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- Research article
- Open Access
Evaluation of existence and transmission of extended spectrum beta lactamase producing bacteria from post-delivery women to neonates at Bugando Medical Center, Mwanza-Tanzania
- Edwin Nelson†1,
- Juma Kayega†1,
- Jeremiah Seni1Email author,
- Martha F Mushi1,
- Benson R Kidenya2,
- Adolfine Hokororo3,
- Antke Zuechner3,
- Albert Kihunrwa4 and
- Stephen E Mshana1
© Nelson et al.; licensee BioMed Central Ltd. 2014
- Received: 6 January 2014
- Accepted: 28 April 2014
- Published: 3 May 2014
Extended spectrum beta-lactamase producing bacteria (ESBL) are common causes of neonatal sepsis worldwide. Neonatal sepsis due to ESBL is associated with increased morbidity and mortality at Bugando Medical Centre (BMC). Due to limited information on the sources of these ESBL strains at BMC, this study was conducted to evaluate the existence, magnitude and transmission of ESBL from post-delivery women to neonates at BMC, Mwanza-Tanzania.
A cross-sectional study was conducted at obstetrics and neonatal wards from May to July 2013, involving post-delivery women and their neonates. Rectal swabs were collected and processed to identify the ESBL strains and their antimicrobial susceptibility patterns. Patients' data were obtained using a standardized data collection tool. We enrolled 113 women and 126 neonates with mean age of 26.5 ± 5.5 years and median gestation age [IQR] of 39 [35–40] weeks respectively. The prevalence of ESBL carriage among women and neonates were 15% (17/113) and 25.4% (32/126) respectively. The acquisition of ESBL isolates among neonates on day 1, day 3 and day 7 were 60.0% (21/35), 25.7% (9/35) and 14.3% (5/35) respectively. There was no phenotypic similarity between ESBL strains from women and their respective neonates, suggesting other sources of transmission. Neonates given antibiotics were more likely to carry ESBL than those not given [100% (32/32) versus 86% (81/94), p = 0.018].
The carriage rate of ESBL strains among post-delivery women and neonates at BMC is high. Our findings suggest that neonates acquire these strains from sources other than post-delivery women and more than half acquire them on the first day of life. More studies are recommended to further explore the sources of ESBL strains among neonates.
- Post-delivery women
- Neonates
- Tanzania
The escalating burden of multidrug resistant (MDR) gram negative bacteria of the family Enterobacteriaceae is currently one of the most challenging situations both in developed and developing countries [1–4]. The exposure of these bacteria notably, Escherichia coli and Klebsiella pneumoniae to antibiotics especially in the hospital environment has induced dynamic and continuous mutation leading to production extended spectrum beta lactamase (ESBL) which confer resistance to first, second, third and fourth generation cephalosporins as well as aztreonam [5–7]. These ESBL strains in turn have spread not only in the hospital environment but also to the community settings with significant regional variations [4, 6, 8, 9].
Although shown in few studies, gastrointestinal carriage of ESBL strains can be a predictor of subsequent infection [10–12]. The prevalence of ESBL carriage has been shown to range from 3.2% to 67.9% [12–16]. Furthermore, pregnant women colonized by ESBL in the gastrointestinal tract have a potential to subsequently transmit these strains to their neonates (during and after delivery), to other hospitalized patients and to health workers [17, 18].
Few studies have addressed the magnitude of ESBL associated infections with undue complications and deaths in Tanzania [3, 9, 19–21] however information showing the ESBL carriage among post-delivery women and their neonates remain to be explored. Thus, this study aimed at evaluating the existence, magnitude and transmission of ESBL strains from post-delivery women to their neonates during or after delivery so as to specifically guide infection prevention and control at Bugando Medical Center (BMC) where ESBL associated infections have been shown to be an independent predictor of deaths among neonates [3].
Study design and sampling procedures
This was a cross sectional hospital based study conducted from May to July 2013 in the obstetrics wards, neonatal ICU and neonatal wards at BMC. Post-delivery women who delivered at BMC within 24 hours and who consented to participate in the study were serially recruited and their respective neonates. The sample size of 113 post-delivery women was estimated using Kish Leslie (1965) formula and using a previous prevalence of 8% [14].
Data and clinical sample collection
Every post-delivery woman was informed about details regarding the aims of the study. A standardized data collection tool and patients' files were used to collect demographic and clinical data among consented women and their respective neonates.
Then, after a thorough explanation, using sterile cotton swab in Amies transport medium (Biolab, HUNGARY) rectal swabs were collected from women within 24 hours after delivery. To assess acquisition of ESBL strains in neonates, the rectal swabs were collected on day 1, day 3 and day 7 post-delivery. Rectal swab specimens were delivered to the Laboratory within two hours after collection.
Laboratory procedures
The rectal swab samples were plated onto MacConkey agar (OXOID, Basingstoke, UK) supplemented with cefotaxime 2 mg/L for preliminary screening of ESBL bacterial isolates and then plates were incubated at 35-37°C for 18–24 hours. All gram negative bacteria were identified using phenotypic characteristics such as lactose fermentation reaction on Mac Conkey agar, Urease, Citrate, Sulphur indole motility (SIM) and Triple sugar iron (TSI) tests as previously described [22].
Susceptibility testing was done using disc diffusion method based on the Clinical Laboratory Standard Institute (CLSI) guideline [23]. The antibiotic discs tested were ampicillin (10 μg), amoxicillin/clavulanate (20/10 μg), ciprofloxacin (5 μg), tetracycline (30 μg), gentamicin (10 μg), sulfamethoxazole/trimethoprim (1.25/23.75 μg), ceftriaxone (30 μg), ceftazidime (30 μg) and imipenem (10 μg) (OXOID, Basingstoke, UK). The phenotypic confirmation of ESBL isolates was done using disc approximation method i.e. ceftazidime (30 μg) and cefotaxime (30 μg) discs were placed equidistant from the amoxicillin/clavunate (20/10 μg) disc, followed by overnight incubation at 37°C for 18–24 hrs. Enhanced zone of inhibition towards amoxicillin/clavulanate disc was considered as positive result for ESBL production whereas interpretation of susceptibility patterns on other antimicrobial disks was done using guidelines laid down in the CLSI, which provides break points corresponding to zone of inhibition diameter [9, 23].
Quality control
Standard laboratory procedures were strictly adhered to so as to avoid contamination. Escherichia coli ATCC 25922 and Escherichia coli ATCC 35218 were used as negative and positive ESBL controls respectively.
Data management and analysis
The demographic, clinical and laboratory data were entered into Microsoft excel and then exported to the STATA version 11.0 software for analysis according to the objectives of the study. Results were presented into percentages/proportions for categorical variables whereas continuous variables were described as mean (±standard deviation). The difference in distribution of predictor variable was considered significant if p-value was less than 0.05.
Study clearance and ethical consideration
The study was approved by CUHAS/BMC Ethical Review Board, and written informed consent was obtained from every post-delivery woman (who also provided consent for her neonate) before collection of demographic, clinical data and rectal swab specimens.
A total of 113 post-delivery women and 126 neonates with mean age of 26.5 ± 5.5 years and median gestation age [IQR] of 39 [35–40] weeks respectively were recruited.
The acquisition of ESBL isolates among neonates on day 1, day 3 and day 7 were 60.0% (21/35), 25.7% (9/35) and 14.3% (5/35) respectively. Furthermore, there was no phenotypic similarity between ESBL strains from post-delivery women and their respective neonates.
Association between ESBL carriage among post-delivery women with variables
Non ESBL carrier, n (%)
ESBL carrier, n (%)
Mean age ± SD ǂ
27.1 ± 5.5 years
23.4 ± 3.6 years
Mode of delivery
36 (37.5)
8 (47.1)
60 (62.5)
9 (52.9)
Admission in the past 30 days
96 (100)
17 (100)
0 (0.0)
0 (0.0)
Admission in the past 3 months
83 (86.5)
13 (76.5)
13 (13.5)
4 (23.5)
Previous use of antibiotics in the past 30 days
67 (69.8)
9 (52.9)
49 (30.2)
8 (47.1)
Previous use of antibiotics in the past 3 months
54 (56.3)
7 (41.2)
42 (43.7)
10 (58.8)
Antibiotics use in the current admission
57 (59.4)
9 (52.9)
39 (40.6)
8 (47.1)
Presence of catheter
59 (61.5)
10 (58.8)
37 (38.5)
7 (41.2)
Presence of i/v line
54 (56.3)
10 (58.8)
42 (43.7)
7 (41.2)
HIV serostatus
84 (87.5)
16 (94.1)
12 (12.5)
1 (5.9)
Association between ESBL carriage among neonates with variables
Non ESBL carrier, n
ESBL carrier, n
Median gestational (IQR) ǂ
39 (35–40)
39 (35–40)
Median birth weight (kg)
2.6 (1.9-3)
2.9 (1.7-3.4)
44 (46.8%)
17 (53.1%)
50 (53.2%)
15 (46.9%)
Mode of Delivery
35 (37.2%)
12 (37.5%)
59 (62.8%)
20 (62.5%)
19 (20.2%)
8 (25.0%)
75 (79.8%)
24 (75.0%)
Antibiotic Use
13 (13.8%)
0 (0.0%)
81 (86.2%)
32 (100.0%)
85 (90.4%)
28 (87.5%)
9 (9.6%)
4 (12.5%)
Antimicrobial resistance patterns among ESBL isolates from post-delivery women and neonates
Antimicrobial agents
Post-delivery women, n (%)
Neonates, n (%)
20 (100.0)
25 (71.4)
14 (70.0)
17 (48.6)
15 (75.0)
32 (91.4)
11 (55.0)
12 (34.3)
0 (0.0)
0 (0.0)
The prevalence of ESBL carriage among women shown in this study (15%) is relatively close to 10% to 12.7% found in some Asian and African countries [13, 15, 16] but lower than 3% and 3.2% in Sweden and USA respectively [11, 24]. The lower rates in ESBL carriage in developed countries as opposed to developing countries may be attributable to different policies in antimicrobial use and infection control in the respective settings. The present study and a similar one in Madagascar found the rates of ESBL carriage in children to be 15% and 22.1% respectively, with acquisition increasing progressively in the course of hospitalization [25]. This emphasizes the need to protect this vulnerable population of children against the MDR strains in the hospital settings. The predominance of Escherichia coli and Klebsiella pneumonia producing ESBL strains in this study is also similar to findings in some other studies across the world showing their preponderance in gastrointestinal tract colonization and their evolutionary potential into MDR strains [12, 15, 25, 26].
It is well known that gastrointestinal carriage of ESBL strains among pregnant women can be a potential source of transmitting these resistant strains to their newborns [17, 18] but contrary to this, there was no phenotypic similarity between ESBL strains from women and their respective neonates. This suggests that effective control of transmission of ESBL strains at BMC should go beyond mothers and that other possible sources should be further scrutinized so as to curb the growing burden of antimicrobial resistance in Tanzania [3, 20] and other countries with similar problem [4, 7].
As shown in some other studies [25–29], previous use of antibiotics among neonates has also been shown to be associated with ESBL carriage in the present study. The possible reason of high neonatal ESBL carriage in our setting may be due to antimicrobial selective pressure conferred by the empirical use of ampiclox and cefotaxime. Therefore, as shown from other settings [11], neonatal screening for ESBL strains and adherence to the rational antimicrobial use policy should be an enduring exercise at BMC. Other predictive factors such as older age, prolonged hospitalization, vaginal delivery, low birth weight and prematurity though shown in other studies [14, 25, 26, 30] were not found to be statistically associated with ESBL carriage in the present study.
The MDR nature of the ESBL isolates in the present study is worrisome as these post-delivery women and their neonates may be the potential sources of these strains in the hospital environment, and should of necessity be among the target groups in infection prevention and control activities at BMC. The present study has shown excellent activity of carbapenems and borderline activity of ciprofloxacin against ESBL strains, the findings which are similar to other studies [8, 25].
The carriage rates of ESBL strains among neonates and their mothers at BMC are high. Our findings suggest that neonates acquire these strains from sources other than post-delivery women and more than half acquire them on the first day of life. These two groups should be among the target groups for ESBL screening at BMC so as to prevent ESBL spread in the hospital environment. In the light of these findings, more studies are recommended to further explore the sources of the ESBL strains among neonates.
The authors would like to sincerely thank all post-delivery women and their neonates for participating in this study. All staffs in the Department of Obstetrics & Gynaecology, Paediatrics & Child Health as well as Microbiology & Immunology of CUHAS and BMC for their excellent technical support. This work was internally funded by CUHAS to SEM and reagents from SACIDS to SEM.
Authors' Affiliations
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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.


