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Neuroblastoma Treatment (PDQ®)NCI PDQ Summaries for Patients
General Information About Neuroblastoma
Stages of Neuroblastoma
Recurrent Neuroblastoma
Treatment Option Overview
Treatment Options for Neuroblastoma
To Learn More About Neuroblastoma
About This PDQ Summary
General Information About Neuroblastoma
Neuroblastoma is a disease in which malignant (cancer) cells form in nerve tissue of the adrenal gland, neck, chest, or spinal cord.
Neuroblastoma often begins in the nerve tissue of the adrenal glands. There are two adrenal glands, one on top of each kidney in the back of the upper abdomen. The adrenal glands make important hormones that help control heart rate, blood pressure, blood sugar, and the way the body reacts to stress. Neuroblastoma may also begin in the abdomen, in the chest, in nerve tissue near the spine in the neck, or in the spinal cord.
Neuroblastoma most often begins during early childhood, usually in children younger than 5 years of age. It is found when the tumor begins to grow and cause signs or symptoms. Sometimes it forms before birth and is found during a fetal ultrasound.
By the time neuroblastoma is diagnosed, the cancer has usually metastasized (spread). Neuroblastoma spreads most often to the lymph nodes, bones, bone marrow, liver, and in infants, skin.
See the PDQ summary on Neuroblastoma Screening for more information.
Neuroblastoma is sometimes caused by a gene mutation (change) passed from the parent to the child.
The gene mutation that increases the risk of neuroblastoma is sometimes inherited (passed from the parent to the child). In patients with this gene mutation, neuroblastoma usually occurs at a younger age and more than one tumor may form in the adrenal medulla.
Signs and symptoms of neuroblastoma include bone pain and a lump in the abdomen, neck, or chest.
The most common signs and symptoms of neuroblastoma are caused by the tumor pressing on nearby tissues as it grows or by cancer spreading to the bone. These and other signs and symptoms may be caused by neuroblastoma or by other conditions.
Check with your child's doctor if your child has any of the following:
- Lump in the abdomen, neck, or chest.
- Bulging eyes.
- Dark circles around the eyes ("black eyes").
- Bone pain.
- Swollen stomach and trouble breathing (in infants).
- Painless, bluish lumps under the skin (in infants).
- Weakness or paralysis (loss of ability to move a body part).
Less common signs and symptoms of neuroblastoma include the following:
- Fever.
- Shortness of breath.
- Feeling tired.
- Easy bruising or bleeding.
- Petechiae (flat, pinpoint spots under the skin caused by bleeding).
- High blood pressure.
- Severe watery diarrhea.
- Jerky muscle movements.
- Uncontrolled eye movement.
Tests that examine many different body tissues and fluids are used to detect (find) and diagnose neuroblastoma.
The following tests and procedures may be used:
- Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient's health habits and past illnesses and treatments will also be taken.
- Neurological exam: A series of questions and tests to check the brain, spinal cord, and nerve function. The exam checks a person's mental status, coordination, and ability to walk normally, and how well the muscles, senses, and reflexes work. This may also be called a neuro exam or a neurologic exam.
- Urine catecholamine studies: A procedure in which a urine sample is checked to measure the amount of certain substances, vanillylmandelic acid (VMA) and homovanillic acid (HVA), that are made when catecholamines break down and are released into the urine. A higher than normal amount of VMA or HVA can be a sign of neuroblastoma.
- Blood chemistry studies: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease.
- Hormone test: A procedure in which a blood sample is checked to measure the amount of hormones released into the blood by the adrenal medulla. A higher than normal amount of the hormones dopamine and norepinephrine may be a sign of neuroblastoma.
- mIBG (metaiodobenzylguanidine) scan: A procedure used to find neuroendocrine tumors, such as neuroblastoma and pheochromocytoma. A very small amount of a substance called radioactive mIBG is injected into a vein and travels through the bloodstream. Neuroendocrine tumor cells take up the radioactive mIBG and are detected by a scanner. Scans may be taken over 1-3 days. An iodine solution may be given before or during the test to keep the thyroid gland from absorbing too much of the mIBG. This test is also used to find out how well the tumor is responding to treatment. mIBG is used in high doses to treat neuroblastoma.
- Bone marrow aspiration and biopsy: The removal of bone marrow, blood, and a small piece of bone by inserting a hollow needle into the hipbone or breastbone. A pathologist views the bone marrow, blood, and bone under a microscope to look for signs of cancer.
- X-ray: An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
- CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
- MRI (magnetic resonance imaging) with gadolinium: A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. A substance called gadolinium is injected into a vein. The gadolinium collects around the cancer cells so they show up brighter in the picture. This procedure is also called nuclear magnetic resonance imaging (NMRI).
- Ultrasound exam: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. The picture can be printed to be looked at later.
A biopsy is done to diagnose neuroblastoma.
Cells and tissues are removed during a biopsy so they can be viewed under a microscope by a pathologist to check for signs of cancer. The way the biopsy is done depends on where the tumor is in the body. Sometimes the whole tumor is removed at the same time the biopsy is done.
The following tests may be done on the tissue that is removed:
- Cytogenetic analysis: A laboratory test in which cells in a sample of tissue are viewed under a microscope to look for certain changes in the chromosomes.
- Light and electron microscopy: A laboratory test in which cells in a sample of tissue are viewed under regular and high-powered microscopes to look for certain changes in the cells.
- Immunohistochemistry: A test that uses antibodies to check for certain antigens in a sample of tissue. The antibody is usually linked to a radioactive substance or a dye that causes the tissue to light up under a microscope. This type of test may be used to tell the difference between different types of cancer.
- MYC-N amplification study: A laboratory study in which tumor or bone marrow cells are checked for the level of MYC-N. MYC-N is important for cell growth. A higher level of MYC-N (more than 10 copies of the gene) is called MYC-N amplification. Neuroblastoma with MYC-N amplification is more likely to spread in the body and less likely to respond to treatment.
Children who are 6 months old or younger may not need a biopsy or surgery to remove the tumor because the tumor may disappear without treatment.
Certain factors affect prognosis (chance of recovery) and treatment options.
The prognosis (chance of recovery) and treatment options depend on the following:
- Age of the child at diagnosis.
- Stage of the cancer.
- Where in the body the tumor started.
- Tumor histology (the shape, function, and structure of the tumor cells).
- Whether there is cancer in the lymph nodes on the same side of the body as the cancer or whether there is cancer in the lymph nodes on the opposite side of the body.
- How the tumor responds to treatment.
- Whether there are certain changes in the chromosomes.
- How much time passed between diagnosis and when the cancer recurred (for recurrent cancer).
Prognosis and treatment options for neuroblastoma are also affected by tumor biology, which includes:
- The patterns of the tumor cells.
- How different the tumor cells are from normal cells.
- How fast the tumor cells are growing.
- Whether the tumor shows MYC-N amplification.
The tumor biology is said to be favorable or unfavorable, depending on these factors. A favorable tumor biology means there is a better chance of recovery.
In some children who are 6 months old and younger, neuroblastoma may disappear without treatment. The child is closely watched for signs or symptoms of neuroblastoma. If signs or symptoms occur, treatment may be needed.
Stages of Neuroblastoma
After neuroblastoma has been diagnosed, tests are done to find out if cancer has spread from where it started to other parts of the body.
The process used to find out the extent or spread of cancer is called staging. The information gathered from the staging process helps determine the stage of the disease. For neuroblastoma, stage is one of the factors used to plan treatment. The results of tests and procedures used to diagnose neuroblastoma may also be used for staging. See the General Information section for a description of these tests and procedures.
The following tests and procedures also may be used to determine the stage:
- Lumbar puncture: A procedure used to collect cerebrospinal fluid (CSF) from the spinal column. This is done by placing a needle between two bones in the spine and into the CSF around the spinal cord and removing a sample of the fluid. The sample of CSF is checked under a microscope for signs that the cancer has spread to the brain and spinal cord. This procedure is also called an LP or spinal tap.
Lymph node biopsy: The removal of all or part of a lymph node. A pathologist views the tissue under a microscope to look for cancer cells. One of the following types of biopsies may be done:
- Excisional biopsy: The removal of an entire lymph node.
- Incisional biopsy: The removal of part of a lymph node.
- Core biopsy: The removal of tissue from a lymph node using a wide needle.
- Fine-needle aspiration (FNA) biopsy: The removal of tissue or fluid from a lymph node using a thin needle.
- X-rays of the chest, bones, and abdomen: An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
- Bone scan: A procedure to check if there are rapidly dividing cells, such as cancer cells, in the bone. A very small amount of radioactive material is injected into a vein and travels through the bloodstream. The radioactive material collects in the bones with cancer and is detected by a scanner.
There are three ways that cancer spreads in the body.
Cancer can spread through tissue, the lymph system, and the blood:
- Tissue. The cancer spreads from where it began by growing into nearby areas.
- Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
- Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.
Cancer may spread from where it began to other parts of the body.
When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began (the primary tumor) and travel through the lymph system or blood.
- Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor (metastatic tumor) in another part of the body.
- Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body.
The metastatic tumor is the same type of cancer as the primary tumor. For example, if neuroblastoma spreads to the liver, the cancer cells in the liver are actually neuroblastoma cells. The disease is metastatic neuroblastoma, not liver cancer.
The following stages are used for neuroblastoma:
Stage 1
In stage 1, the tumor is in only one area and all of the tumor that can be seen is completely removed during surgery.
Stage 2
Stage 2 is divided into stages 2A and 2B.
- Stage 2A: The tumor is in only one area and all of the tumor that can be seen cannot be completely removed during surgery.
- Stage 2B: The tumor is in only one area and all of the tumor that can be seen may be completely removed during surgery. Cancer cells are found in the lymph nodes near the tumor.
Stage 3
In stage 3, one of the following is true:
- the tumor cannot be completely removed during surgery and has spread from one side of the body to the other side and may also have spread to nearby lymph nodes; or
- the tumor is in only one area, on one side of the body, but has spread to lymph nodes on the other side of the body; or
- the tumor is in the middle of the body and has spread to tissues or lymph nodes on both sides of the body, and the tumor cannot be removed by surgery.
Stage 4
Stage 4 is divided into stages 4 and 4S.
- In stage 4, the tumor has spread to distant lymph nodes or other parts of the body.
- In stage 4S:
- the child is younger than 12 months; and
- the cancer has spread to the skin, liver, and/or bone marrow; and
- the tumor is in only one area and all of the tumor that can be seen may be completely removed during surgery; and/or
- cancer cells may be found in the lymph nodes near the tumor.
Treatment of neuroblastoma is based on risk groups.
For many types of cancer, stages are used to plan treatment. For neuroblastoma, treatment depends on risk groups. The stage of neuroblastoma is one factor used to determine risk group. Other factors are the age of the child, tumor histology, and tumor biology.
There are three risk groups: low risk, intermediate risk, and high risk.
- Low-risk and intermediate-risk neuroblastoma have a good chance of being cured.
- High-risk neuroblastoma may be hard to cure.
Recurrent Neuroblastoma
Recurrent neuroblastoma is cancer that has recurred (come back) after it has been treated. The cancer may come back in the same place or in other parts of the body.
Treatment Option Overview
There are different types of treatment for patients with neuroblastoma.
Different types of treatment are available for patients with neuroblastoma. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment.
Because cancer in children is rare, taking part in a clinical trial should be considered. Some clinical trials are open only to patients who have not started treatment.
Children with neuroblastoma should have their treatment planned by a team of doctors who are experts in treating childhood cancer, especially neuroblastoma.
Treatment will be overseen by a pediatric oncologist, a doctor who specializes in treating children with cancer. The pediatric oncologist works with other pediatric health care providers who are experts in treating children with neuroblastoma and who specialize in certain areas of medicine. These may include the following specialists:
- Pediatric surgeon.
- Radiation oncologist.
- Endocrinologist.
- Neurologist.
- Neuropathologist.
- Neuroradiologist.
- Pediatrician.
- Pediatric nurse specialist.
- Social worker.
- Child life professional.
- Rehabilitation specialist.
- Psychologist.
Children who are treated for neuroblastoma may have an increased risk of second cancers.
Some cancer treatments cause side effects that continue or appear years after cancer treatment has ended. These are called late effects. Late effects of cancer treatment may include:
- Physical problems.
- Changes in mood, feelings, thinking, learning, or memory.
- Second cancers (new types of cancer).
Some late effects may be treated or controlled. It is important that parents of children who are treated for neuroblastoma talk with their doctors about the possible late effects caused by some treatments. See the PDQ summary on Late Effects of Treatment for Childhood Cancer for more information.
Five types of standard treatment are used:
Observation is closely monitoring a patient's condition without giving any treatment until signs or symptoms appear or change.
Surgery is used to treat neuroblastoma unless it has spread to other parts of the body. Depending on where the tumor is, as much of the tumor as is safely possible will be removed. If the tumor cannot be removed, a biopsy may be done instead.
Radiation therapy
Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer.
The way the radiation therapy is given depends on the type and stage of the cancer being treated. External radiation therapy is used to treat neuroblastoma.
High-risk neuroblastoma that comes back after initial treatment is sometimes treated with mIBG (radioactive iodine therapy). Radioactive iodine is given through an intravenous (IV) line and enters the bloodstream which carries radiation directly to tumor cells. Radioactive iodine collects in neuroblastoma cells and kills them with the radiation that is given off.
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.
The use of two or more anticancer drugs is called combination chemotherapy.
See Drugs Approved for Neuroblastoma for more information.
High-dose chemotherapy and radiation therapy with stem cell rescue
High-dose chemotherapy and radiation therapy with stem cell rescue is a way of giving high doses of chemotherapy and radiation therapy and replacing blood-forming cells destroyed by cancer treatment for high-risk neuroblastoma. Stem cells (immature blood cells) are removed from the blood or bone marrow of the patient and are frozen and stored. After chemotherapy and radiation therapy are completed, the stored stem cells are thawed and given back to the patient through an infusion. These reinfused stem cells grow into (and restore) the body's blood cells.
Maintenance therapy is given after high-dose chemotherapy and radiation therapy with stem cell rescue to kill any cancer cells that may regrow and cause the disease to come back. Maintenance therapy is given for 6 months and includes the following treatments:
- Isotretinoin: A vitamin-like drug that slows the cancer's ability to make more cancer cells and changes how these cells look and act. This drug is taken by mouth.
- Anti-GD2 antibody ch14.18: A type of monoclonal antibody therapy that uses an antibody (ch14.18) made in the laboratory from a single type of immune system cell. ch14.18 identifies and attaches to a substance, called GD2, on the surface of neuroblastoma cells. Once the ch14.18 attaches to the GD2, a signal is sent to the immune system that a foreign substance has been found and needs to be killed. Then the body's immune system kills the neuroblastoma cell. This drug is given by infusion.
- Granulocyte-macrophage colony-stimulating factor (GM-CSF): A cytokine that helps make more immune system cells, especially granulocytes and macrophages (white blood cells), which can attack and kill cancer cells.
- Interleukin-2 (IL-2): A type of biologic therapy that boosts the growth and activity of many immune cells, especially lymphocytes (a type of white blood cell). Lymphocytes can attack and kill cancer cells.
New types of treatment are being tested in clinical trials.
This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the NCI website.
Targeted therapy
Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells. Tyrosine kinase inhibitor (TKI) therapy is one type of targeted therapy being studied in the treatment of neuroblastoma.
TKI therapy blocks signals needed for tumors to grow. TKIs block the enzyme, tyrosine kinase, that causes stem cells to become more white blood cells (granulocytes or blasts) than the body needs. Crizotinib is one of the TKIs being studied to treat neuroblastoma that has come back after treatment. TKIs may be used in combination with other anticancer drugs as adjuvant therapy (treatment given after the initial treatment, to lower the risk that the cancer will come back).
Vaccine therapy
Vaccine therapy is a type of biologic therapy. Biologic therapy is a treatment that uses the patient's immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against cancer. This type of cancer treatment is also called biotherapy or immunotherapy.
Other drug therapy
Lenalidomide is a type of angiogenesis inhibitor. It prevents the growth of new blood vessels that are needed by a tumor to grow.
Patients may want to think about taking part in a clinical trial.
For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.
Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.
Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.
Patients can enter clinical trials before, during, or after starting their cancer treatment.
Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.
Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's listing of clinical trials.
Follow-up tests may be needed.
Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.
Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your child's condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.
Treatment Options for Neuroblastoma
Low-Risk Neuroblastoma
Treatment of low-risk neuroblastoma may include the following:
- Surgery followed by observation.
- Chemotherapy with or without surgery, for some patients.
- Observation alone for infants who do not have signs or symptoms of neuroblastoma. More studies are needed before this is considered a standard treatment.
- A clinical trial of treatment guided by the tumor's response to treatment and whether there are certain changes in the tumor cells.
Intermediate-Risk Neuroblastoma
Treatment of intermediate-risk neuroblastoma may include the following:
- Chemotherapy with or without surgery.
- Surgery alone for infants.
- Observation alone for certain infants.
- Radiation therapy to treat tumors that are causing serious problems and do not respond quickly to chemotherapy or surgery.
- Radiation therapy for tumors that do not respond to other treatment.
- A clinical trial of treatment guided by the tumor's response to treatment and whether there are certain changes in the tumor cells.
High-Risk Neuroblastoma
Treatment of high-risk neuroblastoma may include the following:
- A regimen of combination chemotherapy, surgery, stem cell rescue, radiation therapy, and anti-GD2 ch14.18 with interleukin-2 (IL-2), granulocyte-macrophage colony-stimulating factor (GM-CSF), and isotretinoin.
Stage 4S Neuroblastoma
There is no standard treatment for stage 4S neuroblastoma but treatment options include the following:
- Observation with supportive care for certain patients who have favorable tumor biology and do not have signs or symptoms.
- Chemotherapy, for children who have signs or symptoms of neuroblastoma or unfavorable tumor biology, or for very young infants.
- A clinical trial of treatment guided by the tumor's response to treatment and whether there are certain changes in the tumor cells.
Recurrent Neuroblastoma
Patients First Treated for Low-Risk Neuroblastoma
Treatment for recurrent neuroblastoma that is found in one place in the body may include the following:
- Surgery followed by observation or chemotherapy.
- Chemotherapy that may be followed by surgery.
Treatment for recurrent neuroblastoma that has spread to other parts of the body may include the following:
- Observation for certain infants.
- Chemotherapy.
- Surgery followed by chemotherapy.
- Combination chemotherapy.
Patients First Treated for Intermediate-Risk Neuroblastoma
Treatment for recurrent neuroblastoma that is found in one place in the body may include the following:
- Surgery that may be followed by chemotherapy.
Recurrent neuroblastoma that has spread to other parts of the body is treated the same way as newly diagnosed high-risk neuroblastoma.
Patients First Treated for High-Risk Neuroblastoma
Treatment for recurrent neuroblastoma may include the following:
- Combination chemotherapy.
- mIBG therapy to relieve symptoms and improve quality of life. It may be given alone or in combination with other therapy, or after stem cell rescue.
- A second course of high-dose chemotherapy and stem cell rescue.
Because there is no standard treatment for recurrent neuroblastoma in patients first treated for high-risk neuroblastoma, patients may want to consider a clinical trial. For information about clinical trials, please see the NCI website.
Patients with Recurrent CNS Neuroblastoma
Treatment for neuroblastoma that recurs (comes back) in the central nervous system (CNS; brain and spinal cord) may include the following:
- Surgery to remove the tumor in the CNS followed by radiation therapy.
- A clinical trial of a new therapy.
Treatments in Clinical Trials for Progressive/Recurrent Neuroblastoma
Some of the treatments being studied in clinical trials for neuroblastoma that recurs (comes back) or progresses (grows, spreads, or does not respond to treatment) include the following:
- Combination chemotherapy and ch14.18 monoclonal antibody therapy.
- Lenalidomide and ch14.18 monoclonal antibody therapy with or without isotretinoin.
- Vaccine therapy.
- A tyrosine kinase inhibitor (crizotinib) with or without combination chemotherapy.
Check the list of NCI-supported cancer clinical trials that are now accepting patients with neuroblastoma. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your child's doctor about clinical trials that may be right for your child. General information about clinical trials is available from the NCI website.
To Learn More About Neuroblastoma
For more information from the National Cancer Institute about neuroblastoma, see the following:
- Neuroblastoma Home Page
- Neuroblastoma Screening
- Computed Tomography (CT) Scans and Cancer
- Drugs Approved for Neuroblastoma
- Targeted Cancer Therapies
- Biological Therapies for Cancer
- New Approaches to Neuroblastoma Therapy (NANT)
For more childhood cancer information and other general cancer resources, see the following:
- Childhood Cancers
- CureSearch for Children's Cancer
- Late Effects of Treatment for Childhood Cancer
- Adolescents and Young Adults with Cancer
- Children with Cancer: A Guide for Parents
- Cancer in Children and Adolescents
- Cancer Staging
- Coping with Cancer
- Questions to Ask Your Doctor about Cancer
- For Survivors and Caregivers
About This PDQ Summary
About PDQ
Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in Spanish.
PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government's center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.
Purpose of This Summary
This PDQ cancer information summary has current information about the treatment of neuroblastoma. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.
Reviewers and Updates
Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change.
The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Pediatric Treatment Editorial Board.
Clinical Trial Information
A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Clinical trials are listed in PDQ and can be found online at NCI's website. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237).
Permission to Use This Summary
PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as "NCI's PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary]."
The best way to cite this PDQ summary is:
National Cancer Institute: PDQ® Neuroblastoma Treatment. Bethesda, MD: National Cancer Institute. Date last modified <MM/DD/YYYY>. Available at: http://www.cancer.gov/types/neuroblastoma/patient/neuroblastoma-treatment-pdq. Accessed <MM/DD/YYYY>.
Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in Visuals Online. Visuals Online is a collection of more than 2,000 scientific images.
The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer.gov on the Managing Cancer Care page.
Contact Us
More information about contacting us or receiving help with the Cancer.gov website can be found on our Contact Us for Help page. Questions can also be submitted to Cancer.gov through the website's E-mail Us.Date last modified: 2016-01-20


