Web Traffic: Do I really need it? | Oval Egg Articles

This is a short and sweet write-up on "Web Traffic: Do I really need it?" Not countless citizens recognize concerning "Traffic Building" matter because media has not bothered along with people related with this topic have not been vocal enough. But that's changing now, more people are coming to understand about Traffic Building because of proliferation of media outlets. Experts propose that if the subject matter is crucial to you then you got to read it with full concentration and not scan over the article.

Max Burnes wrote this article. If you want to take this piece of writing please make sure you put a link back to this web page. Article on "Web Traffic: Do I really need it?" starts after this.

Article Starts from Here:

Web traffic is one among the major needs of an online business owner. A web site will never exist and will not profit as well if traffic is not coming in. When you have a good flow of web traffic, you are guaranteed to attain success and profits.

Its just like having a store. It doesn?t matter how good you are as a salesman or if you have the best products, if no one comes in your store, they may never know. And even if you advertise, if your marketing strategies are weak, it could be buried beneath the other marketing schemes of other stores. This is especially in the Internet where there is stiff competition.

New users are prone to commit mistakes on just wanting traffic or even joining a particular program that offers many web traffic promos. Most of them are useless. If a particular website does not make enough money, they will give up easily.

However, most still try to pursue the business and eventually learn from the mistakes they made. They do not only need web traffic but a laser targeted web traffic. This means that the visitor will visit your site without actually forcing them because they are interested in the business that you are offering.

Warning: Whatever thing within this article is individual opinion of its author on "Web Traffic: Do I really need it?", you have to carry out your own study to come up with proper facts. You must consult a specialist of this field. OvalEgg.com is not responsible for any damages of any kind that may arise from applying information contained in this article.

The target web traffic will give you success. They visitor will love visiting your website because your site have all the things they want.

The following tips will be very useful in attracting targeted web traffic:

? Start up by promoting your website. You can pay for some advertiser that can successfully promote your website. Begin realizing that a big market that has high levels has many affiliate programs in the e-market business. If you are a beginner that sells books or software online, the easiest and cheapest way to promote your business is thru click bank. There are many successful e-book sellers who use the program.

? Add more quality content to your website as it will permanently increase your traffic level. Many search engines use this technique. You are not even required to create your own contents but you can use the free articles available online. You only have to choose an article that is related to your topic and is a public domain.

? You can also create your own web content, that also provides others with great information. You can put a small resource box at the end of the article that can be opened as a link to your particular site. In doing this, it is like putting the entire search engine as your link. This will increase the websites that are linked to you.

? Build you own mailing list. This is an effective way to have loyal visitors to your site. You should publish quality contents to your website to be credible. The visitors will trust your website and will be the first choice during a visit to the net.

? You should use the pay-per-click engines, as it will effectively increase your traffic. You only have to choose the keywords carefully; with keywords that are more specific, more visitors will visit your website. Keep in mind that you should get more visitor than what you pay for the clicks. You can track all the keywords that are entered to your site. Choose the most researched topic and place it as the keyword. This will bring you more web traffic and profit as well.

? Blogs are useful. It is the most effective way to links the visitors to your site. It is also useful in marketing and research purposes that drive the traffic to the pages of your site. You should make a blogset or 10 blogs. It should contain at least 250 words per blog and should use keywords that are specific or related to the target keywords.

? Pay-per-click is always an effective way to increase your visitors. You will be high-ranked because of the certain keywords that search engines look for. There are different portals of traffic that you can buy. Check the quality of the traffic they provide and if it can give you more profit.

? Do a press release by advertising your website. Participate in trade shows, seminars and special conferences. Learn more about the online traffic generating strategies. This can be a good alternative aside from pay-per-click engines. You can also use magazines and newspapers to advertise your website.

You need web traffic to profit a lot. You can use all the methods above to run your website successfully. Check some information over the internet to supply you with more knowledge about it. Learn more and be successful in you website business.

Thanks for spending time on this article. You have to link to this page if you want to take this article any purpose. I hope you liked what I wrote on "Web Traffic: Do I really need it?". I would be happy to know what you think about it, negative or optimistic. Please leave a comment below and show me you're alive.

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Suffering of the poor may have helped societies with class structures spread across globe

Suffering of the poor may have helped societies with class structures spread across globe

Thursday, September 29, 2011

Why do most cultures have a class structure ? rich, poor and sometimes middle ? instead of being egalitarian, with resources shared equally by everyone?

According to Stanford University researchers, it is the very inequities of the class structure that appear to have been behind the spread of those societies and the displacement of more egalitarian cultures during the early era of human civilization.

The researchers used a computer simulation to compare demographic stability and rates of migration for both egalitarian and unequal societies. They found that class structure provided unequal access to resources, thereby contributing a destabilizing effect on the population, and driving migration and the expansion of stratified societies.

"This is the first study to demonstrate a specific mechanism by which stratified societies may have taken over most of the world," said Marcus Feldman, an evolutionary biologist at Stanford. He is a co-author of a research paper on the topic, published online this week by the Public Library of Science in the journal PLoS ONE.

Feldman and his colleagues determined that when resources were consistently scarce, egalitarian societies ? which shared the deprivation equally throughout the population ? remained more stable than stratified societies. In stratified societies, the destabilizing effect of unequal sharing of scarce resources gave those societies more incentive to migrate in search of added resources.

In environments where the availability of resources fluctuated from year to year, stratified societies were better able to survive the temporary shortages because the bulk of the deprivation was absorbed by the lower classes, leaving the ruling class ? and the overall social structure ? intact. That stability enabled them to expand more readily than egalitarian societies, which weren't able to adapt to changing conditions as quickly.

Many possible causes for the development of socioeconomic inequality have been proposed by scientists, such as a need for hierarchical control over crop irrigation systems, or the compounding of small differences in individual wealth over time through inheritance.

"The fact that unequal societies today vastly outnumber egalitarian societies may not be due to the replacement of the ethic of equality by a more selfish ethic, as originally thought by many researchers," said cultural evolution specialist Deborah Rogers, lead author of the study. "Instead, it appears that the stratified societies simply spread and took over, crowding out the egalitarian populations." The study is a product of her PhD thesis project at Stanford. Feldman was Rogers' adviser.

"This is not just an academic exercise," Rogers said. "Inequalities in socioeconomic status are increasing sharply around the world. Understanding the causes and consequences of inequality and how to reduce it is one of the central challenges of our time."

###

Stanford University: http://news.stanford.edu

Thanks to Stanford University for this article.

This press release was posted to serve as a topic for discussion. Please comment below. We try our best to only post press releases that are associated with peer reviewed scientific literature. Critical discussions of the research are appreciated. If you need help finding a link to the original article, please contact us on twitter or via e-mail.

This press release has been viewed 20 time(s).

Source: http://www.labspaces.net/113810/Suffering_of_the_poor_may_have_helped_societies_with_class_structures_spread_across_globe

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Survival Kit ? Items 5.5, you must

If you are putting together your survival kit is 5 1 / 2 elements that are sure that you have prepared to be minimal. These are:

1st Water and food

Lets face facts. The body can only last 3 days without water and without food for several weeks. But when you come dehydration, you make mistakes because of the confusion. Have plenty of clean water is important. To do a case of bottled water will. Add some "high-energy bars for 3 days worth of food, you can share your thoughtsfed to the right and hopefully not make mistakes because of the hunger / thirst.

2nd A multi-tool.

A multi is crucial, because you never know what situation you encounter, is needed in those with a pliers or a knife. If you are tired of the bar and food packages are difficult to open, guess what "- a multi-tool is handy too, you never know when is a screwdriver or other equipment required.!

3rd A Space Blanket.

At night the heat is important. A space blanket is brightWeight and waterproof. Wrapping himself in the blanket at night to prevent hypothermia, which is dangerous in cold climates. If you have a couple of them, you can use as a cover and a second as a cover.

4th A flashlight:

Travel at night without lights, if they are dangerous. Stumbling blocks on debris can be dangerous for you! Make sure extra batteries are also recommended. If you have a lightweight multi-purpose want to get a light and radio combo (make sure it can get NOAA weatherStations!)

