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AIDS officials are desperately trying to find out the reason for the recent spike in HIV cases among older persons within Antigua and Barbuda.
According to AIDS Programme Manager Delcora Williams, the country has seen an increase in the amount of persons over the age of 50 becoming infected with HIV/AIDS since 2015.
Williams said that this trend was observed about two years ago and since then her department has been engaging in outreach programs to ensure that testing is available to persons who fall within the category. She said this is the plan going forward in 2016.
The AIDS Programme Manager also pointed out that once a person has tested positive HIV, treatment will be available.
To date 1100 persons have tested positive for HIV within Antigua and Barbuda with 578 males, 495 females and 27 children. So far 254 persons have died.


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Once upon a time there was a little boy named JR, who lived in a big tall house in the city with his mommy and his daddy, who loved him so. Today, when JR woke up, it was a beautiful day. JR and Mommy went downstairs and did his breathing machine. They then ate a nice breakfast of cereal and orange juice. By then, Daddy was awake, looking for his coffee. JR and Daddy watched some TV while Mom got dressed and ready for church. Then Daddy and JR got dressed and ready for church. Daddy took a bit too long, though, so by the time he was dressed and ready, it was too late to go to 10:00 a.m. mass. By then, Mommy and JR were outside anyway, enjoying the day. Mommy suggested they go somewhere to enjoy the nice weather before church. JR suggested "THE ZOO!" Mommy and Daddy had other ideas, but JR was determined. "THE ZOO!"
So the family went to the Zoo, along with everyone else in the big city. They were in such a hurry, they didn't even bring JR's stroller. JR said he would be a big boy and walk, which he mostly did, except when he couldn't, and then Mommy would carry him, or Daddy would carry him (and then JR would ask Mommy to carry him again).
While in the Monkey House, JR saw his neighbor and school friend Evyn, who was there with her Mommy, Auntie and Uncle. This was funny, because the last time JR went to the Zoo, he had run into his other neighbor and school friend while in the Monkey House. What is it about the Monkey House, Mommy wanted to know.
JR and his friend didn't spend much time together, though, as Evyn wanted to see "MORE MONKEYS, MORE MONKEYS!" and JR wanted a hot dog. The hot dogs were yummy, even if it did take Daddy too long in line and Mommy and JR had trouble finding a table to sit at.
Next stop was the petting zoo, where JR got to feed the ducks, go on his first pony ride, and brush the goats and sheep. He also got to wash his hands with soap and lots of water and splashing.
First Pony Ride
JR and Mommy and Daddy had a great time at the Zoo, and didn't even really miss not going to church.
The end.
(As told to JR at the end of his day Sunday)
lots and lots of sourdough–my routine
2 years ago

subset: commoncrawl


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Welcome to RecipeSource!
RecipeSource is the new home of
SOAR: The Searchable Online Archive of Recipes
and your source for recipes on the Internet.
|RecipeSource : Dessert Recipes : Candy Recipes : California Fig Coconut Balls
---------- Recipe via Meal-Master (tm) v8.02 Title: California Fig Coconut Balls Categories: Candies, Desserts, Fruits Yield: 1 batch 3/4 c California dried figs 3/4 c Shredded coconut 1/2 c Nut meats 1 ts Grated lemon rind 1 ts Lemon juice Steam figs. With scissors, clip off stems, and grind or chop fine. Grind coconut and nut meats, then combine all ingredients and work to a paste. Add more lemon juice if necessary. Shape mixture into little balls about 3/4 inch in diameter, and roll in finely chopped coconut. Source: 48 Family Favorites with California Figs Reprinted with the permission of The California Fig Advisory Board Electronic format courtesy of Karen Mintzias -----
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Irina Shayk nude collectionp. Irina Shayk nude Bodypainting on a beach.
She made a change from swimwear to high fashion with a spread in Spain's Harper's Bazaar and landed the cover of Elle Spain for their November issue. She ranks 14th in the "Top 20 Sexiest Models" list on Models. Shayk is helping a maternity hospital in her hometown of Yemanzhelinsk. Toggle navigation. Newbie Alice Has an anal Audition and Casting
Harmony russian girl 16 min Ekaxar - 1. Russian foursome sex with Irina and Olya 29 min Jesus - Shayk made her acting debut as Megara alongside Dwayne Johnson in the film Hercules. Petersburg, Naples, Grenada and Chile.


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Conversation Development
Leadership Development
Personal Development
Ongoing Training, Online
We live in a technology dominated world that has conditioned our culture to interact through digital instruments. The live interaction between people is being compromised and thus the connection with other people is weak. Furthermore, cheap tactics and deceitful methods are mostly being taught as strategies to manipulate and persuade people to buy into another's ideas. With decades or research and experience behind us, only Victor Midgley Training can deliver the true principles that leads to compelling conversation, which is the fundamental element to progress and prosperity in one's personal and professional life. Companies have gained quantum production through this program alone.
Nearly 86% of customers reported that their expectations had not been exceeded in their last interaction with a company representative.
Harvard Business Review
Almost 84% of employees that engage with customers feel unprepared or have a lack of confidence when speaking with customers or prospects.
Forester Research
Close to 76% of customers stated that they switched companies because of poor customer experience and not because of the product.
Gallup Consumer Report
It may seem obvious that the first step to a compelling conversation is to make a positive impression. How to effectively accomplish this is the secret. When people first meet, instantly they are evaluating each other. The evaluation of the person offering the service is whether they are an authentic authority. Preparation in this initial step is critical to the success of the conversation.
Voltaire said, "do not judge a man by what he says, but rather by the questions he asks." Asking questions that maintains a compelling conversation is a skill that few people possess. We teach the powerful and appropriate questions to ask that will keep the conversation compelling.
Most conversations fall apart for the very reason that there was a gross lack of awareness of what was being said and more important, the inability to match the frequency. When you can ask questions that produces clues or insights to what the underlying message is, you gain a huge advantage to being a source to the other person. The central key to success will be to pay attention to the clues.
As the conversation flows and words are being exchanged, the only method to engaging trust between people will be in the demonstration of empathy. To understand the emotions of the other person will draw them closer to you than anything you can say or do. We teach the most effective strategy for accomplishing effective empathy.
So many conversations loose there energy because of failure to keep things relevant. In a professional situation this is why "scripts" have more of a negative impact than a positive one. Without an ability to adjust and fluctuate or worse force a expect a person to express their message how you plan it will result in a collapse of the conversation. There is a technique to ensure your conversations are meaningful.
A conversation without a solution lacks purpose. A solution does not necessarily have to be big or tangible. We teach strategies that form simple habits and are effective. The value of the conversation simply comes down to what happens next – the understanding of what will come of the current conversation.
We have improved the productivity for companies with call center projects across the globe with our effective conversation development training program. Of all the phases of a successful call center operation, and as important to the overall accomplishments, nothing will be more critical to progress and achievment as the conversation. What we teach, is how to hold a compelling conversation and that is what will drive abundance and prosperity more than anything.