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text: Monday, February 13, 2012 CSM Daily News Recaps Lectures and Sessions Read summaries of the Pauline Cerasoli and Linda Crane lectures and learn about the implications of cardiac comorbidities in outpatient settings, use of red flags when assessing low back pain, benefits of aquatic physical therapy as a complement to land-based therapy, and more in the February 11 issue of CSM 2012 Daily News. The February 9 and February 10 issues also are available on the Combined Sections Meeting (CSM) Web page, and a final, digital "wrap-up" issue will be e-mailed to all members in the next 2 weeks. Comments I am a long-time CSM attendee since 1985.....the logistics in Chicago were so challenging and created so much negative energy that I doubt I would return there for another CSM. I had the idea that a city as big as Chicago would have handled much larger groups than ours in the past and that shuttle service in particular would have been very smooth. Also, I was astonished that the Palmer House had no in-room coffee and no free internet. Overall not impressed with my week for CSM 2012. Posted by Barbara Settles-Huge -> >OP]C on 2/13/2012 2:40 PM Although the transportation from the hotels was not ideal the conference itself was fantastic. I was very pleased with the lectures and speakers that were presenting for Sports, Ortho, and Private Practice. I felt it was the best overall presenters out of all the CSM conferences that I have attended. I have no regrets. Posted by Chris on 2/14/2012 11:58 AM I very much enjoyed my first CSM. I had no trouble with the shuttle service and the Chicago Hilton was great. I appreciate all of the hard work APTA staff put into this, especially with the higher than expected turn out. I would definately return to Chicago. Thank you! Posted by Ann Lowrey on 2/17/2012 4:07 PM


