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Noah Kahan has mastered the art of honesty. At only 21, he's the small town success story stirring the dreams of aspiring musicians across the country. Best known for his song "Hurt Somebody" with Julia Michaels, Kahan's releases consistently accumulate millions of streams, further establishing him as a muse to budding lyricists. We met up with the indie up & comer in the midst of his current tour and on the tails of his most recent single to gain some insights on his songwriting. Get a glimpse of the mind that's shaking up the songwriting sphere as Noah Kahan deconstructs the anatomy of "False Confidence."
BRAIN: The Thought Process
OTW: Take us through the first writing session for "False Confidence." What was your headspace?
Noah Kahan: I was seeing all these people on instagram and online, these artists that were getting attention by looking the part and giving the world this processed version of themselves that fit the spectrum of what brings fans– dressing crazy, or having a vibe or a super crazy aesthetic and I just didn't have that. I always struggle with social media and branding myself. I love writing songs and singing and I was always comparing myself to people who have great brands. It made me feel like I had to do the same thing to get success. So for a while, I felt like I was losing myself in trying to brand myself or trying to have an aesthetic and look a certain way instead of focusing on the music and what makes me, me. That idea planted the seed for the song.
OTW: How did you start getting the ideas down?
Noah Kahan: I wrote the first line, first verse and then I wrote the chorus chord structure. Then I went to lunch with an artist called Joy Williams who is an amazing folk singer from The Civil Wars. I was about to go to France on a songwriting expo that ASCAP puts on, and I was really nervous because I was really young, and I hadn't done much songwriting and all these famous songwriters were there. I was super scared. So I was talking to Joy, and she was like, "You just have to have false confidence about it and go in and act like you're the man." And that phrase really stuck with me. It fit really well into this idea of putting on a mask or putting on a show, which is what I felt like I was doing. So that gave me the seed. Then I went to France and brought the verse and chorus that I had started, and me and Chris DeStefano dug through the whole production of it there. So that's how the song came together. Then I went to LA and recorded it with Joel Little.
OTW: He's your go-to producer, right?
Yeah I've been lucky enough to work with Joel on almost every song that I've done. He's amazing, I think he's the best producer in the world.
OTW: What's your role like in production or do you sit back and let Joel take the wheel?
The technicalities of production are overwhelming for me. My brain is not very technical, it's more of a creative, free-flowing thing so I can't do the actual production part. But I aid in the vibe and what instruments we should use and what parts of the song needs a certain feel. In terms of actually producing the song, I don't do much. (laughs)
OTW: When you write is it usually just you and your guitar? Do you write in fragments or full songs?
It really depends. Before I got signed I was writing songs every couple of weeks because things would happen that would fill me with emotion, and they'd just pour out of me. When I got signed, it became that I needed to find more consistency and make it more of a routine. I changed the process a little bit in that I would do what I could for that day. If one day I had a good idea or melody or guitar lick I'd write that down. I'd never try to force a whole song. So it just depends on the day. Sometimes I really do feel a whole song coming out. "Young Blood" was like 30 minutes, "Hurt Somebody" was like 15. Other songs like "Come Down" and "False Confidence" took a while, so it depends on how much time the song needs.
HEART: The Core Emotion
OTW: What does "False Confidence" mean to you compared to other songs you've written?
All of my songs are personal stories and real parts of me, but I think "False Confidence" is a vulnerable song, and talking to myself and digging into myself like I do in the song makes it more personal. So it's a song I hold close to my heart. It's not a story as much as it is these feelings I was having. It's been cool to share that, it makes me feel less alone.
LEGS: The Means to Take Off
OTW: What made "False Confidence" follow your other releases so strongly?
After the success of "Hurt Somebody," it's kind of scary putting music back in the world. I'm down with being a one hit wonder, but I'd prefer not to. So I was like, "Oh shit I hope people like the song." So going through the YouTube and Instagram comments and seeing people share their own story or how they interpret the song is really cool. It's really overwhelming to see people take their own meaning from it and find a piece of themselves through the lyrics.
HANDS: Advice For Songwriters Who Need A Lift
OTW: What kind of advice have you gotten that resonated with you?
I got a lot of good advice, I still get good advice all the time. If there's one thing, it'd be to write everyday. My mom is an author, and I had struggled really badly with writer's block and doubt in general, and she'd always tell me to write everyday. Even if it sucks, you have to keep writing because it's a muscle and you'll learn that it doesn't suck as bad as you think it will. It's so easy to stop doing it and withdraw into yourself and not believe in yourself, and I think if you write everyday you're forced to see the progress that is going to be there intrinsically. I've always written like six or seven terrible songs and thought, "I'm never going to write a good song again." And eventually you just do because you're trained to do it.
Other than that, it's not comparing yourself to other writers and not trying to sound like anybody else, because you'll never sound genuine. Never try to chase someone else's vibe because that's just a rabbit hole you'll go down forever and never end up sounding good.
OTW: What advice would you give small town artists who have talent but don't know how to make a name for themselves?
I get asked that by people on Instagram all the time. It's a tough question because I really won the lottery in the way I was discovered. I didn't promote myself at all; I didn't advertise my music but I posted on a Facebook page and people connected with it immediately and spread it around. So if I could give any advice based on my experience, it would be to make music that you believe in and if other people believe in it too, it'll get shared. I've never met someone incredibly talented that hasn't had at least some kind of chance, and I don't think this idea of it being impossible to make it in the music industry is as legit as people say it is. If you're really great and you have something unique and you're honest then you'll find a chance. Other than that, play as much as possible if you're in a small town so when you do get that shot you can be ready for it.
OTW: You know what comes next! Any new Ones to Watch?
I'll try to find someone that nobody really knows so it's a cooler answer. Juke Ross has a really quiet, tender sound which I love. Luca Fogale is really great coming out of England. Dermot Kennedy, obviously incredible, he's blowing up. Other than that Isaac Gracie and Toulouse are great. My boy Cory Harper is an incredible artist, he's here in LA and he's going to be coming out on the road with me.


