text:
Skip to content. |
Skip to navigation
Did you not find what you were looking for? Try the
Advanced Search
to refine your search.
Subscribe to an always-updated RSS feed.
Wyoming Game and Fish plans to test feedgrounds elk and
slaughter any that are infected with brucellosis in order to keep
the disease from spreading to cattle
Tom Bell still inspires a young Westerner.
High Country News' founder, Tom Bell, marks our 40th anniversary with a grim prediction: The West -- and the world -- are doomed.
The Bureau of Land Management is tightening its standards
on what it considers worthwhile, "substantive" public comments from
citizen activists
Some of the environmental movement's greatest heroes were also heroes of World War II.
Astronomer Perry Walker uses his stargazing tools and
skills to work with the oil and gas industry to prevent air
pollution in Wyoming
A series of animal poisonings in Wyoming and Idaho raises
questions about whether the states are ready to take on management
of wolves
Two Democratic governors – Dave Freudenthal of
Wyoming and Bill Richardson of New Mexico – find themselves
caught between the money that comes from the energy industry and
the environmental impacts of oil and gas development
The West in your Inbox


text:
BoxWave Home
Innovative Accessories for More than 3,600 Devices
iPhone 5s
View All iPhone 5s Accessories
Cases & Covers
Stands and Mounts
Plug Adapters
iPhone 5 Image
Amazon Kindle Fire HDX 7.0
View All Kindle Fire HDX 7.0 Accessories
Cases & Covers
Screen Protectors
Plug Adapters
Travel Chargers
Amazon Kindle Fire HDX 7.0 Image
Tablet Cases
iPad mini (2nd Generation)
iPad (4th Generation)
Kindle Fire HD 8.9
Nexus 7 (2nd Generation)
Galaxy Note 10.1
Galaxy Tab Image
iPad Air
View All iPad Air Accessories
Cases & Covers
Screen Protectors
Plug Adapters
iPad Air Image
View All Accessories
Audio Accessories
Bluetooth Keyboards
Screen Protectors
Travel Charges
Stylus Image
Find Accessories for Another Device
My Account
Sign In
New customer?
Create an Account
View Order History
0 Items
Your Cart
There are no items in your cart
View Cart
Continue Shopping
Bringing You Tomorrow's Products Today
New Apple iPhone 5 Case
News Article
September 18, 2012
New Apple iPhone 5 Case - Apple iPhone 5 Simple Element Case Now Available for Pre-Order
BoxWave is now accepting pre-orders for the
Simple Element Case
for the Apple iPhone 5!
BoxWave introduces the
Simple Element Case
, a form-fitting hard plastic shell case that protects your entire Apple iPhone 5 in the simple element of durable plastic, one element to protect against all other elements!
Simple Element Case
's durable plastic protects the back of your Apple iPhone 5 as well as its edges, as well as provide front raised edges to protect your Apple iPhone 5's touchscreen when placed face down. The
Simple Element Case
has openings to access all of the device buttons and controls, so you will never have take it off! And since it is durable plastic, the
Simple Element Case
guarantees against stains, tears, and wear!
Simple Element Case
: one element against all.
You can find more information about the
Apple iPhone 5 Simple Element Case
and other
Apple iPhone 5 cases and covers
Apple iPhone 5 accessories
by BoxWave.

subset: commoncrawl


text:
7-year-old boy killed, three injured in two-vehicle collision in Eastland County
Published On: Dec 24 2013 10:30:20 AM CST
Updated On: Oct 16 2013 04:14:20 PM CDT
Updated On: Oct 16 2013 04:14:20 PM CDT
A fatal accident occurred on I20 near westbound mile marker 358 in Eastland County, killing a 7-year-old boy and injuring three others.
A Chevy Impala carrying three veered off the wet, rainy roadway crossing the center median and striking a Dodge Challenger with a sole occupant.
Both drivers and one of the passengers were injured. Another passenger was pronounced dead on the scene.
Cameron Mitchell Jr. of Fort Worth was the sole fatality. He was not wearing a seat belt at the time of the crash.
Copyright 2013 by KTXS All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
The views expressed are not those of this site, this station or its affiliated companies. By posting your comments you agree to accept our terms of use, which are located at the bottom of this page.


text:
Sprites and Atmospheric Electricity
Sprites: Upper Atmospheric Lightning
These ghostly flickerings in the ionosphere are the coolest things in the sky.
Sprites from Space
The last flight of space shuttle Columbia had a sprite experiment, and its data survived.
Sprite Research: Glimpse of a TIGER
The gallery of upper-atmosphere lights has a new member: tigers.
Les Farfadets
A well-done brief presentation in French adds the humbling note that science has been quick to discount the early sprite observations.
FMA Research
The Yucca Ridge Field Station, run by Walter Lyons, is the foremost laboratory for observing the great thunderstorm complexes of the American Midwest and a prime player in sprite research.
"The 100-Year Hunt for the Sprite"
A thorough article by Walter Lyons and others also mentions trolls.
"Photometry of Flashes Above Thunderstorms"
The doctoral thesis of Chris Barrington-Leigh is full of hard-core basic information about studying sprites and their cousins.
"Space Shuttle Videos of Sprites, Jets, and Elves"
The history of early sprite observations from the Space Shuttle by William Boeck of Niagara University and other authors.
"Sprites, Elves, and Glow Discharge Tubes"
Physics Today published this industrial-strength article by Earle Williams in November 2001. Don't miss the image gallery.
Stanford Very Low Frequency Group
VLF is a major center of upper-atmosphere physics, and the operator of the Fly's Eye photometer array.


text:
Description of Ani DiFranco's Music:
Recommended Albums by Ani DiFranco:
Ani Difranco (Righteous Babe, 1990)
Out of Range (Righteous Babe, 1994)
Living in Clip (Righteous Babe, 1997)
To The Teeth (Righteous Babe, 1999)
Interviews With Ani DiFranco:
Ani DiFranco on her album Red Letter Year (2008)
Ani DiFranco Album, DVD, and Book Reviews:
DiFranco's first book of poetry, reviewed.
Ani DiFranco - Reprieve
A biting commentary on the Bush administration.
Ani DiFranco - Canon
A greatest hits collection.
Ani DiFranco - Red Letter Year
An album full of love songs.
Ani DiFranco - Live at Babeville
Concert DVD
Purchase/Download Ani DiFranco MP3s:
Ani Difranco Biography:
At the age of 19, DiFranco moved to New York City to live and play among all the other folksingers in the Village. During this time, she was also taking classes at the New School, but her weekends were spent touring and playing out in the Folk clubs, bars, festivals, and coffeehouses around the northeastern US.
Her first recording in 1990 sold out rapidly, and she quickly made a second record the following year. She released each on her own Righteous Babe label, which at first was more of a concept than anything. As her career gained more momentum, Ani was courted by A&R reps from major and minor labels, but she continued to turn them down.
Now, after two decades of playing over a hundred shows a year, DiFranco is packing clubs from the Hard Rock in Vegas to Carnegie Hall in New York. Her Righteous Babe label employs more than a dozen people in her hometown of Buffalo, and supports the recordings of cutting edge artists from Drums & Tuba to Andrew Bird and Toshi Reagan. And her rhythmic, staccato guitar technique has innovated the way the instrument is played.
After releasing about an album of new material each year for more than two decades, DiFranco has developed a habit of writing and recording more slowly and mindfully. Her 2012 release Which Side Are You On? saw her collaborating with Pete Seeger on that classic folk song penned during a coal mining strike in Kentucky, by Florence Reece.
She has two children and lives in New Orleans with her husband, Mike Napolitano.