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When OOD Sue Grigg arrived she wanted the Y flag hoisted; this states that all competitors should wear life jackets, because from the moorings we could see plenty of white water. In the Roads we were surprised to see such rough water from a northerly wind because in this direction it is rare to see these conditions. After anchoring several powerful squalls came through churning up the surface even more and the forecast was for the wind strength to increase during the evening. As Sue races in G class she knows their capabilities and so it was decided that their racing should be cancelled and after even more squalls she included V class and these were radioed to the clubhouse. Two or three Sunbeams were already out and when one sailed close by he gave us the thumbs up sign showing that he was happy with the decision, but one or two were disappointed. As the evening drew on, just to be difficult, instead of following the forecast, the wind and sea abated, however at the time they were made the decisions were correct. It was also decided to set short courses so that fleets would not be exposed too long to the forecast worsening weather.
Incite, one of the bigger boats in W class, although well reefed, lead at the first windward mark and then eased sheets and charged away down wind being chased by the rest of the class. Martin Leech, the skipper was happy to be in this position until he saw that they were not following his line so closely and then not at all as they veered away going to a different mark. After a quick re-read of the course instructions he had to make a major change of course and head for the correct mark behind many of the others. He still managed a gallant sixth place out of nine. It was suggested that the class may have a whip round to buy a satnav to help him in the future. Deep Purple was first over the line but had to work hard going to the mark so close to Cleda Mur, the biggest boat in the class.
In U fleet Mandy Owen helmed Aurora to a good start at the pin end and held the lead to the windward mark but on the next downwind leg Paul Collins in Moonlighter overtook by going close inshore. On board Wilkie all went well until the spinnaker was hoisted upside down which explains their still creditable fifth position out of eight.
In Q class John Hick, the owner of Jitterbug, helmed Macavity for the first time and so he was last on the windward leg but he improved on the off wind leg gradually learning how to maximise performance on this slippery high performance boat. I hear that it will be for sale at the end of the season.
In E fleet Hawk was over the line at the start but they returned and restarted and still had second place. Because of the short courses several classes after turning the windward mark hoisted the spinnakers for the run to the next mark but the direct line lead them back through the starting line while others were crossing in the opposite direction. In order to avoid an infringement of rules they were forced to reach across the line with the pole end on the fore stay, not easy in such gusty airs. One unfortunate found himself trapped upwind of a working boat and they lost a lot of ground before they succeeded in falling under the stern of the B class boat
This was the last race of the thirteen week Hine-Downing Series and these are these are the season's results.
Harold Martin
B class.
1st Victory. D. Carne.
2nd Moon. P. Selman.
3rd Rita. J. Peters.
E class.
1st Charley Farley. G. Hughes.
2nd Excelle. J, Fox &T. Claridge.
3rd Temeraire. M. Eddy.
Q class.
1st Encore. D. Cunliffe.
2nd Macavity. J. Murrell.
3rd Tresillian. J. Beavis.
G class.
1st Magpie of Mylor.
2nd Morwennel. N. Glanville.
3rd Dragonfly. M. Maguire.
U class.
1st Gap Year. L. Trenoweth.
2nd Mary Boon. J. Cruise.
3rd Wilkie. B. Chapple.
W class.
1st Wild Child. N. Chamberlain.
2nd Sweet Friday. L. Cheshire.
3rd Amneris. D. Layton.
V class.
1st Verity. N. Andrew.
2nd Whimsey. C. Perkins.
3rd Saucy Sally. J. Lowry & I. Heseltine.
M class.
1st Firefly. C. Gladwell.
2nd Cornish Meadow. S. Hutt.
3rd Crackerjack. M. Webb.


