EXHIBIT 9.1

     VOTING AND  SHAREHOLDERS  AGREEMENT  dated as of May 21,  1999 by and among
Advanced Medical Sciences, Inc., a Virginia corporation  ("Advanced"),  the sole
shareholder  of  America's  Shopping  Mall,  Inc.,  a  Nevada  corporation  (the
"Company"), Pioneer Ventures Associates Limited Partnership, having an office at
651 Day Hill Road, Windsor,  Connecticut 06095 (the "Pioneer Partnership"),  AND
certain   Shareholders  of  Advanced,   who  are  parties  hereto  (collectively
hereinafter referred to as the "Principal Shareholders").

     WHEREAS,  the Principal  Shareholders have "beneficial  ownership," as that
term is defined  under the  Securities  Exchange  Act of 1934,  as amended  (the
"Exchange Act") of an aggregate of 28,550,000 shares of common stock,  $.001 par
value per share ("Common  Shares") of Advanced as more specifically set forth in
Exhibit A attached hereto;

     WHEREAS,  pursuant to a certain Investment  Agreement dated the date hereof
(the  "Investment  Agreement"),  the Pioneer  Partnership  is  investing  in the
Company  through  the  purchase of  Preferred  Stock and  Warrants  and may make
additional  investments  in the Company  through the exercise of the Warrants in
the future and the  Company is  assuming  Two Million  Dollars  ($2,000,000)  in
principal  amount  of debt  owed  from  Initio,  Inc.  to the  Company  and,  in
connection  therewith is issuing to the Pioneer  Partnership  a debenture in the
principal amount of Two Million Dollars  ($2,000,000) of even date herewith (the
"Debenture"); and

     WHEREAS,  Advanced and the Company are parties to an Agreement  and Plan of
Merger  dated May 21, 1999  pursuant to which  Advanced is to be merged into the
Company (the "Merger");

     WHEREAS,  the  execution  of this  Agreement  by the  parties  hereto  is a
condition precedent to the consummation of the transactions  provided for in the
Investment Agreement.

     NOW,  THEREFORE,  in consideration of the mutual promises contained herein,
the parties hereto agree as follows:

                                   ARTICLE I.

     1.1 Voting by Principal Shareholders; Agreement to Vote.

     Each of Advanced and the Principal Shareholders agrees that, so long as (i)
the Pioneer  Partnership,  its Partners or  affiliates  shall own any  Preferred
Stock,  Warrants or Common  Stock  obtained  either  through  conversion  of the
Preferred  Stock  or  exercise  of the  Warrants,  or (ii)  any  amounts  remain
outstanding under the Debenture  Advanced,  and upon consummation of the Merger,
each of the  Principal  Shareholders  shall  vote  all of their  Common  Shares,
whether now owned or hereafter  acquired,  for the election as a director(s)  of
the Company of the  designee(s) of the Pioneer  Partnership  in accordance  with
paragraph  1.10 of the  Investment  Agreement  at any  meeting of the  Company's
shareholders  at which such designee  shall be nominated as a director.  Without
limiting  the   generality  of  the   foregoing,   Advanced  and  the  Principal
Shareholders agree to execute and deliver any and all documents,  agreements and
instruments, including, without limitation, proxies,



as the Pioneer  Partnership  shall  reasonably  request so that at least one (1)
designee  of the Pioneer  Partnership  shall be a director of the Company at all
times  while any  Preferred  Stock or such  Common  Stock is held by the Pioneer
Partnership or any amounts remain outstanding under the Debenture.

     1.2 Special Meeting Upon Default.

     In the event of a default under,  or a breach of, this Agreement  which (in
the  judgment  of  the  Pioneer  Partnership)   adversely  affects  the  Pioneer
Partnership,  or the Investment Agreement,  or the Certificate of Designation of
Preferred Stock under which the Pioneer  Partnership or its assigns are a holder
of  Preferred  Stock,  or  under  the  Debenture,  Advanced  and  the  Principal
Shareholders agree to call and the Company agrees to pay the expenses associated
with a special  meeting of the  Shareholders at the sole expense of the Company,
and Advanced and the Principal  Shareholders  each agree that they shall vote in
favor of that number of and those nominees to the Board of Directors  designated
by the Pioneer  Partnership  such that the nominees of the Pioneer  Partnership,
taken in the  aggregate,  shall  constitute  a majority of the  directors of the
Company,  after any such defaults,  for so long as the Pioneer Partnership,  its
partners or affiliates  own Preferred  Stock,  Warrants or Common Stock obtained
through the  conversion of Preferred  Stock or the exercise of Warrants or there
remains any amount  outstanding under the Debenture.  Advanced and the Principal
Shareholders  hereby agree to take no action to  contravene,  limit or otherwise
terminate the Pioneer  Partnership  board election  mechanism.  Advanced and the
Principal  Shareholders  agree  to vote in  favor  of such  Pioneer  Partnership
nominees for so long as the Pioneer Partnership,  its partners or affiliates own
Preferred  Stock,  Warrants or Common Stock  obtained  through the conversion of
Preferred  Stock or the  exercise  of  Warrants  or  there  remains  any  amount
outstanding under the Debenture.