text:
Tampa Bay Buccaneers
Mike Williams - #19 - WR
|6' 2"/ 212 lbs.
|Buffalo, NY
|Years played
|2010, 4th round, 3rd pick by Buccaneers
NFC South Spin cycle: Panthers are in disarray
The Saints beat the Bucs, and the Panthers are still a mess, as most of the NFC South came up short with the Falcons on bye.
Brees tosses four TDs, Saints hold off Buccaneers
Saints QB Drew Brees threw for 377 yards and four touchdowns to pace a 35-28 come-from-behind victory over the Buccaneers on Sunday.
Buccaneers promote CB Lewis
The Buccaneers promoted CB LeQuan Lewis to the 53-man roster from the team's practice squad on Saturday.
On thin ice, Bucs grant Talib a reprieve
It appears that suspended CB Aqib Talib's future this season is with the Buccaneers.
NFC South Spin cycle: Freeman roller coaster continues
With the Panthers and Saints on bye, the NFC South went 2-0 vs. the AFC West on Sunday.
Freeman leads Bucs past reeling Chiefs
Josh Freeman threw for 328 yards and three touchdowns to help the Buccaneers beat the struggling Chiefs 38-10
Buccaneers CB Talib suspended four games
The NFL suspended Buccaneers CB Aqib Talib for four games on Saturday for violating its policy on performance-enhancing substances.
Bucs learning how to maximize Freeman's potential
The Bucs' coaching staff spent the team's Week Five bye trying to figure out what parts of the offense work best for QB Josh Freeman.
Thursday's 60-second rant: Time for Bucs to snap out of funk
For the sake of his credibility, Greg Schiano needs to make it abundantly clear that his team is heading in the right direction on Sunday.
Bucs-Chiefs blacked out in Tampa
The Buccaneers-Chiefs game in Tampa Bay will be blacked out and not televised in the Tampa area.
Chiefs QB Cassel ruled out for Sunday
Chiefs QB Matt Cassel has been ruled out for Sunday's game against the Buccaneers. Brady Quinn will start in his place.
Key matchup: Chiefs RB Jamaal Charles vs. Bucs run defense
In today's Key Matchup, we delve into the looming battle between the league leader in rushing yards and Tampa Bay's run defense.
Bucs place CB Gaitor on I.R. with designation to return
The Buccaneers placed CB Anthony Gaitor on the injured reserve list with the designation to return. Gatior can return to action in six weeks.
NFC South Spin cycle: Week Five
The Falcons are 5-0 for the first time in franchise history, and the Saints finally have a victory, but the Panthers continued their downward spiral.
Bucs looking for ways to jumpstart running game
While rookie Doug Martin is still the Buccaneers' primary ballcarrier, the team will be more inclined to give its other backs opportunities coming out of its Week Five bye.
Williams finished strong with six catches for 65 yards and a touchdown in the Buccaneers' win over Atlanta on Sunday.||||||| He finished the season with 13 catches for 197 yards and two scores in his last two games. He ended up just shy of 1,000 yards with 996 on the season.
Williams caught seven passes for 132 yards and one score during Sunday's 28-13 loss to St. Louis.||||||| Williams enjoyed his best day in terms of receiving yards.
Williams had one touchdowns and 68 yards on six receptions in Thursday's win over Minnesota.||||||| Williams has caught 18 passes for 332 yards with two TDs in his last four games.
Williams finished with four receptions for 113 yards Sunday, his second consecutive 100-yard game||||||| This is a nice boost for Williams' fantasy owners. However, as quarterback Josh Freeman goes so too may Williams' production.
Williams set season highs with four receptions for 115 yards in Sunday's loss to Washington.||||||| Williams had a good game, but is at best a No. 3 fantasy receiver.


text:
A Domain Decomposition Algorithm for Dissipative or non Dissipative Acoustic Cavities
Balabane M.
University Paris 13 - Math. dpt.
This note is devoted to a domain decomposition method solving the Helmholtz equation in the frequency domain. We need to perform this global computation as a sequence of local computations, each computation being performed on a single subdomain, without any knowledge of the geometry and meshing of the other subdomains. This is useful when the global geometry is too big to be stored in a single ...
Vibratory Study of the Soundboard of a Piano
P. Olivier, and J. Alenda
Enseeiht, Toulouse, France
In this presentation, we present our work on the vibratory study of the soundboard of a piano. Material parameters as well as thickness of the material is studied in detail.
Modeling an electric cell actuator and loudspeaker using COMSOL Multiphysics
W. J. Wu
NTU Nano-Bio MEMS Group
National Taiwan University,
This presentation presented the following: * The building of an FEA model of an electric cell actuator using COMSOL Multiphysics * Validation of this model through the AVID and ESPI measurement systems * The building of an FEA model of an electric loudspeaker using COMSOL Multiphysics * Validation of this model throughan acoustic measurement systems This paper is in Chinese.
Acoustic Attenuation Performance Of Helicoidal Resonator Due To Distance Change From Different Cross-Sectional Elements Of Cylindrical Duct
W. Łapka
Poznań University of Technology, Poznań, Poland
This work presents acoustic attenuation performance of helicoidal resonator due to distance change from different cross-sectional elements of cylindrical duct. The helicoidal resonator properties are described mainly in in infinite long cylindrical duct. For practical applications it is important to know the limits of use of this solution. This paper describes how the helicoidal resonator should ...
The Significance of Coupling in 3D Modelling of Acoustic Wave Propagation in a Cavity Containing Air and Porous Absorbent
L. Kelly, Y.W. Lam, and M. Avis
Research Institute for the Built and Human Environment, University of Salford
This study examines acoustic wave propagation in air and porous media in three dimensions using numerical models; in particular it looks at the significance of the coupling effect between the air and porous layer. The numerical model consist of a layer of air and a layer of porous absorbent which are modelled as equivalent fluid and are characterised by complex characteristic impedance based ...
Design and Simulation of SAW Device using MEMS Technology
P.R. Basha, B. Mishra, and A. Zachariah
School of Electronics Engineering, VIT University, Vellore, Tamil Nadu, India
The realization of miniature SAW device is compatible on CMOS device for mobile and wireless communication system has become very important in recent years. Acoustic wave propagation along the surface of a piezoelectric material provides a means of implementing a variety of signal processing devices at frequency ranging from several MHz to a few GHz. In this work, a Miniature SAW device is ...
Room-Acoustics in Open Space Offices
T. Zeugin
Zeugin Bauberatungen AG
Münsingen, Switzerland
Especially in large offices and call centers the noise pollution of Employees and mutual disturbance is an actual problem. The existing distribution of the sound pressure level in a range of frequency from 100 – 250 Hz show significant noise pollution also at remote workplaces for the current state of the examined large office. For improvements the influence of compact wideband sound ...
Matryoshka Locally Resonant Sonic Crystal
D. P. Elford, L. Chalmers, F. V. Kusmartsev, and G. M. Swallowe
Department of Physics
Loughborough University
Loughborough, UK
The results of numerical modelling of sonic crystals with resonant array elements are reported. The acoustic band structure and transmission characteristics of such systems have been computed with the use of finite element methods. An existence of a separate attenuation mechanism associated with the resonant elements, which increases performance in the lower frequency regime has been ...
Design Optimization of a Microphone by Modeling and Simulation
E. Nesvijski
Acoustics@ MBD Consultants LLC.
Westborough, MA
Applied 2D scale model presents a semi-realistic design or a microphone and shows the main mechanical, magnetic coil and electrical parts. Some non-vital elements are excluded for better focusing on acoustic properties of the microphone. The models are tested for frequency response, acoustic power loss, directivity patterns as well design and materials optimization. Based on 2D model analysis ...


text:
---- — Social Security beneficiary outreach Wed.
PLATTSBURGH — The North Country Workforce Investment Board and One Work Source Center are hosting a beneficiary outreach from 10 a.m. to noon Wednesday at North Country One Work Source, Room 220, 194 US Oval.
The event will give attendees the opportunity to learn about the Social Security Administration's Ticket to Work Program, which provides incentives to beneficiaries who are interested in employment. Attendees will learn how working will impact Social Security disability benefits and health insurance from Social Security, as well as information about work incentives that Social Security offers its beneficiaries.
Additionally, Chelsea Scheefer, the disability resource coordinator, will be available to offer supports such as career counseling, job search assistance, resume writing, interview skills, referral to community resources, Social Security Administration disability benefits advisement and individualized job development.
For more information, contact Scheefer at 561-0430, Ext. 3032.
Funds from Zumba class to benefit needy
ELIZABETHTOWN — The Elizabethtown Social Center is adding a Wednesday Zumba Fitness Class to its schedule.
The class will be held at 3 p.m. at Elizabethtown-Lewis Central School. The cost is $8 per class or $20 for the Nov. 28; Dec. 5, 12 and 19 classes.
All proceeds from Nov. 28 through Dec. 19 benefit the High School Secret Santa program led by ELCS English teacher Sarah Rice. The program provides Christmas gifts for needy families.
For questions, contact the Social Center at 873-6408. For the full Zumba class schedule, visit www.elizabethtownsocialcenter.org/calendar.html.


