Cushings Disease Case Study

To present a case study of a 34-year-old woman with Cushing's disease and provide nurse practitioners (NPs) with the understanding of the clinical presentation needed for early recognition and treatment of the disease.

Data sources

A comprehensive review of published literature on Cushing's disease. Findings from history, physical examination, and diagnostic studies of a woman presenting to primary care NPs, physicians and other healthcare providers with multiple symptoms of Cushing's disease.

Cushing's disease is the result of the pituitary gland producing excess amounts of adrenocorticotropic hormone (ACTH) causing the overproduction of cortisol. The disease is fairly rare and is seen mostly in women. Common chief complaints include increased facial hair, weight gain, amenorrhea, changes in the face, neck, and abdomen, with muscle wasting of the lower extremities. Untreated, diabetes mellitus and hypertension can occur and increase the patient's morbidity and mortality. Early recognition and appropriate referral can reverse the signs and symptoms over time and lead to a significantly improved quality of life.

Implications for practice

This case presented the challenges faced by NPs and physicians in diagnosing patients with Cushing's disease.

Case report: Patient presenting with Cushing's disease

Dawn Shaver*

University of Virginia Medical Center, Neurosurgery Pituitary Program, CDW 3530, Hospital Dr. Charlottesville, VA 22908-0212, USA

Dawn Shaver: ude.ainigriv.ccm.liamcsh@j7seD

*Corresponding author

Author information ►Article notes ►Copyright and License information ►

Received 2015 Feb 17; Accepted 2015 Feb 18.

Copyright : © 2015 Shaver D.

Cushing's syndrome is a rare disease that is caused by the overproduction of cortisol by the adrenal glands. This can be caused by a tumor of the adrenal glands, the lungs or the pituitary gland. When a pituitary tumor produces too much ACTH (adrenocorticotropic hormone), it causes the overproduction of cortisol by the adrenal glands. When the pituitary is the source of the over production, it is called Cushing's disease.

Case Description:

A 32-year-old female who developed symptoms of Cushing's about one and a half years prior to her visit at a large teaching hospital in the Mid-Atlantic. Her symptoms included amenorrhea, facial hair and acne, and back pain. She had previously been diagnosed with polycystic ovarian syndrome.

Cushing's disease is a rare disease, which can be successfully treated by experienced pituitary specialists.

Keywords: Adrenocorticotropic hormone, Cortisol, Cushing's

The Pituitary Program is an integrated program consisting of (2) Neurosurgeons and (3) Neuro-endocrinologists. They work closely with the Neuro-ophthalmologist, Neuropathologist, Otolaryngologists, Neuro-radiologists, and the Gamma Knife surgeon. Patients often come from long distances seeking treatment for their pituitary tumors. They are seen by both the Neurosurgeon and the Neuro-endocrinologist together in a joint clinic. If they need to see the Otolaryngologist or the Neuro-ophthalmologist, we can usually arrange that during the same visit.

Cushing's syndrome is a rare disease that is caused by the over production of cortisol by the adrenal glands.[2] This can be caused by a tumor of the adrenal glands, the lungs, or the pituitary gland. When the tumor produces too much ACTH, it causes over production of cortisol by the adrenal glands. If the source is the pituitary, it is called Cushing's disease.[2] Cushing's disease occurs more often in women than men and more often occurs between the ages of 20 and 40. Common features of Cushing's disease are weight gain, hypertension, diabetes, poor short-term memory, irritability, excess hair growth (women), red-ruddy face, extra fat around the neck, round face, fatigue, poor concentration, and menstrual irregularity in addition to muscle weakness. Some of the less common features include insomnia, recurrent infection, thin skin and stretch marks, easy bruising, depression, weak bones, acne, balding (women), hip and shoulder weakness, violaceous striae, hypokalemia, unexplained osteoporosis, diabetes mellitus, and swelling of feet/legs.[3] Not all patients have all of the signs and symptoms of Cushing's disease.

The diagnosis for Cushing's disease is made by laboratory testing, which demonstrates the consistent overproduction of cortisol. The tests most commonly used are midnight salivary cortisol test, a 1 mg dexamethasone suppression test, or a 24-h urine-free cortisol level.[1,2] All of these tests are approximately 92% accurate (2015, personal communication by Dr. Mary Lee Vance). A pituitary protocol magnetic resonce imaging (MRI) is also done to see if there is a visible tumor, if the blood ACTH level is detectable or elevated. Approximately 50% of patients with Cushing's disease do not have tumors which are visible on MRI.[1,3] If no obvious tumor is seen, patients may have the inferior petrosal sinus sampling test. If the pituitary is the source of the excess cortisol production, the patient should undergo surgery by an experienced pituitary neurosurgeon.

Cushing's disease is characterized by a delay in diagnosis because of overlaps with other more common medical problems such as polycystic ovarian syndrome, diabetes, obesity and high blood pressure. The average time from onset of symptoms to diagnosis is 3–5 years.[1]

The patient is a 32-year-old female who developed symptoms of Cushing's disease about one and a half years prior to her visit at the Pituitary Center in a large hospital in the Mid-Atlantic. After she stopped nursing her baby, she had no resumption of menses. She was told by her gynecologist that she had Polycystic ovary syndrome (after five successful pregnancies achieved without assistance). She then developed facial hair and acne about 6 months later. She subsequently developed back pain and was found to have a compression fracture of the lumbar spine. She saw a local physician who diagnosed her with Cushing's syndrome.

Local testing showed the following results:

Laboratory testing showed urine-free cortisol values of 228, 235, 265, and 246 (normal is less than 50).

Inferior petrosal sinus sampling was performed, which showed that the pituitary was the source of her Cushing's. Her prior MRI, done locally was interpreted as negative per the MRI report.

The patient presented to the Pituitary Clinic with this information. Upon examination, she denied changes in mood, depression, sleep disturbance, or symptoms of sleep apnea. She had not gained weight, which is typical of Cushing's but she did note redistribution of body fat. She noted enlargement of her abdomen. She continued to have some back pain. She had developed fairly profound muscle weakness and was unable to lift her 3-year-old child. She was prescribed mifepristone 300 mg BID 2 months prior to her visit at the Pituitary Center. This drug blocks the effects of cortisol. She noted her face was less round but there was no improvement in the acne, hirsutism, or other symptoms. The Neurosurgeon and Neuro-endocrinologist ordered repeat imaging using both thin cut pituitary and dynamic imaging.[4] The imaging clearly showed a 7 × 5 mm micro-adenoma on the left side of her pituitary that reached the medial wall of the left cavernous sinus but did not show evidence of invasion on the scan.

The patient was scheduled for surgery and underwent transsphenoidal resection of her pituitary micro-adenoma. After surgery, the patient was carefully monitored, measuring cortisol levels every 6 h in addition to checking urine specific gravity levels (diabetes insipidus) and sodium levels (diabetes insipidus and syndrome of inappropriate diuretic hormone).[6] Diabetes insipidus following pituitary surgery is usually transient.[5,8] She was also carefully monitored for a cerebrospinal fluid (CSF) leak. On postoperative day #1, cortisol was 2.8. There was no sign of diabetes insipidus. On postoperative day #2, morning laboratory results showed that cortisol was 1.8. She had two cortisol levels of 1.8 and on postoperative day #3, she was replaced with hydrocortisone. She did not develop any signs of diabetes insipidus or SIADH and was discharged on a dose of 40 mg of hydrocortisone each morning upon waking and 20 mg each evening between 5:00 and 6:00 pm. She was instructed to continue this dose for 3 weeks and then reduce her hydrocortisone dose to 20 mg each morning and 10 mg each evening. She was to continue this dose until 2 days before her follow up visit at which time she was instructed to hold the medication.[6] Her cortisol level would be checked at her postoperative visit to see if her pituitary was “waking up” and stimulating normal cortisol production. Before discharge, the patient was also given information regarding signs and symptoms of meningitis, Syndrome of Inappropriate Antidiuretic Hormone (SIADH), and diabetes insipidus, which can occur postoperatively. She was given instructions to lift no more than 10 pounds for 2 weeks and then not more than 25 pounds for an additional 4 weeks, no blowing her nose for 6 weeks, no submerging her head for 8 weeks, and no straining for 6 weeks. She was instructed to use saline nasal spray every hour she was awake for 2 weeks and then every 3–4 h for another 4 weeks and Neil Med Sinus Rinse three times per day for 2 weeks and then two times a day for 3 months.[7]

On postoperative day 5, the patient's father called to report the patient was having an increased headache, nausea, and two episodes of emesis. Laboratory reports were obtained and it was determined that the patient's symptoms were most likely related to cortisol withdrawal.

The patient returned to the Pituitary Clinic 8 weeks later for her follow-up appointment. She had lost 8.6 pounds. Her facial plethora had resolved and her face was thinner. Her bilateral supraclavicular fat pads were smaller but not completely resolved. She still had some facial acne. She denied fatigue or myalgias. Patient stated she was weaker than she had been in the past but was better than before surgery. She reported her skin felt like it was burning, particularly over her legs. Patient asked about contraception and the Neuro-endocrinologist recommended that she not become pregnant for at least 6 months after her surgery in order for her to recover from the catabolic effects of Cushing's.

The patient's laboratory tests drawn at her visit showed the following results:

  • Cortisol normal at 7.2 after holding hydrocortisone for 2 days and her ACTH was normal at 15. This showed that her own pituitary gland was “waking up” and she could stop taking the hydrocortisone. Her thyroid tests were normal, FT4 at 1.31 and the thyroid-stimulating hormone (TSH) 1.14. Her testosterone level was normal at 34.

Patient was successfully treated with surgery and achieved remission from her Cushing's disease. She will be monitored for recurrence the rest of her life.