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Nowadays people are traveling bigger and better not forgetting faster than before. The changes to this sector might have been brought about by the demand for immediacy, seamless experience, and more personalized services.
Technology is one to blame for higher customer demands and any transformations in travel patterns. It has really transformed this field from organizing a trip to booking and flying to the destinations to helping to make sure you fully enjoy your trips by using all essential tools available. So, what has technology transformed?
- Technology has enhanced fun activities
People used to pack a few items to play a game with their travel parties but nowadays you can easily access these games online. If you want to have a lot of fun while on transit you can play casino games or any other online game that you love.
In addition, since many travelers like attending entertainment spots, they prefer finding them before they arrive at the destination. For example; one can find casinos in West Virginia before getting there to get fore-informed. Eventually, you won't have a hard time trying to locate them once you are there.
- It has made travel-friendly to the environment and less-time devouring
Travel has become eco-friendly. Nowadays you do not have to print airline tickets or a hotel reservation. Thanks to e-tickets, mobile check-ins, and online reservations.
You do not have to spend a few hours lining up to book any travel reservation or carry with your papers. This is because most of the services are currently offered online. This technology has helped in saving the environment and the time.
- Technology has surpassed language barriers
Nowadays, smartphones have apps that can help in translating multiple languages. You do not have to carry a phrase book with you like in the ancient days. Some mobile phone feature will even let you translate menus and signs in real time.
- Payments made easier than ever
In this era of electronic payment, a lot of conveniences and low risk has been achieved. You do not have to carry a lot of cash or credit cards. Technology has enabled cashless ways to pay for all the services you need.
- Technology has allowed people to enjoy more personalized and extraordinary experiences
Personalization is a common buzzword for the travel industry. Most people will want to experience a customized trip. Especially for most millennials, personalized tours have been achieved through technology. They find this useful information on niche websites, blogs, and apps.
- Easy communication
Many flight companies and hotels now offer messaging options to their esteemed customers. They have established apps or messaging channels to allow customers to interact with them. So customers can easily make inquiries about any services that they would like to get.
- Technology has altered packing routines
You can now use a mobile phone to access music or the internet or music apps. You do not have to carry other gadgets for the same purpose. For avid readers, you can have several eBooks on your device instead of carrying several books in your travel case.
You have seen how technology has made travel easy and fascinating. From finding real fun as you travel too easy payment modes to easy communication between customers and travel service providers. However, the world of travel may take a larger stride in the future with increased and innovative technological advancements.


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Getting through the JEE Main & JEE Advanced is not all about conceptual clarity and knowledge of the appropriate formulae and theories of Mathematics, Chemistry and Physics. Here are a few additional tips & tricks from subject experts that will help you to solve questions and cracking JEE Main 2019 & JEE Advanced 2019 with high score and rank.
JEE Main 2019 Tips & Tricks::


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Hello Gorgeous!
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Modern society has mercifully become more aware of, and sensitive to, the need to respect and honor people of all shapes and sizes -- but that doesn't mean that carrying excess weight is okay from a health perspective. Obesity is a known factor in some terrible diseases and disorders, from chronic joint pain to life-threatening organ problems. But instead of reaching for risky, ineffective fad diets, turn to the safe, medically sound weight loss offerings at Genesis Health Solutions, serving Lynchburg, Forest, Roanoke and surrounding communities.
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You don't have to let that extra weight set limits on your life. Call Genesis Health Solutions at 434-316-0001 to ask about our safe, healthy weight loss services!


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Any bad habit starts with believing a lie. Some ideas are widespread in today's society and can very quickly destroy a marriage. (Suite of the series) Lie # 3: "My private immorality does not affect my marriage" "I can watch pornographic images in my private area at home.
Category Culture
Difficult to escape: meditation seems to have become an unavoidable practice for coping with daily stress. Scientists have demonstrated its benefits. Meditators give us their point of view. Anne-Laure Gannac Joséphine Lebard Everybody goes there. Alone in his living room, at the wheel of his car, at the hospital, with his colleagues at Google or Transport for London (to name only the most famous companies), hundreds in front of a charismatic master or with some novices gathered in a gym, chainin
Are you ready to let yourself be surprised, to give up using your usual tools, your mind, your reason, to come into contact with a new dimension of your being? If you are reading these lines, the answer is necessarily yes. Whether you are a believer, an agnostic or an atheist, come explore in a singular way, using exercises of "spiritual development", new inner lands.
In these times of massacres, attacks, wars and tragic news, ensuring the preeminence of goodness in man sounds like a provocation. To the psychologist Jacques Lecomte, who supports this thesis, answer a psychoanalyst and two philosophers. Christilla Pellé-Douël "The human being has potential for goodness as well as for cruelty, beside potentially aggressive tendencies (which I do not seek to deny) are present, and more importantly , tendencies to empathy, to altruism, to cooperation.
Read for pleasure. First. But also to understand, learn and get better. Works of personal development, of psychology, novels or collections of poems, all contain valuable ferments of life and healing. Flavia Mazelin Salvi Every month for more than a year, I join the members of the Sans Nom, the reading circle that we have created with some friends to share our favorites, our favorite classics and our disappointments.
Intimacy, light, materials, discover how to create a space in your home for the daily practice of meditation. By Anne-Valérie Rocourt for Houzz We no longer count the merits attributed to meditation: learning to manage stress, to live better emotions or to develop your creativity ... Even companies get started and begin to offer meditation sessions to their collaborators.
Criticism, mockeries, comparisons ... We spend our time judging. Situations, others, ourselves. Most often to reassure us and to escape reality. Our journalist tried to put non-judgment into practice, a principle at the heart of most spiritual traditions. Flavia Mazelin Salvi The idea has come to an editorial conference, in the course of the exchanges on the book The Year I lived according to the Bible of A.
His guided meditations are followed by thousands of people on YouTube just like his Antiseches of Happiness, tracks and mantras to be happy . For three years, Jonathan Lehmann has shared his discoveries on the science of happiness: these spiritual levers, these small changes that allow access to them.
In his latest book, Psychotherapy of God , Boris Cyrulnik questions our need for belief. Where is he from? What is it for us? The neuropsychiatrist offers us an unprecedented vision of our relationship to religion. Interview by Christilla Pellé-Douël Psychologies: Your book is called Psychotherapy of God.
Season of interiority par excellence, the winter invites us to plunge in oneself to (re) discover our forgotten or neglected treasures. A trip to which you are invited to the new edition of Spirit, on sale at your newspaper vendors since December 11, in bookstores since January 3 and in our online store.
Good seated, his back straight, his heart open ... Fabrice Midal , philosopher and Buddhist specialist, shows us how to adopt a good position is fundamental to be fully in the practice of meditation. Meditating in 10 lessons: What position for ... by Psychologies-com Meditating in 10 lessons: What position to meditate?
S immobilize. To shut up. To witness what happens in itself. For many of us, this sounds like a challenge. We were encouraged to multiply activities, to feed ourselves with the "noise and fury" of the world, to consider silence as sterile. We believed that the source of our balance was outside of us.
Samuel was a boy in a hurry, stressed. During a stay in Thailand, he discovered the practice of vipassana meditation, a "motionless journey" that reconciles body and mind. Since then, his eyes, his emotions and all his life have been metamorphosed ... I had been working in Bangkok for two years and my curiosity led me to meditate, as do some of my Buddhist friends.
Postures, breathing, frequency ... Using your mental strength to find peace is easier than you think. A precise seven-step guide for those who want to learn how to practice meditation on a daily basis. Laurence Lemoine When stress suffocates us, we are like the mountains encircled by clouds. To meditate is to let the wind clear the sky and reveal the azure.
We do not necessarily see them at the exit of the church, the mosque or the synagogue. But they are not atheists. How do they live in the religion in which they grew up? How do they transmit it? Helen, Saba and Michele tell. Margot Deville On the night of December 24, there will be many churches to display complete.
They are young and of different faith, but all have chosen to follow the spiritual path. Why did they become imam, rabbi, pastor, Buddhist nun or Carmelite brother? They tell us about their quest and their way of living it on a daily basis. Richard Belfer "I want to teach an Islam faithful to the text, but enlightened, adapted to Western life" Messaoud, 30, imam "I spent my childhood in Algeria.
"I am Muslim", "I am a Christian", "I am Jewish" ... Religion always looks like a part of the world identity of each believer. But how far? At a time when the faith is not well-known and where only community withdrawal, extremism and rejection of the other are in the news, three representatives of the three monotheistic religions have agreed to confide in one another.
To find inner peace, you do not need to put on a dress. More simply, we can inspire each day principles of wisdom common to the great religious orders. Flavia Mazelin Salvi Withdraw from the turmoil of the world, afford the luxury of time and silence, immerse yourself in giving meaning to your life .
To set up a break "out of the world" is not reserved for monks or believers. We can all, without leaving our living environment, withdraw to better connect us. To our inner dimension, but also to others. Flavia Mazelin Salvi Finding yourself Retreating from the hustle and bustle of the world, alone, at home, for a few hours or a few days: spiritual retreat is not a new way of practicing art regressive cocooning, but an opportunity to connect with the spiritual dimension of our being.
Each month, a personality comes back to a moment of spiritual or existential awareness. This month, Anne Roumanoff. Bertrand Révillion She begins by saying "no." "My spiritual life is watching me, I have no desire to see it spread in the newspapers." We dare to insist, we argue that his words may be able to become a small flash of light for others .
Each month, a personality comes back to a moment of spiritual or existential awareness. This month, Patrick Bruel. Bertrand Révillion He greetily describes his return to the stage. The actor becomes a singer and offers us a bunch of new songs where we feel that life, with its joys, its wounds and its mournings, has matured man .