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Heather J. Carlson - postbulletin.com - While some southeast Minnesota Republicans are already pledging to vote for presumptive Republican nominee Donald Trump, others aren't ready to commit.
"At this point, I'm just going to wait and see what happens. I know that Trump is not a conservative. He's not a conservative on life. He's not a conservative on guns. He's not a conservative on a lot of issues," said Rep. Steve Drazkowski, R-Mazeppa.
Rochester GOP Sen. Carla Nelson hasn't made up her mind about Trump yet, saying she's been focused on the legislative session.
"I haven't given it any thought, to tell you the truth at this point. But I'm sure there will be plenty of time between now and Nov. 8 to give that some thought," Nelson said.
Sen. Jeremy Miller, R-Winona, had a similar response.
"I haven't thought that far ahead at this point. I'm worried about getting through the next two weeks of the legislative session," Miller said.
Trump's big primary win in Indiana on Tuesday cemented his status as the party's presumptive nominee. His two remaining opponents, Texas Sen. Ted Cruz and Ohio Gov. John Kasich, ended their presidential bids following Trump's win. In Minnesota, Trump's campaign struggled to take hold. He placed third in the state's Republican caucuses, behind Florida Sen. Marco Rubio and Cruz.
Some Republicans have been hesitant to declare support for Trump. Minnesota GOP House Speaker Kurt Daudt — a delegate to the national GOP convention — told reporters this week he's not ready to say whether he'll vote for Trump.
"I don't think you can say that I will support him or not support him. I'm not saying either one," Daudt said.
Nationally, U.S. GOP House Speaker Paul Ryan has said he's not ready to support Trump at this point.
Some say time to get behind Trump
Republican Party of Olmsted County Chairman Aaron Miller said the time has come for local Republicans to get behind Trump.
"I will tell you this: People are slow to warm to the idea in southern Minnesota," Miller said.
Nonetheless, Miller is urging his fellow Republicans to unite behind Trump. He wrote a letter-to-the-editor to the Post-Bulletin in March calling on Republicans to rally behind the New Yorker. He's also seeking to be a delegate at the national convention for Trump.
Miller added, "It comes down to this: Do you want Hillary or do you want a Republican?"
Several local Republicans said they are willing to vote for Trump because they can't support Democratic candidate Hillary Clinton or Bernie Sanders.
"Donald Trump was not my first choice, not my second choice and probably not my third choice, but the process worked, the people have spoken and I consider the alternative to be far worse," said former Rochester Rep. Fran Bradley, who is running for the House District 25B seat.
Rochester GOP Rep. Nels Pierson agrees.
"I certainly think Trump compared to Hillary Clinton is a positive alternative and certainly over Bernie Sanders as well, so I will be voting for him in the fall," Pierson said.
'Happy' to run with Trump
First District GOP candidate Jim Hagedorn said he has no problem supporting Trump if he's the party's nominee. Hagedorn hopes to defeat 1st District DFL Rep. Tim Walz in November. He said Republicans are offering a bold vision focused on securing the nation's border, defending America from radical Islam and reducing government bureaucracy.
"Whoever wins, I'm happy to run with. I'm focused on Tim Walz and showing the differences," Hagedorn said.
Byron GOP Rep. Duane Quam is also ready to cast a ballot for Trump if he's the party's nominee, saying that it's critical something is done to improve the nation's economy.
"We've got to do something to change things around," Quam said.
House Taxes Committee Chairman Greg Davids, R-Preston, said he's said from the beginning he'd support party's nominee and "I see no reason to change that position."
Toning down the rhetoric
Some Republicans are holding out hope that Trump will tone down his rhetoric as attention shifts to the general election.
"I think, at least I would hope, that Mr. Trump mellows out a little bit in subsequent months, and I think he will," said Rochester GOP Sen. Dave Senjem.
As for Drazkowski, he said he realizes that Trump may end up being the only option conservatives have because of the hope he will support at least some conservative principles. Still, he said the Republican party needs to do some serious soul searching about the future.
Drazkowski added, "I think us conservatives need to use these next four years to regroup and work to re-brand things."