text:
From Here to Serenity
Whether looking for an Ayurvedic practitioner in the United States or India, Svoboda advises caution. "If you have an inexpert doctor," he cautions, "your life is in danger." He explains that the procedures might "aggravate the doshas without getting them to move, or move the doshas in the wrong direction, deeper into the tissues." Scott Gerson, M.D., medical director of the National Institute of Ayurvedic Medicine, underscores the importance of accurately assessing which stage of disease the patient is experiencing. He warns that if the practitioner "erroneously applies radical cure measures to someone who can only be palliated, you risk injuring the patient, pushing disease deeper into the physiology and accelerating disease progression." Dr. Marc Halpern adds that panchakarma is "the single most profound and deepest treatment offered through the science of Ayurveda. Because of that, the potential for healing is greater and so is the potential for causing imbalance."
That said, many people find qualified practitioners that provide profoundly healing treatments. My own experience was that the aftermath lasted much longer than anticipated. There was an immediate shift towards feeling more present. The increased self-awareness put me more in touch with my deep fatigue, which lingered two long months. For better or worse, that New York City edge that enabled me to function against all odds didn't survive Albuquerque. It took a while to acclimate to my new just-can't-quite-force-myself-against-my-needs M.O., but somehow life gets done, and I'm not done-in by the process.
Those interested in panchakarma but looking for some lower-octane care can try some simple home treatments. It's not technically panchakarma�that is strictly a clinical process that must be monitored by an experienced Ayurvedic physician. But outside the clinic, Ayurveda's strong point is the education of the client into a life of ongoing self-care. More than a health care system, Ayurveda is a lifestyle. Halpern asserts that "the best at-home care is to create a lifestyle that is in harmony with your environment through the principles and practices of Ayurveda," such as daily oil massage, meditation, yoga, and healthy eating habits. He stresses the value of simply resting 15 minutes after eating. Remember, Ayurveda sees indigestion as the beginning of disease.
Reflecting on my experience, I hear Bri Maya Tiwari's softly resonant voice: "The intention of panchakarma is to bring us into harmony with who we are." The shifts in my well-being are both subtle and very real. I'm distinctly more present, more patient with my kids and myself, more appreciative and respectful of both friends and adversaries, more satisfied with life. Blood sugar is stable, digestion strong, and sleep refreshing. When stress is unavoidable, I have deeper resilience and simple, effective tools. But am I satisfied? Not totally. One week has done all this. What could six weeks do? I'll see you in India.
Pamela Miles has written on the humanization of medicine and on natural supports in HIV treatment in Healthy Living and the New York Daily News.
Related Articles
Popular Ayurveda Articles
Recent Health Articles
Reader Comments
Subscribe to YJ
Join Yoga Journal's Benefits Plus
Liability insurance and benefits to support
teachers and studios.
Learn More


text:
Students experience English L'Abri
April 07, 2009
Back row: John Moore, Allie Jones, Eddy
Davila, Ashley Felker; front row:
Anna Downer, Philip Meznar,
Kim Woody, Rachel Carr
L'Abri (French for "the shelter"), founded in 1955 by Francis and Edith Schaeffer in Switzerland, today has centers in Asia, North and South America, and Europe.
Describing the L'Abri experience, Matt states, "L'Abri seeks to explore the understanding that Christianity speaks to all areas of life. Spiritual depth and purpose have long been nurtured throughout church history through a variety of intentional Christian communities. L'Abri is one such vibrant spiritual community and is a great fit for Bryan students because one of Bryan's strengths is its strong sense of community."
Senior Anna Downer explains what happens on a typical day at L'Abri:
- Everyone shares breakfast (including English tea) together in the dining room.
The rest of the morning, students are either assigned to work with a group or to study. Work duties include yardwork, cutting wood, cooking, and the like. Those who are assigned to study in the morning and work in the afternoon choose from 1800 lectures and a library of books or just sit by the fire and think, pray, or listen. L'Abri tutors are available to provide direction on what to study.
Philip, John, and Eddy are hard
at work refilling the wood house.
Students break for tea and conversation.
- Everyone stops what they are doing for a mid-morning break to meet on the lawn for English tea and a conversation with a friend, a game of volleyball, or singing along with a guitarist.
- Students are assigned to tables for lunch (which also includes English tea) for a 90-minute discussion on questions on topics of interest, including theological, cultural, literary, and philosophical issues.
- The afternoon is dedicated to either work or study, whichever was not done that morning. Included is a mid-afternoon break for English tea, conversation, and recreation.
- Following dinner (which includes English tea), students enjoy lectures, movies followed by discussion, or a free night to spend as they wish.
Located in the countryside of Hampshire, the
Manor House is where up to 60 students
and staff members live, eat, study, and work.


text:
A day-long leadership training in the Shambhala Buddhist tradition. This workshop will provide skills and trainings in support of the path of contemplative leadership. In the morning we will focus on taking leadership as part of one's spiritual path.
In the morning we will focus on taking the view and practice of taking Basic Goodness and Enlightened Socity as a basis of one's leadership. In the afternoon we will explore the art of communication and conflict resolution from a Shambhala Buddhist perspective.
How we lead our lives in households and in families, at work and at play, publicly and privately, affects the health of an entire society. Join with leaders in Shambhala to explore our mutual commitment to creating a more sane society through principles of universal leadership.
PrerequisitesEveryone is qualified to take leadership training, and it is not neccessary to take the trainings in sequence.
Creating Enlightened Society will explore how the principle of Basic Goodness can serve as a foundation for our path of leadership and the creation of Enlightened Society.
Schedule 9:00-10:00 Opening Chants and Sitting Meditation 10:00-12:30 Leadership as Path Teachings and Workshop 12:30-1:30 Lunch 1:30-4:00 Working with Wealth Teachings and Workshop
Price$50This program is free to Shambhala Interns and Teachers. Membership discounts apply. For financial aid or work-study please contact Mery, volunteer [at] sfshambhala [dot] org, at least a week in advance. No one will be turned away for lack of funds.
Acharya Melissa Moore Ph.D.has been a student of Shambhala since 1979. She has an MA in Contemplative Psychotherapy from Naropa University, attended the 1985 seminary, has been teaching internationally since 1990, and was empowered as a Shastri in 2010. She co-founded, and continues to teach and develop, The Karuna Training, a 3-year professional certificate training in Contemplative Psychology and a division of Shambhala Europe.Melissa is a Senior Executive of Family Service Agency of San Francisco and since 2005 has been the founding Director of The Felton Institute dedicated to research and training in community mental health services for marginalized populations suffering from mental illness. Melissa has a PhD in Psychological Anthropology from California Institute of Integral Studies and a Post Doctoral degree from University of California San Francisco in Community Based Research and Psychiatric Treatment. She has extensive experience as a clinician and manager of several clinics developed for the treatment of eating disorders, dissociative disorders and trauma related illnesses.
Shastri Manuel Madeiros became a student of the Druk Sakyong in 1980. In 1981 his wife Patricia and he became founding members of what is now the Davis Shambhala Center. He served as Chair of the Northern California Shambhala Board of Directors from 2007 to 2013, when he was appointed Shastri. He recently retired from the California Attorney General's office, where he held the position of Solicitor General since 2002. His wife Patricia is the Regional Representative of the Shambhala Office of Culture & Decorum. They have two adult daughters living in Southern California and expect to become grandparents in June, 2013.
Shambhala Online Teleclasses
Intro Meditation Programs
Find a Meditation Centre
Quick View of Programs by Center


text:
Festive round-up: Cooper School parcels (From The Oxford Times)
When It Happens Panel Get involved: send your photos, videos, news & views by texting 'OXFORD NEWS' to 80360 or email
Festive round-up: Cooper School parcels
5:00pm Friday 28th December 2012 in News
PUPILS from the Cooper School in Bicester spread festive cheer by delivering grocery parcels to older people around the town.
For the past five years pupils have brought in provisions from home, and worked with local businesses, churches and charities to collect food and donations, to help older people struggling in the winter.
Among those receiving Cooper School hampers this year were elderly members of the Bicester Good Neighbour Scheme, a charity which sends volunteers to visit 25 elderly people in the town.
Barbara Spurrell, 84, of Kingsclere Road, said: "I have been part of the good neighbour scheme for about a year and am visited by a lady called Corinna and her daughter every week. They light up my life.
"Now to receive a parcel from the school children too, with lots of goodies inside is absolutely lovely – and will help a lot with managing my money this Christmas."
To volunteer call 01869 242808 or speak to members of the team in Bicester town centre on Saturday, January 19, from 10.30am.


text:
October 28, 2013 – Thomas (Tom) Mulligan, Jordan Allott, Fr. Antoine Thomas
// October 28th, 2013 // Sacred Treasures
Tom Mulligan and Fr. Antoine Thomas with the expedition team of nine (including priests and laymen) who made the Mexico Mountain Climb filmed by Jordan Allott, one of the climbers who made the DVD called: The Eucharist Expedition-To the Summit.
Podcast: Play in new window | Download


text:
Free Radical Radiation Biology (PhD)
The PhD in Free Radical Radiation Biology is awarded by the Graduate College. Instruction is offered through the Carver College of Medicine. The MS is offered with or without a thesis.
Admission Requirements
Applicants must meet the Admission Requirements of the Graduate College and the department offering the degree program (review the department's web site or the General Catalog for departmental requirements).
Estimated Cost of Attendance
Tuition and fees vary by degree program and the type of student you are.
Application Deadlines
- Fall semester—January 1
- Spring semester*—January 1
- Summer session*—January 1
*Fall admission is preferred
Application Procedures
To apply to this degree program, you will need to submit some application materials the Biosciences Centralized Application System and some to the Office of Admissions.
Materials to send to the Biosciences Centralized Application System:
- An online Preliminary Application through the Biosciences Centralized Application System
Materials to send to Admissions:
- A set of your official academic records/transcripts (current and former UI students do not need to provide UI transcripts)
- Your official GRE scores from Educational Testing Service (the University's institutional code is 6681).
- International students may also be required to submit TOEFL or IELTS scores to comply with the university's English Language Proficiency Requirements.
- Once recommended for admission, international students must send a Financial Statement.
Once your Preliminary Application is approved by Free Radical & Radiation Biology, you may Apply Online, the $60 application fee ($100 for international students) is payable by Discover, MasterCard, or Visa. If you cannot pay by credit card, you may Download and Print an Application (PDF) and pay the fee by check or money order in U.S. currency made payable to "The University of Iowa."
Contact Information
Free Radical & Radiation Biology Graduate Program
B-180 Medical Laboratories
The University of Iowa
Iowa City, IA 52242
Biosciences Centralized Application System
The University of Iowa
Phone: 319-335-8306
Office of Admissions
The University of Iowa
107 Calvin Hall
Iowa City, IA 52242-1396


