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About PI
Hotline 1-866-INFO-4-PI
Frequent Asked Questions..
We have compiled a list of questions often posed by patients, their families and friends, as well as discussed among physicians. If you have any inquiries that are not addressed here, you can submit a question by contacting the JMF via email at
or through our toll-free hotline
at 1-866-INFO-4-PI.
What is Primary Immunodeficiency?
What are the signs and symptoms of having a Primary Immunodeficiency disease?
How can Primary Immunodeficiencies be treated?
What is it like to live with Primary Immunodeficiency?
Is it possible to outgrow a Primary Immune Deficiency disease?
How long will a primary immunodeficiency disease stay within a family's gene pool?
If Primary Immune Deficiency diseases are genetic, or congenital, why is it that some of these defects are diagnosed in adults?
Can diet help fight infections?
Why is it that physicians don't always seem aware of these immune defects?
What type of information should you take to a Genetics Counselor and what should you expect in return?
What is an antibody deficiency?
Is antibody deficiency the same as AIDS?
What are the symptoms of antibody deficiencies?
How can a doctor confirm a diagnosis of antibody deficiency?
Can antibody deficiencies be treated?
When is IVIG used and what disorders does it treat?
Is IVIG therapy successful?
What sort of follow-up and monitoring is needed while on IVIG?
Why can't family members donate blood for the IVIG therapy treatments?
Are there different kinds of IVIG products and how is it determined what type you get?
Are there side effects with IVIG therapy?
What is gene therapy and how can it benefit patients with Primary Immunodeficiency diseases?
What is Primary Immunodeficiency?
When a defect in the immune system is inherited (carried through the genes), it is called primary, or inherited, immune deficiency. There are over 150 forms of Primary Immunodeficiency, ranging widely in severity. Together, they affect more people than leukemia and lymphoma combined. Primary Immunodeficiency often presents itself in the form of "ordinary" infections. Physicians sometimes treat the infections while missing the underlying cause, allowing the illnesses to recur, and leaving the patient vulnerable to vital organ damage, physical disability, and even death. Families struggling with immunodeficiency often do not know where to turn for help. Social, emotional, and financial burdens can often be overwhelming. The problems presented in inherited immunodeficiency disease have challenged researchers and immunologists to reach improved diagnoses, treatments, and new therapies. Promising results in this area of immunology are also yielding benefits for victims of cancer, AIDS, autoimmunity, cystic fibrosis, and a wide range of pulmonary and allergic conditions.
What are the signs and symptoms of having a Primary Immunodeficiency disease?
There are a number of different signs and symptoms of a Primary Immunodeficiency disease. Although it varies somewhat from individual to individual and disorder to disorder, there are some signs and symptoms that occur commonly in many of the disorders.
Perhaps the most common problem that patients with a PI disease have is increased susceptibility to infection. PI patients have too many, and often recurrent, infections. They may have recurrent and repeated ear infections, pneumonia, bronchitis, sinusitis or skin infections.
Although less common, immunodeficient patients may have abscesses of their internal organs, such as the liver, or infections of their blood; however, the common theme is that they have more infections than they or their doctor believes is appropriate.
Not every patient with a PI disease presents with recurrent infections. In some patients, the first infection is serious enough to render the possibility of a PI disease. Moreover, there are certain infections caused by germs that only afflict PI patients, therefore the type of infection itself may serve as a red flag for PI disease.
Patients with Primary Immunodeficiency diseases may also present with a variety of autoimmune or rheumatologic problems. In some cases, the rheumatic disorder can take the form of systemic lupus erythematosis or rheumatoid arthritis and involve many organs and tissues. However, the rheumatic disorder may also only affect one organ and take the form of an isolated arthritis, kidney disease, thyroid disease, low platelet counts in the blood, or anemia.
Furthermore, gastrointestinal (digestive) problems may occur in some patients with a Primary Immunodeficiency disease. Patients may have excessive cramping, loss of appetite, nausea and diarrhea. In some patients, the gastrointestinal problems can be the result of an infection of the intestines - in others, they may be a reflection of an autoimmune or rheumatic disorder.
How can Primary Immunodeficiencies be treated?
Once a diagnosis is established, much can be done for immunodeficient patients. At a minimum, the recurring infections can be treated with low or moderate doses of appropriate antibiotics. These can help prevent permanent damage to the lungs and bronchial tubes, thus promoting the patient's long-term survival while improving the quality of life. When appropriate, immunoglobulin therapy is the accepted protocol for a wide range of Primary Immunodeficiency diseases. Advanced treatments such as the interleukins, PEG-ADA, and gamma interferon can help in some complex cases. Bone marrow transplantation and gene therapy may be the appropriate protocol in specific disorders.
What is it like to live with Primary Immunodeficiency?
There has never been more hope for people who are immunodeficient. All the same, families struggling with any Primary Immunodeficiency disease face a number of difficulties; for instance, the patient may have long periods of normal health, then suddenly be struck by high fevers, pneumonia, or any of the other problems noted above. The illnesses themselves are frightening, the lack of a definite diagnosis and treatment is frustrating, and "waiting for the next attack" can turn even healthy periods into times of great anxiety.
Lack of public awareness for PI diseases can make the family feel isolated in its attempts to cope. Until recently, public sources of information have been scarce, even for doctors. Also, many patients and parents find they cannot get teachers, principals, employers, etc. to understand the nature of the medical problem at hand. Treatment can be very costly, especially if IVIG treatment is involved. Lack of adequate insurance can add to this problem.
Is it possible to outgrow a Primary Immune Deficiency disease?
Primary Immunodeficiencies are a diverse group of disorders that predispose patients to recurrent infections. There are several forms. All of the forms may involve one or more parts of the immune system. These parts include the neutrophil, complement, cellular (T-cell driven) and humoral (B-cell driven) components. Patients who have neutrophil, complement and T-cell disorder rarely outgrow their immunodeficiency. Some patients with T-cell disorders like DiGeorge Syndrome may increase their T-cell numbers as they progress in age. This is often associated with improving T-cell function.
The most common immune deficiency that seems to resolve with age is transient hypogammaglobulinemia. These patients develop symptoms at approximately six months of age. This is about the time when the maternal antibodies are diminishing in the infant's circulation. At this point, the infant may not be able to completely maintain his/her immunoglobulins on his/her own. Infections may occur during this time. Serum immunoglobulins in the infant may ultimately reach normal levels at four to six years of age. Other immunodeficiencies, such as IgA deficiency, may also resolve with age.
How long will a primary immunodeficiency disease stay within a family's gene pool?
Genes may be passed on to any of our offspring, but how they are passed on, and to which children, depends on the way the gene is inherited and expressed. Usually, a specific gene is only passed on to some of the children, but not all. If the gene for a Primary Immunodeficiency disease is passed on from parent to child, it may then be passed on from that child to some of their children, and so on and so on. In each generation there is some chance that the gene will be passed on. Therefore, a gene for a Primary Immunodeficiency disease, like any other gene, can stay in a family's gene pool for many generations.
If Primary Immune Deficiency diseases are genetic, or congenital, why is it that some of these defects are diagnosed in adults?
It is possible that these defects are present all along, but not diagnosed due to compensating immune functions that keep serious problems from developing earlier. It is also possible that there is a slowly deteriorating immune function, genetically determined, that does not become significant until later in life.
Can diet help fight infections?
YES. Good nutrition gives the body the energy and the resources to fight infections. Eating right always makes good sense, and families with antibody deficiencies should take extra care to maintain a healthy and balanced diet.
Why is it that physicians don't always seem aware of these immune defects?
In the last twenty years it has become clear that immune defects are more common than originally thought. In the United States, most specialists who see and treat patients with congenital immune defect are pediatricians and many physicians are not aware that adults may be found who have these defects, not just infants and children.
What type of information should you take to a Genetics Counselor and what should you expect in return?
Genetics Counselors can be very helpful, but it is important for patients and their families to prepare for a meeting with a Genetics Counselor by obtaining certain pertinent and organized information. Since some genetically determined disorders are inherited in predictable patterns, knowing who in the family may have had the disorder previously can be valuable information. The family history of both the father and mother is pertinent. In addition, understanding how everyone is related and to whom they are related is necessary in interpreting the pattern of inheritance. Finally, if the parents are all blood related (even distantly) that information should also be provided. A qualified genetics counselor will gather the family information and the information obtained by testing the patients' genes. Then he/she will provide information on the way in which the disorder can be inherited, how it may have been inherited in your specific family, the chances that future children will be affected with the disorder, and who in the family may carry the gene but not be affected. He/she will also provide information on what reproductive options the family may have, should they decide to have more children.
Most importantly, the Genetics Counselor will not tell the family what decisions they should make regarding their reproductive options. Their primary responsibility is to provide information, help families understand that information and apply it to their own situation. The decisions the family makes based on that information is the family's responsibility, since it is made in accordance with their own personal choices and beliefs.
What is an antibody deficiency?
An antibody deficiency is an immune defect that limits the body's ability to identify "foreign invaders" or pathogens.
In a fully functional immune system, specialized cells produce antibodies, which contribute to immune defenses by binding to the invading cell or particle, identifying it for destruction. In patients with antibody deficiency, these specialized proteins may be missing, not working properly, or too few in number to be effective.
Antibody deficiencies are classified as either "primary" or "secondary". Primary antibody deficiencies arise spontaneously from genetic errors and other mechanisms that are only partially understood. Primary antibody deficiencies can either involve all antibodies or be limited to specific types of antibodies.
Is antibody deficiency the same as AIDS?
NO. Acquired Immune Deficiency Syndrome (AIDS) is a widespread disruption of the immune system caused by a specific viral infection, known as human immunodeficiency virus (HIV). Primary antibody deficiencies (and most secondary antibody deficiencies) are not contagious, and do not present any risk to other people. In fact, healthy people carrying infections pose a threat to people with antibody deficiencies because those with deficiencies are so vulnerable to infections.
What are the symptoms of antibody deficiencies?
Antibody deficiencies limit the ability of the immune system to recognize and respond to infections caused by bacteria, viruses, or other pathogens. A patient with an antibody deficiency will therefore tend to have both more frequent and more severe infections, and infections will often be of longer duration. These patients are also less capable of "developing immunity," and as a result, often suffer from chronic and recurring infections.