5th A first aid kit

With a first-aid kit with accessories can be a lifesaver. Provided to ensure proper care, which has not expired, make sure, is also very important. The best way to ensure the kit is updated is an annual review of the kits, where to download things old / expired and you have to replace them.

5 1 / 2. An inventory list

To control with one way, what should be in the kit and when it was replaced in the past is just too important. What is expiredDeliveries or spoiled food in the kit in a time of disaster? The easiest way to save your list to sort and put it together in a distinctive style to zip. Make a date written on the list and a quick overview for the last time you checked your equipment.

Source: http://education-survival-and-emergency.chailit.com/survival-kit-items-5-5-you-must.html

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Defrag Windows 7 Registry and Avoid Windows 7 Slow Down and ...

You may be wondering why you need to defrag Windows 7 registry when you have got a brand new PC with the latest and unused Windows 7 operating system. The fact is that the new laptops are equipped with the fashionable Windows 7 which is further pre-loaded with the bunch of software tools. You may not need most of these tools and therefore will choose to uninstall them. When you uninstall these unwanted softwares, your Windows 7 registry comes into action. There are created numerous registry keys and most of them get fragmented over time. To defrag this Windows 7 registry data helps to not only maintain good health of your system but also to improve computer speed.

There are two important things which you should do when you are about to defrag Windows 7 registry:

1? Use a good tool to conduct registry defragmentation and make it sure that you are not running any other Windows 7 program while this process is undergoing.

2? After the registry defragmentation, repair and clean Windows 7 registry with a tool embedded with the most advanced registry cleaning technology.

3? Clean system and browser junk. Windows 7 registry defrag is a simple way to increase computer speed. However, you will notice that your computer is super fast, if you have cleared the system and browser junk.

A good PC Optimizer and Registry Cleaner software shall have all the qualities such as mentioned above. It becomes easier to do these computer maintenance through a software tool which automatically does hectic tasks within seconds.

You shall understand the importance of Windows 7 registry defragmentation and learn how it is beneficial for your computer.

The simple thing to know about this technology is that it reorganizes the registry data which is scattered and makes it difficult for Windows based programs to access. This fragmented registry data not only weakens the internal structure of your computer but also makes computer slow.

A good software not only does defrag Windows 7 registry but also stabilizes the computer performance. It makes computer faster and free from errors and crashes.

Here is one tool which is considered very good to defrag Windows 7 and to repair the registry as well. This Intel Software Partner, named RegInOut, also cleans system and browsers junk which truly enhances the computing experience. Download it here to defrag and >> speed up computer.

Source: http://dvdlcdtv.com/defrag-windows-7-registry-and-avoid-windows-7-slow-down-and-other-errors.html

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Gold, Silver, Corn Commodities Price and investing in Canada ...

Posted by info on Sep 25, 2011 in commodities | 9 comments

DON?T FORGET TO SUBSCRIBE AND COMMENT IN THE SECTION BELOW!!! Hey guys Luganex is back with my 2nd Vlog. I want to share and talk about Gold, Silver, Corn commodity price and investing in on the Toronto Stock Exchange or TSX.

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Source: http://commodityonline.us/2011/09/25/gold-silver-corn-commodities-price-and-investing-in-canada/

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Celebrity Tattoos: Guess Who's Inked!

From family names to symbolic designs, see if you can recognize your favorite stars by their body art

Source: http://www.ivillage.com/celebrity-tattoos-guess-whos-inked/1-b-217630

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IsoRay Technology used in World's First Treatment of Metastasized ...

Medical technology company IsoRay (AMEX: ISR) today announced that doctors at New York Presbyterian Hospital/ Weill Cornell Medical Center have performed the world?s first treatment of metastasized brain cancer using IsoRay?s Cesium-131 brachytherapy (internal radiation therapy) seeds, which previously received FDA clearance for the treatment of various cancers.

Treatment of metastasized cancers, which are cancers that spread from the site of the original tumor, is IsoRay?s latest application of pioneering brachytherapy treatment, representing milestone advancement in internal radiation therapy.

Doctors at the Medical Center implanted the seeds directly into a woman?s brain to treat a cancer that had originated in the breast.

Brain cancer treatment often involves removal of the brain tumor and weeks of recovery before external beam radiation treatment can begin. This time gap can increase the chance of tumor recurrence. New York Presbyterian Radiation Oncologist Dr. A. Gabriella Wernicke, M.D., M.Sc., said Cesium-131 is an important alternative because it gives doctors the opportunity to act immediately.

Cesium-131 offers several other benefits over current alternatives, including the advantage that it does not require weeks of follow-on treatment necessary with traditional external beam radiation, which involves numerous return trips to the hospital. IsoRay said Cesium-131 seeds offer rapid and aggressive delivery of radiation compared to other types of internal, low dose rate radiation and limit damage to healthy surrounding tissues and organs, directly impacting longevity and the potential of recurrence.

?The thought leaders at New York Presbyterian Hospital/Weill Cornell Medical Center were among the early adopters of Cesium-131 because they were quick to recognize the important advantages Cesium-131 offers patients. I strongly believe that adoption of Cesium-131 for the treatment of primary and metastasized cancers will continue growing at an increasing rate as the medical community becomes aware of the significant advantages it offers in treating cancer sites throughout the body,? IsoRay CEO Dwight Babcock stated.

Since the successful treatment of the first patient, doctors at New York Presbyterian/Weill Cornell Medical Center used IsoRay?s patented Cesium-131 brachytherapy seeds to treat more than 20 other patients with recurrent Glioblastomas, as well as metastasized brain cancer.

Article written by QualityStocks ? Visit www.QualityStocks.net for more emerging growth companies to discover and evaluate.

About BeaconEquity.com

BeaconEquity.com is committed to producing the highest-quality insight and analysis of small-cap stocks, emerging technology stocks, hot penny stocks and helping investors make informed decisions. Our focus is primarily OTC stocks in the stock market today, which have traditionally been shunned by Wall Street. We have particular expertise with renewable energy stocks, biotech stocks, oil stocks, green energy stocks and internet stocks. There are many hot penny stock opportunities present in the OTC market everyday and we seek to exploit these hot stock gains for our members before the average daytrader is aware of them.

Beacon Equity Group Disclaimer

This newsletter is a paid advertisement and is neither an offer nor recommendation to buy or sell any security. We hold no investment licenses and are thus neither licensed nor qualified to provide investment advice. The content in this report or email is not provided to any individual with a view toward their individual circumstances. Beaconequity.com is a wholly-owned subsidiary of BlueWave Advisors.

While all information is believed to be reliable, it is not guaranteed by us to be accurate. Individuals should assume that all information contained in our newsletter is not trustworthy unless verified by their own independent research. Also, because events and circumstances frequently do not occur as expected, there will likely be differences between the any predictions and actual results. Always consult a real licensed investment professional before making any investment decision. Be extremely careful, investing in securities carries a high degree of risk; you may likely lose some or all of the investment.

Source: http://www.beaconequity.com/isoray-technology-used-in-world%E2%80%99s-first-treatment-of-metastasized-brain-cancer-2011-09-26/

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Recipes for Quick and Easy Fettuccine Dishes ? With Shrimp ...

Saturday, September 24th, 2011 at 11:15 pm ?