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Events history occurred during the life of Louis XI
1440 the Praguerie: Louis XI revolts against father Charles VII, with Alençon, Dunois, La Fayette, Trémoille, the Hire, this earns the Dauphiné.
1444 Louis XI to nodded mercenaries roads leads the war in Switzerland against the antipope Felix V. gonfaloniere, i.e. protector of the Church, was named by Pope Eugène IV.
1445 orders companies creation (the roads of mercenaries become the 1st regiments of the French army)
1450 Gutenberg invents the printing press
death of Agnès Sorel
1452-birth of Leonardo Da Vici (Leonardo da Vinci)
1453 battle of Castillon (last battle war of hundred years English/french)
1455 beginning of the war of the roses 2 (English civil war)
1456 new feuds between Charles VII and Louis XI, Charles invaded the Dauphiné. Louis fled and took refuge among the Burgundians (Brabant) Joan of arc rehabilitated
1461 death of Charles VII, Louis XI become King of France (August 15, 1461 in Reims)
1463 Louis XI began to recover the cities of the sum, according to the Treaty lost d Arras. Duke Charles the bold accepted this proposal on August 20, for 400 000 ECU d gold.
1464 Louis XI the conflict in the sum s worse, the King leaves the sum and arrives at Arras. Then he continued to stay in Flanders
1465 battle of Montlhéry (Louis XI vs Charles the bold the bourguignon) treated of river, the towns of the Somme back to France (Amiens, Abbeville, Guines, San Quentin)
1468 end of the campaign of Picardy, the peace of Péronne supposed to put an end to the conflict armagnacs/Burgundians, and confirms the line of the Somme as border between the France and Burgundian lands (the towns of the Somme are confirmed Burgundy)(signature forcé et annulé en 1469)
1469 establishment of the order of Saint Michael
1472 birth of the dauphin Charles VIII
1472, Charles the bold attack Picardy through Bray on sum, Péronne and Nesle massacre, and attempts to take Beauvais defended by Jeanne Hachette.
1475 Treaty of Picquigny, putting an end to the hundred years war
1477 death of Charles the bold, Artois attached to the France.
Invention of the post by Louis XI
1480 creation of the 1st regiment d line infantry, the arch bridge-of-l (11 October), from the bands of Picardy, whose motto is always this update:


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Sold Out
Coming Soon Lavender Syrup & Lavender Blueberry Syrup:
Lavender brings about calming, soothing attributes. The flower has been around for since the Roman Empire and long considered an aphrodisiac, denoting love and romance. Lavender was historically used to spice the food of queens, colonists and conquerors. Lavender was then bought from Europe to the Americas, where it was grown as a herb of hospitality, medicine, perfume and spice. We find this a perfect flavoring for sorbets, shortbreads, champagne cocktails, hot teas or sparkling water.
Lavender Margarita
Lavender Roast Chicken
Grilled Pear Salad with Lavender Syrup & Gorgonzola
Lavender Saffron Fettuccine
Pears Poached with Lavender Syrup and Lemon
Lavender & Chocolate Sorbet
Lavender Ice Cream


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Due to the ongoing medical situation, we will be offering URGENT EYE CARE ONLY. We would like patients that are unsure if they have an urgent eye care need to please call our office as we are ready to assist them in coordinating their care.
For anyone that has already ordered glasses, we will be in touch with them to arrange for a private appointment to pick them up or will have them delivered to their home.


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Woody Allen looks to Adrien Brody for "Midnight in Paris"
Hollywoodnews.com: Despite the lukewarm reviews that Woody Allen's latest comedy "You Will Meet a Tall Dark Stranger" has received out of Cannes, the helmer continues to habitually churn out one film annually.
The Hollywood Reporter recently announced that Oscar winning actor Adrien Brody will join Allen's latest romantic comedy production "Midnight in Paris" which already boasts a top-shelf cast of Owen Wilson, Marion Cotillard, Rachel McAdams, Kathy Bates and Michael Sheen as well as the first lady of France Carla Bruni-Sarkozy.
"Midnight" begins lensing this summer in Paris, of course.
Brody and Wilson previously starred together onscreen in "the Darjeeling Limited." Brody can next be seen in the Warner Bros. sci-fi thriller "Splice" on June 4 and Fox's July 9 release "Predators."
"Midnight" follows a family's travels in Paris, one set of protagonists being a couple who are romantically on the fence.