How can a doctor confirm a diagnosis of antibody deficiency?
When it is suspected that a patient's immune system is not working properly, the physician can run a set of laboratory tests to confirm the diagnosis. For most people, all that is required is a blood sample and a vaccination test, then a second blood test two to three weeks later. Examination of the first blood sample will determine whether any of the cells needed to complete immune response are missing and whether antibodies are present in adequate amounts.
The vaccination and second blood test are performed to determine if functioning antibodies are being produced by the body against specific organisms.
The vaccination introduces a noninfectious foreign protein to the immune system. When the second blood test is done at the return visit, it should reveal the presence of antibodies created specifically to fight against the test protein. A lack of specific antibodies demonstrates an inability to mount an effective defense against infections.
Can antibody deficiencies be treated?
YES. Many years ago, the only form of active treatment for antibody deficiency was antibiotic therapy, and the only form of prevention was isolation. For children, this meant staying out of school and out of contact with other children and adults.
Today, however, antibody replacement therapy is available. Because antibodies are also known as immunoglobulins, the term "immunoglobulin therapy" is commonly used. This treatment can be given intravenously (IVIG) or subcutaneously (SCIG).
IGIV and SCIG therapy replaces the antibodies that are missing. The infusion contains antibodies purified from the blood donated by American volunteer donors. These antibodies remain in circulation for about a month.
When is IVIG used and what disorders does it treat?
IVIG is used for three purposes; for patients who do not make antibodies or gammaglobulin, for patients with specific infections, and for patients with autoimmune and inflammatory diseases. Some individuals make no or too few antibodies and thus suffer from recurrent infections. Sometimes the antibody producing cells (B-cells) of individuals have an intrinsic inability to make antibodies; these are patients with Primary Immunodeficiency diseases, and many require life-long IVIG infusions. Examples include X-linked Agammaglobulinemia and Common Variable Immunodeficiency.
Blood tests are available to determine if a patient has low antibodies and needs IVIG. Since this treatment is often life-long and very expensive, careful testing needs to be done prior to starting IVIG. Indeed, like other drugs, IVIG may have side effects, so its use is reserved for just a few patients.
A second use of IVIG is in the treatment of certain infections in which antibiotic or antiviral therapy is ineffective. Examples include severe parvovirus infection and chronic viral meningitis. These patients do not require life-long IVIG and it can be discontinued after the infection is controlled. A final use of IVIG is in certain inflammatory and immunologic diseases, often of unknown causes. Examples include an acute fever-causing childhood disease termed Kawasaki disease, and a blood disease termed immune thrombocytopenia (ITP), where the blood platelet levels are low and the patient develops bruising or bleeding.
Is IVIG therapy successful?
YES. IVIG infusions help to restore the missing antibody protection against infections, allowing the patient to lead a normal life.
Since a normal life does involve getting sick sometimes, patients receiving IVIG therapy may still have an occasional cold or infection that needs treatment with antibiotics. However, they will have far fewer, milder, more controllable infections than they had before starting IVIG therapy. This means that they will be able to lead more active, less restricted lives.
What sort of follow-up and monitoring is needed while on IVIG?
Close follow-up of patients on IVIG is important. Moreso than any of the laboratory parameters or serum immunoglobulin levels, clinical improvement is the target of replacement therapy. Careful attention to both specific and non-specific complaints is mandatory and is the major issue when considering adjustments in therapy such as dosing or frequency of infusions.
In patients with Primary Immunodeficiency of the humoral (antibody-mediated) immune system, IVIG replacement therapy is started to prevent infections. As a result, the primary follow-up issue is "has IVIG reduced the number of infections?" A simple diary is an excellent tool to monitor several key issues on a month-to-month basis between infusions. The major questions are: Have you had any infections since your last infusion? What were the symptoms? Did you see a health care professional? Did you visit the emergency room? Or need hospitalization? Since replacement therapy generally requires several months to reach a stable plateau level, it may take several months to appreciate significant reductions in the number of infections.
Prior to beginning treatment and as a baseline for further follow-up, a number of laboratory assessments are generally recommended. These include a complete blood count and differential cell count, liver function tests, biochemistry panel, and culture and sensitivity of sites of infection. Baseline pulmonary function testing is important as is a high resolution CT scan of the chest. The latter is helpful in determining if bronchiectasis is present, and is much more sensitive than a routine chest X-ray. Baseline serum immunoglobulin levels and antibody titers post-vaccination should have been obtained in establishing the diagnosis of antibody deficiency.
Once IVIG treatment begins and symptoms are regularly monitored, routine testing (CBC, liver function tests, spirometry) may be obtained every 4-6 months. If bronchiectasis was present, a CT at least every 12 months to assess progression or improvement may be necessary.
Symptoms are the important parameter regardless of the serum levels of IgG. The levels of IgG can be used to ensure that suitable levels have been achieved and maintained and that hypercatabolism is not a problem.
Why can't family members donate blood for the IVIG therapy treatments?
IVIG is made from the pooled plasma of many donors for several different reasons. One reason is that people who need antibody replacement need a very broad coverage of antibodies, so that they have protection from a wide variety of diseases. Therefore, blood plasma from a single donor will only have antibodies against a limited variety of microorganisms. Pooling blood from a number of subjects makes this more possible. The pooling process is rather like consulting a large library for answers to complex questions, rather than just one not-very- complete reference book. The other reason is that IVIG given to humans has to be shown to be safe and effective. The only way to do this is to test a specific product and do quality control on all the lots using the same standards. The only practical way to do this is to make large batches in a factory setting. Current lots are usually made with plasma from 50-60,000 or more units of plasma. No individual family could donate enough plasma to make this possible.
Are there different kinds of IVIG products and how is it determined what type you get?
There are several different IVIG products on the market. All are >95% IgG, the main serum protein that contains protective antibodies. They differ from each other in strength, bottle size, storage (some are liquid, others are powder that have to be reconstituted), excipients (substances added to the IgG such as sugar or albumin to stabilize the product), manufacturing and viral inactivation methods.
All should be free of Hepatitis C and HIV and other pathogens, but this is not 100% guaranteed since they are all derived from plasma from human donors. For the most part, all of the products have protective antibodies against common viruses and bacteria, thus, all are of value in the treatment of primary antibody immunodeficiencies.
Some products are lower in IgA, a minor immune globulin that may sensitize individuals who lack serum IgA but can make antibody to the infused IgA. For a patient with a selective IgA deficiency who needs IVIG (most do not need it) such products may be preferred.
There are differences in side effects with different products. Sometimes patients experience more adverse reactions with the new products than with the original products. For this reason, most patients that are doing well on one product usually stick with that product.
Conversely, if a patient has a reaction to one product, the doctor may want to try a different brand. Oftentimes, hospitals, clinics, and home infusion companies only stock one or two brands of IVIG because one company may hold the contract for that institution. If the patient has been shown to tolerate only one brand of IVIG, the hospital or clinic can often special-order the well-tolerated brand. We recommend this only if the patient is reacting to one IVIG brand. The brands may differ in cost, depending on local shortages, and the hospital or clinic pharmacy.
Are there side effects with IVIG therapy?
Therapy is safe, but some patients can experience side effects, such as: fever, chills, rash, headaches, muscle aches or abdominal pain. These side effects resemble flu symptoms, and many can be reduced by slowing the rate of infusion or by taking analgesics like aspirin, ibuprofen or acetaminophen.
What is gene therapy and how can it benefit patients with Primary Immunodeficiency diseases?
Gene therapy is a new technology aimed at replacing the function of, or repairing abnormal disease-causing genes in patients with genetic diseases (such as the Primary Immunodeficiency Diseases). In one form of gene therapy, samples of cells from the immune system are taken from the patient's blood or bone marrow, the normal gene is introduced into these cells and they are given back to the patient. In another form of gene therapy, the abnormal genes in the patient's cells are fixed within the cell. Gene therapy has already proven to be successful therapy for Severe Combined Immunodeficiencies and is under development for other Primary Immunodeficiencies.
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If you're ready for a new you in the New Year, kick things off with a makeup bag makeover. Now is a great time to start stocking up some beauty product must-haves, and you can turn to the runways for inspiration. Some of the most-coveted runway looks include even more glitter and shimmering hues for the eyes, the return of the bold lip, and high-drama lashes.
I interviewed Birchbox Co-Founder Katia Beauchamp recently to find out what products we'll be lusting after this season. From CC creams and two-tone manicures, to blue eyeshadow and paper masks, here's a preview of the hottest beauty trends for 2013:
Q: What do you see in the beauty forecast for 2013?
KB: "Dirty hair - More tricks and products will be emerging in 2013 for elongating the wash cycle of your hair.
Bold lashes and lash-lines - The drama of a bold lash is still big. We are seeing more formats that make it easy to create the look.
Deep side part - The deep side part is all over the runways, but is also really wearable.
Blue Eyeshadow - Blue eyeshadow is totally back! It's not just for dressing up and parties any more.
Big buns - On your head, that is. Tease it, put a sock in it; anything to create big volume either on the top of the head, or in a low bun."
Q: What do you think will be the best all-purpose or multi-purpose product for 2013?
KB: "CC Creams and BB Creams will definitely be a big part of 2013.
Also, I'm currently obsessed with the new Benefit Fine One One lip to cheek, a cream-to-powder formula that works as a blush, highlighter, and lip tint. Obsessed!"
Q: We saw rose gold, metallics, and bright hues make a comeback in 2012. What are two hot colors to add to our makeup bag in 2013?
KB: "Emerald green and deeper burgundy! Two-tone manicures are also a hot trend that I see becoming bigger in 2013."
Q: We saw BB creams then CC creams make their way to the beauty counter in 2012. What do you think is coming next for skin care?
KB: BBs and CCs are still new to many, and I still think both trends will have legs into 2013. Another trend that is hitting its stride is paper face masks, where all of the vitamins and treatments are soaked into individual, one-time use masks.
Q: Winter is far from over. What are two Birchbox favorites for glowing skin this season?
KB: Fresh just launched a new Lotus skin cream that deeply hydrates and creates a perfect base for the day. Sunday Riley Juno Serum is another favorite; it's oil based, and it keeps the skin supple and moisturized in the very dry winter season. You can use it on top of your moisturizer, or in place of. A third favorite product of mine is Boscia BB cream; it has luminizers in it that create a lustrous finish, as well as real skin care that functions as a primer, moisturizer, foundation, and SPF.
Interview with Birchbox Co-Founder Katia Beauchamp