Cushing's is a challenging disease to diagnose. The diagnosis is often delayed because Cushing's is frequently masked by its overlap with more common medical problems such as diabetes, high blood pressure, obesity, and polycystic ovary syndrome. Cushing's may be more common than previously thought. In this case, a 32-year-old female was ill for at least one and a half years before diagnosis. We have seen other people who were not diagnosed with Cushing's for many years. Some patients exhibit very few symptoms clinically but have testing, which confirms Cushing's. Other patients have many of the clinical symptoms of Cushing's and are very ill by the time they are diagnosed. Because of the damage hypercortisolism does to the body including muscles, joints, and bones, recovery is often painful and challenging.

Cushing's is difficult to diagnose and increases morbidity and mortality in patients who are untreated.[1]

1. Bansal V, Asmar N, Selman W, Arafah B. Pitfalls in the Diagnosis and Management of Cushing's Syndrome. Neurosurg Focus. 2015;38:1–11.

3. Nieman L, Swearingen B. New York: 2013. Cushing's Syndrome and Cushing's Disease (2013 updated.) [Brochure] Author.

4. Oldfield E, Vance M. A Cryptic Cause of Cushing's Disease. J Clin Endocrinol Metab. 2013;98:4593–4.[PubMed]

5. Smith T, Hulou M, Huang K, Nery B, Moura M, Cote D, et al. Complications After Transsphenoidal Surgery for Patients with Cushing's Disease and Silent Corticotroph Adenomas. Neurosurg Focus. 2015;38:E12.[PubMed]

6. Starke R, Reames D, Chen C, Laws E, Jane J., Jr Endoscopic Transsphenoidal Surgery for Cushing Disease: Techniques, Outcomes, and Predictors of Remission. Neurosurgery. 2013;72:240–7.[PubMed]

7. Charlottesville, VA: [Last updated in 2014 Jun 06]. UVA Pituitary Physicians. University of Virginia Medical Center Pituitary Discharge Instructions [Brochure] Author.

8. Zada G, Liu CY, Fishback D, Singer PA, Weiss MH. Recognition and management of delayed hyponatremia following transsphenoidal pituitary surgery. J Neurosurg. 2007;106:66–71.[PubMed]

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Organizations consists of different business activities such as human resources, finance, marketing and etc. Even if these activities are interlinked and dependent on each other, marketing takes a special place among any company’s departments by fulfilling many essential tasks for the organization. Marketing is a vast area and the success of any company depends on it. We are lucky to have been blessed with internet since each and every organization does so many various things pertaining to their business via the internet. Any organization’s ultimate motive is to earn more profits by improving their productivity and competing with their competitors. Marketing activities carried out through the internet are very successful and there are various benefits organizations of any sector can gain through using this method in order to market their products and services.

Cost effective

Using the internet in order to conduct marketing related activities is extremely cost effective. Using traditional methods such as newspapers, television and radio can be very costly. This is because such modes require repetition. But, carrying out marketing activities through company websites and other social media monitoring tools are comparatively inexpensive and are definitely worth to be a part of any company’s marketing plan. Go here  for more information about business intelligence solution.

Vast audience

These days people are very busy with their careers and life. Sometimes they tend to not have time to spend time with their loved ones. Most of them do not watch television or read newspapers. But, almost all of them have access to internet through laptops, tabs and smartphones. Hence, any marketing tactics you use with the help of internet becomes extremely successful. Additionally, since many people can access websites and apps, there is a vast audience. The ease of accessing many people and improved social listening at a lower cost is extremely great for any organization in terms of making profits.

Ease of access

People would simply require internet and a device to access internet in order to check websites or apps launched by organizations or any other online advertisements. People do not have to read long articles or listen to long recordings because contents on internet are constructed with illustrations and attention to the most important details. Hence, it marketing through internet is with no doubt extremely effective at the same time since people pay attention and understand easily.

The above are a few important benefits any organization would receive through carrying out their marketing activities through the internet. It is extremely important that any decision regarding businesses and their activities is taken with proper prior consideration and assesment.

The best video editors know that they have to find a balance between quality and speed when it comes to putting together a video clip. This means that you have to be fully aware of all the options available to you when you are using Final Cut Pro X. This will not only ensure that you will produce an aesthetically pleasing clip but that you will also do it quickly. You need to be able to manipulate media, audio, free FCPX effects, and other features with the greatest of ease. Here are some tips and tricks that you can learn about Final Cut Pro X:

You can either get free FCPX effects online or use the ones provided by the Final Cut Pro X software. Here is some important information:
•    When you are trying to color correct when editing, you should always employ video scopes. You will be able to see a great more detail, particularly if you are playing close attention to the clips.
•    Blurring the blue channel can help you cover up a multitude of errors. This includes reducing video noise or cleaning up details such as physical blemishes.
•    If you want to see two or more images on the screen simultaneously, they need to be stacked. The alternative to this is to use drop-zones.

Here are some tips that will help you edit your videos better:
•    It is always best to store less than 3000 video clips in the free FCPX transitions library.
•    Use Project Properties to change the render file settings at any time.
•    You should only change your frame rate when there are no clips present in the timeline. The presence of clips can disrupt your most or all of your edits.
•    You cannot mix audio in between tracks or combine images from different angles with multi-cam editing.

Here is how you can manage your media better:
•    The more a codec has to compress a file, the great the amount of color information that is lost. For media that has had a great deal of color correction, use a codec that only does minimal compression.
•    To make media easier to share, you should store in a location separate from the library. This will make it simpler to share between libraries and editors.
•    Use still images that are smaller than 10,000 pixels on a single side. It will make it easier for free fcpx transitions to work with each image.
All of these tips and tricks will help you create videos faster and better than before. They will also help you to maneuver through the software much better.

Depending On The Technology For Your Operations

Operations, whether it is in the service industry or of the business of any type is likely to be dependent upon the use of technology to a great extent.  Not only will it be required for manufacturing and processing, but also advertising, marketing, Data Storage and analysis, and communication.  The use of traditional Manpower and labor in order to take care of all these there is no longer applicable.  The latest technology has made it possible to undertake all these tasks without having to put in too much effort.  However, there will have to be some preliminary initiatives as far as having these installed is concerned.  Since you’re not an expert in the field of such technology, you will require professionals who will be able to come in and described the best possible measures.

Industry specific tools which are mandatory
Chances are that no matter what industry you are involved in, there will be some technology or the other which will make your work much easier.  That does not necessarily mean that you will have to go and purchase the one which is more expensive or up to date.  You need something that is completely appropriate for your requirements.  Therefore, get the best IT consulting services that are available.

A thorough inspection is very crucial
The professionals who will be coming to give you managed IT services brisbane will make sure that they carry out a complete assessment with regard to the operations which you will be carrying out so that they can prescribe the right tools which you need.  That way, you will also have a financial estimate with regard to how much money you need to spend in order to purchase the equipment.  Additionally, you will also have to pay service charges in order to have it installed and made ready to function as far as everyday operations are concerned.

Getting trained staff for the purpose
The staffs who will be working with you need to be extremely skilled as far as operating these devices and gadgets are concerned.  You can enter into an agreement with the company that will be installing them so that they can provide you with skilled workmen who can be on your payroll.  That may, you will not have any cumbersome situations later on.

Keep adapting as per the industry standards
In order to make sure that you recruitment is going to be handy and relevant to the times, keep on getting it outdated so that the latest innovations are incorporated in it.  You do not want to find yourself backdated and let your competitors take advantage of the latest innovations. This will eventually ease your job manifold, and thereby influencing the overall output.

There are moments where productivity just hits a down low, you (or your employees) don’t feel like doing anything, not one original thought passes the mind and that’s all natural. However prolong lack of productivity is a hint of lethargy and that’s not a good thing as it can be very damaging to your business. Here are a few ways to overcome the lack of productivity.
Indentifying and Quantifying the Tasks at HandOvercoming lack of productivity begins with careful analysis of the tasks at hand or the task you intend to perform. Begin by writing down all tasks so that you can visually recognize them. Begin by placing the most prominent tasks, that is the most difficult or tasks with a tight deadline right at the top. And set yourself a timer for each task to be performed.
Motivating yourself to become betterWhen you speak of productivity, motivation is the next word that follows, they both go hand in hand, and you don’t get one without the other. That being said, the key method to increase productivity is by exposure to the right motivation. Now many people confuse money with motivation, it’s only partly true. True motivation means satisfying one’s basic needs or one’s inner desires. Even it means including a motivational poster in your work environment, do it as long as you feel like you want to do something.
Making Use of Software ToolsOne may think why even do everything in pen and paper when you can do everything via your smart-phones, tablets and computers. Of course there is a truth in both, while studies say those who write things down actually perform better, one cannot forget the ease of technology. For example the use of Google Calendar to mark your appointments for the month, not only will you be able to see it in all platforms, but even have occasional reminders in the pal, of your hand via your smart-phone. All you need to do is simply look for mobile business applications in your online app store from your phone.
Mobile business applications have been tailor made to assist you in your various activities depending on your activity and the type of application. For example there are apps that will constantly remind you to perform your tasks in case you forget and helps establish strict deadlines as well. Examples of apps include Evernote,.
ExpensifyAvoiding Common MistakesThe most common mistake that most people perform is take a little too much of breaks in between work. It is by far more beneficial that you take a big break in the end than take a lot of little ones that can eventually have you start procrastinating. Don’t get into the habit of rewarding yourself for every little accomplishment, this creates a negative factor, instead reward yourself only when major tasks of avaya ip telephones are accomplished and when you finally get your work done.

How To Declutter Your Home Office

Decide what needs to be thrown out.

Wires and cords.

Your laptop or PC.