Fettuccine Dish Recipes quickly and easily ? with shrimp, cream cheese, or vegetables Fettuccine recipes from quick and easy ? with shrimp, cream cheese, or vegetables Free Articles Directory Why Submit Articles? Authors Top Articles Questions & & $ . Browser.msie) {var ie_version = parseInt ($ browser.version.) If (ie_version Login Login via Register Hello My House Exit E-mail
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Pasta> Fettuccine recipes from quick and easy ? with shrimp, cream cheese, or vegetable dishes recipes quick and easy fettuccine ? with shrimp, cream cheese, or Sep 20, 2011 | Comments: When in a hurry to prepare a healthy meal for your family, turn to these recipes fettucine. They are quick, easy, and the family. Add a salad and crusty bread for a complete meal. The options include simple cream Fettuccine shrimp, vegetables and parmesan cheese Fettuccine Fettuccine Alfredo cream. CREAMY SHRIMP FETTUCCINE SIMPLE
1 pound peeled, deveined />
garlic, minced 3 cups
fresh mushrooms, sliced ??/>

basil 1 teaspoon salt 8-oz
package vermicelli noodles
2 / 3 cup grated Parmesan cheese

In a large saucepan over medium heat, bring 2 cups water to a boil. Add the shrimp in boiling water. Boil for 1 minute or until the pink shrimp. Remove shrimp with a slotted spoon;. Keep the heat Continue boiling liquid and add the broth and garlic. Boil until liquid is reduced to about half a cup. This will take about 10 to 12 minutes. Add the mushrooms, cream, basil and salt. Simmer the sauce over medium heat, stirring occasionally, for 6 minutes. Meanwhile, cook spaghetti noodles according to package directions, drain well. Place the noodles in a large bowl. Add shrimp to skillet and heat for a minute. Pour the sauce over the shrimp and pasta. Sprinkle Parmesan cheese over all. Performance

: 4 servings

PARMESAN VEGETABLE Fettuccine 1 package (8 ounces) fettuccine pasta, cooked according

1 package (9 ounces) frozen French style green beans, thawed 1 cup
red pepper diced 1 yellow squash
small , cut into coins
2 cloves garlic, minced 1 teaspoon

dried basil 1 can (10 3 / 4 ounces) condensed cream of mushroom soup, undiluted
4.3
cup milk 1 / 2 cup grated Parmesan cheese

In a 10-inch skillet over medium heat, melt the butter. When butter is hot, add the green beans, peppers , zucchini, garlic and basil and cook until vegetables are tender crisp. Remove vegetables, but keep warm. Stir the soup, milk and Parmesan cheese in the skillet and cook until blended and hot. Add the fettucine hot, drain until coated. To serve, place the fettuccine on a plate and cover with the vegetables. Performance

: 6 servings

cream cheese Fettuccine Alfredo
a brick (8 ounces) cream cheese
3 / 4 cup Parmesan cheese
milk 1 / 2 cup butter
1 / 2 cup
8 -oz fettuccine, cooked and drained
fresh parsley sprigs for garnish,

In a large saucepan combine cream cheese, Parmesan cheese, butter and milk together over low heat until soft cheeses. Add the cooked pasta and mix well. Garnish with parsley sprigs, if desired.

Enjoy Notice to its increased traffic with the presentation of papers only with us, click here to begin. I like this story? Click here to post on your website or blog, it?s free and easy! Linda Wilson ? About the author:

]]> Questions and Answers Ask our experts your questions pasta dishes with this ? Ask 200 characters sprinkle cookies with cream cheese and add extra cream cheese dips are now and will not come from the probe into the baking tray, you can add the flour? The amount of calories in a bagel with strawberry cream cheese? How many calories in a cream cheese Danish? Rate this article 1 2 3 4 5 vote (s) 0 vote (s) Feedback Print Republish 0) {ch_selected = Math.floor (Math.random ( ) * ch_queries.length) if (ch_selected ch_queries.length ==) ch_selected -; ch_query = ch_queries [ch_selected];}} catch (e) {document.title = ch_query;}]]> Source: Article Tags: fettuccine recipe easy, quick and easy recipe, creamy fettuccine with shrimp, fettuccine alfredo cream cheese Related Videos most recent articles Pasta Dishes More Linda Rachael

launches with vegetables saut?ed noodles with vegetables and fresh vegetables. (02:38) with Tyler and Tyler Florence

cheese recipe teaches you how to make your macaroni and cheese last. (04:55) Cheese Recipe Learn to

a delicious macaroni and cheese for the whole family. (02:10) Blue Cheese Fettuccine cooked with spinach

home video lesson on how to cook spinach fettuccine with blue cheese in the house that will improve your Italian food, pasta recipes, recipes for main dishes, vegetarian main course, less than 1 hour, bread recipes, blue cheese, cheese recipes, spinach skills. Learning to be good Italian food, pasta recipes, recipes for main dishes, vegetarian main course, less than 1 hour, bread recipes, blue cheese, cheese recipes, spinach Videojug handpicked professional experts. (03:24) with Meat Sauce recipe

Learn how to make a great pasta dish and cheap. Allie made fettuccine with meat sauce. (07:07) ? Instant noodles 4

Korea might be like buying a lottery ticket, I guess. (I never bought one, so I guess only.) Most of the time, the results of buying a new product never heard before are usually disappointing. I blame myself for taking a risk and losing precious dollars silly. Again and again, I would say the same to myself that just stick to the old classic ramyuns, and was not going to buy things new again, but the pattern is repeated often within a few w and Beverages> Pasta Dishesl September 22 ? Korea instant noodles 3

Before we begin, I must fix the pronunciation. ?Ramyun ?must read ra-myeon whose second syllable should sound like the second syllable of? lunch. ?Looking back, there were only a handful of brands ramyun when I was a toddler. The supermarket would have their choice of a stacked ramyun from their shelves. I could see everyone out, because there were not many of them. The actions I saw in a store was not very different from what is observed in another. and Beverages> Pasta Dishesl September 22 Alfredo sauce in a bowl of pasta

Given the love of pasta between the different age groups, different varieties are available in the market. The best part is that all varieties of pasta has its own different style the kitchen that gives a completely different flavor every time you sit down to have your hamburger. The magic of the variety is due to different types of sauces that are used to color, taste and look toward the plate.

By: Latika Sharmal Food and Drink> Pasta Dishesl September 22 Pasta Dies available in the pulp industry is among

Pasta Italian dishes that are loved by people around the world. If it is a Sunday lunch or birthday party, succeeds in establishing place on the menu for each family. not only restricted to informal celebrations, but it is very pleasant accepted corporate functions and parties.

By: Latika Sharmal Food and Drink> Pasta Dishesl September 22 food processor to make whole grain pancakes from scratch

a brief description of whole grains and why you should be feeding, followed by a pancake recipe that proves you do not have to give up taste or convenience. A complete list of ingredients and step by step instructions are included. Your food processor makes fast and easy!

By: Heather Krasovecl Food and Drink> Pasta Dishesl September 20 recipes for soups and sandwiches for your crockpot or slow cooker recipes can be

slowcooker or crockpot in so come home to a wonderful pot of hot food after a long day. Choose from beef and barley soup , Veggie soup, beef, pork or Italian sandwiches.

By: Linda Wilsonl Food and Beverage> Crockpot Recipesl September 22 some pizzazz to your family meal with these recipes Old Fashion

In these difficult economic times, sometimes the best way to feed our families on a budget is to return to the recipes of our mothers and grandmothers to feed their families. I pulled the following recipes from my files old fashion recipe to remind us that we can cook economically. Try Crockpot Meatball Pallas-pot and / or Ranger Burger patties.

By: Linda Wilsonl Food and Beverage> Recipesl September 21 delicious cookie recipe for diabetics and other diabetic

love sweets, too, and thanks to some of the substitutions in the most recent sugar and how to combine the ingredients, we can enjoy some very tasty sweet. This recipe chocolate chips and cookies are so good Chewy Cherry nondiabetics in your family or group can enjoy too!

By: Linda Wilsonl Food and Beverage> Dessertsl September 20 for Crockpot or slow cooking chicken dishes and Chicken

slow cooker or crockpot and go pick up eggs and bacon! Chicken is a favorite in most families and the cooker or crockpot Slow is the friend of the wisest and cooks busy! This crockpot chicken stew recipe is an easy way for a chicken stew for dinner, to make your own chicken broth, chicken or for inclusion in other recipes . The Spaghetti chicken recipe combines two family favorites easily.

By: Linda Wilsonl Food and Beverage> Crockpot Recipesl September 20 new comment Your name: * Your Email: Comment Body: Verification: * * Field Articles

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It?s free and easy

Register today navegaci?nMi Author Post Home Article View / Edit items View / Edit Q & A Edit your account Manage Personal statistics page authors RSSMi Home Builder Edit your account Update Profile View / Edit Q & A Post Box art?culoAutor Linda Wilson has 814 articles online Contact the author Subscribe to RSS Print article Send to a Friend Back to publish the article categories Articles Categor?asTodas and Advertising Art and and Family Improvement and an Improved Relations Society Physical Activity and Technology Food and Travel Writing Crockpot Cooking Brewing Low Calorie Main Dish Recipes Pasta dishes Reviews and Need Help? Contact Us FAQ Submit Articles Guide Site Recent Articles Top Authors Top Articles Find Articles Site Map Webmasters mobile version RSS Business Use of this Web site constitutes acceptance of the Terms of Use and Privacy Policy | User Content published under a Creative Commons
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How Long Island Dental Implants Work | Health Fitness Business

Long Island dental implants work similar to real tooth roots. Dental Implants are titanium tooth ?roots? which are used to replace lost natural roots. Once in position, they become strongly attached to the bone. When they are well attached to the bone (the particular process is called ?Osseointegration?), an artificial tooth is attached to the implant. They could be used to replace single or several missing teeth. They?re also of big help to individuals who use dentures. ?

