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Aims/Introduction Sodium\blood sugar co\transporter 2 inhibitors certainly are a promising treatment for type 2 diabetes mellitus, but are connected with worries about particular adverse medication reactions. and hypoglycemia) was 2.19, 2.32, 1.33, 1.13, 1.46 and 0.73%, respectively. No brand-new safety worries were determined. Among those evaluable for scientific efficiency, the mean (regular deviation) glycated hemoglobin reduced from 7.65% (1.35%) at baseline to 7.25% (1.16%) at 12 weeks by 0.39% (0.94%; 0.0001). Conclusions This interim evaluation characterized the protection account of tofogliflozin in Japanese older sufferers with type 2 diabetes mellitus through the early post\advertising period. = 0.0005) and 2:15 (= 0.0026), respectively. Among the reported occasions of urinary system infection was significant pyelonephritis, which improved after discontinuation of tofogliflozin. For genital infections, all had been non\significant, and all except one solved with continuing treatment or after treatment interruption or various other actions, with the rest of the one not solved. Skin disorders happened in 22 sufferers (1.5%), nine of whom (40.9%) experienced the function within the initial 2 weeks. non-e were significant, and the most frequent had been pruritus and allergy. Tofogliflozin was discontinued in 18 sufferers, and your skin disorders solved in all sufferers. Hypoglycemia happened in 11 sufferers (0.73%), five of whom (45.5%) experienced the function inside the first 14 days. When the hypoglycemia happened, nine of 11 sufferers were getting CGI1746 concomitant insulin (4) or sulfonylurea (5) therapy. The sulfonylureas included glimepiride 3 mg (1), 2 mg (1) and 1 mg (2), and glibenclamide 5 mg (1). One affected individual had been treated with tofogliflozin monotherapy, as well as the hypoglycemia happened within the initial 2 weeks. non-e of the occasions of hypoglycemia had been serious. Desk 3 Adverse medication reactions with the category of effects of special curiosity 0.0001). Sufferers using a baseline BMI of 22 (= 88), 22 to 25 (= 183), 25 to 30 (= 387) and 30 kg/m2 (= 181) acquired a mean transformation of ?1.21 kg (1.56 kg), ?1.60 kg (1.87 kg), ?1.85 kg (1.95 kg) and ?2.77 kg (3.94 kg), respectively. Hence, the decrease in bodyweight tended to end up being better in sufferers with an increased baseline BMI, but also those with set up a baseline BMI of significantly less than 22 kg/m2 acquired a mean reduced amount of a lot more than 1 kg. The regularity of adverse medication reactions was analyzed according to age group and the amount of renal function. Among sufferers aged 65 to 75 years (= 1,005) and the ones aged 75 years (= IL22 antibody 501), the amount of sufferers who developed a number of adverse medication reactions was 124 (12.34%) and 54 (10.78%), respectively (Desk S2). The related number for severe adverse medication reactions was nine (0.90%) and seven (1.40%). When stratified by renal function, the amount of individuals who developed a number of adverse medication reactions was two (10.53%), 16 (17.20%), 31 (12.86%), 72 (12.24%), and 14 (10.45%) among people that have set up a baseline eGFR of 30 (= 19), 30 to 45 (= 93), 45 to 60 (= 241), 60 to 90 (= 588) and 90 mL/min/1.73 m2 (= 134), respectively (Desk S3). The related number for severe adverse medication reactions was one (5.26%), two (2.15%), four (1.66%), four (0.68%) and two (1.49%). Performance outcomes The CGI1746 mean HbA1c reduced as time passes from 7.65% (1.35%) at baseline (= 1,327) to 7.44% (1.24%), 7.21% (1.07%), and 7.25% (1.16%) at four weeks (= 1,100), 12 weeks (= 1,152) and 12 weeks with LOCF, respectively, as well as the mean switch was ?0.39% (0.94%; LOCF; 0.0001). Desk 4 displays the adjustments in HbA1c and bodyweight stratified by baseline eGFR. The decrease in HbA1c was significant in organizations having a baseline eGFR of 45 mL/min/1.73 m2, and tended to be higher in groups with an increased baseline eGFR. The decrease in bodyweight was significant in every organizations, and tended to become higher in organizations with an increased baseline eGFR. Desk 4 Performance by baseline approximated glomerular filtration price 0.000167.48 12.5465.59 12.23?1.94 2.43 0.0001(1327)(1354)(1296)(1027)(1063)(969) 307.20 1.257.33 1.830.13 1.13 = 0.665668.46 13.3067.04 14.34?1.68 1.70 = 0.0182(16)(16)(16)(12)(10)(9)30 to 457.55 1.577.50 1.57? 0.06 0.77 = 0.516568.91 11.5968.09 12.37?1.99 2.49 0.0001(84)(81)(80)(59)(55)(50)45 to 607.47 1.277.30 1.27? 0.17 0.98 = 0.008366.98 12.4465.63 12.21?1.81 1.95 0.0001(229)(227)(227)(182)(185)(176)60 to 907.66 1.377.20 1.11? CGI1746 0.47 0.94 0.000167.93 12.5565.87 12.00?2.08 2.97 0.0001(553)(548)(543)(438)(449)(422)907.89 1.437.27 1.01? 0.63 0.95 0.000167.38 14.6065.20 14.55?2.21 .
Tag Archives: CGI1746
Aims/Introduction Sodium\blood sugar co\transporter 2 inhibitors certainly are a promising treatment
Advanced gastric cancer (AGC) is normally associated with a higher mortality
Advanced gastric cancer (AGC) is normally associated with a higher mortality price and, despite multiple brand-new chemotherapy options, the survival prices of individuals with AGC remains poor. that soon many different targeted remedies will maintain make use of for treatment of AGC. Within this review, the existing position of targeted remedies in the treating AGC and gastroesophageal junction tumors, including HER (2-3) inhibitors, epidermal development aspect receptor inhibitors, tyrosine kinase inhibitors, antiangiogenic realtors, c-MET inhibitors, mammalian focus on of rapamycin inhibitors, realtors against various other molecular pathways fibroblast development aspect, Claudins, insulin-like development factor, CGI1746 heat surprise protein, and immunotherapy, will end up being talked about. hybridization (Seafood). Of these, 594 acquired a +3 staining rating on IHC or had been FISH-positive (HER2:CEP17 proportion 2). These sufferers were randomly designated to get chemotherapy plus trastuzumab or chemotherapy by itself. The sufferers received capecitabine coupled with cisplatin or cisplatin coupled with fluorouracil being a chemotherapy program. The percentage of HER2 positivity was 22.1%. Median Operating-system was 13.8 mo (95%CI: 12-16) in sufferers receiving trastuzumab and chemotherapy in comparison to 11.1 mo (95%CWe: 10-13) in sufferers receiving chemotherapy alone, as well as the difference was statistically significant (HR = 0.74; 95%CI: 0.60-0.91, = 0.0046). Within a analysis from the ToGA trial, the Operating-system of sufferers with high HER2 appearance (IHC2+ and Seafood positive or IHC3+; = 446) who received trastuzumab was 160 mo (95%CI: 15-19) weighed against 11.8 mo (95%CI: 10-13) in sufferers receiving chemotherapy alone (HR = 0.65; 95%CI: 0.51-0.83, = 0.036). Median PFS was also considerably improved in the trastuzumab plus chemotherapy arm weighed against chemotherapy by itself (median PFS: 6.7 mo 5.5 mo, HR = 0.71; 95%CI: 0.59-0.85, = 0.0002). All levels of adverse occasions and serious undesirable events (quality three or four 4) were very similar CGI1746 between your two groups. It had been previously observed that trastuzumab may cause significant cardiac toxicity. Nevertheless, within this CGI1746 trial, cardiac toxicity was uncommon and prices of cardiac occasions were similar between your trastuzumab plus chemotherapy and chemotherapy by itself groupings [17 (6%) 18 (6%)]. Following the amazing results from the ToGA trial, trastuzumab in conjunction with cisplatin and a fluoropyrimidine (fluorouracil or capecitabine) was recommended as category 1 first-line therapy in sufferers with HER2 overexpressed AGC (Country wide Comprehensive Cancer tumor Network, European Culture of Medical Oncology Suggestions). This year 2010, the meals and Medication Administration, and Western european Medicine Agency accepted trastuzumab in conjunction with chemotherapy for make use of in HER2-overexpressed AGC sufferers. In a report presented on the American Culture CGI1746 of Clinical Oncology (ASCO) Get together 2013, trastzumab-naive sufferers with AGC had been treated with trastzumab in conjunction with paxlitaxel. 40 six patients had been enrolled and received paclitaxel (80 mg/m2 on times 1, 8, and, 15 q4w) plus trastuzumab (8 mg/kg preliminary dose, accompanied by 6 mg/kg, every 3 wk). The entire response price (ORR) was 37.2% (95%CWe: 23.0%-53.3%). Median PFS was 5.2 mo (95%CWe: 3.9-6.6). The mix of trastuzumab with paxlitaxel as second-line therapy demonstrated efficiency in AGC sufferers[15]. In the stage II NEOHX research, perioperative chemotherapy treatment with trastuzumab in conjunction with capecitabine and oxaliplatin was examined in sufferers with HER2-positive resectable gastric cancers. This combination program was implemented as 3 cycles in the preoperative and postoperative period. Thirty-six patients had been enrolled. Three patiens acquired a pathological comprehensive response (8.3%; 95%CI: 2%-22%). The disease-free success at 18 and 24 mo was 71% (95%CI: 53%-83%) and 60%, respectively. Perioperative trastuzumab plus capecitabin/oxaliplatin demonstrated promising efficiency[16] (Desks ?(Desks11 and ?and22). Desk 1 Finished randomized Stage II and Stage III Rabbit polyclonal to Amyloid beta A4 studies valueOS (mo)valueResultsFluoropyrimide/cisplainToGA, Initial lineIII5946.7 55 0.00113.8 11.10.004PFS and.
Two reference monoclonal antibodies against the meningococcal P1. aimed against epitopes
Two reference monoclonal antibodies against the meningococcal P1. aimed against epitopes in VR2 or VR1; as a result, each PorA can bind two different subtype-specific MAbs. Furthermore, CGI1746 variants in VR2 and VR1 are examined by sequencing of genes (4, 8, 17C20, 23C26). Inside a earlier characterization of meningococcal isolates, both guide MAbs against the normal P1.15 subtype, MN3C5C (1) and 2-1-P1.15, did not show identical binding patterns (29). The epitope for MN3C5C has previously been mapped to a 3-amino-acid sequence in VR2 (19), but that for 2-1-P1.15 has not been reported. Because those MAbs have been used for serological characterization of several large strain collections (1, 3, 9, 27), the aim of our study was to elucidate the reason for their different specificities. (Parts of this work were presented at the Tenth International Pathogenic Conference, Baltimore, Md., 8 to 13 September 1996 [28]). For this purpose, whole-cell suspensions of 707 strains, isolated between 1987 and 1995 from patients with meningococcal disease in Norway, were screened on dot blots with a panel of serotype- and subtype-specific MAbs as described elsewhere (31). Strains that were positive with MN3C5C HIF1A and 2-1-P1.15 on dot blots were also immunoblotted with those MAbs following sodium dodecyl sulfate (SDS) gel electrophoresis of boiled cell suspensions (31). PorA bands on the blots, as well as the corresponding PorA bands in SDS gels, stained with Coomassie brilliant blue, were scanned by densitometry (30). The rationale behind this analysis was that PorA epitope variants CGI1746 might be revealed by their weaker antibody binding after antigen denaturation. Isolates were also characterized by multilocus enzyme electrophoresis from the combination of alleles at 14 enzyme loci (7). Distinctive multilocus genotypes were designated as electrophoretic types (ETs). For DNA sequencing of the gene, chromosomal DNA was isolated from a loopful of cells, suspended in 400 l of TE buffer (10 mM Tris-HClC1 mM EDTA [pH 8.0]), essentially as described previously (10), except for a 2-h lysozyme treatment. One microliter of DNA, diluted 1:5, was amplified in a PCR assay (total volume, 50 l) with the primer pair 5-AAACTTACCGCCCTCGTA-3 and 5-TTAGAATTTGTGGCGCAAACCGAC-3 (8). Sequencing of PCR products was performed as reported previously (8) or by automated sequencing using an ABI Prism 377 and the Big Dye Terminator Cycle Sequencing Kit (Perkin-Elmer Applied Biosystems). The epitope for MAb 2-1-P1.15 was localized by reacting the MAb in an ELISA (22) with synthetic 25- to 29-mer peptides corresponding to loops 1 (VR1), 4 (VR2), and 5 of the subtype P1.19,15 PorA from reference strain H355 (18, 25). The peptides were used in the oxidized state and bound directly to the plate. Detailed epitope mapping was performed by the Geysen method with pins derivatized to allow cleavage of the completed peptides from the pins (15). Twenty-three overlapping decapeptides (each shifted along the sequence by 1 amino acid) that spanned all of VR1 from P1.19,15 PorA were prepared. A 4-amino-acid spacer (SGSG) was added N-terminally to each decapeptide, and the completed peptides were biotinylated at the N terminus before CGI1746 cleavage from the pins (15). The SGSG spacer served to raise the reactive peptides from the surface of the ELISA plate and allow for mobility and conformational freedom of the potentially reactive sequences. The biotinylated peptides were bound to ELISA plates previously coated with streptavidin (50 l of 50 g ml?1, dried overnight at 37C). After three washes, peptides diluted to 50 g ml?1 in phosphate-buffered saline were added, and the plates were incubated for 2 h at space temperatures. The MAb was diluted 1:1,000 and permitted to respond using the peptides at space temperature overnight. Alkaline phosphatase-labelled anti-mouse immunoglobulin G (1 g ml?1) was used while the next antibody and incubated for 2 h in space temperatures. The assay was finished and read as referred to previously (22). Dot blot evaluation demonstrated that 25 from the 707 affected person strains indicated PorAs that reacted with both research MAbs, 2-1-P1 and MN3C5C.15, whereas 12 strains bound 2-1-P1.15 but not MN3C5C (Desk ?(Desk1).1). Five from the last mentioned strains expressed epitopes for the P1 also.1, P1.2, or P1.14 subtype-specific MAbs. Basically 1 of the 37 strains belonged to serogroup B, and everything strains portrayed a course 3 PorB proteins aside from one nontypeable stress that seemed to absence the PorB in SDS gels. From multilocus enzyme electrophoresis, the 37 isolates which were 2-1-P1.15 positive belonged to three distinct clone complexes. Eleven strains had been members from the ET-5 complicated; these included the four serotype 15 strains and seven from the serotype 4 strains (Desk ?(Desk1).1). The various other five serotype 4 isolates belonged to a clonal group (J1).


