. (2014) Skeletal muscle abnormalities and exercise intolerance in older patients with heart failure and preserved ejection fraction. Am J Physiol Heart Circ Physiol 306:H1364-70
|Klepin, Heidi D; Geiger, Ann M; Bandos, Hanna et al. (2014) Cognitive factors associated with adherence to oral antiestrogen therapy: results from the cognition in the study of tamoxifen and raloxifene (Co-STAR) study. Cancer Prev Res (Phila) 7:161-8
|Groban, Leanne; Kitzman, Dalane W; Register, Thomas C et al. (2014) Effect of depression and sertraline treatment on cardiac function in female nonhuman primates. Psychosom Med 76:137-46
|Grosicki, Gregory J; Miller, Michael E; Marsh, Anthony P (2014) Resistance exercise performance variability at submaximal intensities in older and younger adults. Clin Interv Aging 9:209-18
Showing the most recent 10 out of 279 publications


text:
With Instructables you can share what you make with the world, and tap into an ever-growing community of creative experts.
Hellow instructablers! This is a knex gun that looks like a tape dispencer! Hope ye like !
i would make 2 of these lol.
The barrel is fun. oh 10 yellow connectors are required.
1.attach barrel 2.make pin (tape) Thanks for making
Powerful K'nex Gunby nickgro100
pen gunby R134687
AP4 K`nex Gun by Oblivitusby Oblivitus
Join 2 million + to receive instant DIY inspiration in your inbox.
© 2016 Autodesk, Inc.


text:
This is our studio site. Among other things, we run two businesses:
Field Notes Brand and The Deck Network. Visit them please.
Fresh Signals
From Second City, one in a series of sketches serving as a promo for the film: "What Is the Godzilla?" -sd.05.16.14 #
A post from the daily flow of linkage called Fresh Signals, at Coudal.com.


text:
To make reservations by phone, call 1-800-331-3131 in the USA and Canada (or any of our worldwide reservation telephone numbers).
821 20th Street South
Birmingham, Alabama 35205
Birmingham-Shuttlesworth International Airport - BHM
Airport Phone: +1 205 595 0533
Hotel direction: 6 miles NE
This hotel does not provide shuttle service.
Take I-20 West towards Tuscaloosa and exit onto Carraway Blvd/Hwy 31 South. Exit onto 8th Ave and make a right. Travel to 20th street and make a left. Hotel will be on the left.
2508 5th Avenue S
Birmingham, Alabama 35233
Phone: +1-205-320-2533
2728 4th Ave S, Birmingham, AL
Birmingham, Alabama 35205
Phone: +1-205-326-6555
5500 Airline Dr
Birmingham, Alabama 35205
Phone: +1-205-592-8901


text:
Christina RicciActor
Born: 12 February 1980
Birthplace: Santa Monica, California
Best known as: Wednesday in the Addams Family movies
Christina Ricci made her movie debut in Mermaids (1990, with Cher and Winona Ryder) and followed up with memorable performances as Wednesday Addams in The Addams Family (1991) and Addams Family Values (1993). After making a splash as a child actress in children's movies, Ricci moved full-speed ahead into independent films and mature performances, including The Ice Storm (1997, with Elijah Wood and Tobey Maguire), The Opposite of Sex (1998) and John Waters's Pecker (1998). Her other films include 200 Cigarettes (1999), Sleepy Hollow (1999, with Christopher Walken) and the story of serial killer Aileen Wuornos, Monster (2003, starring Charlize Theron).
Copyright © 1998-2017 by Who2?, LLC. All rights reserved.


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Residents want constant police presence, not just symbolic
No doubt, it's an impressive - and comforting - sight for residents in high-crime areas.
Row upon row of spit-and-polished Milwaukee Police Department officers standing at attention in the street during roll call as Police Chief Ed Flynn gives them the once-over as the good people in the neighborhood stand by watching.
The public roll call has become a staple in the Ed Flynn book of good community policing; it's a calculated show of force in troubled areas. It's been done other places but it's something new for this city.
"I certainly don't ever remember another police chief doing something like this," said Milwaukee Ald. Robert Donovan, a veteran politician and recent vocal critic of Flynn's policing strategies.
