text:
CCI welcomes you!If you, your family member, or someone you know needs health care, call the numbers below for an appointment, or stop by any location for information or to make an appointment at the front desk. CCI encourages appointments so you have reserved time to receive the attention you need. Walk-ins are welcome and will be seen as the schedule allows. Community Clinic services are available equally to all patients regardless of their ability to pay.
** Tips for Your First Appointment **
Bring the following:
Picture ID
Insurance Card (If applicable)
If you do not have health insurance, you will be asked to pay on a sliding scale fee, which is based on your income and household information. Please bring the following documents with you:
Proof of Address:
Utility Bill (gas, water, electricity, or cell phone)
Or a notarized letter from your landlord
Proof of Income:
Two recent pay stubs or a notarized letter from your employer.
If you are not employed, you should bring proof of unemployment or a notarized letter from the person who supports you.


text:
Ask electrician Willa Cantillon if she's feeling strong today.
"I'll say, 'Yeah, I feel strong every day,' " Cantillon said. "I was born strong. I have good genes."
That's a good thing because the 53-year-old San Francisco native prefers big jobs.
She helped install the huge steel trays that carry power cables and conduit beneath the travel decks of the new eastern span of the Bay Bridge.
"I liked it," the San Francisco native said. "When I was young and we would be driving home, we were always so happy to see the Bay Bridge because it meant we were about to see the fog and get out of the heat."
The youngest of five children born to Irish immigrants, Cantillon wanted to be a firefighter. But she was drawn to construction after she took a job as a bank's first maintenance worker. Cantillon signed on as an electrician's apprentice and never looked back.
She has a good-paying job, benefits and a pension. And she has had a hand in building the Bay Area. In addition to the bridge, she helped restore San Francisco City Hall and is working on the city's new $90 million cruise ship terminal.
Cantillon credits her parents.
"When I told my mom I signed up for the electrician's program … she didn't say, 'What are you doing trying to get a man's job?' " she said. "My dad was happy. He needed his house rewired!"
— Lisa Vorderbrueggen
Job: Electrician for 23 years, International Brotherhood of Electrical Workers Local 6 in San Francisco
Age: 53
Residence: San Francisco
Bay Bridge work: She installed steel trays for power cables and conduit beneath the self-anchored suspension span decks in spring 2010.
Job advice: "Do it. Don't let old stereotypes stop you. There are a few dinosaurs around but things have really improved for women and the unions are very supportive. It's a brotherhood but it's a sisterhood, too."

subset: commoncrawl


text:
Having problems with your Leica M9 Digital Camera ?
When turned on and off quickly sometimes the red light does show and the camera will not operate is this a fault or is it because its like a computer re setting itself i never had this happen with the m8
Answers :
Repair Help & Product Troubleshooting for Leica M9 Digital Camera
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Suggested Questions/Answers :
When turned on and off quickly sometimes the red light does show and the camera will not operate is this a fault or is it because its like a computer re setting itself i never had this happen with the m8
... Leica M9 Digital Camera
Blue Hue I have 2 A345 cameras. One is continually taking pictures with a very blue hue to them, useless as a photo, whilst the other camera with same settings takes great pictures. This happens whether indoors or outdoors in a good light. The camera has been back under warranty with no fault found. If I have pictures like this, how can it be no fault found. To demonstrate exactly the blue hue go to web page http://1sourpuss.blogspot.com/2007/05/hoses-trucks-muscles-oh-my.html It is exactly like
Make sure your White Balance is set to Auto! ... Fuji FinePix A345 Digital Camera
I have a Coolpix Nikon L1 and everything works fine with the camera except when I try to transfer the pictures over to the computer. It used to let me but I would still have to run them through other programs because it never automatically comes up like it used it. I have already tried going through the set-up menu on the camera and did everything it told me to and it still does not work. Any solutions?
If you're using the software provided, there may be settings for automatic download. Check the pc settings of the software you're using. ... Nikon Coolpix L1 Digital Camera
I have had a Nikon CoolPix L110 for 10 months. I've never encountered a problem transferring pictures from my camera to my computer during this time...until now. When I connect my camera using the USB cable, Nikon Transfer opens as usual, but nothing happens after that. The source is not showing the camera. The camera works fine. I can view and take pictures. However, the difference this time is that my camera is full. Could that have something to do with it? I would like to be able to
Welcome to FixyaTry the alternate way of transferring the pictures to your computer instead of using cable. To download pictures from your camera to your computer involves removing the memory card from the camera a ... Nikon Coolpix L110 Digital Camera
Pics on my My Nikon S600 will no longer download on to my computer via the USB cable. The 'Photo Wizard' (or similar name) pops up but immediately goes away again and a message comes up saying that the devices are not properly connected. This never used to happen. My Microsoft Outlook email has also started to open then go away immediately. I have restored all my settings but don't know what's wrong. Google etc still fine. Any clues as to waht i can do?
A couple of suggestions here, if you have recently switched to using WIndows 7 you will have to download drivers for your Nikon so they can read itl. \015\012If you have not changed any of your software or using the same computer, your ports mi ... Nikon Coolpix S600 Digital Camera
I cant download my pictures from my camera to my computer. i can take pictures no problem. iv used different computers. but wont show up in "my computer" when i plug in the usb the green light comes on like its charging, i turn it on and the light flickers like its going to open onto my computer but never dose.
Possible solutions:Remember you need to turn the camera on when transferring.\015\012Try a different USB outlet\015\012Try a diferent cable\015\012Try a different computer.\015\012\015\012If all fails.\015\01 ... Kodak Easyshare M753 Digital Camera
Each time I switch my Casio Exilim ex-fc100 camera on, the set time and date menu appears and my previous setting are lost (like photo resolution, flash setting and so on) like it is re-set everything. This happens even if I do not remove the battery. Can you help me, please? Max [email protected]
... Casio EXILIM EX-FC100 Digital Camera
I have a Samsung PL100 (Dualview). I'm having trouble uploading my photos to my computer using the USB. I have installed the CD that came with the camera (InteliStudio) and when I connect the camera and computer with the USB cord, the red indicator light lights up. However, nothing else happens. The User's Manual says that it should automatically connect and the computer should be able to recognize it. It doesn't. I have tried different settings in the Menu and still nothing happens. Please help
I find that alot of times using the camera to unload your pictures to your computer is more trouble them you need to worry about. i say you just pull out the SD or SDHC card and plug that into you computer. if you dont have an SD or SDHC card reader ... Samsung DualView TL205 / PL100 Digital Camera
I had my mp4 player hooked up to my computer, I did a few things like deleted a few songs and I also moved a few folders into other folders. Now, when I turn it on, it just shows the main screen and won't go into my music or move to anything else, like the radio for example. It's like it's locked. All the music is still on it according to my computer and I tried undo-ing everything I moved but still nothing. I don't know how to unlock it if it is locked, I was never given that when I purchased i
... Digital Cameras
When I upload pics they come out funny on the computer. It looks like the picture was cut in half and put back together or I should say put back like a puzzle and arm here and a head here it is like they do not line up. Is that a camera problem or a computer problem. The pics look fine on the camera. It is once they are uploaded is when the problem happen. I have Windows XP I just need an answer I am frustrated.
As an experiment, take the card to a store like Walmart that has a Kodak Picture Kiosk machine. Insert the card and print a couple of the pics. Are they ok? If so, the problem lies with your computer. ... Nikon COOLPIX L4 Digital Camera
I would like to set up 3 webcams at my cottage (very close to city) because of thefts. My ideal objective would be for my family or me to be able to view pictures from any of our various home, office and school computers online in near real time. My question - is it possible for the cams to feed through a wireless router and modem directly on to the net without an intervening computer? We have lots of electricity and a permanent cable/internet connection. I can use my computer for set-up but am
I agree IP cameras are great but are still expensive. A dedicated CCTV DVR connected to your network is the proper solution. These can be found online and will cost the same as a multiple IP camera set up. You could also use a PC with video captur ... Digital Cameras
When i plug my usb into my computer to put photos on nothing happens. this has never happened before ive had the camera for 1.5 years. there is nothing wrong with my computer as it works for my ipod and my sisters camera usb
I have had this problem with Canon cameras, it seems to be a bug in their software. What make and model is your camera?\015\012\015\012My solution was to manually open the camera transfer software, and manually select all images for down ... Digital Cameras
Hello. So this is my problem: I have the CD's and the cable from my panasonic dmc fz18. I instaled the drivers from the cd but when I connect my camera to the pc nothing happens. On my computer I don't get the warning that I insert a USB cable and on my camera nothing happens. it like there is no cable in it. i can take pictures, record..do anything with the cable connected to my computer. It used to work.. Is there an option in the camera menu? maybe i did something in the menu..or mayb
Please downloaded it here :\012www2.panasonic.com/consumer-electronics/support\012\012 ... Panasonic Lumix DMC-FZ18K Digital Camera
I have a Canon A700 powershot. For some reason the camera is not automatically downloading the photos to my computer. I have reinstalled the software to the computer but when I connect the camera to the computer the blue light on the camera denoting download capability no longer comes on and the computer whilst sound prompting the connection does not appear to be recognising/connecting the camera to the computer. This is a recent problem. Is it likely to be a fault with the camera, computer
Consider NOT connecting your camera to your computer.\012\012\012The best way to download pictures from your camera to your computer involves removing the memory card from the camera and plugging it into a card reader (either built-in to ... Canon PowerShot A700 Digital Camera
Blurry Pictures I would like to know how can I get the perfect picture because when I throw the picture it looks fine sometimes then when I enter them into my computer & zoom in, it looks blurry like a fake picture I mean this camera cost me $350 and it doesn't seem to be worth it. I would like to know what settings I have to use for normal daily pictures at my house. Sometimes I take a picture and in the camera it looks like a different color than the actual color doesn't real so I would like t
This camera should still be under warranty, so if it's not focussing correctly then let Sony fix it. Before doing so, check that you haven't accidentally left the camera set to macro (close-up focussing) mode. ... Sony Cyber-shot DSC-T700 Digital Camera
I bought a digital camera from Ebay. I have NEVER done this before and have no idea how to send my pictures to the computer. I used the camera but want to copy them to computer so I can send to friends via email. I have a HP photosmart E 317 and a card in the camera, I bought a cord connecting to computer. When plugged in to computer nothing happens. I know I am dumb but I am 53 yrs age and learning a new skill. Thank you for any assistance you can give. Oh I also do not have a manual.
Okay first here is a link and it's a biggy for a PDF manualhttp://www.google.ca/webhp?hl=en#hl=en&source=hp&biw=1383&bih=834&q=HP+photosmart+E+317+PDF+Manual&aq=f&aqi=&aql=&oq=&gs_rfai=&fp=6a0673dc5c3f3912Copy and past into yo ... Digital Cameras
Aperture Error My camera is displaying a code 0x58. I spoke with the Sony representative, and she said it is actually 0x5B, but it really looks like an 8. Anyway she said the error means a problem in the aperture programming. She had no idea what would trigger such a thing to happen or how to prevent it from happening again. We will have to pay $228 to send it in for repair with no reassurance it won't happen again. We take very good care of the camera. Never banging it around, letting dust or r
This blog will clear up what is going on with the camera and you can send it to them to fix also. www.teleplancamerarepair.com\015\012Their blog steps you through ... Sony Alpha DSLR-A100 Digital Camera
I have the Samsung HZ35W camera and I can't set up the gps in the camera. I am not good at downloading and I had 2 people that know alot about computers and they couldn't get it. I need assitance in setting this up in simple terms. Please help. I would really like this set up in my camera. Thank you.
... Samsung HZ35W Digital Camera
Downloading pictures I have a canon power shot s31s. I have downloaded all the software previously on my home computer with no dramas. I have been using the camera constantly while on holidays with no problem (downloading pics) to my laptop, but now that i am back home, i went to download pictures to my home computer and it doesn't find the camera when i hook it to the computer?? I have never had this happen before. When i do a search it doesn't find the camera and i have uninstalled the program
You can always use a CF card reader to download the pics to your pc... thats one way out and is much faster.. \015\012\015\012but try this... \015\0121) uninstall the software... \015\0122) Reboot PC... \015\0123) instal ... Canon PowerShot S3 IS Digital Camera
Transfers I have a hp 733 photosmart 3.2 MP with a 3x optical zoom. I have pictures on the camera but would like to transfer them to my computer. I lost the book (yeah I know!). When I go into the my computer hp photosmart is there, I click on that and there is a box that says get pictures from camera. When I click on that nothing happens. The camera says "connected to computer". Brenda K. Nummer [email protected]
The best way to download pictures from your camera to your computer involves removing the memory card from the camera and plugging it into a card reader (either built-in to the computer or connected via USB or FireWire). This is likely to be faster t ... HP Photosmart 735 Digital Camera
Downloading pictures I have a canon power shot s31s. I have downloaded all the software previously on my home computer with no dramas. I have been using the camera constantly while on holidays with no problem (downloading pics) to my laptop, but now that i am back home, i went to download pictures to my home computer and it doesn't find the camera when i hook it to the computer?? I have never had this happen before. When i do a search it doesn't find the camera and i have uninstalled the program
I think the USB driver in your laptop is malfuntioning.\015\012Try the following step.\015\0121. Press windows+Pause Key\015\0122. Click on device manager\015\0123. Check if there is any ? sign in USB drive.\015\0124. If ... Canon PowerShot A75 Digital Camera
No response When I connect my Pentax E10 to my desktop or to my laptop, the camera turns on (the lens comes out) and the computer won't read it! I'm dying because I love my camera! I've had it for over a year and this is the first time this happens! I haven't dorpped it, I never lend it to anyone, nothing different has happened to it! Help!
Consider NOT connecting your camera to your computer.The best way to download pictures from your camera to your computer involves removing the memory card from the camera and plugging it into a card reader (either built-in to the computer ... Pentax Optio E10 Digital Camera
Battery Problem My 18-month-old Canon A70 is giving "change the battery pack" message and turning off constantly, even though I have fully charged three different sets of new rechargeable batteries and rotate them as soon as the message comes on. Sometimes with this message I pull out one charged set and put the same back in, and it works fine for quite awhile, then repeats later. I imagine this is a problem in the camera battery power circuit or something. Never happens when plugged into the co
I figured out the problem. My AA battery recharger was not making good contact, so although it said the batteries were recharged, this was not the case. After fixing this and getting full recharges, the problem went away. ... Canon PowerShot A70 Digital Camera
My Cannon Power Shot A520 Camera will not power the lens up when I turn it on. I get the message "No Image" on the viewing screen, but nothing else happens. Back Switch is set on camera symbol, but camera acts like it is set on view. I have installed new batteries and battery terminals are clean.
The camera may need a software update which can be done through manufacture for $50 or you can downlaod an update from their website and follow the directionsOr the zoom may be dirty or debris is stuck in the zoom lens and needs to be blow out ... Digital Cameras
My Sony DSC-T200 also vibrates periodically. I've never dropped it, and 90% of the time, its functioning just fine, but once in a while (usually for the duration of a whole event that I'd like to take pictures at), it vibrates very much like a cell phone with ringer set on vibrate. It seems to be the autofocus lense since the focus of the picture is also oscillating with the vibration. Is there a tooth on a gear broken or something? Is this camera prone to this? Should I avoid Sony DSC cameras i
On Sony T100 and similar, its the vibration canceling unit, i had the same problem.if you have good hads you can fix it.( on your oun risk)1) disasamble the camera, you will see black plas ... Sony Cyber-shot® DSC-T200 Digital Camera