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6"x6" Oil on board
Click here to purchase
I know it's not even December yet...but when I tied the ribbon on this it reminded me of the small red apple decorations I put on our Christmas tree every year!
This is for 'an apple a day' art project Michel Oosterhout has started on his website to see who he can reach and where the apples come from. The goal is 365, one for each day.


text: 1158 ENGLISH BLUFF ROAD Tsawwassen BC Court Ordered Sale - Renovated basement entry home with 5 bedrooms & 3 full baths on 10,398 sqft lot in fabulous English Bluff area of Tsawwassen. Functional main floor with beautiful kitchen opening up to newly built deck over looking swimming pool, large living room, 3 bedrooms and 2 full baths. Downstairs accommodates 2 bedroom legal suite with separate entrance. The Buyer or the Buyers agent to verify measurements if important.


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There are a lot of different options when it comes to formatting a date in Excel, and the variety of reasons that you might be storing dates in a spreadsheet will dictate the format that you select. But if the only important part of a date for your purposes is the year, then you might be looking for a way to display your date as just the year.
Our guide below will show you how to apply this formatting to your date to achieve your desired result.
How to Format for "Year Only" in Excel 2013
The steps in this article will assume that you have a date in a cell, or group of cells, and that you only want to display the year from that date. The full date will still be stored as the value in the cell, but only the year will be shown.
Here is how to only display the year of a date in Excel 2013 –
- Open the spreadsheet in Excel 2013.
- Select the cell(s) containing the date(s) that you want to format as year-only.
- Right-click a selected cell, then click the Format Cells option.
- Click Custom from the options in the column at the left side of the window.
- Enter yyy in the Type field, then click the OK button.
You can see these steps below, but with pictures –
Step 1: Open the spreadsheet in Excel 2013.
Step 2: Select the cell, or group of cells, containing the dates that you wish to format to only show the year.
Step 3: Right-click one of the selected cells, then click the Format Cells option.
Step 4: Click Custom in the Category column at the left side of the window.
Step 5: Enter yyy into the Type field at the center of the window, then click the OK button to apply your changes.
Note that you can also use the formula =YEAR(XX) where XX is the cell containing the date whose year you wish to display.
Does your worksheet have a lot of formatting that you need to remove, and you would prefer to simply remove all of it at once? Learn how to clear all cell formatting in Excel with just a few short steps.
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The prevalence rates of Mycoplasma genitalium infections and coinfections with other sexually transmitted organisms and the frequency of a macrolide antibiotic resistance phenotype were determined in urogenital specimens collected from female and male subjects enrolled in a multicenter clinical study in the United States. Specimens from 946 subjects seeking care from seven geographically diverse clinical sites were tested for M. genitalium and for Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis. Sequencing was used to assess macrolide antibiotic resistance among M. genitalium-positive subjects. M. genitalium prevalence rates were 16.1% for females and 17.2% for males. Significant risk factors for M. genitalium infections were black race, younger age, non-Hispanic ethnicity, and female symptomatic status. Female M. genitalium infections were significantly more prevalent than C. trachomatis and N. gonorrhoeae infections, while the M. genitalium infection rate in males was significantly higher than the N. gonorrhoeae and T. vaginalis infection rates. The macrolide-resistant phenotype was found in 50.8% of females and 42% of males. These results show a high prevalence of M. genitalium single infections, a lower prevalence of coinfections with other sexually transmitted organisms, and high rates of macrolide antibiotic resistance in a diverse sample of subjects seeking care across a wide geographic area of the United States.
Urogenital tract infections involving Chlamydia trachomatis and Neisseria gonorrhoeae have long been recognized as significant causes of adverse reproductive and sexual health outcomes. In the past decade, accumulating evidence has supported the hypothesis that sexual transmission of and infection with the mollicute Mycoplasma genitalium represent an additional cause of host inflammatory responses in female and male urogenital epithelia, being associated with significantly elevated risks of nongonococcal urethritis in men (1) and of cervicitis, pelvic inflammatory disease, preterm birth, infertility, and spontaneous abortion in women (2).
Due to the generally fastidious requirements for culturing of Mycoplasma species in vitro, molecular methods have been the predominant means for detecting M. genitalium in clinical specimens. The use of nucleic acid amplification tests (NAATs) employing PCR for detection of M. genitalium genomic DNA targets (3, 4) and transcription-mediated amplification (TMA) for detection of M. genitalium 16S rRNA (5–7) has increased our understanding of the epidemiology of M. genitalium, as well as associations between M. genitalium infections and reproductive health morbidities. Such studies revealed M. genitalium prevalence rates of approximately 1% in a screening population (8) and ranging from 9% to >50% in populations at high risk for sexually transmitted infections (STIs) (9–12). However, the cohorts evaluated were often of relatively small enrollment size, originated in narrow geographic locales in the United States, or represented subjects from homogeneous demographic groups (7, 12–16). In this study, we used a sensitive TMA-based NAAT to detect M. genitalium in specimens obtained from subjects enrolled in a multicenter clinical study encompassing a diverse sample of adolescent and adult women and men seeking care across a broad geographic area of the United States. We also determined the rates of coinfection of M. genitalium with C. trachomatis, N. gonorrhoeae, and Trichomonas vaginalis and assessed the rate of macrolide antibiotic resistance markers present in M. genitalium 23S rRNA isolated from a subset of the subjects studied.
(Some of the data included in this study were previously presented at the following conferences: 2014 National STD Prevention Conference, Atlanta, GA, 9 to 12 June 2014; 115th General Meeting of the American Society for Microbiology, New Orleans, LA, 30 May to 2 June 2015; International Union against Sexually Transmitted Infections-Europe Conference, Barcelona, Spain, 24 to 27 September 2015; and World STI & HIV Congress 2015, Brisbane, Australia, 17 to 20 September 2015.)
Study population.Specimens analyzed in this study were collected as part of a previous unpublished clinical study, for which participating subjects provided written informed consent. In brief, specimens were obtained from symptomatic (cervicitis, vaginitis, or urethritis for females or urethritis for males) and asymptomatic subjects enrolled from seven diverse U.S. clinical sites, including family medicine, obstetrics and gynecology (OB-GYN), family planning, public health, and sexually transmitted disease (STD) clinics. A total of 1,368 female subjects and 599 male subjects were enrolled between January 2013 and July 2014. For the purposes of the current analysis, only subjects with complete specimen collections and test results for M. genitalium, C. trachomatis, N. gonorrhoeae, and T. vaginalis were included. Thus, the final cohort used for the analysis consisted of 515 female subjects (14 to 70 years of age) and 431 male subjects (18 to 78 years of age). Demographic characteristics, enrollment sites, and the symptomatic status of the subjects are presented in Table 1. The majority of female and male subjects were of younger age (<30 yr), black race, and non-Hispanic ethnicity. The symptomatic status of each subject was determined by the attending physician at the time of the patient's visit to the health care facility.
Laboratory procedures.Four female specimens (clinician-collected vaginal swab, endocervical swab, ThinPrep Pap Preservcyt liquid [Hologic, Inc., San Diego, CA] cervical specimen, and self-collected urine specimen) and two male specimens (urethral swab and self-collected urine specimen) were obtained during single patient visits to the clinical sites. Swab and urine samples were collected into Aptima swab specimen and urine specimen transport tubes, respectively (Hologic), according to the manufacturer's package inserts and either were tested directly or were stored frozen at −70°C and tested at later dates.
Specimens were tested for M. genitalium using a research-use-only TMA assay for M. genitalium 16S rRNA, as described previously (5–7) except that testing was performed with the Tigris DTS system or the Panther system (both from Hologic), using a cutoff value of 100,000 relative light units. C. trachomatis, N. gonorrhoeae, and T. vaginalis testing was performed with the Panther system and the FDA-cleared Aptima Combo 2 and Aptima Trichomonas vaginalis assays (Hologic), according to the assay package inserts.
M. genitalium macrolide resistance was assessed using nested reverse transcription-PCR of M. genitalium 23S rRNA, using a modification of a previously described method (17), followed by Sanger sequencing. To detect mutations at base locations 2058 and 2059 (Escherichia coli numbering; located in region V of the 23S rRNA), which have been shown to be associated with M. genitalium macrolide resistance (18), M. genitalium rRNA was purified from clinical specimens using Aptima general purpose target capture reagent (Hologic) on a KingFisher purification system (Thermo Scientific). The reverse transcription and PCR primers used were as follows: reverse transcription, 5′-CCACCTAACACTGTCTTGAAACTGG-3′; first-round PCR, 5′-GGAGGTTAGCAATTTATTGCAAAGC-3′ (forward) and 5′-CCACCTAACACTGTCTTGAAACTGG-3′ (reverse); second-round PCR, 5′-CGTAACTATAACGGTCCTAAGGTAG-3′ (forward) and 5′-CACATCAACAAATCCTTGCGAAC-3′ (reverse). Reverse transcription of M. genitalium 23S rRNA was conducted at 55°C for 15 min, followed by 94°C for 2 min. Cycling conditions for both first- and second-round PCRs were as follows: 94°C for 15 s, 62°C for 30 s, and 68°C for 30 s for 40 cycles, followed by 68°C for 5 min. Sanger sequencing was performed with PCR amplicons, using the second-round PCR primers as the sequencing primers.
Statistical analyses.For all sexually transmitted organisms (STOs), subjects were considered infected if they had one or more specimens with positive results. The prevalence of infection was calculated using the infected status standard. All tests for 95% confidence intervals (CIs) were two-tailed and performed at the 0.05 significance level, using the efficient score method. Calculation of odds ratios (ORs) and tests for significance were performed as described previously (19), with P values of <0.05 being considered significant.
Prevalence of M. genitalium infections.The prevalence rates of M. genitalium infections are presented in Table 1, categorized by gender, age group, symptomatic status, race/ethnicity, and enrollment site. The prevalence of M. genitalium infections in all females (14 to 70 years of age) was 16.3% (95% CI, 13.4 to 19.8%) and that in all males (18 to 78 years of age) was 17.2% (95% CI, 13.9 to 21.0%). M. genitalium infections were significantly more prevalent in subjects ≤30 years of age than in subjects >30 years of age (female, 19.2% versus 7.2% [OR, 2.67; P = 0.0075]; male, 22% versus 9.2% [OR, 2.39; P = 0.0043]). The prevalence of M. genitalium infections in females was highest in the youngest age groups (30.0% for ages 14 to 17 years and 25.0% for ages 18 to 20 years) and declined in older age groups (13.3% for ages 21 to 30 years, 9.6% for ages 31 to 40 years, 2.9% for ages 41 to 50 years, 6.3% for ages 51 to 60 years, and 0% for ages 61 to 70 years). In males, the prevalence of M. genitalium infections was 12.5% for ages 18 to 20 years, peaked at ages 21 to 30 years (24.1%), and declined thereafter (14.7% for ages 31 to 40 years, 6.1% for ages 41 to 50 years, 3.4% for ages 51 to 60 years, and 0% for ages 61 to 78 years). Subjects self-identifying as black had the highest prevalence of M. genitalium infections (female, 23.5%; male, 27.9%). The highest rates of M. genitalium infections in female subjects occurred among those enrolled from a midwestern adolescent gynecology clinic (28.9%) and a mid-Atlantic public health clinic (20.5%). Male subjects enrolled from a mid-Atlantic public health clinic and a midwestern hospital-based high-risk STD clinic system had the highest M. genitalium infection rates (25.3% and 50%, respectively), although male enrollment at the latter site was low (n = 6). Symptomatic subjects had higher prevalence rates of M. genitalium infections (symptomatic versus asymptomatic: female, 21.1% versus 7.5%; male, 19.3% versus 15.4%). Thus, in addition to age differences, significant risk factors for M. genitalium infections were black race (female black versus white: OR, 4.79 [P < 0.0001]; male black versus white: OR, 6.54 [P < 0.0001]), non-Hispanic ethnicity (female non-Hispanic versus Hispanic: OR, 9.41 [P = 0.0276]; male non-Hispanic versus Hispanic: OR, 4.02 [P = 0.0089]), and symptomatic status in females (versus asymptomatic status: OR, 2.83 [P < 0.0007]).