A triple shooting in Donovan's district last week prompted Flynn's most recent public roll call. Asked for his opinion, Donovan repeated what I've heard from several people about these impressive displays of uniformed officers meant to give reassurance to beleaguered residents.
"Largely, I think it's all for show," said Donovan. "In a couple of days, the cops are gone."
Flynn takes issue with that perception although he didn't deny the roll call was meant to send a symbolic message about the department's commitment to the community.
"It's symbolic but it's not phony," the chief insisted. "I think it's a great opportunity for residents to see the resources committed to the area."
Flynn said he got the idea after watching other police forces do it during his law enforcement career. He did it at his previous stop as police chief in Springfield, Mass., and continued the practice in Milwaukee after being appointed chief in 2008.
"I see a real benefit for it," he said. "It's great for the cops and the neighborhood."
But some residents I've talked to in areas where Flynn has held roll calls question if the practice actually was having any real impact against hardened criminals.
"It's usually first shift when crime is low and everybody is in bed," said one African-American male who lives in an area with regular gun violence and drug dealing. "We all know when the MPD shift change is, and crime resumes as normal."
Flynn said the roll calls were not intended solely to scare off criminals; part of the purpose was to build more trust with law-abiding residents. He's already seen some positive results; after the recent roll call at the scene of a south side shooting, Flynn said more residents started cooperating with police.
Not everyone's convinced. Donovan said he preferred a more consistent level of police presence in embattled areas in order to address serious problems.
"I think we're chasing after the violence; we're reacting to it," said Donovan, who said he'd like to see more cops in the area, on foot patrols and even bikes.
I think the level of gun violence in some areas of Milwaukee has escalated to the point where many residents don't believe periodic shows of force by police will help things much. No matter how impressive the sight, the bad guys realize cops can't be around all the time. That's too bad; most of the good people in troubled neighborhoods wish they could.
Contact Eugene Kane at (414) 223-5521 or firstname.lastname@example.com and follow him on Twitter @eugene_kane


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Forever More
You Ride The Tides With Me.
For Ever And Always
You Surprise Me.
I abide in the shelter
where I was secured
and all that surrounds me
has become
There is a creative force
with guidance in the
whimsical nature that I am.
I have found the touch of a song
and the scent of a smile *
I have fixed myself to you
as the essence of you
that I am!
I have never been anywhere
but here,
and yet I didn't know...
© Copyright 2017 air. All rights reserved.
Status: Finished
Genre: Religion and Spirituality
Always and forever perfect. Love it.
Such beautifull words -i have found the touch of a song and the scent of a smile...very moving for me.....great writing really really liked this one have read it three times......Smile be happy love peace juliet
oh, Thank You Juliet * it's kinda the same concept as alot of my stuff but ya, that one line 'a touch of a song' came to me once and is in another poem but I don't know the name of it off hand. I think some of it went: 'to me you are dreams come true, the spirit of life with de-javu" "you are the touch of a song, all that is right and nothing wrong"
I don't know, something like that anyway. YA, I was in *LOVE* once upon a time LOL! eons and eons ago (smile) just kidding, but it has been a while! :) LOl! thanks Juliet! we'll see you soon....love, and peace....katie
Lovely Katie, as usual. It demands a couple of re-reads as Juliet alluded to. Peace and love.....Jerry
Really? I kinda thought it was more of the same-o same-o you know? But Thank You!!! :) I am trying to download a couple of kids stories I put together during the holidays but not getting it yet almost though (I think)(frown) lol! well sooner or later one of these days Lol!
Very nice. If you would please read my poem"The Cooking Pot" and tell me what you think. Tyrone.
Poem / Poetry
Poem / Poetry
Poem / Poetry
Shelves: 7
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The Horse Forum (http://www.horseforum.com/forumindex.php)
- Horse Jobs (/horse-jobs/)
- - dressage working student position available (http://www.horseforum.com/horse-jobs/dressage-working-student-position-available-117268/)
dressage working student position available
I currently have a working student position available for dressage. We are located in Wellington, Florida all year around. It is a live-in position with an apartment on site included. Our website is Caballo Ranch Sporthorses - Home.