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at The Olmsted
General Donation
Monetary Donations – To make a Financial Donation to SPARC Hope, use the Donate Button below. We are a Federal Non Profit under section 501(c)(3). SPARC Hope will send out tax statements at the end of the year!
Support A Single Parent
If you would like to Support a Single Parent, a full year is $2400; half a year is $1200. Use the Donate Button below. We will send out tax statements at the end of the year! Will keep you updated on moms in our program through newsletters and annual reports!
We have many ways to volunteer at SPARC Hope. One of the biggest ways to help is by coming to work in our food pantry. This is one of the largest resources that we have for our single parents.
What We Do
SPARC Hope, Single Parent Resource Center, serves single parents who are struggling to make ends meet and who are willing to make the extra effort to help secure the future for themselves and their children. We are also a liaison between resources and services for single parents in our community. SPARC Hope is not welfare or charity, but rather a hand up. Our goal is to uplift the Spiritual, Physical and Emotional needs of single parents. We want to empower single parents to seek a better quality of life through pursuing a higher education, allowing them to become self-supportive through a new career. We understand the road to the American Dream is often full of obstacles, ones we are trying to alleviate.
How We Began
Bob Cherry, Senior Pastor of Northeast Christian Church, challenged 100 members with what he called a Kingdom Assignment. The Kingdom Assignment in short: Take $100.00 and change the world. When Sheila Day received her challenge she ultimately felt that God was laying single mothers on her heart. Her first step was to send out 50 letters asking friends and family to match her $100.00. She wound up receiving $15,000 back. With that she rented her first space which would become Mom's Closet Resource Center (MCRC).
Since its humble beginnings in 2003 MCRC has changed and grown into a multi-faceted program. We are dedicated to helping single mothers break the cycle of poverty in their own families by encouraging them to engage in higher education. We at SPARC believe the only way to become independent is to strive for excellence through education.
When doing our strategic planning for 2019, we decided it was time to Re-Brand. In doing our research, we determined the need was still great in our community to assist single moms, but realized that the need to assist single dads was on the rise. We also wanted to shed the thought that our organization was a clothes closet. So, with lots of help, we finally landed on SPARC Hope, Single Parent Resource Center. We revealed our new name at our Breakfast of Champions on 7/23/19. Dawne Gee was our guest speaker, and WAVE 3 captured our reveal! Excited to see what our future holds!
Our Mission & Vision
We will be known as a premier resource for single parents that enable and empower them to become self-supporting to achieve a better quality of life for themselves and their children
Our purpose is to provide support, encouragement and guidance to single parents in the pursuit of identifying life choice options that will enhance their opportunities for career advancement and independence.
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prefest (estradiol and norgestimate)
[Duramed Pharmaceuticals, Inc.]
Rx only
Revised DECEMBER 2006
Estrogens and progestins should not be used for the prevention of cardiovascular disease. (See WARNINGS, Cardiovascular disorders.)
The Women's Health Initiative (WHI) study reported increased risks of myocardial infarction, stroke, invasive breast cancer, pulmonary emboli, and deep vein thrombosis in postmenopausal women (50 to 79 years of age) during 5 years of treatment with oral conjugated equine estrogens (CE 0.625 mg) combined with medroxyprogesterone acetate (MPA 2.5 mg) relative to placebo (See CLINICAL PHARMACOLOGY, Clinical Studies).
The Women's Health Initiative Memory Study (WHIMS), a substudy of WHI, reported increased risk of developing probable dementia in postmenopausal women 65 years of age or older during 4 years of treatment with oral conjugated estrogens plus medroxyprogesterone acetate relative to placebo. It is unknown whether this finding applies to younger postmenopausal women or to women taking estrogen alone therapy. (See CLINICAL PHARMACOLOGY, Clinical Studies.)
Other doses of oral conjugated estrogens with medroxyprogesterone acetate, and other combinations and dosage forms of estrogens and progestins were not studied in the WHI clinical trials and, in the absence of comparable data, these risks should be assumed to be similar. Because of these risks, estrogens with or without progestins should be prescribed at the lowest effective doses and for the shortest duration consistent with treatment goals and risks for the individual woman.
The PREFEST regimen provides for a single oral tablet to be taken once daily. The peach tablet containing 1 mg estradiol is taken on days one through three of therapy; the white tablet containing 1 mg estradiol and 0.09 mg norgestimate is taken on days four through six of therapy. This pattern is then repeated continuously to produce the constant estrogen/intermittent progestogen regimen of PREFEST.
The estrogenic component of PREFEST is estradiol, USP. It is a white, crystalline solid, chemically described as estra-1,3,5(10)-triene-3,17β-diol. The structural formula is as follows:
C18H24O2 Molecular Weight: 272.39
The progestational component of PREFEST is micronized norgestimate, a white powder which is chemically described as 18,19-dinor-17-pregn-4-en-20-yn-3-one, 17-(acetyloxy)-13-ethyl-,oxime,(17α)-(+)-. The structural formula is as follows:
C23H31NO3 Molecular Weight: 369.50
Each tablet for oral administration contains 1 mg estradiol alone or 1 mg estradiol and 0.09 mg of norgestimate. The inactive ingredients are as follows:
The estradiol tablet contains anhydrous lactose, croscarmellose sodium, FD&C yellow no. 6 aluminum lake, magnesium stearate and microcrystalline cellulose.
The estradiol and norgestimate tablet contains anhydrous lactose, croscarmellose sodium, magnesium stearate and microcrystalline cellulose.
Endogenous estrogens are largely responsible for the development and maintenance of the female reproductive system and secondary sexual characteristics. Although circulating estrogens exist in a dynamic equilibrium of metabolic interconversions, estradiol is the principal intracellular human estrogen and is substantially more potent than its metabolites, estrone and estriol, at the receptor level.
The primary source of estrogen in normally cycling adult women is the ovarian follicle, which secretes 70 to 500 mcg of estradiol daily, depending on the phase of the menstrual cycle. After menopause, most endogenous estrogen is produced by conversion of androstenedione, secreted by the adrenal cortex, to estrone by peripheral tissues. Thus, estrone and the sulfate conjugated form, estrone sulfate, are the most abundant circulating estrogens in postmenopausal women.
Estrogens act through binding to nuclear receptors in estrogen-responsive tissues. To date, two estrogen receptors have been identified. These vary in proportion from tissue to tissue.
Circulating estrogens modulate the pituitary secretion of the gonadotropins, luteinizing hormone (LH) and follicle stimulating hormone (FSH), through a negative feedback mechanism. Estrogens act to reduce the elevated levels of these hormones seen in postmenopausal women.
Norgestimate is a derivative of 19-nortestosterone and binds to androgen and progestogen receptors, similar to that of the natural hormone progesterone; it does not bind to estrogen receptors. Progestins counter the estrogenic effects by decreasing the number of nuclear estradiol receptors and suppressing epithelial DNA synthesis in endometrial tissue.
Estradiol reaches its peak serum concentration (Cmax) at approximately 7 hours in postmenopausal women receiving PREFEST (Table 1). Norgestimate is completely metabolized; its primary active metabolite, 17-deacetylnorgestimate, reaches Cmax at approximately 2 hours after dose (Table 1). Upon co-administration of PREFEST with a high fat meal, the Cmax values for estrone and estrone sulfate were increased by 14% and 24%, respectively, and the Cmax for 17-deacetylnorgestimate was decreased by 16%. The AUC values for these analytes were not significantly affected by food.
The distribution of exogenous estrogens is similar to that of endogenous estrogens. Estrogens are widely distributed in the body and are generally found in higher concentrations in the sex hormone target organs. Estrogens circulate in the blood largely bound to sex hormone binding globulin (SHBG) and albumin. 17-deacetylnorgestimate, the primary active metabolite of norgestimate, does not bind to SHBG, but to other serum proteins. The percent protein binding of 17-deacetylnorgestimate is approximately 99%.
Exogenous estrogens are metabolized in the same manner as endogenous estrogens. Circulating estrogens exist in a dynamic equilibrium of metabolic interconversions. These transformations take place mainly in the liver. Estradiol is converted reversibly to estrone, and both can be converted to estriol, which is the major urinary metabolite. Estrogens also undergo enterohepatic recirculation via sulfate and glucuronide conjugation in the liver, biliary secretion of conjugates into the intestine, and hydrolysis in the gut followed by reabsorption. In postmenopausal women, a significant portion of the circulating estrogens exist as sulfate conjugates, especially estrone sulfate, which serves as a circulating reservoir for the formation of more active estrogens. Norgestimate is extensively metabolized by first-pass mechanisms in the gastrointestinal tract and/or liver. Norgestimate's primary active metabolite is 17-deacetylnorgestimate.
Estradiol, estrone, and estriol are excreted in the urine along with glucuronide and sulfate conjugates. Norgestimate metabolites are eliminated in the urine and feces. The half-life (t1/2) of estradiol and 17-deacetylnorgestimate in postmenopausal women receiving PREFEST is approximately 16 and 37 hours, respectively.
In vitro and in vivo studies have shown that estrogens are metabolized partially by cytochrome P450 3A4 (CYP3A4). Therefore, inducers or inhibitors of CYP3A4 may affect estrogen drug metabolism. Inducers of CYP3A4 such as St. John's Wort preparations (Hypericum perforatum), phenobarbital, carbamazepine, and rifampin may reduce plasma concentrations of estrogens, possibly resulting in a decrease in therapeutic effects and/or changes in the uterine bleeding profile. Inhibitors of CYP3A4 such as erythromycin, clarithromycin, ketoconazole, itraconazole, ritonavir and grapefruit juice may increase plasma concentrations of estrogens and may result in side effects.
Results of a subset population (n=24) from a clinical study conducted in 36 healthy postmenopausal women indicated that the steady state serum estradiol levels during the estradiol plus norgestimate phase of the regimen may be lower by 12-18% as compared with estradiol administered alone. The serum estrone levels may decrease by 4% and the serum estrone sulfate levels may increase by 17% during the estradiol plus norgestimate phase as compared with estradiol administered alone. The clinical relevance of these observations is unknown.
The effects of race and body weight on the pharmacokinetics of estradiol, norgestimate, and their metabolites were evaluated in 164 healthy postmenopausal women (100 Caucasians, 61 Hispanics, 2 Blacks, and 1 Asian). No significant pharmacokinetic difference was observed between the Caucasian and the Hispanic postmenopausal women. No significant difference due to body weight was observed in women in the 60 to 80 kg weight range.Women with body weight higher than 80 kg, however, had approximately 40% lower peak serum levels of 17-deacetylnorgestimate, 30% lower AUC values for 17-deacetylnorgestimate and 30% lower Cmax values for norgestrel. The clinical relevance of these observations is unknown.
No pharmacokinetic studies were conducted in other special populations.
FirstDose E2
|First Dose E2/NGM
|Multiple Dose E2
|Multiple Dose E2/NGM
tmaxAUC (0-24 h)
hpg. h/mL
tmaxAUC (0-24 h)
hpg. h/mL
tmaxAUC (0-24 h)
hng. h/mL
AUC (0-24 h)t½
pg. h/mLh
The effect of the estrogen component of PREFEST on vasomotor symptoms was confirmed in a 12-week placebo-controlled trial of 168 healthy postmenopausal women between 28 and 66 years of age (87% Caucasian) with moderate to severe vasomotor symptoms (MSVS). The addition of norgestimate to estrogen (i.e., the PREFEST regimen) was studied in two 12-month trials in 1212 healthy postmenopausal women between 40 and 65 years of age (85% Caucasian) for endometrial protection. Results from a subset population (n=119) of these 12-month trials (women with MSVS) are shown in Table 2.
|1 mg E2
Week 4
Week 8Week 12
The effects of the addition of norgestimate on steady state estrogen levels and the clinical relevance thereof have been discussed in CLINICAL PHARMACOLOGY (see Drug Interactions).
The effect of the estrogen component of PREFEST on vulvar and vaginal atrophy was confirmed in a 12-week placebo-controlled trial of healthy postmenopausal women with moderate to severe vasomotor symptoms (MSVS). The addition of norgestimate to estrogen (i.e., the PREFEST regimen) was studied in a 12-month trial in 143 healthy postmenopausal women between 42 and 65 years of age (92% Caucasian) for endometrial protection. Results from a subset population (n=69) with paired tests for maturation index of the vaginal mucosa are shown in Table 3.
|Pretreatment Mean
Month 7Mean
|1 mg Estradiol (N=37)
Parabasal Cells (%)
Intermediate Cells (%)Superficial Cells (%)
Parabasal Cells (%)
Intermediate Cells (%)Superficial Cells (%)
The effect of PREFEST on the endometrium was evaluated in two 12-month trials. The combined results are shown in Table 4.
1 mg estradiol
Total No. Subjects
Total No. Evaluable Biopsies
Normal endometrium
Simple hyperplasia
Complex hyperplasiaHyperplasia with cytological atypia
256 (97%)
182 (71%)
64 (25%)
2 (0.8%)8 (3%)
227 (94%)
227 (100%)
0 (0%)
0 (0%)0 (0%)
In another 12-month controlled clinical trial for endometrial protection an additional 190 postmenopausal women were treated with PREFEST. No subject had a diagnosis of endometrial hyperplasia after treatment.
The effects of PREFEST on uterine bleeding or spotting, as recorded on daily diary cards, were evaluated in two 12-month trials. Combined results are shown in Figure 1.
Figure 1: Subjects with Cumulative Amenorrhea Over Time (Percentage of Women With No Bleeding or Spotting at a Given Month Through Month 12), Intent to treat Population
The effect of PREFEST on lipids was evaluated in a 12-month metabolic trial of healthy postmenopausal women. Results are shown in Table 5.
|1 mg E2
Total Cholesterol
The Women's Health Initiative (WHI) enrolled a total of 27,000 predominantly healthy postmenopausal women to assess the risks and benefits of either the use of oral 0.625 mg conjugated estrogens (CE) per day alone or the use of oral 0.625 mg conjugated estrogens plus 2.5 mg medroxyprogesterone acetate (MPA) per day compared to placebo in the prevention of certain chronic diseases. The primary endpoint was the incidence of coronary heart disease (CHD) (nonfatal myocardial infarction and CHD death), with invasive breast cancer as the primary adverse outcome studied. A "global index" included the earliest occurrence of CHD, invasive breast cancer, stroke, pulmonary embolism (PE), endometrial cancer, colorectal cancer, hip fracture, or death due to other cause. The study did not evaluate the effects of CE or CE/MPA on menopausal symptoms.
The CE/MPA substudy was stopped early because, according to the predefined stopping rule, the increased risk of breast cancer and cardiovascular events exceeded the specified benefits included in the "global index." Results of the CE/MPA substudy, which included 16,608 women (average age of 63 years, range 50 to 79; 83.9% White, 6.5% Black, 5.5% Hispanic), after an average follow-up of 5.2 years are presented in Table 6 below:
Relative Risk
CE/MPA vs placebo
at 5.2 Years
Placebo n = 8102
n = 8506
|Absolute Risk per 10,000 Person-years
CHD events
Non-fatal MICHD death
1.29 (1.02-1.63)
1.32 (1.02-1.72)1.18 (0.70-1.97)
|Invasive breast cancer§
|1.26 (1.00-1.59)
|1.41 (1.07-1.85)
|Pulmonary embolism
|2.13 (1.39-3.25)
|Colorectal cancer
|0.63 (0.43-0.92)
|Endometrial cancer
|0.83 (0.47-1.47)
|Hip fracture
|0.66 (0.45-0.98)
|Death due to causes other than the events above
|0.92 (0.74-1.14)
|Global Index†
|1.15 (1.03-1.28)
|Deep vein thrombosis¶
|2.07 (1.49-2.87)
|Vertebral fractures¶
|0.66 (0.44-0.98)
|Other osteoporotic fractures¶
|0.77 (0.69-0.86)
For those outcomes included in the "global index," the absolute excess risks per 10,000 women-years in the group treated with CE/MPA were 7 more CHD events, 8 more strokes, 8 more PEs, and 8 more invasive breast cancers, while absolute risk reductions per 10,000 women-years were 6 fewer colorectal cancers and 5 fewer hip fractures. The absolute excess risk of events included in the "global index" was 19 per 10,000 women-years. There was no difference between the groups in terms of all-cause mortality. (See BOXED WARNING,WARNINGS, and PRECAUTIONS.)
The Women's Health Initiative Memory Study (WHIMS), a substudy of WHI, enrolled 4,532 predominantly healthy postmenopausal women 65 years of age and older (47% were age 65 to 69 years, 35% were 70 to 74 years, and 18% were 75 years of age and older) to evaluate the effects of CE/MPA (0.625 mg conjugated estrogens plus 2.5 mg medroxyprogesterone acetate) on the incidence of probable dementia (primary outcome) compared with placebo.
After an average follow-up of 4 years, 40 women in the estrogen/progestin group (45 per 10,000 women-years) and 21 in the placebo group (22 per 10,000 women-years) were diagnosed with probable dementia. The relative risk of probable dementia in the hormone therapy group was 2.05 (95% CI, 1.21 to 3.48) compared to placebo. Differences between groups became apparent in the first year of treatment. It is unknown whether these findings apply to younger postmenopausal women. (See BOXED WARNING and WARNINGS, Dementia.)
PREFEST is indicated in women who have a uterus for the:
The mainstays for decreasing the risk of postmenopausal osteoporosis are weight bearing exercise, adequate calcium and vitamin D intake, and when indicated, pharmacologic therapy. Postmenopausal women require an average of 1500 mg/day of elemental calcium. Therefore, when not contraindicated, calcium supplementation may be helpfulfor women with suboptimal dietary intake. Vitamin D supplementation of 400-800 IU/day may also be required to ensure adequate daily intake in postmenopausal women.