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Drawing, "Project for a sedan chair", ca. 1775
type: Drawing
See all objects.
Shown from the rear right corner with two bars. The upper rim is waved. Leaf branches are at the corners and on top of the roof. Tassels hang at corners. The panels beside the window and the corresponding one at the back are decorated with garlands as frames and inside with an oval medallion with a standing woman, at the back an octagonal representation of a sacrifice, laterally. Above and below are roughly sketched ornaments. The lower panels have similar frames. Festoons are inside. They hang from knobs and respectively from a child's and a ram's head. The bar is decorated in the width of the chair.
Drawings, Prints, and Graphic Design


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Ballard Chalmers Ltd was established 10 years ago today, with the merge of the IT consultancies owned and managed by Geoff Ballard and Andrew Chalmers.
Our founders would like to thank all staff, clients and partners for the last decade, with Andrew saying in his blog, "It has been a great experience, and thankfully Geoff and I are not yet too old for another ten years, and so we look forward to seeing where the business and the custom software development sector is in 2025! I'm sure it will be even more interesting than the last decade!"


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"It wasn't easy," said Federer. "I thought Fritz had some good moments there. He gained control of the baseline, he had a little bit of an upper-hand at times. He served well and I was a little bit cautious, unsure of how to move and questioning my defence. These are the things I will need to iron out.
"I can take a lot of confidence out of this match. I need to improve a few things, but I served big and I was able to handle three sets over two days, and find some energy at the end of the match. I know I have an extra gear. My next goal is to stretch leads - once I get a lead, I need to know that I can protect it then take the next step."
The match resumed on Thursday with Federer leading Fritz 4-3 in the first set, following a rain suspension overnight. Fritz, who had previously played two Top 10 players, converted his fourth set point opportunity in the 12th game of the second set.
"It's always disappointing to take a loss, when you've come close and you've definitely had chances in the match," said Fritz. "I played great and if you'd told me before that I would have taken a set off Federer, I would have been happy."
Federer, who last played in a third-round Rome loss to Dominic Thiem, then missed the French Open, is building for another run at Wimbledon, where he is a seven-time champion.
He has now drawn level with Ivan Lendl on 1,071 victories, for the second-most match wins in the Open Era (since May 1968). Jimmy Connors is the overall leader with 1,256 victories.
1. Jimmy Connors - 1,256
2. Roger Federer - 1,071
2. Ivan Lendl - 1,071
4. Guillermo Vilas - 929
5. John McEnroe - 877
6. Andre Agass - 870
7. Stefan Edberg - 801
8. Rafael Nadal - 796
9. Ilie Nastase - 780
10. Pete Sampras - 762
Federer will play Florian Mayer in the quarter-final.
Date: 9 June 2016, Source: ATP and AFP