text: To strengthen the security of your WordPress website, we have added an additional layer of protection. You will need to first provide your cPanel username and password before being able to load the WordPress administration panel. This additional security measure will help protect your WordPress site from brute force attempts at gaining access to your admin panel.


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Chance the Rapper led a "parade to the polls" Monday evening after performing at a free concert in downtown Chicago.
The Chi-town native, whose real name is Chancellor Bennett, hosted and headlined a get-out-of-the-vote event at the Petrillo Music Shell in Grant Park.
The concert, sponsored by Chance's non-profit organization Social Works, featured performances from a slew of local talent, including rapper and activist Malcolm London, rock outfit Twin Peaks and Chance's brother, rapper Taylor Bennett.
U.S. & World
Stories that affect your life across the U.S. and around the world.
After the show, Chance led concertgoers through rush-hour traffic to an early-voting site, where there was already a long line of voters waiting to vote. Chance went inside and the polling place cast his ballot.
But this isn't the "Coloring Book" rapper's first dip in the politics pool. In September, he teamed with the NAACP for its #StayWokeAndVote campaign to register concertgoers to vote during stops of his Magnificent Coloring World Tour.
Chance is the son of Ken Bennett, who served as Mayor Rahm Emanuel's first deputy chief of staff and director of the office of public engagement before taking a job with Chicago's tourism bureau earlier this year, Crain's Chicago Business reported. Additionally, Bennett previously served under Mayor Harold Washington and President Barack Obama.


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So here we are looking 2014 right in the eye - how did that happen!? I am so glad that I can kick off 2014 with some super sweet blog friends of mine.
Take a break from thinking about New Year's Resolutions and enjoy a fun blog hop...we all think you're perfect just the way you are!
From New Year's Ever to January 2nd, you can pick up exclusive freebies along the way AND enter a rafflecopter to win some fun prizes!
Be sure to enter the Rafflecopter at The Teaching Tribune for your chance to win one of these fabulous prizes.
Today I would love to share with you my new "Print, Cut, Make, Read" reader, called 'Hat on a Rat"! Simply click on the picture to take you to my store to download it.
Copy the pages, and staple 4 times down the side. Cut down the middle - now you have 2 readers!
Ask your students to shade the pictures on the worksheet - and cut them out.
Students will then be required to read each sentence and find the matching picture!
Before pasting it into position on the correct page!
I hope you like it!
I know how much you love bundles, so by request, I have put this one together that will contain all my interactive readers (not alphabet ones). I will keep adding them until we reach the TpT limit! I have it listed at 50% off for the fist day, so you might like to grab it an this very special early bird price! AND my store is on SALE! Waahoooo!!
While you're at my store you may also want to check out this new product, just perfect for those first few weeks back at school. This 'Letters of the Alphabet Pinning Pages" resource will help you provide fun fine motor and phonics activities for your sweeties!
Students will pin to create a nice big outline of the letter shapes.
Just staple a bright piece of paper behind the pinning page.
Put it down on a newspaper stack or carpet square... and get pinning!
Take the staple out and you have some bright pages to display on your windows with the light shining through!
Students can write words on the top page and shade the picture in, instead of just throwing it away.
Thank you so much for stopping by today, I hope you enjoy the rest of the hop!
Be sure to continue the circle on the blog hop by clicking the "NEXT" button below.
We truly hope that 2014 is your best year yet and that it brings you good health, happiness and many other good things.


