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The development of evidence-based clinical practice guidelines has gained wide acceptance in high-income countries and reputable international organizations. Whereas this approach may be a desirable standard, challenges remain in low-income settings with limited capacity and resources for evidence synthesis and guideline development. We present our experience using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach for the recent revision of the Kenyan pediatric clinical guidelines focusing on antibiotic treatment of pneumonia.
A team of health professionals, many with minimal prior experience conducting systematic reviews, carried out evidence synthesis for structured clinical questions. Summaries were compiled and distributed to a panel of clinicians, academicians and policy-makers to generate recommendations based on best available research evidence and locally-relevant contextual factors.
We reviewed six eligible articles on non-severe and 13 on severe/very severe pneumonia. Moderate quality evidence suggesting similar clinical outcomes comparing amoxicillin and cotrimoxazole for non-severe pneumonia received a strong recommendation against adopting amoxicillin. The panel voted strongly against amoxicillin for severe pneumonia over benzyl penicillin despite moderate quality evidence suggesting clinical equivalence between the two and additional factors favoring amoxicillin. Very low quality evidence suggesting ceftriaxone was as effective as the standard benzyl penicillin plus gentamicin for very severe pneumonia received a strong recommendation supporting the standard treatment.
Although this exercise may have fallen short of the rigorous requirements recommended by the developers of GRADE, it was arguably an improvement on previous attempts at guideline development in low-income countries and offers valuable lessons for future similar exercises where resources and locally-generated evidence are scarce.
The approach to developing clinical practice guidelines has become increasingly formal over the last two decades. Requirements now span rigor in evidence appraisal to incorporation of user preferences. As a result developed countries have invested substantially in national institutes to develop guidelines (National Institute for Health and Clinical Excellence [1],; Agency for Healthcare Research and Quality [2], Norwegian Knowledge Centre for the Health Services [3] etc). The World Health Organization (WHO), after criticisms of its guideline development procedures [4], recently adopted the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach [5] expecting it to be used for all new technical advice [6]. Some of the challenges of using GRADE or similar structured approaches to guideline development at international and national levels in developed economies are emerging [7,8]. However, reports documenting experiences from low-income settings are lacking. Yet the GRADE approach, acknowledging that evidence alone is inadequate for making recommendations, specifically directs that local contextual factors be taken into account when producing recommendations. This has resulted in more transparently developed guidance than in the past, where guideline development usually took the form of a small meeting of experts behind closed doors. However the price of this has been increasingly formal procedures making new demands on limited national capacity.
In 2009 the Kenyan Ministry of Medical Services requested support to revise the national pediatric guidelines. We decided, with limited technical and financial resources, to attempt the use of the GRADE approach (see summary in Table Table2)2) for this national exercise. Here we illustrate, from the perspective of those reviewing, summarizing and presenting the evidence in a resource-constrained setting, challenges encountered during this process and when moving from evidence to recommendations. In doing this we seek to go beyond the current focus on further improvements in methodology [9] and broaden the discussion to questions around implementation of GRADE procedures in low income settings. Although we attempted to tackle eleven guideline-related questions we focus here, as an exemplar, on questions identified when attempting to update the case-management guideline for pneumonia in children.
Childhood pneumonia continues to rank as the leading cause of hospitalization and death in children globally [10]. The current Kenyan guidelines (Table (Table1)1) for antibiotic treatment of community-acquired childhood pneumonia are adapted from those of WHO and recommend classification of children into one of 3 clinical categories of severity to guide decisions on appropriate treatment [11]. Key treatment recommendations for children without HIV infection are largely unchanged since their first launch over twenty years ago and concerns have been expressed over their current and future appropriateness [12]. Perhaps linked to such concerns there is evidence of poor guideline adherence revealing possible preferences for 'stronger' (broader spectrum, non-beta-lactam) antibiotics [13].
When resources are limited compromises are made. We illustrate such compromises here both to indicate where sharing resources, capacity and prior work may be helpful and because they raise the question of whether or not what we describe, as an illustration of what may be possible in low income settings, is a 'GRADE-compliant' process.
Our task was updating of pediatric national guidelines in a period of 9 months. In a recent report an international guideline development group engaged an extensive network of experts taking into account multidisciplinary expertise, and regional and gender representation to determine policy-relevant questions [14]. Such an elaborate process was not possible in our case. Policy relevant questions were thus based on the scope of prior guidelines, working knowledge of topic areas and observed local clinical practice, discussions with a small number of key-informants in government and a priori considerations of what might be feasible. Similarly, we defined within the 'GRADE-team' predominantly critical outcomes (mortality and morbidity) that spanned all guideline topics under review. This approach was used to help standardize procedures and in anticipation of presentation and discussion with a national recommendations panel likely to have limited experience considering research evidence. PICO (Population, Intervention, Comparator, Outcome) formatted questions (Table (Table2)2) were thus constrained from the outset by a modest set of opinions from those within the GRADE-team and local observations. This was in large part driven by limited resources and an absence of mechanisms to rapidly gain wider opinions from key sources including patients, caregivers and policy makers. Although this relatively narrow focus has the potential for introducing bias such compromises seem inevitable in the short to medium term in settings like Kenya.
We defined the following clinical questions regarding antibiotic treatment for children aged 2 - 59 months with non-severe, severe and very severe pneumonia:
1. For children with non-severe pneumonia, should cotrimoxazole be replaced by amoxicillin?
2. For children with severe pneumonia, should benzyl penicillin be replaced by oral amoxicillin?
3. For children with severe pneumonia, should benzyl penicillin monotherapy be replaced by benzyl penicillin plus gentamicin?
4. For children with very severe pneumonia, should chloramphenicol be abandoned as an alternative treatment to benzyl penicillin plus gentamicin?
5. For children with very severe pneumonia, should benzyl penicillin plus gentamicin be replaced by ceftriaxone?
Children exposed to, or infected with HIV and those with severe acute malnutrition were excluded from our population of interest due to the unique treatment considerations among these groups.
The decision to review clinical questions 1 and 4 was based on recent WHO technical updates. These recommend the use of amoxicillin in favor of cotrimoxazole in regions with high resistance to cotrimoxazole and benzyl penicillin plus gentamicin in preference to chloramphenicol for very severe pneumonia [15]. Evidence from Asian studies suggesting comparable effectiveness of oral amoxicillin and benzyl-penicillin for treatment of severe pneumonia led us to review clinical question 2. Widespread use of benzyl penicillin plus gentamicin and ceftriaxone among Kenyan clinicians for the treatment of severe and very severe pneumonia respectively, contrary to the recommended guidelines [13], prompted our choice of clinical questions 3 and 5.