PREFEST should not be used in women with any of the following conditions:
See BOXED WARNINGS.
Estrogen and estrogen/progestin therapy has been associated with an increased risk of cardiovascular events such as myocardial infarction and stroke, as well as venous thrombosis and pulmonary embolism (venous thromboembolism or VTE). Should any of these occur or be suspected, estrogens should be discontinued immediately.
Risk factors for arterial vascular disease (e.g., hypertension, diabetes mellitus, tobacco use, hypercholesterolemia, and obesity) and/or venous thromboembolism (e.g., personal history or family history of VTE, obesity, and systemic lupus erythematosus) should be managed appropriately.
In the Women's Health Initiative (WHI) study, an increase in the number of myocardial infarctions and strokes has been observed in women receiving CE compared to placebo. These observations are preliminary. (See CLINICAL PHARMACOLOGY, Clinical Studies.)
In the CE/MPA substudy of WHI, an increased risk of coronary heart disease (CHD) events (defined as nonfatal myocardial infarction and CHD death) was observed in women receiving CE/MPA compared to women receiving placebo (37 vs 30 per 10,000 women-years). The increase in risk was observed in year one and persisted.
In the same substudy of WHI, an increased risk of stroke was observed in women receiving CE/MPA compared to women receiving placebo (29 vs 21 per 10,000 women-years). The increase in risk was observed after the first year and persisted.
In postmenopausal women with documented heart disease (n=2,763, average age 66.7 years) a controlled clinical trial of secondary prevention of cardiovascular disease (Heart and Estrogen/Progestin Replacement Study; HERS) treatment with (CE/MPA 0.625 mg/2.5 mg per day) demonstrated no cardiovascular benefit. During an average follow-up of 4.1 years, treatment with CE/MPA did not reduce the overall rate of CHD events in postmenopausal women with established coronary heart disease. There were more CHD events in the CE/MPA-treated group than in the placebo group in year 1, but not during the subsequent years. Two thousand three hundred and twenty one women from the original HERS trial agreed to participate in an open label extension of HERS, HERS II. Average follow-up in HERS II was an additional 2.7 years, for a total of 6.8 years overall. Rates of CHD events were comparable among women in the CE/MPA group and the placebo group in HERS, HERS II, and overall.
Large doses of estrogen (5 mg conjugated estrogens per day), comparable to those used to treat cancer of the prostate and breast, have been shown in a large prospective clinical trial in men to increase the risks of nonfatal myocardial infarction, pulmonary embolism, and thrombophlebitis.
In the Women's Health Initiative (WHI) study, an increase in VTE has been observed in women receiving CE compared to placebo. These observations are preliminary. (See CLINICAL PHARMACOLOGY, Clinical Studies.)
In the CE/MPA substudy of WHI, a 2-fold greater rate of VTE, including deep venous thrombosis and pulmonary embolism, was observed in women receiving CE/MPA compared to women receiving placebo. The rate of VTE was 34 per 10,000 women-years in the CE/MPA group compared to 16 per 10,000 women-years in the placebo group. The increase in VTE risk was observed during the first year and persisted.
If feasible, estrogens should be discontinued at least 4 to 6 weeks before surgery of the type associated with an increased risk of thromboembolism, or during periods of prolonged immobilization.
The use of unopposed estrogens in women with intact uteri has been associated with an increased risk of endometrial cancer. The reported endometrial cancer risk among unopposed estrogen users is about 2- to 12-fold greater than in non-users, and appears dependent on duration of treatment and on estrogen dose. Most studies show no significant increased risk associated with use of estrogens for less than one year. The greatest risk appears associated with prolonged use, with increased risks of 15- to 24-fold for five to ten years or more and this risk has been shown to persist for at least 8 to 15 years after estrogen therapy is discontinued.
Clinical surveillance of all women taking estrogen/progestin combinations is important. Adequate diagnostic measures, including endometrial sampling when indicated, should be undertaken to rule out malignancy in all cases of undiagnosed persistent or recurring abnormal vaginal bleeding. There is no evidence that the use of natural estrogens results in a different endometrial risk profile than synthetic estrogens of equivalent estrogen dose. Adding a progestin to estrogen therapy has been shown to reduce the risk of endometrial hyperplasia, which may be a precursor to endometrial cancer.
The use of estrogens and progestins by postmenopausal women has been reported to increase the risk of breast cancer. The most important randomized clinical trial providing information about this issue is the Women's Health Initiative (WHI) substudy of CE/MPA (see CLINICAL PHARMACOLOGY, Clinical Studies). The results from observational studies are generally consistent with those of the WHI clinical trial and report no significant variation in the risk of breast cancer among different estrogens or progestins, doses, or routes of administration.
The CE/MPA substudy of WHI reported an increased risk of breast cancer in women who took CE/MPA for a mean follow-up of 5.6 years. Observational studies have also reported an increased risk for estrogen/progestin combination therapy, and a smaller increased risk for estrogen alone therapy, after several years of use. In the WHI trial and from observational studies, the excess risk increased with duration of use. From observational studies, the risk appeared to return to baseline in about five years after stopping treatment. In addition, observational studies suggest that the risk of breast cancer was greater, and become apparent earlier, with estrogen/progestin combination therapy as compared to estrogen alone therapy.
In the CE/MPA substudy, 26% of the women reported prior use of estrogen alone and/or estrogen/progestin combination hormone therapy. After a mean follow-up of 5.6 years during the clinical trial, the overall relative risk of invasive breast cancer was 1.24 (95% confidence interval 1.01-1.54), and the overall absolute risk was 41 vs. 33 cases per 10,000 women-years, for CE/MPA compared with placebo. Among women who reported prior use of hormone therapy, the relative risk of invasive breast cancer was 1.86, and the absolute risk was 46 vs. 25 cases per 10,000 women-years, for CE/MPA compared with placebo. Among women who reported no prior use of hormone therapy, the relative risk of invasive breast cancer was 1.09 and the absolute risk was 40 vs. 36 cases per 10,000 women-years for CE/MPA compared with placebo. In the same substudy, invasive breast cancers were larger and diagnosed at a more advanced stage in the CE/MPA group compared with the placebo group. Metastatic disease was rare with no apparent difference between the two groups. Other prognostic factors such as histologic subtype, grade and hormone receptor status did not differ between the groups.
The use of estrogen plus progestin has been reported to result in an increase in abnormal mammograms requiring further evaluation. All women should receive yearly breast examinations by a healthcare provider and perform monthly breast self-examinations. In addition, mammography examinations should be scheduled based on patients age, risk factors, and prior mammogram results.
In the Women's Health Initiative Memory Study (WHIMS), 4,532 generally healthy postmenopausal women 65 years of age and older were studied, of whom 35% were 70 to 74 years of age and 18% were 75 or older. After an average follow-up of 4 years, 40 women being treated with CE/MPA (1.8%, n=2,229) and 21 women in the placebo group (0.9%, n=2,303) received diagnoses of probable dementia. The relative risk for CE/MPA versus placebo was 2.05 (95% confidence interval 1.21–3.48), and was similar for women with and without histories of menopausal hormone use before WHIMS. The absolute risk of probable dementia for CE/MPA versus placebo was 45 versus 22 cases per 10,000 women-years, and the absolute excess risk for CE/MPA was 23 cases per 10,000 women-years. It is unknown whether these findings apply to younger postmenopausal women. (See CLINICAL PHARMACOLOGY, Clinical Studies and PRECAUTIONS, Geriatric Use.)
It is unknown whether these findings apply to estrogen alone therapy.
A 2- to 4-fold increase in the risk of gallbladder disease requiring surgery in postmenopausal women receiving estrogens has been reported.
Estrogen administration may lead to severe hypercalcemia in patients with breast cancer and bone metastases. If hypercalcemia occurs, use of the drug should be stopped and appropriate measures taken to reduce the serum calcium level.
Retinal vascular thrombosis has been reported in patients receiving estrogens. Discontinue medication pending examination if there is sudden partial or complete loss of vision, or a sudden onset of proptosis, diplopia, or migraine. If examination reveals papilledema or retinal vascular lesions, estrogens should be permanently discontinued.
Physicians are advised to discuss the contents of the PATIENT INFORMATION leaflet with patients for whom they prescribe PREFEST.
Estrogen administration should be initiated at the lowest dose approved for the indication and then guided by clinical response rather than by serum hormone levels (e.g., estradiol, FSH).
Long-term continuous administration of estrogen, with and without progestin, in women with and without a uterus, has shown an increased risk of endometrial cancer, breast cancer, and ovarian cancer. (See BOXED WARNINGS, WARNINGS and PRECAUTIONS.)
Long-term continuous administration of natural and synthetic estrogens in certain animal species increases the frequency of carcinomas of the breast, uterus, cervix, vagina, testis, and liver.
PREFEST should not be used during pregnancy. (See CONTRAINDICATIONS.)
Estrogen administration to nursing mothers has been shown to decrease the quantity and quality of the milk. Detectable amounts of estrogens and progestins have been identified in the milk of mothers receiving this drug. Caution should be exercised when PREFEST is administered to a nursing mother.
PREFEST is not indicated for use in children.
There have not been sufficient numbers of geriatric patients involved in clinical studies utilizing PREFEST to determine whether those over 65 years of age differ from younger subjects in their response to PREFEST.
In the Women's Health Initiative Memory Study, including 4,532 women 65 years of age and older, followed for an average of 4 years, 82% (n=3,729) were 65 to 74 while 18% (n=803) were 75 and over. Most women (80%) had no prior hormone therapy use.Women treated with conjugated estrogens plus medroxyprogesterone acetate were reported to have a two-fold increase in the risk of developing probable dementia. Alzheimer's disease was the most common classification of probable dementia in both the conjugated estrogens plus medroxyprogesterone acetate group and the placebo group. Ninety percent of the cases of probable dementia occurred in the 54% of women that were older than 70. (See WARNINGS, Dementia.)
It is unknown whether these findings apply to estrogen alone therapy.
See BOXED WARNINGS,WARNINGS, and PRECAUTIONS.
Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice. The adverse reaction information from clinical trials does, however, provide a basis for identifying the adverse events that appear to be related to drug use and for approximating rates.
PREFEST (Estradiol and Norgestimate)
|Body as a Whole
|Back pain
|69 (12%)
|32 (6%)
|Influenza-like symptoms
|64 (11%)
|37 (6%)
|Digestive System
|Abdominal pain
|70 (12%)
|29 (5%)
|34 (6%)
|Tooth disorder
|27 (5%)
|Musculoskeletal System
|51 (9%)
|30 (5%)
|Nervous System
|27 (5%)
|132 (23%)
|Psychiatric Disorders
|27 (5%)
|Reproductive System
|Breast pain
|92 (16%)
|48 (8%)
|Vaginal bleeding (all)
|52 (9%)
|42 (7%)
|Resistance Mechanism Disorders
|Viral infection
|35 (6%)
|Respiratory System
|28 (5%)
|38 (7%)
|44 (8%)
|Upper respiratory-tract infection
|121 (21%)
The following additional adverse reactions have been reported with estrogen and/or progestin therapy:
Serious ill effects have not been reported following acute ingestion of large doses of estrogen-containing drug products by young children. Overdosage of estrogen may cause nausea and vomiting, and withdrawal bleeding may occur in females.
Use of estrogen, alone or in combination with a progestin, should be with the lowest effective dose and for the shortest duration consistent with treatment goals and risks for the individual woman. Patients should be reevaluated periodically as clinically appropriate (e.g., 3-month to 6-month intervals) to determine if treatment is still necessary (See BOXED WARNINGS and WARNINGS). For women who have a uterus, adequate diagnostic measures, such as endometrial sampling, when indicated, should be undertaken to rule out malignancy in cases of undiagnosed persistent or recurring abnormal vaginal bleeding.
PREFEST regimen consists of the daily administration of a single tablet containing 1 mg estradiol (peach color) for three days followed by a single tablet of 1 mg estradiol combined with 0.09 mg norgestimate (white color) for three days. This regimen is repeated continuously without interruption.
If a tablet is missed for one or more days, therapy should be resumed with the next available tablet. The patient should continue to take only one tablet each day in sequence.
The lowest effective dose of PREFEST has not been determined.
PREFEST® (estradiol 1 mg and estradiol 1mg/norgestimate 0.09 mg) tablets are packaged in cartons of six pouches.
1 mg estradiol: Peach, round, flat-faced, beveled-edge, unscored tablets, debossed with P on one side and 93 on the other side.
1 mg estradiol and 0.09 mg norgestimate: White, round, flat-faced, beveled-edge, unscored tablets, debossed with P on one side and 92 on the other side.
Each pouch consists of a blister card containing 3 peach tablets followed by 3 white tablets. This pattern of 3 peach tablets and 3 white tablets repeats for a total of 30 tablets per blister card. Each blister card contains 15 tablets of each of the two tablets. The 3-day phases are alternated continuously during treatment.
|30 Tablets
Store at 20º to 25ºC (68º to 77ºF) [See USP Controlled Room Temperature].
Keep out of reach of children.
(estradiol/norgestimate) tablets
Read this PATIENT INFORMATION before you start taking PREFEST and read what you get each time you refill PREFEST. There may be new information. This information does not take the place of talking to your healthcare provider about your medical condition or your treatment.
What is the most important information I should know about PREFEST (a combination of estrogen and progestin hormones)?
Using estrogens and progestins may increase your chances of getting heart attacks, strokes, breast cancer, and blood clots. Using estrogens with progestins may increase your risk of dementia. You and your healthcare provider should talk regularly about whether you still need treatment with PREFEST.
What is PREFEST?
PREFEST is a medicine that contains two kinds of hormones, estrogen and progestin.
What is PREFEST used for?
PREFEST is used after menopause to:
Who Should Not Take PREFEST?
Do not start taking PREFEST if you:
Tell your healthcare provider:
How Should I Take PREFEST?
Estrogens and progestins should be used at the lowest dose possible for your treatment, only as long as needed. The lowest effective dose of PREFEST has not been determined. You and your healthcare provider should talk regularly (for example, every 3 to 6 months) about the dose you are taking and whether you still need treatment with PREFEST.
What are the possible side effects of estrogens?
Less common but serious side effects include:
These are some of the warning signs of serious side effects:
Call your healthcare provider right away if you get any of these warning signs, or any other unusual symptom that concerns you.
Common side effects include:
Other side effects include:
These are not all the possible side effects of PREFEST. For more information, ask your healthcare provider or pharmacist.
What can I do to lower my chances of a serious side effect with PREFEST?
Talk with your healthcare provider regularly about whether you should continue taking PREFEST. See your healthcare provider right away if you get vaginal bleeding while taking PREFEST. Have a breast exam and mammogram (breast X-ray) every year unless your healthcare provider tells you something else. If members of your family have had breast cancer or if you have ever had breast lumps or an abnormal mammogram you may need to have breast exams more often. If you have high blood pressure, high cholesterol (fat in blood), diabetes, are overweight, or if you use tobacco, you may have higher chances for getting heart disease. Ask your healthcare provider for ways to lower your chances for getting heart disease.
General information about the safe and effective use of PREFEST
Medicines are sometimes prescribed for conditions that are not mentioned in patient information leaflets. Do not take PREFEST for conditions for which it was not prescribed. Do not give PREFEST to other people, even if they have the same symptoms you have. It may harm them.
Keep PREFEST out of reach of children.
This leaflet provides a summary of the most important information about PREFEST. If you would like more information, talk with your healthcare provider or pharmacist. You can ask for information about PREFEST that is written for health professionals.
What are the ingredients in PREFEST?
PREFEST® (estradiol and norgestimate) tablets contain 1 mg estradiol tablets alone and 1 mg estradiol and 0.09 mg of norgestimate tablets. The inactive ingredients are as follows:
The estradiol tablet contains anhydrous lactose, croscarmellose sodium, FD&C yellow no. 6 aluminum lake, magnesium stearate and microcrystalline cellulose.
The estradiol and norgestimate tablet contains anhydrous lactose, croscarmellose sodium, magnesium stearate and microcrystalline cellulose.
Duramed Pharmaceuticals, Inc.
Subsidiary of Barr Pharmaceuticals, Inc.
Pomona, New York 10970
Revised DECEMBER 2006 (v.3)
|PREFEST (estradiol and norgestimate)
Data are from FDA and U.S. National Library of Medicine.