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Russian leaders have taken notice of the U.S. Air Force's plans to build a next generation bomber announcing they have set their sites on building a hypersonic bomber.
Russian Deputy Prime Minister Dmitry Rogozin said his country won't settle for a bomber like the B-2. Air Force leaders want to pursue the same hypersonic technology the U.S. military is trying to develop.
Rogozin's comments come conspicuously close to a failed hypersonic test flight the U.S. Air Force held on Aug. 15. The test flight vehicle dropped into the Pacific Ocean 15 seconds after it was released from a specially outfitted B-52 and never reached the Mach 6 speeds U.S. Air Force officials had hoped.
To fly hypersonic means flying five times the speed of sound (Mach 5) or faster than 3,840 miles per hour.
The Russians hope to build their hypersonic bomber by 2020, Rogozin said. That timeline seems a bit ambitious if they are starting to develop the engines now.
The U.S. started its Waverider program in 2004 having spent $140 million. The Aug. 15 was the last test scheduled under the program. Pentagon officials will have to seek additional funding to continue the program.
Engineers built the X-51A Waverider's scramjet engine to fly without liquid jet propellant. The engine instead uses the oxygen in the air to propel it. It also harnesses the energy created by its own shock wave to reach top speeds up to Mach 6.
The U.S. Air Force had hoped to outfit an operational aircraft with hypersonic engines by 2016. Following this month's test failure and the questions over future funding, those goals are very much in doubt. For the Russians to design and deliver a hypersonic bomber by 2020, seems just as unlikely.
U.S. officials have not specified whether their own next generation bomber would fly hypersonic speeds. The U.S. Air Force said in 2007 the bomber would likely be subsonic to keep costs under control. Of course, the next generation bomber program has been scrapped and then brought back since then by the Pentagon.
However, it's hard to envision the U.S. fielding a hypersonic bomber in the next decade with the budget shortfalls they will experience the next five years. Not to mention the struggle they've had building the fifth generation fighter fleet.


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I am operating an Ubuntu 11.10 server and one of the PHP scripts calls a bash script for inserting jobs and starting them.
The script copies the job into
Everything is fine except that the jobs don't get started with
sudo /sbin/initctl start my-tiny-job
(I think the reason is unknown job)
When I run the bash script by hand:
php-user$ ./bashscript.sh
then it works! So this means the job file is correct.
Since this is a functionality called from a web interface I really need to know why this doesn't work.


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Wednesday, December 9, 2009
All Too General
Greetings Grammophiles!
After a semi-hiatus due to hip surgery and the birth of my first child (a son!), I have found my way back to the wild world of English grammar. Today's post has less to do with grammar proper and more to do with word choice and style. Stringing words together in an acceptable order is one thing, but it is quite another to know which words create the best sentences and, ultimately, the best arguments. As a general rule, the more general a word is, the less meaning it conveys. "Many" does not have the same mathematical force as "hundreds," nor does "have" express as much as emotional attachment as "possess."
General words exist in all parts of speech, and it's nearly impossible to avoid them all the time (nor should you). There are general verbs, adjectives, and even nouns. Here, I am not advocating that you spice up your prose by using obscure synonyms from a dictionary. The meaning of "manifold" is just as general as "many." The purpose of this post is to remind you to do some thinking about what exactly you are trying to say and then to think about how to say it in the most concrete, non-abstract way possible.
In earlier posts, I have already discussed ways to avoid general verbs. The main culprits are "do-everything" verbs such as "to be," "to do," and "to have." Another verb that writers often overlook is "to talk." Using "talk" in reference to what someone says does little to express how the person said it. Think of the phrases, "talk is cheap"; "just talking"; and "talk, talk, talk." All of these phrases suggest that whatever is being said is relatively insignificant. If you are looking for verbs to express human speech, focus on what the speaker is doing with his or her words rather than the fact that he or she is speaking. One example may be: "In her History lesson, Mrs. Ferguson connected America's founding history with Rome's."
I have already touched on the perils of using "many." As an instructor, I often see "many"-based sentence in introductory paragraphs. Sentences such as, "Many believe that oranges taste better in warm weather," provide little support to an overall argument. In fact, such general sentences often lead readers to ask more questions about the merits of the argument. How "many" believers are there, and how did this writer discover their opinions? In short, any time you can quantify, itemize, or categorize who or what you are talking about, you are well on your way to avoiding the trap of generality. This is why "hundreds" is so much better than "many." Here is a list of other general adjectives that are worth avoiding:
many, few, some, other, any, all, every
When thinking about style, writers often overlook the negative impact that general nouns have on their writing. In this sense, using "something" is as good as saying nothing at all, because "something" specifically expresses an unknown quantity. I often see generalities appear in reference to people or groups of people. Even the word, "people," identifies absolutely no one in particular. Instead of "people," try to be more specific about your subjects. These "people" might actually be university students, coffee drinkers, or SUV drivers. Think about exactly who it is you want to write about and leave the people alone. Other examples include
persons, everyone, no one, these, kids, individuals, persons
Happy writing!
Brady Spangenberg
Posted by Brady Spangenberg at 7:44 AM
Labels: general words, style, verb, word choice
3 comments:
- Unknown said...
As a science teacher, one of my pet peeve 'general' words is "amount". Students use this word instead of number, mass, or volume.
- December 16, 2009 at 9:27 AM
- Andrea Duff said...
Yes, Angela, we also teach science students and engineers at the Mawson Lakes campus of the University of South Australia and try to steer students away from 'several' 'numerous' 'many' and other non-specific quantitative words.
- December 18, 2009 at 11:28 PM
Bless you for explaining this!!!! Your blog is an invaluable resource and I will be sharing it with other teachers I know. As a new teacher I am quickly developing my own pet peeve list-and lack of clarity is tops!
- April 5, 2010 at 3:15 PM
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Ceremonial Music for Brass QuartetThomas, Neu, et al - Music Express
Ceremonial Music for Brass QuartetThomas, Neu, et al - Music Express
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Take a look at this superb collection of performance music for brass quartet! These arrangements are perfectly suited for weddings and concert performances by mature ensembles, and are also accessible to groups at the medium-easy level. Each arrangement is straightforward and full sounding, and the collection encompasses some of the most requested works known! Includes: Byrd: Earl Of Oxford's March; Bach: Sheep May Safely Graze; Mouret: Rondeau; Wagner: Bridal Chorus; Clark: Trumpet Voluntary; Vittoria: O Magnum Mysterium; Pachelbel: Kanon; Purcell/Charpentier: Fanfare Te Deum; Scheidt: Canzona Bergamasca; Beethoven: Ode To Joy; Mendelssohn: Wedding March; Handel: Fanfare from "Water Music" and more. An incredible selection!
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How to Use
In 1925 Eleanor Roosevelt had a stone cottage constructed on a portion of the property to serve as a retreat for herself and her friends. A year later a second building was constructed to house a small furniture factory to employ local craftsmen. After the factory closed in 1936, the building was converted to a cottage. It was this cottage (christened "Val-Kill Cottage") that Roosevelt chose to use as her permanent home after her husband's death in 1945.
1. Locate the Stone Cottage and Val-Kill Cottage.
2. What can you tell about the kinds of activities that took place at Val-Kill?
3. Would you have called a home like Roosevelt's a "cottage"?* The map on the screen has a resolution of 72 dots per inch (dpi), and therefore will print poorly. You can obtain a high quality version of this map, but be aware that the file will take as much as two minutes to a load with a 28.8K modem.