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|The Black Madonna, 14 X 17, copr William Cook, 1982
Couldn't whip out the camera quick enough. How odd that that everything in
this doorway was spotless exceptfor the statue's face. I actually thought it
was a little strange--the Queen Of Heaven in blackface. Had the
thing been vandalized or was this an accident of nature? I dubbed
her the Black Madonna, and did this piece--knew nothing of the legends.
with black faces for hundreds of years all over Europe. Much of it consists
of local legend or superstition, some of it is mystical and 'dark',
some of it just sounds ridiculous--like the warning not to get her
upset or she'll throw your kid off a cliff.
office of ever greater reaches of strange. Baltimore has its share
of kooky legends. I mean it is possible. We're prepared
for this here, and my imagination was doing handstands
--like this guy.
and that started all the goofy legends. Apparently, whoever
went to church here agreed. Today she's all
cleaned up, good as new.
So much for the legend of the Black Madonna.
But I still wouldn't get her upset.
What do you think?

subset: commoncrawl


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Assassin's Creed 4 Walkthrough Guide
Ubisoft's Assassin's Creed IV: Black Flag is upon us and that means that plenty of people will play the game and get stuck. Luckily, we're in the business of helping players find their way out of a tough bind and we have a video walkthrough series available to help you get out of a pinch.
There's a couple of things I was genuinely shocked with, mostly with the future parts and the graphics. So first up – and not to turn this into a graphics whore debate – but I was very shocked at how good the game looks for the Xbox 360. I was almost positive that Ubisoft was going to throw out a trash version for the current gen consoles, but they surprised us all by putting as much effort as possible into the 360 and PS3 version of the game.
Now, there are still some obvious animation shortcuts, lighting issues, geometry LOD and texture downscaling that makes it obvious it's current-gen. But as for the overall presentation, I was genuinely impressed that Ubisoft didn't cut corners or make the changes so obvious like Battlefield 4 on 360 and PS3 compared to Battlefield 4 on PC and PS4 (I would have named the Xbox One version but for all we know it could be native 480p upscaled to 720p).
As for the future parts... Ubisoft was slick breaking the fourth wall like that. That was a slick narrative decision that may or may not backfire on them. The premise of the future parts reminds me a lot of David Cronenberg's Existenz or that lousy Total Recall remake. Unfortunately, you'll be going back to the future periodically so get used to it.
As for the walkthrough itself... you'll find that it offers everything you might need to help get you situated with playing Assassin's Creed IV: Black Flag. The videos offer players hints and tips with mastering the controls, taking charge of seafaring battles as well as manning ships and partaking in the series' iconic combat.
Much of what's on display in the video is similar to what many gamers experienced in Assassin's Creed III, but there are some new additions to the game that you might appreciate as well. If you find yourself getting stuck or you need help ironing out your direction on where to go and what to do in the game, feel free to check back in and click on the appropriate video.
Each video in the playlist is attached to a sequence, so you shouldn't have too many problems getting around or finding out what you need or where you need to go if you follow the videos.
Assassin's Creed IV: Black Flag is set for release on October 29th for the current gen systems as well as the Wii U, and it's set for release on PS4 on November 15th, Xbox One on November 21st and PC November 19th. For more information feel free to visit the official Assassin's Creed website.
Staff Writer at CinemaBlend.
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Pakistan hands over 145 fishermen to Indian authorities
LAHORE, Pakistan – A Pakistani official says 145 Indian fishermen have been handed over to Indian authorities at a border crossing near the eastern city of Lahore.
Maj. Azam Sher said Friday that the Indian fishermen were previously released from a Karachi prison and transported to Lahore.
The fishermen had been imprisoned during the past year for illegally fishing in Pakistani territorial waters.
Another group of Indian fishermen will be released next month as a good will gesture. The country released 220 Indian fishermen in Dec 2016, a move reciprocated by India but with a smaller figure.
Pakistan and India's maritime agencies frequently arrest each other's fishermen. Detained fishermen from both sides languish in prison until such goodwill gestures are shown from either side.


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The dessert table for my nephew's 2nd birthday was so much fun to style. He loves Thomas the Train… so labels, signs and candies in the character's colors were in order!
I created labels to look like the cartoon's title, but personalized them with my nephew's name to wrap around the mini water bottles and yummy chocolates. Circle labels showed the names of all the bright colored candies displayed in glass jars. Bags with Thomas the Train stickers on them were provided for guests to take home sweet treats. The party was a blast and the kids were all wide-eyed at the happy, colorful dessert table — especially the birthday boy.
So sweet! 🙂


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The San Luis Obispo Blues Society is dedicated to providing the Central Coast with high quality Blues music performances at reasonable prices.Reciprocal ticket discounts are given between the Santa Barbara and the SLO Blues Societies.
The Ventura County Blues Society is a non-profit organization dedicated to preserving the rich history of Blues music in Ventura County and surrounding areas. The society actively supports the community and hosts Blues events to raise money for local charities.
The Southern California Blues Society serves to promote, preserve and advance the culture and tradition of blues music as an American cultural art form.They are actively involved in the community, presenting musical performances and special programs designed to promote and sustain the music we love.
The Santa Clarita Valley Blues Society exists to preserve and promote the Blues music artform. In addition to frequent member jams, they plan to bring concerts and festivals to the Santa Clarita Valley and actively participate in a Blues in the schools program.
Blues Lovers United San Diego actively promotes all aspects of blues music throughout Southern California through a variety of activities: web site & monthly newsletter, producing/co-producing blues music events, conducting a Blues in the Schools (BITS) education program,and a host of other activities for the Blues Lover.
The Sierra Blues Society is dedicated to preserving & promoting the blues . Whether you're a musician, a band, or a fan, whatever part of the blues you're from, you'll enjoy surfing connecting with them.
One of the oldest blues societies in California, the Sacramento Blues Society was founded 1979. The SBS has kept the blues tradition alive in the Sacramento area.
Based in Chico California, the Midnight Blues Society (MBS) has been supporting the Blues since 1992. Formed as a Community Service Organization, The Mission of the MBS is to: Nurture, Promote and Preserve All Things Blues, Live & Otherwise.
The Bucks County Blues Society. Our friends keep the Blues going strong in Pennsylvania. They've been in existence nearly as long as the SBBS and remained continuously active year after year.