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8hrs Wedding Photography & Prints£399 instead of £1000 for eight hours of contemporary wedding photography inc. 400 images and prints from Wonderful Weddings - save 60%
Save 60%
Time left to purchase
- Enjoy 8 hours of contemporary wedding photography.
- Includes 400 images on a disc with image copyright.
- Plus five 8" x 10" prints or twenty 4" x 6" prints to treasure forever.
- Experienced photographer.
- One HUGE purse-friendly tick off your to-do list!
The Fine Print
- One per person.
- May buy multiples as gifts.
- Voucher valid until 5th Jan 2016.
- 4-week cancellation policy applies.
- Areas outside the M25 will incur an additional surcharge for petrol.
- Subject to availability.
Full Details
Don't tie yourself up in knots whilst you make plans to tie the knot - tick off one major element on your Big Day to-do list with today's brilliant wedding photography deal...
We're offering eight hours of contemporary wedding photography including 400 images on a disc and a set of prints for the about-to-make-you-squeal-with-joy price of £399, saving you 60% off Wonderful Weddings' price of £1000.
From the moment you don your dress, gals, to the moment you both cut the cake, London and Cambridge-based photographer and Wonderful Weddings founder Nicola will be there to get the shot! With a fun, atmospheric, natural approach to capturing your day, Nicola takes photos that are stylish and cool with a vintage-meets-contemporary look. No cheesy shots around here - unless of course, you've opted for a fashionable cheese wheel wedding 'cake' for the day itself! You'll also receive 400 digital images, copyrighted to you, and your choice of five 8" x 10" prints or twenty 4" x 6" prints. Cool shots at pinch-yourself prices sound good? We thought so - now you can treat yourself to that pair of eye-wateringly expensive pair of shoes you spotted!
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Once purchased, you can redeem this wowcher towards another wowcher or claim a Wowcher Wallet Credit. Click here for more info.
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Date Added : 07/30/2016Author : Anonymous customer
|I absolutely love this bottom. I don't feel like it bunches up, or I have to readjust it when I move around or stand up. It's very comfortable and has a very flattering shape in the front. A very nice shade of black, not hard to find matching tops. So sexy. Love it.


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Is Refine Printing incorrect or missing key business information? Update your Hotfrog listing today.
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Hotfrog Singapore provides information regarding Refine Printing in Singapore. Refine Printing is located at 3 Irving Rd #02-03 Irving Ind Bldg, Singapore 369522 and provides Printing services. Contact them on 6282 7734.
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The Arabic-language page titled "Arms for Sale" was created in early May and already has 2,355 "likes."
His administration faces enormous challenges in the likes of Afghanistan, Iran, China, Russia and North Korea.
In letters to her son, she likes to sign off by writing: "Go with God, as Billy James Hargis always says."
No shrinking violet, Gallagher likes the stage and will appear in a production of Love Letters with Sally Struthers this spring.
From writing this book, what did you learn about the publishing industry and what it likes to see in female characters?
No one wants to take it," replied Pennie, "but she shall give it if she likes.
And to suppose that being ill is doing as one likes, of all odd things!
You see she likes them and is thoroughly interested in all their little affairs.
I hope she is doing nothing but what she likes in this change of plan.
"Let him swim if he likes," said Nikola, with a shrug of his shoulders.
"predilections, preferences," 1851, plural of like (n.); earlier used in singular in this sense (early 15c.).
"having the same characteristics or qualities" (as another), Middle English shortening of Old English gelic "like, similar," from Proto-Germanic *galika- "having the same form," literally "with a corresponding body" (cf. Old Saxon gilik, Dutch gelijk, German gleich, Gothic galeiks "equally, like"), a compound of *ga- "with, together" + Germanic base *lik- "body, form; like, same" (cf. Old English lic "body," German Leiche "corpse," Danish lig, Swedish lik, Dutch lijk "body, corpse"). Analogous, etymologically, to Latin conform. The modern form (rather than *lich) may be from a northern descendant of the Old English word's Norse cognate, glikr.
Formerly with comparative liker and superlative likest (still in use 17c.). The preposition (c.1200) and the adverb (c.1300) both are from the adjective. As a conjunction, first attested early 16c. The word has been used as a postponed filler ("going really fast, like") from 1778; as a presumed emphatic ("going, like, really fast") from 1950, originally in counterculture slang and bop talk. Phrase more like it "closer to what is desired" is from 1888.