Free your table top.

Allot a specific place for each item.

Challenges in Product Development

Global challenges

Technology hurdles

Creative hurdles to overcome

Administrative hurdles faced

Reselling Tips: Giving A New Shine To An Old House

Repairs are a must
Exterior appeal


Better Days Are Coming / May 11 at 12:23AM PDT

If there's one fashion house that understands good style + viral marketing, it would be Uniqlo Japan. For their summer lookbook, they'll reveal a new dress each and every day for 150 days.


Health Tips, Health Information, Health Care And Fitness Ideas

Might I begin with a big Thank You to 2015!!! Whew, what a yr it has been. In fact, let’s sing a few traces. This strike spread to numerous cities within the United States and other people of all walks and backgrounds have picked up the cry in opposition to the refusal of the Republicans to tax people making over 1,000,000 dollars a yr to pay half a % of 1 mum or dad of their first million, which Vice President pointed that this meant that they will have to pay $500.00 for each million they made.

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sumers, and addressing disparities in health and health care”. Once more, this all sounds cheap and good, but I believe the main points will get far more furry. For instance, some would seemingly key on the addressing disparities” phrase and instantly sound alarm that about what that means. The federal government, on the hand of the Health Selections Commissioner, putting its hand into the healthcare system to make it possible for Botox injections in Indiana end up as lovely as those in Beverly Hills? Or, even worse, the Commissioner encouraging research to deal with outcomes for different drugs and procedures to figure out which ones actually work? The horror.

As much as 15% of the population suffers from an allergy to mould, and even when one isn’t allergic to it, breathing in mould spores is simply not good for one’s health. These activities make you push or pull against something, reminiscent of gravity, weights, or exercise bands. Hi habee that was an ideal hub on a most controversial topic. It was good to read on a more pure enjoyable sort of pageant it certainly takes the stigma away from what most people see them as.

The financial benefits of an eight% plan are many. Moreover being inexpensive, paying for itself and inspiring competition, the eight% plan shouldn’t be employer primarily based, so it goes with you. One other benefit of this plan is for companies. In a time when companies, especially small companies, need a lift, not having to pay for an worker’s health care would be precisely the stimulus they want. But wait, there’s much less. They would not need to pay the 1.forty five% Medicare tax, either.


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It's also a great way to get exercise. For some health info, click HERE.

A typical dance evening consists of several dance "tips," lasting about 10 minutes each, with breaks in between. At the beginning of a tip, the dancers line up to form "squares." A square has four couples, with one couple making each side of the square. There may be many squares on the floor, but each is separate. That is, each square of four couples works together as a team, independently of the others.

A "caller" stands at one end of the hall and begins giving a sequence of instructions for the dancers to follow. Each of these instructions, or "calls," requires that some or all of the dancers in the square perform a pre-determined manuever. The caller doesn't literally tell you where to move, he/she just gives the name of the call, such as "linear cycle" or "ends fold," and the dancers respond. Some of the manuevers are simple, others are more complex.

Although they begin in a square, after each manuever the formation of the dancers will change, maybe to waves, or columns, or diamonds, etc., or the dancers' positions within the formation will change. There are lots of variations.

After several calls, the dancers are usually thoroughly "shuffled." For example, your original partner may be somewhere at the other end of the formation from you. But, due to the caller's skill at selecting calls, eventually everyone "magically" ends up with their partner again, back at their home position where they started the tip.

The calls (instructions) that the caller gives are set to music, so the dancers' movements flow to the music. That's part of the fun of dancing. The music can be anything from bluegrass to ballads to rock'n'roll. There are actually two parts to a tip, lasting about 5 minutes each. The first part, although set to music, concentrates more on calls and formations, as the caller manuevers the dancers into myriad formations and positions. The second part concentrates more on the music, and the dancers movements are choreographed to a particular popular song. It's a nice combination.

Of course, the dancers must know how to perform the manuevers for each of the calls, and there are lots of calls to learn. This requires that you attend classes for a period of time before you can "officially" dance with the regulars. But the classes are fun, too (see below).

Part of the challenge and fun of square dancing is trying to remember and immediately perform the manuevers required for each call. This requires that you learn to listen and concentrate. A side benefit of this is that while you're dancing you RELAX, mentally and physically, and completely forget any troubles that may have been plaguing you (bad day at the office, etc.).

Another challenge is trying to adapt what you learned in classes to different formations and positions. For example, you may have learned how to do a manuever from one formation, say a wave, but now the caller wants you to do the manuever when you're in a column, where it might not be so obvious. It can really be fascinating.

In case you're wondering, yes, dancers are human and do make mistakes (i.e., move into the wrong position). That's actually another part of the fun, as your square then attempts to repair the formation before falling too far behind the caller. This almost always evokes a shared laughter among the dancers in your square, as they scurry about, trying to reorganize. If it's impossible to catch up, you simply reform your starting square and wait for the caller to reach another starting point, which is usually within a couple of minutes.

Square dancing is fairly cheap. Evening dances usually range from $2 to $4 per person. Weekend-long festivals are proportionally more. Dance attire has traditionally been western, but more and more that is no longer a requirement.

So, square dancing is fun, good exercise, and inexpensive. But another reason for square dancing is the people you'll meet and the friends you'll make. It's a wonderful opportunity to form friendships that may last a lifetime. And that may be the best reason of all.

To learn the "calls" (manuevers) required for the normal level of dancing, you attend a weekly class for 6-9 months. That may sound like a long time, but it's fun right from the start, and you'll find yourself looking forward to the next class. Classes are offered by a square dance club, of which there are several in the Richmond area, usually meeting at a local school. Typical cost is $2.50 a week per person -- but the first couple of weeks are usually FREE. It's ideal if you bring a partner to dance with, but single dancers are also welcome.

For information about the clubs in Richmond and their classes, click HERE. Classes begin each September, and sometimes in January. And, there's a special "teaching" club in Richmond that starts classes twice a year - around May and October.

Click HERE if you want to see a list of the calls you'll learn. Don't feel too overwhelmed by the large number of calls. Some of them are fairly obvious, such as "partner trade," others are not. But you learn them gradually and gently, with lots of review each week. Note that the normal level of dancing actually encompasses three dance levels known as Basic, Mainstream, and Plus. When you graduate, you are considered a Plus dancer.

After you graduate, you'll be able to dance at your club's dances or at other dances and festivals in Richmond and throughout the state, country, and world. By the way, if you're out traveling you can almost always find a local square dance nearby if you want to get out and meet people or just have something to do.

Some other square dance links:
Richmond Square and Round Dance Association (RSARDA)
RSARDA's links page
MIT's square dance club (their classes are only 14 weeks!)

Feel free to email me if you have questions:

I do not necessarily endorse any of the links on this page or any pages contained within.


Zenith Minisport - Features

Unique features:

  • 2" floppy disk drive (720 kB double-sided, double-density). The 2" media was very expensive, typically $80 for a box of 10 floppies. Like many other laptops, an external 3.5" floppy drive was available as an accessory.
  • Built-in FastLynx transfer software that could install itself on any other DOS computer over a serial cable without the need for any pre-existing software on the remote system. It relied on the user typing in a DOS Mode command on the other computer, which transferred control of that computer's command line to the Zenith over the serial line. The software then copied itself across, and the user could then move files. This to some extent compensated for the fact that no other computer ever used the 2" floppy disks, thus rendering floppy transfers impractical.
  • The ability to set aside some of its upper memory (typically the 384k area between 640k and 1MB) as a battery-backed RAM disk; this was relatively unique in DOS-based laptops (others, like the Toshiba T1000 also supported RAM disks). The RAM disk appeared as C: in DOS and enabled the computer to run with no spinning disks, extending battery life and increasing reliability. Contents were preserved with the power off, though using a minuscule amount of current from the main battery.
  • Later versions included an integral 20MB (Megabyte) hard disc. This was enough to run WordPerfect and associated programs, including spell-checkers and diagnostic programs.

Read more about this topic:  Zenith Minisport

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... Considerable speculation has surrounded the possible adaptive value of other physical features characteristic of groups, such as the constellation of facial features observed in many eastern and northeastern Asians ... selective pressures shaped specific physical features will be difficult, since such features may have resulted from sexual selection for individuals with certain appearances or from genetic drift ...
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    Christopher Lasch (b. 1932)


Information for General Public – Center for Veterinary Drug Development Just another WordPress site Tue, 24 Jul 2018 03:58:13 +0000 ja hourly 1 Medicines and Food Tue, 24 Jul 2018 03:57:01 +0000 Medicines (pharmaceutical products) are mainly used for diagnosis, treatment and prevention of diseases, while food is used for taking nutrition and enjoying taste and flavor. However, some food is considered to have the effect of preventing and treating diseases. In the Food Sanitation Act, article 4 defines that　‘The term “food” as used in this Act shall mean all　food and drink; provided, however, that this term shall not include　pharmaceutical products or quasi-pharmaceutical products specified by the Pharmaceuticals and Medical Devices Law’. Thus, the distinction between pharmaceutical products and food is defined by whether or not efficacy of such a treatment or prevention for diseases can be displayed. To display efficacy leads to being exposed as an infringement of the Pharmaceuticals and Medical Devices Law, even if some food can prevent a disease.

However, health-promoting food which was institutionalized in 2001 is an exceptional case, is divided into 3 types: “food for specified health uses”, “nutritional functional food“, and “food with function claims.” These are allowed to display efficacy about special health on particular expression. Only “food for specified health uses” was scientifically proved efficacy of special health in the national examination and was approved by the Minister of Consumer Affairs, and showed that it “maintains good digestion” or “prevents the absorption of fat.” “Food with function claims,” which was established in 2015, tends to be confused with “food for specified health uses,” however, the functionality based on scientific evidence is displayed under the responsibility of the owner. Thus, “food with function claims” is different from “food for specified health uses” in which the safety and functionality are not examined scientifically by the nation, and are approved only by papers without clinical studies.