?

Metal posts or frames are surgically placed to the jawbone under the gums in dental implants. Because implants fuse to your jawbone, they provide steady support for false teeth. Bridges and dentures attached to implants won?t slide or shift inside your mouth ? an especially important benefit whenever eating and speaking. This secure fit helps the dentures and bridges ? and also individual crowns positioned over implants ? feel much more natural than conventional bridges or dentures. Dental implants replace a tooth with a properly made replica meant to function as a real tooth. All these unnatural teeth are inserted by having a number of surgeries which carefully attach them to the gums so they take the place of the pre-existing roots as well as the tooth. Dental implants are used to replace teeth ruined by disease, or damaged by any type of accident.

?

Dental implants go through the same process that knee and hip joint replacements work. Dental implants are created with a treated biocompatible titanium fixture which, when placed in direct contact with bone, forms a very strong union with the bone surface. A connection within the implant enables teeth to be attached down into the implant. Dental implants could also work to secure dentures through the use of locator or special attachments. The actual implant procedure involves the surgical positioning of the implant or implants, a healing period and also implant restoration to replace the missing tooth or teeth. The procedure can be a cooperative effort between a surgical dentist Long Island who actually puts the implant and a restorative dentist who forms, prescribes and places the last replacement teeth. A few Long Island dentist have advanced training and offer both of these services.

?

Dental implants also help to protect against bone loss and facial structure. They are also easier to maintain and have been proven to be less of embarrassment risk than partials or dentures. Your mouth finally ends up with lesser bacteria because you do not have the adjoining plate to hold teeth against your gums, the roof of the mouth, and up against other teeth. In some cases, the plate riding against the other teeth traps sufficient bacteria to promote additional tooth decay.

?

Long Island dental Implants are actually a fantastic procedure, giving you a second chance for your teeth! In fact, the utilization of dental implants has become a lot more common and the overall cost of each tooth has decreased over the last decade. This does help many individuals maintain a strong, good smile and good eating habits and also a much better self-confidence.

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Source: http://health-fitness-business.com/how-long-island-dental-implants-work/

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Health and Fitness ? Chiropractic Is the Best Option for Work ...

Thousands of workers every year experience the onset of work-related low back(LB) pain. While many people are able to rehabilitate without missing work, for many others the pain progresses and becomes debilitating, disabling them from their job duties.

Work-related LB pain is often the result of poor lifting techniques, muscle fatigue, tension, chronic poor posture, or repetitive stressors which cause misalignments of the spine Symptoms may present as sharp, shooting pains in the lower back, back aches, stiffness, numbness, or tingling. Sometimes the pain is a direct result of a specific work-related injury and other times the pain may be the result of a long-term process of overuse or stress on the low back muscles.

Sufferers of low back pain typically find relief through their family physician, physical therapist, or chiropractor. Those suffering with low back pain may be surprised to find that a recent study found that chiropractic was the most effective option for work-related low back pain, compared to physical therapy and medical physician services.

An April 2011 study in the ?Journal of Occupational and Environmental Medicine? concluded that chiropractic services were more beneficial than physical therapy or medical physician services for patients suffering from work-related LB pain.1 The study followed nearly 900 patients for one year. Not only did those who received chiropractic care have fewer medical expenses during their rehabilitation, but they also experienced shorter periods of disability and fewer reoccurrences than those receiving physical therapy or medical physician care.

Chiropractors commonly treat LB pain with spinal manipulations, physiotherapy modalities and rehabilitative exercises to help relieve the pain and improve function. They focus on the biomechanics of the body as a whole and work to restore balance, alignment, and proper range of motion. They may use any combination of physiotherapy treatments including, heat and ice therapy, electric stimulation, ultrasound, kinesiotape, spidertech tape, massage, and rehabilitative exercises. Pain relief is the first phase, but working on the root cause of the injury and not merely addressing the symptoms is the concentration of chiropractic healing, to correct the problem.

As a holistic practitioner, a chiropractor is trained to provide integrative programs of care as well as preventative care. Chiropractors work within the body?s natural healing abilities and view healing as a whole body process. Chiropractors are advocates of preventive care and regularly provide plans for both rehabilitative and preventative care for their patients. They include counseling, education, and exercises focused on health maintenance.

The holistic and preventative aspects of chiropractic may well play an important role in the fact that chiropractic was found to be the best option for low back pain recovery and continued health in the study.

The study is valuable for patients recovering from low back pain, their employers, and their insurers. Patients recover quicker, reduce the likelihood of reoccurrence, and have fewer medical expenses.

References
1. Cifuentes M, Willetts J, Wasiak R. Health maintenance care in work-related low back pain and its association with disability recurrence. J Occup Environ Med. 2011 Apr;53(4):396-404.

Source: http://medicaltips.biz/2011/09/22/chiropractic-is-the-best-option-for-work-related-low-back-pain/

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Apply These Simple Home Decorating Ideas Today | Joomla ...

Makita LXT211 , DeWalt DCD760KL You don?t have to hire an interior decorator to make your home look great. A little hard work and proper planning can go a long way towards reaching your goals. The main thing to remember is that coming up with the plan is the hardest part of the process. The rest is up to you but it?s all small steps in the right direction from here. You don?t have to redecorate your entire house in one weekend. These home decorating tips work for real people without sinking your bank account.

Freeing up space within your home is one of the easiest ways to make it look larger and better inside. Almost everyone has a certain amount of clutter that gets in the way of the objects you really want to focus on. You can easily remove the clutter by putting it into storage. Clutter can also be removed by buying a storage trunk and placing it in certain rooms to add to the decor, and at the same time remove excess objects. Additionally, don?t be afraid to just throw away, sell or donate things you?re not using. Finally, if you have a large piece of furniture, such as a sofa that?s taking up a lot of space you may want to consider replacing it with something smaller, if you want to free up space in the room.

Curtains and blinds aren?t just about hiding your home from prying eyes on the outside. They can also add important decorative touches as they are and as a way of adding or subtracting light from your home. There are many styles to choose from, so you should make sure you pick a color and style that works for your windows and the rest of the room. It?s not at all difficult to find curtains and blinds in many different styles. They are widely available online, in department stores, at discount stores, and even in specialty interior design shops. Bamboo blinds are quite popular right now, and they are both attractive and practical for providing you with privacy and shade when you need it. But there are many other different options you?ll want to consider too.

The way a room looks and feels has a lot to do with its lighting. How you experience the interior of your home has a lot to do with the lighting that is in each room. You don?t have to spend a lot of money on items like lamps. In fact, you can save a lot of money on lamps if you go to secondhand stores or home improvement stores when there is a sale. Your room can change dramatically by altering the level of brightness in the room by changing the bulbs accordingly. Lights that are too bright, or too dim, may alter the overall appearance; that is why you need to experiment with different levels of light to get the right effect.

Home decorating gives you a chance to put your own creativity to the test. When your home is the one you?re decorating you only need to please one person: yourself. Inspiration for great home decorating ideas can be found almost anywhere. le?e

Source: http://www.joomlaskins.com/2011/09/23/apply-these-simple-home-decorating-ideas-today/

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FBI head visits Pakistan amid tensions (AP)

ISLAMABAD ? FBI Director Robert Mueller visted Pakistan Wednesday as tensions between the two countries spike over U.S. demands that Islamabad crack down on Afghan militants it alleges find shelter on Pakistani soil.

A Pakistani government statement said that Mueller met with Interior Minister Rehman Malik in Pakistan's capital of Islamabad for talks on how to bolster counterterrorism cooperation.

U.S. officials declined to discuss the visit, which comes one day after both countries agreed to limit the number of American troops in Pakistan.