text:
|Biofeedback as a Treatment of Urinary Incontinence in Adults
|Medical Policy
|Last Review Status/Date
Reviewed with literature search/7:2014
|Original Policy Date
|Return to Medical Policy Index
Our medical policies are designed for informational purposes only and are not an authorization, or an explanation of benefits, or a contract. Receipt of benefits is subject to satisfaction of all terms and conditions of the coverage. Medical technology is constantly changing, and we reserve the right to review and update our policies periodically.
Biofeedback is a technique to teach patients self-regulation of physiologic processes not generally considered to be under voluntary control; a variety of approaches and devices are available. Biofeedback, in conjunction with pelvic floor muscle training (PFMT), is proposed as a treatment of urinary incontinence.
Urinary Incontinence is a common condition defined as an involuntary leakage of urine. Women are twice as likely to be affected as men, and prevalence increases with age. The severity of incontinence affects quality of life and treatment decisions. The types of urinary incontinence include stress, urge, overflow, functional, and postprostatectomy incontinence. Nonsurgical treatment options may include pharmacologic treatment, pelvic muscle exercises, bladder training exercises, electrical stimulation, and neuromodulation.
Biofeedback is a technique intended to teach patients self-regulation of certain physiologic processes not normally considered to be under voluntary control. The technique involves the feedback of a variety of types of information not commonly available to the patient, followed by a concerted effort on the part of the patient to use this feedback to help alter the physiologic process in some specific way. Biofeedback has been proposed as a treatment for a variety of diseases and disorders, including anxiety, headaches, hypertension, movement disorders, incontinence, pain, asthma, Raynaud disease, and insomnia. Biofeedback training is done either in individual or group sessions and as a single therapy or in combination with other therapies designed to teach relaxation. A typical program consists of 10 to 20 training sessions of 30 minutes each. Training sessions are performed in a quiet, nonarousing environment. Subjects are instructed to use mental techniques to affect the physiologic variable monitored, and feedback is provided for successful alteration of the physiologic parameter. This feedback may be in the form of signals, such as lights or tone, verbal praise, or other auditory or visual stimuli.
Biofeedback, in conjunction with PFMT, is a possible treatment modality for stress, urge, mixed, and overflow urinary incontinence because it may enhance awareness of body functions and the learning of exercises to train pelvic muscles. There are several proposed methods of biofeedback that may be employed for the treatment of urinary incontinence, including vaginal cones or weights, perineometers, and electromyographic (EMG) systems with vaginal and rectal sensors.
The various forms of biofeedback mainly differ in the nature of the disease or disorder under treatment, the biologic variable that the subject attempts to control, and the information that is fed back to the subject. Biofeedback techniques include peripheral skin temperature feedback, blood-volume-pulse feedback (vasoconstriction and dilation), vasoconstriction training (temporalis artery), and EMG biofeedback; these may be used alone or in conjunction with other therapies (eg, relaxation, behavioral management, medication).
Regulatory Status
A variety of biofeedback devices are cleared for marketing though the U.S. Food and Drug Administration's (FDA) 510(k) process. FDA defines a biofeedback device as "an instrument that provides a visual or auditory signal corresponding to the status of one or more of a patient's physiological parameters (e.g., brain alpha wave activity, muscle activity, skin temperature, etc.) so that the patient can control voluntarily these physiological parameters". FDA Product Code: KPI.
Biofeedback in the outpatient setting is considered investigational as a treatment of urinary incontinence in adults.
Unsupervised home use of biofeedback for treatment of urinary incontinence is investigational.
Policy Guidelines
Benefit Application
Blue Card/National Account Issues
State or federal mandates (e.g., FEP) may dictate that all FDA-approved devices, drugs, or biologics may not be considered investigational, and thus these devices may be assessed only on the basis of their medical necessity.
Biofeedback and biofeedback devices are specifically excluded under many benefit plans. In addition, biofeedback and biofeedback devices are considered behavioral training and education/training in nature, and such services are also specifically excluded under many benefit plans..
This policy was originally created in 1997 and was updated regularly with searches of the MEDLINE database. Most recently, the literature was reviewed through April 25, 2014. Following is a summary of the key literature to date.
As acknowledged in a 1995 TEC Assessment on biofeedback for various indications, there are several methodologic difficulties that arise in assessing biofeedback.(1) For example, most interventions that include biofeedback are multimodal and include relaxation and behavioral instruction, which may have effects separate from those that may occur due to biofeedback. While studies may report a beneficial effect of multimodality treatment, without appropriate control conditions, it is impossible to isolate the specific contribution of biofeedback to the overall treatment effect. For example, relaxation, attention, or suggestion may account for successful results that have been attributed to biofeedback. These effects are nonspecific therapeutic factors, some of which can be considered placebo effects. To demonstrate efficacy of biofeedback for treating incontinence, studies are therefore needed that isolate the effect of biofeedback and demonstrate an improvement in health outcomes compared with other interventions such as relaxation or behavioral therapy alone. In addition, although studies in the 1990s found that feedback on physiologic processes provided patients with an enhanced ability to control these processes, evidence is needed on the relationship between a patient's ability to exert control over the targeted physiologic process and any health benefits of the intervention. The latter finding underscores the importance of seeking controlled studies showing whether use of biofeedback improves disease-related health outcomes, as opposed to physiologic, intermediate outcomes.
Women with Urinary Incontinence
A number of randomized controlled trials (RCTs) addressing biofeedback for urinary incontinence have been published, and there are several systematic reviews of RCTs. In 2012, an Agency for Healthcare Research and Quality comparative effectiveness review was published.(2) The review identified 6 RCTs with a total of 542 patients comparing pelvic floor muscle training (PFMT) including biofeedback with PFMT alone. A meta-analysis of these studies did not find a statistically significant difference between interventions in continence rates. When findings of the studies were pooled, the relative risk (RR) was 1.27 and the 95% confidence interval (CI) was 0.88 to 1.85. The absolute risk difference was 0.08 (95% CI, -0.03 to 0.19).
A 2011 Cochrane systematic review of RCTs included studies on feedback or biofeedback in conjunction with pelvic PFMT for treating urinary incontinence in women.(3) To be included in the review, trials needed to study women with stress, urge or mixed incontinence, and needed to have at least 2 arms with PFMT and at least 1 arm with feedback and/or biofeedback. Feedback was defined as verbal feedback by a clinician, whereas biofeedback involved use of an instrument or device. After examining 36 full-text articles, 24 trials were found to meet the review's eligibility criteria and 17 contributed data to the analysis of at least 1 primary outcome measure. Sixteen of the 24 trials included a comparison of PFMT plus biofeedback with PFMT alone; 9 of these included the same PFMT programs in both groups. The primary outcomes of the review were quality of life and improvement or cure. Nine trials used one of several validated quality-of-life instruments; however, only 4 of these reported data in a form that could be used for meta-analysis. Thus, quality-of-life results were not pooled. Data were pooled for the other primary outcome, improvement or cure, but there were a sufficient number of studies only for the comparison between PFMT with and without biofeedback. In a pooled analysis of 7 studies, there was a significant reduction in the proportion of women reporting 'no improvement or cure' when biofeedback was added to muscle exercise (RR=0.75; 95% CI, 0.66 to 0.86). The authors noted that there may have been other differences between groups, such as more frequent contact with a health care professional or a greater number of treatment sessions, which might partially explain the difference in the improvement or cure rate in women who did or did not receive biofeedback. Moreover, when only the outcome 'no cure' was examined, there was not a significant difference between groups that did and did not receive biofeedback (5 studies; RR=0.92; 95% CI, 0.81 to 1.05). Among secondary outcomes, a pooled analysis of 7 trials did not find a significant difference in leakage episodes in a 24-hour period after treatment (mean difference, -0.01; 95% CI, -0.21 to 0.01). For the outcomes frequency and nocturia, data could not be combined but the review authors reported that the pattern was one of no difference between groups.
As noted in the description of the Cochrane review, previously described, studies evaluating biofeedback for treating urinary incontinence in women have used various combinations of interventions and a variety of comparison interventions. Selected larger RCTs that compared PFMT with and without biofeedback (ie, attempted to isolate the effect of biofeedback) and that were published as full articles are described next.
Burgio et al published a study in 2003 reporting on findings of a RCT with 222 women who had urge or mixed incontinence.(4) Interventions in this 3-armed trial were as follows: (1) n=74 patients who received behavioral training along with digital palpation instruction (no biofeedback) and 4 office visits in 8 weeks; (2) n=73 patients who received biofeedback-assisted behavioral training and 4 office visits in 8 weeks; and (3) n=75 patients who were given a self-help book with no office visits (control condition). Behavioral training in the 2 intervention groups included teaching pelvic floor exercises, as well as skills and strategies for reducing incontinence. Patients in all groups kept bladder diaries through the 8-week treatment period. In an intention-to-treat analysis, the mean reduction in incontinence episodes was 69.4% in the behavioral training plus verbal feedback group, 63.1% in the behavioral training plus biofeedback group, and 58.6% in the control group. The 3 groups were not significantly different from one another (p=0.23). In addition, quality-of-life outcomes were similar in the 3 groups.
In 2006, Williams et al in the U.K. published a study that included 238 women who had failed a primary behavioral therapy (eg, advice on fluid intake, bladder reeducation, weight loss) for 3 months.(5) They were randomized to receive intensive PFMT (n=79), PFMT using vaginal cones (n=80), or continued behavioral therapy (n=79) for 3 months. Patients in all 3 groups were seen in the clinic every other week for 8 weeks and also at 12 weeks. At 12 weeks, all 3 groups had moderate reductions in incontinence episodes and some improvement in voiding frequency; there were no statistically significant differences in outcomes among the 3 groups. For example, mean reduction in incontinence episodes over 24 hours was -1.03 in the PFMT group, -0.28 in the vaginal cone group, and -0.59 in the control group (p=0.2).
Several RCTs comparing the efficacy of PFMT alone with PFMT with biofeedback were published in 2012 and 2013.(6,7) These studies tended not to find statistically significant differences in outcomes between interventions; however, sample sizes were small (ie, <25 per group) and thus the studies may have been underpowered.
Section Summary
Numerous RCTs have evaluated biofeedback as a treatment of urinary incontinence in women. The methodology of the studies has varied, and many were not able to isolate the potential contribution of biofeedback. A comparative effectiveness review did not find a statistically significant difference in continence rates when patients were treated with PFMT with biofeedback and PFMT without biofeedback. Previously, a Cochrane review evaluating biofeedback and/or verbal feedback as part of treatment for urinary incontinence found improvement in some outcomes (eg, improvement or cure) but not others (eg, cure, leakage episodes). There is a lack of consistent evidence from well-designed trials that biofeedback is an effective treatment of urinary incontinence.
Men With Postprostatectomy Urinary Incontinence
Several RCTs evaluating biofeedback to treat postprostatectomy urinary incontinence have been published. In addition, there have been several systematic reviews of RCTs.
In 2007, a systematic review of PFMT to improve urinary incontinence after radical prostatectomy was published by MacDonald et al.(8) The review identified 3 studies (281 men) that compared biofeedback and PFMT with muscle training alone (written/verbal instructions provided). Study findings were not pooled; none of the individual trials found a statistically significant difference in outcomes between groups. In 2012, a Cochrane review was published on conservative treatments for postprostatectomy urinary incontinence.(9) The review included a comparison of PFMT (with or without biofeedback) and sham or no treatment. It did not include an evaluation of the potential added value of biofeedback, ie, by comparing PFMT with biofeedback and PFMT without biofeedback.
Representative relevant RCTs are described next.
A 2013 trial by Dijkstra-Eshuis et al in the Netherlands evaluated the impact of preoperative PFMT and biofeedback on postoperative stress urinary incontinence in men undergoing laparoscopic radical prostatectomy.(10) Patients in the intervention group received 4 weekly sessions of biofeedback-assisted muscle training before surgery. Patients assigned to the control group did not have a presurgical intervention. The primary outcome was the rate of continence 1 year after surgery. The investigators originally planned to enroll 248 patients. However, an interim analysis after 122 patients were enrolled showed no significant benefit for the intervention group, even if the trial was completed as planned and therefore the trial was halted prematurely. Among the 74 patients available for follow-up analysis, 66% in the intervention group and 80% in the control group were continent at 1 year.
In 2012, Tienforti et al in Italy compared biofeedback (sessions before and after surgery) in combination with written/verbal instructions on performing pelvic floor muscle exercises with a control intervention of written/verbal instructions alone.(11) The study included 34 patients, 32 of whom (16 in each group) were available for the final 6-month analysis. By 6 months, 10 of 16 patients (62.5%) in the treatment group and 1 of 16 patients (6.3%) in the control group had achieved continence; this difference was statistically significant (p value not reported). The mean number of incontinence episodes per week was also significantly lower in the intervention group (2.7) than the control group (13.1) at 6 months.