Moreover, supplements are commonly called health foods so as to supply nutrition such as vitamins and amino acids which are deficient in persons. The position of supplements is not clarified although they are legally categorized as a food, not pharmaceutical products. Recently, the health hazards which are caused by taking excessive supplements have been reported, and it is high time that supplements should be legally regulated.

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What Do Drug Expiration Dates Mean? Tue, 22 May 2018 05:01:22 +0000 Expiration dates are set on various products to enhance the convenience of consumers. Users and consumers check expiration dates and use or discard products accordingly. This time, let’s think about the expiration dates on veterinary drugs which are basically determined in a similar way to the human drugs.

To obtain national pharmaceutical approval, specification of the method of inspection needs to be set up to produce and supply product stability. The amount of component substances and physical chemistry characteristics need to be determined clearly, otherwise different pharmaceutical preparations may be produced every time, and safe and effective preparations may not be supplied for consumers. Stability testing, which is essential for new drug approval, is used to determine shelf-life and storage conditions, and to verify that no changes have been introduced in the formulation. Generally, the data of 3 months beyond the desired expiration date are requested. Thus, the data for 1 year and 3 months are required to set up a 1 year expiration date. Sometimes, the government announces that the effectiveness and safety of products beyond the expiration dates do not have any problem when a small amount was used due to data mentioned above. The expiration dates are printed on labels of pharmaceutical preparations or the cases except for certain preparations. Due to the deregulation, the display of expiration dates is not required if the preparations have stability testing data for 3 years. Pharmaceutical preparations which are stable for 3 years are not expected to change in quality even excess for a short period, and might be sold out within 3 years. On the other hand, the marketing authorization holders have a merit which prevents disposing such products. However, we should avoid using pharmaceutical preparations beyond the expiration dates.

Incidentally, expiration dates are also displayed on food as well as pharmaceutical products. Two types of due date are displayed such as “best before date” and “expiration date”. Do you know the difference between them? Do you dispose food just beyond 1 day of best before date? Best before dates are used for stable processed food and refer to the period for which with safe storage no change of flavor and taste. Thus, we can eat such food even beyond a few days. On the other hand, expiration dates are used for fresh food and box lunches which are unstable in quality and are referred to the safety periods to eat. Thus, food with expiration dates should be consumed within expiration dates as soon as possible. We should understand the differences between them and be careful of food waste.

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Miraculous Survivor from Rabies Tue, 22 May 2018 04:57:15 +0000 Rabies, a high fatal zoonosis, is transmitted by saliva through bites from infected dogs. All mammals including humans can be infected with rabies, and nearly 100% patients die if they develop rabies. Every year, approximately 50000 people die overseas, the majority in Asia and Africa. In Japan, a prevalence of rabies was recorded since Edo period. However, Japan has become an unusual country which has no incidence of rabies due to registration and vaccination of pet dogs, and extermination of homeless dogs based on the Rabies Prevention Law established in 1950. It was a great achievement, and both veterinarians and good-quality domestic vaccines played a major role.

Thus, recovery form rabies is difficult once humans develop it, however, recently, it was reported that a Brazilian boy of fourteen had survived from rabies (Jan 11, 2018, Jiji Press). Milwaukee protocol (MP) was used for treatment of this case. MP is an experimental way of treatment for human rabies and was performed on more than 50 patients, in which 6 patients recovered. In Sep. 2014, American high school student J was bitten by a bat and developed rabies. Dr. Willoughby, who was an attending doctor in Children’s Hospital of Wisconsin, performed MP based on the evidence which the brain of a patient was normal though the virus was isolated and which the virus was not isolated from the surviving patient in ICU after a few weeks. Willoughby induced a coma pharmaceutically, and then, administered antiviral drugs (ribavirin and amantadine) to kill the virus. After that, the immune system of the patient was activated and eliminated the virus with antiviral drugs. After a month, the virus was could not to be detected, and his encephalopathy was at low level. He could leave the hospital after the rehabilitation in Jan. 2015. The estimated cost of treatment would be about $800,000. It was not clarified why he could survive from high fatal rabies, however, there are various possibilities about reasons for which the administered virus might have had low pathogenicity, and which the bitten site was far from the brain, and which the immune system of the patient J might have been extraordinary strong. Anyway, he really returned alive, and the effectiveness of MP was reconfirmed through this Brazilian case. Mr. J is now studying to become a veterinarian.

This time, I introduced a recovery case although the patient was infected and developed rabies. However, humans do not always recover from rabies if MP is performed, thus, the preventive measures for rabies may be the most important for us. Countries which have no rabies like Japan are rare, therefore, we should keep rabies in mind when traveling overseas, and should not touch dogs, cats and wild animals without thinking. In 2006, two Japanese men in their 60s died of rabies after returning to Japan. The rabies is thought to be caused by bites from a dog while staying in Philippines. They saw a doctor because of a cold at first, thus, they had no recognition of rabies in spite of having been bitten by a dog. On the other hand, dog owners need to comply with the Rabies Prevention Law and carry out the vaccination every year. Now, there are many owners that do not have their dogs vaccinated because of no rabies in Japan. The vaccination rate in Japan is now below 70% although the WHO recommends 70% rate to prevent rabies from going around. Taiwan, where rabies has not been detected for a long time, confirmed that rabies expanded rapidly because of wild animals infected with it in 2013, followed by the infection to dogs. We should use that case as a lesson, and protect the health of humans in conjunction with that of animals while enforcing the vaccination of dogs. I hope to maintain the monumental achievement in measures for preventing rabies in Japan, with no similarities seen in the world.

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Symbiotic Bacteria Results in Pest Insecticide Resistance Mon, 19 Mar 2018 02:20:39 +0000 A lot of gut flora (gut microbiota) including good and bad bacteria live in intestines of humans and animals. It has become clear that these bacteria are involved in the regulation of intestinal functions and are related to the immune system of hosts and infection.  Furthermore, brain-gut interaction which is an unexpected relationship between the brains feeling stress and the intestine has been also verified. In association with discovering these new systems, gut flora is attracting the attention as a new field of study. Now we would like to introduce symbiotic bacteria which belong to a pest that develops insecticide resistance to the pest itself.

Riptortus clavatus is a harmful soybean pest living in not only Japan and a wide areas of Asia. This pest takes Burkholderiales bacteria from circumstances of soil and lives together. Organophosphorus insecticide fenitrothion is used to kill Riptortus clavatus. Some soil bacteria were reported to decompose fenitrothion into a carbon source and use it for proliferation. Having isolated and examined Burkholderiales bacteria from Riptortus clavatus, bacteria which had decomposed fenitrothion were found in small amounts. Furthermore, it was clarified that Riptortus clavatus which had been infected by fenitrothion decomposing bacteria, significantly increased in resistance to fenitrothion, it indicates that the pest acquires resistance to the insecticide by living symbiotically with insecticide decomposing bacteria.

Until recently we have been thought that a host itself regulates its various characters. However, this study result broke the mold by indicating that characters of symbiotic bacteria living in the intestine reflected host’s characteristics. This report is a case of a pest and can’t be applied to mammals however, we feel the infinite possibilities of symbiotic bacteria (gut flora) which have been acquired in the process of evolution. Now, probiotics have been developed and actively applied, which might be a hint for idea of new efficacy.

Kikuchi Y, Hayatsu M, Hosokawa T, Nagayama A, Tago K, Fukatsu K: Symbiont-mediated insecticide resistance, Proc Natl Acad Sci USA, 109(22):8618-8622, 2012.

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A Fatal Case of Corynebacterium ulcerans Infection from Cats in Japan Mon, 19 Mar 2018 02:18:47 +0000 The health ministry, on Jan 15, 2018 reported that a Fukuoka woman, who is in her 60’s died of Corynebacterium ulcerans infection which is suspected to be caused by infected cats. She fed homeless cats every day, and this bacterium was isolated from these cats. This infectious disease is an extremely rare case, and not only ordinary people but also veterinarians might not recognize it yet. Now let me introduce this infectious disease.

Pathogen: Corynebacterium ulcerans is the cause of the disease and is known to be closely-related with diphtheria, producing cytotoxic diphtheria toxin.

Epidemiology: The most numerous cases are reported in England. From 1989 to 2006 this bacterium was isolated in 56 cases including asymptomatic carriers. Some cases are occasionally reported in other European countries. In Japan, since 2001, 25 cases, including this case, were reported. Patients in most cases have kept cats, sometimes dogs. Most infected people were treated by the use of antibiotics, however, this case was the first fatal case in Japan.

Route of Transmission: This infectious disease is confirmed in humans, dogs, cats, cows, and various animals, and is a zoonosis presenting various symptoms in pharyngolarynx, lungs, skin, and mammary glands, among others. Transmission of the infection from milk produced by cows suffering from mammitis or arthritis has been confirmed overseas, however, recently, infection from infected dogs and cats has been widely confirmed both domestically and abroad. Human-to-human transmition has not reported domestically yet, and is very rare overseas.

Clinical Symptom: A human shows similar clinical symptoms to diphtheria. In respiratory infection, patients initially show similar symptoms to a common cold, following that, pseudomembrane or white coat develops in tonsils and pharynx accompanied with sore throat and a cough. In severe cases, patients suffer from dyspnea and can even die. Other infectious cases have symptoms including swelling of cervical lymph nodes or skin lesions. The symptoms of infected animals are basically the same as for humans, thus, common cold-like symptoms or suppuration on the skin are reported.