Our approach to literature searching and summary are outlined in Table Table33 and Figure Figure1.1. The technical and human resource capacity for accessing literature and for undertaking systematic reviews in low-income country settings, while slowly improving, remains limited. In an effort to ensure a participatory process and despite the absence of 'professional' guideline developers, we engaged government pediatricians in the review process. This meant for all topics, including pneumonia, that only 2 reviewers independently appraised available literature, reaching consensus by discussion where required. In some cases reviewer pairs had very similar professional backgrounds and very limited experience in literature appraisal although limited training and access to technical support were provided over the 8 months preparation phase (Figure (Figure2).2). However, further investment in quality assurance of the review process was beyond the resources and capacity of the group, making errors or misjudgments possible, perhaps particularly when examining topics without existing well conducted systematic reviews. Despite our focus on the major killers of children including pneumonia, malaria, neonatal sepsis and malnutrition, absence of systematic reviews was common and where reviews were available none had GRADE summary of evidence tables (with searches up to March 2010).
Of the 14 team members involved in the entire process only 2 (ME and NO) had experience conducting systematic reviews and limited, prior exposure to the GRADE approach. However, supported by one key team member (NO), software developed by the GRADE Working Group was utilized to classify the quality of available evidence into four categories (Table (Table2)2) after upgrading and downgrading based on our perceptions of merits and weaknesses respectively. As has been pointed out elsewhere [7] there are no absolute criteria for up and down-grading decisions and while GRADE helps make the process explicit the decisions remain to a degree subjective. Where possible, we conducted meta-analyses to improve the precision around estimated effects using RevMan version 5 (Cochrane Collaboration) and subsequently presented the combined data in the GRADEpro software [16]. The meta-analyses included all randomized controlled trials reporting common outcomes and excluded cluster randomized controlled trials.
We now illustrate some of the challenges we found in making these decisions in the case of pneumonia. Before doing this we provide a very concise summary of the primary evidence for selected questions with their GRADE quality of evidence tables. Our full evidence summary, that is entirely consistent with a recently published systematic review (that does not include GRADE tables) [17] can be accessed online [18].
We searched online databases, PubMed and The Cochrane Library using a common search strategy displayed in Table Table33 to identify randomized controlled trials (RCTs) relevant to our questions of interest. The Therapy category and Narrow scope options under the Clinical Queries filter were applied within PubMed. Figure Figure11 illustrates the process used to select the studies we considered for review.
For the policy question "should cotrimoxazole be replaced by amoxicillin in Kenyan children aged 2 - 59 months fulfilling the WHO criteria for non-severe pneumonia?" our search (see Table Table3)3) retrieved 30 publications. Of the 6 eligible articles shortlisted, three were reviews, Kabra et al 2006 (Cochrane) [19] - updated in 2010 [17], Ayieko et al 2007 [20] and Grant et al 2009 [21] and three randomized controlled trials [22-24]. None of the trial data reported mortality as a primary outcome. The estimated effect of the intervention on treatment failure in all three trials was similar to that among children receiving the standard treatment. The quality of evidence from all three studies was downgraded for indirectness with respect to the populations studied since all were conducted in Asia (two in Pakistan [22,23] and one in India [24]). No serious limitations, inconsistencies or imprecision were identified in the studies reviewed, resulting in a conclusion of moderate quality evidence suggesting no difference between the two treatments. Our GRADE evidence summary for these studies is presented in Table Table44.
Among children with severe pneumonia we sought to address the following questions:
1) Should injectable benzyl penicillin be replaced by oral amoxicillin?
2) Should injectable benzyl penicillin monotherapy be replaced by benzyl penicillin plus gentamicin?
We identified 8 articles including 2 Cochrane systematic reviews that addressed the two questions.
Three trials compared oral versus parenteral treatment for severe pneumonia: Addo-Yobo et al [17,20,25,26] conducted a large multi-centre trial of 1702 children in Colombia, Ghana, India, Mexico, Pakistan, South Africa (two sites), Vietnam, and Zambia while Atkinson et al [17,26,27] recruited 203 children with radiologically-confirmed community acquired pneumonia in the UK and Hazir et al [17,28] studied 2100 Pakistani children. All three trials, supported by a meta-analysis of the results of the studies by Hazir et al and Addo-Yobo et al which showed a pooled risk ratio of treatment failure for the two studies of 0.97, 95% CI 0.83 - 1.14, suggested equivalence of the two treatments. Since the studies were conducted among predominantly non-African populations the quality of evidence was downgraded by one level for indirectness. The evidence was therefore graded as moderate quality suggesting equivalence comparing benzyl penicillin and amoxicillin (Table (Table55).
Only one small trial was found comparing costs and clinical outcomes enrolling 40 children with severe pneumonia in Malaysia in 1999/2000 after randomization to either benzyl penicillin/ampicillin monotherapy or combination therapy with gentamicin [17,29]. The results of this trial showed no differences in clinical outcome between the two treatments and higher costs associated with the combination of ampicillin and gentamicin.
Two policy questions were addressed relating to antibiotic treatment of children with very severe pneumonia:
1) Should chloramphenicol be abandoned as an alternative treatment to benzyl penicillin plus gentamicin?
2) Should benzyl penicillin plus gentamicin/chloramphenicol be replaced by ceftriaxone?
Two trials reviewed addressed each of the two questions. The studies were also summarized in a Cochrane review [17].
Two trials compared the effectiveness of benzyl penicillin/ampicillin combined with gentamicin versus chloramphenicol for very severe pneumonia. Duke et al (2002) studied 1116 children in Papua New Guinea [17,20,30] while Asghar et al (2008) recruited 958 children from eight sites in seven developing countries [17,31]. A meta-analysis of the two studies yielded a pooled risk ratio of treatment failure of 0.79, 95% CI 0.66 - 0.94 in favor of penicillin/ampicillin plus gentamicin.
We found no experimental data directly comparing outcomes following treatment of very severe childhood pneumonia using the recommended antibiotics against ceftriaxone, a common regimen used by clinicians in Kenya. One small trial (n = 97) from Turkey compared benzyl penicillin combined with chloramphenicol and ceftriaxone at day 10 of treatment for radiologically-confirmed severe and very severe pneumonia [17,32] while another small trial (n = 71) compared intravenous benzyl penicillin combined with gentamicin with intravenous amoxicillin-clavulanate in Indian children [17,33] with severe hypoxemic pneumonia. Neither trial reported a superior regimen. Failure to report on the process of randomization and allocation concealment in the study conducted in Turkey was considered a serious limitation and therefore the evidence was graded downwards by one level. This quality of evidence was further downgraded on account of serious indirectness of population and comparison as well as imprecision. The evidence from the study conducted in India was also graded downwards for indirectness of population and comparison and imprecision. The overall quality of evidence was regarded to be very low addressing the question of whether ceftriaxone is better than benzyl penicillin plus gentamicin (Table (Table66).