Two trials have evaluated the combination of postoperative biofeedback and electrical stimulation in men with postprostatectomy incontinence.(12,13) (These studies are also discussed in Policy No. 1.01.17 [Pelvic Floor Stimulation as a Treatment of Urinary Incontinence]). The trials had mixed findings. Mariotti et al (2009)(12) found a beneficial effect of the combined intervention of biofeedback and electrical stimulation, whereas the Goode et al (2011)(13) study did not find a benefit compared with behavioral therapy alone. Both studies were limited in that they did not isolate the effect of biofeedback, and thus the independent effect of biofeedback on outcomes cannot be determined. The Mariotti trial, conducted in Italy, compared a program of pelvic floor electrical stimulation and EMG biofeedback (2 sessions weekly for 6 weeks) with written/verbal instructions for pelvic floor muscle exercises. Treatment started 7 days after catheter removal. All 60 patients (30 per group) completed the study through the 6-month follow-up. The mean time to regain continence was significantly shorter in the treatment group (8.0 weeks) than the control group (13.9 weeks, p=0.003). The continence rate was significantly higher in the treatment group beginning at the 4-week visit and continuing through the 20-week visit at which time 29 of 30 (96.7%) in the treatment group and 18 of 30 (60%) in the control group were continent. The difference in the rate of continence was not statistically significantly different at the final, 6-month visit at which time 29 patients in the treatment group continued to be continent compared with 20 of 30 (66.7%) in the control group. In this study, the effect of biofeedback without electrical stimulation compared with written/verbal instructions to perform pelvic floor muscle exercises was not evaluated.
The 2011 study by Goode et al included 208 men with urinary incontinence persisting at least 1 year after radical prostatectomy. Men with preprostatectomy incontinence were excluded. Participants were randomized to 1 of 3 groups; 8 weeks of behavioral therapy (PFMT and bladder control exercises) (n=70), behavioral therapy plus biofeedback and electrical stimulation (n=70), and a delayed-treatment control group (n=68). The biofeedback and electrical stimulation intervention, called "behavior-plus," consisted of in-office electrical stimulation with biofeedback using an anal probe and daily home pelvic floor electrical stimulation. After 8 weeks, patients in the 2 active treatment groups were given instructions for a maintenance program of pelvic floor exercises and fluid control and were followed up at 6 and 12 months. The primary efficacy outcome was reduction in the number of incontinent episodes at 8 weeks, as measured by a 7-day bladder diary. A total of 176 of 208 (85%) randomized men completed the 8 weeks of treatment. In an intention-to-treat analysis of the primary outcome, the mean reduction in incontinent episodes was 55% (28-13 episodes/week) in the behavioral therapy group, 51% (26-12 episodes/week) in the behavior-plus group, and 24% (25-20 episodes/week) in the control group. The overall difference between groups was statistically significant (p=0.001), but the behavior plus intervention did not result in a significantly better outcome than behavioral therapy alone. Findings were similar on other outcomes. For example, at the end of 8 weeks, there was a significantly higher rate of complete continence in the active treatment groups (11/70 [16%] in the behavior group, 12/70 [17%] in the behavior-plus group) than the control group (4/68 [6%]), but the group receiving biofeedback and electrical stimulation did not have a significantly higher continence rate than the group receiving behavioral therapy alone.
Section Summary
Several RCTs on biofeedback for prevention and/or treatment of postprostatectomy incontinence have been completed, with mixed results. Some studies report a significant improvement in symptoms with biofeedback, but others do not. This evidence is insufficient to determine whether biofeedback improves health outcomes for patients with postprostatectomy incontinence.
Clinical Input Received Through Physician Medical Societies and Academic Medical Centers
In response to requests, input was received through 4 physician specialty societies and 2 academic medical centers while this policy was under review in 2009. While the various physician specialty societies and academic medical centers may collaborate with and make recommendations during this process, through the provision of appropriate reviewers, input received does not represent an endorsement or position statement by the physician specialty societies or academic medical centers, unless otherwise noted. The clinical input was variable. Several reviewers commented about the lack of data (eg, those who cannot do pelvic exercises), as well as the inability to separate from the available literature the contribution of biofeedback to overall outcomes in many studies.
There is a lack of consistent evidence from randomized controlled trial that biofeedback improves incontinence outcomes in women, or in men after prostate surgery compared with pelvic floor muscle exercises alone. No published evidence supports the unsupervised home use of biofeedback for treatment of urinary incontinence. Thus, biofeedback for the treatment of urinary incontinence, whether as part of an outpatient program or unsupervised in the home, is considered investigational.
Practice Guidelines and Position Statements
In April 2012, Agency for Healthcare Research and Quality published a comparative effectiveness review on nonsurgical treatment of urinary incontinence in women.(2) (Evidence is discussed earlier). The review included the following conclusion on biofeedback: "Women with stress UI [urinary incontinence] can achieve continence performing PFMT [pelvic floor muscle training]. Continence rates are similar between those who undergo PFMT with and without biofeedback."
In 2013 the National Institute for Health and Clinical Excellence published an updated guideline on the management of urinary incontinence in women.(14) The recommendation is: "perineometry or pelvic floor electromyography as biofeedback should not be used as a routine part of pelvic floor muscle training" but that "electrical stimulation and/or biofeedback should be considered in women who cannot actively contract pelvic floor muscles in order to aid motivation and adherence to therapy." The conclusion regarding use of biofeedback is based on expert opinion.
In 2012, the Canadian Urological Association issued a guideline on treatment of adult urinary incontinence.(15) The guideline included the following conclusions on the use of biofeedback:
Postprostatectomy incontinence: Preoperative biofeedback-assisted behavioral training may shorten the time to regain continence postoperatively and reduce the prevalence of severe incontinence 6 months after the procedure. Postoperative biofeedback did not appear to improve continence outcomes compared with PFMT.
Stress incontinence: The benefit of biofeedback is unknown.
In 2007, National Institutes of Health convened a Consensus Development Conference, Prevention of Fecal and Urinary Incontinence and subsequently released a statement.(16) Included in this statement was the following regarding pelvic floor muscle training and biofeedback:
"Pelvic floor muscle training and biofeedback are effective in preventing and reversing some pregnancy-related fecal and urinary incontinence for the first year after delivery. There is insufficient research on the sustained long-term benefits of pelvic floor muscle training or biofeedback on preventing fecal or urinary incontinence."
U.S. Preventive Services Task Force
No relevant guidelines found.
Medicare National Coverage
This policy applies to biofeedback therapy rendered by a practitioner in an office or other facility setting. Biofeedback is covered for the treatment of stress and/or urge incontinence in cognitively intact patients who have failed a documented trial of pelvic muscle exercise training.(17) Biofeedback is not a treatment, per se but a tool to help patients learn how to perform pelvic muscle exercises. Biofeedback-assisted PFMT incorporates the use of an electronic or mechanical device to relay visual and/or auditory evidence of pelvic floor muscle tone to improve awareness of pelvic floor musculature and to assist patients in the performance of exercises. A failed trial of PFMT is defined as no clinically significant improvement in urinary incontinence after completing 4 weeks of an ordered plan of pelvic muscle exercises to increase periurethral muscle strength. Contractors may decide whether to cover biofeedback as an initial treatment modality. Home use of biofeedback therapy is not covered.
- Blue Cross and Blue Shield Association Technology Evaluation Center (TEC). Biofeedback. TEC Assessments Volume 10, Tab 25 1995.
- Shamliyan T, Wyman J, Kane RL et al. Nonsurgical Treatments for Urinary Incontinence in Adult Women: Diagnosis and Comparative Effectiveness. Comparative Effectiveness Review No. 36. (Prepared by the University of Minnesota Evidence-based Practice Center under Contract No. HHSA 290-2007-10064-I.). 2012. Available online at: http://effectivehealthcare.ahrq.gov/ehc/products/169/834/CER36_UrinaryIncontinence_FinalReport_20120517.pdf. Last accessed May, 2014.
- Herderschee R, Hay-Smith EJ, Herbison GP et al. Feedback or biofeedback to augment pelvic floor muscle training for urinary incontinence in women. Cochrane Database Syst Rev 2011; (7):CD009252.
- Burgio KL, Goode PS, Locher JL et al. Behavioral training with and without biofeedback in the treatment of urge incontinence in older women: a randomized controlled trial. JAMA 2002; 288(18):2293-9.
- Williams KS, Assassa RP, Gillies CL et al. A randomized controlled trial of the effectiveness of pelvic floor therapies for urodynamic stress and mixed incontinence. BJU Int 2006; 98(5):1043-50.
- Hirakawa T, Suzuki S, Kato K et al. Randomized controlled trial of pelvic floor muscle training with or without biofeedback for urinary incontinence. Int Urogynecol J 2013.
- Pereira VS, de Melo MV, Correia GN et al. Vaginal cone for postmenopausal women with stress urinary incontinence: randomized, controlled trial. Climacteric 2012; 15(1):45-51.
- MacDonald R, Fink HA, Huckabay C et al. Pelvic floor muscle training to improve urinary incontinence after radical prostatectomy: a systematic review of effectiveness. BJU Int 2007; 100(1):76-81.
- Campbell SE, Glazener CM, Hunter KF et al. Conservative management for postprostatectomy urinary incontinence. Cochrane Database Syst Rev 2012; 1:CD001843.
- Dijkstra-Eshuis J, Van den Bos TW, Splinter R et al. Effect of preoperative pelvic floor muscle therapy with biofeedback versus standard care on stress urinary incontinence and quality of life in men undergoing laparoscopic radical prostatectomy: A randomised control trial. Neurourol Urodyn 2013.
- Tienforti D, Sacco E, Marangi F et al. Efficacy of an assisted low-intensity programme of perioperative pelvic floor muscle training in improving the recovery of continence after radical prostatectomy: a randomized controlled trial. BJU Int 2012.
- Mariotti G, Sciarra A, Gentilucci A et al. Early recovery of urinary continence after radical prostatectomy using early pelvic floor electrical stimulation and biofeedback associated treatment. J Urol 2009; 181(4):1788-93.
- Goode PS, Burgio KL, Johnson TM, 2nd et al. Behavioral therapy with or without biofeedback and pelvic floor electrical stimulation for persistent postprostatectomy incontinence: a randomized controlled trial. JAMA 2011; 305(2):151-9.
- National Institute of Health and Clinical Excellence (NICE). Urinary Incontinence:the management of urinary incontinece in women. 2013. Available online at: http://publications.nice.org.uk/urinary-incontinence-cg171/recommendations#behavioural-therapies. Last accessed May, 2014.
- Canadian Urological Association. Guidelines for adult urinary incontinence collaborative consensus document. 2012. Available online at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3478335/. Last accessed May, 2014.
- Shamilyan T, Wyman J, Bliss DZ et al. Prevention of urinary and fecal incontinence in adults. AHRQ Publication No. 08-E003, . 2007; 2014(May).
- Centers for Medicare and Medicaid Services. National coverage decision for biofeedback therapy for the treatment of urinary incontinence. Available online at: www.cms.hhs.gov. Last accessed May, 2014.
|Individual psychophysiological therapy incorporating biofeedback training by any modality (face-to-face with the patient), with psychotherapy (e.g., insight oriented, behavior modifying, or supportive psychotherapy); code range
|Biofeedback training by any modality
|Biofeedback training, perineal muscles, anorectal, or urethral sphincter, including EMG and/or manometry
|ICD-9 Procedure
|Urethral sphincter electromyogram
|Other individual psychotherapy (biofeedback)
|ICD-9 Diagnosis
|Investigational for all codes
|Electromyography (EMG), biofeedback device
|ICD-10-CM (effective 10/1/15)
|Investigational for all diagnoses
|ICD-10-PCS (effective 10/1/15)
|Not applicable. ICD-10-PCS codes are only used for inpatient services. Policy is only for outpatient or home services.
|Type of Service
|Place of Service
Biofeedback, Urinary Incontinence in Adults
EMG Biofeedback
Policy History
|Add to Medicine section
|New policy
|Replace policy
|Reviewed with changes; expanded rationale; no change in policy coverage
|Replace policy
|Biofeedback policy separated into 3 policies
|Replace policy
|Policy updated with reference to 2000 TEC Assessment; policy statement unchanged
|Replace policy
|Benefits application section revised to include information regarding BlueCard or National Account
|Replace policy
|Policy updated with literature search; no change in policy statement. References added
|Replace policy
|Policy updated with literature search; no change in policy statement. References added
|Replace policy
|Policy updated with literature search; no change in policy statement. References 20 and 21 added
|Replace policy
|Policy updated with literature search for the period of June 2005 through July 2006; no change in policy statement.
|Replace Policy
|Policy updated with literature search; references 22-24 added; no change in policy statement
|Replace policy
|Policy updated with literature search December 2007 through December 2008; clinical input reviewed; addition to policy statement for unsupervised home use of biofeedback is investigational; references 25-29 added.
|Replace policy
|Policy updated with literature search through May 2010; "outpatient setting" added to first policy statement; no other change in policy statements. Rationale rewritten. References 8 and 10 added/ other references re-numbered or removed.
|Replace policy
|Policy updated with literature search through May 2011. References 8 and 12 added; other references renumbered. No change in policy statements.
|Replace policy
|Policy updated with literature search through May 2012. References 2, 3, 4 and 6 added; other references renumbered. No change in policy statements.
|Replace policy
|Policy updated with literature search through May 29, 2013. References 2, 6, 7 and 9 added; other references renumbered or removed. No change in policy statements.
|Replace policy
|Policy updated with literature review through April 25, 2014. References 10 and 14-15 added. No change in policy statements