Diagnosis: In humans, differentiating a diagnosis with diphtheria is important owing to show similar symptoms to diphtheria. Culture tests and PCR are performed in specialized organizations. In pets, the National Institute of Infectious Diseases can identify C. ulcerans if Corynebacterium sp. are isolated from materials of dogs or cats in laboratory testing service. An application form and the address to send the strain are available from the website of the health ministry.

Treatment and Prevention: Antibiotics are effective. Cases of recovery cases by using macrolide antibiotic in humans were reported domestically. Diphtheria toxoid vaccine is also useful for this disease because diphtheria has the same toxoid as C. ulcerans regardless of the different stain. In infected animals, macrolide antibiotic use is also considered to be effective.

The Infectious Diseases Control Law: Human diphtheria-like disease caused by C. ulcerans do not apply this law.

How to Treat Infected Animals
By Veterinarians: Considering the spread of the infection, it is recommended to isolate and hospitalize infected animals. While treating infected animals, veterinarians need to wear gloves and masks to prevent transfer of the infection to humans and other animals. Gloves used for treatment should be disposed as infectious waste. Hospitalized pets should be given macrolide antibiotics such as erythromycin or clarithromycin. Pets treated by these antibiotics would have no possibility to cause infection unless this bacterium is isolated on re-examination.
By owners: This infectious disease is zoonosis which can be transmitted from infected dogs, cats and the other animals to humans. If pets show a cold-like symptoms such as coughing, sneezing and runny nose, dermatitis and ulcers of skin or mucous membrane, early medical examination is recommended. Furthermore, excessive contact with such pets should be avoided, and washing hands is recommended after touching them.

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Treatment of Canine Filariasis with Tetracycline Mon, 19 Mar 2018 02:15:24 +0000 A. Fleming, a bacteriologist in Scotland, accidentally discovered the world’s first antibiotic substance penicillin in 1928. It became clear that penicillin was useful as a treatment for bacterial infections, and after that, as you know, various antibiotics were developed and frequently utilized as essential treatment for bacterial infections. Let me introduce a case in which an antibiotic can be used for treatment of a parasitic disease.

Canine filariasis, a serious parasitic disease for dogs, is caused by a blood-feeding mosquito parasite (Dirofilaria immitis) which enter a dog’s pulmonary artery and heart, causing chronic cardiovascular and respiratory problems. The mosquitoes mainly live in southern Honshu where they cause problems for dogs and their owners. Treatment was either killing parasites by a poisonous arsenic compound or surgical removal of parasites, both of which cause a big burden on dogs and their owners. Later, the discovery of ivermectin which is a macrolide antibiotic by the Novel Prize winner Satoshi Omura, made the establishment of prevention method for this disease possible. However, if we look overseas, this disease and zoonosis are still serious parasitic diseases. Apart from ivermectin, now let me explain the application of tetracycline for treatment of canine filariasis.

Tetracycline, which is an antibiotic produced by microorganisms, has effect for treatment by inhibiting growth of microorganisms such as bacteria, rickettsiae, and chlamidia. Doxycycline and minocycline in addition to tetracycline are also known are in the same group of antibiotics. Then, why is tetracycline effective for canine filariasis? The answer is related to the symbiotic relationship between a parasite and a bacterium.

It is known that Wolbachia pipientis, which is rickettsiae, frequently live symbiotically with canine filarial nematodes. Wolbachia has the ability of changing the host’s reproductive system in favor of itself, for example, Wolbachia kills male symbiotic arthropods whereas females survive and contribute to the reproduction. To change the reproductive system of filarial nematodes to parthenogesis, a male is not necessary for reproductive, and Wolbachia gives oneself an advantage. If Wolbachia are eliminated from filarial nematodes, they could not survive or reproduce. Thus, the elimination of Wolbacia expels filarial nematodes. Therefore, the use of tetracycline which is essential for rickettsiae is available for the elimination of Wolbachia.

It has been gradually clarified that antibiotics which have been frequently used against bacterial infections are also available for treatment or prevention of parasite diseases. Considering that antibiotics are also utilized for treatment of cancer as an antineoplastic drug, I consider antibiotics to be one of the greatest discoveries of the 20th century.

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Contradiction Of Result By Drug Susceptibility Test Tue, 09 Jan 2018 07:21:31 +0000 When veterinarians see animals with infectious diseases, they perform various bacteriological examinations to diagnose the disease, while they often rely on clinical testing companies, sometimes they examine the diseases by themselves. After separating and identifying bacteria, a drug susceptibility test is performed, and antibiotics which have both high transfer activity and effect are selected and administered for animals. However, sometimes antibiotics judged “susceptible” show ineffectiveness clinically, on the contrary, sometimes antibiotics judged “resistant” show effectiveness clinically. That is when veterinarians have the opportunity to show their skills, depending on their knowledge and clinical experience of antibiotics. Now, let me tell a story of a drug which didn’t have antimicrobial activity but was available clinically.

Atrophic rhinitis; AR is bacterial infection in pigs, characterized by atrophy of the turbinate bones of growing pigs caused by toxins produced by the bacteria. AR rarely leads to death yet prevents growth by insufficient breathing and leads to large economic losses. One bacteria implicated as a major cause is Bordetella bronchiseptica. This bacterium has a capsule with a polysaccharide layer outside the cell envelope of the bacteria. The type of B. bronchiseptica which possesses a capsule is called phase Ⅰ organism, while phase Ⅲ organism lacks a capsule and phase Ⅱ organism is an intermediate type. Bacteria with a capsule have the ability to proliferate after the adhesion to turbinate bones and to prevent the formation of bones by the production of toxins. Therefore, a phase Ⅰ organism is a strongly toxic strain, while a phase Ⅲ organism doesn’t cause atrophy due to the lack of adhesive activity.

Sulfamonomethoxine (SMMX) is sulfa drug for treatment of AR, however, most strains of B. bronchiseptica isolated from AR show resistance for SMMX in a drug susceptibility test. Therefore, SMMX cannot be selected for treatment regarded as the lack of antimicrobial activity, whereas SMMX has been sold as an AR treatment drug even now. Then, Dr. K, a researcher in a manufacturing and selling company, stood up to investigate, and finally clarified that SMMX leads phase Ⅰorganisms to become phase Ⅲ organisms. Thus, a drug susceptibility test is the most useful test for the selection of antibiotics, whereas it may not reflect the clinical effect. After that, Dr. K clarified which part of the sulfa drug structure induces the mutation, and then explained it in a paper. This research was performed by a researcher who just belongs to the manufacturing and selling company of SMMX where there might be limitations on research. I want to express my respect for his great result. In later years, he received the president’s award.

Kuwano A: Inhibitory effect of sulfamonomethoxine on capsule formation of Bordetella bronchiseptica. Zentrabl Veterinarmed B., 1991 Nov, 38(9)685-688.

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How Are Antimicrobial Resistant Bacteria Examined? Tue, 09 Jan 2018 07:14:55 +0000 We often hear the word of antimicrobial resistant bacteria from the media, however, most people don’t seem to understand the correct meaning and definition of this term. The World Health Organization (WHO) defines antimicrobial resistance as “the ability of microbes to resist the effects of drugs”. Thus, it is a phenomenon in which antibiotics lose their effectiveness for treating infectious diseases. The WHO also explains that antimicrobial resistance occurs naturally, but is facilitated by the inappropriate use of medicines. As I have mentioned before, bacteria have a survival instinct like humans, and have the ability to survive against antibiotics like invaders.

Then, how can we determine the antibiotic concentration for treatment? It is performed by an examination called antibiotic susceptibility testing in vitro. Disc diffusion antibiotic sensitivity testing is usually done. In this test, wafers containing antibiotics are placed on an agar plate where bacteria have been placed, and the plate is left to incubate. We judge whether bacteria are resistant or sensitive for antibiotics by the size of area around the wafer where the bacteria have not grown enough to be visible. Bacteria showing resistance to the antibiotics will create small or no zone, while a sensitive bacteria creates a larger zone. This test can be performed inexpensively and easily, however, there are few discs of veterinary antibiotics, and the criterion for the bacteria being resistant or sensitive is not clear. Clinical veterinarians need much knowledge and experience in order to use this testing to select the best antibiotics suited to the condition. Owners can never judge for themselves.

The dilution method, using liquid or agar medium mixed with antibiotics diluted each concentration to inoculate and incubate, is a more precise method to determine the minimum inhibitory concentration (MIC) which is the lowest concentration of antibiotics to prevent bacterial growth. Even if we determine the MIC of bacteria, we can’t evaluate whether it is resistant or sensitive.  The result is evaluated according to the breakpoints published by public institutions in U.S. and others. If the MIC is greater than this value, the bacteria is regarded as resistant. Public breakpoints for animals are not established yet although they should be determined through medical practice.

It is remarkable that bacteria which have already been judged as resistant have their growth prevented by increasing the concentration of antibiotics. Thus, the resistance is viewed as a relative concept rather than an absolute concept. However, we need to control the increase of concentration of antibiotics, because it can unexpectedly cause side effects. That is why we are required to strictly observe dosage and administration backed by data, considering the problems of residual drugs for food animals.

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Can Gargling Prevent A Cold? Tue, 09 Jan 2018 07:10:51 +0000 A cold is known to be caused by virus, bacteria, chlamydia, and mycoplasma, and the majority of colds in adults are caused by viruses. An especially important cold is the flu caused by the influenza virus. When colds are going around in the winter, the media, such as TV and newspapers, recommend people to not only refrain from going to crowded places, but also to gargle and wash hands after returning home. We would like to introduce a paper about the effect of gargling this time.