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Symphytum Officinale - Comfrey
|Characteristics:Long, hairy lower leaves and upright clusters of white, pink, purple, or yellow flowers that can reach 3 feet high.
Growing Information: Give comfrey moist, loose soil in full sun. Space plants about 3 1/2 feet apart.
Propagation: Sow comfrey seed outdoors in fall or spring. You can also transplant divisions of existing plants. Pieces of the root will often sprout, so once planted, comfrey is very hard to eradicate. It can also spread to invade adjacent plantings.
Cultivars: Handsome variegated forms have white-edged leaves.
Possible Problems: To avoid Japanese beetles, trap them with pheromone lures in a far corner of the yard and treat your lawn with milky spore disease. Or handpick and drop them into a container of soapy water.
Harvesting and Using: Comfrey has long been made into medicinal teas, but its safety for human use is now questioned.
Related Herbs: Caucasian comfrey (S. caucasicum) has handsome pink buds that open to reveal blue or white flowers. Some forms have leaf variegation, too. It grows 2 feet high.
Russian comfrey (S. x uplandicum) has pink buds that open to reveal purple flowers. It reaches 6 feet high.


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Today my little sister Josie is here with a review on a book she really enjoyed! Take it away Josie!
The Sea Pony
Series: Piper Green and the Fairy Tree
by Ellen Potter
Illustrated by Qin Leng
128 pages – ages 7 – 9
Publisher: Alfred A. Knopf Books for Young People
Will be published on August 16, 2016
Publishers summary: Piper Green is in for another adventure when she finds an unusual whistle hidden inside the Fairy Tree in her front yard. But Piper doesn't want a whistle… she wants a pony! On a trip with her dad to check the family's lobster traps, the whistle attracts the attention of an unexpected friend. Could the fairy whistle working its magic after all?
What Josie Thought: The story in the book was very cute. I liked that the chapters were small but I got a good story out of them. I think books like that are good for kids who like to read but sometimes have trouble reading. Piper's big brother's name is Erik – I thought that was funny because my big brother's name is Erik. 🙂 There was a lot of funny lines in the book. I really like Piper and want to read more about her. I liked that Piper was wishing for something and didn't get exactly what she thought she would but it turned out even better. I liked the other characters in the book too and the town (or the island) Piper lives in. I really like the idea of the fairy tree. I want to read more about that too. The pictures in each chapter were nice. I liked seeing the pictures that go with the story.
I would read the other books in this series!
I give this book 5 out of 5 bookworms.
Categories: Age 6-9


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The Home of the Creative Mind
Welcome to PooBahSpiel, the online voice and home of the creative mind of Mark Monlux, Illustrator Extraordinaire. Prepare yourself for an endless regaling of art directly from the hand of this stellar artist. And brace yourself against his mighty wind of pontification. Updates are kinda weekly and show daily sketches, current projects, and other really nifty stuff.
Wednesday, November 2, 2011
The Return of Stickman #1340
My brother Randy asked that I do a few strips using characters that a few of the older fans know and love. This won't be a huge saga. I'm going to try a formula of weird news bits along with a story arch. I'll be searching for feedback along the way.
I spent a few hours yesterday being couched by Adam The Alien on monetorizing my YouTube channel. I'm considering do the same to this blog.
Subscribe to: Posts (Atom)


text:
JRSS is very pleased to announce that its S1 registration statement has been declared effective. The Company filed the S1 registration statement in March of 2014 and has been working diligently over the last seven months to obtain this clearance. You may get these documents for free by visiting EDGAR on the SEC web site at: S1
Ticker Symbol
On October 23, 2015 the FINRA cleared the shares of JRSIS Health Care Corporation's common stock to commence trading on the OTCBB under the symbol "JRSS." the 8K on the SEC website at:8K
DTC Eligibility
Our Shares were approved for DTC Eligibility on December 21, 2015
For more detail at: more
Please contact us for further information:
Tel: 86-135.1001.6379.
Email: firstname.lastname@example.com
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AOC Champagne
Pinot noir 70%
Chardonnay 15%
Pinot menuier 15%
12% vol.
Sparkling light yellow colour. Slow and even pearling. Aromas of green apple, citrus fruit, with notes of eucalyptus. Fresh, fiery and well balanced. Elegant finish. A joy to drink!
The Pinot noir is for structure and longevity; Chardonnay is for fire and elegance; Pinot meunier is for the aroma.
Champagne is one of the most recognized wine growing regions in the world, having more than 32500 hectares. The traditional "Methode champenoise" was discovered by the monk Pierre Perignon in the Abbaye d'Haut Villers at the end of the 17th century. The combination of climate (the furthest north French wine region) and ground (previous ocean) makes this region unique.
The Fallet family has been producing wine in Champagne since 1610. Gaston Fallet and Genevieve Dart founded Champagne Fallet-Dart in 1963. Today Gérard and Adrien, as "vignerons indépendants" are responsible for the vineyard.
Champagne Fallet-Dart 37,5cl
This Champange is best served between 6-7 °C.
As an aperitif, with salmon, seafood, flaky white fish, or poultry.


text:
The Weeknd must face copyright infringement suit, court says
yanyong / iStockphoto.com
A Somali-American poet and songwriter has accused singer The Weeknd and electronic duo Daft Punk of copying one of her songs to create hit "Starboy".
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Daft Punk, The Weeknd, music, entertainment, copyright infringement, Yasminah, Starboy, copyright, settlement