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The link to each free pattern is within each post, which may involve a free registration at some websites.
To make it easy to find a free pattern you'll enjoy following, all the patterns are ranked by difficulty level; Super-Easy, Easy, Medium & High.
Unfortunately, patterns are forever disappearing or links changing.
Please drop me a note if you have any problems :)
Wednesday, 23 March 2011
One Bad Egg
(geddit? devilled eggs? ok, not that funny)
{free pattern here}
6 comments:
Well, I thought it was punny, oh, I mean, funny. :PReplyDelete
These little suckers are cute, btw!
They´re so cute and funny looking :)ReplyDelete
Muy lindos!!! Gracias!!! :)ReplyDelete
rofl... thanks Nancy :DReplyDelete
I need major help with the instructions. . .I really think I'm a IDIOT! I just cant get it right and it seems so simple!!!ReplyDelete
What in particular did you need help with, Jenny?ReplyDelete
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The season of eating is upon us at last! Nonstop family and friend dinner parties with leftovers for a week. Treat yourself! You deserve it! But maybe now you're feeling motivated to work off all of those extra pie calories. Need another reason to stay fit this upcoming holiday season? I've got just the extra ...
Beyonce Shares New Video of Rumi and Sir with a Possible Vow Renewal
Beyonce and Jay-Z kicked off their On the Run Tour II on Wednesday in Cardiff, Wales, and gave fans a glimpse of intimate moments between the pair. During the concert, Beyonce shares new video of Rumi and Sir with a possible vow renewal and the beyhive went crazy. The Carters have mastered keeping her private life private until ...
8 Killer Summer Concerts To Get Pumped For
Less than two weeks for the start of summer. Yes! Wow, this year is flying by so fast. Some may look at summer as the time to sit back on a reclining beach chair, with a cold one in your hand, feeling the nice breeze. But we're more concerned with summer as the time to ...
10 Songs to Add to Your Gym Playlist ASAP
The weather is getting warmer and the pressure is on to tighten up for beach season. Now, I am a firm believer in every body being a bikini body, but plenty of us still want to get into tip-top shape for just ourselves. That being said, it isn't always easy. From your gym buddy cancelling ...
Coachella 2018: Women To Watch
In the wake of Beyoncé's absolutely epic, news-making Coachella performance, now is as good a time as any to uncover some more life-giving female talent to add to your playlists. Here are some women to watch, picked fresh from the Coachella 2018 lineup. Peggy Gou Berlin-based South Korean DJ Peggy Gou is absolutely masterful when it ...
4 Artists Who Should Try Another Genre
There's been a few times we've listened to our favorite artists sing a particular note or cover a particular song, and us as the listeners choose to question what if they take it a step further? What if they create an original work in a different genre, giving us a seamless gift of music? With ...
How Jay-Z's Failures Became His Comeback
Within an hour of Jay-Z's 4:44 dropping on TIDAL, people were already calling the album "Jay's Lemonade." This was inevitable, as some tracks appear to be his most confessional songs to date. For example, "4:44" — arguably the strongest track on the album and one of the best he's ever written — details in brutally honest lyrics any shortcomings in his relationships with his wife, children, and himself. Ultimately, this album tells the story of how Jay-Z's failures became his comeback.
Mother's Day: Our Favorite Celebrity Moms
Let's be honest: every day should be Mother's Day. Mothers should be celebrated for all that they do. However, with no disrespect to my mom at all (sorry in advance, Ma!), there are just some families I wish I could be adopted into. I can't be the only one; I see all the fans out there who comment "MOM" on a photo or tweet to their favorite celeb. I think it's safe to assume that there are just some lives we want to be part of even if it's 100% not possible.
The 59th Annual Grammy Awards Recap
Last night's 59th Grammy award show opened with Adele performing "Hello," sending off a warm welcome to the audience and viewers at home. Following Adele's performance, Grammy's host of the night, James Corden, held the audiences' attention with a dramatic tumble down the stairs, losing a shoe in the process. Immediately, we knew we were in for a crazy night.
Beyoncé Announces That She's Pregnant With Twins
Hello, February! New day, new month, new baby news?! Not just one baby, but two! In case you haven't heard, Queen Bey is carrying twins and Blue Ivy is going to be a big sister two times over as the Carters expand their family. This isn't the first time Beyoncé and husband Jay-Z have made the world stop with their baby news.
MTV Video Music Awards Recap
This year, the MTV Video Music Awards found its way back to New York City, but instead of using Radio City Music Hall as its classic venue, the show took place at Madison Square Garden for the first time. In recent years, the VMAs has not had a traditional host and this year was no different. Comedians Keegan-Michael Key and Jordan Peele were in character as social media mavens (because if you know anything at all, you know the best place to watch an award show is on Twitter) but none of their antics, most of which were impossible to follow, seemed to connect with the audience.
The Artists You Should Be Following on Instagram
This summer, Instagram has been swamped with pictures of celebrities, socialites, and our favorite artists. Instagram allows us, as the audience, to learn more about our favorite artists and connect with them on a human level. Disclosing behind-the-scenes pictures of their concerts, fabulous vacations bikini pics, and snippets of up-and-coming new songs, music artists have been using the top-grossing app to their advantage to accumulate followers, promote the release of albums, and products. From the reigning Instagram Queen Selena Gomez to the eccentric, lovable Tyler, the Creator, here are the artists you should be following on Instagram:


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The Strategic Brief
The 90 Day Strategic Brief is short (brief!), shares the critical and future orientated strategic thinking, and positions the organization with a picture in words of where the organization is heading and how each member can positively contribute to this future.
A key learning in leading an organization strategically has been the inability to communicate (both internally and externally) clearly the strategic priorities of the organization. The management theory of the last two decades has suggested that these priorities are communicated and internalized through a strategic plan.
A shorter, more concise paper is easy to understand and communicate. In practice this means that it should never be more than 2 pages and should be something that any employee can read and comprehend in less than 15 minutes. It would obviously be inappropriate (and hypocrisy to management consultants!) to call this a plan.


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I had an interesting thing happen this morning. I woke up in my bed at home, stretched, welcomed the day...and found a straight pin in my bed!!! I could have lost an eye!! Why in hell are there pins in my bed? What is my mom quilting in my bed when I'm not home??? I was very alarmed by this.
The cold is getting better its just in my chest. I will backing in fighting shape in no time. I have pics to post but they have to go up tomorrow.


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City of Medicine HatHome Menu
Medicine Hat Airport Safety Program
<< Back
The Medicine Hat Regional Airport is committed to providing a safe environment for employees, contractors, visitors and users. As a result, we have implemented a Safety Management System in accordance with the requirements of the Canadian Aviation Regulations.
Please use the form below to submit concerns relating to operational safety, security, workplace health and safety, or to make suggestions as to how we can improve. If you wish to submit anonymously please note that we will be unable to provide feedback to you regarding your concern.


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If there were no schools to take the children away from home part of the time, the insane asylums would be filled with mothers. ~Edgar W. Howe
- off to work.... gearing up for Back to School shoppers.. I love this time of year!!
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Gov. Bill Haslam, Economic and Community Development Commissioner Randy Boyd and 18 business leaders from Tennessee, including three from Knoxville, recently returned from a trip to Israel to "sell" Tennessee as a site for new business.
The biggest challenge, Boyd says, is that the only thing most Israelis know about the state is that it's the home of Jack Daniel's and Elvis Presley.
New York, California and even New Jersey are on the international radar. But Tennessee requires a sales pitch, and Haslam and Boyd did a great job, says Stephen Rosen, managing director of the institutional bonds division at Raymond James.
Rosen, one of several Jewish community leaders who traveled with the group to give cultural guidance, says the sales pitch would've worked on him.
"I'm ready to move to Tennessee," he laughs.
It was Rosen's fourth trip to Israel. All members of the state delegation paid their own way.
Israel is known for its large number of start-up companies, which Boyd partially attributes to an atmosphere of uncertainty created by political turmoil.
"To start a business is not a big deal in that culture. Risk-taking is natural."
Hard work and innovation also influence the business culture. STEM (Science, Technology, Engineering and Math education) is part of elementary school curriculum, and the military is heavily involved in research.
But Israel would rather be a growth nation than a start-up nation, he says. The goal of the trip was to encourage business owners to grow their U.S. market from Tennessee.
The state is welcoming, supportive, situated well logistically and economical to live in. But the biggest advantage may be Tennessee Promise. Two years of tuition-free community college or technical school for the state's high school graduates, which guarantees a future workforce, differentiates Tennessee, Boyd says.
The trip was a success on a number of levels. Boyd is confident that numerous meetings with potential business partners will eventually pay off with new jobs in Tennessee.
It was also inspiring, he says. Best practices were shared, and the group learned about Israel's success in technology transfer. They were also impressed with Israel's technical college system, ORT, and hope for future partnerships between ORT and the state's Colleges of Applied Technology.
He also values the relationships that developed among the Tennessee delegation.
Rosen was thrilled to have the opportunity to participate in the trip. The group visited a kibbutz north of Tel Aviv where Clinton-based auto-parts manufacturer MAG was founded. It's an example of how East Tennessee can successfully grow new business.
"We're part of the story, too. We're part of the Welcome Wagon."
The delegation got the royal treatment, he says. Haslam met with Israeli Prime Minister Benjamin Netanyahu and former Israeli President Shimon Peres, and he rang the opening bell at the Tel Aviv Stock Exchange.
One sight Rosen especially enjoyed was quiet streets with few soldiers. During the weeks that have passed since the trip, that's changed, he says.