The primary evidence retrieved was from randomized controlled trials and therefore might initially be considered high in quality. However, after subjecting the studies to the GRADE quality assessment process, all the studies were graded downwards leaving no high quality evidence for any of our 5 Kenyan policy questions. Although the GRADE system provides for the inclusion of data from observational studies, we found none that addressed our clinical questions. Our reasons for downgrading evidence, and any challenges with this are highlighted below.
Limitations that might result in downgrading are reasonably clearly defined in GRADE and include lack of allocation concealment, absence of blinding and large losses to follow up. For pneumonia two trials failed to report allocation concealment [29,32] and blinding was only achieved in the trials comparing cotrimoxazole versus amoxicillin, likely due to practical limitations related to the nature of the interventions in the other trials (e.g. comparisons between injectable versus oral treatments [25,27,28]). Reported losses to follow up were low in all of the identified studies. Despite the global importance of pneumonia as a cause of mortality in children [34] evidence was often inadequate in quantity or quality or both, a finding common to most other topic areas we examined.
Inconsistency refers to large and unexplained variability in magnitude of effects across studies. Hidden inconsistency becomes more apparent as the number of studies compared increases. With only a few studies available apparent inconsistency was only detected in one instance, in trials comparing cotrimoxazole and amoxicillin for non-severe pneumonia. Straus et al [22] reported superiority of amoxicillin over cotrimoxazole with other studies [23,24] reporting equivalence. Although this trial appeared to influence the conclusions of an influential review suggesting amoxicillin should be the preferred treatment [21] the effect appeared due to the inclusion of a group of children with severe pneumonia. We, therefore, did not downgrade the quality of evidence but instead opted to consider evidence from only those children with non-severe pneumonia, a decision which resulted in three reports indicating equivalence of these drugs in children with only non-severe pneumonia.
Indirectness refers to differences between the evidence under review and the clinical question of interest in relation to the PICO elements. We downgraded all the studies reviewed by one level for indirectness of population based on geographic location since they included little or no data from African children. This subjective decision was based on studies suggesting higher risks of treatment failure and mortality in African children with pneumonia [31,35,36]. Interestingly, this position was shared by the Kenyan audience who cited professional experiences to back their distrust of the generalizability of data from Asia. Indirectness was also related to the interventions studied and resulted in downgrading the evidence available for treating very severe pneumonia [32,33], where this, coupled with only data from non-African populations led us to downgrade for indirectness alone by two levels. Amongst other topics we found we also downgraded evidence on the basis that data were relatively old, were available only or predominantly on adults or dealt with outcomes other than those pre-specified as critical.
In studies where sample size is small and number of events few, estimated effects are associated with wide confidence intervals and therefore regarded as imprecise. This was relatively common with three trials which recruited less than 100 patients graded downwards by one level for imprecision [29,32,33].
Our ability to conduct meta-analysis incorporating data from all of the studies reviewed was frustrated by differences in reported outcomes [27] or an inability to incorporate data from a large cluster randomized controlled trial [24] (because entry of primary data assumes individual randomization) into a pooled analysis in GRADEpro.
Reliance only on published studies may cause bias if there is a preference for reporting only 'positive' outcomes. Our resources and we suspect those of many in low income settings, precluded detailed searches of grey literature making such a bias likely, particularly where there are already very few published trials. In the case of pneumonia the similarity of studies to those identified in a subsequently published Cochrane review [17] are reassuring but for other topics this remains a threat to our findings.
We did not find any studies reporting on cost-effectiveness of alternative pneumonia treatments. We considered that evidence from observational studies suggesting no clinical difference following treatment of pneumonia in children with beta-lactam antibiotics in the presence of penicillin-resistant or penicillin-sensitive pneumococci [37] to be of potential value when considering recommendations. However, local data on in vitro resistance and the clinical effectiveness of antibiotic treatments were either limited or completely lacking respectively.
The GRADE approach indicates that contextual factors including cost, local values and preferences, feasibility, undesired effects and benefits should be taken into account in making a recommendation based on evidence. There is no explicitly defined preferred method for taking these factors into account. Our pragmatic approach was to engage a national guideline development forum attended by a panel of 70 people from academic and policy backgrounds and routine clinical settings. After presenting and discussing the evidence we invited discussion on these contextual considerations (Figure (Figure2)2) amongst panelists to inform development of recommendations rather than relying on research data alone. However, this forum did not include patient representatives as is recommended in GRADE [38], instead professional health workers were asked to consider this perspective. Such an approach is pragmatic but has clear limitations. However, gaining patients' perspectives, particularly when they are children, is a poorly developed area of practice and research in both low and high income settings alike. How this forum and deliberative process proceeded will be described in detail elsewhere, however here we illustrate how the evidence met with contrasting fates in the process of making recommendations.
Most notable was a strong recommendation against the proposal to adopt oral amoxicillin in place of or even as an alternative to benzyl penicillin/ampicillin for severe pneumonia. This was despite evidence from three large trials suggesting equivalence between the treatments and several additional factors apparently favoring oral amoxicillin including lower cost, more convenient twice daily dosing and reduction in the use of injections in children. In this case the panel essentially discounted moderate quality evidence and felt that such a change in policy should only be informed by locally-generated data. Such an absolute rejection of evidence gathered from trials involving almost 5000 children, something of a surprise to those summarizing it, was also observed for other guideline topics. In this particular case one could speculate that the absence of patient views, children who might receive either multiple injections or oral therapy, might have been an important omission.
Interestingly, strong recommendations were also made against proposals to adopt penicillin plus gentamicin for severe pneumonia and ceftriaxone for very severe pneumonia. Although evidence was largely absent, and thus did not support these proposals, such regimens were admitted to be common local practice. Here a major reason given for strongly rejecting what was already being practiced, in support of existing recommendations, was the perceived need to preserve the alternative treatments as second line regimens in the absence of viable alternatives. It is thus possible that here discussions on the absence of evidence supporting superiority of non-guideline regimens being used in practice may have helped to rebuild confidence in existing guidelines. In line with the evidence presented, the panel made a strong recommendation to abandon chloramphenicol as an alternative treatment to benzyl penicillin/ampicillin and gentamicin for very severe pneumonia. In this case, although the decision was consistent with the moderate quality evidence, much of the data summarized was from non-African children. This contrasts with rejection of similar quality evidence, also from non-African children, referred to above in the case of amoxicillin in severe pneumonia. In this case we speculate that abandoning chloramphenicol may have resonated with existing views that the drug was no longer suitable, having been abandoned by western countries many years ago on the grounds of safety.