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Steely Dan Nite with Deacon Blues
Add to my Calendar Get DirectionsPrint This Event
If you're planning to see a concert at the Arcada Theater in downtown St Charles, you'll want to book the Rock & Recover package at Pheasant Run Resort! Includes a discount code to purchase your Arcada concert tickets, overnight accommodations, recovery gift package, and food and beverage credit at the hotel. Visit https://www.pheasantrun.com/special-pkg/rock-recover-package.aspx for complete package details and to book today! Entertainment subject to change. Verify show dates and times with the Arcada Theater.
- Start:February 10, 2018
- End:February 10, 2018
- Where:Arcada Theater, 105 E Main Street, St Charles, IL, USA, 60174
- Phone:(630)-584-6300
- Event Type: Concerts & Music
- Ticket Price:0


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The Houston Dynamo completely dominated Saturday's game against the San Jose Earthquakes, outshooting San Jose 16-6, but were undone by two goals on counterattacks in a 2-1 loss at Robertson Stadium.
Shortly after two chances in the attacking end of the field, the Dynamo allowed the opening goal in the sixth minute when San Jose's Geovanni, making his first MLS start, broke free on the right and sent in a low cross that Khari Stephenson one-timed into the left side of the net.
It was the second consecutive game in which the Dynamo allowed a goal in the first 10 minute; Colorado scored two minutes into last week's match. Houston has allowed the first goal in 14 of its 23 matches this season; it is 1-12-1 in those games.
Houston controlled possession throughout the half but struggled to get its shots on goal. The Dynamo finally broke through in first-half stoppage time, when Brian Mullan broke free along the end line. After his initial cross was blocked, he floated a ball in toward the penalty spot, and Brad Davis rose to direct an accurate header inside the left-hand post for his fifth goal of the season, tying last year's total as the second-highest of his career. It was the first headed goal of Davis' professional career. Mullan earned his third assist of the season.
The Dynamo continued to dominate in the second half, outshooting the Earthquakes 10-2. San Jose goalkeeper Jon Busch made five total saves on the night to keep the Dynamo out of the net again, and the Earthquakes got the game-winning goal in the 64th minute. A well-worked counterattack on the left wing led to a cross, which was deflected toward the top of the penalty area. Geovanni reached it first and lashed a low shot past Pat Onstad for the game-winning goal.
Houston pushed forward, aided by an 84th-minute red card to San Jose's Sam Cronin, but could not tie the match.
The Dynamo began the match without forward Brian Ching due to a calf strain and missed his presence in front of goal, but Ching came on as a late substitute in the 82nd minute. Houston also played without starting midfielder Lovel Palmer (Jamaican national team) and reserve midfielder Francisco Navas Cobo (U.S. U-20 national team).
The loss drops Houston's home record in the regular season to 5-4-3 in 2010, the most losses the Dynamo have ever suffered at Robertson Stadium in league play. They lost three home games in their championship seasons of 2006 and 2007.
Houston goalkeeper Pat Onstad made his 165th appearance for the Dynamo in all competitions and wore the captain's armband for the first time. It was also his 215th career MLS appearance. Midfielder Richard Mulrooney appeared in his 280th career MLS game, 20th in league history, and midfielder Brian Mullan played in his 250th league game, tied for 34th in league history.
Defender Bobby Boswell made the 160th appearance of his MLS career and his 110th appearance for Houston in all competitions. Midfielder Corey Ashe played 12 minutes as a substitute to reach the 4,000-minute mark for his MLS regular season career.
Next Game: Saturday, September 18, 7:30 p.m., Houston Dynamo vs. Toronto FC, Robertson Stadium
On the game …
"They were very troublesome tonight. Even before they scored, they had some chances in our area and took advantage of a little lack of intensity on our part. And even on their second goal. I don't know what the shots were, but even their dangerous opportunities in the second half … They took advantage of a ball that we played directly to them and then ran through midfield. There are lots of circumstances of why we are disappointed: It puts the playoff picture very bleak; we lost another home game; it's a game we should have had well in hand even before they got their second goal. The first 45 minutes was probably the best half we played all year, attacking-wise but we still need to score goals. If you don't score goals, it all goes for nothing."
On the ramifications of the result …
"It's a heavy one, as I said before. If we win tonight, we are three points behind San Jose. I think right now those 29 points probably hold the last playoff spot. If you don't score goals and you don't take it to their team when they are down, home or away, [they] are always going to get one or two chances during the game, and I think that's what they got, those two chances, and they took advantage. At the end of the day, they hit their chances and we missed ours, and that is what counts."
On the game …
"We had plenty of chances to win the game. It feels terrible. I should have had a few, and I feel as if I let the team down. As a striker, when you get those chances, you have to put them away."
On his chances …
"I've been doing a lot of finishing in training, and I've been doing well in training. It was just a couple feet to each side, and it's really tough to swallow."
On wearing the captain's armband
"It would have been a lot nicer with the win. It was the first time in 215 [MLS] appearances, so it was a nice nod from Dominic [Kinnear]. We had another fantastic performance tonight, but we gave up two goals, and that's all that really matters."
On the game …
"I thought we put together the best game we have put together all year; we had a lot of good opportunities. They had two chances, and they scored on both of them. That's been the story of our year, and that's the way things have been going. We know where we are right now: We have to win out, so that's what is ahead of us."
On the timing of his goal …
"To score right before halftime and tie it up is always good. When you are on the other side, it's a bit disheartening, so I thought we were going to come out in the second half and do the same thing, which I thought we did. They got one more opportunity on the break, and they scored on it. It's the way things have been going for us all year. Two chances on two goals, and we had more chances in this game than we had all year, and they just aren't going in."
On scoring with a header …
"I actually scored some goals in training this week with my head, and guys were getting on my case, so it's pretty ironic that I come to the game and do the same thing."


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The Cheltenham Collection features five suit options that include Tails, Albert and Edward Frock Coat Suits, Nehru, and Wedding suits. As well as being available with the classic striped trousers, there is also a black herringbone trousers option. This wool suit features a self-coloured herringbone fabric that is both timeless in its appeal and very stylish. The suits look very smart and are also available for children in the Tails, Edward and Wedding suit options. Whilst the Groom, Groomsmen and Pageboys may wish to achieve a uniform look by all wearing the same style, there is also the option to mix styles within the collection, so the groom, for example, can wear a co-ordinating suit that is different to the rest of the wedding party. Typically worn with grey single or double breasted waistcoats, Cheltenham also looks superb when you add either a tweed, brocade or check option. Being black ensures that virtually anything will look good with these suits.
- Prices start at £59.95 for the two piece suit and you can add whatever waistcoat and accessories you require from our extensive selection – see price list for full details, or visit us in-store and we will be happy to provide a full quotation.
- Free Suit for the Groom Hire available on this collection, if there are four or more adult's booking in the same party. Waistcoat and accessories will be as per the price list.
- There is a wide choice of sizes and fittings to select from in chest sizes from 20" to 62" chest.
- We offer a full fitting service at time of booking and can do length adjustments if needed to achieve the perfect fit. For men, we recommend fitting the outfit 12 to 16 weeks ahead of the wedding. On Saturdays, and at some of our branches, we recommend booking an appointment as our hirewear departments can be very busy. We look after all customers as quickly as possible, but bookings take priority
- Coes Occasions has branches throughout East Anglia in Ipswich, Maldon and Felixstowe, plus within Goddards of King's Lynn and Golding of Newmarket. If you wish to reserve your garments online you can do this by filling in our order form, but we still recommend a full fitting on the day of collection.
- Our reputation for high standards of service, ensure the men and boy's attire is perfect for your special occasion. Please contact your nearest branch, or email us if you have any questions.


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We all wish that "the one" would come along every season, but let's face it. You probably won't fall deeply in love with a new TV series every year — or even every decade. There are only a few that are ultra-special. What was your most recent experience of true TV love?
Please include a description of the show, and some links, video and pictures, so we can all share your feels.


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Join today and get instant access to all test results and research.
No obvious good points.
Testing for emissions, efficiency and power output using AS/NZS 4012/4013 was carried out by an independent lab in New Zealand.
We analyse data from National Environmental Standards (NES) testing to generate scores out of 10 for emissions and efficiency, along with an overall score. This gives us a clear picture of the performance, features and specifications for almost every model on the market.
Where available, we've also included the NZHHA output results. These results reflect the absolute maximum heat output you could achieve in your home.
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Trump's Takeover
Season 2018 Episode 6 | 54m 47s
FRONTLINE tells the inside story of a president who vowed to take down the Washington establishment, and who has fought an intense war for control of the Republican Party. "Trump's Takeover" is a window into the potential lasting impact of the Trump era on the GOP and the American political system as a whole.
Aired: 04/10/18Video has closed captioning.
Buy Now:
Problems Playing Video?
Funding for FRONTLINE is provided through the support of PBS viewers and by the Corporation for Public Broadcasting. Major funding for FRONTLINE is provided by the John D. and Catherine T. MacArthur Foundation. Additional funding is provided by the Abrams Foundation, the Park Foundation, The John and Helen Glessner Family Trust, and the FRONTLINE Journalism Fund with major support from Jon and Jo Ann Hagler on behalf of the Jon L. Hagler Foundation.