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In January, I wrote a pre-season analysis of the 2011 Nationals roster at that time. Because of a crazy-busy work and home life, it also was my last post on this blog — until now.
In January, I wrote a pre-season analysis of the 2011 Nationals roster at that time. Because of a crazy-busy work and home life, it also was my last post on this blog — until now.
For the first time since major league baseball returned to Washington, D.C., Nationals fans have reasonable grounds for hope. Thanks to Mike Rizzo's whirlwind of moves the past two seasons, the team has a promising mix of veterans and youngsters. Veterans Ivan "Pudge" Rodriguez, free agent blockbuster Jayson Werth, Ryan Zimmerman and Adam LaRoche are proven veterans. Paired with high-potential youngsters like Wilson Ramos, Danny Espinosa, Ian Desmond, and Roger Bernadina, the Nationals look like a bona fide professional club. The pitching, a perennial weaknesses since fans closed out 2005 with a standing ovation for Frank Robinson's boys, finally has credible starters like Livan Hernandez, Tom Gorzelanny, Jason Marquis, and John Lannan. Unlike 2005, Rizzo has also added depth with Yunesky Maya, Ross Detwiler, Chien-Ming Wang, and Rule 5 pick Brian Broderick, with 2nd round pick Sammy Solis waiting in the wings.
Ron Menchine, a long-time presence on the Washington area sports scene and the last voice heard on the Washington Senators radio network on WWDC, died on September 11, 2010 at the age of 76.
On Saturday, January 30, National SABR Day, I presented at the Bob Davids Chapter (Washington and Baltimore areas combined) Winter Meeting in Rosalyn, Virginia.
Awhile back, I appeared with Glenn Harris on NewsChannel 8′s SportsTalk to discuss my book "A Whole New Ballgame: The 1969 Washington Senators". The segment includes footage of Frank Howard at the 1969 All-Star game at RFK, and his upper deck home run.
Below, are the data I used for my research presentation at the SABR National Convention at the J.W. Marriott in Washington, D.C, on July 30, 2009. This year marks the 39th SABR National and my first convention. If you would like a PDF file of my presentation, please let me know via including your email address in a comment to this post.
I wanted to let everyone know that the Archdiocese of Baltimore's Catholic Review profiled "A Whole New Ballgame: The 1969 Washington Senators" along with five other books written by members of the archdiocese. I guess we might have the beginnings of a Catholic literati!
My long-time friend and devoted Washington baseball fan David Gough penned a brief review of my book "A Whole New Ballgame: The 1969 Washington Senators." I'm posting it here with a lot of gratefulness. Dave is an author of two fine books himself ("They've Stolen Our Team" – a story of the 1960 Senators and "Lil' Nel" a biography he co-wrote with Jim Bard on Nellie Fox, the '69 Senators first base coach and Hall of Fame member). Dave provided inspiration and mentoring for me as I developed the ideas and path for "A Whole New Ballgame."
I will be appearing on WJLA's News Channel 8 this Friday evening, July 3 (8-9 p.m.) on their SportsTalk show with Glenn Harris. The information to call or send email questions is below. If you can watch and call in, please do. If not, please email a question. It'd be great if the show gets more questions about the book than they have time for me to answer.
I am thrilled to announce that I will be making three appearances to sign and discuss my book, A Whole New Ballgame: The 1969 Washington Senators. Here's the information and links. Mark your calendars!
In April, Pocol Press published my first book, "A Whole New Ballgame: The 1969 Washington Senators." So far, I have one confirmed appearance to speak about and sign books. As part of the local chapter of the Society for American Baseball Research (SABR), termed the Bob Davids chapter in honor of SABR's first and one of its finest founding members, I will appear at Brighton Gardens at 9:00 a.m. on Saturday, July 11, 2009. Here is a link to the notice:
My book, "A Whole New Ballgame: The 1969 Washington Senators" is now in print and available for purchase! The ISBN number is 978-1-929763-38-2
The publisher, Pocol Press informed me today, that my book "A Whole New Ballgame: The 1969 Washington Senators" has been sent to the printer. It should be available in three weeks. If you would like to read an insightful, heartwarming remembrance of the best baseball team to grace Washington, D.C. for the past 50 years, you'll enjoy this book. Feel free to spread the word!
The announcement today that the Nationals signed free agent Adam Dunn to a 2-year contract evoked a variety of responses. Here's the two expressed most often:
The president of the Washington Nationals Fan Club quotes ESPN's Bill Simmons as saying ""People in DC do not
care about that team. At all."
This spring, Pocol Press (www.pocolpress.com) will publish my book on the 1969 Senators. The title is "A Whole New Ballgame: The 1969 Washington Senators". Below is information if you would like to pre-order.
I love retrosheet's (retrosheet.org) feature that shows how a hitter performed against every pitcher they faced in their career and vice-versa. I wanted to see how some well-known players from our two nearby major league baseball teams performed against other players, each other, and each other's teams in 1969, my favorite baseball season, mainly because of the Senators' unlikely and wonderful 86-win season.
I much prefer watching, following and discussing baseball to football (I am a Redskins fan suffering under our current Synderian reign of incompetence), but I've recognized an unmistakable trend in this season's NFL Play-offs. Have you?
Here's some details on the pictures on the 2nd page of our annual family Christmas letter:
Column 1 (from top to bottom on the page):
The past week, Christian Guzman earned National League co-player of the week honors for his amazing display of hitting that led the Washington Nationals to an 8-1 home stand. Guzman turned in multi-hit games for seven consecutive contests. The last baseball player in Washington to achieve that feat? Hank Allen, April 15 to April 26, 1969. You can look it up on the wonderful site www.retrosheet.org.