We used the GRADE system to review and contextualize the evidence on a number of topics as part of an effort to revise Kenyan national guidelines. We have used the antibiotic treatment of community-acquired pneumonia in Kenyan children to illustrate the approach and some of the challenges encountered. Perhaps one of the most striking findings is the limited availability of high quality evidence generalizable to the population of interest, Kenyan or African children. Whereas it is not feasible for all policies to have supporting data from large randomized controlled trials, we noted a serious shortage of good evidence on a number of other important guideline related questions in pediatric and neonatal care. This contrasts with the situation for a topic such as outpatient malaria, where a recent systematic review managed to include fifty randomized trials [39], reflecting the disparities in interest and funding in child and newborn health.
Where studies are few limitations of the evidence are likely to be greatest. It is hard to detect publication bias, inconsistency is clearly hard to evaluate, imprecision is likely and indirectness related to study site will be common. With low quality data recommendations should generally be weak if the GRADE system is adhered to. We employed a voting system based on an adaptation of the GRADE grid [40] that it was anticipated would allow the consensus group to indicate strong or weak support for a recommendation. However, in almost all cases strong recommendations were made irrespective of the evidence quality. While the decision making process might have influenced this observation we speculate that it may also reflect concern that a weak recommendation does not make for a good national guideline.
Grading the evidence when resources are limited may depend, to a considerable degree, on the subjective decisions of a small number of people. In our case evidence was summarized and graded by only two to three people. In an attempt to engage the local pediatric establishment review teams included people with very limited prior training or experience in this field. While the GRADE approach and software appeared relatively intuitive to use after limited introductory training, decisions on how to grade the quality of evidence, for example down-grading for indirectness, might have influenced subsequent recommendations and inexperience resulting in inappropriate decisions may have been important. The alternative of engaging a team of experienced methodologists in an effort to minimize the potential limitations referred to above would have been associated with substantial increases in the cost of the process challenging the feasibility of this exercise in low income settings [41]. Instead we attempted to minimize the potential for error and bias through adopting measures such as having two authors independently generate GRADE evidence profiles and facilitating a transparent reporting of the reviews.
The GRADE approach promotes a more transparent contextualization of evidence to produce final recommendations. The degree to which it is reasonable to 'abandon' evidence in favor of context is perhaps debatable. It appeared to us that moderate quality evidence was on occasions influential and on others ignored. Thus in the absence of likely significant additional contextual factors (such as costs or feasibility) decisions appeared to be based largely on the preferences of the people assembled and their views on patient preferences. The dynamics of the group process, the choice of the discussion moderator and his interaction with the recommendations panel, the composition of this panel, the mode of presentation of the evidence and other factors may all have contributed to the direction and strength of final recommendations [42-44]. We will report observations on these potentially important aspects of the use of GRADE in real life settings in full in due course.
Although our application of the GRADE system may have implications for the validity of our final recommendations, it can be argued that our approach was in fact an improvement on previous exercises in national guideline development that lacked transparency [45]. Previously, the local process involved the adaptation of recommendations issued by the WHO through a relatively closed process by a small panel of local experts [41]. The weaknesses of this practice were compounded further by flaws in the process guideline development at the WHO [46]. As more groups in low income settings use GRADE open sharing of resources and experiences is likely to gain importance, hence all the material we generated in this exercise is freely available online [18]. Such sharing of reviews is important to avoid duplication of efforts and should help set priorities for undertaking and disseminating formal systematic reviews. Sharing lessons from users of GRADE will also be valuable for the further refinement and adaptation of this system to optimize guideline development in settings where the capacity is limited and locally generated evidence lacking.
The authors declare that they have no competing interests.
AA supported by ME and NO was primarily responsible for the systematic review of pneumonia case management. AA produced the first draft of the report on use of GRADE that was further developed with input from ME and NO. All authors reviewed and approved the final version of the manuscript.
The pre-publication history for this paper can be accessed here:
We would like to thank the Kenyan Ministries of Health for engaging us in the guideline development process and all those who took part in the recommendations development forum. AA and NO are supported by funding from a Wellcome Trust Strategic Award (#084538) and ME is funded by a Wellcome Trust Senior Fellowship (#076827). This manuscript is published with the permission of the Director of KEMRI.
PubMed Central Canada is a service of the Canadian Institutes of Health Research (CIHR) working in partnership with the National Research Council's national science library in cooperation with the National Center for Biotechnology Information at the U.S. National Library of Medicine(NCBI/NLM). It includes content provided to the PubMed Central International archive by participating publishers.


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eGov Services • 1300 Perdido St, New Orleans, LA 70112 • (504) 658-4000
Home » New Orleans Police Department » Press Releases » 2014 » 20140316 Car Crash In New Orleans East Claims The Life Of A 35-Year-Old Man
NOPD launched a new website that will serve as a 24/7 online source for news and information from and about the police department.
Find the latest news and search all press releases since 2012 at NOPDNews.com
Visit NOPDNews.com
This morning members of the New Orleans Police Department's Fatality Unit are investigating a car accident that left a 35-year-old man dead in New Orleans East. The name of the man is being withheld pending notification of family members. The accident occurred at approximately 6:25 A.M., on I-10 Westbound near Irish Bayou.
A 35-year-old man was driving a dark colored Dodge Intrepid Eastbound on I-10 when for reason unknown lost control of his vehicle. He went across the median and struck a dark colored Nissan Juke traveling Westbound on the I-10 driven by a 61-year-old man.
The 35-year-old man died at the hospital and the 61-year-old man is listed in stable condition.
Blood and alcohol tests are pending and the Orleans Parish Coroner will conduct an autopsy to determine the exact cause of death.
The lead Fatality Investigator is Edgar Edwards and can be contacted at 658-6200.
Officer Garry Flot
Last updated: 12/15/2014 2:17:47 PM


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New Whale Pincushion Sewing Pattern -- Meet Seymour Spyhop
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and other silly things
Pulling out Boxes and look who I found...
Lots of pieces from 2007 when I worked with Midwest of Cannon Falls on a line of Christmas, Easter, and all around decor... I'll be shooting more of these ...
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Meandering Quilt Thoughts
Springtime...(And still with the eyebrows)
Hello Everybody! It's a lovely Spring around here - a little rain, a little sunshine, a little warmth and a little cold, beautiful flowers - perfect! Stil...