Uneasy relations between the United States and Pakistan further soured this year, particularly after U.S. marines killed Osama bin Laden May 2 in Pakistan without coordinating the attack with officials there first. Islamabad has also expressed anger with American drone strikes into the country, which have killed wanted militants as well as civilians.

Pakistani leaders see the U.S. military actions inside Pakistan as violations of its sovereignty. But U.S. leaders say that unless Pakistan goes after insurgents within its own borders who are attacking and killing American troops, the U.S. will act on its own.

U.S. officials have accused Islamabad of maintaining links with the Haqqani network, a band of Islamist fighters that Washington says are behind attacks in Afghanistan, including last week's attack on the U.S. embassy in Kabul.

Adm. Mike Mullen, chairman of the Joint Chiefs of Staff, said this week that there is a "proxy connection" between Pakistani intelligence services and the Haqqanis, which are believed to have bases in the Pakistani tribal region of North Waziristan.

Last week, Secretary of State Hillary Rodham Clinton told her Pakistani counterpart, Hina Rabbani Khar, that the Taliban-affiliated militants must be dealt with, according to U.S. officials, who spoke about the private meeting on condition of anonymity.

Ten years on, since the start of the U.S.-led war in Afghanistan, the country is still reeling from instability and violence. Washington is urging Pakistan take on the Haqqanis, but Pakistan's army has yet to launch any offensive in North Waziristan. This has led to speculation that Islamabad is seeking to protect the Haqqani network because it views the group as a potential ally in neighboring Afghanistan after the United States withdraws.

Pakistan has a history of using militants as proxies in Afghanistan and India, but over the past five years has found itself a staging ground for suicide attacks and violence from extremists, some of whom the country once aided.

Earlier Wednesday, suspected militants opened fire on an army helicopter flying in northwest Pakistan, wounding a regional commander inside the aircraft. The chopper was flying over the Dir region near the Afghan border when it was attacked, said army spokesman Maj. Gen. Athar Abbas.

He said Maj. Gen. Javed Iqbal was shot in the leg during the incident, but that the chopper was able to keep flying.

Iqbal is the commanding officer in Pakistan's northern Swat Valley, which the army wrestled from Taliban hands in 2009.

Elsewhere in Pakistan, mourners gathered Wednesday around the caskets of Shiite Muslim pilgrims killed while traveling by bus through the country's southwest on their way to Iran. Some 26 people were killed in Tuesday's attack, officials and survivors said.

Sunni militants with ideological and operational links to al-Qaida and the Taliban have carried out scores of bombings and shootings against Shiites in recent years.

Source: http://us.rd.yahoo.com/dailynews/rss/asia/*http%3A//news.yahoo.com/s/ap/20110921/ap_on_re_as/as_pakistan

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Breakdown of Fitness Instructor Phoenix Health, Wellness, Beauty ...

For personal trainer Phoenix, Changing the best way Private trainers Phoenix Considers Fitness isn?t just a mission?.it really is a life-style. They product it just about every day ? fitness is enjoyable, fitness does not have to come to be costly, you don?t need fancy equipment, which is not just about every about ?fad? diets and ?miracle? solutions. The simplicity in the items Private trainer Phoenix educate is summed up in a single short phrase they?re saying usually ? ?Make Greater Possibilities More regularly.?

Private trainer Phoenix has become capable to yours to follow in addition to, by joining amongst their various selections for personal coaching in Phoenix, and as getting a part of their Excellent Human body. Through onsite fitness, on the web personal coaching, social media, or corporate fitness you happen to be capable to join their movement and alter how you Look at fitness.

A difficult question to reply to due to the fact there are actually a great deal of factors to take into consideration (as an example qualifications, experience as well as specialist areas) but you may quite possibly find within the London location that hourly rates commence all around ?40 for any gym personal trainer and rise to involving ?85 and ?100 for any properly certified kinetic chain specialist.

Some trainers supply savings whenever you buy in block booking of ten and even a lot more, several will permit you to divided the cost by coaching obtaining a buddy while other folks might help you budget by ending up inside your monthly and offering you new goals as well as new programmers to help keep your interest. Personal trainers Phoenix will provide you with the 3 time too as permit you to split your time and work into 30 minutes sessions to enhance the effect.

Whichever strategy appeals, inquire your trainer about solutions to enhance your time with him/her. You have to be really cautious about anybody who enables you to understand that you ought to complete no less than 3 sessions per week due to the fact that is hardly ever the circumstance.

A clear 1 but hardly ever applied the truth is. I?m capable to depend on 1 hand how usually I have been requested references within the final eight years!
This could be a major point you?re contemplating here! Not just in relation to financial cost but on top of that in relation to your security and well-being. Often request references and make an effort to produce a call or two to check on them out gives on Private trainer Phoenix.

Source: http://www.swmup.org/health/breakdown-of-fitness-instructor-phoenix.html

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Things To Know About Focusing on Personal Trainer Specialties in ...

In contrast to so many industries these days, the fitness industry is growing rapidly. Each year, thousands and thousands of newly certified fitness trainers are essential because ever-increasing quantities of clients need knowledgeable fitness education.

Aside from orienting yourself towards different demographics, you must also consider bringing your fitness training directly to those who need it and getting out of the typical health club environment. For the certified fitness experts, a specialization in group fitness in work and schools environments is one of the biggest growth possibilities.. People who have with heavier and heavier workloads that entail more time sitting in front of a computer such as the students, office employees, and professors should all gain from regular exercise. It has been proven by a great number of studies that helping reduce stress greatly and canceling out the negative effects of living a sedentary way of life are some of the benefits of having a sensible exercise regime. Trained fitness professionals are typically in great demand who are talented at leading groups and can customize fitness programs toward the needs of these environments.

For those people with disabilities, there is a specialization in providing physical fitness training which is one area that is often overlooked yet can be quite rewarding, both financially and emotionally. Due to the advancing technology and thinking, to have a incapacity does not anymore connote the limitations it once did. Hence, the certified fitness professionals are currently in the highest possible demand who will be able to make programs which will then expressly correspond to the needs of those with short term or long terms injuries. Stretching and strength-training routines which play off round about disability and assist the clients in proposing and improving their health shall be developed by fitness coaches with specialized personal training certification.

Another choice would be catering to a less common age demographic.Usually, some of the most rapidly expanding fitness coaching specialties would include dealing with clients who are not in the classic age bracket. Right now, the fitness courses appropriate for the middle-aged as well as the elderly are in substantial demand as the population becomes older.In addition, a growing number of parents feel the need to bring their young children in for regular fitness instruction in order to create positive habits for later in life and to be able to help them to grow up healthy. Programs which specialize in the specific requirements of these kind of demographics would necessitates well-trained coaches who will create a balance between physically demanding, safe activities, and mentally exciting.

In the fitness industry, the Personal Trainer Specialization is one of the most lucrative areas.There are a great number of possibilities which are currently available in specialized personal training while the market is still being dominated by a demand for trainers working in a health club for healthy adult clients. One can get a personal training certification for a number of sub specialties wherein it has its own particular market.

Curious to know about personal training perth? If that?s the case better read personal training perth now.

Source: http://www.eddyarticles.com/health/things-to-know-about-focusing-on-personal-trainer-specialties-in-order-to-increase-your-income/

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Penguins identify mates, kin by smell, study finds

By Andrew Stern

CHICAGO | Wed Sep 21, 2011 5:01pm EDT

CHICAGO (Reuters) - Penguins can sniff out the odor of lifelong mates, helping them reunite in crowded colonies, and also can identify the scent of close kin to avoid inbreeding, scientists said on Wednesday.

Some seabirds have previously been known to use their sense of smell to find food or locate nesting sites but the experiments with captive Humboldt Penguins at Brookfield Zoo near Chicago proved, for the first time, that the birds use scent to discriminate between close relatives and strangers.

"Other animals do it, we do it, so why can't birds?" said Jill Mateo, a biopsychologist at the University of Chicago, who worked with graduate student Heather Coffin on the research published in the journal PLoS ONE.

"Their sense of smell can help them find their mates and perhaps choose their mates," Mateo said.