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Pictured Recipe: Sausage, Pepper & Mushroom Pizza
Following a recipe is easy for most people, but not always practical. Oftentimes what we have in our fridge is a hodgepodge of ingredients that a single recipe can't cover. So we wing it. When I develop recipes in the EatingWell Test Kitchen, I rely on a few basic principles to get me through the first test and ensure that (hopefully) what I make is tasty. Below are some tips to keep in mind when you're cooking without a recipe:
—Hilary Meyer, Associate Food Editor


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Anti-human trafficking consultant John Vanek defines human trafficking and who is affected by the slavery trade worldwide - both the victims and the criminals who profit from it.
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Mother is facing 7 felony charges and 1 misdemeanor after police say she led them on a high-speed pursuit with her daughter in her lap
The Houston City Council unanimously approved an anti-hoarding ordinance Wednesday without a clear idea of how it will be enforced
Police officials said internal investigation will focus on the time it took officers to respond to the home, and whether dispatchers properly prioritized call
A male police officer spent much of December and January dressed as an Amish woman in hopes of scaring off a man suspected of exposing himself to children


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Water Resources of the United States
This software and related material (data and documentation) are made available by the U.S. Geological Survey (USGS) to be used in the public interest and the advancement of science. You may, without any fee or cost, use, copy, modify, or distribute this software, and any derivative works thereof, and its supporting documentation, subject to the USGS software User's Rights Notice.
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Introducing a bronze tint version of our best-selling face primer, Primed & Poreless. Formulated to prime and enhance all skin tones, our innovative new product imparts a warm glow while providing optimum sun protection. The silky formula banishes complexion imperfections as it leaves skin virtually poreless.
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Too Faced Cosmetics, Inc.
|Active Ingredients: Octinoxate (7.5%), Octisalate 5%
Inactive Ingredients: Cyclopentasiloxane, Dimethicone Crosspolymer, Silica, HDI/Trimethol Hexyllactone Crosspolymer, Caprylic/Capric Triglyceride, Dimethicone Vinyl Dimethicone Crosspolymer, Camellia Oleifera (Green Tea) Seed Oil, Phenoxyethanol, Dimethiconal, Hexyl Laurate, Polyglyceryl 4 Isostearate, PEG 10 Dimethicone, Stearic Acid, Ethylhexl Glycerin, Tetrahexyldecyl Ascorbate, Alumina, Cyclohexasiloxane, Cyclodextrin, PPG 26 Buteth 26, Diacetyl Boldine, Morus Alba (Mulberry) Bark Extract, Polysorbate 80, Arctostaphylos Uva Ursi (Bearberry) Leaf Extract, PEG 40 Hydrogenated Castor Oil, Hedera Helix (Ivy) Leaf/Stem Extract, Cycloheptasiloxane, Polysorbate 20, Retinol, Retinyl Palmitate, Tocopheryl Acetate, Allantoin (Comfrey Root), Bioflavonoids, Ascorbyl Palmitate (Vitamin C), BHT, BHA, Mica, Titanium Dioxide, Iron Oxides, Bismuth Oxchloride (CI 77163)
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(2 of 2 customers found this review helpful)
Not bad wish less shimmer
By Kayci
from Ac, nj
describe yourself Trendy Style
- Blends Easily
- Easy To Apply
- Too Shimmery
Best Uses
- Contouring & Highlighting
- Nighttime
Comments about Too Faced The Bronzed & the Beautiful Bronzing Collection, 1 ea:
I like it I love the primer that comes with it, I wish it wasn't as shimmery, cause it makes it a little more noticeable I don't want to people to know I am wearing something but look good at the same time. But I do well with it.
- Skin Tone:
- Fair
Bottom Line Yes, I would recommend this to a friend
(2 of 2 customers found this review helpful)
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(2 of 2 customers found this review helpful)
Subtle yet pretty glow
By JBmummy
from new port richey, florida
describe yourself Classic Style
- Blends Easily
- Doesn't Appear Cakey
- Easy To Apply
- Good Pigmentation
Best Uses
- Anytime
Comments about Too Faced The Bronzed & the Beautiful Bronzing Collection, 1 ea:
I just received this palette yesterday, and wore it immediately. I have an NC 40-42 skintone in MAC (for reference), and these bronzers were pigmented enough to show up on my skin. The chocolate soleil smells divine, and I use it as a contour. I love the snow bunny bronzer too. I swirl the snow bunny onto a blush brush and apply it lightly to the apples of my cheeks and used it in place of blush for a healthy glow. I would imagine that at night you could use a heavier hand for a more dramatic look, but given the shimmer in two out of the three bronzers (there is also a highlighter in this package) you don't want to go too overboard in day light hours (unless that's the look you are going for).
- Skin Tone:
- Deep
Bottom Line Yes, I would recommend this to a friend
(2 of 2 customers found this review helpful)
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Chocolate Peanut Butter Whoopie Pies
- Prep Time: 40 min
- Cook Time: 10 min
- Ready Time: 90 min
- Yield: 18 whoopie pies
- 1 package Pillsbury® Moist Supreme® Devil's Food Premium Cake Mix
- 2/3 cup water
- 1/3 cup Crisco® Pure Vegetable Oil
- 3 large eggs
- 1 (12 oz.) container Pillsbury® Whipped Supreme® Vanilla Flavored Frosting
- 1 cup Jif® Whips Whipped Creamy Peanut Butter
Preparation Directions
- HEAT oven to 350°F. Line baking sheets with parchment paper.
- BEAT cake mix, water, oil and eggs in large bowl with electric mixer on medium speed for 2 minutes, scraping bowl occasionally.
- DROP batter onto prepared baking sheets, 2 inches apart, preferably using a medium scoop (2 tablespoons). Using the back of a spoon, spread batter into 2-inch diameter circles. Bake 8 to 9 minutes or until centers are set. Cool 1 minute. Remove to wire rack to cool completely.
- BEAT frosting and peanut butter in medium bowl with electric mixer on medium speed until light and fluffy. Place half of pies flat side up. Spread each with 2 tablespoons filling. Top with remaining pies, rounded side up, to form whoopie pies.
Nutritional Information Per Serving
Calories 0 (Calories from Fat 0), Total Fat 0g (Saturated Fat 0g, Trans Fat 0g), Cholesterol 0mg, Sodium 0mg, Total Carbohydrate 0g (Dietary Fiber 0g, Sugars 0g), Protein 0g; Percent Daily Value*: Vitamin A 0%, Vitamin C 0%, Calcium 0%, Iron 0%.
*Percent Daily Values are based on a 2,000 calorie diet.


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Results 1 to 5 of 12
May 8th, 2013 12:28 AM #1Senior Member
- Join Date
- Mar 2011
- Location
- American Midwest
- Posts
- 1,812
Is anyone else bothered by these types of "games"?
I keep seeing these games where the stories involve infertility, miscarriage, death of a child, etc. I am so disturbed by this. Am I being overly sensitive? It's an issue I've struggled with personally so maybe I have a stronger reaction than most? I just find this terribly offensive. Do others?Current Top 10s
Silas~Cyrus~Jasper~Gideon~Callum (Cal)Dexter (Dex)~Leander (Leo)~Everett~August (Gus)~Abraham (Abram)
Selah~Willa~Scarlett (Lettie)~Rosemary (Romy)~Coretta (Cora)Maisy~Cecelia~Calista (Calla)~Hattie~Celia
(formerly chrbaker)
May 8th, 2013 12:43 AM #3
I truly just think it's a game to come up with different names. I don't think anyone should take offense to it. That being said, I haven't struggled with these types of personal issues so I can't fairly say you're being overly sensitive to it either. Maybe if it really bothers you, you should try to avoid the games then? :/ I don't think anyone is trying to be offensive or hurtful, I think it's just thrown out there..My Favorites:
Colette Kristine. Alice Evanna. Gemma Elizabeth. Mabel Verity. Rosalie Grace.
Jack Jeffrey. Carson Luke. Felix James. Leo Patrick. River Justin.
can't wait to marry my love!
May 8th, 2013 12:44 AM #5Junior Member
- Join Date
- Mar 2013
- Posts
- 27
I agree with you, these games are fairly offensive and could stir up sensitive memories for some people. Besides the vast majority of miscarriages are not given names, especially early miscarriages. After all, what's the point of having a deceased child or miscarriage in these story games? Is there really any difference in how a name given to a living child as opposed to a stillbirth or miscarriage? I'm pretty surprised that there are so many people who participate in these things.I have no idea where I came up with my account nameLauren
No Kids, Lots of Pets
Fur Aunt to: Nikolai, Pepsi, Creampuff, Waffletrain, Boris, Stella Luna, Alexi, Marshmallow and finally Chester
Rats, Guinea Pigs, Parakeets, and a Cockatiel.
May 8th, 2013 12:48 AM #7
I haven't come across any of these games, but I never look at the game threads. I agree, it's offensive, but remember most of these games are made up by teenagers who have no experience with these issues and probably don't realise they're upsetting people. They should reconsider their narratives. There are plenty of ways to come up with names rather than naming miscarriages or stillborn babies. It's very macabre, if you ask me.Alice - Beatrix - Clara - Daphne - Flora - Harriet - Mabel - Susannah
Albert - Barnaby - Edward - Frederick - Henry - Rupert - Theodore - Walter
May 8th, 2013 02:24 AM #9
I agree with everyone. I don't think anyone should get TERRIBLY offended, but at the same time, it doesn't make sense to put something like that in a game where you're supposed to just name imaginary children.Madison, 14-year-old name nerd! My style is all over the place, my favorites change all the time.
Boys: David, Eric, Finlay, George, James, Jude, Lee, Michael, Paul, Richard, Rory.
Girls: Emmanuelle, Frederica, Jayne, Juliet, Lauren, Mary, Molly, Nora, Raffaela, Stella.