Rates of detection of M. genitalium and other sexually transmitted organisms (C. trachomatis, N. gonorrhoeae, and T. vaginalis) for both female and male subjects are presented in Table 2. Based on the infected status standard, the overall female M. genitalium prevalence rate of 16.3% was significantly higher than the prevalence rates for C. trachomatis (9.3% [OR, 1.75; P = 0.0035]) and N. gonorrhoeae (1.9% [OR, 8.4; P < 0.0001]). For males, the prevalence rate for M. genitalium (17.2%) was significantly higher than those for N. gonorrhoeae (4.2% [OR, 4.11; P < 0.0001]) and T. vaginalis (5.6% [OR, 3.08; P < 0.0001]) but not significantly different from that for C. trachomatis (17.8% [OR, 0.961; P = 0.8218]).
Rates of single infections and coinfections of M. genitalium with C. trachomatis, N. gonorrhoeae, and T. vaginalis.Fig. 1 shows the distribution of single infections and coinfections of the four STOs tested for, among 233 female and 155 male subjects positive for one or more STOs. The majority of subjects were infected with a single organism (female, 80.7%; male, 85.2%). The most prevalent single infection in females was T. vaginalis (45.7% of all female subjects with a STI), followed by M. genitalium (25.6%), C. trachomatis (9%), and N. gonorrhoeae (0.4%). Single M. genitalium infections represented 68.7% of all M. genitalium infections in female subjects. By comparison, 71.6% of C. trachomatis infections in female subjects were single, as were 78.5% of all T. vaginalis infections. M. genitalium presented in dual infections with T. vaginalis and C. trachomatis in 6.3% and 3.1% of infected subjects, respectively. Infections with combinations of three or four organisms were rare (<1% per combination).
Among male subjects, the most prevalent single infection was C. trachomatis (34.2% of all male subjects with a STI), followed by M. genitalium (31%) and N. gonorrhoeae (5.2%). In male subjects, single M. genitalium infections represented 75% of all M. genitalium infections, single C. trachomatis infections represented 41.7% of all C. trachomatis infections, and single T. vaginalis infections represented 95.8% of all T. vaginalis infections. The most prominent dual infection combination among males with a STI was M. genitalium and C. trachomatis (9.7%); other dual infection combinations together represented 5.1% of infected subjects. There were no higher-order infection combinations in males.
Rates of macrolide antibiotic resistance markers.Reverse transcription-PCR and Sanger sequencing of M. genitalium 23S rRNA was used to assess the rates of macrolide resistance markers in a subset of subjects in the study (Table 3). Overall, 65 of 128 female subjects (50.8% [95% CI, 42.2 to 59.3%]) and 21 of 50 male subjects (42% [95% CI, 29.4 to 55.8]) harbored M. genitalium organisms with base position 2058/2059 mutations in 23S rRNA. Among both male and female subjects, the macrolide resistance marker prevalence was slightly higher in younger (14 to 24 years of age) versus older (25 to 47 years of age) subjects and higher in black versus white subjects, although the differences were not statistically significant. Non-Hispanic females had a >3-fold higher 23S rRNA mutation frequency than did Hispanic females (54.5% versus 16.7%), although the number of Hispanic female specimens evaluated by sequencing was small (n = 6).
This study investigated the prevalence of M. genitalium and three other sexually transmitted organisms in a diverse cohort of female and male subjects seeking care at a variety of health care facilities in the United States. To our knowledge, these data represent the broadest geographic population studied to date for ascertainment of the M. genitalium prevalence in the United States. The results show high rates of M. genitalium infections in adolescent and adult women and men, with prevalence rates exceeding 24% in young adult men and 25% in adolescent and young adult women and then gradually decreasing at older age for both genders. M. genitalium prevalence rates were also elevated for female and male subjects who self-identified as black or of non-Hispanic ethnicity and for subjects who sought care at public health, family planning, adolescent gynecology, or STD health care facilities in the Midwest, Mid-Atlantic, or Southeast regions of the United States. Subjects who received care at family medicine or OB-GYN practices in the Northeast or at a public health clinic in the Southwest had low rates of M. genitalium infection, as did subjects who self-identified as being white or Asian or of Hispanic ethnicity. Hispanic females especially appeared to harbor a low burden of M. genitalium infection, with only 1 subject testing positive of 49 evaluated.
The overall prevalence rates for M. genitalium infections reported here are similar to those reported previously in smaller studies of high-risk populations in the United States (6, 9, 10, 14, 15, 20) and in the European community (21, 22), Australia and New Zealand (23–25), Asia (26, 27), and Africa (28, 29). Age-related trends for M. genitalium infection prevalence similar to those reported here have also been observed previously (7, 30), and the low prevalence (∼1.0%) of M. genitalium infections observed here among subjects attending family medicine or OB-GYN facilities is on par with that reported previously for low-risk segments of the general population in the United States (8). In addition, the higher rates of M. genitalium infections seen in black subjects are in agreement with previous studies involving at-risk African Americans in the United States (14, 15, 31). These new results reinforce the need for effective STI detection, treatment, and education efforts among young African Americans engaging in high-risk sexual practices.
Our data differ from those reported previously (14, 32) in that testing for M. genitalium and other sexually transmitted organisms using sensitive NAAT methods revealed that the majority of subjects (>80%) of both genders were infected with a single organism and infections with ≥2 organisms were relatively uncommon. The reason for this difference is not clear, although the use of geographically and clinically diverse medical practices for the initiation of patient encounters in this study might have revealed infection patterns not apparent in previous studies with smaller or more geographically constrained enrollments. Regardless of the reason, we found here that, for M. genitalium, two-thirds of females and three-quarters of males who tested positive for the organism by a NAAT did not have a concurrent infection with another STO. Similarly, for C. trachomatis, approximately one-half of males and three-quarters of females who were positive for the organism by a NAAT had a single infection; for T. vaginalis, three-quarters of females and nearly all males had single infections. This apparent predominance of subjects harboring single-organism infections has implications for the diagnosis and treatment of individuals who are at high risk for STIs. Current treatment guidelines recommend antibiotic therapy that is specific to each microorganism (33) and, since coinfection with one or more STOs may be uncommon, the choice of therapy for managing mucosal epithelial inflammatory conditions should be guided by the employment of clinically validated diagnostic methods, rather than a syndromic management approach.
For M. genitalium infections, macrolide antibiotics are the current treatment of choice (33). In recent years, numerous studies on cohorts originating outside the United States have reported high detection rates for a macrolide antibiotic resistance genotype of M. genitalium, thereby limiting the options for treatment (18, 34–37). In the present study, we also found high rates of a M. genitalium macrolide resistance phenotype (51% in females and 42% in males), indicating that resistance to this class of drugs is not a regional phenomenon outside North America but is likely to be endemic in the U.S. population as well. Confirmation of this finding using broader evaluations of the U.S. population would complicate current treatment methods for M. genitalium infections and might indicate a need for comprehensive reassessment of current diagnostic and pharmacological solutions for treating infected patients.
Major strengths of this study include the number of subjects evaluated (n = 946), the demographic and geographic diversity of the population sample studied, and the variety of clinical practice types employed for enrollment of subjects seeking care. Other important attributes of the study were the use of sensitive NAATs to detect all four sexually transmitted organisms and the use of RNA sequencing to detect expression of the M. genitalium macrolide resistance phenotype.
Interpretation of our results is constrained by several limitations. First, subjects of Asian descent or Hispanic ethnicity constituted relatively small proportions of all enrolled subjects (0.7% and 13.1%, respectively). Therefore, the findings shown here may not be representative of the true STI burden in these populations in the United States. Second, the TMA assay used for M. genitalium detection is a research-use-only assay that has not been subjected to formal clinical validation. In the absence of confirmatory testing by second and third sensitive NAATs, the M. genitalium results reported include unknown numbers of false-positive and false-negative results. However, this concern is mitigated by previous studies showing good clinical agreement between the TMA NAAT used and PCR-based M. genitalium NAATs (5, 6). Third, only a subset of specimens from enrolled subjects were available for testing for macrolide resistance makers, thus introducing a selection bias of unknown magnitude to the final prevalence estimates for the resistance phenotype in the cohort. Finally, our assessment of macrolide antibiotic resistance relied solely on detection of the A2058/2059 mutations that are known to result in a high-level macrolide resistance phenotype (18). We did not investigate markers for other possible mechanisms conferring macrolide resistance, such as the mtr promoter mutations found in macrolide-resistant N. gonorrhoeae (38). Hence, the macrolide resistance prevalence estimates reported here may underestimate the true prevalence of resistance to this antibiotic class in M. genitalium in the U.S. population.
The results of this study show a high prevalence of single M. genitalium infections and limited coinfection with other sexually transmitted organisms in a broad cross section of U.S. subjects at risk of acquiring a sexually transmitted infection. These findings support the monitoring of M. genitalium infections in high-risk populations as part of public health STI screening programs. The high rate of macrolide antibiotic resistance markers found in this study is concordant with resistance rates seen in other populations throughout the world and supports the testing of M. genitalium-positive subjects for macrolide resistance before the initiation of treatment.
D. Getman, A. Jiang, and M. O'Donnell are scientists employed by Hologic, Inc., the manufacturer of the diagnostic tests used in this study. During the time this study was being conducted, S. Cohen was an undergraduate student at Occidental College and a summer intern at Hologic.
- Received 16 May 2016.
- Returned for modification 3 June 2016.
- Accepted 9 June 2016.
- Accepted manuscript posted online 15 June 2016.
- Copyright © 2016 Getman et al.
This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International license.