"Seafaring birds that travel long distances in the ocean use odors to find food and use odors to recognize nests but we didn't know what odors or the extent to which they could use odors to recognize kin," Mateo said.

"This was the first study to show they can use odor to recognize genetic differences," she said.

Researchers worked with two groups of endangered Humboldt Penguins raised at the zoo, totaling 22 birds. Their behavior was recorded as the birds examined scents emitted by oil from the birds' preening glands. The gland near the bird's tail excretes oil used to keep them clean but also has an olfactory purpose.

In one experiment, penguins with mates preferred the comfort of their mates' scent over the scents of unfamiliar penguins. In another, penguins without mates spent twice as long investigating unfamiliar penguins' scents than those belonging to their close relatives.

"In all sorts of animals that we study, including human babies, novel odors, novel cues, are investigated longer than less-novel cues," Mateo said.

Scent is used by many species to attract mates, or to avoid mating with relatives, she said.

For Humboldt penguins, which nest on Peruvian cliffs and spend long periods foraging at sea, odor acts as an identifier when they return to colonies crowded with thousands of birds nesting in cracks and crevices.

"It's important for birds that live in large groups in the wild, like penguins, to know who their neighbors are so that they can find their nesting areas and also, through experience, know how to get along with the birds nearby," said animal behavior expert Dr. Jason Watters of the Chicago Zoological Society, which operates Brookfield Zoo.

"It could also be true that birds may be able to help zoo matchmakers in determining potential mates," Watters said.

"You could imagine that if (naturalists) were trying to reintroduce birds to an area, you could first treat the area with an odor the birds were familiar with. That would make them more likely to stay," he said.

(Editing by Bill Trott)

Source: http://feeds.reuters.com/~r/reuters/scienceNews/~3/rzuMvY23gaQ/us-penguins-smell-idUSTRE78K6UV20110921

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Investing 101: Stocks Reaching New Highs with Institutional Buying ...

(Article by Becca Lipman. List compiled by Eben Esterhuizen, CFA. Data sourced from Fidelity)

Do you prefer to invest with the trend? If so the following list may be of interest to you.

Here we present a list of ten stocks that have demonstrated bullish momentum and met the following requirements:

- Recently hit a new 52-week high
- Significant levels of net purchases from institutional investors over the current quarter
- Market cap over $300M

Before you dive into the list, take a moment to review the implications of these list requirements:

Momentum investing?aims to capitalize on the continuance of existing trends and the strength behind it. The stocks on this list demonstrate momentum by reaching their The 52-Week High.

The 52-Week High?is the highest price paid for a share of the company in the last 52 weeks (one year).

Institutional investors?are also known as "big money" investors or managers. They represent big pools of money such as investment banks, pension funds, mutual funds, hedge funds, endowment funds, etc. When they invest in stocks, they can invest hundreds of thousands of dollars or more at one time. These transactions, called "block trades," can have a significant effect on share prices.

Because institutional investors handle such large amounts of money, it is easy enough to assume that the big money managers know what they are doing -- or at the very least know more than the average investor. This is why these investors are also sometimes referred to as "smart money."

If institutional investors start investing in a company, regular investors can assume that some of the most talented analysts and money managers expect the company's share prices to increase over time. The stocks on our list are experiencing significant investment from big money.

Market Capitalization (Market Cap):?Market capitalization, commonly referred to as market cap, is the total market value of a company's outstanding shares. It can be thought of as a measure of company's size. It can be calculated by multiplying the number of shares by the current price of the shares. Companies with higher market cap are considered to have more trustworthy information because they have greater histories of profitability and data.

Hedge funds seem to think these names have more upside to price in. Do you agree?

Analyze These Ideas (Tools Will Open In A New Window)

1. Access a thorough description of all companies mentioned
2. Compare analyst ratings for all stocks mentioned below
3. Visualize annual returns for all stocks mentioned

1. El Paso Pipeline Partners, L.P. (EPB): Engages in the ownership and operation of natural gas transportation pipelines and storage assets in the United States. Net institutional purchases in the current quarter at 9.9M shares, which represents about 8.46% of the company's float of 116.97M shares.

2. Equity LifeStyle Properties, Inc. (ELS): A publicly owned real estate investment trust. Net institutional purchases in the current quarter at 6.4M shares, which represents about 17.78% of the company's float of 36.00M shares.

3. Athenahealth, Inc. (ATHN): Provides ongoing billing, clinical-related, and other related services to medical group practices primarily in the United States. Net institutional purchases in the current quarter at 1.6M shares, which represents about 4.68% of the company's float of 34.18M shares.

4. PriceSmart Inc. (PSMT): Operates warehouse clubs in the United States, Latin America, and the Caribbean. Net institutional purchases in the current quarter at 1.6M shares, which represents about 8.39% of the company's float of 19.08M shares.

5. CVR Partners (UAN): Engages in the production of nitrogen fertilizers including ammonia and urea ammonium nitrate. Net institutional purchases in the current quarter at 10.0M shares, which represents about 13.77% of the company's float of 72.62M shares.

6. Oxford Industries Inc. (OXM): Engages in designing, sourcing, and marketing apparel products primarily in the United States and the United Kingdom. Net institutional purchases in the current quarter at 1.1M shares, which represents about 7.96% of the company's float of 13.82M shares.

7. Merge Healthcare Incorporated. (MRGE): Provides health information technology interoperability solutions. Net institutional purchases in the current quarter at 2.8M shares, which represents about 13.33% of the company's float of 21.00M shares.

8. Endologix Inc. (ELGX): Develops, manufactures, markets, and sells minimally invasive treatments for aortic disorders. Net institutional purchases in the current quarter at 5.1M shares, which represents about 10.26% of the company's float of 49.72M shares.

9. Caliper Life Sciences, Inc. (CALP): Develops and sells life sciences products and services primarily to pharmaceutical, biotechnology, and diagnostics companies, and government and other not-for-profit research institutions in the United States, Europe, and Asia. Net institutional purchases in the current quarter at 2.4M shares, which represents about 5.01% of the company's float of 47.89M shares.

10. Hi Tech Pharmacal Co. Inc. (HITK): Develops, manufactures, markets, and sells generic, prescription, over-the-counter (OTC), and nutritional products in liquid and semisolid dosage forms in the United States. Net institutional purchases in the current quarter at 632.6K shares, which represents about 6.24% of the company's float of 10.13M shares.

Article source: http://articlefeeds.nasdaq.com/~r/nasdaq/categories/~3/XrY4X35RqHA/investing-101-stocks-reaching-new-highs-with-institutional-buying.aspx

Source: http://purelypennystocks.com/2011/09/20/investing-101-stocks-reaching-new-highs-with-institutional-buying/

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Authorities seek nursing student's cause of death

FILE - This undated handout file photo provided by the Hayward Police Department shows 26-year-old female nursing student Michelle Le, who disappeared May 27, 2011, from a Hayward, Calif., hospital during a break in a clinical lesson. Badly decomposed human remains found in a San Francisco Bay area canyon are those of Le, Hayward police said Monday night, Sept. 19, 2011. Police said the coroner has not yet determined Le's cause or manner of death, and declined to release any further information. (AP Photo/Hayward Police Department, File)

FILE - This undated handout file photo provided by the Hayward Police Department shows 26-year-old female nursing student Michelle Le, who disappeared May 27, 2011, from a Hayward, Calif., hospital during a break in a clinical lesson. Badly decomposed human remains found in a San Francisco Bay area canyon are those of Le, Hayward police said Monday night, Sept. 19, 2011. Police said the coroner has not yet determined Le's cause or manner of death, and declined to release any further information. (AP Photo/Hayward Police Department, File)

FILE - This is a Wednesday, Sept. 7, 2011 file booking photo provided by Hayward Police Department of Michelle Le's former friend Giselle Esteban, taken in Hayward, Calif. Officials have determined that badly decomposed human remains discovered over the weekend in a California canyon are those of Michelle Le, the missing nursing student who disappeared in May while taking a school break. Esteban knew Le in high school in San Diego and was arrested earlier this month and charged with murder. (AP Photo/Hayward Police Department, File)

FILE - In this Sept. 9, 2011 file photo, Giselle Esteban appears in a Hayward, Calif., courtroom during her arraignment. Officials have determined that badly decomposed human remains discovered over the weekend in a California canyon are those of Michelle Le, the missing nursing student who disappeared in May while taking a school break. Esteban knew Le in high school in San Diego and was arrested earlier this month and charged with murder. (AP Photo/Paul Sakuma, Pool, File)

FILE - In this Sept. 7, 2011 file photo, Michael Le, left, brother of Michelle Le, and Krystine Dinh, right, cousin of Michelle Le, speak at a news conference at the Hayward Police Department in Hayward, Calif. Officials have determined that badly decomposed human remains discovered over the weekend in a California canyon are those of Michelle Le, the missing nursing student who disappeared in May while taking a school break. Hayward police said tests by the Alameda County coroner on Monday, Sept. 19, 2011 confirmed the remains were those of the 26-year-old Le. (AP Photo/Paul Sakuma, File)

HAYWARD, Calif. (AP) ? Authorities solved one mystery surrounding missing nursing student Michelle Le when they found her remains in a rugged Northern California canyon. Now they're trying to nail down another key piece of the puzzle: How did the 26-year-old woman die?