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Monday's city council meeting in Elizabethtown leaned heavily on land transactions, be they donations or fulfillment of a long-established agreement.
City officials approved donation of two properties on East Railroad Avenue to Hardin County Habitat for Humanity while accepting several acres of land in the city as a gift.
Planning Director Ed Poppe said the donated lots, 211 and 215 E. Railroad Ave., are vacant and worth $8,000 to $10,000 each. The city donated the property at no cost to Hardin County Habitat for construction of single-family homes.
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Previous section: Marriott London Sevens
Photo: Getty Images
During the London Sevens, more entertainment is packed into Twickenham stadium than during any other event.
On the pitch, there's over 12 hours of side-stepping, break-making, high-octane rugby.
Cheerleaders, bands and big screen entertainment keep the tempo up between games and around the stadium live music ensures you're never far from the action. Stay in the stands for on the spot prizes for fancy dress and you could also be a lucky winner in one of the many competitions to win great prizes.
All the stadium bars are of course open, as are a huge range of food and snack outlets to help keep your energy and enthusiasm up!
This year will see a number of new additions to make the day as enjoyable as possible for all of our fans, whether you're bringing the kids, a diehard sevens fan or a first time visitor we have you covered.
Another first for London in 2012, the West Car Park will be turned into Funky Town for the weekend, it will be open for all ticket holders across the weekend with live music, inflatable's for the kids (and adults), picnic areas and plenty of food and drink.
If you're a HSBC customer you'll have the added bonus of accessing the HSBC Disco Lounge to enjoy a few extra perks on the day. You can even test your rugby skills against the HSBC ambassadors in the HSBC Skills zone, this area is open to all fans on the day to have a go (age restrictions apply).


text: The Health Insurance Exchange provisions within the Affordable Care Act impact multiple sectors within the Health Sciences & Government (HS&G) industry. Exchanges will create online marketplaces where individuals, small employers, and eventually larger employers can shop and compare health insurance options. We believe that they will have dramatic impacts on states, the Federal government, health plans, and employers. Learn more.


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This thing has now moved to the #1 spot on Amazon for antenna sales. I see a lot of glowing reviews on the site ... but have yet to see a real analysis on it's performance. Does anybody have any real experience or analysis of this antenna and it's performance as an indoor antenna?
post #1 of 67
5/10/11 at 7:35am
Thread Starter


text: Amie Sabo has been Senior Counsel with Caesars Entertainment Corporation since January 2012. She is licensed to practice law in Nevada and California. Prior to joining Caesars, Amie served as Associate General Counsel for two other gaming companies, The Cosmopolitan of Las Vegas and Fontainebleau Resorts, LLC. After graduating from University of California, Hastings College of Law with a concentration in litigation in 1997, Amie began her legal career as a Law Clerk to the Honorable Dennis L. Beck, and thereafter as an Honor Law Graduate with the Department of Justice. Amie is originally from upstate New York and completed her Bachelor of Arts at Columbia University in New York.


text:
Volvo 940 Parts in Canada
Canada 940 Parts at AutoPartsWAY.ca
Canada 940 PartsLooking for Volvo 940 parts in Canada? Do you need rotors, brake pads, car cover, alternator, or any other Volvo 940 parts? At AutoPartsWAY.ca we are glad you came. For years we have been providing Volvo 940 parts in Canada. No matter where you are in Canada, we can deliver your Volvo 940 parts.
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text:
You can also read manga online try the Takahashi Rumiko Gekijou manga!
You're reading Takahashi Rumiko Gekijou 12 online. You can try some of the related manga below or try some other manga from our manga list.
Users who read Takahashi Rumiko Gekijou also read Aishiteruze Baby, Kamichu!, Nicoichi, Natsume Yuujinchou, Ah! Itoshi no Banchousama, Kurosagi Shitai Takuhaibin, Giri no Vacance, Kyoko and her Dad, Akatoki Hoshi Residence, Do You Remember, Mogwa?, Ketchup Mayonnaise, My Heart is Beating, Ao Haru Ride, Haunted House, Dansai Bunri no Crime Edge and Uchuu Kyoudai


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This base layer is constructed from a lightweight high wicking material, perfect for providing efficient moisture transfer underneath an outer garment. With mesh underarm panels, flatlock stitching and constructed from quick dry fabric, this base layer top will keep you feeling cool and comfortable.Colour: Black. Polyester. Machine washable.
The Altura Night Vision Long Sleeve Jersey features traditional design combined with Night Vision treatment to produce an essential piece of kit for those riding on the road. Features soft touch high wicking thermal fabric with full length front zip, three rear pockets, velcro lightstick LED mount and highly reflective trim.Colours: Red, Yellow.
The Altura Fleece Long Sleeve Jersey is a micro fleece mid layer that provides fantastic warmth on or off the bike. Features a casual cut for versatility with lightweight, high wicking micro fleece for performance and comfort.Colour: Black/Grey.


text:
1988 CE24, 1995 CE22, 2000 SC, 2006 Cu24 AP, 2003 Standard, 2006 SC AP, 2007 CuRo22, 2010 Starla Stoptail, 2010 Mira
2007 SE Soapy 2, 2010 SE 25th Anni Cu24, 2012 SE Bernie, 2013 SE Angelus
PRS SE50, Mesa Single RectoVerb, Mesa Lonestar, Fender Hot Rod Deluxe
Happy Birthday ...
PRS Private Stock #3568
PRS Swamp Ash Special
Mesa Mark V combo
Fishman Loudbox Artist
LOL...thank you guys, I am pretty sure Paul would say the same
Happy birthday to you both, I wonder if Paul will treat himself to one of his own guitars? Lol
tres bon anniversaire Paul and aduayer!!
Last edited by Shawn@PRS; 02-18-2013 at 02:58 PM.
It's been done...
Guitar and Amp!
Oh, and Happy Birthday, PRSH!
Happy Birthday Mate! (that's Australian for Happy Birthday Paul)
HAPPY BIRTHDAY Paul!!!!
2010 Black cherry 10 Top Tremonti-signed by Tremonti Modded by PTC DGT frets
2010 Mira Vintage Mahogany-Dragon 1 pup in bridge
2012 Faded Blue Jean Burst 10 Top Tremonti
2012 PRS Tremonti Custom SE Grey/Black PRS Phase 2 tuners, Mannmade 2000NOS Trem,Refret with DGT frets at PTC, USA nut, PRS USA pots and knobs
'Appy Birthday to Paul & Aduayer!!!
Modified SE Bernie Marsden, SE Custom 24 2012, Fender Strat
Laney Lionheart L5T-112, Fender Mustang 1
Wishing for a Blue Bernie!
Click here for SE Bernie Marsden demo!
Lessons, covers, backing tracks, etc...www.youtube.com/mikegarveyblues
Happy Birthday PRSH!
I guess we now capitalize the H now? Missed that thred.
A very happy birthday to the old man.
And Happy Birthday to you too, Paul.
One Life