text: Arts, Music, and Recreation › Music Tribute Songs That Sound Like Elvis Songs that imitate, impersonate, or pay vocal tribute to the King Share Flipboard Email Print RB / Staff / Getty Images Music Oldies Top Picks Major Artists Key Genres The 50s The 60s The 70s Rock Pop Alternative Music Classical Country Folk Rap & Hip Hop Rhythm & Blues Dance Music World Music Punk Music Heavy Metal Jazz Latin Music Children's Music Christian Music Music Education View More by Robert Fontenot Robert Fontenot Jr. is an entertainment critic and journalist focusing on classic rock and roll and published nationally for more than 25 years. Updated May 06, 2017 Seeing as how Elvis Presley was the biggest entertainer in history, it's no surprise that the record industry wasted no time in finding soundalike vocalists who could duplicate his sound. Some were good at it, and some weren't -- several early hillbilly boppers even stole his songs outright, like Sleepy LaBeef, whose "All The Time" borrows heavily from "That's All Right Mama," or Billy Barrix, whose "Cool Off Baby" is a direct steal on "Baby, Let's Play House." This list, however, compiles the greatest commercial and artistic successes of the men who, somehow, dared to play at being King. Even if only for a moment. 01 of 10 "The Girl Of My Best Friend," Ral Donner Michael Ochs Archives / Stringer / Getty Images Straddling the line between Elvis impersonator and hit original artist was Donner, who scored with this one in 1961. He's best remembered for his hit "You Don't Know What You've Got (Until You Lose It)," but this was the record that made him, and with good reason: it was a Presley album track. Only Ral, who'd been groomed as a "new Elvis" since Sammy Davis Jr. discovered him singing Elvis tunes on a Chicago teen dance show, could pull it off. Donner wanted to be his own man, but industry heads prevailed, and the British Invasion soon swept the old music away, leaving him with projects like the Sunset Boulevard-style narration on 1981's documentary This Is Elvis. Because Ral could not only sing just like the King, he could also speak like him! 02 of 10 "Such A Night," Vince Everett If the name sounds familiar, it's not because the man born Marvin Benefield ever made the Top 40. He didn't. But this cat sounded so much like Elvis -- more, his admirers say, than even Ral Donner -- that ABC-Paramount producer Felton Jarvis took the young singer and changed his name to that of Presley's character in the movie Jailhouse Rock. The original songs given Everett weren't very good, but he did wonders for covers like this one: given the slightly bouncier arrangement, this one almost beats The King at his own game. And this from a Brit! (Ironically, Jarvis would go on to produce Elvis' great comeback hits in the late Sixties.) 03 of 10 "Suspicion," Terry Stafford Another Presley album cut that became a hit for another singer, although this Doc Pomus-Mort Shuman mini-classic was arguably given a better, more wistful arrangement in this version. Something must have worked, anyway; Stafford, who did indeed sound a great deal like the King, managed to land a Top Five hit with this one while the Beatles were occupying the rest of that hallowed ground. Although Terry's life was cut short at 55 by liver disease, he spent the intervening years productively, gaining quite a bit of success as a Nashville songwriter -- he co-wrote George Strait's "Amarillo by Morning." 04 of 10 "I Can Help," Billy Swan As Elvis was the biggest recording star in the history of the world, quite a number of pop songwriters attempted to get their songs to him. Most of these attempts, rightly or wrongly, failed, leaving another artist -- or, in this case, the songwriter himself -- with the hit. Such is the case with 1974's "I Can Help," an excellent swamp-pop essay coming at the very tail end of the decade's Fifties revival. Oddly enough, Swan doesn't make any special attempt to emulate the King's delivery; although he, like every other similar artist, naturally carried a little Elvis around in his voice. This time, it's the song and arrangement that give the game away -- and Elvis liked both so much he eventually covered it. 05 of 10 "(It's Only) Make Believe," Conway Twitty Of all the Elvis clones that popped up in the late Fifties, Conway was of course the most talented, going on to become country and western's answer to Al Green with his seductive everyman persona. But it helps to remember that he was also the most popular of those teen idols for a while there -- after all, the Bye Bye Birdie play and movie, were both created around a fictional Elvis clone called "Conrad Birdie." And "Make Believe" is a superb ballad, not just a song crafted around a vocal range or style but a cut with the proper dramatics to stand up as a real Presley artifact. And before the advent of Gene Pitney's success (or Roy Orbison's re-invention), Twitty was probably the only other popular singer with that kind of gravitas. 06 of 10 "Crazy Little Thing Called Love," Queen Written by lead singer Freddie Mercury in his bathtub, this rockabilly quickie was a major shift away from Queen's signature operatic bombast and into a leaner, meaner sort of area. But avid fans of the band know that they experimented with wildly different genres almost as a matter of course; the real shocker in the authenticity department was Freddie's vocal, which manages to capture the spirit of Presley's rich baritone and sexy, swooping dramatics without ever sounding like a mere imitation. For this reason, it's a song that even Queen haters routinely admit they enjoy. 07 of 10 "The King Is Gone," Ronnie McDowell The first and longest-lasting of the immediate post-death Elvis tribute records, and surprisingly sincere and classy given the near-novelty nature of the genre. And singing it AS an Elvis song made it a truly remarkable feat, a chance for the King himself to say goodbye (at least a better chance for those fans who hate anybody's version of "My Way"). Unlike Donner, McDowell became his own man, escaping into country with the help of, ironically enough, Conway Twitty. But that didn't stop him from vocally masquerading as Presley in the TV-movies Elvis Elvis and Me Elvis Meets Nixon Elvis -- and he still does an Elvis tribute show today. 08 of 10 "Candy Store Rock," Led Zeppelin Hard-rock icons or no, Led Zeppelin were well known for their love of Fifties music, and indulged it quite frequently in concert with long medleys that often included Elvis' and other signature rockabilly tunes. Lead singer Robert Plant cited the King as a primary influence, too (along with Janis Joplin). So perhaps it wasn't surprising when, stuck for songs and running out of studio time, Plant simply lifted some phrases from old Elvis tunes, embroidered them into a weird knew thing, and let loose with his best King impression. Indeed, this track stays true to the spirit of Sun Records, despite being heavier and, well, more Zeppelinesque. Too bad it was written at a time when Elvis was more or less preparing to die. 09 of 10 "Young Love," Sonny James For someone who supposedly watered down black music and made it palatable to whites, Elvis had more than a hint of country in his voice; in fact, country artists almost universally had the easiest time replicating the King's style. A case in point is Soony James, who despite having some of the thunder stolen from him by Tab Hunter's bland cover, scored big with this Presleyesque ballad in 1956. In fact, this is the most traditionally country-sounding hit to sound like Elvis, and it opened the door for the likes of Marty Robbins and Ferlin Husky to establish a foothold for country in the pop charts. Everyone wins, especially James, whose way with a ballad earned him an astonishing 16 consecutive Number Ones on the other side of the fence. 10 of 10 "Turn Me Loose," Fabian The most notorious of the Elvis "tributes," this record was the classic example of an industry looking for a face first and a sound later. He looked the part, but Fabian Forte, at least at that time, wasn't much of a singer, so he depended on a lot of faux-dangerous Elvisian attitude to put the ruse over. In fact, the payola scandal of the late Fifties leaned very heavily on this record to "prove" that rock and roll was a fake art form, a scam perpetuated by people with no talent. History quickly reversed that decision, and Forte, who sings just fine now, headlines Dick Clark's Branson caravan of stars. Continue Reading