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full house
Sometime in the dead of night, somewhere high above the dark waters of the Atlantic Ocean, Junebug marked the end of her second month of life with her first long-distance flight.
Raising a family half a world away from the country where neither one of us was born but which we proudly call home has led to a good deal of soul searching regarding our identities.
The wait, seemingly unbearable at the outset but not that long in the grand scheme of things, is nearly over. After packing first the layette shipment and then her suitcases, S is making the final preparations for her return to Kigali this weekend. It has been a whirlwind summer — on both sides of the Atlantic — and much as D will grumble about the lost sleep that awaits with the arrival of two jet-legged kids, he is very much looking forward to seeing them again.
Composing the speech for Junebug's baby-naming ceremony cracked open the floodgates of S's memory. Writing about her grandmothers' lives and looking through old photographs of their younger days, S tried to reconcile her recollections with the stories she had heard from her parents – it's not easy to paint a portrait of someone's life when one only shares in that person's twilight years.
One of the things we wondered and worried about before Junebug was born was how Munchkin would greet the arrival of his baby sister. Would he be jealous of her for stealing mama's love and attention, and how would he act out his envy? Or would he be loving and protective and act proud of being a big brother?
"Zero to one was tough, and two to three was challenging, but going from one child to two wasn't that bad," several friends told us with the benefit of hindsight, and perhaps a dose of selective amnesia. Intuitively, this makes sense. First-time parenthood is tough because there is so much to learn. And going from two to three is hard because sometimes you find that you have more little humans who need attention than arms at your disposal. Still, adding a new baby into the mix is bound to make life more complicated, and we've found that having two small children frequently feels much more than twice as difficult as just having one.
For the first month of Junebug's life, we followed a divide and conquer strategy. With D home on R&R and plenty of relatives visiting, balancing two kids was a manageable challenge. Newborns sleep a lot and are relatively portable, and with an endless stream of visitors who gave Munchkin the attention he covets and helped with the day-to-day household chores, the first four weeks flew by. We felt incredibly lucky to have had so much family support, but S was under no illusions about how daunting being home alone with both kids would be.
The first week passed in a haze of cruel jet lag. The next was marked by Rwanda's presidential election – a week full of long days at the office that seemed to persist long after the final ballots had been cast. The third week was blissfully uneventful and marked in its passing the midway point of our separation.
S's sister recently sent us a New Yorker article that chronicled one French/American couple's travails in choosing a name for their son. Charmingly witty, humorous, and filled with all sorts of quirky name trivia, the article also hit a nerve, for despite the fact that S had compiled a list of girl names she liked long before she was even pregnant with our firstborn (who turned out to be a boy), we had a hard time choosing a name for Junebug.
The grass always seems greener on the other side, so the saying goes, but there are exceptions, and this was one of them. There was no doubt in D's mind as he transited three airports over the course of 27 hours that the return alone from Portland to Kigali was going to be a bit of a downer. What he hadn't quite counted on was to find the saying to have literal implications as well. Rwanda is a lush, verdant country for most of the year, but D returned during the height of the dry season to find the countryside sere, the grass wilting brown, and the air pregnant with dust.