     1.3 Preservation of Bylaws.

     The  provisions of Sections 1(a) and 1(b) above are in consonance  with the
amendments  to of the  Bylaws of the  Company  as set forth in the  minutes of a
special  meeting  (Unanimous  Written  Consent) of the Board of Directors of the
Company, attached hereto as Exhibit B, and incorporated herein by this reference
(the "Resolutions"). If the directors or the shareholders of the Company further
amend such Bylaws at any time during which the Pioneer Partnership shall own any
Preferred Stock,  Warrants or Common Stock obtained upon conversion of Preferred
Stock or exercise of Warrants or there remains any amount  outstanding under the
Debenture,  notice  shall  be  given to the  Pioneer  Partnership,  and upon the
written demand  therefor by the Pioneer  Partnership,  Advanced or the Principal
Shareholders  shall promptly call a special meeting of the  Shareholders and the
Company  hereby agrees to pay all expenses in connection  with such meeting,  at
the sole expense of the Company,  and  Advanced and the  Principal  Shareholders
each agree that they shall vote all of their Common Shares, whether now owned or
hereafter  acquired,  for the Bylaws to be restored to or retained,  as the case
may be,  to the form as set forth in the  Resolutions,  in  accordance  with the
Bylaws.

                                        2



                              ARTICLE II. Transfers

     2.1 Transfer of Common Shares to Affiliates.

     During  the  term  of  this  Agreement,  neither  Advanced,  the  Principal
Shareholders  nor any other  person who shall become a party to or bound by this
Agreement shall transfer any Common Shares,  whether now or hereafter  acquired,
other  than (i) to any  person  who  agrees to be bound by and be subject to the
terms and conditions of this Agreement with the same force and effect as if such
person were named as a party to this  Agreement  or as a  Principal  Shareholder
hereunder, provided that the Pioneer Partnership consents to such transfer, such
consent  not to be  unreasonably  withheld,  and (ii)  beginning  May 21,  2000,
pursuant to any sale of  securities  pursuant to a  distribution  to the public,
whether pursuant to a registered public offering,  a Rule 144 sale or otherwise,
provided that the Pioneer Partnership consents to such sale, such consent not to
be unreasonably withheld.

     2.2 Legend on Stock Certificates.

     Advanced and the Principal  Shareholder  shall submit to the Transfer Agent
for the Common  Stock the  certificates  evidencing  the Common  Stock  owned by
Advanced  or the  Principal  Shareholders  at any time  during  the term of this
Agreement  (the  "Restricted  Shares") and the Company  shall cause the Transfer
Agent  to  imprint  upon  such  certificates  (or  replacement  certificates)  a
restrictive legend as follows:

     The shares of stock  represented by this  certificate are subject to all of
the terms of a certain Voting and  Shareholders  Agreement dated May 21, 1999, a
copy of which is on file at the offices of the issuer of this  certificate.  The
shares are subject to certain  voting,  co-sale and transfer  restrictions.  Any
actions taken in contravention to that agreement shall be null and void.

     The  terms  of such  endorsement  and  restrictions  are  hereby  expressly
consented to and accepted.


                         ARTICLE III. Co-Sale Provisions

     3.1 Third-Party Offer and Notice.

     Any voluntary or  involuntary  transfer of the Common Shares by Advanced or
any Principal Shareholder will be subject to a participation right of co-sale by
the Pioneer Partnership or its assigns on a pro rata fully diluted basis. If any
one or more of Advanced or the Principal  Shareholders obtain from a third party
("Third Party  Purchaser") an offer to purchase any amount of his or her Shares,
and Advanced or the Principal Shareholder(s) wish to accept such offer, Advanced
or the  Principal  Shareholder(s)  shall submit a written  notice (the  "Co-Sale
Notice")  to the  Pioneer  Partnership  disclosing  the amount of Common  Shares
proposed to be sold, the offered

                                        3



purchase price, the proposed closing date, and the total number of Common Shares
owned by the Principal Shareholder(s).