Old English lician "to please, be sufficient," from Proto-Germanic *likjan (cf. Old Norse lika, Old Frisian likia, Old High German lihhen, Gothic leikan "to please"), from *lik- "body, form; like, same."
The basic meaning seems to be "to be like" (see like (adj.)), thus, "to be suitable." Like (and dislike) originally flowed the other way: It likes me, where we would say I like it. The modern flow began to appear late 14c. (cf. please).
c.1200, "a similar thing" (to another), from like (adj.).
As if; really; you know; sort of •A generalized
used to lend a somewhat tentative and detached tone to the speaker, to give the speaker time to rally words and ideas: Like I was like groovin' like, you know what I mean? (1950s+ Counterculture & bop talk)
To pick; bet on: I liked Felton. I took his folder and read it again (1950s+)
Related Terms


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Hi all.
Well. Thats pretty much the issue. Max 6.1 with live 9. No apc40 or launchpad detected. I tryed with the LOM navigator device and live.api.explorer device too. in the same Pc i have no problems with max 5.1 and Live 8.3.
Any advice?
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Wego.com.sg recently found 9 hotels in Marmari, Greece. Book last minute hotel or find great hotel deals such as GIKAS Apartments for S$114 per night. Save more on cheap hotels with rates from as low as S$114 per night.
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Marmari Hotels 3 Star Hotels Marmari Cheap Hotels Marmari Cheap Accommodation Marmari
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The goals of this program are to identify, inspire and train promising candidates for research careers in academic nephrology and to assist qualified trainees in obtaining suitable academic positions. The program is designed to provide physicians heading for careers in academic nephrology the thorough scientific grounding necessary for a successful research career and to attract recent PhD graduates and provide them postdoctoral research training in a scientific discipline relevant to nephrology. Research training will continue for at least two years. On average, three new trainees will enter the program each year. The principal mechanism for training is direct performance of research under the personal supervision of one or more of the training staff comprised of nine nephrologists and seven basic scientists. Experienced, interdisciplinary training staff provide training in immunopathology, autoimmunity, renal cell physiology, ischemic and toxic renal injury, gene regulation related to renal cancer and developmental biology, and clinical research relevant to kidney diseases. Well-established collaborative arrangements allow each trainee to acquire a broad research experience and focus a variety of skills on a specific research protocol. Trainees assume graded responsibility for the design, conduct and interpretation of experiments, progressively becoming more independent but always remaining under the supervision of the preceptor. All trainees and staff meet frequently for seminars, journal clubs and other formal group teaching exercises. Coursework leading to a PhD is available in the Graduate Program in Molecular Medicine, and formal training in clinical research is provided through the BU School of Public Health and Division of Graduate Medical Sciences. Trainees work in modern, well-equipped laboratory space in the Evans Biomedical Research Center and laboratories of basic science faculty. These are in close proximity to core facilities, modern animal care quarters supervised by a full-time veterinarian, and the BUSPH. The General Clinical Research Center at Boston Medical Center is available for clinical studies.
This program is designed to provide research training for physicians and scientists to investigate the causes and consequences of kidney diseases;to identify ways to prevent diseaes of the kidney from progressing to kidney failure and to improve the quality and duration of the lives of those who do develop end stage kidney failure.