text:
When the economy went south starting in 2008, leadership at the Independent Oracle Users Group started looking for ways to generate more revenue. At a time when many associations were struggling to make profits or even stay the course, IOUG charged ahead with three new initiatives designed to boost income: a virtual extension of the annual meeting, live road shows, and a webinar series. The result? A 20 percent boost in annual revenues and year-round content for members beyond the annual meeting.
IOUG is a nonprofit association whose approximately 20,000 members are users of Oracle technology—predominantly information technology professionals, database administrators, developers, technical managers, and other computer specialists from a variety of organizations, including Fortune 500 companies, colleges and universities, and government agencies.
"The 12-member IOUG board of directors has a strategic plan in which growth and diversification of revenues is one of the primary objectives," explains Carol McGury, executive director at IOUG and senior vice president, education and learning services unit, SmithBucklin, Chicago. SmithBucklin manages several technology user groups, including IOUG, which it has managed since 1993.
Step 1: Virtual Extension
The first step was to create a virtual extension of the annual meeting. In 2008, when the economy first took a downturn, "we were hit pretty significantly because technology was one of the highest impacted sectors," says McGury. The group hadn't yet seen a decline in attendance, but leadership anticipated one based on the direction the economy was taking. It wanted to establish a virtual extension of the annual meeting to reach more members and diversify the revenue stream. "We went back to some of the large Fortune 500 companies that had said they could send only two people instead of five to our live event and asked if some would attend a virtual event instead." If the companies said yes, IOUG leaders asked what types of topics they would like to have access to. "So we would tailor the program based on that feedback," she adds.
IOUG streamed live audio from the annual meeting, along with each presentation's PowerPoint slides, to the virtual audience. Attendees could also submit questions to the speakers. The group streamed about 40 different sessions over the course of the three-day conference with selections based on feedback from the companies and members. Access to the live virtual conference was less expensive than the registration fee for the physical event because it offered access to just a portion of the total sessions and because IOUG leaders understood that the virtual extension couldn't match the face-to-face experience. Yet, for those who couldn't attend due to budget, travel, or time constraints, virtual access to select, high-quality education and information appeared to be a worthwhile investment. In addition, the content was captured and archived and accessible to attendees all year on the Web.
"Since the virtual component was launched in 2008, IOUG has seen a steady increase in the number of licenses sold," says McGury. Some attendees purchase individual licenses (like a registration fee), but companies can buy licenses and let multiple people get together in one room to attend the meeting. Last year, IOUG sold more than 200 licenses to attend the virtual sessions, which means at least 200 paid to attend, but the likelihood is that more than that viewed the content. Meanwhile, physical attendance at the annual meeting, which usually attracts about 1,000 IOUG members, has not suffered. Last year, the user group saw a 10 percent increase in attendance at its face-to-face annual meeting, Collaborate, held in Orlando. (IOUG co-locates with two other user groups at Collaborate, which attracts about 5,000 in total attendance.)
"IOUG sees a net annual profit of $20,000 from the virtual extension," says McGury. "A key is to keep it simple and affordable." IOUG doesn¹t offer video streaming or virtual trade shows, so it's a low-cost model that focuses on delivering what members want. Members value the opportunity to sit and listen to a technical presentation, says McGury. And while there is no video of the presenter, the virtual audience can view the slide presentations and submit questions. "We don't see the value in delivering the video component because the majority of the value is in the presentation itself and in the audio and the Q&A."
Step 2: Road Shows
Following the success of the virtual extension, IOUG looked for additional opportunities to serve members and generate revenue. It identified five technical growth areas within the Oracle universe—MySQL (a database management system), DBA (database administrators), security, performance engineering, and business intelligence—and looked for ways to bring education to members in those areas. In conversations with Oracle, the association came up with an idea for a road show.
"We¹re calling it the Rock Stars of IOUG," says McGury, with the tagline of "Rock Your Performance Engineering." The association partnered with the vendor, Oracle, to develop a 20-city tour, bringing education on the subject to mostly first-tier cities in the U.S.—New York, Chicago, and San Francisco—as well as cities in Europe. The one-day sessions are all led by IOUG "rock stars," three well-known Oracle educators in the field.
Step 3: Webinar Series
To round out its growth areas, IOUG launched a webinar series. For each topic, there is a series of three free webinars. The content is recorded and archived and available on demand for use by those who couldn¹t attend. IOUG has already done four series and plans to do another three this year into next year. Attendance at each webinar is about 100. Since people generally don¹t like to pay for webinars, the revenues come from sponsorships, says McGury. So far, the webinars have not generated profits, but they have provided value to members. Over time, as the webinar program becomes more established, IOUG officials hope to increase sponsorship levels.
"These initiatives don't cost a lot of money to do," says McGury. "It's pretty low risk, there's a low point of entry, but it's really driving the value." When tallying up the net impact of these three initiatives, IOUG has realized a 20 percent increase in annual revenues. "Obviously that's good, but the bigger value is the year-round engagement and having more touch points with the community. Technology changes quickly, so we need to bring the community together more frequently, more than just at the annual event, to keep up with the changes."


text:
Apilco Gold Accent Rectangle Roasting Dish
- Exclusive
- Summary
Porcelain conducts heat gently and is easy to clean, which is why French cooks often roast meats and poultry in a deep porcelain dish rather than a metal roaster. Now the classic Apilco porcelain roaster gets an elegant update with a hand-painted rim in 10-karat gold. It's perfect for vegetables, casseroles and fresh-fruit crisps, with an unglazed underside that increases the absorption of heat. Apilco, the renowned French manufacturer, has supplied chefs and home cooks with top-quality porcelain wares for over a century. Oven safe. Due to the gold detailing, the roaster should not be placed in the microwave. Hand-wash. 2-3/4 qt. cap., 13 1/2" x 8 1/2" x 2 1/4" high,. Made in France. A Williams-Sonoma exclusive.
- Shipping
Shipping Information
This item is shipped from our warehouse by UPS to arrive within five business days of our receiving your order.
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The shipping rate varies depending on your order total and shipping destination. View Shipping Options and Charges.
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For an additional charge of $15 per address, we can rush delivery to most destinations. This service is not available for some oversize items, items shipped directly from the supplier (including perishable and custom-manufactured items), out-of-stock items and items to be shipped outside the contiguous 48 states.
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At Williams-Sonoma, we take great pride in the quality and craftsmanship of our products. If, within 30 days, you are not completely satisfied with your purchase for any reason, please return the item for an exchange or refund of the merchandise value. View Full Return Policy.


text:
Pleasures Eau de Parfum Spray 1 oz
designer's notes
Fragrance notes: lilies and violets, roses and peonies, with other exotic blossoms and fragrant woods.
color: N/A Pleasures by Estee Lauder Eau de Parfum Spray 1 oz Year Introduced: 1995 Recommended use: daytime This item cannot be shipped 2nd day air. Allow 1-2 additional shipping days for beauty and fragrance items. This item cannot be shipped outside of the United States. Fragrances; Imported; style# 312503701


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Ohio Christian University Psychology and Sports Management Departments Create Coaching Certificate to Enhance Student Resumes full story..
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President Smith and Dr. Benny Tate joined GOP Presidential Candidate Newt Gingrich, who spoke on God and Country in Milner, Georgia, Feb. 26th. full story..
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Congratulations to Lauren Long and Monica Taylor! full story..
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Ohio Christian University has renamed its Business Department to Department of Business and Government. The Government Relations major was created to serve the nationwide interest in a faith-based government and political science education. full story..
Dr. Mark Smith Discusses Contraceptive Mandate with Tony Perkins, President of the Family Research...
Dr. Mark A. Smith, President of Ohio Christian University, joins Tony Perkins, President of the Family Research Council to discuss the contraceptive mandate on FRC Action's webcast: Healthcare Mandate: Violating the Separation of Church and State. full story..
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What began as a typical college course has turned into a real world experience for a team of students from Ohio Christian University. full story..
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Ohio Christian University's Business Association hosted the second annual Small Business Round Table on Monday, November 28, 2011 with sixty-five OCU students and six business people. full story..
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Since its inception, the Disaster Management and Relief program at Ohio Christian University has always tried to be ahead of the curve. When the program was designed, full story..
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The International Association of Emergency Manager's Annual Conference was held this past week in Las Vegas Nevada and Disaster Management Program Director, Thad Hicks attended. The conferenc full story..