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Quilting Sea Glass
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Design Mom
House Hunters International Tell All
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Paint in My Hair
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House of Whimsy
FINALLY....Our Kitchen Remodel Post!!
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That Seams Fun...
Imparare a fare Binary Trading Profits
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Approachable Art
Lifus Interruptus
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Anna Maria Horner
Spinning Blooms Mini
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Bee Creative Parties and Charity Fundraiser at QuiltShopGal
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Secret Sewing Sisterhood
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How About Orange
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wishes, true and kind
Weekend Sewing in Manzanita
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Confounded By Quilting
Quilter Blogs
Make It and Love It
Minimize Don't Organize
Ann Champion's Blog
A Commonplace Life
Thursday, April 1, 2010
Look what came home with me!
Singer 66 or Singer 99?
Singer 99 or Singer 66?
Both handcranks. F5271388, and F2599030. Basically a 1912 and 1914 Singer Sewing Machine. Looked at the Singer 66 manual, that came with one of the machines, to make bobbin thread, and to thread the machines to make sure that they worked. They did. One of them is a bit rougher than the other machine, well, they've been used. That was this week's purchase. I'm still working on last week's Red "S" Featherweight, that I bought locally. Got my "e" washer, so that I can put the tension assembly back on.
It has been raining sewing machines!!
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Gail Pickens-Barger, E-RYT
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Yoga with Gaileee, Registered & Certified Yoga Teacher. Beaumont & Nederland Texas, Tx.
Chair Yoga, BackPack Food Ministry, Thursdays 10 am at Wesley UMC in Nederland, Texas
I teach adaptive yoga for MS at Wesley United Methodist Church, 3515 Helena Avenue, Nederland, Texas on Thursdays at 10 am. Those with MS and their compan...
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Singer Featherweight 221 - Everything & Anything you wanted to know about the Singer 221 Sewing.
Featherweight Tension Adjustments by Alex Sussex
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Yoga Kiddos With Gaileee. Teaching yoga to the kiddos. Beaumont & Nederland, Tx.
YogaKiddos in Nederland, Texas.
Lots of YogaKiddos activities this mid-winter at Wesley UMC in Nederland, Texas. We are gearing up for International Kids Yoga Day in April. Here are som...
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Zumba® Fitness Class with Gaileee - in Nederland and Beaumont Tx
Have a new site!
I have a new site! Click on over to: http://zumbawithgaileee.wordpress.com/ Thank you!
4 years ago
Gaileee's Adventure 2 Mongolia's Blog
Life without electricity….
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Ponca City, We love you
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My Peace Corps Mongolia Experience
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All of the big Marvel news announced so far this year seems to concern Fox's Logan feature or Thor: Ragnarok, but the real Marvel entries we need to focus on are the new titles being added to MarvelTV's growing universe. Marvel and its affiliate, Disney just announced the development of The Runaways, as well as a Cloak And Dagger series.
The Runaways series has been rumored to be in development for some time, though no evidence proved those rumors to be true. Now that we know #TheRunaways is in fact being developed, we can move on to the even more interesting title added to Marvel's lineup of upcoming series, Cloak And Dagger.
Cloak And Dagger and The Runaways Series Announced
#CloakAndDagger is expected to follow Tandy and Tyrone as they become underground superheroes of New York City. Tandy becomes Cloak while her partner, Tyrone, becomes Dagger, thus creating 'Cloak and Dagger'.
That superhero description may sound familiar to that of Daredevil, so there's a good possibility for Cloak And Dagger to crossover with Netflix's Daredevil series seeing as they all police New York city.
The list of #MarvelTV series has expanded dramatically in the past few years. What began with Agents Of S.H.I.E.L.D. has expanded into two additional ABC series and a whole variety of series exclusively available on #Netflix, some of which will debut this year.
More MarvelTV Is What We Need
2017 is expected to introduce Iron Fist, The Punisher, and The Defenders to the MarvelTV universe, so with the news of The Runaways and Cloak And Dagger being added to the upcoming lineup of television series as well, it won't be a surprise to see more Marvel properties become episodic series within the MarvelTV universe. That said, more MarvelTV series would be the way to go when we account for all of Marvel's worthwhile properties, just sitting in development limbo, waiting for an opportunity to shine.
Most fans would like to see their favorite Marvel titles become movies but that's not likely to take place. The #MarvelCinematicUniverse only has so much room to develop unique stories, while still keeping the collective plot together which means the best option for lesser known Marvel titles to be developed lie within MarvelTV.
We can also expect Marvel's Defenders to arrive in 2017:
There's a chance some fan-favorite characters will make their way into the MCU but we should be expectant of characters and properties which exist outside of Marvel's mainstream comics to be developed into MarvelTV series rather than movies; The Runaways and Cloak And Dagger series being perfect examples.
After learning that the MarvelTV universe is expanding into more properties than the MCU, it's only a matter of time before the popularity of MarvelTV surpasses that of the MCU. When that happens, the call for more MarvelTV series will see the universe expand into territories we never thought possible.
Here are some of the Marvel properties which have been rumored to be in development, and could be the next Netflix series to join the MarvelTV universe.
The Blade title has been rumored to be in development since Marvel /Disney regained the rights to Blade. The biggest indicator of Blade moving into development came when a fan question for Kate Beckinsale, spilled the beans on Marvel's plans on Blade, not literally though; we all know how #Blade would react to food being spilled on him.
When asked at New York Comic-Con whether or not her next Underworld film would crossover with Blade, Beckinsale responded to the question by stating:
"They (Marvel) said no. They're doing something else with Blade."
No other followup remarks were made, but just from reading Beckinsale's confirmation of Marvel doing something with Blade means "some" project involving Blade must be in development. And with MarvelTV continually expanding its catalog of episodic series, Blade could be the next title added.
Ghost Rider
A Ghost Rider television series is another Marvel property rumored to be in development for some time now. After Season 4 of Agents Of S.H.I.E.L.D. left us all clamoring for more #GhostRider, fans immediately began hoping Marvel would answer their calls.
Despite there being no official confirmation of a Ghost Rider series in development, all the hints of Johnny Blaze's Ghost Rider on Agents Of S.H.I.E.L.D. seem to be leaning towards his introduction in the MarvelTV universe.
When we consider how many plots will be expanded upon when Agents Of S.H.I.E.L.D. returns from its winter hiatus, there probably won't be enough time to devote to a character like #JohnnyBlaze. With that in mind, Johnny Blaze's Ghost Rider would be more fitting on a MarvelTV series all his own. If that does come to be, then Johnny Blaze could be joined by other known Ghost Riders like Dan Ketch and Carter Slade, making a series about Ghost Rider well worth watching.