While gargling is commonly accepted as a means of cold prevention, its effectiveness is not adequately verified. It is known that commercial gargle products have been proven to kill viruses that cause a cold in laboratory experiments. However, their effectiveness in cold prevention is a different matter. To establish the effectiveness of gargling, Kyoto University Health Service conducted an experiment with 387 participants who were randomly assigned to water-gargling, povidone-iodine gargling, and usual care (control), two months. The results were, 17.0 of 100 participants in the water-gargling group, 23.6 of 100 in the povidone-iodine gargling group became infected with a cold during a month, compared with 26.4 of 100 participants in the control group.

This study suggests that the water-gargling group had the greatest cold prevention effect while the povidone-iodine gargling group showed less preventative effect. Thus, water-gargling seems to effectively wash away the viruses that cause a cold, compared with povidone-iodine gargling which may demolish normal flora in the pharynx and injure pharyngeal tissue. Recently I heard that Aomori Prefecture recommends not gargling when returning home for cold prevention.

After reading this paper, I once again checked the instructions in the gargle medicine package.  It stated that the product is effective for “prevention of infection by injuries of the oral cavity, a sterilization of oral cavity”, not “effect of preventing a cold”.  Thus, manufacturing and selling companies have not indicated ‘effect of preventing a cold’ from the beginning. However, given both the actual usage of gargle medicine for cold prevention, and the gargling research as mentioned above, the effect of gargle containing bactericidal disinfectant composition needs to be examined through scientific clinical studies by manufacturing and selling companies.

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January 06, 2015

Let’s talk about the usability of broken systems for a moment. Have you ever truly spent the time to observe your own habits and understand what potentially broken systems you or others are working around every day? First of all, we must recognize that humans are adept at self correcting and circumventing broken systems, often subconsciously.

Usability is the discipline of methodically reviewing a design or system, observing users and reviewing real user data, and taking the sum of those internal and external efforts and constantly iterating on the user experience to make it better based on those findings. I’d challenge anyone in the web usability community to also pay close attention to accessibility and performance, if they aren’t already doing so.

Broken systems are experienced constantly: the elevator doesn’t work, the car doesn’t start, the button doesn’t click, the web application crashes and loses the user input, the door sticks and you have to lift the handle to open it, the drain pipe doesn’t flow fast enough to move water, or the door has a handle instead of a push plate but pushes open.

Door with both push and pull signsThe door with a confusing user interface is a common trope in the context of this discussion. This is an occurrence where someone will pull a handle when presented with one, when perhaps the door needs to be pushed open instead. It’s a frustrating experience and the frequent addition of signage indicating a handle should be “pushed” is a bandage on an already broken system. Interestingly, no matter how many of these door handles someone encounters, people very often instinctively pull instead of push — even with signage indicating the opposite action is necessary.

Building upon the door push versus pull example, if any one of these simple or complex systems was corrected or improved, you as the user may save invaluable time if not simply be amazed by the change you experience. However, interestingly, humans excel so much at working around broken systems that they often won’t realize they are self correcting.

Additionally, there is certainly a range of acceptable yet functionally broken systems. For example, a stopped clock gives the correct time twice a day but requires a higher degree of adaptability while an escalator that has stopped working is still a functional staircase. So, what does usability of software and the general subject of broken systems have to do with one another?

In the ecosystem of the Internet, we encounter micro- and macrocosms of excellent usability and broken systems regularly. Not long after the Internet was invented, email, Internet Relay Chat (IRC), and web pages were created. IRC is one of those mediums that is still alive and well, however it’s quite old, and yet many people in the world have no idea that it exists. IRC is a medium that built the foundation for nearly real-time chat we take for granted today in Facebook, Google+, other instant messenger services, SMS, etc.

Look at a product like Facebook; ubiquitous now with nearly 1.5 billion users. That service is an amalgamation of many of the basic features available in those early systems. It was initially new and inventive, even though it was an improvement over earlier offerings such as Friendster, MySpace, and Orkut. Over time it’s remained relevant because of iterative usability measurements, feedback, and improvements of broken systems.

User behaviors are analyzed in realtime by many modern websites, and Facebook is a great example of real user monitoring of features as they are rolled out and tested in a production setting. If any of these systems are broken, either due to misconfiguration or software bugs, or just because the feature isn’t well received or is a bad user experience, the measurements tell the tale and corrective action can be taken.

Etsy is another great example of a team using this approach as they are known to release 50-60 small iterations of their software to production in a day and utilize feature flags around their software to toggle the availability of that feature to the public. This approach is tremendous for collecting data assuming you’ve set up your application appropriately to do so.

We follow many of these processes at Cox Media Group, but we’re always improving, too. My advice: get a handle on your front end instrumentation and testing strategy early and stick with it. Establish a performance budget with your business partners and other crucial team members, monitor and measure, and react when you start to slip. Reinforce your best practices through automation and code reviews, linters, and git hooks; reject any code that doesn’t pass the bar and help your fellow team members improve their discipline. Prototype new apps or user experiences quickly using tools such as yeoman, bower, and grunt/gulp. Sit in on user studies and really gain an appreciation for objective observation of the users of the things you build. Small development iterations provide clarity, while metrics and user feedback inform your next move.

As a frequent user of various Internet services and applications, mobile devices and computers, TVs and coffee pots, doors and escalators, take the time to occasionally outwardly observe yourself or your space, your home or work habits, your commute, whatever. What do you see that might be broken? What about the products and services you use? Are you working around bothersome or cumbersome systems just to complete simple tasks?

Usability is a discipline that always strives to observe and collect data and focus on improving the ease of use of something. We live in a golden age of information, automation, and smart devices. The most crucial piece of these systems is you, the user. Without the user, these systems become broken themselves. Do yourself a favor and break the systems that aren’t necessarily broken, correct your own behavior and subconscious work arounds, and focus on improving that next iteration. Be the empowered user and don’t just self correct but fix the broken parts of the system in your experience.

The state of web performance and Internet advertising

Take me home, country roads

Published on May 31, 2015

10,944 sunrises and sunsets

Published on March 26, 2015


addLinks to top.links in Magento

We’re always creating custom magento implementations for our clients and that typically starts with a local.xml file. One of our more common tasks revolves around adding and/or removing links from the “top.links” portion of the header.

Below you can see an example of a best practice when it comes to adding a new link to the top.links within Magento. The snippet does utilize some lesser known child nodes

The trick here is that the “urlParams” node in our XML below is referencing a helper class to build out the link that will eventually show up in top.links instead of hardcoding a “/” at the beginning of our “url” node.

<layout version="0.1.0">
        <reference name="top.links">
		        <label>Free Shipping & Returns</label>
		        <title>Free Shipping And Returns</title>
		        <urlParams helper="core/url/getHomeUrl"/>

Since switching over to the structure above it’s helped our team alleviate QA issues that previously came up when migrating from one server to another and one server possibly used a different base path that included a subfolder.

Example URL

Aaron Ware

| @aaronware


Home repossessions in north three times national average

For sale signHome repossessions in some northern towns are running at more than three times the national average amid a regional gulf in fortunes.

Chester has the highest number of repossessed homes in England and Wales, with 53 in 10,000 houses taken over by banks, compared with the national average of 15 in 10,000, according to research by e.surv chartered surveyors.
In the second half of last year, the worst-affected areas were the North East, parts of Yorkshire and towns in the M62 corridor.

In Darlington and Durham, the number of repossessions was 60% higher than the national average, with industrial Lancashire and Yorkshire towns such as Bradford and Doncaster also high on the list.

In contrast, Oxfordshire saw only 12 homes in 10,000 repossessed, 20% below the national average, and numbers were also low in the Cotswolds, the West Midlands, the West Country, and the southern coast of England.

Weak economic growth and austerity are blamed for the regional divide, with people in the north being more affected by Government cuts due to dependency on public sector employment, and a larger proportion of southerners working in the private sector.

Richard Sexton, business development director of e.surv, said: "Spending cuts, negative wage growth, falling house prices and public sector unemployment have hit the north much harder than the south. This has opened up a gaping geographical divide in repossession levels."

Clusters of affluent retired people have helped some areas in the north buck the trend, with only one home in 10,000 repossessed in Galashiels. Harrogate in North Yorkshire - another area with affluent pensioners - had only 11 repossessions per 10,000 households, a low number despite being surrounded by more deprived postcodes.

Parts of the south, including boroughs in east London, Essex, Kent, and South Wales, compared poorly to the wider region due to high unemployment. Home repossessions in Romford and Dagenham were 87% higher than the national average, closely followed by Medway at 60%.

Mr Sexton added: "Repossession levels can vary wildly within a confined geographical space thanks to local disparities in affluence and employment rates. However, with the north more exposed to the grind of public sector austerity and a downturn in the economy, the north-south divide could become even starker over the coming months."
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Charge Mammography Technician

A not for profit Connecticut hospital is in need of an experienced Mammography Technician to join their Radiology department.  The hospital is located in a historic area in Connecticut that has continued to change and grow with the new generations of residents.

The Charge Mammography Technician will join a 300+bed hospital with advanced healthcare services such as Behavioral Health, Cancer Care, Emergency Services, Surgical Services and Women’s Health.  The hospital system is proud to provide the best medical services in a cost-effective manor for the community.  The hospitals Comprehensive Imaging Center offers a full spectrum of clinical services, the most advanced medical diagnostic imaging and treatment technology and a team of highly trained specialized medical professionals.

The Charge Mammography Technician will have hands on responsibilities including performing routine Mammography procedures and service and process improvement efforts.   Under the supervision of the Radiology Manager the Charge Mammography Technician will maintain appropriate staffing, coordinate daily activities, develop and implement department objectives, solve equipment issues and maintain required records.  As Charge Mammography Technician, he/she will aid in the planning, direction, coordination and control of all Mammography activities.