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I liked the cards because we were able to customize them exactly how we wanted them.
However, there were not enough envelopes for each card. Also, the thickness of paper was not what I expected. It was very thin. I would have liked a thicker card.
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XTRA LRGE Studio Apartment, Fully Furnished, All Bills Inc "St Andrews" Apt 605
Apartment, Melbourne City
Confirmation within 24hr
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Apartment 605
10 St. Andrews Place Melbourne – 'St Andrews'
Balcony with breathtaking views over city skyline
Free Tram Zone
120 m to Parliament Train Station
Rent also includes;
All furniture
Fully equipped kitchen
All housewares
Utilities connection and ongoing usage charges electricity, water & gas
All Linen and Towels
LCD television
Heating and cooling
Unlimited wi-fi is an additional $22 per week
Car park $70 per week
There is a once of exit clean fee of $250
Bond $2,500
Rent is paid every second Friday in advance
The location is unbeatable in terms of living, a fantastic lifestyle. The apartments are literally metres from the beautiful Fitzroy Gardens with its lush lawns and ponds.
The Paris end of Collins Street is also within walking distance for some shopping or perhaps just to window shop. As is the Burke St. Mall, Melbourne Emporium and Melbourne Central.
Restaurants, cafes, bars, cinemas, all on your doorstep
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Laszlo Nemes
Born in 1977 in Budapest, Hungary. After studying History, International Relations and Screenwriting in Paris, he started working as an assistant director in France and Hungary on short and feature films.
For two years, he worked as Béla Tarr's assistant and subsequently studied film directing at New York University's Tisch School of the Arts.
His shorts With A Little Patience, The Counterpart and The Gentleman Takes His Leave have been awarded 30 prizes (Angers, Bilbao, Odense, Lisbon) and participated in more than 100 international film festivals (including Venice, Palm Springs, Ghent, Gijon, Milan).
Son of Saul is Laszlo's first full length feature film, which premiered in Cannes' 2015 Official Competition, where it won the festival's Grand Prix.


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Some time between 21.00 hrs on 17/1/18 and 16.30 hrs on 18/1/18, unknown offender(s) accessed a farm on Breach Oak Lane, Corley. A shed and barn was entered and 2 strimmers and a mower was taken.
If you saw anyone acting suspiciously or have any information that could help the police with their enquiries please call 101 and refer to inc 373 of 18/1/18.


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John Berrymore is always a treat, he can really bring a performance all be this one is a bit underwhelming. The costumes, the set-design, the whole thing really has the potential but it just can't make it out of the gates. The transformation in the movie is amazing. Dr. Jekyll into Mr. Hyde is one of the better transformations and Barrymore didn't even have to use that much make-up. He is quite the character actor.
Watching the film for a second time made me realize that my dislike for the movie comes from the soundtrack. There is no musical change to set moods or even scenes. Long, pointless, songs are played with disregard to the things going on in the movie.
This won't be the last time we see these characters, or John Barrymore for that matter.