The Runaways and Cloak And Dagger will debut in 2018. Cloak And Dagger will apparently appear on the Freeform channel while The Runaways is presumed to air on ABC alongside The Inhumans and Agents Of S.H.I.E.L.D.
Agents Of S.H.I.E.L.D. returns from its hiatus tomorrow night, January 10, 2017.
Those were just some predictions of which Marvel titles will be next to join the MarvelTV universe. Are there any Marvel properties you'd want to see become MarvelTV series?


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BUSTED! Recruitment Method of Trump Protesters Uncovered!
by Team DML/ June 5, 2016/ CRAZY LEFT
People demonstrate against Republican U.S. presidential candidate Donald Trump outside his campaign event in San Diego, California , U.S. May 27, 2016. REUTERS/David McNew
The violent rioting that is escalating at every Trump campaign rally across the country is not just local people who are against Donald Trump. Authorities have become aware that many protesters are traveling from one rally to the next, state to state. They are being paid very well to do so, plus benefits.
Screenshots of printed ads from Craigslist can be seen below. The ad reads: "We will pay $15.00 an hour plus travel (including room and board), clothing, flags, signs, etc. for individuals willing to disrupt Trump rallies throughout the US." The ad is dated June 3, 2016.
Trump Protest Ad 2a CraigsList Trump Protest Ad 2b Craigslist
Sign up to get alerts about Dennis Michael Lynch's upcoming Donald Trump film and breaking news.


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Separate names with a comma.
Discussion in 'Original Pictures Forum' started by landsoul, Aug 18, 2010.
South Bend, IN
Nice stuff.
Nice stuff, the lettering on the dump looks photoshopped?
That's what I was thinking... But just figured it was a really bad graphic job.
we just had it done. That's the sign co. proof for us.
Lets get more pics of the ford. That bed looks sweet.
I do like that bed, it looks very functional.
Don't do the stuff below the tailgate, it is just going to get torn off when you dump a load and that spot on the truck is always dirty.
Posted via Mobile Device
How do you like that Dingo?
I was thinking about getting one to trench areas that I can't get the bigger machine into.
I purchased the Dingo new in '03. Has been so reliable and a perfect machine for our industry. Can get into some pretty tight backyards while doing minimal dammage. The thing has been flawless. 1400 HRS. and hasn't missed a beat. It's almost like having an extra employee or sometimes two.


text: I NEVER POST... but after clicking one thread stating why people shouldn't complain about the $10 surcharge for EVO.. and finding nothing but snarky comments instead of real argument towards persuasion... I just had to give my 2 cents. Please top trying to pick sides within sides... its effin' gross... So in being relatively new to android I have done a ton of research on the intricacies of the OS and all that it can do. What I have found most is that there are more people (majority, not all) trying to sound like know it alls, than there are informative people. People complain about how the OS is getting fragmented but it seems the users are being more so. There is too much animosity amongst people who have pretty much the same phone. Alot of that can be seen with the whole EVO vs Incredible. Even those with Nexus Ones have been found gloating about getting the next OS rev first. Seriously, we all know any facts you want to try to rub in our faces. Heck ALL three phones are HTC and near identical. The average consumer will not take to the platform if they get such a distaste from opinion spewing wannabe techies. People are generally open and trusting in these scenarios and to scoff or think you are somehow better than those, is severely delusional. As odd as it is, wide adoption is necessary for us if this platform is to grow and be competitive. There is way too much hating going on from one thing to another... I can gather it comes mostly from the bored/lonely/unsocial... but still.. the whole "if you don't know you should return the phone" "nuff said" and so on is just going to make us lose. Just like on blogs, lack of information in comments, and just boasting or bitching is a cop out for people who have nothing worth while to say. I for one don't want the stigma of being douchey assholes if iphone people are the fad followers. Seriously... I love the platform, but if the iphone's for ditzy girls then some of you make android seem like its for angry nerds. Please consider those you speak to, just because they can't see you doesn't mean you get to be a ****** who wastes all OUR time. (off topic) I have been on all sorts of forums and its sad enough people touting their different porsches, lexus', and what nots in their tags... but lol phones and the specs in those too?(ok that was a bit of hate)


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Back when I was in school the library used to be my second home. Say, I was done with classes for the day and had time to spare, or I was working on an assignment / project, or I was studying for a test, or I just wanted to rest for a while – there was only one place I would go to – the library. My home away from home; my sanctuary.
Then came the time to graduate and to move to a new place, new job. The first few months here, I spent most of the time at work trying to get used to it all. And once I was settled in comfortably, I found myself with so much spare time in the evenings and started missing the library back in school. As I was debating whether or not to go visit the public library nearby, the distant dream of one day having a good collection of books of my own started knocking on my heart's door more frequently. Now, I could afford to spend on books that weren't textbooks and I thought why not.
And that's when I became a regular at the Borders store near work.
Since then, so much time I've spent in the company of books there! And how attached I've gotten to that place because it holds so many memories – of the time I took my sister there and she picked book after book all the while telling me it would be the last, but still couldn't stop; of those weekends I studying for the test while K sat next to me and passed time with a good book in hand; of the evenings K spent preparing for interviews while I sat there lost in a world that the story took me to; of those days when we would meet there after work, sit upstairs at the store and just watch people walk by down in the streets – people rushing home after work, tourists stopping here and there to take in what the city has to offer, kids chasing pigeons, couples, hand in hand, smiling for photos; and of all those afternoons and evenings that I have spent there alone – wandering around different sections of the store, browsing a page or two of a book here and there, sitting near the window and reading a novel, digging through coupons to buy the books I want – good times!
I've made Borders a part of my life only in the past few years and I was heartbroken when I heard the news of all stores across the country closing. What must they be feeling – the ones who've seen the franchise grow alongside them; the ones who've spent time with their children and then their grandchildren in the stores seeing the generations after theirs grow just as fond of the written words as they are; the ones who've made it part of their routine to go to the bookstore to meet friends or family to spend time every now and then to appreciate the world of books, be it in the form of discussing favorite reads or recommending good books or buying a bestseller; and most of all, the ones who've spent years working for the company, the devoted employees.
This post might sound like an exaggeration to many, but to me it's just the way I feel – deeply sad to know that one of my safe havens would be no more in a matter of months. Of course there are other bookstores around and I am sure I will come to like those too, but that's a different thing altogether. For now all I know is that I'll miss the comfort that comes from being in a place that always brings a smile, the memories that are written all over the walls, the familiar faces that I get to see every time I walk into those doors, and those isles that I've strolled through so many times or those shelves that I've skimmed through week after week.