text:
- Shuffle Toggle OnToggle Off
- Alphabetize Toggle OnToggle Off
- Front First Toggle OnToggle Off
- Both Sides Toggle OnToggle Off
- Read Toggle OnToggle Off
How to study your flashcards.
Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key
Up/Down arrow keys: Flip the card between the front and back.down keyup key
H key: Show hint (3rd side).h key
A key: Read text to speech.a key
79 Cards in this Set
- Front
- Back
What are some normal respiratory changes for a pregnant woman.
Changes in hormones increase o2 consumption by 15-20%, increase tidal volume increase 30-40%, and an increase in vital capacity (the max amount of air that can be moved in/out of the lungs w/forced respiration). change is related to elevated estrogen levels. Estrogen prompts hypertrophy of the lung tissue, progesterone decreases airway resistance by relaxing smooth muscle of bronchi and alveoli; all this creates increase in 02 consumption along with vital capacity. Lungs will go more outward to compensate for upward pressure on diaphragm from uterus; can't go up and down as much, so goes outward to keep pulmonary fnctn stable.Increase mucus production (due to effects of progesterone (increased blood flow to mucus membranes of the sinus and nasal passages) and estrogen (hypertrophy & hyperplasia of mucosa); stuffiness; educate that these are normal changes; increase fluid intake to thin mucus. Edema (caused by estrogen) & vascular congestion (from progesterone) in upper respiratory tract (clogged due to excess mucus) Blurred vision due to fluid retention.
what are some gi system changes in the pregnant woman?
Starting with the mouth: Ptylaysm: excessive saliva production often w/bitter taste; encourage eating small, frequent meals; avoid starch (pasta, potatoes, bread); cause unknown; epulis gravidarum (growths on the gums that bleed easily and usually regress w/in 2 months after childbirth. ), gingivitis (inflammation of the gums. Down to esophagus and stomach: due to hight levels of hCG and relaxation of stomach, esophagus, and sphincters causes Pyrosis: heart burn; progesterone causes relaxation fo smooth muscle in esophagus, nausea and vomiting can occur. Inflammation of the gall bladder due to slow emptying time and bile back flow or bile stasis which can cause severe itching called pruritis gravidarum. Down to colon: constipation from iron, and slowing down of digestion, Constipation: uterus sits on top of intestines and cause constipation and Hemorrhoids: vein varicosities in lower rectum and anus
Puritis graviderum : itching with pregnancy; caused by bile that sits in liver;occurs in late preggo and can cause severe itching.
Encourage a lot of water!!!
What are some common issues for urinary system in pregnant women?
UTIs are common and pressure on the bladder causes urgency and frequency, glucose increase is normal, but should still be watched for diabetes.Urinary
Bladder compression in 1st trimester (cuz uterus is growing in pelvis & bladder is in pelvis) and 3rd trimester bladder compression due to fetal presentation descending into pelvis & urgency, frequency and nocturia return. (not usually in 2nd cuz uterus is growing up and becomes and abdominal organ, so no pressure on bladder)
Added pressure along w/progesterone induced relaxation of urethra and sphincter musculature leads to urinary frequency, urgency, and nocturia.
UTI: don't get same s/s; may be back-up of urine, not voiding completely; why we want 1st morning urine to determine.
Infections occur more freq in preg due to relaxation of smooth muscle of bladder & urinary sphincter, changes that allow bacterial ascent into the bladder.
Relaxation of ureters, elongation and dilation, and reduced peristalsis that helps move urine from kidneys to bladder is reduced; cause obstruction of urine flow (stagnation=infection)
Increased GFR by 2nd trimester by 50%; alteration prompts body to excrete more glucose in virtually all pregnant women; normal finding to have increased glucose in urine; but have to r/o gestational diabetes cuz urine glucose doesn't accurately reflect blood glucose levels.
What are the normal musculoskeletal changes of the pregnant woman?
Rectus abdominus muscles separate (called diastasis recti), lumbar lordosis in compensation of gravity, relaxin a hromone produced by the placenta and progesteron relax the ligaments including pubis symphysis, round ligament pain due to hypertrophy and stretching. Musculoskeletal uterus is growing and causes diastsis recti (separating of abdominal muscle/rectus abdominis); Lordosis (sway back); as weight of uterus shifts upward & outward, lordosis develops; compensates for changing center of gravity & allows centering to remain over womens legs. Back pain is normal from changes. Pregnancy waddle: relaxin hormone (produced by placenta) along w/action of progesterone relaxes all joints (ligaments) the makes more room from baby to grow; these changes result in waddle as the bones of pelvis shift and move; unsteady gait=greater risk for falls. Round ligament pain: sharp pain in lower abdominal quadrants or groin area (r/o appendicitis); caused by stretching & hypertrophy of round ligaments; right side most often affected due to dextrorotation of uterus. Leg cramps: caused by poor circulation to the extremities; also linked to imbalances w/calcium and phosphorus; to alleviate cramps: stand and lean forward to stretch calf muscle; daily walks to increase circulation to muscles will improve it.
Define the following terms: gravid, gravida, nulligravida, primigravida, gravidity, secundigravida, multigravida, and parity.
Gravid=pregnant; gravida=pregnant lady; nulligravida=never experienced pregnancy; primigravida=woman pregnant for the 1st time; secundigravida=woman pregnant for the 2nd time; multigravida a woman pregnant for the 3rd time, and parity=number of pregnancies carried to point of viability regardless of outcome. Example: para 1 indicateds that 1 preg reached the age of viability, para 2, etc...., does not reflect whether fetus lived or died.
What is the digital system used for recording number of pregnancies and there out comes? Also Woman is pregnant again and has 6 children at home she has had 2 miscarriages and 1 baby that was preterm, 1 set of twins. What is her GTPALM? Also...Her past period august 30. what is her EDC.
Called GTPAL, it is only used for people who have had multiple births.
G=Gravida, a current pregnancy, T= is number of term pregnancies (term meaning made it to 37 weeks, not necessarily alive), P=preterm delivery (at least 20 weeks, but before 37weeks), A=Aboritions both spontaneous (miscarriage),or induced, and L=number of living children. M=Multiple Births( only used if they have a multiple birth (twins...)
G=8 (how many pregnancies)
EDC= june 6
What is Naegel's rule?
It is a sytem of calculating the EDC "Estimated Date of Confinement". EDC now comes from date of last period. You add on 7 days to that date, then go back 3 months and that will be the due date for the baby.
What do the following pregnancy abbreviations stand for? EDD, EDB, LMP, and EDC?
Estimated date of delivery, estimated date of birth, last menstrual period, estimated date of confinment.
Explain the distinctive characteristics and the differences between presumptive signs of pregnancy, probable signs of pregnancy and positive signs of pregancy.
PRESUMPTIVE PREGNANCY: Subjective from patient: "I think I might be"- patient might think they are pregnant and have ammenorhea, nausea, vomiting, fatique, urinary frequency, they can be signs, but could be something else. PROBABLE PREGNANCY: Objective indicators that are observed by the examiner. But because other things could possible cause them, they are probable not positive. They include: Pskacek sign: a soft prominence on implantation side, Hegar sign: softening of lower uterine segment; Pap smears, and vaginal exams, Goodell sign: softening of tip of cervix; Chadwick sign:violet-blue color mucosa and cervix; Braxton Hicks: intermittent contractions; and positive pregancy test; blood in urine; and Ballotment: palpate one side and something moves on the other; passive movement of the unengaged fetus, passive movement. POSITIVE PREGNANCY: Fetal heartbeat w/ a doppler; Visualization of the fetus; and Fetal movements palpated by the examiner.
When does a fetus gain the most of its weight?
1st, 2nd or 3rd trimester. In the third trimester.
From where are the hormones estrogen and progesterone coming from during pregnancy?
adrenal cortex, placenta, corpus luteum, anterior hypophysis.
Answer is placenta.
In fetal bl vessels the o2 content is hightest in the
ductus venosus, umbilical artery, pulmonal artery or ductus arteriosis.
Answer is ductus venosus because it is opposite blood gas exchange to the fetus.
What are the first 2 psychological tasks of pregnancy?
1) Accepting pregnancy: denial due to being young or not coming to terms w/preg.; needs to create a safe place for baby & needs understanding from those around her. Woman needs to accept the pregnancy & incorporate it into her own reality & self-concept; process known as "binding in".1st trimester: woman's focus centers on her physical discomforts like fatigue, nausea and her own rather than on the developing child. 2nd trimester: by this time she feels fetalmovement (quickening), has most likely seen the baby (ultrasound) & heard heart beat, & begins to conceptualize the child as an individual w/in her.3rd trimester: as the due date nears, the mother wants the child just as much as she wants the pregnancy to be over with; @ this point, she is tired & needs lots of emotional and physical support from her family & friends.