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Price: $16.00
Size: 9 ounce
Other Sizes: 33.8 ounce
The perfect defense against dull, dry, discolored, damaged locks caused by malicious minerals hiding in your water, this 100% vegan super shampoo boasts top-notch cleansing capabilities without harsh chemicals or sulfates and features the sweetly scented aroma of Orange Dreamsicle that will blast you back to your youth.
Shampoo with Malibu C® Hard Water Wellness Shampoo. Follow with Malibu C® Hard Water Wellness Conditioner.
Water/Aqua/Eau, Sodium C14-16 Olefin Sulfonate, Cocamide DIPA, Disodium Laureth Sulfosuccinate, Butylene Glycol, Glycerin, Cocamidopropyl Betaine, PEG-120 Methyl Glucose Dioleate, Disodium EDTA, Sodium Lauryl Sulfoacetate, Panthenol, Hydrolyzed Rice Protein, PEG-16 Macadamia Glycerides, Polyquaternium 10, Linum Usitatissimum Seed Extract, Sodium Gluconate, Glucose, Citric Acid, Phenoxyethanol, Potassium Sorbate, Fragrance/Parfum, Limonene, Benzyl Benzoate, Linalool.
• • •
All content on this site is for information only and is not intended to substitute for the advice available from your own medical professional. The information contained herein should not be used as a medical diagnosis and should not be used as prescription for any medication. It is very important to read the information on every product package. If you have or suspect a medical problem, you should promptly contact your health care provider. Claims made above have not been reviewed by FDA.
Malibu Wellness' vitamin technology is a patented technology protected by patent #5,804,172.


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Funk band, DJs featured at first Last Chair Music Festival
OLYMPIC VALLEY, Calif. – Squaw Valley's inaugural Last Chair Music Festival features the funk band Lettuce and nationally known DJs.Slated the first two weekends of January, the festival will bring live music on Friday and Saturday nights to the Squaw Valley Conference Center, including live DJ sets by Passion Pit, Foster the People and Bonobo, and a live concert by Lettuce, featuring guitarists Eric Krasno and Adam "Shmeeans" Smirnoff, Neal Evans (keyboards, Hammond B-3 organ, piano), Adam Deitch (drums/percussion), Erick "E.D." Coomes (bass), Sam Kininger (saxophone), Ryan Zoidis (ssaxophone), Nigel Hall (vocals) and partial-member Rashawn Ross (trumpet).Lettuce is known for their energetic live shows. Krasno also plays in the trio Soulive.Tickets for each day of the festival will be available packaged with a daily lift ticket for $99. The lift ticket purchased as part of the concert package will be valid for the day of or the day after the concert, meaning a lift ticket packaged with a Friday show can be used on either Friday or Saturday, and a lift ticket packaged with a Saturday show can be used on either Saturday or Sunday.Learn more at http://www.squaw.com.


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Challenge Course/ Ropes Course
To book a Challenge Course experience, please fill out our Reservation Request Form.
(2-Hour Program)
This group initiatives program is a whirlwind of fun and challenging games and group problem-solving exercises. This program is great to use as an introduction for groups that are just forming or for something a little different to use with established groups. The emphasis is on fun and building connections within a group. This program is mobile; we can bring it to your site! Additional fees will be added for travel costs.
University of Maine Groups: $14/person
Non-University of Maine Groups: $17/person
Half-Day Challenge Course
(4-Hour Program)
The day will start with some warm-up activities designed to be fun and to get the group prepared for the day. This will be followed by some group initiatives which focus on providing a mental and physical challenge for the group to solve. After that, you will move on to the challenge course low elements which will continue to stretch the group's problem-solving abilities.
If your group's goals are fun, getting to know one another better, and/or doing something different together, choose half day challenge course program, which provides a great alternative to traditional staff training or orientation.
University of Maine Groups: $25/person*
Non-University of Maine Groups: $33/person**
*minimum of $150 or 6 people
**minimum of $198 or 6 people
Full-Day Challenge Course
(8 Hour Program)
The full-day challenge course program includes all the elements half-day program with the addition of the high elements. After completing the half-day program, your group will move to the high elements which allow individuals within the group to explore their personal limits in a supportive outdoor setting.
If your group wants an opportunity for self assessment, reflection, and an introduction to team-building, a full-day challenge course program goes beyond fun and begins to point out successful dynamics along with broader issues and roadblocks that often challenge a group's success.
University of Maine Groups: $35/person*
Non-University of Maine Groups: $60/person**
*minimum of $280 or 8 people
**minimum of $480 or 8 people
Custom Programs
Maine Bound can customize a challenge course experience to meet the needs and goals of any group. Games, adventure initiatives, and team building programs can be done anywhere, indoors or outdoors. We also offer rock climbing, rappelling, canoeing, and more. Call 207.581.1794 for more information.
Each team-building program is designed to fit the needs of your group. The descriptions listed above depict a typical program. However, the facilitator may deviate from the description at his or her discretion in order to best meet the group's goals.


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be thrilled to death(redirected from am thrilled to death)
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be thrilled to death
To be ecstatic; to be very pleased and excited. A: "I really hope Mary enjoys her surprise birthday party." B: "I'm sure she'll be thrilled to death!" I was thrilled to death to hear that I'd been selected for a literary award in New York City.


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Unspeakably brilliant.
There are around 330 words in this column and I still don't know if that is enough to justify just how good Overwatch is.
Seeing as I've already wasted 24 of them I'd better get on with it.
Last week I said Uncharted 4 already had the 2016 Game of the Year sewn up.
Well that is certainly no longer a one-horse race given how brilliant Blizzard's new team-based first-person shooter is.
You have a cast of various heroes, each with their own abilities and roles within a team, at your fingertips.
Each one is so exquisitely different they could have an entire game built around them alone.
Squad-based combat is the name of the game with four general character roles including offensive characters with high speed and attack but low defence, defensive characters meant to form choke points for enemies, support characters who are there to help their allies and enemies respectively (such as healing or speed alterations), and tank characters that have a large amount of armor and hit points to withstand enemy attacks and draw fire away from teammates.
Overwatch is actually quite cutesy and colourful in terms of its quirky graphics but don't be fooled, this is a seriously good shooter.
Players can switch between characters in-game following deaths or by returning to their home base, which is encouraged by the game's overall design. The maps are inspired by real-world locations and have the look and feel of an experienced developer like Blizzard behind them.
When I first played Overwatch it was late, I was tired and I should have been in bed.
Four hours later in the small hours of the morning I still didn't want to put the control pad down. Every match you find or learn something new, there are just so many layers to this fantastic shooter.
Take my word for it, this is the new front runner for Game of the Year... and if you don't want to take my word for it just look around at the widespread overwhelming critical acclaim that has greeted its release.
Overwatch has received perfect or near perfect scores from the top publications in the industry and after one playthrough you'll see why.
Here is another to add to the list. Rating: 10/10.


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SAO JOSE DOS CAMPOS, Brazil, Dec. 17 (UPI) -- Brazil and South Africa will collaborate on building a short-range, air-to-air missile as part of a multibillion-dollar Brazilian program to develop avionics and military aviation for domestic and export markets.
Proliferation of new missile technologies has enabled new manufacturers to enter the defense market with far-reaching effect not only on traditional suppliers in the United States and Europe but also on supply controls.
The SRAAM will be developed by South Africa's Denel Pty Ltd. subsidiary Denel Dynamics and Brazilian air force and Ministry of Defense.
The A-Darter missile has been more than six years in the planning stage. In the meantime, missile technologies have advanced with U.S., European and Israeli models competing with Russian products. China is also developing a competing missile manufacturing industry.
However, both Brazil and South Africa hope they can compete effectively against both Western and Russian suppliers in developing countries where exports of weapons, including missiles, are subject to legislative hurdles.
The planned A-Darter missile will use common LAU-7 type launchers and will be designed to work with standard MIL-STD-1553 data bus systems, Defense Industry Daily said on its website.
It's expected to be a fifth-generation weapon likely to incorporate modern thermal imaging technology for targeting, and a 90-degree look angle with cockpit-selectable seeker scan patterns.
The Brazilian air force aerospace technical center will be in charge of the Brazilian industrial end of the deal alongside missile manufacturer Mectron from its Sao Jose dos Campos manufacturing facility.
South African officials have said they support the deal because it will introduce new technical skills to the country and also reinforce "south-south" collaboration. South Africa is the latest nation to join the BRICS group of emerging markets that includes Brazil, China, India and Russia.
The A-Darter missile is also expected to join the inventory of the South African air force, which deploys Saab's JAS-39 C/D Gripen lightweight single-engine multirole fighter and other aircraft.
In Brazil, the A-Darter is expected to replace the indigenous Mectron MAA-1 Piranha missile on some aircraft and equip whatever fighter jet Brazilian air force chooses for its next-generation inventory.
Saab is a competitor in Brazil's F-X2 multirole fighter competition alongside France's Dassault Aviation and Boeing.
The Brazilian navy may also deploy the A-Darter to replace its AIM-9H Sidewinder missiles, defense sources said.
Denel has created a Denel do Brasil subsidiary office in Sao Jose dos Campos in preparation for the joint manufacturing program.