text:
Fall victim's family hit out at hospital after patient tragedy (From Southend Standard)
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Fall victim's family hit out at Southend Hospital after patient tragedy
11:40am Thursday 19th December 2013 in Echo News
A MAN whose mother was injured in a fall at Southend Hospital said promised changes to procedures were not put in place before another woman fell.
Gordon Jiggens, of Seaforth Grove, Southend, spoke out after an inquest on Jean Kouspetris, 80.
Mrs Kouspetris died in May 2011, after banging her head in a fall at the hospital as she struggled unaided to get to the toilet. Her calls to nurses on understaffed Blenheim Ward went unanswered.
At the inquest, it emerged Mrs Kouspetris suffered a number of falls while not being monitored by staff, even though she was supposed to get round-the-clock monitoring.
Coroner Caroline Beasley- Murray said they all might have contributed to her death.
The coroner recorded a narrative verdict.
Mr Jiggens said his late mother, Margaret Jiggens, survived a "horrendous'' stay on the ward after being admitted in 2008. During seven weeks there, she fell and cut her head. She died in June, 2011, aged 86, of old age.
Her son said: "I was stunned at the similarities. My mother was put on to Blenheim because she kept passing out and falling."
He said she complained nurses would not respond to her buzzing and when relatives visited, nurses stood talking while patients' bells went unanswered.
He added: "On one occasion, we visited Mum, she was in bed, with blood all over her head. She was very distressed and there were stitches to a very large head wound.
I asked what happened and was told she had tried to get a nurse to help her go to the toilet by pressing the button, but no one came, so she got up and went herself and fell."
Mrs Jiggens also contracted MRSA during her stay. Her family made a verbal complaint and at a meeting assurances were made.
Mr Jiggens said: "We were assured at the top level lessons were learned and it would not happen again. Then we read about Mrs Kouspetris. I wish we had taken them to court now, instead of believing they would deal with it."
A trust spokesman said: " "We are sorry to hear Mr Jiggens is unhappy with his mother's care. We take patient safety extremely seriously and have reviewed our falls prevention processes, in line with national guidelines.
"Falls are the most commonly reported patient safety incident nationally. It is impossible to eliminate the total risk of falls.
"However, we have a falls prevention and management policy which identifies patients at risk and provides an appropriate care plan.''
Comments (5)
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4:36pm Thu 19 Dec 13
jolllyboy says...
4:44pm Thu 19 Dec 13
runwellian says...
I recently asked fro something as a discharged letter but it appears they don't even know that I was admitted!
8:32pm Thu 19 Dec 13
Almeda11 says...
jolllyboy wrote:Article Quote:
The problem is they dont answer the buzzer. If you are given one. Also to have the side of the bed up to prevent getting out of bed requires a health and Safety Review which is not done when the patient is admitted which is ridiculous.
"He said she complained nurses would not respond to her buzzing and when relatives visited, nurses stood talking while patients' bells went unanswered"
And this is the reason !! We are a very gossipy nation, but hospital is not the place for gossip, and l have witnessed it first hand as a patient a few years ago.
lf they actually focussed consistently on their jobs these things would not happen, or hardly, and as for their " lessons are being learned" it`s a load of bull ----, they never are.
l have seen seen how hospitals on the continent operate, mainly Germany, and if these things kept happening these nurses would be out the door, no question, it simply would not be tolerated, there the people are focussed on their jobs, private life, tittle tattle and personal calls on mobiles are taboo, but patients are happier and better cared for.
9:46pm Thu 19 Dec 13
Southend Andy says...
9:25pm Fri 20 Dec 13
Almeda11 says...
Southend Andy wrote:lt`s not just this incident is it. There are incidents like this all the time. The nhs is awash with horror stories like this. l know of 2 people personally, one was misdiagnosed with constipation, when in fact it was cancer. By the time they found out it was already too late and she died.
Here we go again, yes what happend was tragic but we have a under funded & under staffed NHS & everyone has to jump on the media bandwagon.
And l also lost a friend to cancer, again because it was picked up too late
People in this country are diagnosed far later than in EU countries, wher doctors are far quicker to authorise the correct tests, and where patients themselves take more responsibility and actually go to the doctor when they suspect something is wrong.
Then there is the culture of denial in the nhs, and if anyone sees something is wrong and wants to blow the whistle, which l think is commendable, then they are often targeted, or even threatened, albeit in a subtle way. Thank goodness in Winterbourne Viw, where disabled people were beaten with wet towels and other abuse, that an undercover agent with a hidden camera finally exposed it, on tv, and the sadistic bullies were jailed. But there are many more places like that, it`s not an isolated incident.
And what about Staffordshire hospital, a failing hospital, now under review and threatened with closure unless it improves, as is also Basildon Hospital.
And funding has NOTHING to do with the sadistic nurses or healthcare assistants who deliberately put food and drink out of patients reach, they would never get away with that in Germany, about time for the person in charge of a ward to start acting like one.
This isn`t about bashing the nhs just for the sake of it ! There are real and present dangers, an attitude and culture of denial, where there should be transparency, and it is that culture that NEEDS to be changed.
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I would like to plus rep the guy that just neg repped me with a decent comment, but because you have removed the name of the repper, I will have to just rep everyone.
As Matos above you points out, the viability to fighting out of siege is up for debate, but the important part is that its actually possible, you can actively choose to fight out of siege.
Post change thats an option removed from the dread, probably the most under used ship in game behind the Pilgrim, without spending literally a titans worth of isk on yur dread fit (this is what the titans will have to do to hit subcaps, the problem with the nerf is that most titan pilots have already spent this money, whereas very few if any dread pilots will ever stack 20 dreads worth of mods on one dread).
It doesn't matter if any of you think fighting out of siege is smart or worth it (you should look at the numbers before forming an opinion), the point is its an option being removed from the game for absolutely no reason at all. Nobody was crying about dreads out of siege ruining their game play, why nerf them at all, when you can easily apply the nerf directly to Titans themselves without bothering dreads.
But just getting rid of them is probably the easiest solution.
Turning pretend colourblind angels from spaceship to madship samurais, one post at a time.
I thought so too, but I dont know how to search for a user to rep, looked like far too much work.
I made it past 3 pages and didnt see him
don't get me wrong ships should definitively be balanced pvp wise over pve. and dreads rly need a buff over a nerf its just damn stupid to change anything that makes the dreads even the slightest worse then they already are.
iff ccp wanna get titans of the field making dreads worse is not exactly the way to go as they fill the same roll in sov warfare.
Its a slight Nerf to Dreads if you view it from that PoV. But I can't Imagine this change affecting the current usage of Dreads outside of extreme cases. Maybe PL had planned something along these lines?
They will still shoot other caps and Structures and suck against subcaps in most circumstances.
Also; enough with the split weapon naglfar. Fucking bullshit.
Lame triple sry
They can't fight out of siege anymore.
That might not seem like much to you, but by your own words you're currently unsubscribed to EVE, so who gives a shit if you think that role is under used or not, other people do in fact use them like that.
But no.
No you see PL have this theorycrafted unsieged dread fit which they've never actually deployed but they've given it a cat name, therefore unsieged dreads are the new AHAC, everyone uses them now, and if ccp make any changes which affect it they're turbohitler
Well thank God, because I was getting pretty worried that this would mean that Dreads couldn't shoot structures or supercaps or anything that they're used to do currently.
Did I get it all right?
Up until recently dreads would be dropped quite frequently around Syndicate and used to kill subcaps or gank carriers, being able to actually kill battlecruisers and batleships with transversal without the need of Vindicators for webbing was a nice bonus. RnK will quite often drop dreads to kill caps and do damage to heavily webbed Battleships, but being able to do damage while out of siege can be very important when the majority of your fleets damage comes from those dreads. The aditional tracking you get while out of siege can make a huge difference, as a Moros out of siege will still do 1500dps.
So basicly nerfing their out-of-siege tracking won't change much, but it does slightly decrease their use in smaller scale engagements.
You guys don't have to post here anymore. I'm not reading this thread anymore, so there's no point in continuing to post here and trying to impress me. You'll have to pursue my approval in other threads.
Just a heads up.
Easy John, you're dangerously close to making malcanis look dumber.
Next they'll be on about how Dreads shouldn't be able to hit sub caps, which strongly points towards the fact that they don't want sub caps to be touched at all by caps, but lets let their argument make the trip with them at the wheel, I think its more fun this way.
I just want a wordfilter that replaces "subcaps" with "hubcaps" and "supercaps" with "I am a faggot"
New title, same argument gogogo
Lousy tracking meant they weren't all that versatile. With the nerf now obviously this will work less as a fleet concept.
Edit: If you are a dumb nigger and don't believe this there are videos, including one form Gneeznow IIRC that shows this.
I am 100% on-board with deleting all titans and refunding the skills/minerals to the current pilots. To solve the problem of titan-bridges, just allow super-carriers to fit a bridge instead.
CCP has NEVER really had a good plan for how players should engage titans once they go from being extremely rare to showing up a nightly basis in double digits.
Even when they were rare, I never found them fun to fight against - especially under jammers. The meat-grinders of the mid 2000's probably turned as many people off from playing Eve as the ugly noob ships everyone is so excited about fixing.
Why do this now? Let's face reality, the odds of CCP coming up with some amazing new role that makes all the current pilots happy without pissing off people who hate titans are slim to none. Everyone is going to be mad if the eventual revision of Titans makes them either worthless junk or - worse still - just as good as before.