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We are seeking a Home Health Clinical Manager to become a part of our team! You will coordinate medical and health services in hospitals, clinics or similar organizations.
- Oversee medical and health service activities and personnel
- Plan and coordinate health services
- Work collaboratively with physicians to implement appropriate healthcare programs
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- Previous experience in healthcare or other medical fields
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- Strong leadership qualities
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- Excellent written and verbal communications skills


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The following narrative poem reveals the adventure of a knight who experiences a little bit of everything. From dragon slaying to finding true love, he remains courageous through it all. Read on to embark on this journey alongside the noble knight.
Journey's End
Journey's End
We traveled exactly a month and a day,
Searching to find dragon's lair,
But instead of sharp teeth, and great claws,
We encountered a lady fair.
She told us her carriage and men were destroyed,
Gone in a flick of his tail,
When asked who the culprit of this was,
She said 'twas the dragon of tale.
We traveled exactly a week and an hour,
My steed, the lady, and I
To find the dragon, the one feared the most,
In the land of Starry Sky.
We met on the way, an ogre as big,
As the trees that grew all 'round.
He growled and he snarled, his feet stomping hard,
But I fought and left him on the ground.
We traveled exactly a day and three minutes,
Looking to slay the dragon,
With me, my horse, and lassie so fair,
We knew that journey begun.
Night fell in the forest, but clouds filled the sky,
We are all tempted to sleep,
But howls in the dark, eyes, glowing sparks,
Made us stay up on our feet.
We traveled exactly a week and a day,
Encountering nothing but trees.
But behold stood a werewolf, his glare as cold
As the freezing winter breeze.
I slashed with my sword, but it was in vain.
The wolf's fur was like nettle,
But the lady took off her bracelet of silver,
And killed him as he touched the metal.
We traveled exactly an hour from the wolf,
In search for a dragon with gold,
But in our path, stood a wizard in wrath,
He seemed like a hundred years old.
The lady scoffed as he brandished his stick,
Trying to cast a "spell,"
But riding my horse, we headed on course,
And the wizard chased us 'till he fell.
We traveled not far from the wizard affair,
We were approaching our goal
When we nearly squished, but I wish
The fairy wouldn't give a look of coal.
She flittered around us, like a mad fly.
Making obnoxious buzzing sounds,
Exchanging a look, the lady held up her book,
And squashed the pixie to the ground.
We traveled a day from the fairy's attack,
We were becoming restless,
But soon we could see, the zenith, the peak,
And the view made us breathless.
We climbed until we were over the clouds,
I pointed to the mouth of the cave,
We entered with care, since this was a lair,
And I forgot how to be brave.
The dragon was scarlet, his eyes a deep green,
His teeth, like daggers of ice
His tail was long, almost a furlong
And he was feasting upon mice.
I quivered in fear, cowered in shame,
While the lady drew my sheath,
She fought without tire, while the dragon blew fire,
And I could see his foot-long teeth
The woman was finished, her dragon was dead,
The gold was set out like a feast,
The gold was set out like a feast,
She had but one scar, but it was by far,
Nothing compared to the beast.
We traveled exactly a week and a day,
She had completed my task,
With not more to do, we would start anew,
And I had one question to ask.
I bent on one knee, my heart beating fast.
I wanted to spend my whole life,
I wanted to spend my whole life,
Standing beside who I hoped was my bride,
And asked her to be my wife.
And asked her to be my wife.
-- by Rebecca S., Grade 7