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Main navigation | Main content
Dr. Massoud Amin, Professor of Electrical and Computer Engineering, holds the Honeywell/H.W. Sweatt Chair in Technological Leadership, and is the Director of the Technological Leadership Institute at the University of Minnesota in Twin Cities. In addition to his administrative and research responsibilities, he serves as the director of graduate studies (DGS) for the security technologies (MSST) program (2008-present), served as the DGS for the management of technology (MOT) program (2003-2009) and teaches several courses including MOT 8920 (Science & Technology Policy), MOT 8224 (Pivotal & Emerging Technologies), MOT 8940 (Intellectual Property Valuation & Strategy), MOT 8950 (International MOT Project), MOT8234 (Capstone Project), and ISE 5302 (Critical Infrastructure Security and Protection).
His research focuses on two areas: 1) Global transition dynamics to enhance resilience, agility, security and efficiency of complex dynamic systems. These systems include national critical infrastructures for interdependent energy, computer networks, communications, transportation and economic systems. 2) Technology scanning, mapping, and valuation to identify new science and technology-based opportunities that meet the needs and aspirations of today's consumers, companies and the broader society. This thrust builds coherence between short- and longer-term R&D opportunities and their potential impact.
Prior to joining the University of Minnesota in March 2003, Dr. Amin held positions of increased responsibility including Area Manager of Infrastructure Security, Grid Operations/Planning, and Energy Markets at the Electric Power Research Institute (EPRI) in Palo Alto, California. In the aftermath of the tragic events of 9/11, he directed all security-related research and development at EPRI, including the Infrastructure Security Initiative (ISI) and the Enterprise Information Security (EIS). Prior to October 2001, he served as manager of mathematics and information science at EPRI, where he led strategic research in modeling, simulation, optimization, and adaptive control of national infrastructures for energy, telecommunication, transportation, and finance.
At EPRI, Dr. Amin developed collaborative research initiatives with diverse groups, including electric power industry, the government, universities and other stakeholders (including EPRI and its members, the US DOD, DOE, NSF, National Governors' Association, NRC/NAE, and the White House OSTP). This primarily involved creation and successful launch of the Complex Interactive Networks/Systems Initiative (CIN/SI), initiated in mid-1998 in response to growing concerns over the vulnerability of critical national infrastructures. CIN/SI developed six research consortia consisting of 108 professors and over 200 researchers in 28 U.S. universities, along with two energy companies, co-funded equally by EPRI and the U.S. DOD. In the course of the CIN/SI, Dr. Amin pioneered R&D in smart grids and self-healing infrastructures in 1998 during his tenure at EPRI, and led the development of over 24 technologies transferred to industry. He is considered by many as the "father of the smart grid."
Prior to joining EPRI in January 1998, he held positions of associate professor of systems science and mathematics and associate director of the Center for Optimization & Semantic Control at Washington University in St. Louis, Missouri. During his twelve years at Washington University, he was one of the main contributors to several projects with United States Air Force, NASA-Ames, Rockwell International, McDonnell Douglas, Boeing, MEMC, ESCO, Systems & Electronics Inc. and United Van Lines. While at Washington University, his research focused on:
Dr. Amin is the author or co-author of more than 190 research papers and the editor of seven collections of manuscripts, and serves on the editorial boards of six academic journals. At Washington University, students voted him three times Professor of the Year (voted annually by seniors in the School of Engineering and Applied Science at Washington University, 1992-1995), Mentor-of-The-Year (Assoc. of Graduate Engineering Students, Feb. 1996), and the Leadership Award (voted by the senior engineering class, May 1995). Dr. Amin received Best Session Paper Presentation Awards (American Control Conference, 1997) and an AIAA Young Professional Award (St. Louis section, 1991). At EPRI he received several awards including the 2002 President's Award for the Infrastructure Security Initiative, 2000 and 2002 Chauncey Awards (the highest annual EPRI Award, in March 2001 and 2003), and six EPRI Performance Recognition Awards during 1999-2002 for leadership in three areas.
He served as a member of the Board on Infrastructure and the Constructed Environment (BICE) at the U.S. National Academy of Engineering during 2001-2007, and is a member of the Board on Mathematical Sciences and Applications (BMSA) at the National Academy of Sciences during 2006-2009, Sigma Xi, Tau Beta Pi, Eta Kappa Nu, a senior member of IEEE, AAAS, AIAA, ASME, NY Academy of Sciences, SIAM, and Informs. He is a member of the IEEE Computer Society's Task Force on Security and Privacy, and served on the Board of the Center for Security Technologies (CST) at Washington University (2002-2006). Dr. Amin holds B.S. (cum laude) and M.S. degrees in electrical and computer engineering from the University of Massachusetts-Amherst, and M.S. and D.Sc. degrees in systems science and mathematics from Washington University in St. Louis, Missouri.
Electric Power Research Institute (EPRI), McDonnell Douglas, Boeing, NASA-Ames Research Center, Rockwell International, MEMC Electronic Materials Inc., Electronics & Space Corp., TSI, IBM, Hartford Steam Boiler Inspection & Insurance Co., United States (US) Dept. of Defense, US Air Force, US Army Research Office, US Dept. of Energy, NSF, National Governors' Association, White House Office of Science and Technology Policy, and the US National Academy of Engineering.
|Edited Journals
|Journal Articles
|Articles in Refereed Conferences
|Other Major Technical Reports
|Invited Lectures: Oct. 1992 - Dec. 2010
|Keynote Addresses:
May 1998 - Dec. 2010
|Technological Leadership Institute Home Page
|University of Minnesota Dept. of Electrical and Computer Engineering Home Page


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Adam Jones joined the Lipscomb men's basketball staff in the summer of 2013 as Director of Operations. The Siloam Springs, Ark. native previously served in the same position at Stetson University during the 2013-14 under current Bisons head coach Casey Alexander.
Jones spent two seasons as the Hatters graduate assistant coach before joining the staff on a full-time basis. Along with serving as the video coordinator for the Bisons staff, Jones aides in the organization and planning of the storied Lipscomb summer basketball camps.
Before heading to DeLand, Fla., Jones spent three seasons working with the University of Arkansas program as a student manager under former coach John Pelfrey. Jones also spent a season with the Razorbacks football team under then head coach Houston Nutt.
In addition to coordinating the Lipscomb camps, Jones has previously worked camps at Arkansas, Duke and Clemson.
Jones was a three-year letterwinner in hoops at Siloam Springs High School before heading to Arkansas where he graduated with a degree in Kinesiology in 2010. He then went on to earn his Master's in Reading Education from Stetson in 2012.