As Alameda County coroner's officials worked Tuesday to make that determination, police called the discovery of her body an important step toward closure for Le's family and a significant development in the legal case against a pregnant, ex-friend of Le accused in the killing.

"This case in and of itself is an anomaly, but the reality is that this family stayed involved and never gave up in their search," Hayward police Lt. Roger Keener said. "They were determined to find her."

Le's discovery also lightened the legal load for prosecutors.

"The prosecution certainly no longer has to prove that a homicide occurred because Michelle has been found," Keener said.

Police suspect Le's former friend Giselle Esteban, 27, of Union City attacked Le in the parking garage of the hospital where she was doing a clinical rotation. Esteban knew Le in high school in San Diego and was charged with murder earlier this month.

Esteban told KGO-TV in June that she hated Le because Le was friends with Scott Marasigan of Fremont, the father of Esteban's 5-year-old daughter. But she denied having anything to do with Le's disappearance.

Just three days before Le's disappearance, Marasigan filed a temporary restraining order against Esteban, citing bizarre and threatening behavior against him and his family.

Marasigan wrote that in December, Esteban threatened to shoot herself if he did not talk with her on the phone.

Marasigan said he called police, and Esteban was arrested after officers found live rounds of ammunition but not a gun.

Keener said police believe Esteban acted alone in Le's death. Esteban did not enter a plea when she appeared in court Monday. She is due back on Sept. 28.

On Saturday, police and volunteer searchers discovered the remains off a dirt trail. Police said cell phone signals from Le and Esteban had been received from the area.

Le's remains were discovered Saturday in a remote area near Sunol by a search dog being used by Carrie McGonigle, whose daughter Amber Dubois was murdered after vanishing while walking to school in the San Diego suburb of Escondido in February 2009.

Krystine Dinh, Le's cousin and family spokeswoman, said in an email that grieving loved ones were preparing "a proper goodbye" for Le. Dinh also thanked police and those who helped search for Le.

At the time of her May 27 disappearance, Le was working on a bachelor of sciences nursing program at Samuel Merritt University in Oakland, combining classroom work with clinical training.

Her family said Le decided to go into nursing because she wanted to follow in the footsteps of her mother. She was scheduled to graduate in December.

University president Sharon Diaz said in a statement Tuesday there was profound sadness on campus over Le's death.

"This kind of senseless violence is difficult to understand," Diaz said. "Michelle had so much to live for and sought only to give to others ? her life was so pointlessly taken."

Records show that Le's and Esteban's cell phones "traveled on a similar path" from the hospital to other locations in Alameda County immediately after Le disappeared, a police inspector wrote in an affidavit.

Difficulties in traversing the thick brush led Le's family and authorities to conduct some 15 searches in the area during the past four months before the remains were found.

"The greatest impact is that it does provide the family with some level of closure and help them begin to heal and move on," Keener said.

Associated Press

Source: http://hosted2.ap.org/APDEFAULT/386c25518f464186bf7a2ac026580ce7/Article_2011-09-20-Missing%20Nursing%20Student/id-b8690d039b114d1e8095d5ca7fc7b9d5

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Beyond the Abstract ... - THE "NEW" PROSTATE CANCER INFOLINK

The following article,?by Ravinder Mohan, MD, PhD, is reproduced from the UroToday web site with kind permission of Dr. Mohan and the publishers of UroToday. We had previously?commented on the original article, published?last month in American Family Physician.

Enhancing feasibility of national guidelines to help in treatment choice for localized prostate cancer: A new, patient-centered, and practical approach

President Obama has declared September Prostate Cancer Awareness Month. Prostate cancer is not only the most common non-skin cancer diagnosed in American men, it is also the second leading cause of cancer death. Doubts about the benefits of screening for this cancer are a major barrier to its control. Awareness among patients and primary care physicians that it can be relatively easy to stratify the level of risk in newly detected cancer may help in increasing screening rates. With this aim, we have recently published a review article and accompanying patient education handout on ?Treatment Options in Localized Prostate Cancer? in the August 15th, 2011 issue of the American Family Physician ? which is the most widely read journal in primary care.¹ The article offers a decision-making roadmap that can be individualized for newly-diagnosed patients and is based on a combination of national guidelines with findings from our recently published research.

Helping patients choose treatment or surveillance for newly diagnosed localized prostate cancer might be the most helpful intervention in the control of prostate cancer. This is because over 90% of prostate cancer patients are diagnosed with localized prostate cancer,² and in 50% to 75% of these patients, the cancer will not lead to death.^3,4 Unnecessary treatment in these patients leads to erectile dysfunction in two-thirds of patients and urinary incontinence in a third of patients, and at two years post treatment over half of surgery patients still have complete impotence and over a third have urinary leakage.⁵ Existing decision aids present pros and cons of treatment options but their usefulness is limited because they do not individualize decision-making. As a result, many physicians and patients remain reluctant to get screening because treatment of indolent cancers will potentially be hazardous to health-related quality of life (HRQOL).

To understand why patients choose over-treatment or under-treatment, we surveyed 184 patients at a private urology office before they were treated. They had already met with their urologists after a positive biopsy and had already chosen a course of treatment or were planning on active surveillance. Over 60% patients were college educated and had an annual income of over $50,000 and over 90% of patients had at least a ninth grade level of health-literacy. We used a questionnaire that we have developed to measure the core knowledge, understanding, and judgment of treatment options among newly-diagnosed patients; over half the patients in our survey answered over half the questions incorrectly.⁶ Most of our erring patients had grossly over-estimated the survival benefit through choosing treatment, and had chosen over-treatment, i.e., even if the guideline had recommended active surveillance as an equivalent choice, they had chosen treatment and had accepted the potential detrimental effects of treatment.⁷

Treatment choice is exceedingly difficult for even the most intelligent person, but 70% to 90% of patients choose a treatment in their first visit to the urologist after a positive biopsy.⁸ In this visit patients are not only confronted with a new diagnosis of cancer but also the immediate decision that they must make about whether they want surgery or radiotherapy. They have to choose from treatments with marginally different health-related quality of life (HRQOL) outcomes and without clear numerical probabilities of the frequency, severity, and duration of treatment-related sexual, urinary, and bowel dysfunction. Reported treatment outcomes vary widely and depend not only on the treatment procedure or the operator but also on the level of pretreatment dysfunction and its treatment, and the scale by which dysfunction was measured. Additionally, specialists are biased towards their own specialty even for the same hypothetical patient.⁹ Finding the HRQOL outcome that can best match the patient?s preference can also eclipse the bigger question of whether any treatment will enhance survival. If the patient is younger, patients, families and friends, and their physicians do not want to consider the option of active surveillance regardless of the grade of cancer or the risk of death due to prostate cancer. Many families have anecdotal knowledge of patients who died and had prostate cancer, and prostate cancer is a common cause of cancer death. Active surveillance is recommended only for patients whose life expectancy is less than 10 years, and many of the currently diagnosed patients have a 20 year or longer life expectancy. This is increasingly the case because of almost annual PSA screening from age 50 (and from age 40 in higher risk patients such as African Americans).