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The Northwestern Law Alumni Association is pleased to present the latest edition of E-Briefs, an electronic newsletter for alumni and friends of the Law School. Enjoy this connection to Northwestern Law.
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February 2013
8th Annual Entrepreneurship Law Conference, March 9
The Bluhm Legal Clinic's Entrepreneurship Law Center will host their 8th annual conference on Saturday, March 9, at the Law School. Designed to provide practical, relevant information about various legal issues that entrepreneurs face, the conference will include panel discussions on topics such as entity selection, founder agreements, venture and angel financing, intellectual property, and employment issues. J.B. Pritzker JD '93, the 2013 Distinguished Entrepreneur award recipient, will serve as the keynote speaker for the conference. Read more...
Former U.S. Attorney to Deliver Pope and John Lecture
Patrick Fitzgerald, esteemed trial lawyer, investigator, and former United States Attorney for the Northern District of Illinois, will be the featured speaker for the Law School's Pope & John Lecture Series on Professionalism on Tuesday, February 26, at 5:30 p.m. Register...
Save the Date: All Alumni Weekend 2013
All Northwestern Law alumni are invited to celebrate All Alumni Weekend, which will be held on September 27-28, 2013. Reunite with friends, rekindle the memories of your student days, and see how the Law School has changed over the years. Additional events will be held for this year's reunion classes: 1963, 1968, 1973, 1978, 1983, 1988, 1993, 1998, 2003 and 2008. To learn about opportunities to volunteer on your class committee and help plan your reunion, complete the committee form, e-mail Charley Boynton, or call (312) 503-1769.
Conference: Rethinking 'Shareholder Value' and the Purpose of the Corporation, March 7-8
Northwestern Law alumni and peers are invited to attend the Kellogg School of Management and Aspen Institute Business and Society Conference on March 7-8. The two-day conference will bring together leading experts in academia and business to discuss how corporations can respond to the competing pressures of shareholder value maximization and social responsibility. Conference panelists include Northwestern Law professors Bernie Black and Marty Redish. More information and registration...
Judges Needed for Arlyn Miner Moot Court Program
Judges are needed for the oral arguments at the noncompetitive 2013 Arlyn Miner Moot Court. The program will be held April 8, 9, 10, 15, 16 and 17. Alumni living in the Chicago area and interested in being a judge can e-mail Bonnie Jackson or call (312) 503-5355. CLE credit is available for this event.
Save the Date: Trienens Visiting Judicial Scholar
The Honorable Guido Calabresi, of the U.S. Court of Appeals for the Second Circuit, will visit Northwestern Law on April 8-9, 2013, as the Howard J. Trienens Visiting Judicial Scholar. Judge Calabresi will deliver a community lecture on Tuesday, April 9 at 4:00 PM at the Law School followed by a community reception. Registration to follow.
Applying Neurobiology to Mediation and Negotiation, April 3
How do brains work in negotiation and mediation when the parties, their counsels and/or the mediator try to manage their emotions, when they need to focus their attention, take a decision or analyze the behavior of another person? The Center on Negotiation and Mediation is partnering with Neuroawareness Consulting Services to present this one-day workshop, providing practical new tools to improve your legal and/or ADR practice. Register with NU alumni discount code NUNEURO.
In the News
Alumni in the News
Can Chicago be the Next Silicon Valley?
Hua Wang, JD '12 in MIT Entrepreneurship Review, January 17, 2013
Faculty in the News
Set Daniel Taylor free
Karen L. Daniel in The Chicago Tribune, February 06, 2013
Rosenthal: U.S. lawsuit against S&P carries risk
David Ruder in The Chicago Tribune, February 06, 2013
A journey into the unknown
David J. Scheffer in The Journal, February 06, 2013
Fixing common affairs
John O. McGinnis in The Economist, February 02, 2013
A brief history of the income tax
Charlotte Crane on Marketplace, February 01, 2013
Nation Lifting Boy Scout Ban On Gays: One Legal Perspective
Andrew M. Koppelman on Oregon Public Broadcasting, January 30, 2013
Scholars scoff at Scalia claim
Martin H. Redish in Politico, January 29, 2013
Make Law Schools Earn a Third Year
Daniel B. Rodriguez in The New York Times, January 17, 2013
Music Sales Are Just 6% of Average Musician's Income
Peter C. DiCola in TorrentFreak, January 14, 2013
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Date: February 25
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"The Perils of Prosecutors Facing Ticking Time Bombs" delivered by Patrick Fitzgerald
Date: February 26
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LLM Tax Alumni Club Happy Hour - Chicago
Date: March 6
Location: Municipal Bar and Dining Co.
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A similar soil database would be needed for global scale forecasting, modelling and research. However the only available soil map with a global coverage is the 1 to 5 million scale FAO soil map of the world, which has been compiled from data collected up to the late seventies. Since the completion of the FAO soil map much new data have been documented and new approaches of mapping and database development have been developed. The lack of a standardized, compatible, credible soils database at appropriate scale is a major constraint to global modelling. Therefore, the SOTER (World SOil and TERrain Digital Database) project was initiated by the International Society of Soil Science (ISSS) in 1986 (ISSS, 1986). SOTER is intended to have a global coverage at 1:1 million scale (Batjes, 1990; ISRIC, 1993), which goal was later degraded to 1:5 million scale due to the lack of means.
An SRTM-based procedure to delineate SOTER terrain units on 1:1 and 1:5 million scales
Soil data of various scales is needed to well manage our agricultural and environmental resources. On the European level soil information is used for crop monitoring, yield forecasting, agricultural planning, feasibility studies for rural development, natural hazards forecasting, such as floods and landslides or slowly acting processes such as erosion, acidification and other types of chemical, biological and physical degradation of soils. No appropriate scale soil database for the European Union had existed before the late eighties. The strong need for policy support has speed up the database compilation and resulted in the first version of the Soil Geographical Database of Eurasia at scale 1:1 million (SGDBE1M). Despite of its limitations, SGDBE1M is still among the few databases, which serve as a flagship in the development of the small scale spatial databases in Europe. The version 2.0 of SGDBE1M was published recently, in 2004. The refinement of the database and the extension of its geographic coverage to Eurasia and the Mediterranean Africa are in preparation.
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In 1994 a 13 year-old boy disappears without trace in San Antonio, Texas. Three and a half years later he is found alive, thousands of miles away in a village in southern Spain with a horrifying story of kidnap and torture. His family is overjoyed to bring him home. But all is not quite as it seems. The boy bears many of the same distinguishing marks he always had, but why does he now have a strange accent? Why does he look so different? And why doesn't the family seem to notice these glaring inconsistencies? It's only when an investigator starts asking questions that this strange tale takes an even stranger turn.
Documentary meets film noir in this extraordinary true story, which has the twists and turns of a thriller.