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by Scott Boyle
Monticello and San Juan were at the top of the heap at the 12th Annual Red Rock Invite XC meet in Moab last week.
The Bucks claimed first place in both the boys and girls races, with the Bronco boys placing second to the Bucks.
Collin Hatch again led the Buckaroo pack with a third place finish. Buckaroos were also fifth, sixth, eighth and ninth, with Jens Brewer, Justin Wright, Sheldon Black, and Tyler Bird filling those spots.
Only 37 seconds separated the Buckaroo five. Kyler LaRose, Everett Hatch, Hunter Bowring, Nash Freestone, and Tanner Eardley also ran well for the Bucks, all finishing in the top 20 in the six-team event.
San Juan's Christian Sherrow led the Bronco boys' team to that second place team placing with his fourth place individual finish.
Cole Chamberlain was next in for the Broncos in seventh with Dallin Jacobsen (10th), Braden Meyer (16th), and Chase Chamberlain (18th), providing the scoring.
Brandon Deschene and Spencer Beck rounding out the Bronco varsity team.
Bailey Goodwine returned to tip-top condition, winning the girls race by 15 seconds on the mostly grass course held at the Moab Golf Club.
She was followed by Elena Mitchell in fifth, Cambria Welch in ninth, Ashley Hoggard in 11th place and Brittany Keith in 16th. Brittany Redd also ran on the Buck varsity.
The Bronco girls' XC team placed fourth overall led by freshman Alexia Stash's 12th place individual finish, followed by Katrisa Ward (18th), Kira Simpson (22nd), Brittany Bleak (24th), and Heidi Hiatt (25th). Lynalla Benn, and Tallie Chamberlain also ran for the Broncos.
Jamikal Shakespeare continued his torrid run on the junior high meets with a 19 second win over Shadin Sherron and Grange Simpson of ARL in Blanding.
Ryan Bird and Lucas Hatch were fourth and fifth for the Buckaroos as ARL won the team race, following by the Bucks in second. Derek Francom was seventh for ARL.
ARL girls also took first place, with MHS second when Nizhoni Warren, Jessica Walker and Skye Jeppsen finished 1, 2, 3.
Kendal Harris was the first Buckaroo runner with a fourth place finish.
Monticello competed in the Chicken Creek Meet in Mancos, CO on Saturday, winning the boys meet and taking third in the girls.
Collin Hatch won the boys event by 29 seconds with Justin Wright and Jens Brewer finishing fourth and fifth. Sheldon Black continued his improvement with a ninth place finish. Nash Freestone was 14th for the Bucks.
Bailey Goodwine was fourth overall to pace the Lady Buckaroo runners. Cambria Welch was 12th, Brittany Keith 19th, and Ashley Hoggard 21st.
Brittany Redd was eighth in JV girls. The MHS JV boys grabbed 1-4 when Tyler Bird won, followed by Kyler LaRose, Everett Hatch, and Tanner Eardley.
Jamikal Shakespeare was second in the middle school race with Kendall Harris seventh for the girls MS.
Next meet is in Blanding as the Broncos host their home meet, the John Thornton Invitational, on Wednesday at USU-Eastern-San Juan Campus, with the first race starting at 4 p.m.
San Juan is cruisin' in 2A football, dropping the Kanab Cowboys, 40-10.
After Kyle Marian scored the first Bronco touchdown on a 10-yard pass from Barkley Christensen, the Broncos pounded the running game, scoring four more times to take a 28-0 halftime lead.
Justin Nielson (seven and five yards) and Logan Meyer (eight and two yards) each lugged the pigskin to two touchdowns rushing and Christensen added another kickoff return for a touchdown just for good measure.
The 7-0 Broncos face their first real test of the region season with a road game at 6-1 Beaver, who are beating people by Bronco-esque scores after a 43-0 thumping of Parowan. Should be interesting.
The Buckaroos are finding Altamont a not-fun place to play football after suffering a 22-20 loss Friday night in the Longhorn pasture.
The Buck defense couldn't stop Kyle Foy, of wrestling fame, as he ran through the Buck defense for 200 yards. The Longhorns took the lead in the second half at 22-14 and when the Bucks scored late to pull within two, the Longhorns rose up and stopped the Buckaroo two point attempt to tie the game.
Two years ago, the Bucks took a 26-8 lead into the fourth quarter only to see the Longhorns score 38 fourth quarter points to overcome a stunned Buckaroo team, 46-26.
The loss this year, Altamont's first 1A win of the season drops the Bucks to 5-2 on the season.
The Lady Bucks nearly swept the Parowan Tournament, beating Valley, Dixie JV, Cedar, North Sevier, Green River and Whitehorse with only a loss to Dixie JV mixed in there to run their season record to 13-6.
San Juan is 8-12 after splitting region contests with Richfield and South Sevier. The Bucks and Broncos gathered for a matchup Tuesday night. Results next week.


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Controlling the Message
The government of Islamist president Mohammed Mursi has been toppled, his supporters are now either in prison or on the run. Now, the new rulers in Cairo also want to limit the Muslim Brotherhood's access to religion: With a series of laws, the Ministry for Religious Affairs is striving to impose tighter state controls on the nation's mosques. In future, anyone disseminating political messages from the pulpit will have his licence withdrawn.
Furthermore, as of this month only imams who have graduated from Al Azhar University, which is viewed as a moderate institution, will be allowed to hold Friday sermons. This meant that the government has effectively sacked 53,000 preachers overnight.
Abdulghani Hendi, Chairman of the Egyptian trade union for Imams, welcomes the measure: "Over the last two years since the revolution we have seen people exploiting the sermon for political means. They are profiting from their presence in the mosques financially, spiritually and in other ways," he says. Like Hendi, many Egyptians deem the new laws to be necessary for the creation of a civilian state. Others however are warning against a surveillance policy comparable to that in place during the Mubarak era.
Amalgamation of politics and religion
The Muslim Brotherhood has been accused of exploiting mosques to further its political interests – and not just since the onset of political upheaval in Egypt. Islamists have been recruiting new members in houses of worship for decades. But while red lines existed during the Mubarak era, these fell away after the revolution that began on 25 January 2011. In many places, Islamist preachers canvassed openly for the Muslim Brotherhood. After his election, President Mursi held several sermons in mosques himself.
But this open intermeshing of religion and politics was met with public resistance. Sheikh Refaat, imam at a mosque in central Cairo, therefore perceives the new government's approach as a reaction to the rejection of Islamist ideology by the people: "The people who pray are the ones who judge the imam. The Muslim Brotherhood and the entire Islamist movement have been outcast by these people. Why? Because the people know their religion very well, and they are devout by nature," he says. To ensure there are no doubts as to the ethos of his own mosque, Sheikh Refaat has hung a poster up in the entrance with the words: "No to political parties".
Demand for a constitutional article
But Islamist preachers are not going quietly everywhere. There are more than 110,000 registered mosques in Egypt. But the number of imams with a qualification from Al Azhar is just 58,000 – far too few to provide blanket coverage of all the nation's pulpits. In Upper Egypt in particular, the heartland of the Islamists, many mosques are owned by family clans. These also generally decide who is allowed to address the faithful on Fridays. The government aims to sidestep this dilemma with further legal restrictions. These stipulate, for example, that Friday prayers will only be permitted in mosques that are larger than 80 square metres.
Also from the point of view of Abdulghani Hendi, the prohibition policies fall short of the mark. Instead, the chairman of the imams' trade union is calling for the matter to be taken up by the constitutional assembly: "We want a constitutional article that regulates the preacher's profession thereby guaranteeing the nation protection. This is a very important, but also a very dangerous profession. Just like reporting, like journalism. It's even more dangerous, because the imam communicates directly with the people," he says.
Murder calls from the pulpit
Activists in the nation on the Nile are also sounding alarm bells at the interim government's course of action. They warn that instead of the Islamists, the new rulers could in future misuse the mosques as a vehicle for their own propaganda. Over the past few weeks, numerous imams have already given their blessing to the security personnel who take brutal action against supporters of Mursi. A sheikh who often preaches on Tahrir Square in Cairo recently issued a public call to murder members of Hamas, the Palestinian arm of the Muslim Brotherhod: "Listen up, Egyptians! If you should find a Hamas supporter in any Egyptian province who supports the Muslim Brotherhood, then you are permitted to kill him, because he has contravened the laws of our country," he (is alleged to have) said.
Representatives of Al Azhar University are also taking part in the smear campaign: In a sermon, former Grand Mufti Ali Gomaa praised army chief Abdel Fattah al-Sisi for his "extraordinary courage". He also disputed the right of members of the Muslim Brotherhood to define themselves as Egyptians. It would appear that the politics ban for imams is still only applicable to one half of society.
Markus Symank
© Qantara.de 2013
Editor: Lewis Gropp/Qantara.de


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Women today are an economic powerhouse. 98% of them are sole or joint decision-makers on daily banking, and 84% are fully or partially responsible for the family investment portfolio.* And women are increasingly single, living longer and in line to inherit wealth. Despite these strides, women often have different financial needs, circumstances and opportunities than men, which makes it especially important to start planning early and carefully. Consider these four key factors:
Yet these differences don't need to be obstacles. Simply taking these things into consideration when planning for your future can help set you on the right path.
No matter what your goals are—if you want to provide a college education for your children, start a business or just enjoy a rewarding retirement— we can help. Please contact me today to discuss how I can help you grow more than wealth.


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This is a very preliminary, informal poll to gauge interest in "Scandal Sheet!" merchandise. If you think you would be likely to order merchandise if it should become available, here's your chance to tell me. (If your response would be "I wish I could order something, but I probably couldn't afford to," go ahead and choose "no." I'm trying to get an idea of how many people might actually order one, not just how many people would if they could.)
Also, post in here and tell me what sort of merchandise you'd be interested in - t-shirts? Caps? Mouse pads? Coffee mugs? Inflatable sheep?
If there's enough interest, I'll get cracking on some designs and show them here in the forum when they're ready so people can choose the ones they like best.


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Episode 5 Preview | Escape from Cuba
Preview: Season 2 Episode 5 | 30s
Join Ann Curry as two men search for the people who helped them settle in the U.S. when they fled Castro's Cuba. One hopes to find the family who took him in as a boy while another looks for the shrimp boat skipper who brought him to safety.
Aired: 01/01/19Video has closed captioning.


text: Administrative Team Bell Schedule News School Accountability Report Card Attendance Office Library STAFF ACCESS School Map / Directions Calendar School Profile Administrative Office Health Office Security About Us Here at CCMS Panthers are PAWsitively changing the future! Panthers are all about Academics, Activities, Athletics and Arts! We proud of our diverse student population and we encourage leadership and involvement on our campus. Welcome to the Panther Family!


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Your little one is a busy bee, absolutely prolific with colored pencil doodles and handwriting worksheets? The Cay Filing Cabinet is built to give him/her a little extra storage and fits nicely beneath most tables. Choose from 50 colors to match almost any room. Seen here in Wisteria, Bark, Oyster, and Bluebell.
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