text:
Customize your JAMA Network experience by selecting one or more topics from the list below.
Goldfeld KS, Grabowski DC, Caudry DJ, Mitchell SL. Health Insurance Status and the Care of Nursing Home Residents With Advanced Dementia . JAMA Intern Med. 2013;173(22):2047–2053. doi:10.1001/jamainternmed.2013.10573
© 2022
Nursing home residents with advanced dementia commonly experience burdensome and costly hospitalizations that may not extend survival or improve the quality of life. Fragmentation in health care has contributed to poor coordination of care for acutely ill nursing home residents.
To compare patterns of care and quality outcomes for nursing home residents with advanced dementia covered by managed care with those covered by traditional fee-for-service Medicare.
Design, Setting, and Participants
Choices, Attitudes, and Strategies for Care of Advanced Dementia at the End-of-Life (CASCADE) was a prospective cohort study including 22 nursing homes in the Boston, Massachusetts, area that monitored 323 nursing home residents for 18 months to better understand the course of advanced dementia at or near the end of life. Data from CASCADE and Medicare were linked to determine the health insurance status of study participants.
The health insurance status of the resident, either managed care or traditional fee for service.
Main Outcomes and Measures
The outcomes included survival, symptoms related to comfort, treatment of pain and dyspnea, presence of pressure ulcers, presence of a do-not-hospitalize order, treatment of pneumonia, hospital transfer (admission or emergency department visit) for an acute illness, hospice referral, primary care visits, and family satisfaction with care.
Residents enrolled in managed care (n = 133) were more likely to have do-not-hospitalize orders compared with those in traditional Medicare fee for service (n = 158) (63.7% vs 50.9%; adjusted odds ratio, 1.9; 95% CI, 1.1-3.4), were less likely to be transferred to the hospital for acute illness (3.8% vs 15.7%; adjusted odds ratio, 0.2; 95% CI, 0.1-0.5), had more primary care visits per 90 days (mean [SD], 4.8 [2.6] vs 4.2 [5.0]; adjusted rate ratio, 1.3; 95% CI, 1.1-1.6), and had more nurse practitioner visits (3.0 [2.1] vs 0.8 [2.6]; adjusted rate ratio, 3.0; 95% CI, 2.2-4.1). Survival, comfort, and other treatment outcomes did not differ significantly across groups.
Conclusions and Relevance
Medicare managed-care programs may offer a promising approach to ensure that nursing homes are able to provide appropriate, less burdensome, and affordable care, especially at the end of life.
Dementia is a leading cause of death in the United States1; however, patients dying with this disease may not receive optimal end-of-life care. With the advent of health care reform in the United States, increasing opportunities exist to improve the quality and cost-effectiveness of care provided to nursing home residents with advanced dementia.2
Recent research has led to a growing appreciation of advanced dementia as a terminal illness and the clinical complications that characterize the end stage of the disease, most notably eating problems and infections.3 More than 90% of proxies for nursing home residents with advanced dementia state that their preferred goal of care is comfort, which should guide how these complications are treated.3 Nonetheless, many of these residents commonly experience burdensome and costly interventions, such as hospital transfers, tube-feeding, and intravenous antibiotics, that do not promote comfort and, in many instances, do not have any demonstrable clinical benefits in this profoundly debilitated population.3-6
Nursing home reimbursement policies are among the factors that incentivize more aggressive care,7 including burdensome interventions for residents with advanced dementia. Most of these individuals are long-stay residents dually eligible for Medicare and Medicaid. Medicaid reimburses nursing homes for daily room and board and nursing care. Medicare has historically paid for acute, subacute, and physician services on a fee-for-service basis. Given that nursing homes do not receive higher reimbursement to manage acutely ill long-term-care residents on site, the nursing home has an incentive to transfer them to the hospital, temporarily shifting the cost of their care from Medicaid to Medicare. Even if the resident's preference is for palliation, this too requires a more focused approach. Nursing homes are not directly reimbursed for providing specialized palliative care services. Finally, although the Medicare hospice benefit is available for nursing home residents,8 it is underused among those with dementia,9 and access is hindered by complex fiscal arrangements that once again involve shifting the costs to Medicare.10
The Affordable Care Act presents a timely opportunity to evaluate alternative financial structures to pay for higher quality and more cost-effective care for dual-eligible nursing home residents, particularly those with advanced dementia. Such approaches include capitated or global payment programs similar to the Program of All-Inclusive Care for the Elderly (PACE) or the Medicare Advantage Special Needs Plans, which strive to integrate Medicare and Medicaid financing for dual-eligible nursing home residents.11 However, evidence demonstrating that such approaches improve the quality of end-of-life care for nursing home residents is limited. In an observational study from 2003, Kane et al12 found that Evercare, a nurse practitioner–based capitated managed-care program, reduced acute care use among nursing home residents, but did not focus specifically on those with end-stage disease or examine other end-of-life outcomes.
In this report, we merged the rich clinical data set from the Choices, Attitudes, and Strategies for Care of Advanced Dementia at the End-of-Life (CASCADE) study, a prospective cohort study that monitored 323 nursing home residents with advanced dementia for 18 months, with Medicare claims files. This approach enabled us to compare a broad range of outcomes reflecting the quality of care provided to residents covered by traditional fee-for-service Medicare with those covered by managed care.
Two data sources were used: CASCADE study data set and Medicare claims files. The CASCADE study was a National Institutes of Health–funded prospective cohort study conducted between February 1, 2003, and March 1, 2009, that described the experience of nursing home residents with advanced dementia and their families, the details of which are provided elsewhere.3,13 Data were collected to characterize the residents' survival, clinical complications, symptoms, and treatments, as well as the proxies' perspectives on the quality of care. The CASCADE data set was linked to Medicare claims files from February 1, 2003, until December 31, 2010, using the following identifiers: name, Social Security number, sex, and date of birth. The institutional review board of Hebrew SeniorLife and Harvard Medical School approved the conduct of this study to analyze CASCADE data merged with Medicare claims files.
The study sample included nursing home residents with advanced dementia who participated in the CASCADE study. A total of 323 residents with advanced dementia were recruited from 22 Boston-area nursing homes. Eligibility criteria included (1) age older than 60 years, (2) dementia (any type), (3) Global Deterioration Scale score of 7,14 and (4) available English-speaking health care proxies to provide informed consent for their participation and for the residents' participation. At Global Deterioration Scale stage 7, residents have profound memory deficits, virtually no verbal communication, incontinence, and inability to walk.
Unless otherwise indicated, resident variables were obtained from the CASCADE data set from assessments conducted at baseline, quarterly for up to 18 months, and within 14 days of death using medical record reviews, direct resident examination, and nurse interviews. Baseline resident characteristics obtained from the medical record included demographics (sex, race [white vs other], and age), whether the resident lived in a special care dementia unit, whether nursing home length of stay at baseline was less than 3 years, comorbidities (congestive heart failure, active cancer, chronic obstructive pulmonary disease), and presence of a percutaneous endoscopic gastrostomy tube. Cognitive status was measured by direct resident examination at the baseline and quarterly assessments using the Test for Severe Impairment score (range, 0-24; higher scores indicate better cognition, categorized as 0 or >0).
Other resident variables collected from the medical record at baseline and quarterly assessments included presence of a do-not-hospitalize order (DNH), treatment for pain and dyspnea, occurrence of acute illness, and health services utilization. At each assessment, the frequency of pain and dyspnea that occurred since the prior assessment was ascertained. Pain and dyspnea were quantified based on documentation in the medical record as follows: 0, never; 1, rarely (<5 days/month); 2, sometimes (5-10 days/month); 3, often (11-20 days/month); and 4, almost daily (>20 days/month). For residents who experienced any pain, it was determined whether they received oral or parenteral opioids on a regularly scheduled basis. For residents who experienced any dyspnea, it was determined whether they received any of the following: oxygen, morphine sulfate, scopolamine, or hyoscyamine. Acute illnesses occurring since the prior assessment included infectious episodes (eg, suspected pneumonia and febrile episodes) and other sentinel events (eg, stroke, bone fracture, myocardial infarction, and seizure). A febrile episode was defined as an oral (≥37.8°C), rectal (≥38.3°C), or axillary (≥37.2°C) temperature at least once within a 7-day period (>1 recorded fever during a 7-day period was considered a single episode). If residents had experienced pneumonia, the type of treatment they received was determined and classified as follows: no antibiotics, oral antibiotics only, intramuscular antibiotics, and intravenous antibiotics or hospitalization. All heath care utilization data, including dates of service, were determined from primary data collected in CASCADE and included all hospitalizations, emergency department visits, hospice referrals, and the number of primary care visits at the nursing home documented by nurse practitioners (NPs) and physicians in the prior 90 days.
Nurse interviews included measures of functional status and resident discomfort. Functional status was quantified at each assessment using the Bedford Alzheimer Nursing Severity Scale (range, 7-28; higher scores signify greater disability).15 The Symptom Management–End-of-Life in Dementia (SM-EOLD) scale was used to quantify resident comfort during the preceding 90 days at the baseline and quarterly nurse interviews. The SM-EOLD is a validated scale that ranges from 0 to 45, with higher scores representing greater comfort; the Comfort Assessment in Dying With Dementia (CAD-EOLD) scale is a similar scale that quantifies discomfort in the last week of life (scores ranges from 14 to 42, with higher scores indicating greater comfort).16,17 Nurses also stated whether the resident had pressure ulcers at stage 2 or higher in the period between interviews.18
Survival was measured in days from the date of enrollment in CASCADE until the date of death. For residents who died during CASCADE, death dates were determined from official death certificates, which were obtained for all decedents. The vital status as of December 31, 2010, for residents who survived the full 18-month CASCADE follow-up period was determined by the Medicare Beneficiary Eligibility and Enrollment Files, and for those who died, death dates were taken from that source.
The Medicare Beneficiary Eligibility and Enrollment Files were used to classify each resident's insurance coverage during the entire CASCADE follow-up period as either managed care or traditional fee-for-service Medicare (nonmanaged care). Insurance status for each resident was consistent throughout CASCADE (ie, did not fluctuate between managed-care and fee-for-service status).
All proxy variables were obtained from interviews conducted during CASCADE. Characteristics obtained at baseline included age, sex, and relationship to the resident (child vs other). At each proxy interview, satisfaction with care was measured using the Satisfaction With Care at the End-of-Life in Dementia (SWC-EOLD) scale, a validated instrument with scores that range from 10 to 40; higher scores indicate greater satisfaction.16,17
All resident and proxy characteristics were described using mean (SD) for continuous variables and proportion for categorical variables. The main independent variable was whether the residents' health insurance status was managed care or fee-for-service during the period of observation.
We were interested in examining the association between managed-care status and palliative care outcomes. Therefore, outcomes were selected that have been endorsed as measures of the quality of end-of-life care for older persons19 and specifically for those with advanced dementia.20 These outcomes included survival, symptoms (SM-EOLD and CAD-EOLD scores) and treatment of pain and dyspnea, presence of a DNH order, presence of stage 2 or higher pressure ulcers, treatment for pneumonia, hospital transfer (admission or emergency department visit) for an acute illness, hospice referral, physician and NP visits, and family satisfaction with care (SWC-EOLD score).
The units of analysis varied depending on the outcome. Measures collected at each assessment (ie, assessment level) framed the analysis for the following outcomes: SM-EOLD score, pain and dyspnea treatment, pressure ulcer, DNH order, primary care visits, and SWC-EOLD score. The CAD-EOLD score was recorded only once for residents who died during the 18-month observation period. Analyses examining the management of pneumonia and acute illnesses were conducted at the episode level. For hospice referral, the resident was the unit of analysis.
Unadjusted and adjusted associations between managed-care status and each outcome were calculated using logistic and linear regression for dichotomous and continuous outcomes, respectively. Multinomial regression was used to analyze the categorical pneumonia treatment outcome. Poisson regression methods were used to analyze the number of primary care visits per 90 days of follow-up. For survival, a log-rank test was performed, and multivariable analyses were conducted using Cox proportional hazards models.
Odds ratios (ORs) were generated from the logistic and multinomial models, parameter estimates from the linear regression models, and hazard ratios from the Cox model. In addition, 95% CIs were provided for all measures of association. All multivariable models were adjusted for the baseline resident and proxy characteristics presented in Table 1. The Cox proportional hazards model was adjusted for a time-dependent variable representing acute illness. For outcomes analyzed at the assessment and episode levels, generalized estimating equation methods adjusted for clustering at the facility and resident levels. When the resident was the unit of analysis, generalized estimating equation methods were adjusted only for clustering at the facility level. All analyses were conducted using R, version 3.0.1 (R Foundation for Statistical Computing ; http://r-project.org/), with the exception of the 2-level generalized estimating equation analyses, for which commercial software (SAS, version 9.1.3; SAS Institute Inc) was used.
Of the 323 residents recruited into the CASCADE study, 291 were included in these analyses. Reasons for lack of inclusion for the remaining 32 residents were incorrect or no available Social Security number (n = 14), definite match could not be made with Medicare (n = 8), and managed-care status could not be determined from Medicare Enrollment Files (n = 10). No statistically significant differences were observed in the baseline characteristics reported in Table 1 between residents who were and were not included in the analyses.
Among the 291 residents included in this study, 133 individuals (45.7%) were enrolled in a managed-care plan and 158 residents (54.3%) were covered by the traditional Medicare fee-for-service plan for the entire CASCADE follow-up period. The mean age of the entire sample was 85.5 years, 85.6% were female, 89.7% were white, and 43.6% lived in a special care unit for advanced dementia (Table 1). Baseline characteristics between the managed-care and fee-for-service residents were similar except that the managed-care residents were more likely to be female (91.0% vs 81.0%; P = .02) and less likely to have congestive heart failure (10.5% vs 22.2%; P = .01).
During CASCADE, 158 of the 291 residents (54.3%) died, and an additional 118 residents (40.5%) died prior to the end of the Medicare data observation period, for a total of 276 decedents (94.8%): 126 individuals (94.7%) in the managed-care group and 150 individuals (94.9%) in the fee-for-service group. Survival did not differ significantly between the 2 groups in the unadjusted analyses (log-rank test, P = .88) and the adjusted Cox proportional hazards model (adjusted hazards ratio, 0.93; 95% CI, 0.77-1.50).
Table 2 presents the analyses comparing the remaining outcomes between the managed-care and fee-for-service groups. In the adjusted analysis, residents with advanced dementia enrolled in managed care were significantly more likely to have DNH orders compared with those in the traditional Medicare fee-for service program (63.7% vs 50.9%; adjusted OR [AOR], 1.9; 95% CI, 1.1-3.4). Managed-care residents were also less likely to be transferred to the hospital for any acute illness (3.8% vs 15.7%; AOR, 0.2; 95% CI, 0.1-0.5). Managed-care residents had more primary care visits per 90 days than fee-for-service residents (mean [SD], 4.8 [2.6] vs 4.2 [5.0]; adjusted rate ratio [ARR], 1.3; 95% CI, 1.1-1.6) and managed-care residents had relatively more NP visits (mean [SD], 3.0 [2.1] vs 0.8 [2.6]; ARR, 3.0; 95% CI, 2.2-4.1).
A larger proportion of managed-care (23.3%) compared with fee-for-service residents (18.4%) were referred to hospice, although this difference was not statistically significant. Additionally, family satisfaction with care (SWC-EOLD) was slightly higher for the managed-care group (difference, 0.9; 95% CI, 0.0-1.8), although the difference was also not statistically significant.
This study linked unique prospective clinical data with Medicare claims to describe and compare patterns of care between nursing home residents with advanced dementia enrolled in a Medicare managed-care insurance plan and those with fee-for-service Medicare. Residents enrolled in Medicare managed care received more primary care visits (principally from NPs), were more likely to have a DNH order, and had fewer hospital transfers for acute illness compared with those who had traditional Medicare coverage. Our findings also suggest that managed-care residents may have been more likely to enter hospice and that family members may have been more satisfied with the level of care. For all other outcomes, including survival, residents with managed care fared as well as those with traditional Medicare.
In the era of health care reform, tremendous focus has been placed on reducing unnecessary and costly care, in particular reducing avoidable hospitalizations of nursing home residents.21 Residents with advanced dementia who are profoundly disabled, near the end of life, and most often have comfort as a primary goal of care are obvious targets for such initiatives. Hospital transfers can be traumatic for these residents and their families22,23 and most often do not improve their clinical outcomes (eg, survival) or comfort,4,5,24 albeit with possible exceptions, such as hip fracture. The challenge is to understand the mechanisms that will encourage nursing homes to provide goal-directed care for acutely ill residents on-site, either by providing high-quality palliative care or potentially curative conservative treatments (ie, antibiotics).
Researchers7 have argued that fragmentation at both the payment and delivery levels has contributed to poor coordination of care for nursing home residents who are acutely ill. At the payment level, nursing homes and other providers have historically been reimbursed on a fee-for-service basis separately for each service. As such, Medicaid has not incentivized nursing homes to prevent unnecessary hospital transfers. Because Medicare managed-care plans are at risk for hospitalization costs, they have an incentive to invest in the infrastructure and resources necessary to prevent unnecessary hospital transfers.25 Indeed, one review25 estimated that managed care might reduce hospitalizations by 30% to 80%, which is consistent with our findings.
At the delivery level, our findings support the notion that a possible mechanism for the managed-care plans to reduce hospital transfers is by increasing the intensity of primary care services provided in the nursing home, mainly by employing on-site NPs.25 Studies26,27 have shown that greater NP presence in nursing homes is associated with reduced hospitalizations independent of insurance status. In advanced dementia, having an NP on-site has been associated with higher DNH order rates28 and lower use of feeding tubes.6 Higher DNH order rates suggest that NPs may be more engaged in advance care planning, which is the most consistent modifiable factor associated with better palliative care outcomes for residents with advanced dementia.3,4,29,30 The presence of a DNH order among these patients has been associated with fewer hospital transfers, greater family satisfaction,29 and more cost-effective care.31 Thus, the presence of advance directives, especially DNH orders, is generally considered a marker of higher quality advanced dementia care.Although the prevalence of DNH orders in the CASCADE cohort was considerably higher compared with national averages,28 the fact that it was 63.7% and 50.9% in the health management organization and non–health management organization groups, respectively, suggests an opportunity to improve advance care planning in these residents regardless of insurance status.
Findings from evaluations of the 2 prominent Medicare risk models, PACE32 and Evercare,12 stressed the importance of NPs in helping to reduce hospital transfers under managed care. Some of the increase in NP visits was offset by fewer physician visits in our data, but residents receiving managed care ultimately received more primary care visits. In addition, survival and other end-of-life outcomes were similar in residents who were and were not covered by managed-care programs. In fact, a trend was found toward higher satisfaction with care in the managed-care group.
One important development under the Affordable Care Act that is directed toward improving care coordination for dually eligible beneficiaries is the Integrated Care Demonstration.2 This 26-state program blends payment and delivery reforms to improve care coordination for dually eligible beneficiaries, including nursing home residents with advanced dementia.33 Currently, 21 of these states have proposed some capitated managed-care models under this demonstration to combine Medicare and Medicaid financing and offer enhanced primary care for beneficiaries. It will be important to monitor whether the favorable managed-care results observed in the present study generalize to nursing home residents with advanced dementia who participate in these demonstrations.
The present study has several limitations. Because CASCADE was an observational study, we are unable to make causal inferences regarding the observed associations between patient insurance status and outcomes. The possibility of unmeasured confounding remains despite the fact that the managed-care and traditional Medicare groups were balanced on measured factors and the robustness of the adjusted analyses. Moreover, CASCADE was not designed to examine facility factors associated with patient-level outcomes, and the relatively few residents per facility did not provide adequate power to do so. Thus, unmeasured nursing home characteristics are another possible source of confounding, although our analyses adjusted for clustering at the facility level. Inaccuracies also may have occurred in the ascertainment of CASCADE data from the residents' medical records (eg, pain, dyspnea, utilization of primary care services); however, such errors are likely to be nondifferential between the 2 groups. We also were unable to identify the exact managed-care plan in which individuals were enrolled. Given the heterogeneity of managed-care programs, we cannot contend that all such programs will be associated with the same findings as those observed in this study. Specifically, we do not know whether individuals were in a standard Medicare Advantage plan or a plan that also included coverage of Medicaid services and hospice. However, it is notable that the managed-care residents in our sample did not have Medicare hospice claims even though hospice care was indicated in the CASCADE data, suggesting that hospice care was part of the capitated services provided by their managed-care plan. In Massachusetts, the Evercare Senior Care Options plan covers all Medicare (including hospice) and Medicaid services. Finally, because our entire sample was drawn from the Boston area, generalizability to other areas is uncertain.
Despite these limitations, this study provides novel data suggesting that the model of health care delivery in a nursing home has important effects on the type of care received by individual residents. Intensive primary care services may be a promising approach to ensure that nursing homes are able to provide appropriate, less burdensome, and affordable care, especially at the end of life. Ultimately, it may require a change in the underlying financial structure to institute those changes.
Accepted for Publication: June 29, 2013.
Corresponding Author: Keith S. Goldfeld, DrPH, MS, MPA, Department of Population Health, NYU School of Medicine, 227 E 30th St, Room 651, New York, NY 10016 (firstname.lastname@example.com).
Published Online: September 23, 2013. doi:10.1001/jamainternmed.2013.10573.
Author Contributions: Dr Goldfeld and Ms Caudry had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
Study concept and design: Goldfeld, Grabowski, Mitchell.
Acquisition of data: Mitchell.
Analysis and interpretation of data: All authors.
Drafting of the manuscript: Goldfeld, Grabowski, Mitchell.
Critical revision of the manuscript for important intellectual content: All authors.
Statistical analysis: All authors.
Obtained funding: Grabowski, Mitchell.
Administrative, technical, and material support: Grabowski, Mitchell.
Study supervision: Grabowski, Mitchell.
Conflict of Interest Disclosures: None reported.
Funding/Support: This study was supported in part by grants R21AG039658-01, R01AG024091, and K24AG033640 (Dr Mitchell) from the National Institute on Aging.
Role of the Sponsor: The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; or preparation of the manuscript.