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Custom Search
Electromagnetic Point Sensor. This device detects a frequency
change caused by the reflected impedance of an intruder entering an antenna's
field. Two oscillators are tightly coupled to the antenna. A change in
antenna impedance results in a change in frequency of each oscillator. This
sensor adjusts automatically to changes in the background noise level. As
the background noise level increases, the sensitivity is automatically
reduced, but detection range is also shortened.
Geophone Point Sensor. Geophone sensors are normally buried
in the ground to detect seismic disturbances generated by intruders. This
sensor is sensitive to seismic and acoustic energy sources and far-field
effects must be discriminated against.
Point Sensor. Magnetic point sensors contain one or
more magnetometers that
are used to detect the movement of ferrous objects.
Using two magnetometers
spaced at various distances, it is possible to
determine the direction
of motion of such ferrous targets.
10) Infrared Beam Sensor. Exterior infrared intrusion detection
systems can be active or passive. Passive sensors detect changes in thermal
changes in signal power between a transmitter and a receiver. Generally,
multiple beams are employed in columns at the ends of a detection zone. An
intruder passing through one or more beams causes a "beam-break," thus
generating a signal. As this sensor can be defeated by tunneling, seismic
sensors should be used as well.
Exterior IDS Detection at Building Exteriors. Several candidate
options for use at building exteriors are briefly described here.
Ported Coaxial Cable Sensors. In addition to use in the clear
zones between perimeter fences, the Ported Coax Cable System (described in
par. 220.127.116.11) can also be used around the exterior of buildings.
Vibration Sensors. Vibration sensors can be mounted on or within
walls and roofs to detect intrusion attempts at facility exteriors. The
simplest vibration sensor is a mechanical contact switch designed to actuate
when the surface on which the sensor is mounted starts to vibrate.
Grid Wire Sensors. Grid wire sensors may be embedded in the walls
or roof of a building. When the barrier is penetrated, the wire is broken
causing an alarm.
Exterior Closed-Circuit Television
Introduction. This section provides a summary of the function and
placement of CCTV's applicable minimum requirements; and the types of CCTV
equipment available. Sources of more detailed design information include:


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Special Twilights
Midweek Twilight Retreats
Various groups (church and other) are welcome to arrange for a meditative evening (6:00 9:00 pm). Registration is at 6:00 pm with supper at 6:30 pm.
Our program consists of a reflective talk given after supper followed by a silent meditation, and a closing ceremony. You may bring your own facilitator if you so wish.
Please phone 403-932-2012 during office hours to book your group for a twilight retreat. A minimum of 25 people is suggested.


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We have seen the surge of new, special and fascinating digital advertising strategies and they have proved to be successful and outcome oriented as properly. They are an intelligent, third generation photo frame, just like a digital photo frame they have an LCD show, up to 19 inches wide by 25 inches high and they show the photos in a slide show format, now right here is the had been a digital poster is distinct to a photo frame. When males feel and respond to the needs marketing creates, they are adhering to its excellent of life. An additional intriguing feature that you need to look out at time of acquiring digital advertising application is it permits the customers to retailer massive numbers of data as they want. The digital poster comes with some software program so you can drag and drop your photos onto the memory card then set the rotation time, so that the photos rotate in sequence, as you demand. In Pull Digital Marketing and advertising, you truly have to 'pull' the consumers to the targeted location.
So whether or not shoppers are waiting for a bus, standing in a bank queue or in a shop waiting to be served, they can be exposed to these digital signage displays. Whilst these local and national efforts have brought convergence to a new level, a lot of significant and local news organizations have but to incorporate all the components of media. In fact, it essentially turns them into a digital marketing and advertising agency that just so takes place to have a printed book as nicely. Organizations are searching to develop grassroots video campaigns with their customers and not only expert media agencies.
According to a study performed by the Web Video Marketing and advertising Council, 96% of B2B marketers are making use of video in their digital advertising and marketing technique. These symbols were a helpful shorthand for the mass media, because they permitted the entertainment and news media to capsulize much much more complicated personalities and issues in a shortened character or term. Digital games distort these mental maps, substituting the evoking of action for inter-individual connections.
Digital signage is distinctive in that the target audience can not only be seen consuming the marketing message but the ads can be altered to make them far more relevant to the target audience. As opposed to those of us who have had to migrate into a digital globe, Generation Z youngsters are accurate digital natives who have in no way identified life with out mobile phones or the Net. Each and every day, we are presented a cost-free present of joy and serenity courtesy of Mother Nature, but we typically opt rather for artificial pleasures like video games. And the dissonance in between our digital selves and our analog bodies has thrown us into a new state of anxiousness: present shock. And in sports stadiums digital signage is becoming employed successfully for all of these applications.
Connect: Marketing agencies that pooh-poohs standard techniques are living in the fool's globe and they are a bunch of narcissistic idiots. Partnerships with entertainment businesses such as Lions Gate Entertainment and MGM have also been main milestones in the web sites e-commerce journey. As firms try to reach an audience that is increasingly tuning out conventional advertising, they have turned to new media, like digital signage. These hugely targeted banner ads are served via digital advertising services that specialize in providing banner advertisements globally. Surely they are digital technologies, but digital advertising and marketing is regarded as simply quantifiable. Then you have to insert the media card into the player, when secured into position, the digital poster is now prepared to hang in your store window or on the wall. The institution had to hire additional employees to turn handwritten papers into digital files.