Borders – you'll be missed immensely by me and so many others. Thank you for all these years of service. My best wishes to all your employees.


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The story of Jet Black continues, and more of the mystery unfolds as Jet and his friends prepare to rescue the remaining children held at Miracle Manor, by the sinister Dr. Drexler.
More clues come together to reveal a larger picture as Drexler's plans come to light, piece by insidious piece.
Grandpa's story is continued, which further sheds light on the history of Nebulous and the Key holders who came before Jethro Black.
The Enigma of Serenity further unfolds, and as Fig embarks upon this new world, opportunities are discovered for expanded perception and insight, not only into the past, present, and possible future, but perhaps into the very nature of mankind's existence.
Insidious is the second release in the young adult science fiction series...Jet Black.
©2015 T.S. Littlefield (P)2016 T.S. Littlefield
"This is pretty darn good story"
This is pretty darn good story, and it flies along at a nice fast pace. I'm not exactly sure how to rate children's stories, whether based on my own image of what a children story should be (I don't really have a clear idea of that, I never read books of this nature when I was a kid), or compared to the historical, theological, or generally more adult themed books I normally read. Neither seem very fair, so I went with what I think it deserves for what it is: 4 stars for good, clean, fun.
Jet's story continues, there are more children being kidnapped, hence, more children to rescue. With the help of his friends, Balance (an alien computer), and some cool tech inherited from his grandfather, he does just that.
Meanwhile his father - long believed dead - has gone to Balance's home world to recover from some old injuries, and check things out in the hopes of bringing his family as well. There are the obvious themes of good and evil throughout the book, but there is a lot of Christian analogy in the scenes that take place on Balance's planet. It's rather pretty well done, not very subtle, though it might go over the heads of younger children. We also get more back story for Balance and Serenity and their relationship.
Our villain, Dr. Drexler suffers from Evil Overlord syndrome, he can't stop monologuing, sees his enemies as puny weaklings, and hires idiot minions.
The production quality is fairly average, there are a couple places where the narrator whispers, and the overall sound of his voice changed a bit, but on the whole, it's consistent. Every word is easily understood. No music.
The writing is rather of the sensational style, which works pretty well for a children's story, and Ray Greenley amplifies it. I'm still not sure how I feel about his narration. His voices for minor characters get a little repetitive, though I never lost track of who was talking. He does a good job keeping all the characters distinct, but a couple of his voices are on the weird side.
All in all, I'm still up for finishing the series.
Audiobook was provided for review by the narrator.
Please find this complete review and many others at my review blog
[If this review helped, please press YES. Thanks!]
"Loved this incredible YA book"
TARGET AUDIENCE: Young Adult, but great for adults too. Modern day Fantasy My 16 year old son loved it and so did I.
PROFANITY AND SEX: None, appropriate for all ages.
NARRATOR: Wow. Top notch. The narrator really brings this book to life. Ray Greenley is amazing, you never get confused as to who is speaking, each voice is rich and distinct.
OVERALL: Book number two of the series. My son and I have both listened to it, and have laughed at references to the "deseret bee" (you have to be from Utah), and the tree of life. My son has begged me to leave this review, and to get the next book in the series. Absolutely recommend this book. I can't wait to find out what happens to this young hero. What happens when his mother finds that her husband isn't dead? Will all the kids have gloves?
"This audiobook was given by the author, narrator, or publisher at no cost in exchange for an unbiased review via Audiobook Boom."
"My son (13) and I enjoyed this book."
My son (13) and I had the pleasure of listening to Insidious, the second book in the Jet Black series.
We really enjoyed the first book, Nebulous. In fact, Nebulous is my son's favorite book to date.
Insidious continues directly where Nebulous ends, and is a more action filled story. More secrets are revealed, and the story is unfolding at a satisfying pace.
The book does seem to be a little more adult, but I believe that is to be expected for a series of this nature. The characters also get more fleshed out, and the scope of the story landscape is widened considerably. My only real negative comment is that the small bit of romance in the story seems a bit forced and the chemistry between the characters involved really is not there at this point. It is a very small part of the story, but I suppose it stood out to me because so many of the other characters and situations flow much more naturally.
The narration is excellent. Ray Greenley has a way of making each characters distinct. You always know who is talking just by the sound and cadence of Ray's voice. His tone works very well for this style of book.
Here is my 13 yo old son's review:
"It was an interesting book with a good story and a good plot. It was a quick read, and in my opinion had everything necessary in it to be a short entertaining book. I liked it because there was a lot of action sequences and the adventure part of the story I found interesting. I give the book 5 stars and I would recommend it to the ya. Also Ray Greenly did a very good job at narrating the book being sure to change his voice for each character."
Disclaimer, We received an audio copy of this book in exchange for a written review.
"Can't wait for more!"
I really love this story! It's something I can share with my twelve year old on our long weekend commute! The adventures of a boy and his spaceship, this is fantasy at its finest!
"Cliff hangers"
Please complete storylines for each book. I don't mind buying a series of books, but each chapter should have a proper conclusions stead of cliff hanger endings.
"Good continuation of this series"
This is a continuation of Nebulous, the first story in the Jet Black series. It picks up right where Nebulous left off with Jet, Travis, Balance, and everyone else trying to finish the rescue efforts they started in book 1. It was fast moving, and I was disappointed when it ended because I was really getting into it.
I have listened to several other books narrated by Ray Greenley including the first Jet Black book and part of The Atomic Sea series. Greenley shows development as a narrator in this book, and seems to have found his flow in creating fitting character voices. This one is a bit more fun and lighthearted than the darker Atomic Sea series.
Yes, and if my drive time was longer I would have been able to (not that I'd want to be driving longer...) It was over too quickly, the time just flew by as I was listening. It was one of those books that presents the strange dichotomy of "Oh man I want to hurry up and listen to it all RIGHT NOW" and then "Aww, man, it's over....now I'll have to wait for the next book."
This is a fun, lighthearted young adult series that is quick-moving and interesting. The story has a few plot holes and too-easy solutions at times, but overall the story is engaging and it's easy to overlook those few imperfections.
"Awesome follow up... Bring on the sequel!"
Even better than the first book. I can't share much about what I liked in the story without spoiling it so I will just say that if you liked the first story... don't think, just spend a credit. I love how the characters are developed and that Greenley used the same voices as with the first.
I am now even more hooked than before and hope the next installment is here soon. I'm sure it is a great read but the audio performance is top notch so I wouldn't know. T.S. Littlefield would be very wise to keep the same narrator here for the sake of the listeners who appreciate the individualized voices behind each evolving character and how this adds to the experience.
"Is that fair?"