     3.2 Co-Sale Right of Participation.

     Upon  receipt  of  a  Co-Sale   Notice  from   Advanced  or  any  Principal
Shareholder,  the Pioneer Partnership or its assigns may elect to participate in
such  transaction and shall have the right to offer its securities,  at the same
price and on the same terms, on a fully diluted pro rata basis with the proposed
selling  shareholder(s)  as set  forth  in the  offer  made by the  Third  Party
Purchaser. Each participating selling party shall in turn be entitled to receive
at the  applicable  closing  the  net  proceeds  of the  sale  allocable  to the
securities sold on behalf of each selling  shareholder,  after deduction of such
selling  shareholder's  proportionate  share of the  reasonable  expenses of the
sale. These co-sale provisions will not apply to any sale of securities pursuant
to a  distribution  to the  public,  whether  pursuant  to a  registered  public
offering,  a Rule 144 sale or  otherwise.  If less  than all of a  shareholder's
securities  are being sold  pursuant to this Article III, the  securities  to be
sold shall be determined on a pro rata fully diluted basis.

     3.3 Notice of Intent to Participate in Co-Sale.

     If the Pioneer  Partnership  wishes to  participate  in any sale under this
Article III, then the Pioneer  Partnership  shall notify Advanced or the selling
Principal  Shareholder(s)  in writing of such  intention as soon as  practicable
after such Pioneer  Partnership's receipt of the Co-Sale Notice made pursuant to
Section 3.1, and in any event within  fifteen (15)  business days after the date
of such Co-Sale Notice has been delivered.  Such notification shall be delivered
in person or by facsimile  to Advanced or the  Principal  Shareholder(s)  at the
Company's offices.


                              ARTICLE IV. Remedies

     4.1. Violation of Agreement; Consent to Injunctive Relief.

     Each of Advanced and the Principal Shareholders  recognizes and agrees that
any violation of any of his or her obligations set forth in this Agreement would
cause  irreparable  damage which could not be compensated  by monetary  damages.
Such  violation  shall  constitute  an Event of  Default  under  the  Investment
Agreement.  Accordingly,  in the  event  of any  breach  of any  obligations  of
Advanced or any Principal  Shareholder  under this  Agreement,  Advanced or such
Principal Shareholder consents to the entry of injunctive relief,  including the
remedy of specific performance, by a court of competent jurisdiction restraining
any  such  violation  or  threatened  violation,  and/or  granting  full  voting
authority to the Pioneer Partnership for purposes of this Agreement, in addition
to any other remedies  available at law or in equity.  Advanced or the Principal
Shareholders  agree  to pay the  reasonable  costs of the  Pioneer  Partnership,
including  reasonable  attorneys  fees,  incurred in enforcing the provisions of
this Article IV.

                                        4



                            ARTICLE V. Miscellaneous

     5.1. Representations.

     Advanced and the Principal  Shareholders represent and warrant that, at the
date hereof, they are the sole record and beneficial owners of the securities of
the Company set forth  opposite his name on Exhibit A to this  Agreement and has
full  power  to  enter  into  this  Agreement  and to  perform  its  obligations
hereunder.  Each of Advanced  and the  Principal  Shareholders  represents  that
he/she  is not the  beneficial  owner  of any  Common  Shares  or any  warrants,
options,  rights to acquire or  securities  convertible  into Common  Shares NOT
disclosed herein, whether directly, through any affiliate or otherwise.

     5.2 Term.

     This  Agreement  shall  terminate  on the  earlier to occur of (i) ten (10)
years from the Closing Date or (ii) the date upon which the Pioneer Partnership,
its partners  and  affiliates  no longer own five percent (5%) of the  Preferred
Stock  (including  for purposes of such  calculation  all shares of Common Stock
received  upon  conversion  of  the  Preferred  Stock),  and no  amounts  remain
outstanding under the Debenture.

     5.3 Further Assurances.

     From and after the date of this Agreement, the parties hereto shall
from time to time,  at the  request  of any  other  party  and  without  further
consideration,  do,  execute  and  deliver,  or cause to be done,  executed  and
delivered,  all such further acts,  things and  instruments as may be reasonably
requested  or  required  more  effectively  to  evidence  and give effect to the
transactions provided for in this Agreement.

     5.4 Notices.

     All  notices,  requests,  demands  and  other  communications  required  or
permitted  under this Agreement  shall be in writing and shall be deemed to have
been duly given if personally  delivered or if mailed by first class  registered
or certified mail return receipt requested,  or by first class mail or overnight
courier if received,  addressed to the parties at their respective addresses set
forth on the first page of this Agreement, or to such other person or address as
may be designated by like notice hereunder.