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One of the perks of the job title "stay at home mom" is being close to my kitchen so that I can bake during the day. I can leave the butter and eggs on the counter in the morning, and after feeding the baby lunch, whip up a little something sweet, a smackerel as Pooh says, for big sis when she comes home from school. Darling daughter lives on Fluffernutters, hot dogs and air, and the occasional piece of this cake. She will eat it after school, for breakfast, and as a snack before bedtime. It's the perfect partner for a glass of milk, with its Hostess-like moist texture (without the cottony mouthfeel). Adults go for it, too, I guess because of the melty chocolate chips.
This cake is based on one from America's Test Kitchen Family Cookbook, one of my absolute fave cookbooks (again with the ring-bound thing). I've made similar cakes that use sour cream, which I don't usually keep on hand, so I'm pleased that this version with whole milk can be made with ingredients in my pantry and a few black nanners from the freezer. The ATK cake is made with an electric mixer, but whenever I fire up the Kitchenaid, helpful kidoodles come running. I've discovered that stirring the cake by hand yields a perfect cake and a calm mommy and a cleaner kitchen.
Banana Chocolate Cake
2 cups all-purpose flour
2 1/2 tsp. baking powder
1/4 tsp. salt
1 1/4 cups sugar
8 tbsp. unsalted butter, softened
2 eggs, at room temperature
2 large ripe bananas, peeled & mashed to equal one cup
1/2 cup milk, room temperature (I always have whole milk on hand.)
1 tsp. vanilla extract
3/4 cup mini chocolate chip morsels
1. Heat oven to 350. Use butter wrapper to lightly grease a 9-inch square cake pan. (I use a Pampered Chef stoneware pan, with excellent results.) Stir together the flour, baking powder and salt and set aside.
2. With a sturdy wire whisk, beat together sugar and butter together until well-combined. Beat in eggs, followed by bananas, milk and vanilla.
3. Stir flour mixture into egg mixture. Pour half of the batter into the prepared pan. Sprinkle mini chocolate chips over batter. Spread remaining batter over chips. Bake 55 to 60 minutes. (I use convection and it's always spot-on, 55 minutes.) Cake is done when a toothpick inserted in center comes clean or a very clean finger can gently press the center of the cake and the cake pops back up.
4. Let cake cool and then serve in generous squares to happy kids.


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The Salt Lake Chamber will honor Sen. Orrin Hatch, R-Utah, as the 39th annual "Giant in Our City" this Saturday evening at the Grand America Hotel's Grand Ballroom.
And while U.S. House Speaker Paul Ryan, R-Wis., who is giving the keynote address, will be the marquee guest at the black-tie event, Grammy award-winning musician-songwriters Monty Powell and Anna Wilson will also be in attendance, and count themselves as "honored and humbled to be a part of this big night."
Powell and Wilson are among the evening's musical entertainment, which will also include former Eagles guitarist Don Felder.
The husband-and-wife duo, who now live near Snowbasin Resort in Huntsville for about half the year, previously spent a quarter-century in Nashville writing hits for the likes of country stars Keith Urban, Lady Antebellum, Reba McEntire, and Brooks & Dunn, among others.
But they also worked with Hatch briefly back in 2012.
Powell said that ahead of that year's Grammys on the Hill event — an annual function intended to honor musical artists and legislators who work to improve musician royalties generated in the digital era — he got a request to collaborate with Hatch, himself a frequent songwriter, for a surprise performance at the soiree.
They wrote two songs, and, along with Wilson, performed one of them, "High Country," which Powell noted was "based on our mutual love of mountains and the West."
They've counted themselves as fans of the longest-serving Republican senator in history (who announced he will retire when his current term expires at the end of 2018) ever since.
That Hatch introduced the bipartisan-backed Music Modernization Act into the Senate last month, which seeks to address outdated music licensing laws and generate greater download- and streaming-based royalties for songwriters, endeared him to them further.
So when Zions Bank CEO A. Scott Anderson reached out, offering Powell and Wilson an opportunity to perform for Hatch, they immediately accepted.
"To be able to celebrate one of the biggest advocates for songwriters' rights, it's a tremendous opportunity," Powell said.
"We're honored and humbled to be a part of this big night," Wilson added. "… Utah's become a second home for us, and it's embraced us and invited us into a really welcoming community. So this is just such a nice way to shine a light on [Hatch's] third act, and what he's going to be doing in the community."
The Salt Lake Chamber established the Giant in Our City award in 1969 as a way for the business group "to honor exceptional and distinguished public service and extraordinary professional achievement." It normally goes to chief executives, though it has been bestowed on others, such as former Govs. Calvin Rampton and Mike Leavitt, former LDS Church President Gordon B. Hinckley, the late industrialist-philanthropist Jon M. Huntsman Sr., and Mitt Romney — who is running to fill Hatch's seat in the Senate — who was honored for his work on the 2002 Winter Olympics.
Editor's note • Paul Huntsman, owner and publisher of The Salt Lake Tribune, is a son of Jon Huntsman Sr.


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Hello everyone,
My name is Dheeraj Reddy. I'm planning to buy a bicycle but am confused.
I would use my cycle for fitness, to cycle when I'm bored and maybe for a race :)
My height is 5' 9", weight is 66kg. I will be riding mostly on roads (tar or kachha) and that too only in the city. I left cycling when I was in 7th class and now I'm in my 2nd year of engineering. Budget for the cycle cannot exceed 10,000 rupees.
Based on the above info., could anyone suggest a suitable bicycle?
Views: 477
i have firefox roadrunner. one and half year old, not perfect but in good condition. If you want you can check it.
What is the distance you will be riding per day?
if its shorter distance, you can opt for MTB or Hybrid.
Thanks for the reply!
I will be riding mostly on weekends but not daily! Whenever I take it out ill be riding for around 2km for sure. Weekly once I plan to travel around 10-12km for fitness or just to kill boredom.
Than you can go for single geared bike. that will give you better result for fitness in shorter distance.
check BSA mach or hero hawk nu age (will be around 3,5-4.500)
bike is heavy, but good for shorter distance. where are you located?
you can find second hand too. that will cost cheaper.
once you feel better on wheel, you can opt for cycle of little higher price.
welcome to cyling
I currently live in Hyderabad. Is there any online site to check out where in Hyderabad we could get second hand bikes or get them for rent?
check the cyclop/cyclope group on FB, you will find awesome deal.
dont take it on rent (if you are planning for regular cycling).
i have heard from my friends that bsa mach is a good choice for racing or even u can consider the octane.
I use a Mach with 6 speed Shimano for short distances of unto 10-15 kms. Cost was Rs 4600 in 2010, ordered via website. With the Mach, ensure that you maintain proper tyre pressure, or rims will go out of shape due to bumps in road. In order to do this I fitted GRL tires with air seal tubes. The stock TI tyres develop sidewall cracks at high pressure.
Go for a test ride of some bikes, i'd recommend a firefox but you should go with what you like & are omfortable with.
Guidance : http://www.bikeszone.com/forum/viewtopic.php?f=6&t=3268
Pricing : Another matter.
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There is no shortage of activity this week as Fire Prevention Week is in full tilt. The Massachusetts Department of Fire Services had several FPW banners adorning their headquarters in Stow, MA. Send us a photo of your banner. Let's see how many we can get.
!http://nfpa.typepad.com/.a/6a00d8351b9f3453ef017ee3fa6386970d-800wi|border=0|src=http://nfpa.typepad.com/.a/6a00d8351b9f3453ef017ee3fa6386970d-800wi|alt=Llffpw|title=Llffpw|class=asset asset-image at-xid-6a00d8351b9f3453ef017ee3fa6386970d image-full!
As the temperature climbed into the 90's in the hot Florida
sun, a crowd filled the Lego City Stage to see yesterday's first showing of The
Big Test, a zany, acrobatic show that imparts important safety messages as part
of a 20 minute comedic extravaganza.
The audience of kids and adults alike were not only treated to a few
laughs and some splashes of water, they were on hand to help NFPA kick-off Fire
Prevention Week and announce the winner of its video contest.
[NFPA | http://www.nfpa.org] and LEGOLAND Florida asked the public to give their
best rendition of "Put the Hot Stuff on the Wet Stuff", the catchy tune from
The Big Test. After two weeks of voting and more than 10,000 votes, Kathleen
Marler of Florida was the winner. Her and her family received a trip to
LEGOLAND Florida as their prize.
The winning video
The announcement was part of a full day of activities.
Firefighters from Polk County and the Florida State Fire Marshal's office
conducted a series of learning stations, teaching children and parents how to
test smoke alarms and create a home fire escape plan.
Continuing through the month of October, LEGOLAND Florida
will feature Firefighter Fridays, where local firefighters are on hand to show
guests their gear and answer questions about fire safety.
NFPA is the official fire safety partner for LEGOLAND
Florida and sponsor of The Big Test show.
For more information on NFPA's partnership with LEGOLAND
Florida, visit www.nfpa.org/legoland .</p>