|Yasuda, Kei; Watkins, Amanda A; Kochar, Guneet S et al. (2014) Interferon regulatory factor-5 deficiency ameliorates disease severity in the MRL/lpr mouse model of lupus in the absence of a mutation in DOCK2. PLoS One 9:e103478
|Roseman, Daniel A; Hwang, Shih-Jen; Manders, Emily S et al. (2014) Renal artery calcium, cardiovascular risk factors, and indexes of renal function. Am J Cardiol 113:156-61
|Ma, Hong; Sandor, Dana G; Beck Jr, Laurence H (2013) The role of complement in membranous nephropathy. Semin Nephrol 33:531-42
|Yasuda, Kei; Nundel, Kerstin; Watkins, Amanda A et al. (2013) Phenotype and function of B cells and dendritic cells from interferon regulatory factor 5-deficient mice with and without a mutation in DOCK2. Int Immunol 25:295-306
|Roseman, D A; Kabbani, D; Kwah, J et al. (2013) Strongyloides stercoralis transmission by kidney transplantation in two recipients from a common donor. Am J Transplant 13:2483-6
|Correa, Stephanie M; Washburn, Linda L; Kahlon, Ravi S et al. (2012) Sex reversal in C57BL/6J XY mice caused by increased expression of ovarian genes and insufficient activation of the testis determining pathway. PLoS Genet 8:e1002569
|Richez, Christophe; Yasuda, Kei; Bonegio, Ramon G et al. (2010) IFN regulatory factor 5 is required for disease development in the FcgammaRIIB-/-Yaa and FcgammaRIIB-/- mouse models of systemic lupus erythematosus. J Immunol 184:796-806
|Chitalia, Vipul C; Foy, Rebecca L; Bachschmid, Markus M et al. (2008) Jade-1 inhibits Wnt signalling by ubiquitylating beta-catenin and mediates Wnt pathway inhibition by pVHL. Nat Cell Biol 10:1208-16
|Panchenko, Maria V; Zhou, Mina I; Cohen, Herbert T (2004) von Hippel-Lindau partner Jade-1 is a transcriptional co-activator associated with histone acetyltransferase activity. J Biol Chem 279:56032-41
|Saran, Anita M; Yuan, Huaping; Takeuchi, Emiko et al. (2003) Complement mediates nephrin redistribution and actin dissociation in experimental membranous nephropathy. Kidney Int 64:2072-8
Showing the most recent 10 out of 23 publications


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Link building for the German market
- Status Closed
- Budget N/A
- Total Bids 4
Project Description
We are looking for an experience link builder who fully understands, or lives in Germany and the market. We require you to build links for a German website specialising in treating neurological diseases such as epilepsy, Down Syndrome or autism.
We don't want exchange links, or some dead links. The links should come from quality websites including forums and blog comments. We prefer links coming from articles.
We will want you to build links on a regular basis, therefore, you will be paid on a monthly basis. So you are bidding for the monthly rate, we want you to spend 4-6 hours a month on link-building.Get free quotes for a project like this
Skills Required
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Getting you more information on this room
The restaurant was not open for breakfast the morning of our departure. We were told it was because they didn't expect to be busy enough. This was 4 days before Christmas. The free Continental breakfast offered as a substitute was the saddest one I have ever seen at a hotel in the U.S., Canada or Europe. Even my young children...
Good afternoon,
I am very sorry to learn that you were not completely satisfied with your stay. I can assure you we are working diligently to correct the issues you described. I hope that you will give us another opportunity to serve you in the future.
We stay here a few times a year for a night here and there. The hotel is under renovations but the upgrades are very nice. The rooms are clean and smoke free . The bars has great drinks and appetizers. I love the pool the deep end is deep 9 feet and the hot tub is nice. Towels are a...
Good afternoon,
Thank you for the kind words! Our staff couldn't help but comment on how cute your pup was! We look forward to hosting you again in the near future.
Happy Holidays,
Do you have a van that would drive to the Gathering Place to pick up guests from a wedding to stay at your hotel
Has this facility been renovated? And if we book a room may we get a room that has been redone.
See all questions
"Pick a room by the pool or one with a balcony"
"do not stay in 133"
"Kings court are the newly remodeled rooms. I would not suggest one by the elevator they are a bit noisy ."
"Not sure what else is close, but I would avoid this one."
"Upper Floor"


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Not So Standard Deviations Episode 9 - Spreadsheet Drama12 Feb 2016
For this episode, special guest Jenny Bryan (@jennybryan) joins us from the University of British Columbia! Jenny, Hilary, and I talk about spreadsheets and why some people love them and some people despise them. We also discuss blogging as part of scientific discourse.
Subscribe to the podcast on iTunes.
Show notes:
- Jenny's Stat 545
- Coding is not the new literacy
- Goldman Sachs spreadsheet error
- Jingmai O'Connor episode
- De-weaponizing reproducibility
- Vintage Space
- Tabby Cats


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VTIGER Implementation for inventory tracking.