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Dumpster diving in Orlando seemed like an urban myth. I'd heard of people nabbing a coffee table or an ugly lamp from the trash, but that's not the kind of diving we're talking about here. There are dumpster divers right here in Central Florida who devote entire nights to the hunt. Like stealthy trash-fairies, they emerge under cover of darkness to rifle through trash bins in search of free stuff. I wanted to see what it was all about. So I put out a request to meet divers on a diving forum. And I quickly discovered that these folks are a secretive lot. They don't like reporters. My request yielded one response: "lol.fork.teh.media."
Despite the errant grammar, I got the hint. Luckily one guy from Palm Bay let's call him Steve called a few days later to say he'd be willing to let me tag along.
So at about 9 p.m. on a recent Friday night, I trek out to Palm Bay to immerse myself in the world of dumpster diving. (Note: "Dumpster" is actually a trademark for a brand of large trash bins, but I'm using it in the generic, lowercase sense; sorry about that, Krug International Corporation.) At first, diving brings up images of Joe Homeless scrounging for yesterday's Big Mac. It's not entirely glamorous to hop in a bin of refuse, and you might think that divers take the one-man's-trash-another-man's-treasure saying a bit too literally. The forum I've been lurking on for the past two weeks, however, counters such stereotypes with posts from people who describe themselves as everything from carpenters to office clerks. Still, I wonder what I'll encounter.
After some missed streets, I finally turn into a new subdivision and pull up to a Spanish-style house. Steve answers the door and invites me in. I peer around at the spacious rooms, and noticing my wandering eye, he tells me the house would sell for $220,000 on the market.
"Not what you expected, huh?" he asks. "Well, you ready to go tonight?"
Central Florida, it turns out, is a hotbed of dumpster diving. If you Google the term, the second listing you'll get is www.dumpsterworld.com, a forum run by a 21-year-old Orlando man. Mr. Bobo, his screen name on the forum, began the site in May 2003 as mrbobo.net/forum. He bought the domain name dumpsterworld.com in September that year, and the site's membership has ballooned since. There are numerous topics asking about diving partners in Central Florida, and at least 10 people on the site identify themselves as from the area. As Mr. Bobo wrote on hardforum.com, another site frequented by divers, "`There's` lots of competition in Orlando these days. No wonder I haven't been finding anything lately."
Luckily, Steve lives in Palm Bay, so perhaps tonight will prove fruitful. Before heading out, we sit in the screened-in porch at the back of his house. Pulling on a cigarette, he tries to explain the allure of diving. It's the free stuff for sure, and it's also the adventure, the thrill of the hunt. But the 33-year-old is no adrenaline-junkie punk. His neatly shaved head and wire-rimmed glasses say "corporate world," not "trash scrounger." He works with test equipment for a government communications contractor and makes $38,000 a year. His wife, Misty, is a dental assistant making $54,000. Steve certainly doesn't need to be diving.
He started in Alaska in 2002 when he took a shortcut behind CompUSA and saw a full dumpster. The coolest thing he ever found was a Sega Dreamcast demo with the full plastic casing and the controller on a slinky arm, the kind you see kids playing in the aisles of the Wal-Mart video game department. Since moving to Florida a year ago, Steve's only been out four times. Tonight is his first dive in months.
The plan? He's plotted a course concentrated along U.S. Highway 192 where most of the office supply stores are located in Melbourne, just north of Palm Bay. That will take us to Big Lots, CompUSA, a mom-and-pop computer store, Office Depot, Staples and any other site his instincts tell him are ripe. Not knowing the proper fashion for this occasion, I'm in a pair of Adidas warm-up pants, a long-sleeved shirt and some old sneakers. Steve's wearing jeans, a T-shirt and boots. He outfits me with some raggedy motocross gloves and a pocket-sized flashlight. He dons a new pair of similar gloves and puts a small light in his pocket.
"Ready?" he asks.
To jump in the trash? Absolutely.
With his wife sleeping in the back room, Steve and I leave at 10:15 p.m. and load into his Nissan Xterra. The back of the car is empty, a candy jar waiting to be filled.
As we make our way toward our first stop, Steve opens a yellow American Spirit pack and slides another cigarette between his lips. On the deserted streets of Melbourne, there is little light, and with every drag the burning cigarette tip casts an eerie shadow on Steve's face. During the 15-minute trip, he goes over some of the unofficial guidelines of diving.
Nine times out of 10, reclaiming trash is legal. Most cities do have ordinances against removing garbage from city-owned bins, but you don't get much good booty out of city trash, so that's not a factor. When diving you shouldn't announce yourself, but you also don't want to hide. That looks suspicious. If confronted by a cop or, God forbid, a rent-a-cop with a power complex be cool. If asked why you're standing in a dumpster, it's best to go with the always-believable "I'm moving soon, and I'm looking for boxes."
But the strictest of diving codes, the one you must follow, is this: Don't make a mess.
"There are a lot of punks out there who will get in a dumpster and just start throwing all the shit out," Steve says, nearing our first stop. Once people start making a mess, more stores start locking up their dumpsters, and that's bad for everyone.
Instead of pulling right into an alley, Steve drives by once and peers down the long drive to make sure it's clear. It is, and he pulls in behind the shopping center.
"That's Bealls' dumpster," he says, nodding to one bin as we pass. "That's probably the grocery store because there's the cooler," he says, pointing to another dumpster. "And here's Big Lots."
He parks the Xterra next to a bin and gets out. The orange glow of security lights rains down. Steve throws back the lid. There's some cardboard and trash bags, but he says it's no good. We throw the lid back on another. Nothing. We're back in the car in less than five minutes.
Down the road we pull in the CompUSA parking lot and park next to the dumpster. Behind the store, it's dark and quiet, creating a scene that, in a horror movie, would have to end in a gruesome death. Steve peers in the bin and sees something he likes. He clicks on the flashlight and shines it into the half-empty can. Putting his foot on one of the bin's ledges, he hoists himself up and over. He's in. He begins to tear open bags and inspect their innards. Soon he hands me a two-drawer stackable CD storage case and an over-the-chair back massager.
"It looks like it's just missing a power supply," he says. "Maybe I can find the manufacturer and get a replacement for cheap. You'd be surprised what stores throw out."
Still, this bin is not producing and we're off to another. Driving from CompUSA to our next destination, Steve passes by the Melbourne Square Mall. The red sign of Office Max catches his eye, and he looks back over his shoulder as we barrel down U.S. 192. The store was not on his list of planned stops. He wonders out loud if it would be a good dive.
"Malls are a little too high-profile," he says and keeps driving.
The next stop is a mom-and-pop computer store. There's a van in the parking lot and he pulls up next to it. This draws less attention. In the dumpster, there are plenty of small computer parts, but apparently nothing of value for Steve. He pulls out a piece of metal.
"Ooh, this looks good," he says. Then he reconsiders. "Actually, I can hear what Misty would say: 'You fucking packrat.'" The piece goes back where it came from, and we're out of there. It's 11:15 p.m. We've been diving for an hour now. Three stops, three crap draws. In the car, Steve asks if I mind going back to the Office Max in the mall.
"I got an itch."
Dumpster diving has been getting some bad press lately. Identity thieves apparently love to dive for sensitive credit information. One Feb. 8 story in an Alabama newspaper reported that a couple had been arrested after trying to pass off checks pulled from the trash. A sheriff's officer was quoted as saying, "That is called dumpster diving."
Technically, yes, they were diving in dumpsters. But to the people who frequent dumpsterworld.com, criminals give everyone a bad name.
It's not only bad press divers disdain, however; it's any press at all. Of the more than 50 people I contacted for this story, only two offered to let me come along on a dive. Mr. Bobo, the administrator of dumpsterworld.com, never responded to repeated e-mails asking to talk, and my requests for help on the forums fell on deaf ears.
There are two reasons for this. One, as was explained to me many times, is the fact that the more attention diving gets, the more stores will lock their bins for liability reasons. Reason No. 2 is that with more light on diving, more people want to participate, reducing the amount of swag. To keep their activities under wraps, members on dumpsterworld.com go so far as to alter the names of stores they dive. For instance, you might write that you got some good stuff from Pet Dumb (Pet Smart) or dove last night at Poor One (Pier One). This ensures that companies won't find their store's name on a site devoted to diving.
Even among the forum's members, secrecy is the norm. When a Central Florida diver asked if people in the area wanted to group-dive, others responded positively, but when it came down to going, most were hesitant to share their more bountiful dumpsters.
Frankly, it's easy to see why divers don't want to talk. In addition to the link between dumpster diving and the media's scare-story-of-the-week, identity theft, there is another slice of the diving community that has received some less-flattering attention. Freegans a cross between "free" and "vegan," though you don't have to be a vegan are people aghast at America's overconsumption; in an attempt to abstain from the conventional economy, they use what others throw out. Media coverage of freegans hasn't always been kind. On a Dec. 16 edition of ABC Nightly News, the female anchor introduced a story like this: "They're called freegans, and they're eating other people's garbage by choice." With a smirk on her face, she handed off the story to a correspondent.
Finally, there's the "ick" factor. Garbage is garbage. By definition, it's something you don't want.
"I'm disgusted by really raunchy stuff, too," says Steve. "But you just get kind of used to going through it."
We pull into the mall and make our way to the Office Max. We stop about 40 feet from the dumpsters in an alcove next to the store. Steve tells me that when we get out I should walk fast but not run. Shining from behind us, the streetlamps cast long shadows across the pavement. Besides the low rumble of cars on U.S. 192, our footsteps are the only sound here in the vacant lot.
We make our way to the dumpster and open it up. It's about half-full of white trash bags and free-floating items. "Looks good," he says and asks me to hold his flashlight. He gets himself up and gingerly straddles the edge. His other foot swings over, and he disappears into his second dumpster of the night.
Up to now, I thought I'd hop in with Steve when he found a fertile bin. Now that I'm here, I'm rethinking my plan. The smell is not overly pungent, but it's not a bouquet of roses, either; it's something akin to a car sitting in the sun all day with a pizza on the dashboard. I peer in and see a few ants skitter across the dumpster wall, and I can't get it out of my head: This is trash. Our previous sites required little contact with garbage, but Steve is hunched over, shin-deep in it now. I can't do it. I designate myself the night's point man and stand guard next to the dumpster.
Steve, on the other hand, is on a roll. Every few minutes his hand sticks up out of the bin offering me something. Three-ring binder, plastic folder organizer, paper cutter minus blade, another three-ring binder. After 15 minutes of this, I get bored and peer over the edge. A small beam of light twitters about like a firefly. He is ripping open bags and peeling unopened packets of highlighters off the dumpster floor. He's obviously a seasoned veteran, focusing on one corner at a time. He picks up every bit of trash, inspects it in the light and makes a split-second decision on its keepability. Sharpie pens: yes. Glow-in-the-dark erasers: yes. Unopened case of individual pot-size Folgers coffee bags: hmmm … yes. After he exhausts a corner, he moves on to the next and repeats the process.
Soon, there is a pile of items next to my feet. Every few minutes a car, probably some mall employee leaving for the night, drives by, and I slink back behind the dumpster. Around 11:45 p.m., the white SUV of the mall police rolls by with its yellow lights flashing. Not paying attention, I am caught out in the open as it passes, and I try to stand as nonchalantly as you can when you're next to a mall dumpster at midnight. The security car never slows, and Steve, buried in the dumpster, continues his exploration.
After 30 minutes in the bin, Steve pops his head up like a mole peeking up out of the ground. He's done. He climbs the wall again and lands outside the dumpster. We grab the haul and lug it to the car. We leave the dumpster just as we found it. Steve has not made a mess.
The yield: 12 three-ring binders, five unopened two-packs of highlighters, six unopened two-packs of glow-in-the-dark erasers, four packs of vinyl letters, two staple pullers, 15 Sharpie markers of assorted colors, two plastic desk paper trays, a 12-inch paper cutter minus the blade, three magazine holders and the coffee.
If I were still a college student, this would be a useful stash. Even by conservative estimates, this was a $40 dive, and I'm eyeing those Sharpies, dumpster juice or not. After feeding the trunk full of office supplies, Steve stands outside the car under the streetlamp and relaxes after the tedious dive. He pulls out a cigarette. Drops of sweat roll down his bald head as he takes slow deliberate puffs.
"How would you rate this night?" I ask. He thinks for a second.
"I'd say about a five out of 10," he says. "I got some solid usable stuff but nothing great."
"So what are you going to do with all those binders?"
"I don't know, but I've got them," he responds. "I can use them for something or I can bury them or whatever. They're mine now. Who knows, maybe I won't use them, and I'll throw them away."
And the cycle continues.