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Bambadjan Bamba is a busy working actor, but when I get him on the phone, it's clear he's also a busy working dad.
"I have to get my daughter home," he says. "Can I call you back in 15 minutes?"
Bamba's toddler daughter happily babbles in the backseat. It's clearly been a fun afternoon with dad. My phone rings exactly 15 minutes later. Bamba is a man of his word.
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Montana CDA and Child Care Training
Montana Early Care and Education (ECE) Course Approval
ProSolutions Training offers Montana educators more than 100 individual courses in early childhood education. Most are also offered in Spanish.
The coursework is skills-based and encourages Montana teachers and directors to reflect on individual teaching or professional style and transfer new knowledge to daily work. We continually develop new courses and update existing content based on the latest research to keep courses current and relevant. Curriculum development is directed by our dedicated in-house professional staff with advanced degrees to ensure quality course content.
Click the button below to view the online courses and training available in Montana.
Montana CDA Training and CDA Renewal TrainingProSolutions Training is proud to be a formal partner of the Council for Professional Recognition, a non-profit organization that administers the Child Development Associate® (CDA) CredentialTM. In July 2017, ProSolutions Training received the CDA Council's new CDA Gold StandardSM certification in recognition of the quality of our online coursework, the support services we provide for students and our comprehensive learning management system.
ProSolutions Training offers Montana CDA Training (available in English & Spanish) that can be used to meet the training requirements of the Council for Professional Recognition for the Child Development Associate® (CDA) CredentialTM. Head Start staff in Montana can use ProSolutions Training CDA and professional development coursework to meet Head Start Training requirements.
Learn more about Montana CDA Training and Montana CDA Renewal.
Montana Group SubscriptionThe Montana Child Care Training Group Subscription is a great way to train and retain early childhood educators. The Group Subscription allows your child care staff to choose from more than 100 courses developed by curriculum experts specifically for early childhood education professionals. The child care facility director or administrator manages the account access and can easily add and remove staff. It's simple to assign courses to individuals or the entire team.
Montana Individual SubscriptionThe Montana Child Care Training Individual Subscription is the perfect online early childhood education solution for individuals. This subscription gives access to more than 100 online training courses developed by curriculum experts at ProSolutions Training. Print individual Professional Development Certificates as each course is completed. This is the most economical online child care training option for individuals.
International Association for Continuing Education and Training (IACET)ProSolutions Training has been accredited as an Authorized Provider by the International Association for Continuing Education and Training (IACET). ProSolutions Training coursework adheres to the highest standards set by IACET. ProSolutions Training includes CEUs at no extra charge with every Professional Development Certificate.
Montana Professional Development and Quality Rating Information
You can locate information on Montana's Professional Development Registry at Montana Early Childhood Project Professional Development Approval System.Find information about Montana's Quality Rating and Improvement System at Best Beginnings STARS to Quality Program.
Information supplied above for your state explains the current status of ProSolutions Training approvals in fulfilling training requirements. Please check with your state training approval entity to verify.
Return to State and CEU Approvals


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Ryan Christopher Coleman
On the last Friday in March, an eclectic group of artists, musicians, and comedians convened at one of Pasadena's tried and true watering holes, the Old Towne Pub.
"It's a bunch of freaks, basically," says Jeremy Fawrup, the man behind dark electronic act Bimsha Swang, as well as the organizer of the night's festivities. He looks satisfied, mingling with the overflow of attendees that have spilled out onto the patio. He flashes me a wicked smirk and adds, "I love them."
It's been months, "maybe upwards of a year," Fawrup tells me he has been conceiving of Black Volume. The concept took several forms before it settled on a monthly bazaar of art and entertainment. For its inaugural show, Black Volume delivered comedy, rap, experimental rock, jazz, live painting, jewelry making, an array of local clothiers, and more.
What helped the rubber of Fawrup's idea meet the road was Steven Rodela, the independent booker known as Vert Ventures. Rodela recalls the challenges he used to face when he played in a local band. It can be difficult for unrepresented acts to advocate for themselves in nightlife spaces, in particular regard to issues like payment. Vert Ventures was born out of a desire to foster a more supportive and dynamic local music scene.
"It's less of a show, more of a showcase," says artist Julia Lynch, the first face you met stepping from the bar to the bustling patio. She's vending an assortment of her lush ink and watercolor portraits alongside Michael Weinstock of Designs From Chaos, who makes precise, mandala-like ink designs as well as jewelry. Down the line are Nancy Crowd from Silent Crowd Clothing, an urban activewear line fully designed, managed, and marketed by Crowd herself and LiqudBrain, a "low-brow pop surrealist" working on a live latex painting.
Kicking off the night were Pasadena-based duo KrOniC, with a crowd-pleasing fusion of rap, soul, and electronic elements. Following KrOniC were art-rock band POM, DJ and house music producer D'Auria, and finally a thrashing electronic set by Bimsha Swang, all interspersed with short comedy sets.
Talking to the artists and musicians invited to Black Volume, you start to notice a pattern. For both the boys from KrOniC, to the designer behind GoodXDreams clothing, to Lynch and Weinstock, while making art may not be a new process, being invited to promote and perform their art certainly is.
"Music is my outlet," D'Auria tells me, mentally preparing for his set amongst his friends, who happen to be 3/4 of the other artists. "I started making music when I got clean." D'Auria's been at it under wraps for years, but Black Volume is his first show. I ask him how he's feeling, and as he surveys the enthusiastic crowd of artists being given a long-awaited platform, responds, "I hope there's going to be more Black Volume."


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Many people want to travel across the globe. It's fun to daydream about exploring different places, but proper planning is key to a memorable trip. This article will advise you on how to make the most out from your vacation in new places.
Once you've chosen your destination, take the time to get to know more about where you're going. Find a map of where you will be visiting and study it for locations you plan to visit. This will give you ideas on the different activities that you can do.
Air travel requires a bit of planning. If an airport is in a major city, it can be quite difficult to get to, especially during rush hour when traffic is at its heaviest. Always do your packing the night before you travel. You need to make all of your travel plans far before you plan to fly. Not making your flight will cost you time and money.
Be wise about food allergies when visiting a foreign country to avoid dangerous liaisons. If you have food allergies, you should familiarize yourself with the foreign language names of your allergies. This way you can be sure to alert wait staff of your allergies to specific foods and, in the worst case scenario, be able to inform medical professionals of your condition.
As you plan your vacation, try and be open minded about the destination. While you may have your favorites, checking out new places is part of the fun of going on a trip. If you don't have a lot of money to spend, broadening your options when it comes to the location can be beneficial.
Be vigilant when dealing with local police or other officials, in case they're not who they claim to be, but instead are imposters. Do not ever give someone your passport; they may steal it. If someone insists you must visit their office, then walk there with them. Never ride in a vehicle with a stranger, no matter how nice they are.
Try signing up for travel price watcher. This feature is offered by some websites and lets you input your desired destinations for it to watch. When the price for airfare or lodging meets your expectations, you're going to get an alert. This saves you from the need to check the prices yourself every day.
If you have a pet, bring him or her with you if it is allowed. There are a ton of travel ideas out there that welcome pets and even have facilities for them as you head out to explore. Some of these accommodations include cat spas, day care for your pooch and sometimes even cruises where you can take your pets. Do not be intimidated by the experience and bring your furry friend along.
With the advice above, you can avoid stress and actually enjoy your trip. Your fellow travelers might admire you for your ability to avoid obstacles and get past other difficulties easily. Using this advice will give you the stress-free trip you've always wanted.


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Helicopter Emergency Medical Services in Finland
FinnHEMS 30 – Tampere
In Tampere, a physician-staffed HEMS helicopter began operating in September 2012. Its operating base is located at the Tampere-Pirkkala Airport. Since 1 September 2011, FinnHEMS has operated a ground unit in Tampere.
From the Tampere base, the physician-staffed HEMS helicopter reaches the entire Pirkanmaa region around the city of Tampere and parts of the Kanta-Häme, Satakunta and Varsinais-Suomi regions as well as Central Finland. On average, the base carries out eight missions in a day and about 3,000 missions in a year. Most missions involve an accident or a failure of basic vital functions: patients are unconscious or lifeless or have breathing difficulties. The HEMS unit is dispatched to a scene of emergency by the emergency response centre.
Staff and key people
HEMS operations require seamless cooperation between professionals from various fields. In total, the Tampere FinnHEMS 30 base has 21 employees: 9 EMS physicians, 6 pilots, and 6 HEMS paramedics. In addition, FinnHEMS medical and flight experts and the flight operator's experts continuously work to maintain the high quality and safety of HEMS operations.
At the Tampere base, emergency medical services are operated byt the Pirkanmaa Hospital District and flight operations by Skärgårdshavets Helikoptertjänst Ab (SHT Ab).
Chief Physician, Emergency Medicine
Lead Physician, Tampere base
Chief Pilot, Tampere base