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Where do I get the wood for a brick oven?
Hey all,
My parents had a brick oven built for their house with the intention of churning out pizzas every weekend. We've learned how to use it by some family in Italy who were using the wood from trees on their property. Now that we're back in New York, we have no idea where to source this stuff.
Anyone have a good connection/some knowledge on where to get appropriate pizza wood?


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Crosswords Printables > Daily Crossword Puzzles > Saturday's Crossword Puzzles > Children are Precious Puzzle
Children are Precious Puzzle
We hope you enjoy your crossword puzzle that you have selected! Remember to check our more of our LA Times Crossword Puzzles and share them with your friends. If you are a parent or teacher, print as many as you'd like and use them for extra learning practice and fun activities!
Try this puzzle about children and enjoy the precious kids you have. Do you have children? If you do, raise them right so they will know what they are supposed to do in life. There are many people who can't have kids so enjoy them if you do have them. Enjoy this daily, Saturday puzzle.
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St. Sebastian
Commemorated December 18
Troparion, Tone 1
O Sebastian, spurning the assemblies of the wicked, you gathered the wise martyrs who with you cast down the enemy; and standing worthily before the throne of God, you gladden those who cry to you: Glory to him who has strengthened you! Glory to him who has granted you a crown! Glory to him who through you works healing for all!
Kontakion, Tone 4
Excelling in godly zeal, you gathered a band of martyrs from which you shone as a star. The arrows that wounded your body, O Sebastian, pierced the hearts of the enemy. Therefore Christ has glorified you!