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Comedian Ricky Gervais has engaged in a debate about theology with the Archbishop of Canterbury – confessing at the end that he might have "blown his image" by taking life seriously.
The Office star told Dr Rowan Williams he was concerned about "brainwashing" of children who are sent to faith schools at an early age, comparing teaching that God exists to belief in Father Christmas.
"Because I believe in evolution, I believe that a child's brain is a sponge, and it is meant to be because it believes everything it is taught because it has to to survive," Gervais said on BBC Radio 5 Live's Simon Mayo show.
In a largely light-hearted conversation, Gervais told the Archbishop that God's "biggest mistake" was giving him free will.
At the end of the conversation, Gervais observed: "That was fantastic – have I blown my image – taking life seriously?"
Mayo joked: "Do you think he is a secret Christian under the atheist facade?" Dr Williams joked: "I'll give him time."
Gervais also asked "What's the Archbishop plugging?" to which Mayo responded, "I think he is plugging Christmas." Gervais said: "Of course, I love Christmas, I say go for it. Brilliant."


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Call + Response – Trailer
|Call + Response – Trailer
A feature length documentary film that reveals the world's 27 million dirtiest secrets: there are more slaves today than ever before in human history. CALL+RESPONSE takes viewers deep undercover where slavery is thriving – from the child brothels of Cambodia to the slave brick kilns of rural India – and reveals that in 2007, Slave Traders made more money than Google, Nike and Starbucks combined.
Directed by: Justin Dillon
Starring: Ashley Judd, Cornel West, Madeleine Albright, Daryl Hannah, Julia Ormond


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The peak of Adam. Buddhist's believe it's where Buddha rose to nirvana from, leaving behind his footprint. In Islam, it is believe to be where Adam landed after being kicked out of the Garden of Eden when he used the earliest version of Google – the apple.
Read about the climb that all most took me out with 6,642 steps going up – and surprisingly, the same amount coming down on The Good Men Project


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Hobe Naturals Jojoba Soap Unscented
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We're two cat brothers who live in a little house in Bloomington, Indiana. You can also follow us on Facebook! Welcome to our blog!
Friday, May 7, 2010
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Frootbats Vertical... Frootbats Horizontal!
17 comments:
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That would be a tricky one!
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Have a terrific Friday and weekend and happy Mother's Day too! :-)
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No one wants to think that they paid too much for flights.
We are regularly asked for tips on getting the best value air fares – and here are some of points we consider when researching. As any regular travellers will attest, there are no iron-clad guarantees, but these suggestions might help.
Plan well ahead
For international air fares we try to search about 170 days before our flying date. As an initial part of online research, we set up 'fare drop' alerts with air fare websites.
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When looking online use the best web sites
Our favourites include; CleverLayover; The FlightDeal; Skiplagged; Skyscanner; ITAMatrix; Which Budget; AirfareWatchdog; and Trip Advisor; all of which have their pros and cons.
We have often spoken about CleverLayover, which finds savings by linking together two separate return flights.
It's also smart to keep your online searches secret by wiping your computer's cookies and history – or using private browsing mode – before returning to a site. Don't risk a price suddenly rising if a route is repeatedly searched.
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If possible, arrive at your destination in low season, rather than peak summer or late Spring.
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Try to fly during the middle of the week and on flights that leave early morning or late at night. The value of this is debatable, but sometimes it seem to work.
Find the cheapest place to fly
Especially in Europe, compare the price of flying into various airports – and there is a web tool called Kayak Explore, that will help with this.
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If you are not on a tight schedule, why not consider using layovers to see more destinations than you normally would.


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Christy Hickman, MSSW
Assistant Professor of Practice
- BA, The University of Tennessee, Knoxville
- MSSW, The University of Tennessee, Knoxville
Courses Taught:
- Introduction to Social Work (SW 200)
- Social Welfare (SW 250)
- Child Welfare I: History, Programs, and Policies (SW 461)
- Child Welfare II: Skills and Practice Methods (SW 462)
- Advanced Policy Practice (SW 548)
Christy Hickman joined the College of Social Work as an Assistant Professor of Practice at the Knoxville campus in October 2013. Christy's prior roles in the College include serving as an adjunct instructor, field instructor, field liaison, and as the IV-E Child Welfare Certification Program Coordinator.
In addition to her work in the College of Social Work, Christy served at the University of Tennessee as the Assistant Director of the Safety, Environment, and Education (S.E.E.) Center .
Prior to her work at the University of Tennessee, Christy worked in practice areas including interpersonal violence prevention and treatment, crisis intervention, case and class advocacy, program development, training development and delivery, and community mental health.


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|You are in: Health
Thursday, 30 August, 2001, 09:18 GMT 10:18 UK
Gene check could predict menopause
The age at which a woman will lose the ability to have children is almost entirely predicted by the genes she carries, say doctors.
This could lead to an "early warning" test for women who could be robbed of their fertility by premature menopause.
This is an increasingly serious problem for women in developed countries where the trend is often to delay motherhood beyond the age of 30.
Women who will enter menopause before the age of 50 will already be significantly less fertile than the average woman, even at this age.
It is thought that fertility begins to decrease as much as 20 years before the menopause.
While doctors have long suspected that menopausal age has a strong genetic link, researchers at the University of Utrecht in the Netherlands feel they have now confirmed this.
They looked at 243 non-twin sisters, and a smaller number of identical twins.
High accuracy
They found that it was possible to predict the age of menopause of one sister with as much as 87% accuracy simply by looking at the age at which the other ended her fertile life.
Dr Jan-Peter de Bruin, who led the research team, said that it was unlikely that gene therapy could ever be used to correct the problem, as it was likely that a large number of genes were involved in the process.
He said: "If we do succeed in isolating the responsible genes it is a distinct possibility that young women in the future will be able to have a DNA test that will predict their age of menopause.
"Women invest a lot of years in education and work to obtain a professional career.
"It would be an advance if we can, at least, discriminate from this group, those who are really at risk of early reproductive failure."
The strong genetic link means that women whose mothers suffered early menopause should consider themselves at greater risk of the same - and perhaps plan to start a family earlier in life, he said.
Egg store
Every woman is born with all the eggs she will ever use in her lifetime already present in an immature form in her ovaries.
Over time, this reserve of eggs is depleted, and once reduced to a certain level, menopause arrives.
Scientists believe that the original number of eggs in the ovaries, as well as their rate of "consumption" could be governed by genetic factors.
The research is published in the journal Human Reproduction.
See also:
30 Nov 00 | Health
Premature menopause 'gene found'
23 Sep 99 | Medical notes
23 Sep 99 | Medical notes
Ovary grafting
Internet links:
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Links to more Health stories are at the foot of the page.
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