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Pisco: India's CS Santosh was placed at a creditable 13th among the bikers at the end of the first stage of the gruelling Dakar Rally while his Hero Motorsports Rally teammate Joaquim Rodrigues met with a spectacular crash to end his race.
Santosh clocked 24 minutes 11 seconds to cover the first stage of 30 km. The first stage covered from Lima to Pisco. Another 13 stages are remaining in the world's toughest off-road rally which will end on 20 January in Cordoba of Argentina via Bolivia.
"First day of a race is usually nervous. Today was just 30 km and tomorrow more than 200km. It is a long way to go and anything can happen at any stage in such a long rally," he said after the first day's race.
"This year, there is a big change in the bike from last year and so much easier to ride. I am enjoying my time."
Riding on a vastly improved and new look Hero RR 450 bike with the Indian tri-colour imprint on it, Santosh set off from the starting line in bib no 49 on Saturday.
His Hero Motorsports Team Rally teammate Joaquim Rodrigues met with a crash midway into the 1st stage. The rider from Portugal, who finished 12th last year, suffered injuries at his hand and back and will not take part in the remaining stages.
"It is unfortunate that Rodrigues' race ended early. He met with a crash and suffered injuries in his hand and back. He is all right now but will not further take part in the race," a team official said.
Rodrigues overshot a sand dune for nearly 10m and his bike landed on top of another dune. He was thrown out of his bike and had to be evacuated from the course. He was rushed to a nearby hospital for treatment.
"X-rays were taken and he was examined by doctors. He was all right and his condition was not that serious. But he is out of the race," the team spokesperson said.
Hero Motorsports Rally's third rider Oriol Mena Valdearcos of Spain was placed at 22nd after first stage.
Another Indian in the bikers' category, Prabhakar Arvind of TVS Racing was at 30th.
Earlier on Saturday, Santosh set off for the fourth time at the gruelling Dakar Rally with an aim of recording his best ever show at world's toughest off-road rally.
"I believe I am having my best preparation ever and I hope to do well. I am mentally and physically prepared," Santosh said, even as he rode his bike towards the starting line in Lima.
"The weather is also almost similar with that in India and so I am confident I can do well. Let us see," he added.
Asked if he is expecting the best ever finish this time, he said, "Every time I take part in a race I want to do my best. The same this time in this race also, I want to have the best ever finish."
Santosh is taking part for the fourth year in the Dakar Rally. But this is his second year with Hero Motorsports Team Rally. He finished 36th in his debut year in 2015 but failed to complete the race in his next two attempts due to problems in his bike.
Head of Hero MotoSports and Hero MotoCorp Chief Technology Officer Markus Braunsperger said the team's main target was to have a top 10 finish.
"If there is no major issues or an accident, we hope all our riders to complete the race and then a top 10 finish is our aim and it can happen. At least we can do better then last year. If that is done we will be happy," he said.
"Our CMD Mr Munjal had sent us good wishes. He is very happy about taking part in world's toughest off-road race and India flag flying. He is in constant touch with us," he added.
The new 'Hero RR 450' rally bike made its debut at the Dakar this year. The new bike is an upgrade of the well-proven rally bike from last year, with new design and styling of tank, body parts and front section to improve mass centralization, handling and riding ergonomics.
The new 'Hero 450 RR' proved its capabilities at the OiLibya Rally in Morocco this year. The key learning from the Teams rookie year and last year's Dakar experience have been implemented in the bike.
There are several improvements in the bike, which have affected an increase in riders confidence.
The biggest and toughest rally-raid in the world, Dakar, in its 40th edition will cross three countries, starting with Peru today and travelling through Bolivia before concluding in Argentina on January 20.
This edition will witness participation of 500 competitors from 60 countries who will cover a grueling stretch of almost 9,000 km.
Out of the overall 14 stages, seven will include 100 percent dunes/off-piste, 1 marathon stage for all categories and 1 marathon stage for bikes and quads only.
Find latest and upcoming tech gadgets online on Tech2 Gadgets. Get technology news, gadgets reviews & ratings. Popular gadgets including laptop, tablet and mobile specifications, features, prices, comparison.
Updated Date: Jan 07, 2018 13:47:04 IST


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Category Archives: privacy
The Facebook backlash is growing
By Richard Forster | Published: May 12, 2010
Jason Calacanis has written a damning blog post about Mark Zuckerberg overplaying his hand It's part of a growing backlash to Facebook and it's attitude to it's users and it's partners. I couldn't agree more. I wrote this on Robert Scoble's blog: "The privacy debate is a storm in a teacup. Right now it matters [...]
Also posted in Facebook | Tagged Facebook, Jason Calacanis, Social network | Leave a comment


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TURIN - Fiat Auto returned to profit at the operating level in 2000, but is expected to show a net loss for the year when final financial numbers are announced on March 29.
The company has so far seen little net savings from its purchasing and powertrain joint ventures with General Motors. The alliance is expected to show its first substantial cost benefits in 2001.
Fiat SpA's passenger-car unit posted a E44 million operating profit in 2000, compared with a loss of E121 million in 1999. Revenues rose 5.2 percent to E25.36 billion.
But fourth quarter results deteriorated. Fiat Auto reported an operating profit of E66 million in the quarter, compared with a E197 million profit in the same period of 1999.
In a statement, Fiat said it increased fourth quarter spending on advertising and incentives by E150 million, compared with the same period in 1999.
Fiat also said that research and development spending grew by E67 million last year, but that it found ways to lower costs. Manufacturing costs were lowered by E350 million and other costs by E150 million.
Fiat Auto's alliance with General Motors signed in March 2000 resulted in E20 million in savings on parts purchasing. But the alliance added E30 million in costs needed to set up the companies' purchasing and powertrain joint ventures.
Fiat Auto said the alliance is expected to generate 'over E200 million' in savings in 2001, down from a forecast of E250 million when the deal was announced.
'Purchasing synergies are already showing savings higher than originally planned,' said a Fiat insider. 'On the powertrain side, the savings also look higher than what was expected. But they will take longer to be cashed in.'
Fiat Auto and GM's Opel will share more engines and transmissions than originally planned, said the source. 'But modifying existing products means engineering updates and vehicle testing that takes time and additional money,' he said.
Fiat Auto ended 2000 with 2,439,000 vehicle units sold, up 2.2 percent compared with 1999. It plans around 2.7 million for 2001. At the Geneva auto show, Managing Director Roberto Testore said the company plans to reach sales of 3 million units in 2004.
Fiat Auto's best year was in 1997, when it sold 2,739,000 units. In late 1997, Testore predicted sales of 3.2 million to 3.5 million units by 2004. The current lower forecast largely reflects the slowdown in Fiat's emerging markets. The company's 178 world car series was expected to rise to over 1 million units by 2001. But sales have stuck at around 500,000.
Fiat said the second-generation Punto, which was launched in September 1999, is off to a strong start. It needed just 19 months to reach 1 million units built. That compares to 22 months for the original Punto. In its first year, the Fiat sold 543,000 units of the second Punto, compared with 482,000 for the original Punto in its first year.


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Luxury Yacht, exploring Koh Samui Islands in Luxury
Luxury Yacht tours are a fantastic way to explore the beautiful Islands off Koh Samui.
The Luxury Yacht Koh Samui Islands tour includes the following Islands surrounding Koh Samui.
Koh Taen is the closest Island from Koh Samui, southwestern coast of Koh Samui from Taling Nam fishing village. It is a small, unspoiled island, known for its coral and marine life. Giant clams, fan corals and a wide variety of fish species live in and around the protected reefs.
On the island is a small village with no cars or roads. Koh Tan can be reached by local longtail fishing boat located at Thong Krut Fishing Village at the South of the Island.
Koh Matsum is south of Koh Tan. Directly opposite the beach at the Laem Sor Chedi and Pagoda. Its beach is a long sandy beach and a favourite with local Thai. Tourists enjoy for picnics, and there are often groups of students camping on the beach or singing songs around campfires. It's a good place to join the locals on a 'tio', Thai for a day out.
The Five Islands are known locally as the "Four Islands-Five Islands" as one island is hidden behind another when viewed from the shore.
These islands are protected by Sea Gypsy guards, who deal harshly with anyone trying to sneak in under cover of darkness and steal the bird's nests The bird's nests are the principal ingredient of Chinese bird-nest soup.
At great risk, agile gathers clamber up a web of bamboo poles to reach nests for which Hong Kong restaurants will pay up to $4000 a kilo.
Few outsiders have ever set foot on the islands in luxury, treat yourself today!
The Luxury Yacht exploring Koh Samui Islands is the perfect tour for those simply wanting to relax, and enjoy the passing scenery of our tropical Island Koh Taen, Koh Mudson and the Five Islands. Indulge in a little luxury on board this beautiful luxury yacht.
Terms and Conditions
Cancellation 48 hrs before. Deposit nonrefundable after 48 hrs. Cancellation after 24 hrs full payment of the balance is required.If the weather should change the tour will be cancelled and a full refund was given. if they customers cancel, no refund given.


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Newly launched ABNxcess, a digital cable TV service with high-speed broadband internet and voice calls, is looking to cater to about 2.9 million homes in Malaysia that are not Astro subscribers.
The new service has already rolled out in Bandar Sri Damansara, catering to about 20 out of 800 households in the area.
The service offers 50 channels, including KidsCo, Luxe HD and Al Jazeera and Australia Network.
According to a source, even though the service has started in Bandar Sri Damansara, the company will not launch a marketing campaign until it acquires more subscribers.
The company also plans to target about 300,000 subscribers in the first year to break even and that it has allocated about RM10 million for marketing in the first year.
With the tagline "Access for All", ABNxcess is operated by holding company ABN Media Group.
Earlier this year, A+M reported that it has targeted 17 prime locations throughout Malaysia to deliver its CATV services, high-speed broadband internet and voice services by mid 2013.


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