This project received 17 bids from talented freelancers with an average bid price of $1280 USD.Get free quotes for a project like this
Project Budget$750 - $1500 USD
Total Bids17
Project Description
I own a company based in Mexico City that deals in renting out, setting up and unmounting furniture for red carpet events.
The simplicity of it is we require a VTIGER implementation for around 10 users and the creation of a workflow that will allow us to track the inventory, where it is currently at, and most importantly, if it checked out for that specific day (being used at an event), we will not be able to check it out for use at another event if there is no inventory left.
Run of the mill invoicing, sales, contact, etcetera. the crux is as laid out above.
Skills Required
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Commissioner Füle visits Jordan
"I commend the efforts made so far by the country and stress the willingness of the EU to continue supporting Jordan in addressing the current economic and financial challenges the country is facing. Referring to the work of both the National Dialogue and Royal Committees, I emphasize the need for concrete implementation of reforms to the benefit of the Jordanian citizens. Let me reiterate the principle of "more EU support for more reforms''." said Commissioner Füle in Amman on 2 May.
More information: press release


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A layer of lemon custard brings a fresh touch to mincemeat in this holiday pie. If making up to 1 day ahead, cover and chill.
Makes 10 to 12 servings
+ Add To Shopping List
1 jar (29 oz.) prepared mincemeat
1 lemon (5 oz.), rinsed
2/3 cup sugar
2 tablespoons all-purpose flour
1 cup milk
3 tablespoons melted butter or margarine
2 large eggs
1. Spread mincemeat evenly over bottom of unbaked 10-inch pastry in pan. Set pan in a foil-lined 12-inch pizza pan or 10- by 15-inch baking pan.
2. Grate 1 tablespoon of peel (yellow part only) from the lemon. Ream 3 tablespoons juice.
3. In a bowl, mix sugar and flour. Whisk in milk, butter, eggs, lemon peel, and lemon juice. Carefully pour mixture over mincemeat.
4. Bake in a 375° oven until custard barely jiggles when pan is gently shaken, 45 to 55 minutes (35 to 45 minutes in a convection oven). If pie browns too quickly (check after 15 minutes), cover loosely with foil. Let cool on a rack, uncovered, about 2 hours. Cut into wedges.
Created date
October 2005
Nutritional Information
Calories 385
Caloriesfromfat 33 %
Protein 4.3 g
Fat 14 g
Satfat 5.9 g
Carbohydrate 60 g
Fiber 0.5 g
Sodium 320 mg
Cholesterol 56 mg


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Design Characters
- Status Closed
- Budget $10 - $30 USD
- Total Bids 45
Project Description
I need a designer to create multiple animal illustrations that mimic the style of the attachment. I will ask for ONE sample before awarding the project. Must be done entirely in adobe illustrator. COPY PASTE BIDS NOT ACCEPTED. Thanks.
** MUST BE ABLE TO DO TODAY **Get free quotes for a project like this
Skills Required
Looking to make some money?
- Set your budget and the timeframe
- Outline your proposal
- Get paid for your work
Hire Freelancers who also bid on this project
Looking for work?