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Prays for the lessening of 'youthful violence'
Published 6:13 pm, Wednesday, February 13, 2013
To the Editor:
Words cannot express the grief we felt on Dec. 14, 2012, about the Sandy Hook Elementary School in Newtown.
The 26 people killed, mostly children, was due to a senseless act of extreme violence. This will remain in our minds and hearts forever.
My prayers are always spoken from the bottom of my heart that everyone, including family and friends, will overcome their sorrow in time.
I am concerned about the youthful violence in the United States and throughout the world.
I also recall the time on April 20, 1999, when two high school students tragically killed 12 students and a teacher at Columbine High School.
How can we transform this disregard for life that has been deeply rooted in the minds of children from the war and violence that plagued the 20th century?
This is the most important issue for us still early in the 21st century.
We should strive to do everything possible with the memory of Sandy Hook Elementary School victims etched in our hearts.
New Milford


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DeMarcus Ware says it's 'put up or shut up' time for Tony Romo
Dallas Cowboys linebacker-turned-defensive end DeMarcus Ware is happy quarterback Tony Romo received his long-term extension, but the seven-time Pro Bowler would like to see Romo step up and take the team to the next level.
"I feel like everybody is deserving to whatever is given to him, but at the end of the day, to me it's put up or shut up," Ware said during a Thursday appearance on SiriusXM radio (via the Dallas Morning News). "I'm just being straight-up honest with you. Get out there and be productive, and that's with any player. Whatever they get, they're deserving of it. You just got to get out there and play and I know he can be and will be the quarterback that is going to be the quarterback that is going to take us to the next level."
It's hard to argue with Ware, who has certainly lived up to the six-year, $78 million extension he signed midway through the 2009 season. Ware led the NFL in sacks with 15.5 in 2010, posted 19.5 sacks in 2011 and battled through injuries to lead the Cowboys with 11.5 sacks last season.
The pressure will certainly be on Romo the next two seasons.
According to a source with knowledge of the details of Romo's extension, his 2013 cash compensation has more than doubled, going from $11.5 million in his previous deal to $26.5 million, mostly through a $25 million signing bonus. The increase can be attributed to Romo holding all the leverage in contract negotiations with the Cowboys, who needed cap space to continue building their roster and were unable to use the franchise tag on Romo once his previous contract voided after the 2013 season. Romo had additional leverage to get an extension done this offseason as previous restructures of his contract to clear cap space would have forced the Cowboys to carry $8.181 million in "dead money" from Romo's signing bonuses on their 2014 cap, even if the quarterback was playing elsewhere.
Romo is due $13.5 million in fully guaranteed base salary in 2014 and has a $21.773 million cap figure. Romo's cap number is scheduled to increase to $25.273 million in 2015. Romo has a $17 million base salary in 2015 and currently $15 million of that salary is guaranteed for injury only. Half of that injury only guarantee — $7.5 million — will become fully guaranteed if Romo is on the Cowboys' roster on the third day of the 2014 league year, with the remaining $7.5 million becoming fully guaranteed if Romo is on the Cowboys' roster on the third day of the 2015 league year.
Getting back to Ware, the 2005 first-round pick is looking forward to a more simpler role as the team moves to a 4-3 defense, in which Ware will play defensive end.
"It's a 4-3. It's maybe a little bit more simpler for guys," said Ware. "I just have one job now, getting to the quarterback. Holding the edge is still the same like the 3-4, but the cornerbacks can be a little bit more diverse in knowing what's going and maybe being a little bit more aggressive can create a little bit more productivity."


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As for Mississippi State getting in trouble over this, Yancy doesn't know how immunity works. This shouldn't be surprising to anyone given his history, "ginny" pig and all. Leo Lewis was interviewed with MSU representatives present and was asked only about Ole Miss allegations that they already had knowledge about. Hell, the NCAA doesn't even have the resources to investigate State because they can't get done in Oxford.
Last edited by Mimi's Babies; 04-20-2017 at 05:13 PM.
Damn, Yancy gone full retard.
Stolen from the other board:
NOTICE OF ALLEGATIONS to the Chancellor of the University of Mississippi
[(4) Intentional, willful or blatant disregard for the NCAA constitution and bylaws [NCAA Bylaw 19.9.3-(m) (2016-17)]
I love reading their board as they justify to themselves how we and Rose have been right all this time and they have been wrong at every turn. They're fully convinced that this whole thing is an orchestrated plot by our administration to bring them down and since Rose is a reporter covering MSU he has access to all the ones making this happen and pushing it. That's also why all of their reporters have been dead wrong 100% of the time because they are not here with the MSU mafia. They have turned this into the whole thing boils down to Leo Lewis because the NCAA couldn't find anything in all those previous years of investigating and they just have a hard on to nail freeze (no pun intended) and resorted to using Leo as a plant to get them to try and commit a violation.
ETA: They also don't appear to be overly pleased to be called a shitbird and claim they have no idea what Hey Hugh means. Now we all know that's BS because they live on this board and are probably responsible for half the clicks on that link when it was posted here.
What's hilarious to me is they've blamed State, Leo, Mullen, Sankey, Elitedawgs, Rosebowl, Alabama, Nick Saban, Tunsil's step dad, and damn near everybody else under the sun. But they have yet to accept any level of responsibility of this. Not Freeze's fault his program is the CHEATINGEST PROGRAM IN THE HISTORY OF COLLEGIATE ATHLETICS. Yes, I made up a new word... CHEATINGEST.


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Earlier Tuesday, CNN broke the news of a controversial report regarding Trump's "alleged" relationship with Russia which states that Russia has been "cultivating, supporting, and assisting Trump for years through surrogates communicating with Russian intermediaries." The report also alleges that Trump has been involved in perverted sexual acts while visiting the country, including hiring prostitutes to urinate on his bed, which at one time was the same bed that President Obama and the first lady slept in when they visited Moscow.
BuzzFeed published the full document this afternoon, and as expected, Trump went completely insane, drawing even more attention to his embarrassing behavior, and took to Twitter to rant his complaints.
— Donald J. Trump (@realDonaldTrump) January 11, 2017
This has been the hot topic for most of Tuesday, and it just so happened that Seth Meyers had the perfect person scheduled to appear on his show Late Night to discuss it with — Trump's former campaign manager turned top adviser, Kellyanne Conway. When the interview began, Meyers wasted no time with the usual pleasantries and jumped right in, grilling her about this report and Trump's salacious behavior.
Conway, of course, went on the defensive immediately saying:
"Guess what hasn't happened, Seth? Nobody has sourced it. They're all unnamed, unspoken sources in the story, and it says it was based on a Russian investigator to begin with, so where are we?"
Meyers then corrected her statement and filled her in on a pretty important fact — this report was based on British intelligence, not Russian. Conway was visibly uncomfortable and forced another ridiculous response:
"Right, well one of those, and then it said that it also may have originated with a Russian investigator. It also says that Hillary Clinton, groups that wanted Hillary Clinton to win, may have been behind the investigations themselves. And most importantly, it says that the FBI is trying to confirm it. So nothing has been confirmed. And I have to say, as an American citizen…we should be concerned that intelligence officials leaked to the press and won't go and tell the president elect or [Obama] what the information is."
The above is blatantly untrue, and Seth fills her in yet again citing facts from the CNN report that said:
"Classified documents presented last week to President Obama and President-elect Trump included allegations that Russian operatives claim to have compromising personal and financial information about Mr. Trump, multiple US officials with direct knowledge of the briefings tell CNN."
Kellyanne grows even more uncomfortable and tries again and again to weasel her way out of her predicament, but Seth wasn't having it.
Watch the video below:
Featured image via screenshot


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#1 Ranked Children's Hospital by U.S. News & World Report
MyPatients provides referring primary care providers with secure access to their patients' information.
Boston Children's has launched the world's 1st program dedicated to offering hand transplants to children who qualify.
Innovation insider is a semi-monthly e-newsletter analyzes innovations at Boston Children's, other academic medical centers and from industry.
Read the latest blog by a Boston Children's doctor, clinician or staff member.
There are many ways you can help children and their families get the care they need.
Patients and referring physicians can contact the Boston Children's Hospital Vascular Anomalies Center (VAC) anytime by email, or by phone (Monday through Friday) at 617-355-5226. The VAC staff can assist you in arranging appointments or consultations, and/or provide information about the center's services.
Vascular Anomalies Center
Boston Children's Hospital
Fegan Building, Third Floor
300 Longwood Avenue
Boston, MA 02115
Phone: 617-355-5226
Fax: 617-730-0752
For families residing outside of the United States, please contact Boston Children's International Health Services, which facilitates the medical review of patient records and appointment scheduling and which provides assistance with customs and immigration, transportation, hotel and housing accommodations.
International Health Services
Boston Children's Hospital
Pavilion Building, Room 119
300 Longwood Avenue
Boston, MA 02115 USA
Phone: 1-617-355-5209
Fax: 1-617-730-0627
Boston Children's is so much more than a hospital—it's a community of researchers, clinicians, administrators, support staff, innovators, teachers, patients and families, all working together to make the impossible possible.


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Facebook, Friend or Foe?
Investors have realized that companies no longer compete with Facebook, they compete on it
Stuck to the wall by the entrance to Badoo's office in London's Soho district is a postcard that says 'No, I'm Not On Facebook'.
Badoo's 135 million registered users in 180 countries—who pay the firm to meet new people online— generate around $150 million a year in revenue. This, naturally, is dwarfed by Facebook.
According to its own statistics, Facebook had 845 million active users at the end of December last year—more...