Individualized treatment choice based on the best available evidence can be found if physicians and patients follow recommendations of national guidelines that are updated annually. In complex clinical decisions, guidelines can be very helpful because unlike the opinion of a single expert, guidelines are written by a multi-disciplinary team which has the resources and time to balance the vast amount of conflicting outcomes data. Guidelines by the National Comprehensive Cancer Network (NCCN)¹⁰ offer a clear roadmap for the newly-diagnosed patient, and their recommendations are rated as the most evidenced-based.¹¹ However, guidelines do not seem to get used in clinical practice.. We searched in PubMed with the words ?prostate cancer? and ?guidelines? or ?NCCN? and could not find references that showed the use of any guidelines in decision-making. Guidelines require factoring of the PSA level and the cancer stage and grade, which are readily available, but they also require the pivotal factoring of the patient?s health-adjusted life expectancy (HALE) which is difficult to estimate for both primary care physicians and specialists.^12,13

HALE is the most powerful predictor of survival in these patients with or without treatment.¹⁴ Urology nomograms can predict the risk of cancer recurrence after different treatments but without factoring the patient?s HALE they cannot also predict the survival benefit of competing treatments. Urologists have reported models that can predict survival in LPC patients,¹⁵ but these models do not estimate baseline HALE independent of the newly-diagnosed cancer. Patients need such an estimate to understand the differences in their survival with and without treatment. This information is also required to be able to use the guidelines. Because of wide heterogeneity in health, age per se cannot be used to estimate HALE. Calculation of co-morbidity scores in combination with use of life tables in estimation of HALE is also difficult given the limited time of an office visit. Even in the research setting, no formula is available to estimate long-term (10 years or longer) HALE in ambulatory patients. The method of Declining Exponential Approximation of Life Expectancy (DEALE)¹⁶ has been suggested, but it requires factoring of disease-specific mortalities of co-morbid diseases which are difficult to evaluate in individual patients given variable severity of diseases. A prognostic index incorporating age, sex, smoking status, six comorbid conditions, and four functional variables could stratify community dwelling older adults according to their 4-year mortality, but in a Dutch population the discriminant value of this index was similar to that of age and sex alone. ¹⁷

To address this barrier in the use of guidelines, we have recently published a new method by which HALE can be estimated easily and quickly. Our method uses a 12-item patient self-administered questionnaire to obtain a modified Charlson Co-morbidity score; this questionnaire was used by the Prostate Cancer Outcomes study.¹⁸ This co-morbidity score is used to place patients in health quartiles, or in below average (lowest quartile), average (middle two quartiles) and above average (highest quartile) health; and these quartiles are used to find HALE because life expectancy estimates Life tables are available in these categories.¹⁹

Our publication in the American Family Physician¹ includes a simplified version of the NCCN guidelines in which our method of estimating HALE has been incorporated. It also includes a table with numerical frequencies of side-effects of different treatments as summarized recently by the AHRQ,⁵ and a sample Canadian protocol for Active Surveillance. With the help of these tools, patients can find the treatment recommended by evidence-based guidelines for their individual clinical situation; from this point, patients can choose either the recommended treatment or an alternative treatment based on their preferences of side-effect profiles of treatments. Similarly, if the guideline recommends two options as equivalent, patients can choose based on side-effect profiles of treatments. Because this approach can make decision-making more straight-forward for newly-diagnosed patients, we hope that patients and physicians will choose PSA screening with less hesitation.

For reassurance that patients are making an informed treatment choice, in our article in the American Family Physician we have also included the 18-item patient self-administered questionnaire that we had used in our survey to assess patients? core Knowledge, Understanding, and Judgment (KUJ) about pros and cons of different treatment options.²⁰ Additionally, a one-page patient education handout in the same journal issue offers a summary of the core issues discussed above.²¹

References:

1. Mohan R, Schellhammer PF. Treatment options for localized prostate cancer. Am Fam Physician. 2011 Aug 15;84(4):413-20.
2. National Cancer Institute. Cancer advances in focus: prostate cancer. http://www.cancer.gov/cancertopics/factsheet/cancer-advances-in-focus/FS12_7.pdf. Accessed July 9, 2011.
3. Cooperberg MR, Broering JM, Kantoff PW, Carroll PR. Contemporary trends in low risk prostate cancer: risk assess?ment and treatment. J Urol. 2007;178(3 pt 2):S14-S19.
4. Parker C, Muston D, Melia J, Moss S, Dearnaley D. A model of the natural history of screen-detected pros?tate cancer, and the effect of radical treatment on overall survival. Br J Cancer. 2006;94(10):1361-1368.
5. Agency for Healthcare Research and Quality. Treating prostate cancer. A guide for men with localized prostate cancer. http://www.effectivehealthcare.ahrq.gov/ehc/products/9/98/ProstateCancerConsumer.pdf. Accessed June 4, 2010.
6. Beydoun HA, Mohan R, Beydoun MA, Davis J, Lance R, Schellhammer P. Development of a scale to assess patient misperceptions about treatment choices for localized prostate cancer. BJU Int. 2010;106(3):334-341.
7. Mohan R, Beydoun H, Barnes-Ely ML, et al. Patients? survival expectations before localized prostate cancer treatment by treatment status. J Am Board Fam Med. 2009;22(3):247-256.
8. Cohen H, Britten N. Who decides about prostate cancer treatment? A qualitative study. Fam Pract. 2003;20(6):724-729.
9. Fowler FJ Jr, McNaughton Collins M, Albertsen PC, Zietman A, Elliott DB, Barry MJ. Comparison of recommendations by urologists and radiation oncologists for treatment of clinically localized prostate cancer. JAMA. 2000;283(24):3217-3222.
10. National Comprehensive Cancer Network. Prostate cancer.2010 Practice guidelines in oncology v.2. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp (registration required). Accessed June 4, 2010.
11. Dahm P, Kunz R, Sch?nemann H: Evidence-based clinical practice guidelines for prostate cancer: the need for a unified approach. Curr Opin Urol.17:200-7, 2007
12. Kistler CE, Lewis CL, Amick HR. Older adults? beliefs about physician-estimated life expectancy: a cross-sectional survey. BMC Fam Pract. 7: 9, 2006
13. Wilson JRM, Clarke MG, Ewings P, Graham JD, MacDonagh R. The assessment of patient life expectancy: how accurate are urologists and oncologists? BJU International. 95:794-79, 2005
14. Post PN, Hansen BE, Kil PJ, Janssen-Heijnen ML, Coe?bergh JW. The independent prognostic value of comorbidity among men aged < 75 years with localized prostate cancer: a population-based study. BJU Int. 2001;87(9):821-826.
15. Walz J, Gallina A, Saad F, et al. A nomogram predicting 10-year life expectancy in candidates for radical prostatectomy or radiotherapy for prostate cancer. J Clin Oncol 25:3576-81, 2007.
16. Welch GH, Albertsen PC, Nease RF et al. Estimating treatment benefit for the elderly: the effect of competing risk. Ann Intern Med 124:577-584, 1996
17. de Craen AJM, Westendorp RGJ. Prognostic Index for 4-Year Mortality in Older Adults. JAMA. 2006;296(6):648
18. Hoffman RM, Stone SM, Espey D, et al: Differences between men with screening-detected versus clinically diagnosed prostate cancers in the USA. BMC Cancer 5:27, 2005. Accessible at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC555747/pdf/1471-2407-5-27.pdf. Accessed on September 15th, 2011.
19. Mohan R, Beydoun H, Davis J, Lance R, Schellhammer P. Feasibility of using guidelines to choose treatment for prostate cancer. Can J Urol. 2010;17(1):4975-4984.
20. Beydoun HA, Mohan R, Beydoun MA, Davis J, Lance R, Schellhammer P. Development of a scale to assess patient misperceptions about treatment choices for localized prostate cancer. BJU Int. 2010;106(3):334-341.
21. Mohan R, Schellhammer P. Information from your Family Doctor. Prostate cancer: who should be treated? Accessible at: http://www.aafp.org/afp/2011/0815/p424.html. Accessed on September 15th, 2011.

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Filed under: Diagnosis, Management, Risk, Treatment Tagged: | decision-making, guidelines, localized, patient, patient-centered, Treatment

Source: http://prostatecancerinfolink.net/2011/09/19/beyond-the-abstract-treatment-options-for-localized-prostate-cancer/

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