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Darko Milicic Will Never Be an All-Star, Sorry David Kahn
Minnesota Timberwolves center Darko Milicic was infamously picked second overall in the 2003 NBA Draft by the Detroit Pistons, ahead of superstars like Carmelo Anthony, Chris Bosh and Dwyane Wade. Detroit GM Joe Dumars pulled the trigger on Darko ahead of even Chris Kaman, David West and Mo Williams — all solid contributors who have made All-Star teams. Milicic has career averages of 5.9 points, 4.2 rebounds and 1.3 blocks per game, or the elusive career triple-single. During Monday's Timberwolves-Celtics game, Minnesota President of Basketball Operations David Kahn had this to say about Milicic's future:
There's no way. While Milicic is having a "career" year, that's not saying a lot. This season he's averaging career highs in points, blocks and assists per game with 9.3, 2.3 and 1.9 respectively. He's only 25, but in his eighth year in the league it seems like he is what he is — a bust. He's not the first high draft pick not to pan-out and won't be the last, but he's never shown anything to the contrary.
This also isn't the first time Kahn has made ridiculous statements about Milicic. Kahn and former NBA superstar Chris Webber had an interesting conversation about Milicic last summer, and Kahn was not very happy about it.
Thanks to YouTube user blazersedgeben for the video.