The hospital is located in a family friendly area of Connecticut that is known for its outdoor recreation, festivals and events, and great dining options. Residents have easy access to city life and beach towns.

The Charge Mammography Technician would be offered a great benefits package that includes a competitive salary, medical benefits, retirement benefits, paid time off and free parking. This is a great opportunity for a Mammography Technologist to take the next step in their career.


Science of Storytelling

Laura Knudson & Jenny Ersbak | December 2016

Storytelling is an age-old form of communication that is part of every country and culture. It is an essential tool to connect with audiences in a meaningful way, because people remember stories and experiences better than facts. Research shows that storytelling engages more areas of the brain than processing facts, allowing people to connect on a deeper level by turning the story into their own ideas or experiences.

The brain releases dopamine when experiencing an emotionally-charged event, which helps trigger greater memory and accuracy. MRI neuro-imagery shows that consumers primarily use emotions, not information, when assessing brands, and that the emotion of “likeability” is the measure most predictive of whether an advertisement will increase a brand’s sales. While it is clear that storytelling shows great potential as an impactful tool for the travel industry, the key is knowing how to integrate storytelling successfully into a brand’s content marketing strategy.

Integrate Storytelling into a Marketing Campaign

Today, travel brands are using storytelling to drive business and build a community of travellers hungry for unique experiences. However, with limitless potential story angles at our fingertips, how can you single out a signature story that best embodies your brand? The answer lies in differentiation. The primary role of differentiation is to construct a clear “lack of confusion with other destinations or products”. It is essential to consider key factors that set your destination apart from others. Also, identify environmental and cultural aspects that travellers might not know about that could influence their travel decisions.

In order to identify your best stories, start by assessing your destination’s key assets including the people, adventure products, cultural traditions, environment and food. Attach a human narrative to each of these experiences by profiling a main character, someone the audience can immediately relate to and develop a shared connection with.

With the rise of the internet as a major source for trip planning, it has become even more competitive for destinations to stick out as being ‘must see’ places to visit. So, it is essential to highlight what makes your destination unique and what makes your tourism offerings distinctive.

Looking for more articles like this?

Michael Morgan, Peter Lugosi, and JR Brent Ritchie, eds. The tourism and leisure experience: Consumer and managerial perspectives. Vol. 44. Channel View Publications, 2010.

B. Ritchie. “The Branding of Tourism Destinations, Past Achievements & Future Challenges” Annual Congress of the International Association of Scientific Experts in Tourism, Morocco (1998)


Kitchen Confidential: Sebastian Maillard, Le Lafayette

Sebastian Maillard - Le Lafayette - Naples French RestaurantAs a fifth-generation chef, Sebastian Maillard says cooking might as well be in his genes.  He grew up watching his parents, grandmother and great-grandfather work their magic in the kitchen, which is reflected in his culinary creations as chef and owner of Le Lafayette in Naples.
   Having lived in Cannes, France, and Martinique before arriving in Naples in 2001, Maillard says his dishes encompass flavors from all of France. “I am classic traditional, not a regional person,” he says, likening his cuisine to that of Lyon, “the capital of the world for food.”
   In this interview, Maillard shares his influences, plus where his sweeter side comes from.

When did you know you wanted to be a chef?

I am a fifth generation chef. I was born in November 1971, and not my first but second New Year’s Eve, I spent all night in a big [play] pen with a friend. That was also the day I learned to walk and went into the glass room [at my father’s restaurant] and started to drink some Champagne leftover from the customers. From then, I stayed on this side of the kitchen [laughs].

Where did you learn to cook?

I learned from my mom, my grandma and my great grandpa. When you have this past, you have no choice; it’s in your blood.

   I remember a long time ago I was with my mom and my grandma, and they would always tell me, “when you do something, first you need to do it for your customer. When you have a recipe on your menu, be very open and do not get stuck in one region.”

   When I cook with my mom, we always fight because she says “Sebastian, you need to be more concerned then that,” and I always say “ok, I try, I try.” She is always checking what I do. It has helped me be more constant.

So your mom is still helping shape you as a chef?

My mom is in France all summer, cooking every day, creating new recipes for her friends. She will make this [recipe] three or four times, different every time, and they will critique them. From that she makes a recipe. When I go to France during the summer, we will try the recipe. I might change it a little bit my way or keep it her way, and that is the way we work.

   We are always creating, doing research. And after that, we bring the recipe here. This is the way we work. We are always creating new stuff but still traditional.

Le Lafayette - Sebastian Maillard

What is one ingredient you must have?

Aged goat cheese; I love to work with this. It can be with fish, it can be with meat. Fresh goat cheese is nice but too plain for me. I like when it has a lot of flavor and aroma.

Do you have a favorite childhood dish?

Oh yes, my favorite thing from my childhood is riz au lait, rice with milk—it’s a dessert. I remember my dad would make it when we were kids every Sunday afternoon. We had a farm next to the restaurant so the milk was straight from the farm. It was amazing.

What is one rule you live by in the kitchen?

When I create a recipe, the simpler, the better. When you eat fish, the first thing you should taste is the fish. When you eat meat, you should taste the meat. The rest is important, but the most important is the quality of the fish and the meat.

How did Martinique influence your food?

I modified my cuisine and introduced a sweeter side when I was on the island. For example, I now put passion fruit on ribeye—the acidity and sweetness of the fruit is very nice.


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Kangaroo makes unexpected arrival at Australian airport

Australian police had to lock down part of Melbourne Airport Wednesday after a kangaroo bounced into the terminal and surprised passengers shopping in a pharmacy.

“Cyrus, as he has been aptly named after one of the helpers on the scene, will be assessed by a vet following his ordeal,” Wildlife Victoria said.

Australian comedian Julia Morris broke the news on Twitter, where photographs began circulating of the marsupial in the skincare aisle of the terminal’s pharmacy.

“Ok, so I’m at Melbourne airport & a KANGAROO has just jumped into the chemist,” she tweeted, with the hashtags #notajoke, #soundslikeajoke, #mustneedaprescriptionfilled.

Australia’s national airline, Qantas, features one of the animals on its livery and is known as the “Flying Kangaroo”, prompting jokes on social media sites.

Police locked down the chemist while rescuers were called, and Wildlife Victoria said its emergency response team sped to the terminal where “the kangaroo was tranquilised and captured safely”.

In January one of the creatures led police on a chase through the airport’s multi-storey carpark before it could be sedated and caught, following a similar incident in October 2012.

Source Yahoo News: http://uk.news.yahoo.com/kangaroo-checks-australian-airport-030937135.html?vp=1


Gangsta.Renegade 360 чел. 3:42
Осталось: 3:42
Gangsta. Renegade

Карточка исполнителя

Maria japanese, j-pop, female vocalists, pop, J-rock
MARIA (japanese girlband) Members Maiko (???) - Bass, vocals Aika (??) - Bass, vocals Ayuka (???) - Guitar, chorus Reina (???) - Keyboards, violin TATTSU - Drums, chorus SACCHIN - Guitar, leader MARIA was a six-piece girl band headlined by Maiko, formerly of ZONE. Its lineup emphasized pairs: two bassists, two guitarists, and two vocalists. Maiko and Aika served double duty as bassist/vocalists. SACCHIN, the oldest, was the leader. The band was signed to Sony Records and managed by RunTime. In 2010, it was announced that MARIA would break up. The reason behind the dissolution was health problems of drummer, TATTSU. She was diagnosed with thoracic outlet syndrome after one of her arms experienced numbness. Consequently, her doctor advised her to stop straining her arms, leading to various discussions between the band and staff. Although it had been suggested that TATTSU be replaced by another drummer, they turned down the idea and decided to disband after their contract expires in April. Their last concert took place at Akasaka BLITZ on April 3, 2010.
Источник: last.fm


House Appropriations Committee Blocks Cannabis Banking Amendment

The House Appropriations Committee took up and defeated language known as the Safe Banking Amendment offered by Congressman Dave Joyce (R-OH) on Wednesday, June 13th.

If adopted, regulators would not be authorized to use federal funds to threaten sanctions against banks working with marijuana-related businesses and entrepreneurs.

The defeat of the Safe Banking Amendment was not a vote about marijuana, but rather it was about normalizing a nascent industry that serves hundreds-of-thousands of customers in the majority of US states where cannabis is currently regulated. Once these companies have an easier time conducting their day-to-day operations, then they should be willing to offer more consumer-friendly prices instead of inflating them at the point of sale to cover backend costs associated with operating as an all-cash business.

Currently, hundreds of state-legal, licensed, and regulated businesses do not have access to the banking industry and are unable to accept credit cards, deposit revenues, or write checks to meet payroll or pay taxes. This situation is untenable. No industry can operate safely, transparently, or effectively without access to banks or other financial institutions. Congress must move to change federal policy so that these growing number of state-compliant businesses, and their consumers, may operate in a manner that is similar to other legal commercial entities.

As an appropriations amendment, this funding restriction would have only been in place for one year.

There is pending bicameral legislation introduced by Representative Perlmutter (D-CO) and Senator Jeff Merkley that the banking amendment was based, known similarly as the SAFE Banking Act. You can click here to send a message to your lawmakers in support of that legislation.


Cooking With Mezcal in Oaxaca: Casa De Los Sabores Class and Recipe

They came to learn how to cook with mezcal. They came from England, Poland, Australia, United States, and even Oaxaca’s Mixteca Alta. This was a mezcal cooking class as internationally attended as one could imagine. But of course; over the past few years Chef Pilar Cabrera Arroyo has garnered a global reputation as one of Mexico’s top cooks, specializing in preparing Oaxacan regional cuisine for both her Restaurante La Olla and her Casa de los Sabores Cooking School.