Accepting the baby: ppl that don't accept the pregnancy may end up getting abortion (have to ask yourself how you feel about the abortion to understand if you can work in that area); acceptance must come from expectant woman and others she values.Valuing unborn baby, re-ordering life (have to change how she does things so baby can fit into life), have to accept pregnancy and then the baby. Acceptance of the baby: acceptance must come from expectant mom and others she values. 1st trimester: during early pregnancy, announcements R made about pregnancy & positive responses from others about the pregnancy help foster her own acceptance of the child; she wants & needs others in the family to accept the child too 2nd trimester: immediately family needs to exhibit behaviors consistent w/relating to the child as a sibling, a son or daughter. 3rd trimester: the woman must develop an unconditional acceptance of the child or she & others may reject him for not meeting their expectations.
What are the last two psychological tasks of pregnancy?
Reordering relationships: reorder to allow for child to fit into her life, existing family structure, and learn to give of herself to the unborn child.
Woman becomes reflective /examines what things may need to be given up in her life or changed for the infant. If this is her 1st baby, she may grieve the loss of her carefree life/freedom she once had. As preg. progresses, she beings to identify w/the child and makes plans for their life together after the birth. During last few weeks of the pregnancy, she must work through doubts of her ability to be a good mother; positive support from family/friends is important to boost her confidence and assist her w/overcoming her self-doubt. Seeking safe passage: realizing that she has to make herself as safe as possible for the baby to come into the world; not smoking, drinking, huffing; they can get feelings of ambivalence when it comes close (they may want a c-section to "avoid" the pain); getting nursery ready; need a doula etc.
What are the routine lab tests that are part of the admission process at the hospital for labor and delivery?
Tests of rH factor & blood type, complete blood count, hemoglobin & Hematocrit, blood glucose; blood tests for syphilis, hep B and HIV; urine specimen tested for presence of glucose, protein, and ketones.
A woman goes through several physical changes during pregnancy: 1) reproductive 2) integumentary, 3) neurological and 4) cardiovascular. Explain the reproductive physical changes.
Reproductive: p.195 most obvious are physical change in theabdomen & breast changes. Uterus: @ 20 weeks uterus is @ belly button level; @ 38 weeks uterus is underneath breast level (times when breathing becomes really hard, esp with shorter women); @ 40 weeks uterus will drop a bit (couple cm); Cervix: blue tinge; high levels of estrogen cause stim. Of cervical tissue (increases cell # & becomes hyperactive); increased blood flow and engorgement results in blue tone. Vagina: thickening of mucus; blue tone from hyperemia (increased blood flow) as in cerix.
Breasts: become larger (from estrogen & progesterone that produce changes in mammary glands); superficial veins become more prominent; tingling & increased sensitivity; montgomery tubercles (sebaceous glands around nipple) enlarge & provide lubrication for the nipple tissue; 2nd trimester get leakage of colostrum (1st milk) (as early as 16 weeks); colostrum is converted to mature milk during 1st few days of life stretch marks (not genetic)
Explain the integumentary physical changes of a woman in pregnancy.
Integument: Ward, p 197; changes caused by estrogen, progesterone, and alpha-melanocyte stimulating hormones; outward changes in appearance may cause body image/ self-concept issues. Pigment changes occur due to estrogen levels; moles, freckles & scars darken; nipples, areola, perineum, & vulva also darken. Linea negra: linea alba (light line that darkens in pregnancy becomes the linea negra) line that extends from belly button down to mons pubis; when pregnant it gets dark (you will see it even on a fair skinned person). Chloasma/ melasma gravidarum or mask of pregnancy; (dark, blotchy brownish pigmentation change around hairline, brow, nose and cheeks; raccoon look) if darker skin tone it may show up more, but happens in fair skinned too.Chloasma fades after pregnancy but can recur after sun exposure; educate on sun protection due to increase in sunburn/photosensitivity in pregnancy. Nails get stronger, grow faster due to hormones. Lose less hair (this is reversed once baby is delivered=lose hair); reassure patient that virtually all hair will be replaced w/in 6-12 months; acne, sweating (caused by hyper-active sweat and sebaceous glands=skin changes). Stretch marks: striae gravidarum; reddish, wavy, streaks that fade to silver white after birth, but don't totally disappear;abdomen, breasts, buttocks, thighs. Palmar erythema (palms get red), puritius (itiching due to increased blood flow and high hormone levels).
What are the neurological changes in a pregnant woman?
Neurologic: CNS is affected by hormonal changes in pregnancy; women may experience: Poor concentration and attention span, memory lapses during and just after pregnancy.Reduced sleep efficiency, fewer hours of sleep, freq awakenings & difficulty going to sleep; nurses should encourage naps to offset the fatigue due to these changes, and provide anticipatory guidance about what to expect. Carpal tunnel (due to increase fluid and puts pressure on nerves); usually develops in 3rd trimester; symptoms (pain, paresthesia, in the hand that radiates to elbow; intensified w/grasping objects; occurs in dominant hand or both hands); teach to elevate hands @ night to reduce edema, splint; usually subsides after preggo after edema is decreased. Syncope (transient loss of consciousness; passing out from pressure from uterus); attributed to orthostatic hypotension &/or inferior vena cava compression by the uterus ***BIG DEAL w/positioning a client! Left side lying position is preferred to avoid compression of the vena cava (leads to supine hypotension) from the gravid uterus.
May also occur as increased intra abdominal pressure from the uterus putting pressure on the vagas nerve; coughing, straining during bowel movements, & upward pressure from the fetus can trigger a vasovagal response producing faintness or loss of consciousness.
Warning signs: lightheadedness, sweating, nausea, yawning, and feelings of warmth all are signs that precede syncope.
What are the cardiovascular changes in a pregnant woman?
Cardiovascular: Heart:fetus grows- puts pressure on diaphragm & the mom's heart is pushed upward & lateral to the left (would affect where you find PMI?)Cardiac hypertrophy: results from increased BV & CO more fluid, BV incrs by 40-45% (incrs starts in 1st trimester & peaks @ term; increase in BV is due to increase in plasma & erythrocyte volume; extra erythrocytes are need cuz of extra oxygen requirements of maternal & placental tissue that will ensure 02; elevated erythrocyte count remains throughout pregnancy) Murmurs (common during pregnancy) if they are symptomatic she will experience palpitations, chest pain, shortness of breath, or decrs activity tolerance; if this occurs, she should see doc immediately IRON: need extra for formation of extra hemoglobin (o2 carrying component of the erythrocyte) & o2 for baby; the incrs need for o2 requires pregnant woman incrs her Fe intake; Fetal Fe is greatest during last 4 wks of preg. when the fetal Fe stores are amassed. Supine hypotension: avoid laying flat on the back; impinges blood flow return from lwr extremities & causes decrs in BP (w/dizziness, diaphoresis, pallor); turn to left side, so not putting more pressure on vena cava; faintness related to bradycardia. BP: in 1st trimester BP usually stays the same as pre-preggo levels; then gradually decreases by 20 weeks; after 20 weeks, the vascular volume expands and BP incrs to reach pre-preggo levels by term
CO remains incrs throughout pregnancy; w/incrs vascular volume and CO, vasodilation (due to progesterone induced relacation of vascular smooth muscle), prevents and elevation in BP; women's pr usually incrs by 10-15 beats/minute to effectively circulate the increased BV. O/hypotension another condition occuring in pregnancy; results from stagnation of blood in lower extrem. Woman stands too long/ gets up too quickly, gravity causes blood to flow to the lower extremities & away from her brain. All changes to cardio system return to normal by 2nd or 3rd week postpartum.
What are some endocrine changes in pregnancy?
Endocrine:Thyroid: changes size & activity during pregnancy; increased thyroid activity causes increased basal met. rate (the amount of 02 consumed by body over a unit of time); the incrs in BMR has effects of heat intolerance, increase HR, & increased CO; thyroid function returns to normal w/in few weeks of birth; Parathyroid glands (regulate Ca & PO4 metabolism; raises calcium); maternal concentrations of PTH increase as fetus requires more Ca for skeletal growth during 2nd & 3rd trimester. Ca+ intake VERY important; 1200-1500 mg/day recommended.Pituitary gland: ant. pit. gland incrs in size; prolactin (acts on breast milk; responsible for initial lactation); may play role in F&E shifts across fetal membrane. Oxytocin:posterior pituitary gland; stim. milk ejection/let down from breasts. Also stimulates uterine contractions; can be given to induce labor or augment a slow progression of labor due to ineffective uterine contractions. Adrenal glands (on top of kidneys) help incrs circ. fluid vol.; Happens cuz adrenal cortex secretes aldosterone (causes renal reabsorption of sodium=water retention, since water follows sodium);enhances circ. vol.;a protective response to body getting rid of Na+ due to effects of progesterone; it offsets that.