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Interaction Designer
0 people like this description
Our client is a global medical technology company focused on addressing many of the world's most pressing and evolving health needs. They are looking for an experienced Interaction Designer to join their team on a long term contract (to possible permanent) opportunity!
As a member of the User Experience Design team, the Interaction Designer will work with multi-disciplinary teams to strategize and apply strategic thinking to design and deliver innovative end-to-end user experiences that optimize among user needs, business goals, and technological realities for each project. Projects will include cloud-based software, websites, mobile applications for iOS and Android, and laptop software.
This position is extremely collaborative and requires a high degree of professionalism, communication skills, and mentoring ability. In some cases, candidates will visit hospitals to watch clinicians use the company's software to determine what can be designed to improve the customer experience.
• Drive and apply user-centered design processes while working collaboratively with cross-functional teams
• Effectively utilize and teach relevant user experience methods, such as how to apply a corporate design language, design frameworks, problem framing, design principles, and overall design thinking
• Ability to deliver UI specifications, wireframes, workflows, and high- and low-fidelity prototypes
• Build positive, collaborative relationships across teams/groups/functions through facilitative leadership
• Collaborate with key product stakeholders to understand the customer and support product design goals for existing and new products, and to ensure those goals are supported in the solution design
Required Skills
• Demonstrated track record of success designing software apps in a fast-paced, collaborative environment
• Ability to effectively communicate interactive and interface design data, design proposals, and product specifications and negotiate options at management levels.
• Ability to concisely critique designs and to translate customer feedback into design decisions
• Strong skills in creative design tools including Axure, InVision, Adobe Creative Cloud
• At least a basic level of understanding of HTML and CSS
• Broad knowledge of human factors principles, design standards and trends, and cross-platform development
• Success in following, applying, teaching, and maintaining a company product design language guide and ensuring that colleagues apply elements accurately with strong design thinking behind their decisions
• Proven success working in an Agile development environment and strong knowledge of how interaction and visual design are best utilized in a SCRUM environment
• Organized, self-directed, efficient, and able to manage multiple and complex projects in a timely manner
• Experience with the healthcare field and medical devices a plus
• Online portfolio available for viewing preferred
• Bachelor's or Master's degree in User Interface Design, Cognitive Science, or equivalent
• Minimum 6 years of experience working as a senior-level interaction designer or interaction/visual designer


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Software Developed by Wade Schuette
Auto C is used to create user interfaces in the C programming language. Create the skeleton for a generic SDK C Windows application by drawing controls on a form. Use a toolbox, properties box and property pages in a visual-style WYSIWYG environment.
- AutoC_Setup.exe
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- Freeware (Free)
- 890 Kb
- Win2000, WinXP, Win7 x32, Win7 x64, Windows 8, WinServer, WinVista, WinVista x64


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From Cox & Forkum:
Explain to me how Michael Moore's words support the troops but not the war. I believe that you can support the men and women in Iraq while opposing their mission, but this isn't doing so. When I wrote about this very subject yesterday, I was unaware of Moore's words.
Shameful. (via Instapundit)


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Comunidad Oma, Comarca Ngäbe-Buglé, Panama, August 2013
I interviewed Cynthia (17 years old) at her school in the indigenous territory "comarca" of the Ngäbe-Buglé peoples Panama, where she lives. She had previously migrated temporarily to Costa Rica to harvest coffee. I asked her about the experience.
Cinthya's story
"I was born and raised in Cerro Balsa. I walk two hours to and from school every day. I went to Costa Rica when I was ten years old, with my seventeen year-old brother. I am seventeen now. I don't remember what the name of the place is, but it was not close to the border, it was more up north. Yes, San Marcos. My brother had already gone coffee harvesting once.
What my parents said about it, that I went? Nothing, they said: "All the best to you there." Yes, they were proud. They did not say anything.
It was good in Costa Rica. I remember the finca it was nice. The house was nice. It was of tabla, wooden planks. We slept on mattresses. There was no water and electricity though and we shared with a lot of people. I did not like that. I don't like to live like that. I got along well with them, but I did not like it.
I felt good on the finca. You want to know how I felt?", she asks. I said: "Like, happy, sad, annoyed…". She answers: "Ah, happy. Always. Yes, I too have been sad, because I wanted to return to the comarca, because there were many people. I missed my family but I was not really sad because of that. Yes, I have been scared too, when I was alone at home. That happened a lot. I was scared because I did not like to be alone in the house. That happened often, in the afternoon or on Sunday. My brother would go to buy food. I did go with him sometimes. "


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SEC's 2016 Whistleblower Program Awards over $57 million - Tips Up 40%
6th December 2016
On November 15, 2016, the Securities and Exchange Commission ("SEC") released its Annual Report on the Dodd-Frank Whistleblower Program for the 2016 Fiscal Year ("FY"), which ended September 30, 2016.
The report showed that since the beginning of the whistleblower program in August 2011, the SEC has awarded more than $111 million to 34 whistleblowers and that in FY 2016 alone, the SEC issued awards totaling over $57 million, which is more than all awards issued in the previous years combined.
According to the report, the ten highest awards made by the SEC to whistleblowers have each totaled more than $1 million, with the largest exceeding more than $30 million. FY 2016 also included six of the ten largest awards being made.
The report stated that the whistleblower program has had a transformative effect on the SEC's enforcement program. The program has not only provided whistleblowers with protections and financial rewards, but it has also strengthened the SEC's enforcement efforts and aided harmed investors. According to the report, due to the information and cooperation from whistleblowers, hundreds of millions of dollars have been returned to investors and has led to successful enforcement actions in which over $584 million in financial sanctions was ordered, including more than $346 million in disgorgement of ill-gotten gains and interest.
The report also highlighted that for each fiscal year since the inception of the whistleblower program, the SEC has received an increasing number of whistleblower tips, including 4,218 tips from all over the world in FY 2016, which is more than a 40% increase over the 3,001 tips reported in FY 2012, the first full year of available data.
A copy of the SEC's FY 2016 report can be found here:


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Remington 700 STS Tactical 16.5" .308 Rifle
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Firearms must be shipped to an FFL dealer in your state. Firearm Returns: upon arrival at your FFL dealer you will have a 3 business day inspection period to return/exchange firearm. Once your FFL transfers the firearm no returns will be accepted.
It is your responsibility to verify state and local laws / restrictions for any other applicable firearms and ammunition regulations.


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Take a Peek at Carine Roitfeld's Next Uniqlo Collaboration
According to Harper's Bazaar, fashion icon Carine Roitfeld will be collaborating again with Uniqlo for another line of affordable, high-style clothing. This collection, coming out February 11, 2016, will include black and camouflage as the first did, but will also add a sexy Parisian flair to clothing you can wear in the workplace.
Check out the video below for a sneak peek of the new Carine Roitfeld x Uniqlo collaboration!
Shop the most recent Carine Roitfeld x Uniqlo collaboration!
What other designers would you like to see Uniqlo collaborate with? Tell us below!
Opening image: Uniqlo


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Jackpot City Mobile Casino has made its biggest move yet, launching new software for Apple's iPad that will allow customers to enjoy all their favorite games.
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