2, really insufficient data for a meaningful ranking.
Jets escape from his bonds on the table. I find wishing your way out of tough situations to be a bit of a cheat. But then it looks as if this story is relying heavily on some form of spiritualism. Personally my interests lie in the physical world and I like my solutions to be there as well.`
Would have been nice but I had to break it up, managed to get it listened to in a single day.
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Last weekend was another in a seemingly endless succession of Metrorail service disruptions for track maintenance. I would like to thank the front-line Metrorail and Metrobus employees, who spent the weekend helping confused riders reach their destinations. I am sorry you had to do so under needlessly difficult conditions created by the continued mismanagement by Metro officials.
As a rider, I witnessed firsthand the confusion created by Metro's decision to have Yellow Line trains travel a different route: between Eastern Market and Huntington. Any reasonable person would have called this something like a "Blue Line Special," and station announcements should have identified these trains as, for example, a "Blue Line Special from Eastern Market to Huntington by way of Rosslyn."
Metro should simply not have expected the general public, both experienced riders and visitors, to deduce that a train that travels through 20 stations, 18 of them Blue Line stations, is a Yellow Line train.
Darian Glover, Washington


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- Please select a date to see the proper prices!
- Meal can be requested on the spot
Best offer
81 € / person / night, no meal
Description of the accommodation:
Rooms, services Petit Palace Triball Madrid is welcoming all guests in Madrid with 61 comfortable rooms to stay in. If you are curious to discover the highlights of the area, you may also rent a car or take an organized city tour nearby. If you wish to spend your leisure time actively, you may also take the nearby opportunities to rent a bike. Your valuables can be the safely secured in the safe. If you have a suitable portable device, you can connect to the Internet via a wireless network (WiFi) available at the hotel. The exact scope of services offered by Petit Palace Triball Madrid (including those for an extra fee) is available on the information sheet below.
Payment For the reservation you may need to provide advance payment by credit card or credit card guarantee, depending on the exact date, room and price.
Arrival, opening hours The earliest arrival time is 14:00, the latest time to leave the rooms is 12:00. The personnel speaks Spanish and English.
Petit Palace Triball Madrid rooms Rooms
- Please select a date to see the proper prices!
Accommodation services
Free WiFi in shared places
Relaxation: Bike rental at the accommodation
Organized sightseeing nearby, Car rental nearby
Pet friendly, Elevator, Safe deposit box
Hairdryer, Desk in the room, Mini-bar


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Hope you are enjoying your Summer. Comic Con 2011 started on Thursday. In case you're wanting to check up on the latest news we thought we would provide you with some useful links.
A good link from Google for general news – you may want to be a bit more specific for the time frame you're looking for. I found some news that was from 2010.
G4TV is all about Comic Con… in fact it has taken over their whole home page / site.
We hope you have a great weekend.


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Harem Trailer (1986)
"The Loss of Innocence" 09 February 1986 Drama, Romance 190 mins
A young British woman is kidnapped by an Arabian sheikh and held captive in his harem. At first she frantically tries to escape, but as they slowly get to know and appreciate each other the difference between captor and captive dissolves.
Watch the official Harem 1986 trailer in HD below or find more Harem videos on Vidimovie.


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Italian painter Amedeo Modigliani is known for his elegant swan-like necks. Real necks aren't quite so long, of course, but Modigliani's paintings demonstrate the attributes of aesthetically pleasing necks, as plastic surgeons see them.
These are the 4 main features of an attractive neck:
1. A cervicomental angle of 105 to 120 degrees
This is the angle from the chin to the top of the neck to the bottom of the neck, when you are looking at your profile.
2. A distinct jawline with a strong chin
This is the angular, well-projected lower third of the face.
3. A visible sternocleidomastoid muscle
This is the diagonal line you see on your neck when your head is slightly turned.
4. A face shaped like a cone, with the narrowest part downThe heart-shaped face sags and becomes more square-shaped as you age because jowls become prominent.
Less attractive necks lack these characteristics.
They have double-chins, less defined contours and angles, and a less elegant overall first impression.
The aesthetic principles here apply to the art of plastic surgery as well.
Neck microliposculpture, necklift, and chin implants are options for those who want to refine the features of the jawline, neck, and profile.


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The Topeka Daily Capital, Pg. 1 & 12, Friday, Aug. 11, 1916
Died: Aug. 10, 1916
Special to The Capital.
Paola, Kan., Aug. 10---Benjamin Franklin Simpson, Kansas pioneer, statesman, soldier, and the first attorney general of Kansas, died here at 6 o'clock this evening. Death followed an illness of less than one week.
Mr. Simpson was 81 years old and had spent most of his life in Kansas coming here in 1855. He had taken an active part in the political life of the state since it was admitted to the union. Much of his leisure time in late years was spent in writing articles which were invaluable contributions to the history and literature of Kansas.
Mr. Simpson was born in Belmont county, Ohio, in 1836. After receiving an academic education he began the study of law and was admitted to the bar in 1857. He came west the same year and opened an office at Paola. The next year he was u county attorney of Miami county. From that time on his time was given largely to the service of the public.
Few men have been more intimately connected with the history of Kansas than Mr. Simpson. He was chairman of one of the most important committees at the famous constitutional convention at the famous constitutional convention at Wyandotte in 1859. He was the first attorney general of the state, having been elected when the state was admitted to the union in 1861. He resigned this office the following July to enlist in the Union army. His military career covered four years and three months, during which time he served with distinction as captain and major of the Fifteenth Kansas cavalry.
Served in Both Houses.
When the war was over he was elected to the state senate. In 1870 he was elected to the house of representatives from Miami county and was speaker of the house during the session of 1871.
Twice he was sent to the national convention of the Republican party and held various committee memberships. He was again elected to the state senate in 1876 and served as chairman of the judiciary committee. He was a member of the committee appointed by the supreme court of Kansas to revise the statutes of the state in 1877.
President Hayes appointed him United States marshal in 1878, an office he held for eight years. Because of his ability as a jurist, Gov. John A. Martin appointed him on of the supreme court commissioners authorized by the legislature of 1887. Since the dissolution of the commission, Mr. Simpson had been engaged in the practice of his profession at Paola.
Two Daughters in Topeka
The surviving members of the family are Mrs. Simpson, two daughters and five sons all of whom were present when death came. They are Mrs. W. E. Breisford and Miss Carrie Simpson of Topeka; Frank, and Benjamin Jr. of San Francisco; James of Butte, Mont.; Don, of Winnepeg, Canada; Richard of Los Angeles, Cal.
The funeral will be held Saturday morning from the Methodist church at Paola.