Cortisol (produced by adrenal cortex) has incrs production in pregnancy due to decreases renal secretion (prompted by high estrogen levels);cortisol regulates protein and carb metabolism & is believe to promote fetal lung maturation & stimulate labor at term.
Pancreas: increase in beta cells (means more insulin production); these changes R responsible for alterations in carb metabolism during pregnancy. Prostaglandins: lipid substances found in high amounts in female reproductive tract;R produced more; (helps w/BP); a decrs in these levels may contribute to hypertension & preeclampsia; @ term, the increased release of prostaglandins from the cervix as it softens and dilates may contribute to labor onset.
What do the following intitials stand for in L&D?
Fetal heart tones, fetal heart rate, fetal movement.
What are the important elements to Fetal Heart tones?
Fetal heart tones (FHT): range 120-160; if @ 180 (tachycardia) you have to figure out why baby is in stress (pressure, contraction, fever in mom will make HR go up)
HR goes down with contractions, or w/cord around neck
Use doplar or fetoscope for fetal heart tones (conduction is how it works, fetoscope) doplar works on sound waves (ultrasound
both used for Intermittent auscultation; doesn't provide print out of fetal HR, but allows women freedom of movement in labor.
What are the important components to the FHR?
FHR is the average fetal heart rate observed between contractions over a 10 minute period.Variability: the fluctuations is baseline FHR observed on fetal monitor; absent or undetected variability is considered non-reassuring; presence of adequate variability is an important indicator of fetal well being.
Accelerations are considered sign of fetal well-being when they accompany fetal movement
Tachycardia in fetus: FHT greater than 160 beats/minute; conditions associated w/this include:Fetal hypoxia, Maternal fever: increase in mom's temp accelerates the fetal metabolism increasing the HR; can occur in laboring women who become dehydrated or do to increased temp from being in a warm bath.Maternal medications,
infection: tachycardia may be initial sign of uterine infection Fetal anemia: FHR increases to compensate for decreased hemoglobinMaternal hyperthyroidism
Bradycardia of FHR: less than 110 beats/minute; may be associate with:
Late hypoxia Medications:
Maternal hypotension: results in decreased blood flow to fetus and can lower FHR; can result from supine hypotension & is common side effect of epidural Prolonged umbilical cord compression: decreased FHR due to vagal stimulation
What do the kick count test and the non-stress test do in relation to FHR/FHT?
Kick count: done by mom, give sheet to count hourly kicks or 2 hr time frame; need 10 in 2 hrs.
Advantage: need 10FM/hour; mom will be aware of baby; Mom relaxes take time out (once 10 kicks are counted, she can stop counting)
Non-stress test: done in hospital; hooked up to electronic fetal monitor (ultrasound part that is put on abdomen over fetal hear to get FHT; other piece is a toco that goes at top of uterus to detect any contractions); looking for fetal movement (to detect an increase in HR from fetal movement; 15 beats up, 15 beats over..see below. NON-STRESS TEST:If HR is 120, w/non stress test; look @ fetal monitor strip; should go up@ least 15 beats per minute for (3 in 5, 2 in 10 minutes; FHR see on monitor has to go up this many times; looking for accelerations);tells that baby is healthy, can raise their beats w/movement..if don't meet criteria (they may end up doing biophysical profile to double check the well-being). Accelerations: incrs in FHR of 15bpm above fetal baseline that lasts @ least 15-30 sec
Will this baby do better outside the uterus or inside the uterus? This is final criteria/decision to decide if baby should come out. Clap over baby/over abdomen to get baby to move.
Non-stress test (NST) is most common method of antenatal screening; uses electronic fetal monitoring (EFM) for approx 20 minutes; based on premise that fetus moves @ various intervals and that the CNS and myocardium responds to movement
Response is demonstrated by acceleration of fetal heart rate (the FHR "reacts")
Loss of FHR reactivity is associated most commonly w/fetal sleep cycle, but can be result of any cause of CNS depression (fetal hypoxia, acidosis, congenital abnormalities).
Reactivity is based on gestational age 32-34weeks (considered the appropriate age for reactivity to occur)
Acceptable criteria: FHR acceleration of 15 beats bpm that lasts for 15 seconds.
What are some nutritional guidelines for pregnant women?
Weight gain: Not eating for 2!. 25-35 lbs should be gained if u r average wt for ht; 40lbs if u r already too thin; Should not lose wt in preg. Diet: Need 1500-2700 calories/day (2700 calories would be for thinner person to start); 300kcal/ a day increase from pre-pregnancy needs. Cal. r most important in 2nd/3rd trimester when fetal growth is happening more than mom growth. Protein helps w/tissue growth & repair (devel of fetal tissues and organs); incrs intake by 2 serv, day to meet required (eggs, milk, cheese, yogurt r good proteins sources, calcium; meat, poultry, and fish too). Ca+ & vit.D for fetal bone growth & teeth develop- ment (vit D to absorb the calcium); ca+ 1000mg/day (see calcium sources below). Fe for hemoglobin (needs lots); as blood volume increases, # of circulating RBC increases; iron must be increased to maintain 02 carrying capacity of blood; 30mg/day starting @ 12 weeks gestation.Vit C for tissue growth & enhances the absorption of iron.Folic acid needed to prevent neural tube defects, help w/development of organs; essential in production of DNA & RNA, maintain normal brain function. Need 8-10 glasses H2O per day. (can get early contractions due to dehydration; gatorade doesn't count!) Foods to avoid: High sodium drink (soda)NO alcohol, NOcaffeine, NO smoking (all can affect the baby)
Avoid swordfish (high mercury content) NO xtra sug or xtra na+,
Pica (eating non-nutritive; corn starch, dirt, red georgia clay, maybe gives iron/minerals) eating ice chips can indicate iron defficiency.
How is thyroid affected by pregnancy?
Increased activity, which increases metabolism (basal metabolic rate), affects how you tolerate heat, increases pulse rate and increases cardiac output.
What are the common discomforts of antepartum pregnancy?
Nausea/vomiting, Constipation, Hemorrhoids, Fatigue, Hypotension:
Round ligament pain,Varicosities: usually in legs, could get spider veins anywhere, Frequent urination: pressure of the baby on the bladder, Back aches: lordosis, Dyspepsia (heart burn): upset stomach, Dependent edema: all extra fluid; get cankles (large ankles)
Shortness of breath (SOB): will get air hungry (just can't get enough air) as uterus grows, there is less room for diaphragm to go down; can hyperventilate (blow off too much C02)
Explain the differences between true and false labor.
Braxton-Hicks contractions: uterine contractions that happen to get you ready; usually felt in abdomen & often stops w/walking, position changes, etc.; they come and go, not consistent; when close to term it becomes hard to tell real labor from braxton hicks; usually felt in abdomen or groin area; do not lead to dilation or effacement of cervix so are termed "false labor"
True labor: contractions lead to progressive dilation & effacement of cervix; contractions occur w/regularity, increase in frequency, duration, and intensity; pain usually starts in woman's back and radiates to abdomen; pain intensifies w/activity (walking).
Only difference is that true labor will change your cervix and braxton hicks won't.
What is wharton's jelly?
A specialized connective tissue that surrounds the 2 arteries and 1 vein in the umbilical cord that helps keep it protected from compression.
Growth of the uterus displaces the maternal in which way?
Displacement moves the maternal heart upward and laterally to the left.
What is supine hypotension and vena caval syndrome?
Pressure from the enlarged uterus exerted on the vena cava decreases the amount of venous return from the lower extremities and causes a markedd decrease in blood pressure, that causes dizzyness, diaphoresis and pallor. Placing the woman on here left side can relieve symptoms.
What are common signals that the body is preparing for labor?
Lightening, Bloody Show, Rupture of Membranes, Nesting, and braxton hicks.
What is important to note about the rupture of membranes?
Can happen naturally or with a hook by doctor. If bag breaks we need to know color, smell, amount.
Color should be clear or can have slight yellowish color, may be white from vernix. Don't want these colors: green (meconium would make this green; any shade of green means baby got stressed and had bowel movement in uterus; Not good), brown (old blood would make it brown; was mom in car accident, had placental bleed?), dark yellow (goes w/green= how much meconium), red (fresh blood; usually has to do with the placenta; don't want to see this), black (could be chunks of meconium floating in fluid), white (white flecks can be normal; from vernix which is cheesey protection for baby's skin to protect from water; it starts flaking off towards end of term), purple/blue (will take methalane blue in one of the bags/ multiples)Smell: should be odorless/not offensive even if it smells a little; odor would be from infection.Amount: big gush or slow trickle. Viscosity: goes with the color.
What are the 5 Ps of progressive labor and delivery?
Passage: maternal pelvis