Work on projects like this and make money from home!Sign Up Now
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It's a new season in the NBA, the Heat and LeBron James have new championship rings, and yet nothing has changed. You still got the haves and the have-nots, which was easily apparent switching back and forth between the freshman ball (Wizards/Cavs) and the varsity (Celtics/Heat). The fans still don't understand the concept behind the MVP chant (Seriously? In the first game of the season?) And Kevin Garnett is still super ornery. The Heat? They're still pretty good too, ringing up 120 points, 54 percent shooting and just four total turnovers outside of Dwyane Wade (29 points) in a 13-point win over Boston. There were questions before the start about how much small ball the Heat would play. They answered by playing just one guy taller than 6-9 (Chris Bosh, who had 19 points and 10 boards). LeBron James left because of cramps, but not before pummeling his old friends for 26 and 10 … In his absence, Boston cut a big deficit down in the fourth quarter by going super, SUPER small. Leandro Barbosa had 16 points, all of them in the fourth quarter, and without the King on the floor, Boston nearly made the entire deficit up … LeBron broke out some sick gold-themed Nike LeBron Xs to commemorate the championship, and they probably weren't even the best gold-colored shoes on the court. Ray Allen's player exclusive 16s looked like something that would get hypebeasts killed if they ever released them. On the other side, Rajon Rondo (and Jeff Green) was wearing some pink Foams that must've come from Marc Gasol's closet (the big boy rocked them earlier in the preseason), but either way, he should've been slapped for that. And then there was Dwyane Wade, wearing his new Li-Ning joints, just hours after news broke on the exclusive Dynasty Collection … In his first game against his old team, Judas was a difference-maker for Miami (19 points), and his first shot was a triple he splashed from the left corner. Make sure you hold onto this thought, because it'll come into play again sometime next spring in the playoffs: Allen hits 57 percent from that spot, which makes for the deadliest spot for any player in the NBA. He's gonna get a lot of free looks from there … Predictably, he didn't get much love from a few specific Celtics. Before heading into the game for the first time, Allen went down the line on the Boston bench, saying hello. He got to KG, who didn't move and didn't acknowledge him. Allen had to give his shoulder dap. Garnett was actually in midseason form throughout the game, yelling obscenities into the cameras, and also faking an elbow at Mario Chalmers' face (he'd later make good on the promise by swiping Chalmers across the top of the dome in the third quarter) … Rondo had a slow start (suspect in the first quarter, great the rest of the way), but he did become just the fourth player in NBA history to record 25 straight games with at least 10 assists (20 points, seven boards, 13 dimes). The others are Stockton, Magic and Kevin Porter … Without Dirk, Dallas is relying on a bunch of class clowns to keep them competitive. In L.A. last night, it was enough. Six Mavs scored in double figures, led by Darren Collison's 17, in a 99-91 win over the Lakers. Dwight Howard finished with 19 and 10 in his Laker debut, but he also fouled out and shot an embarrassing 3-for-14 from the line. Somewhere out there, Andrew Bynum is sprawled out on a coach, snickering and combing out his new Don King special … The Mavs had Eddy Curry out there dressed up as an NBA player for Halloween, and unfortunately they didn't start him – we had wanted to see Howard throw him through the rim. But Curry was solid, and he represented a small portion of Dallas' fire, which came because they played a number of guys who were fighting for their NBA lives, or fighting to get rid of last season's demons or in the case of Curry, just fighting to lose some weight. Meanwhile, Kobe (22 points) and L.A. played in a trance … The high-low between the two Laker bigs is already a thing of beauty… at least when they used it in the first half. It's almost like Pau Gasol (23 points, 13 rebounds, six assists) would rather stand out 20 feet from the hoop and throw lob passes all game anyways. He seems to get more out of that than anything else he does. In fact, the entire squad just seems a little too giddy to throw Dwight lobs. Steve Blake was throwing stuff up to the moon, and letting Howard get manhandled in the air … Keep reading to hear about the amazing box score Andy Varejao put up…
How long before people realize Kyrie Irving will be chasing shots harder than Russell Westbrook this season? In this situation in Cleveland, that's actually a good thing. Cleveland needed all of him in their opening 94-84 win over Washington, and Uncle Drew was flowing. Triples. Breakdowns off the bounce. What are the odds he leads all point guards in scoring this year? They have to be pretty good… last night, he wasn't even thinking about passing, and finished with 29 points (three off his career-high). We're not big into the plus/minus stats, but Irving was a plus-23 in this one. When they took him out in the second half, the Wizards hit with a 14-0 run. When they put him back in, he put the kids to bed in the final minute, twice eviscerating Washington's defense, and finding Tristan Thompson (12 points, 10 rebounds) for identical dunks under the rim. Watching him last night, it struck us just how easy he makes it look. By the end of this season, we get the feeling he'll be headlining debates about the second-best point guard in the league … But still, halfway through the third quarter, he and Dion Waiters (17 points… and a number of great drives off high screen-n-rolls. He looks like he'll be featured quite prominently in Ohio this year.) had combined for 24 of the team's 53 total shots. Of course, Irving'll NEVER catch flack for that, while out in OKC, people will try to hang Westbrook if he goes one-on-one too often … Anderson Varejao was balling, completely dominating the frontline from D.C. in every hustle category, and doing his best Wilt Chamberlain impersonation on the glass. Before the third quarter had even ended, he already had hit 20 boards (and 12 offensive rebounds), and even added seven assists as icing on the cake. By the end, Sideshow Bob was flirting with a triple-double, and finished with nine points, nine dimes and 23 boards. The dude was making more plays than anyone, and had three sick bounce passes from the high post that led to buckets … And in other NBA news, the T'Wolves announced they've picked up the third-year options for both Ricky Rubio and Derrick Williams … We're out like the preseason.