     5.5 Modifications.

     This  Agreement  may not be  modified  or  discharged  orally,  but only in
writing  duly  executed by the party to be  charged.  In the event the Merger is
consummated,  Advanced shall cease to exist as a separate  corporation  and this
Agreement  shall  remain  in full  force  and  effect  between  Pioneer  and the
Principal Shareholders.

                                        5



     5.6 Successors and Assigns.

     All the covenants, stipulations, promises and agreements in this
Agreement  shall bind the parties'  respective  heirs,  successors  and assigns,
whether so expressed or not.

     5.7 Headings.

     The headings of the various sections of this Agreement are for
convenience  of  reference  only and shall in no way  modify any of the terms or
provisions of this Agreement.

     5.8 Governing Law.

     This  Agreement  shall be governed by and construed in accordance  with the
laws of the State of Nevada  applicable to instruments  made and to be performed
entirely within such State.

     5.9 Counterparts.

     This Agreement may be executed in two or more  counterparts,  each of which
shall be deemed an original but all of which together  shall  constitute one and
the same document.

     5.10 Gender.

     All pronouns  used herein are inserted  for  convenience  only and shall be
applied in the  masculine,  feminine,  or third person as  appropriate  for each
party signing hereto.

     5.11 Use of Term "Pioneer  Partnership".  Notwithstanding  any provision of
this  Agreement to the contrary,  included in the  definition and meaning of the
"Pioneer  Partnership"  shall be any one or more parallel  limited  partnerships
which have been or shall be organized by Ventures Management Partners LLC as the
general partner to invest in parallel with Pioneer Ventures  Associates  Limited
Partnership on the same economic  terms and pro rata based upon their  aggregate
subscriptions.  The limited  partners  of Pioneer  Ventures  Associates  Limited
Partnership  and the  parallel  partnerships  shall be referred to herein as the
"limited partners".

     5.12  Capitalized  terms use in this  Agreement but not  otherwise  defined
herein shall have the meanings given to them in the Investment Agreement.

[   SIGNATURE PAGE TO FOLLOW   ]

                                        6



     IN WITNESS WHEREOF, the parties have duly executed this Agreement as of the
date and year first above written.

By the Pioneer Partnership:

PIONEER VENTURES ASSOCIATES LIMITED PARTNERSHIP


By:      Pioneer Ventures Corp.,
         Managing Member
         of the General Partner
         Ventures Management Partners LLC


By: /s/ John F. Ferraro
   -------------------------------
         John F. Ferraro, Director



 ADVANCED MEDICAL SCIENCES, INC.



By: /s/ Irwin Schneidmill, President
   ---------------------------------
         Name:
         Title:


Consented to, and the  obligation set forth in Article I to pay for such special
meetings of the Shareholders is hereby agreed to:

AMERICA'S SHOPPING MALL, INC.



By: /s/ Irwin Schneidmill, President
   ---------------------------------
         Name:
         Title:


                                        7





By: /s/ Irwin Schneidmill
   ------------------------------------
         Irwin Schneidmill


By: /s/ Dennis McNany
   ------------------------------------
         Dennis McNany


By: /s/ Robert Trause
   ------------------------------------
         Robert Trause


By: /s/ Carmen S. Patten
   ------------------------------------
         Carmen S. Patten Sr.


By: /s/ Mae Parker
   ------------------------------------
         Mae Parker


By: /s/ Mary C. Patten
   ------------------------------------
         Mary C. Patten


By: /s/ Ann L. Patten
   ------------------------------------
         Ann L. Patten


By: /s/ Kathleen Patten
   ------------------------------------
         Kathleen Patten


By: /s/ Kathleen Patten
   ------------------------------------
         Kathleen Patten
         Cust. Sara Patten


By: /s/ Helen E. Patten
   ------------------------------------
         Helen E. Patten

                                        8



                                    EXHIBIT A

                                       to

                                VOTING AGREEMENT





Principal Shareholders              No. of Common Shares

Irwin Schneidmill                   3,000,000

Dennis McNany                       300,000

Robert Trause                       300,000

Carmen S. Patten Sr.                1,200,000

Mae Parker                          3,000,000

Mary C. Patten                      2,740,000

Ann L. Patten                       2,840,000

Kathleen Patten                     10,000,000

Kathleen Patten
Cust. Sara Patten                   2,670,000

Helen E. Patten                     2,500,000
                                    ----------

                                    28,550,000
                                    ==========


                                        9



                                    EXHIBIT B

                                       to

                                VOTING AGREEMENT


                  (Resolutions approved by Board of Directors)









                                       10