Therefore, the only way to avoid long-term resentment from the community is for CCP to ride the wave of tears from both sides (the emo titan owners and the bitter sub-cap lovers) and make a bold change that will resolve this damned topic once and for all.
I think most people would agree to this. The problem is CCP knows that making titans quasi-mandatory in 0.0 progression equates to more accounts.
So, yo, there's practically zero chance CCP is gonna pull titans out of the game. I mean really, they've already got art and stuff, it's content, someone got paid for it. They're staying hth. So what would be the second best alternative to nuking the site from orbit? You know, hilariously awesome as the idea is.
I saw XXL guns suggested (seems like a good way to make changes specific to titans without assfucking dreads), removal of weapon bonuses and probably a few other things. Nobody suggested an EHP nerf, which means it'd either completely neuter them or be totally useless.
I guess what I'm asking is what role would
A) work for titans in a way that'd be fun for current titan pilots
B) wouldn't suck cock for us plebes
C) would be acceptable to CCP
Rhetoric sometimes (SUPAR UNDARSTATAEMENTATOS) gets vicious around here, but I doubt anyone seriously wants to double plus unfun the game of the titan users, and I doubt anyone wants to faceroll subcaps all day long every day -- maybe for a few days, only human, but everyone knows the best fights are the ones where the outcome is uncertain til the last minute. And if someone wants either, well, they're a chucklefuck and should be sterilized.
TBH I can't come up with dick, which is why I'm asking. I think the likely CCP choice is nuking titan dps down to dread DPS and increasing the ROF of DD somewhat or giving them a siege mode. That's a plausible outcome that refocuses the thing on capships, which seems to be what many people want, whatever the original intention of CCP (SERIOUSLY SHUT THE FUCK UP ABOUT IT IT DOESN'T MATTER EVER). But I'm guessing that both are dumbfuck ideas or someone would have suggested them already.
@Manny: You suggested anyone other than the lazy should be able to take down titans by now. I think you're forgetting that middle of the road alliances should be able to fight and maybe take some sov (but not lots). Time frame for them to compete against titan blobs held by top four coalitions is a bit long, you think? Maybe you don't think that.
There are lots of things wrong with the null game atm, but I think maybe arguing laziness is a silly way of fixing it. I'd posit that people have been very actively attempting to find ways of dealing with titan blobs. CFC certainly has, and they went for titans of their own. Doesn't that say something, seeing as they are superserious supernerds.
I could be tots wrong (I often am). So what would you do as a titanless alliance of plebes without sov to take down a titan horde? Serious question. I think the answer is "get titans" but I am not supers smartsies.
Also I am seriously fucking lazy, which is why I drink and game a lot. Suck it dry!
What a shitty change. Titans should be bad-ass viking ships, not pussy sit-at-pos-and-smoke-weed support!
This just in (5 hours ago): CCP Nozh' devblogs from 2009 is the exact stance of CCP forever.
I'm not a supercap pilot and I don't do a lot of fighting against them either, so this is not a gotcha setup rhetorical question, but what exactly is the game mechanic raison d'etre for the remote ecm burst?
Fucking one percenters
titans should be 70m ehp T20 links boosters
see what i did there
I saw (unsieged, I assume) dreads dropped on AHAC gangs before. Dreads were never as versatile as carriers for escalating impromptu PVP, and the drone nerf took away a significant chunk of their subcap fighting abilities. Unplanned small-gang capital dropping is greatly diminished these days already just from the overproliferation of titans and the commensurate risk of a doomsday counterdrop. It's a touch ironic that all these whacks to supers seem to keep hitting dreads.
Dread roles need a look at; right now they're outclassed by supers at shooting everything but a POS and their one potential niche - fully insured suicide drops on supers - is of extremely limited value. But balancing dreadnaughts is of little value while you've still got two common ship classes purpose-built to go through dreadfleets like a fat kid through cake.
Here is my not very well educated opinion on how it should work.
Dreads (in seige) should be the be all and end all of structure shooting. They should be much better at it than supercaps or subcaps. Then everyone is using them all the time to avoid structure shooting time sink. They should have a secondary role of shooting other caps. The real issue is making them better at shooting structures without making them op against supers/carriers/each other. The best i could come up with would be making seiged dreads ignore resistances on structures (playing with structure resists/hp to find a balance)..
Supers should the ultimate cap killers, hopefully with plenty of targets if dreadfleets are more common thanks to being much better at securing sov or moon goo than either supers or subcap fleets. This means DD staying the same, fighterbombers staying the same, titan guns staying the same (post tracking nerf) get rid of the terrible scan res/locked targets nerf. Remote ecm burst doesn't make much sense in this role, maybe change it to be anti dreads/titans in some way. Other anti-cap stuff like the often wished for sig dependant capital neuts could be added. Supers can retain a secondary use against structures but are not as good at it as dreads.
Carriers are basically for protecting other caps from subcaps, whether through RR or fighters/drones.
Sub caps murder dreads or supers that aren't protected by their own subcaps and or carriers. They should be comparitively poor at struture shooting, even in large numbers. Taking sov without deploying dreads or supers should suck. Really suck.
I've ignored the logistics/bonus abilities of titans/carriers as they are separate issues really.
TLDR give Dreads a big buff against structures, nerf subcaps against structures, maybe buff supers against caps a little to make up for being useless against sub caps. Oh and get a proper sov system and balance moon goo at the same time. Hopefully people need to use cap fleets to take sov or moon goo income, need sub caps on the field to protect them, need supercaps to kill cap fleets but need subcaps to neutralize the enemies subcaps so they dont all die as well.
Among the problems in that wall of text are, structure shooting is stupid, CCP knows structure shooting is stupid, optimizing a ship class to shoot structures while dying horribly to any resistance is stupid. You can already one-cycle a tower, hub or station with a fairly small dreadfleet, buffing that is pointless. The coming tech nerf should greatly reduce the need to shoot POS, and other structures are far better shot with supercarriers/titans or subcaps already, none of which have the vulnerabilities of a sieged dreadfleet.
The appropriate role for dreads is and always has been capital killing, but this was usurped with the super changes. There is no need to have multiple capital classes with a DPS delivery role, and there is no way you will see sizable dreadfleets in a situation where hostile DPS-dealing supers can drop, except as suiciders, or bait.
I really just think all titans and supercarriers should be deleted from the game with no refund of minerals, skills or isk. You had your fun (I did too), now it's over. Maybe give them some special in-game item, a unique dreadnought or respectively.
nerf the rogue drone minerals at the same time.
I want to see panic and chaos. Also, death2allsupercaps.
We all keep assuming CCP is going to nerf tech when experience tells us they prefer to let problems fester as long as possible.
So that the middle ground gets fielded to deal with the other two extremes.
IDK either, making a ship designed around capital combat when there currently isnt really any capital combat doesn't sound right. Id rather fade the different classes into each other functionally, layered combat if you will that attracts the next class of ship up.
Sub caps engage sub caps, one side starts to buckle, caps are brought in for that side as a rally point and hitpoint soak, the carriers taking over for the broken logistics, the dreads dropping into siege to secure the landing area, the other side can now counter with its own caps or escalate straight to supercarriers and so on until titans hit the ground and its full scale cap warfare.
I don't think you'd find a titan pilot around who would mind being restricted to cap only warfare if there was a reason for people to want to use caps so they'd have something to fight.
They're not the only ones who have looked at it, its the only thing left in EVE with guns on it thats not a titan and a line member can get into that has the chance to stand up to 300 maelstroms worth of alpha.
It works, I mean it was literally in our forum dump that was here.
if you want to fix titans, just remove their blueprints. That turns them into the rare unicorns CCP intended them to be from day one, and keeps them around so people with the bigger-is-better mentality can strive to ride one.
"Every rifter counts friend" - VR
I agree that dreads should have -some- damage capability again subcaps, even if just giving them their drones back, but trying to make them a less versatile carrier won't do any good if you can just bring more carriers. Carriers don't suffer the versatility problems that dreads do, they're quite competent at ratting, repping and personal logistics, so they remain quite common. Dreads have a role and do it well, the problem is overlap in that role with more versatile ships, giving it more overlap with another versatile class isn't the way to get bigger fleets.
Grath, you've made the argument that supers should not be vulnerable to subcaps before, but it makes no sense outside of a further "I win" button for super pilots and heavy coalitions. First of all, it makes no more sense to make a titan invulnerable to battleship guns than it does to make a BS invulnerable to a swarm of frigates. Second of all, super vulnerability is already vastly reduced (excessively, I think) by being invulnerable to regular tackle and ewar. Last, and perhaps most importantly, making a ship vulnerable only to a class it is purpose-designed to buzzsaw through is obviously broken. Even with the lock nerf, how quickly can a titan fleet go through dreads? If the nerf mattered, three a minute per titan? Drop on a 20-titan fleet suicide short range and you're still all dead before your first siege cycle goes through. How many groups can risk a loss like that? If you remove the ability of welpcanes or Tempests to scare off a super fleet then they'd operate against structures with even more impunity than they do today.


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Octogenarians Georges and Anne are retired music teachers whose daughter lives abroad with her family. When Anne suffers a stroke and is left paralyzed on one side of her body, the couple's abiding love for each other is put to the test.
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