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Last night Brandon posted a now widely-circulated video from Life's a Tripp, Bristol Palin's reality show, in which her son Tripp is seen calling her what looks like the word "faggot".
On her blog today, Palin denies that's what he said:
Let me be clear. I'm not proud of what he did say. Sadly, he used a different "f word."
Lifetime filmed over 12 months (on and off) and they caught a moment on film that would cause any parent to be red in the face. Tripp is always surrounded by adults – around the campfires with cousins and their friends, at the shop with my dad and his snowmachine buddies. He's apparently picked up some language that I'd prefer he not use. On national television or at home.
I do oppose gay marriage, as I've written about before (and the HuffPo points out). I guess the temptation to label my three year old son is just too great for the lefty papers to resist. However, one of my new Twitter followers made an excellent point.
He tweeted that the left tries to hold my three year old son more accountable than their adult spokespeople.
Watch again, AFTER THE JUMP…


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"The Democratic Party now belongs to moderate Republicans." – Noam Chomsky
After the party was on the receiving end of the worst upset in modern political history, reality came crashing, shattering the glass ceiling the nominee had vowed to break. Not only was the White House now lost, but they failed to retake the Senate or the House, all in addition to losing a Supreme Court nomination due to GOP hooliganism, leaving the party without control of any of the three branches of government. This was further compounded by the vast discrepancy between the two major political parties at the state level, with the GOP controlling 32 state legislatures and 33 governorships, relative to the Democrats' 13 state legislatures and 16 governorships.
Nearly a year later, the party is seemingly further fragmented than at the time of the historic defeat. The progressive Sanders wing and the Clintonite establishment wing, have continued to spar in regard to the direction of the party moving forward, including the rehashing of the 2016 Democratic Party presidential primary. Sanders supporters are still healing from the WikiLeaks dumps, which showed a substantial anti-Sanders sentiment within the DNC leadership, pro-Clinton structuring of the primary process, a continued alienation of progressive supporters, and a new bombshell by Donna Brazile, confirming the earlier Politico report indicating the contract between the Clinton camp and the DNC effectively gave Clinton control of the DNC, and that this contract resulted in "essentially … money laundering."
Furthering the divide, and fueling the feeling of helplessness since the revelations, was the DNC Fraud Lawsuit. The lawyers for the DNC argued the DNC is a private entity, and thus were permitted to pick and choose their candidates as they please, even in violation of their own charter.
In contrast, Clinton backers have continued to cast blame on Sanders and his supporters, indicating that Sanders stayed in the race too long, he wasn't as "helpful" as he could've been, and that he was too aggressive and negative during the primary. They portray his policy proposals as utopian, promising everything for free, which they propose made the pragmatic Clinton seem undesirable, particularly to the youth.
Yet, at this point in time, it looks as if the party has conducted little to no introspection into exactly how the party, as a whole, has gotten into the catastrophe they currently find themselves in. How the Democratic Party is a failure at both the state and federal levels of government, all while the political arena continues to polarize.
Glancing back at recent party history, a noticeable shift begins to take place during 1988, immediately after the election of George H.W. Bush, and then drastically so after the election of Bill Clinton in 1992. This new era in the party, ushered in by the "New Democrats," was the beginning of a calculated rightward shift, and the downfall of the Democratic Party.
The DLC's Domination
The "New Democrats" prided themselves on being moderates, or centrists. This was partly in response to losing three of the four prior presidential elections, which elicited views from party insiders that the party had given too much power to the people, and that the reformers were to blame.
In 1985, the Democratic Leadership Council (DLC) was created, a 501 (c)(4), by Al From. From created the DLC with the goal of moving the Democratic Party from the left to the center, in an attempt to win back the white working class and the so-called "Reagan Democrats."
From understood that for the DLC to be taken seriously, they needed a politician that both already had notoriety, yet also had a bright future which ultimately could culminate in reaching higher office. In 1989, From had identified his man, and that man was William "Bill" Clinton.
On April 6, 1989, From met with then Governor of Arkansas, Bill Clinton, and began courting Clinton to become the chairman of the DLC. From took a particular liking to Clinton, a Democratic Party Governor in a conservative state, because, as he put it, "He was not afraid to challenge old orthodoxies." From further stated, "Most important, Clinton believed in the DLC philosophy—in the basic bargain of opportunity and responsibility."
The GOP have utilized such euphemisms as key illustrations of their ideological values — opportunity for those willing to work for it, and responsibility for those who don't — which ultimately were thinly veiled racial ploys to attract white working-class voters. By the time the meeting between From and Clinton had concluded, an agreement had been reached for Clinton to become the chairman of the DLC.
After securing their leader, the DLC shifted its attention to critics that were harming its reputation. The DLC was composed of southern, white, centrist Democrats, most notably Al Gore, Chuck Robb, and Bill Clinton. Bob Squier referred to the DLC as the "Southern White Boys' Caucus." Jesse Jackson, a fierce critic of the DLC and their strategy to move the party to the right, would refer to the DLC as the "Democrats for the Leisure Class."
From admitted that it was difficult to overcome the nicknames critics would give the organization. Thus, they decided to co-opt the term "progressive," essentially calling their right-wing policies "progressive," in an attempt to save face. In late 1989, the DLC launched their own think tank, the Progressive Policy Institute (PPI).
As the DLC began preparing their leader for a potential 1992 presidential bid, they began laying out their policy positions. The PPI's first paper attacked the Democratic Party's support for a higher minimum wage, calling it "anachronistic," with Robert J. Shapiro, the Vice President of PPI, further stating the minimum wage "actually hurts poor people. It's classically regressive." The DLC rejected "old" New Deal politics in favor of a neoliberal agenda. They rejected the concept of wealth redistribution, instead, valuing market-oriented solutions to achieve both economic and social growth.
In her book, The Workfare State: Public Assistance Politics from the New Deal to the New Democrats, Eva Bertram states that the DLC had an "aggressive law-and-order agenda, opposition to affirmative action, and its support of welfare reform were viewed by many as thinly veiled appeals to white working-class voters uneasy over the gains of the civil rights movement."
Another major deviation from party orthodoxy was the DLC's position in regard to education. From detailed Clinton's characteristics that were particularly attractive to the DLC, stating, "He was not afraid to challenge old orthodoxies. In the early 1980s, long before I knew him, he and Hillary Clinton pushed cutting-edge education reforms, like pay for performance and public-school choice, against the opposition of the powerful Arkansas Education Association." Here, From gushes over Clinton's hostility towards teacher's unions, clearly depicting the guiding philosophy of the DLC.
The DLC was adamantly opposed to labor, or as they referred to it, "big labor," and dramatically shifted party emphasis on courting big money corporate donors as opposed to grassroots support. Early financial backers of the organization include the Koch brothers, AT&T, Aetna, Blue Cross Blue Shield, Pfizer, and British Petroleum (BP) among other major financial players. Additionally, wealthy donors were able to essentially pay for power, as the DLC's board of trustees membership was reserved for major donors, which included two high-level Koch executives. Richard Fink was the executive vice president of Koch Industries.
In 1996, From suggested that then-President Clinton, should begin a "fundamental restructuring [of] our biggest systems for delivering public benefits — Medicare, Social Security, and public education, for openers." This was elaborated on further at the time by PPI's Will Marshall, who proposed transforming Medicare and Medicaid "into the new marketplace." Additionally, the DLC were adamant supporters of the Iraq War, and often launched vicious attacks on anti-war liberals who spoke out against the war.
The DLC was largely credited for Clinton's surprise presidential victory, and immediately became the de facto organization of the Democratic Party. Their influence would be witnessed on issue after issue, as the party charted its centrist path to perceived executive relevancy. Clinton's major legislative achievements led to a number of cataclysmic results that shaped the country, and the views of the Democratic Party, to this day.
Clinton, to the dismay of progressives, reappointed Alan Greenspan as the Federal Reserve Chair, which sent a clear, and welcoming message to wall street. Shortly after taking office, Clinton signed the Riegle-Neal Interstate Banking and Branching Efficiency Act of 1994, which cleared the path for large banking mergers.
Possibly the most relevant act of the Clinton presidency, which still has vast influence in the political arena, was the signing of the North American Free Trade Agreement (NAFTA), in 1993. NAFTA effectively gutted American manufacturing jobs, which resulted in a conservative estimate of 600,000 lost jobs in the US, according to Dean Baker of Center for Economic and Policy Research. Furthermore, it resulted in wage stagnation due to the lower costs of moving production elsewhere, an ever-widening trade gap, lowered environmental standards, and disproportionately gave corporations power that allowed them to challenge the local law in the name of profit.
Another DLC position Clinton worked feverishly on was the Crime Bill, or the Violent Crime Control and Law Enforcement Act of 1994, which contained the now infamous 3 strikes rule, as well as mandatory minimum sentencing, including those convicted of nonviolent crimes. This law resulted in the highest surge in the US prison population in history, imprisoning more individuals than George HW Bush and Reagan combined.
A central DLC initiative, which Clinton gleefully backed, was the push on welfare reform, or the Personal Responsibility and Work Opportunity Reconciliation Act of 1996. The passage of the bill eviscerated America's safety net, yet achieved one of Clinton's campaign promises in which he spoke of his desire to "end welfare as we know it."
Several years later, Clinton pressured Democrats to pass the Financial Services Modernization Act of 1999 (Gramm-Leach-Bliley Act), which repealed the Glass-Steagall Act of 1933, and permitted the consolidation of commercial and investment banks, as well as security and insurance firms. Many have suggested that this was the single greatest factor that caused the financial crash of 2008. Ryan Chittum of the Columbia Journalism Review even went so far as to say, "Bill Clinton was responsible for more damaging financial deregulation—and thus, for the financial crisis— than any other president."
The DLC's influence reached far greater than the few instances discussed. Clinton's Defense of Marriage Act (DOMA), the concerted effort to shift the Democratic Party fundraising focus from grassroots centered to emphasizing large donors and corporations, as well as conducting nearly more foreign operations than both Reagan and Bush combined, depict the realities of the Clinton administration that many Democrats fail to recognize.
The DLC capitalized on the fears of Democratic Party representatives in the south, in which the southern realignment had endangered their political careers, and orchestrated a rightward shift of the party, valuing neoliberal principles to achieve both economic and social ends. The major legislative accomplishments of the Clinton administration had catastrophic results for the future of the Democratic Party, none displayed more accurately than in the 2016 presidential elections, in which free trade became the center of the debate. Yet the results of the party at both the federal and state level are even more concerning.
The Democratic Descent
In 1978, the Democratic Party controlled 31 state legislatures, compared to just 11 for the GOP. In 1992, as Clinton won the presidency, the Democrats controlled 26 state legislatures, compared to just 7 for the GOP, with 16 shared control legislatures.
In stark contrast, the GOP currently control 32 state legislatures (most in GOP history), compare to just 14 for the Democrats. Additionally, in 1992, the Democratic Party controlled 30 governorships compared to just 18 for the GOP. In contrast, the GOP currently controls 33 Governorships, compared to just 16 for the Democrats.
At the federal level, the power shift may possibly be even more drastic than at the state level. The GOP controlled the Senate for just 10 years between 1933-1992, leaving Democrats in control of the Senate for 49 years during that span. During this same period, the GOP controlled the house for just 4 years, leaving the Democrats in control of the House for 55 years, and 40 years straight (1955-1995). Then, in 1995, Newt Gingrich's "Contract with America" swept the nation, resulting in what is known as the "Republican Revolution", which gave the GOP control of both the House and Senate for the first time in 40 years.
Since 1995, the Democrats have controlled the Senate for just 6 out of 22 years. Additionally, the Democrats have only controlled the House for 4 of the last 22 years, and have controlled both the house and the Senate for a total of just 2 years out of 22 years. Furthermore, 2016 demonstrated the trend has continued, proving to be a pattern that the party will not be able to sustain without risking irrelevance at every level of government. With the party so battered that a constitutional convention is a possibility, the source of party corporatism must be identified, and the cancer eliminated.
Al From and the DLC's influence has created a noticeable trend in essentially every facet of the party. In a healthy democracy, there are at least 2 parties, often more, presenting differing visions and values for the country. Thanks in large part to the DLC, the Democratic Party is effectively no longer an opposition party to an increasingly radical right-wing GOP. The difference between the Democrats and the GOP has narrowed dramatically, constricting the scope of discussion. Educated debate has devolved into name calling and fear mongering in the name of political opportunism, all culminating in the takeover of the Democratic Party by individuals with a soft spot for neocons and unregulated corporatism.
Centrism, the DLC, and organizations like it, are responsible for the state of the party and the constant capitulation on issue after issue. The team of From and Clinton accomplished more for right-wing causes than those on the right could've ever dreamt of, and their destruction deserves to be highlighted to fully comprehend when and how the party sold its soul. To solve any problem, you first need to identify the cause. Thus, the shift of the party's values and the embracing of free trade, "ending welfare as we know it", favoring the privatization of education, mass incarceration, and deregulation, resulted in a failed, fractured Democratic Party, when America needed them most.