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Kevin Negandhi @KNegandhiESPN
Big congrats to @derek_boyko on his new gig w the Bills. He did excellent work for the Eagles.
Big congrats to @derek_boyko on his new gig w the Bills. He did excellent work for the Eagles.
Cruiserweight titleholder Oleksandr Usyk to fight Michael Hunter on Vasyl Lomachenko-headlined card on April 8. es.pn/2kSdDop
Thanks to the folks at @STRIVRlabs for the very cool VR demo--can see why @ClemsonFB @dallascowboys @WashWizards & others are big fans!
"While he may not need to be vilified, his words do." @stephenasmith on Jameis Winston's message to students: es.pn/2mpZSJI
#Buccaneers announced the release of CB Alterraun Verner.
#Jaguars OT Josh Wells, who re-signed last week, signed a 2-year deal worth $1.52m with $75k fully guaranteed.
#Seahawks CB Perrish Cox, who recently signed with team, signed a 1-year, $855k deal.
ICYMI: Five moves for each team to start the offseason with for the NFC South (including Alterraun Verner's release… twitter.com/i/web/status/8…
#Jets save $7.5m in cap space with releases of K Nick Folk ($3m) and RT Breno Giacomini ($4.5m).
The Jets have released PK Nick Folk and RT Breno Giacomini, creating $7.5 million in much-needed cap room. Folk, who joined the Jets in 2010, is the second-leading scorer in franchise history (729 points), behind only Pat Leahy. "It's a sad day, but that's the business side of things," Folk said. "I had a great seven years here. I think the only thing that would've topped it off would'e been a couple of Super Bowl wins." Giacomini, who played in only five games last season, is recovering from recent back surgery.
A league source tells ESPN's Field Yates that Bucs cornerback Alterraun Verner has been cut. He had signed a four-year deal worth $25.5 million in 2014, and was scheduled to make $6.5 million this year.
Missed today's NFL Insiders show? Here's the podcast version. es.pn/2lAj8VP
The Broncos' decision on Russell Okung formally gives the team an opening at left tackle -- they were already proceeding in offseason planning as if Okung's option bonus would no be paid. In that light the draft is fairly thin at left tackle in terms of walk-in starter potential, but at No. 20 the Broncos will likely have a chance at one of top three tackles on the board --Cam Robinson, Ryan Ramcyzk or Garett Bolles. But they haven't taken an offensive lineman in the first round since Ryan Clady in 2008.
The Lions have signed OT Pierce Burton. Originally undrafted out of Mississippi in 2014, he spent time in Minnesota, Atlanta, Carolina and Indianapolis, primarily on practice squads. The 6-foot-6, 305-pound Burton joins a thin group at tackle including Taylor Decker and Corey Robinson.
Jets planning on releasing kicker Nick Folk, per league sources.
Vikings GM Rick Spielman said team has not talked to Adrian Peterson or his agent about contract for 2017 season.… twitter.com/i/web/status/8…
An Allegheny County (Pa.) judge has modified the conditions of Darrelle Revis' bond, allowing the Jets' cornerback to travel outside the U.S. for a charity event. The court ruled last Friday at the arraignment that Revis, facing four felony charges for his alleged role in a street fight, would have to surrender his passport. His attorney, Robert Del Greco, filed a petition, requesting that Revis be allowed to travel to Turks and Caicos Islands next month for his Revis Island Foundation. The charity, established in 2012, provides meals for underprivileged families, per court papers. After the event, March 23-28, Revis will return to his Florida home to train for the NFL season, his attorney said.
#Vikings named Darrell Hazell wide receivers coach, team announced.