Passenger: fetus & placenta
Powers of labor: physiological forces
Passageway + Passenger: engagement, attitude, position)
Psyche: previous experiences, emotional status.
Explain the passageway in relation labor and delivery?
Passage: concerns the pelvis; baby has to get out of the pelvis/it's passageway; openings of pelvis determine what is going to happen; baby's head molds so that the baby's head can shift to allow for extra room to get out.
Relaxin makes the joints looser to allow the pelvis to open, but may not be enough
Different shapes/sizes of pelvis versus size of baby; antepartum (before baby is born) time is when they will discover if it will all fit.
False pelvis and true pelvis; true pelvis is the passageway
Explain the passenger in relation to presentation in L&D.
Passenger: the baby; how is baby presenting (butt down, shoulder down, feet down, etc); can deliver baby head down (preferred presentation is head down). Presentations: Frank breech: legs up, butt down.; Footling breech: one leg tucked into chest and one leg down into pelvis; or could be double footling breech (like standing up)
Biggest part of baby is head, second biggest are the shoulders; if delivery is attempted with a breech baby issues can arise (head may not be able to get out; smaller parts are coming out first, and head may end up getting stuck..why we end up with c-sections to avoid this from happening; Vertex presentation: head down Fetal lie (fig 12-4, p. 361): refers to relationship of the long axis of the woman to the long axis of the fetus; Longitudinal: head to tailbone axis of the fetus is the same as the woman's; either head or fetal buttocks enter pelvis first.
Transverse: baby is sitting sideways in mom's abdomen; horizontal lie.
Oblique lie: angle between longitudinal and transverse. Molding is the overlapping and overriding of the cranial bones due to the flexibilities from extra room in skull of open sutures and fontanels.
Explain the Powers of Labor in relation to L&D.
Powers of Labor: include uterine contractions and maternal pushing (how well can she push; effectiveness).
assess contractions; put hand on abdomen to feel contraction (contractions go from back to front @ bottom and then @ top front)
Feel for strength, length, how quick they come (peak to peak, start to start), ; duration, strength and time.
Power of contraction works on the cervix (it squeezes down); the cervix will then dilate & soften/thinning (effacement); cervix starts to get pulled up into the uterus (dilating @ same time) to allow passage of baby; powers of labor are making cervix dilate and efface & move fetus down toward birth canal during 1st stage of labor
Uterine contractions are considered primary force of labor.
Notice when contraction peaks and give mom hope that it is almost done.
Power of pushing comes in toward the end when the power of contraction (dilation/effacement have happened)
When mom pushes, we want her to work with gravity; push down into pelvis.
What is Passageway and Passenger mean?
Passageway+Passenger: baby engaging into true pelvis
What is the Psych part of labor and delivery?
Psyche: previous experiences, emotional status.Psyche: is mother ready for this; is she prepared for labor and delivery? Hard to prepare for when you have never experienced it before.
When does the fontanel close?
Anterior fontanel: closes @ approx 18 months to allow normal brain growth to occur.
Posterior fontanel: closes around 6-8 weeks after birth.
What phases are involved in the first stage of labor?
1st Stage: often referred to as stage of dilation; starts w/contractions & ends w/complete cervical dilation.
Phase 1: Contractions start happening (usually 5 minutes apart), debate when to go to hospital, water hasn't broken, relaxed. (dilation up to 3cm); lasts approx 10-14 hrs; Phase 2: Contractions get stronger and get closer together and they last longer (about 60 seconds) (3-5 minutes apart); 3-7cm dilation; usually when people show up to hospital; where most of the work gets done; still have breaks between contractions, can carry on conversations, trying showers, balls, massage, etc to feel good.
Phase 3-Transition:between7-10cm; contractions are harder, last longer, occurring more often. (every 2-3 minutes and last 60-90 seconds); usually time when woman will throw up (good sign for transition period) ; body is making subtle change that indicates body is working; epidurals would be asked for now especially; 1st stage of labor ends w/complete dilation of cervix.
Describe the 2nd stage of labor.
2nd Stage: from 10cm to delivery of baby; usually approx 2hrs (if takes longer, are contractions inadequate?, is baby presented in different way?, is mom not pushing effectively?; would have to figure out why taking longer); if 2nd time mom, this may be only 1 push (encourage a little push since their body already knows what to do/so does mom); never leave her alone during this time. Crowning happens: see baby's head on perineum (area between vagina and anus). Baby delivered.
Describe the 3rd stage of labor.
3rd Stage: from delivery of baby to delivery of the placenta (comes out from 5-35 minutes after the baby; usually delay time between; get some more contractions & push to birth placenta). Should come out intact; our job is to look at placenta to make sure it is all there; may come out in pieces (that is not good, some pieces may be left in mom and cause infection); Shiny shultze and dirty duncan (shiny shultze baby's side of placenta; shiny side showing; dirty duncan is moms side that shows up; looks like hamburger)
If mom wasn't on pitocin before, they can give a synthetic shot after the placenta to contract uterus down to stay down.
What are nursing interventions that the nurse can do in the first stage of labor?
1st Stage p. 375Non-pharmaco-logical: position changes (need them to move), present for them if they need you (you become the support person), hold their hand, massage, information/anticipatory guidance, interpret what the doctor says so they understand what is happening to them, hot & cold packs, fluid intake, toileting q2 hrs or qhr, encourage support people to take care of themselves (eat, drink, pay attn to how shocked the dad is, have them sit down). Doula work! Medications: meds that help her stay in control, don't want to wipe them out; fentanyl nubane, epidurals (anesthesia that goes into epidural space; bathes nerve endings) so make sure she has plenty of fluids and have to help her in correct position while epidural is happening. Careful monitoring of VS since her BP can drop with epidurals.
What are nursing interventions for the 2nd stage of labor?
2nd Stage: help her focus; encourage low noise level and rest between contractions; don't leave her alone
What are nursing interventions for the 3rd stage of labor?
3rd Stage: help with delivery of placenta (coach w/pushing to get placenta out); assist mother w/adjustment of Labor & birth, facilitate attachment.
What are nursing interventions for the 4th stage of labor?
4th Stage: assess her bleeding have to massage uterus; boggy (if uterus is boggy, you have to massage uterus until it feels like the back of hand) rub fundus (top of uterus until it tightens up) VERY important; uterus HAS to be firm, it means it contracts down and constricts blood vessels so she wont' bleed/hemorrhage; assess lochia (bloody vaginal discharge)
Provide privacy and comfort, keep her covered
Monitor VS q15 minutes; rising pulse rate or decreased BP are signs of excessive blood loss.
Get her something to eat, drink, fluff pillows, encourage early bonding!
Help her w/breastfeeding positioning, latching on correctly, etc.
What is a pfannenstiel incision?
It is the most commonly performed incision method for caesarean. AKA transverse.
What is the percentage rate on caesarean?
Back in 1965 less than 5% were caesarean. In 2005 30%, This has increased to about 45%.
What are some of the indications for cesarean birth?
Indications : health of mom and baby in jeopardy, maternal risk factors (hypertension, positive HIV status & diabetes)
Fetal implications: malpresentations (breech, shoulder); placenta abnormalities, dysfunctional labor patterns, umbilical cord prolapse, multiple gestation. Indications – prolonged labor, CPD, fetal distress, maternal distress, genital herpes, any medical problem related to fetal passage through vagina, failure to progress etc.
What are the preoperative nursing interventions for a cesarean?
Pre-operative: blood work (type and cross match) obtained and entered into chart; NPO since midnight before admission; review prenatal history; make sure informed consent is signed.
Pre-op – help mother understand reason for C-section, prepare mother for surgery with IV, foley, shave and medications, support mother (hold her hand, talk with her, call family, reassure her etc.) Nurse maybe in the OR with mother and be able to follow her through the whole procedure.
What are the post operative nursing interventions for a cesarean.
Post-operative: assess her recovery from anesthesia, status of post-op uterus, make sure there is maintenance of patent airway if general anesthesia given ; assess VS q4h for 1st 2 hours, assess fundus, lochia, I&O, instruct her to perform leg exercises (DVT prevention); facilitate bonding & attachment.; BUBBLE-HE assessment;Post-op – care for mother in RR with assessments, assess dressing, turn cough and deep breathe, medications, information, help mother with breast feeding etc.
What are post partum nursing interventions?
Post-partum – same as vagina birth except need to help mother up for first time, assess incision at every check and show mother how to move in bed or get up without using abdominal muscles. Help breast feeding mothers with comfortable positions. Encourage mother to increase physical activity.