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Can Companies Use Mentoring to Increase Employee Retention?
All businesses, from an entrepreneurial start up to an established company, need mentoring. The entrepreneurs of those companies require mentoring as well. A mentor can help a fellow peer develop important business skills, support them in making important career and life decisions and put them in touch with needed network contacts. The purpose of my report is to analyze the results of putting a mentoring program in place in a company and why it can reap rewards for the employees and the organization. The key variable that I will be focusing on is employee retention since "SHRM, the Society for Human Resource Management, estimated that it costs $3,500.00 to replace one $8.00 per hour employee when all costs — recruiting, interviewing, hiring, training, reduced productivity, et cetera, were considered" (Blake 2006). Imagine the cost to the company when considering a $40,000 a year corporate employee!
Mentoring can be an influential tool in familiarizing employees to an organization's culture and help them grow in their jobs. It can be tremendously valuable to have someone who has your best interests at heart and can explain the facts of your corporate culture and offer treasured advice. Informal mentoring has been going on continually, but companies are increasingly identifying that formal mentoring programs can provide momentous benefits for both the employee and the organization. Positive benefits include is statistical growth in employee retention, growth and satisfaction. The focus of my analysis was the increase in employee retention vs.
Blake, Rose. Employee Retention: What Employee Turnover Really Costs Your Company. WebProNews. July 24, 2006. Bridgeford, Lydell. Mentoring Programs Still Have a Place in the 21st Century. Employee Benefit News, August 1, 2007 Corporate Leadership Council. (2005). Mentoring: From Theory to Action. Corporate Leadership...
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A Derry Trade Unionist has challenged those standing for election and re-election in Derry to speak "lay their cards on the table" in terms of their stance on the 'doggedly high' unemployment rates in the North West.
Liam Gallagher of Unite spoke yesterday after the most recent unemployment figures revealed dropping numbers on the live register across Northern Ireland generally. However the figures revealed that Derry continues to top not only the Northern Irish unemployment table but also UK tables.
"The fact that these numbers remain doggedly high is worrying and it is amazing that politicians do not seem to be taking this issue on board. There is an election looming and this should be the most important issue on their agendas."
Mr Gallagher said he would challenge all those standing for election or re-election to outline exactly what their plans are to tackle the unemployment problem during the coming electoral term and to "explain what they have done to tackle this issue during their previous tenure".
"This applies to those running for local council to those running in the European elections," Mr Gallagher said. "There have been a number of measures put in place by the assembly but we have yet to see the benefits of those in the North West. There have been a couple of high profile, good quality, job announcements in Belfast but are yet to have this reach Derry.
"We are now in a position where a high number of our young people are leaving Derry in search of jobs elsewhere because they simply do not see a future for themselves in their hometown.
"I fail to understand why our politicans are remaining so silent."


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Game Credits
|EverQuest (2003)
|(Marketing Team)
|Jet Moto 3 (1999)
|(P.R. and Promotions)
Public Relations
|EverQuest (2003)
|(Public Relations Team)
|PlanetSide (2003)
|(Sales and Marketing)
|EverQuest: The Planes of Power (2002)
|(Sales, Marketing and Public Relations Team)
|EverQuest: The Scars of Velious (2000)
|(Sales, Marketing, and Public Relations Team)
|NFL GameDay 2001 (2000)
|(PR Manager, Sports)
|Syphon Filter 2 (2000)
|(PR and Promotions)
|NFL GameDay 2000 (1999)
|(PR & Promotions)
|Twisted Metal 4 (1999)
|(PR and Promotions)
|EverQuest Online Adventures (2003)
|(Special Thanks)
|Star Wars: Galaxies - An Empire Divided (2003)
|(Special Thanks)
|Cool Boarders 2001 (2001)
|(Special Thanks)
|EverQuest (2003)
|(Sales Team)
Developer Biography
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Corkbin Wine App for iPhone and Android
Get the App
App Store
Google Play Play
5 posts
Hall Cabernet Sauvignon
5 years ago
Thursday tasting..... Why? Why not?
5 years ago
R Rose from Domaine Serene (Dayton, OR). Very nice Rose, yet I still think Trinquevedel Tavel Rose is my favorite.
Celani Family Vineyards Tenacious 2007
5 years ago
07 Celani Family Tenacious - a very tasty blend by Mark Herold!
Coho Headwater 2009
5 years ago
09 Coho Headwaters - young, yet velvety smooth!
Hall Cabernet Sauvignon 2007
5 years ago
07 hall cab - very nice!


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WASHINGTON: Children exposed to pet dander, roach allergens and a wide variety of household bacteria in the first year of life are less likely to develop allergies, wheezing and asthma, U.S. researchers said on Saturday.
Previous research has shown that children who grew up on farms have lower allergy and asthma rates. Other studies, however, have found increased asthma risk among inner-city dwellers exposed to high levels of roach and mouse allergens and pollutants.
In the new study, researchers from the Johns Hopkins University and other institutions found that early exposure to bacteria and certain allergens may have a protective effect by shaping children's immune responses.
The study, published in the Journal of Allergy and Clinical Immunology, was conducted among 467 inner-city newborns from Baltimore, Boston, New York and St. Louis whose health was tracked over three years.
The researchers visited homes to measure the levels and types of allergens present in the infants' surroundings and tested them for allergies and wheezing via periodic blood and skin-prick tests, physical exams and parental surveys. In addition, the researchers collected and analyzed the bacterial content of dust collected from the homes of 104 of the 467 infants in the study.
The study showed that babies who grew up in homes with mouse and cat dander and cockroach droppings in the first year of life had lower rates of wheezing at age 3, compared with children not exposed to these allergens soon after birth.
The protective effect, moreover, was additive with infants exposed to all three allergens having lower risk than those exposed to one, two or none of the allergens, the researchers found.
Specifically, wheezing was three times as common among children who grew up without exposure to such allergens, compared with children who spent their first year of life in houses where all three allergens were present.
In addition, infants in homes with a greater variety of bacteria were less likely to develop environmental allergies and wheezing at age 3.
Further analysis of the effects of cumulative exposure to both bacteria and mouse, cockroach and cat allergens showed that children free of wheezing and allergies at age 3 had grown up with the highest levels of household allergens and were the most likely to live in houses with the richest array of bacterial species.
Some 41 percent of allergy-free and wheeze-free children had grown up in such allergen and bacteria-rich homes. By contrast, only 8 percent of children who suffered from both allergy and wheezing had been exposed to these substances in their first year of life, the researchers said.
Importantly, the protective effects of both allergen and bacterial exposure were not seen if a child's first encounter with these substances occurred after age 1, they said.
"Our study shows that the timing of initial exposure may be critical," said study author Robert Wood, chief of the Division of Allergy and Immunology at the Johns Hopkins Children's Center.
"What this tells us is that not only are many of our immune responses shaped in the first year of life, but also that certain bacteria and allergens play an important role in stimulating and training the immune system to behave a certain way."


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You require to love Thursday if for no other reason when compared with the fantastic television programming on tonight! Besides new offerings from 'The Office,' 'Survivor' and 'Vampire Diaries,' new shows like 'Flash Forward' debut and season premieres for 'Grey's Anatomy' and 'The Mentalist' will be on.
Chris O' Donnell and L.L. Cool J lead a clean cast of rising stars in the Los Angeles based edition of NCIS. Unlike its predecessor, "NCIS: Los Angeles" promises think about the focus away around the forensic associated with murders and toward investing its energy in chasing down dangerous thinks. "NCIS: Los Angeles" premieres on CBS on September 22nd at 9 p.m.
Perhaps probably the most intriguing belonging to the bunch is the new science fiction/action-thriller "Flash Forward." joseph fiennes risen interview and John Cho head a cast of incredible actors in this particular fresh new series, written and directed by David Goyer (co-writer of Batman Begins and also the Dark Knight). The show's premise centers around a phenomenon where entire population of the globe blacks out at precise same time for two minutes and seventeen seconds. During that time, everyone sees what their future can take. Some are good and some are difficult. Once they start piecing together their fate, the characters must join together to help those that do not have this particular type of great future ahead. The series premieres on ABC on September 24th at 8 s.m.
Brian Per. O'Bryne plays the character of Aaron Stark – Aaron Stark works best for the LA Department water and Power as professional. He has had some rough times and weathered it the best that he may be able that would. He is divorced, been in prison, and have been told a father's worst major problem. His daughter was killed when participating in Afghanistan. He or she is also an alcoholic and has also joined Double a. Mark Benford is his sponsor and they have been able encounter pretty good friendship where they can talk with regards to their own difficulties.
You've Got Mail ~ Tom Hanks and Meg Ryan just fall in love via the world wide web. Very predictable romantic comedy, but it made me cry, you'll find hit home with myself. Hanks and Ryan have amazing chemistry in this particular.
The first new show we look into is Cougar Region. Courtney Cox (formerly for this show Friends), will possess top role in technique show. Cox plays a 'going on 40' woman who juggles a successful career and is a mother. She begins to feel her age and feels that work involved . not enough going on in her lifetime. She had dealt with a bad period during her divorce and was now evaluating getting around the dating game. The problem is that she is not able to get with men her own age healthcare priorities . go once the younger the woman. Her married friend and assistant suggests that she get back into the dating pool and she goes hard. Luckily, she meets a friendly and young guy named Bobby and things get interesting from using it point through to. This new addition to your ABC lineup will air on Wednesday September 23rd at 9:30 p.m.
4:00-5:15 delaware.m., Ballroom 20– Dollhouse- Join Dollhouse creator Joss Whedon and star/producer Eliza Dushku for a no-holds-barred Q & An about exactly what they have planned for season 2.