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You might have forgotten about this bag… It took me quite some time to finally finish this one. Not because it was a lot of work but since I got a little demotivated… I will tell you all about it, but before we continue with the making of, let's see where we left off!
Where we left off…
In the previous post, this bag was almost done! I've learned all the tips and tricks from the brown travel clutch and I knew how to make it in the right order. All I had to do was stitch the fronts to the back-to-backs and attach the shoulder strap. Remember? Well… that's not what
Clean up your mess
I don't want to complain or be negative… but every once in a while you screw something up. It is human to feel a little devastated, demotivated and just not in the mood to continue. You have to gain new inspiration, new motivation, new energy. Well especially when you are nearly finished… and you spilled leather dye all over your bag… Whenever it would be glue or a grease stain, I would know how to minimize the damage. But leather dye is supposed to color your leather. Even if you don't want to. Well, what did I learn…? First of all, close all lits of your leather dye put it in a non-leak-able container, and clean even the drips that might have run along the bottles… Since a single drop of brown leather dye on a green bag will leave a permanent stain.
What's next…
I was back to square one. I had to cut all the pieces that were stained again. Remove the lock, and place it on the new front of the bag and do most of the sewing again. Well, what did get me motivated… it's something funny. I've been on a city trip with some of my friends to Dublin! Amazing city and surroundings if you're in Europe and look for a pretty and fun city to go to!! And well, as you might know, everything in Ireland is green. A travel clutch for a city trip inspired by the deep green colors of Ireland…would have been the perfect combination! As you can imagine, right after this trip, I saw the bag and just started! I continued as long as it took to finally finish the bag.
Final result!
I absolutely am back in love with this bag. I am not sure which one is my favorite, the brown or


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Free printable of the paint colors throughout my home!
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Courtney says
I've been admiring that same cabinet for a while now. So glad to see it going to good use in someone's house. It looks really great in your entryway!
Hanna Lei says
I like it! Still in love with how you did the floor. –Hanna Lei
Love Being A Nonny says
Susan says
Hi Erin! That table is beautiful! It sounds like you have a lot of fun things planned for that space! I was laughing at your closing comments about decorating ADD – I am the SAME way! I call myself the "Queen of Unfinished Projects!!"
Have a wonderful weekend!
Jboo says
So pretty! Love it!
Erin says
Thanks everyone! So glad you all like it! :)
Jane Carden says
Erin, I just LOVE the new cabinet in your entryway! The white finish is perfect, and the mirrors make the area look even larger. I can see a topiary and maybe a wooden lantern sitting on it! But Christmas décor will be the best! Can you just imagine how much fun it will be to style that cabinet for Christmas? This is a great purchase! Have a wonderful weekend!
Christina S. says
What a beautiful table! You can style it any which way you please, and it's bound to be beautiful. Such a great find.
P.S. Enough with the spoilers, though! All of us watching The Good Wife on Netflix are a season behind.
Meg says
I love it!! I can't wait to see how you decorate it. I like the lamp idea…how about a big, green, plant or two? :)
cheryl says
I love it. I am looking at a rug from the same catalog but concerned about the quality. How was the quality of the cabinet? Do you have any experience with their rug
holly w says
OMG Will was killed???!!!! I've been meaning to catch up…
Love the cabinet!
Erin says
Cheryl – the cabinet is great quality! Better than I thought it might be actually. I've never ordered anything else from them so I'm not sure about their rugs??
chad says
I love the floor. How did you grout or seal it
Teresa says
Can you share what flooring you have down in the entryway?
Erin says
Hi Theresa! It's wood floors with Carrara marble squares. :)
Jaclyn says
Hi Erin,
Beautiful entryway…and home for that matter! I love the way you set up the front door with the windows and the windows around it. Could you share the manufacturer of the front door and the windows around? We are building a coastal/craftsman beach house and I would love to utilize this door! ;)
best wishes!
Erin says
Hi Jaclyn! Thank you! I designed our doors and had them custom made by my cabinet guy. Sorry that's not much help! Good luck with your beach house! xo
Megan says
What color is the walls in this entry way? Beautiful!
Erin says
Thanks Megan! You can read all about my paint in this post: :)


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5 Screen-Free (and Fun) Ideas
Did you know that on average people spend more than 4 hours of their daily time on a screen (this number doubles for tweens and teens!). I've seen the uptick of screen time viewing, and it is certainly is no longer limited to an "at home" activity. In fact, kids and adults alike are attached to their devices whether it be in a restaurant, waiting on line at the store, or walking down the street. I am guilty and I don't know how I got so attached, but after a recent vacay where all of us were "unplugged" for more than 6 days, I am ready to jump on board to rethink my own screen time. Next week starts screen free week (April 30-May 6th) and we have five screen Free (and fun) Ideas for you to try.
We recently enjoyed Screen-Free Fun from parenting journalist Shannon Philpott-Sanders. The tips in Shannon's book help parents to fight against boredom, keep little hands busy during travel time, encourage craft time, and builds a love for outdoor adventures.
Since many of the activities work well for kids of various ages, they will be able to grow along with the different projects, and occupy both younger and older siblings alike. There is also space for readers to add their own favorite activities, so they never forget a great idea or memory!
We are sharing four ideas from the book Screen Free Fun and one of our own! Say "yes" to screen free fun!
5 Screen Free (and FUN!) Ideas
Boozy Hazelnut Coffee Cocktail
Another week, another cocktail recipe, girls. Last week, I must confess, I thoroughly enjoyed the strawberry bourbon smash cocktail. With family in town for my son's 4th birthday, there were reasons to celebrate. This fall we've switched it up to a warming cocktail a Boozy ...read more
Cookbook for Moms Who Ski and Ride
Winter is here and it's time for outdoor adventures. Skiing, hiking and sledding can make a family hungry. This winter, there's an awesome solution for moms a new cookbook for moms who ski and ride. The Ski Moms Cookbook is a digital cookbook with 36 recipes that are easy to ...read more
How to Celebrate Adoptive Parents
I recently learned that a friend who had been patiently awaiting a child became a parent practically overnight. When I heard about this loving couple bringing home their first baby, it really got me thinking about how to celebrate adoptive parents. We have experience with ...read more
1. Host a "Just Because" Surprise Party: Birthday or not, I love the idea of getting the kiddos involved in hosting a party. This is a no-stress way to host a fun gathering, keep the kids socializing and a great way to boost everyone's spirit. (Just remember to leave the devices at the door!)
2.Build a Playing Card Tower: I had forgotten just how much fun this is and what a challenging activity it is do get the kiddos involved in. If your house is anything like mine, you have several decks ready for this architectural challenge. Bonus? This is STEM learning at its best!
3. Paint with Water: I recently visited the Bronx Zoo and my friend and fellow mom and I were amazed at how long the children spent at the "water painting wall". The children (ages 4-14!) were occupied with water, paintbrushes of all sizes and a blank chalkboard. Craft supplies stores have large chalkboards on the cheap. How much fun would it be to line a few up and create an outdoor "studio"?
4. Make Cards for the Homeless: I love this suggestion. Whether you are crafty and reuse parts of other store-bought cards to make new cards, or construct your own, letting someone know you're thinking about them, will warm their heart (as well as your own!)
5. Launch a Neighborhood Scavenger Hunt: Who doesn't love a good adventure? Get the kiddos involved in curating a fun list of items to hunt and gather some friends and get out there. First one back to base with the most item wins!
This is not a sponsored post. We received a copy of Screen-Free Fun for review.