I attended the class in May, 2015, yet another mezcal event in my adopted hometown, the city of Oaxaca, located in south central Mexico. Others have included cocktail and mixology sessions; evenings of combining the iconic Mexican agave based spirit with chocolate and with craft beer; mezcal tastings of umpteen brands of both the intoxicant as certified for export, and produced for local consumption (often referred to on drink menus as “agave distillate”); federal government sponsored education programs; formal lectures and informational meetings regarding the status of the industry; and of course cooking classes. In my line of work I have to keep abreast. But more importantly I enjoy learning, despite having been around mezcal for a quarter century. The industry is changing rapidly these days.

One of the more recent phenomena, at least in Oaxaca, has been teaching to cook with mezcal. And so it was natural for Chef Pilar to put cooking with mezcal in her six week class rotation. She’d been using the spirit in recipes for years; in her classes, at her restaurant, and when demonstrating and promoting Oaxacan cookery outside of Mexico at American and Canadian cooking schools and restaurants.

But ask Chef Pilar if traditional Oaxacan cooks use mezcal as an ingredient in their dishes, and the answer is a resounding NO. But she’s not a traditional cook by any means, notwithstanding that she learned her trade from her maternal grandmother. Chef Pilar comes to the industry through her university degree program in food sciences and nutrition. Since she keeps up with modern trends in gastronomy, for her mezcal is an ingredient just as other spirits are for the great chefs of the western world.

This particular class began as Chef Pilar’s invariably do, with a brief summary of what will be prepared in class and the ingredients to be purchased at a local marketplace. Where perhaps others are not prepared to adlib, Chef Pilar notes that there could be an extra recipe and dish thrown into the mix, depending on availability of seasonal produce. “Rainy season is just beginning, so we might find some fresh wild mushrooms brought down from the sierra early this morning, and I can then decide what to do with them,” she advises. She then asks if there are any vegetarians in the group, and if anyone has a food allergy.

The market visit also proceeded as predicted, with Chef Pilar buying ingredients while pointing out and explaining about particular chiles, some tropical fruits, gusanos and chapulines, tejate, masa, and more. On this day we also attended a fresh fish market for shrimp and red snapper, the latter being a key ingredient for ceviche al mezcal, a last minute addition to the class menu.

Good chefs are always ready to adapt, and to learn. Pilar is no exception, and where she stands out from some others who instruct, is to not hide from her students the fact that she’s always anxious to learn and doesn’t know it all. Case in point, our special guest attendee was a traditional cook from the Mixteca Alta district of Oaxaca. She had brought down from her region some unique ingredients for teaching how to make a particular salsa, a second supplement to the fixed five course menu. Chef Pilar asked questions with a view to learning about the chiles and nuts being used and how to incorporate them into the salsa recipe – just as the rest of us did.

Not all recipes are suitable for mezcal as an inclusion, especially some moles; and so neither our chicken amarillo nor the memelitas were made with the spirit. Some dishes you just don’t toy with. And each dish calls for a different mezcal. It’s the same as with mixing cocktails, though some barmen would disagree and state that a cocktail should be made with any old inexpensive mezcal. I suggest they have not taken Mixology 101.

Four of our seven dishes were made with mezcal: ceviche, pay (pie) de requesón (similar to ricotta) with chocolate sauce, shrimp brochetas with mango sauce, and chile pasilla Oaxaqueña salsa with gusanitos (not surprisingly made with mezcal de gusano). Although most dishes incorporated espadín, each particular bottle must be carefully selected since the agave varietal is capable of producing so many different nuances. I was asked to choose the appropriate ones based on what Chef Pilar indicated she needed to impart through the mezcal.

It was a hands on class, with each student entrusted with the preparation of each dish. And when all was said and done, before sitting down to our exquisitely prepared comida, naturally there was a mezcal tasting session.

I encourage readers to plan dates for their visit to Oaxaca based on Chef Pilar’s mezcal cooking class schedule, although private individual and group classes centering upon the spirit can be arranged for other dates by contacting her with sufficient advance notice.

If the foregoing hasn’t been convincing enough to illustrate the value in a mezcal cooking class, then perhaps this recipe will, reproduced with permission from the class I attended:

6 servings

4 ounces Oaxacan chocolate
12 tablespoons unsalted butter, divided (see preparation below)
1 piece Mexican cinnamon
1 tablespoon (or perhaps a little more) mezcal espadín
1 package (about 42) María cookies
1 ½ cups fresh requesón (sub ricotta) cheese
4 eggs
¾ cup evaporated milk
½ cup sweetened condensed milk
Zest of 1 lime

1. For the chocolate sauce, in a small saucepan over medium heat, heat the chocolate, 4 tablespoons butter, cinnamon and ½ cup water, stirring constantly until the chocolate melts. Cook, stirring occasionally until thickened, about 5 minutes. Stir in the mezcal. Set aside to cool to room temperature.
2. Put rack in the center of the oven, and preheat to 375 degrees.
3. Melt the remaining butter. Put the cookies in a blender. Pulse until crumbs form. Add the melted butter. Pulse until the crumbs begin to clump together. Transfer to a 12 X 8 inch baking pan. With your fingers, evenly press the crumbs to form a crust. Set aside.
4. In a blender, blend the requesón, eggs, evaporated milk, condensed milk and lime zest, until smooth. Pour into the prepared crust.
5. Bake until the cheese filling is just set, about 30 minutes. Set aside to cool to room temperature.
6. To serve, cut the pie into 6 pieces. Place each piece on a dessert plate. Drizzle chocolate sauce over each serving.

Cook Like a Chef, Present Like a Chef

While reading books of renowned recipes, do you wonder how they actually do it. Do you aspire to cook like a chef? Well, with some tricks you will be cooking like a chef. Many of us, attempt to cook food recipes shown on TV programs or from magazines. However, the point of interest is that how can you succeed in cooking like your favorite chef. Actually, many times, we miss out small things, and these things are often the secrets a Chef will know that we won’t.

While listening to a chef, you must know what exactly they mean by de-glaze the pan, jellied chicken stock, adjust the seasoning, reduce it to a syrup, marinating etc. Several really good home cooks may find problems when following chef’s recipes. However, most of the times, these are really simplified versions of intricate restaurant chef dishes.

If you love to watch cooking shows on TV, the first and most essential thing that you perhaps notice is, how simple the experts make everything appear. There are many ways to enhance and improve your cooking techniques. This can surely aid you in preparing the meal faster and in a finer way.

Even if it is tempting to just toss something in the oven for your lunch or dinner, it is worth learning techniques that will make your dish tastier. First of all, do bear in mind that a recipe you choose does not need to be intricate. If you intend to produce a delicious result, even a simple recipe can make you create miracles. It is possible to make the simplest meals even better by using the secrets of restaurant chefs.

Cooking is an art. Like any other art, your culinary skills will improve with experimentation and practice. Becoming a chef is not easy, but with patience and persistence it will become easy. If you intend to cook like a chef, you must identify how recipes work. Professionals read more in their recipes than just measurements, time, cooking method and other specifications, this is what matters a lot in your recipe. This is usually the difference between a professional Chef and a domestic cook.

Following are some tips that will help you to learn how to cook like a chef?

• Season a dish. This will make you to bring out the natural spices and flavors.
• Confine and strengthen aromas and flavors
• Bring pans to the precise heat.
• Caramelize and serve desserts with a blowtorch
• Garnish your dish and present it hot/ cold (as required) perfectly.

What you need to do is find some good recipes. Be precise at ingredients, measurements and timings. Follow the steps properly and serve your dish in a tempting and fascinating way. All these tips can help you serve delicious and appealing dishes.

So what are you waiting for? Put your apron on, get in the kitchen and get ready to present a scrumptious and lip smacking dish, just like a chef!

Cooking Restaurant Meals at Home With Copycat Recipes

There is something about cooking at home that is so much more satisfying than eating out all the time. Not only can you save a lot of money by cooking at home, it is also genuinely gratifying when there is great appreciation from friends and family eating your specially prepared meals.
Restaurant recipes are usually closely guarded secrets that are never revealled to the public. One obvious reason is that they don’t want to lose business. There is a new trend sweeping cooking circles and that is restaurant copycat recipes. There are some sites on the web that specialize in selling copycat restaurant recipes and many are very good. The secret to copycat recipes is careful research. There are Ebooks available that contain hundreds of copycat restaurant recipes from some of America’s most popular restaurant chains including Applebee’s, Chili’s, McDonalds, KFC, Boston Market, Hard Rock Café, Joe’s Crab Shack, Red Lobster, Olive Garden, The Soup Nazi, Outback Steakhouse and many many more.

While the restaurants themselves don’t really want you to know their secrets, you know the old saying ” imitation is the sincerest form of flattery”.

So if these recipes are jealously guarded secrets by the restaurants, how can you buy them in ebooks? Easy, because interested chefs and cooks from hundreds of backgrounds spend years reverse engineering the original recipes. What they come up with are copycat restaurant recipes which are true to the originals.These contibuting chefs recipes are compiled into ebooks that are available online such as America’s Most Wanted Recipes book. It is hard to find many of the best copycat recipes for free,mainly because when someone finds out the secrets to a great recipe, they are not eager to share it lightly. The bright side though is that you can spend under $20 online and get incredibly large collections of restaurant copycat recipes and have them instantly downloadable so you can get cooking right away.

You don’t need to be a master chef or have years of experiece to cook your favourite restaurant meals at home. When you get a good restaurant copycat recipe you can be sure you will impress anyone you cook for. Just find out their favourite dishes from their favourite restaurant..go to your copycat recipe book and hit them with a surprise feast that will blow their mind, while saving you money at the same time.