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Taking a Break
This the last photo that I'm posting from the Gion Matsuri to this blog for now. Maybe I'll do another feature on it next July, if I'm still going with this BLOG. My wife and I recently made a short trip to Australia and then had a busy week catching up with work after that, so that's why I haven't posted any BLOGs for a while.
I know it's August now, but I wanted to finish off the "July" themed photos with this one, before moving on the "August" themed photos. These guys were taking a break from carrying one of the smaller floats in the Gion Matsuri. I think this float is one of the smaller "yama" floats, but it seems to be a bit small even for one of those, so I'm not sure. There are a number of other objects including Mikoshi (portable Shinto Shrines) that are carried during the parade.
It must be incredibly hard work pushing, pulling, or carrying the floats and Mikoshi during the parade in the summer's heat. Fortunately there are a number of times to rest, when they allow people to cross the roads in front of the parade. I snapped this photo while these four young guys where taking a break as they waited for the crowds to cross the road in front of them.
This this photo was captured in with a Nikon D700 and an AF-S VR Zoom-Nikkor 70-300f/4.5-5.6G IF-ED lens. This the jpeg file straight from the camera, no post processing has been done on this image.
From Kyoto
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We can provide a complete hosted server solution to eliminate all your IT headaches
Tech Solutions allows businesses of all sizes to utilize the enterprise-class messaging, mobility and collaboration offered by Microsoft Exchange Server without the need to purchase and maintain expensive infrastructure and licenses. Simply just pay as you go each month.
Business Benefits
Get business-class email, calendar, and contacts delivered on your PC, phone, and browser. With a simplified approach to high availability and disaster recovery, achieve new levels of reliability and reduce complexity, while protecting sensitive and confidential information.
The benefits of Microsoft Exchange include:
Up-to-date: No fragmented business email, everything is stored centrally, which means you always see the latest version of your email, files, calendar and contacts.
Mobile access: Microsoft Exchange is the software that powers email for smartphones including iPhones, and Android or Windows-powered devices. It also offers access to email from virtually any browser, so you will always be synced with your team.
Shared calendars: Microsoft Exchange lets employees see colleagues' availability to schedule or rearrange meetings, book conference rooms, and plan projects.
Shared task lists: Microsoft Exchange allows 'to do' lists to be created and assigned, then shared with team members. Managers can check off items as they are completed.
Shared contacts: Company or shared address books means your customers' contact details will never be lost or misplaced.
So if would like to get rid of your I.T. headaches and let us manage things, get in touch with us, we are always happy to help.


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The content on this page is provided by a Time Out partner.
¡No te Rajes! restaurant is located in the area of Ciutadella in Barcelona. This is a restaurant specializing in Mexican food, with Mediterranean touches. ¡No te Rajes! restaurant's offers an extensive letter of Mexican specialties. Quality is assured as all dishes are cooked with the best ingredients from the finest market. ¡No te Rajes! restaurant is a safe bet for any kind of event, due to the excellent quality of food, friendly atmosphere and impressive quality price relation. We recommend you to accompany your meal with one of the excellent mexican beers that the restaurant offers.
|Venue name:
|¡No Te Rajes!
Av. Icària, 164-166 Local 16


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|17.04.2013 - India: PM pushes for $100bln sovereign wealth fund
|The prime minister's office does not agree with the finance ministry position that the country does not have enough foreign exchange to set up a sovereign wealth fund. Prime minister Manmohan Singh is keen on creating a $100 billion fund. Finance minister P Chidambaram will soon meet the prime minister to discuss the next steps towards creating the fund. "Inputs from various ministries have been received. The prime minister will now give a final directive," says an official. At a recent meeting chaired by the prime minister's principal secretary Pulok Chatterjee, finance ministry officials said that the foreign exchange was not enough for the fund...........................................Full Article: Source


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Mom-to-be Kim Kardashian dressed her bump in black on Tuesday (February 19) in Los Angeles, Calif. The reality star, 32, rocked leather leggings, paired with a billowing top and stilettos for a family outing with stepfather Bruce Jenner and brother Rob Kardashian.
Rob revealed he's packed on the pounds since splitting with Rita Ora in December 2012 on the latest episode of Kourtney & Kim Take Miami.
"All I did was waste a lot of money and gain 40 pounds," Rob told his sisters over dinner. "I need to focus on me. That's all I wanna be about."
Meanwhile, it's nothing but baby bliss for KimYe.
"I just feel so blessed and excited and ready for the next phase," Kim recently said of her baby on-the-way with boyfriend Kanye West.


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Chef'n Corporation v. Progressive International Corporation
Filing 15
ORDER by Judge Richard A Jones. The court DENIES defendant'S motion. Dkt. # 11 . (CL)
Disclaimer: Justia Dockets & Filings provides public litigation records from the federal appellate and district courts. These filings and docket sheets should not be considered findings of fact or liability, nor do they necessarily reflect the view of Justia.


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THERE'S no denying pre-Christmas is a primal time of year with constant personal battles between lightness, darkness and hibernation.
What better time to cast a long bright shadow through the dark cold days with a shining song or two?
At the Ironworks in Inverness on Monday, ex-Catatonia singer Cerys Matthews flung us a Christmas wreath of songs that looped around the world, taking in Scotland, Wales, 'Dustbowl Troubadour' Woody Guthrie's America and some favourite carols to transport us to the Middle East.
All we had to do back was listen and sing along in the right places.
"Is that as loud as you can sing, Inverness?" Cerys teased four songs in. And sure enough, we did have a bit more volume in us.
"I want you to be a broken record for me," Cerys asked a little later, and we were pretty good at that too.
By then you'd noticed that the gig billed as Cerys By Candlelight could have done with a few more than the twinkling tealights at the front of the stage.
Also that even in the four songs sung, the quirky BBC 6 presenter had already transported you by the power of song from bloody Scotland (Cerys: "Your songs are the best ones of all for goriness and tragedy") to Wales (Cerys: Anyone in from Merthyr?") and on to Woody Guthrie's Who's Gonna To Shoe Your Pretty Little Feet, his chirpy-sounding version of doomy Scots standard The Lass Of Roch Royal.
Dressed in a red velvet jacket, red scarf, jaunty hat, black leather trousers and heels, Cerys played guitar and a homemade banjo –"made in North Carolina, but it doesn't like touring much".
It's not every singer who can do a mean kazoo solo, but Cerys can – sometimes even without the aid of a kazoo, as she demonstrated.
Her voice is usually high, clear and almost childishly pure-sounding, until the naughty-substance song sung by Woody Guthrie Take A Whiff On Me revealed a thrilling almost Elvisy deep tone hiding in the low notes.
For Catatonia fans there was just one song, Johnny Come Lately which Cerys told us, she'd had to practise as she'd last sung it about 13 years ago.
And as promised, in the pre-show publicity, there were stories – free with almost every song.
Too embarrassed to share her Scottish accent, Cerys still gave us both the man and woman voices in her reading of Robert Burns The Cares Of Love. Then before singing Ca' The Yowes, Cerys created her own imaginative contribution to man-woman relations by devising an inspiring alternative to "darling" by calling her manager-husband "ye vile warlock". Must try that one ...
Talking of the ghosts of decapitated colonels, as you do, Cerys pointed out that she'd asked the Ironworks if they had a ghost. A bit disappointed on hearing that they didn't, she told us: "So if anyone fancies it post-death, this would be a place where you'd be really welcome."
More unexpected moments came with one bizarre heckle which Cerys dealt with perfectly.
"This one's for you," she said reproachfully, before launching into Patsy Cline's Crazy, complete with all the country trimmings her versatile voice could provide.
As the night drew to closing, with the help of handy lyric sheets we sang along for carols Ding Dong Merrily On High, Deck The Halls, Go Tell It On The Mountain and Jingle Bells – where Cerys divided us in sections like a panto crowd.
Then it was back to Wales for a dramatised extract Cerys read from Dylan Thomas's A Child's Christmas In Wales, complete with help from audience members Mike and Mark on percussion as fire engine and dinner gong. The obedient crowd miaowed like temperamental cats.
One final Welsh song, then Cerys was welcomed back for an encore.
She chose Johnny Cash's Ring Of Fire which for once – with Cerys's voice ringing out on the lines "I fell for you like a child/ Oh, but the fire went wild" – hit home as one of the darkest songs to love ever written.
But thanks to her subtle plug, at least you knew there was Cerys's festive radio show to look forward to. And it looked as if the throng around the merchandise stall buying her festive album were picking up a lasting reminder to help light their way to Christmas.


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SAN ANTONIO -- Lines of voters wrap around buildings all over the city Monday, as San Antonians turn out in masses for the first day of early voting.
The lines formed at 8 a.m. Monday and people patiently waited, even as the line twisted and turned, snaking its way throughout Wonderland of the Americas.
At its peak, the wait was two hours. However, no one KENS 5 met was upset about the wait, but they did have strong feelings about voting in this election.
"Just get it over with," voters told KENS 5 over and over again.
First-time voters Ariel and Auburne Deaton were a little less pessimistic. They waited for about an hour at the Great Northwest Library off Culebra.
"It's exciting, the turnout the long line that we're standing in," said Auburne. "It's really exciting that people are participating."
This is by no means the first time Mary Miller has voted, but it is her first time early voting.
"It's the most horrible election I've ever participated in," said Miller. "I've heard mudslinging before but this is the worst. It's made me apprehensive. 'Am I voting right…for the common good?'"
Despite some apprehension, voters said they're eager to be part of the what could be a historic election.


text: Eli Lilly announced positive top-line results of two additional Phase III trials for dulaglutide, an investigational, long-acting glucagon-like peptide 1 receptor agonist being studied as a once-weekly treatment for type 2 diabetes. Primary efficacy endpoints of non-inferiority to insulin glargine, as measured by the reduction of hemoglobin A1c levels at the 1.5 mg dose, were met in two studies. Having met the primary endpoints, superiority for HbA1c lowering was examined. The dulaglutide 1.5 mg dose demonstrated statistically superior reduction in HbA1c from baseline compared to insulin glargine at 52 weeks in patients with type 2 diabetes on metformin and glimeperide. The dulaglutide 1.5 mg dose in combination with insulin lispro demonstrated statistically superior reduction in HbA1c from baseline compared to insulin glargine in combination with insulin lispro at 26 weeks. Across these two additional completed AWARD studies, the most frequently reported adverse events were gastrointestinal-related. These adverse event findings are consistent with prior studies of dulaglutide.