Name the general components of the Post-partum nursing assessments and interventions for mothers.
Bubble-He, REED, Lactation, Depression, and expected physical changes.
Explain the Homan's sign of the Bubble-He assessment.
Homans sign: looking for DVT; examiner dorsiflexes the foot, if there is pain in calf it means positive homans; pain is indicative of DVT, but negative sign doesn't r/o DVT (need ultrasound, etc).
Explain the BREAST part of bubble-he assessment.
Breasts:Breasts: inspect nipples (inverted or everted?); will mom breastfeed? If so, inverted nipples need a breast/nipple shield. Notice if nipples are cracked. Breast tissue: palpate..are they soft, filling, firm? Are breasts engorged? Be aware of mastitis. Assess for good sucking, good latch, and bonding during breastfeeding. Temperature & color: warm, pink, cool, red streaked?
Explain the uterus assessment component of bubble-he
Uterus:Uterus/fundus (top of uterus): location (is it midline or deviated or right or left; deviation to right is more common w/bladder distention; deviation to left may be from mom "carrying to the left" or w/multiples)
Remember to have mom urinate first, since a full bladder will prevent the uterus from contracting & will push it upward & deviate it from midline; boggy uterus indicates a uterus that isn't contracting, which is associated w/increased bleeding; worry about hemorrhage!
Risk for hemorrhage: an Atonic uterus (flabby, boggy, non-contracting)
Massaging uterus is #1 nursing intervention to prevent postpartum hemorrhage; breastfeeding also causes uterine contractions (educate the moms that this is GOOD)
When massaging fundus the upper hand cups the fundus, while lower hand stabilizes the uterus @ symphysis pubis to keep uterine inversion from occurring (uterus comes out, cuz not supported); fundus is measured @ or below the umbilicus (F@U or F@U-1, etc)
Explain the bladder assessment component of bubble-he.
Bladder: Bladder: when was last time patient emptied bladder..spontaneously or via catheter? (remember to have her void before fundus/uterine massage) Is the bladder palpable or not? Assess @ symphysis pubis: if bladder is firm, it is distended (if full, higher risk for bleeding). Note the color, odor and amount of urine. Educate moms that we want the bladder empty to not interfere w/uterine contractions/prevents bleeding.
Remember to dangle mom's legs off bed for 1st time getting up to urinate; NEVER let her get up by herself the 1st time.
Explain the Bowel assessment component of Bubble-He.
Bowel:Bowel: Date/time of last BM? Listen to bowel sounds (especially if colon was manipulated as w/c-section); bowel movement may be difficult
Anesthesia, nausea & vomiting all make it harder to defecate.
Passing gas is an indication of intestines working; the more they walk, the more peristalsis will be stimulated.
Constipation help: early ambulation, abundant fluids, and high-fiber diet (stool softeners too).
What is the lochia assessment part of bubble-he?
Lochia:Lochia: the sloughing off of the superficial layer of the uterus after birth; the status of the lochia depends on the woman's status of involution (process by which her uterus returns to pre-pregnant state)
Lochia rubra: occurs in first few days postpartum (1st 3-4 days approx); red color; fleshy odor; may be mixed w/tissues.
Lochia serosa: after 3-4 days, lochia becomrs pinkish-brown as bleeding stops and the uterus is healing.
Lochia alba: after 10-14 days the uterine discharge has reduced fluid content & is mostly composed of leukocytes.
Pattern of lochia flow should not reverse (or it could indicate more bleeding); lochia should NOT have large clots & no offensive odor.
Assess peripad for scant, light, moderate, or saturated lochia flow/hour. **important to assess when peripad was last changed to determine relevance of amount of lochia on the pad; the amount of time passed is important.
Amount should decrease; when woman stands up, may experience a gush (could be from pooling of lochia in the uterus; don't be alarmed, but keep an eye on her).
What is the episiotomy part of Bubble-he?
Episitomy/tear/stitching:Episiotomy: an incision made to perineum to enlarge vaginal opening before birth; easier to heal that an tear. Tears can be 1 -4 degrees (from vagina to anus; 4th degree tear goes all the way to rectum, needs stitches and takes longer to heal.
Explain the EMOTIONS assessment of Bubble-He
Emotions: includes bonding, how is the mom associating w/baby (appropriate interaction?)
What is the REEDA assessment and its parts?
REEDA: perineum assessment
Redness/inflammation, Edema
Ecchymosis or bruising, Drainage from stitches for perineum specifically. Approximation of tissue.
What are some important elements to assess and understand about lactation?
Lactogenesis depends on release of prolactin & oxytocin; milk synthesis starts after the placenta is delivered. The delivery of placenta results in decrease in estrogen & progesterone,& increase in secretion of prolactin from ant pit gland; prolactin stimulates milk secretion. Stimulation from infant suckling or breast pumping triggers the release of oxytocin from the posterior pit; oxytocin prompts milk ejection/let down. May feel like a tingling to the mom. Lack of breastfeeding or failure to empty breasts by pumping causes an increase in hormones that act to inhibit the secretory cells of the breast, causing gradual decrease in milk volume and eventual death of those epithelial cells. Lactation: she will still lactate even if she isn't going to breast feed; will still fillup; needs to bind herself if not breastfeeding, so breasts don't get stimulted (if stimulated they will still produce). Cabbage leaves are used w/engorgement (washed, cooled in fridge, crushed and placed directly on breasts for 15-20 minutes 2-3 times only if they are using for engorgement, otherwise it can diminish the milk supply).Don't pump if you don't want to breast feed; supply and demand.
What are some important elements to consider in postpartum depression?
Depression: don't usually show up in hospital (due to limited time w/ patients), but will show up in doctors' office setting. Baby blues (just blue and life changes, anxious, don't really know what to do ..)may last a day or awhile.1st few days and peaks on 5th day postpartum, then subsides; the "blues" do NOT affect the woman's ability to care for her newborn. Postpartum depression: mom doesn't take of herself or baby; SERIOUS. Usually shows up 2 weeks postpartum (sleep disturb- ances, guilt, fatigue, hopelessness/ worthlessness. Post partum psychosis: delusional,hallucinations, agitation, inability to sleep, bizarre irrational behavior.
What are some of the expected physical changes for a mother post-partum first week?
Physical changes in 1st week
Lose 500ml of fluid w/delivery; shift to blood stream, so you will diurese (pee a lot). Respirations improve
Skin changes will change back to normal; fade out. Get gas and constipation until bowels start to work
Muscle aches and fatigue from labor work. take 6 weeks to resume normal; can take up to 3 months to get it all back. (remind women)
What are some of the discharge topics that a nurse will need to discuss with a postpartum mother. What are the 9 danger signs she should watch for?
Objective 31 Postpartum discharge plan for 1st time mother including self care: SIDS prevention (225): breastfeeding recommended, avoiding cigarette smoke, and BACK to sleep. Other topics: infant bathing, breastfeeding, perineal hygiene, physical activity, rest and expected emotional changes.Sexual activity put off till 6 weeks postpartum (ovulation can resume 2 weeks after birth, so remind them to wait or use contraceptives if sooner)Box 15-5, p. 505 Danger signs: 1)Temp >100.4, chills, flu like symptoms 2)Incision that is red, tender to touch, painful, or if edges come apart. 3) Difficulty w/urination, frequency or painful urination. 4) Increased vaginal bleeding w/or w/out clots, or foul- smelling vaginal discharge. 5) Pain or persistent swelling of perineal laceration or episiotomy. 6) Swelling or masses in breasts, red streaks, shooting pain in breasts, or cracked bleeding nipples. 7) Swelling, warm, or tender, painful areas in the legs
8) Blurred vision or persistent headache that is not relieved by pain meds. 9) Overwhelming feelings of sadness or inability to care of self or baby.
What parts of the fetus have developed by the 4th week?
Spinal cord fused – neural tube defect occurs if not
Head, rudimentary heart, arms and legs budlike
Rudimentary eyes, ears and nose discernible
What parts of the fetus have developed by the 8th week?
End of 8th week: organogenesis complete
Heart with septum and valve, rhythmic beats
Arms and legs developed
External genitalia present, sex not distinguishable
What parts of the fetus have developed by the 12th week?
End of 12th week:
Faint, spontaneous movement present
Tooth buds present; bone ossification centers forming
Kidneys secreting urine
Heartbeat audible with Doppler
What parts of the fetus have developed by the 16th week?
End of 16th week: heart sounds audible with stethoscope
Liver and pancreas functioning
Active swallowing of amniotic fluid present
What parts of the fetus have developed by the 20th week?
End of 20th week:
Spontaneous fetal movement sensed by mother
Sleep and awake periods distinguishable
Hair forms, brown fat & vernix begins to form
What parts of the fetus have developed by the 24th week?
Passive antibody transfer from the mother begins
Active lung surfactant production begins
Eyelids are now open; pupils capable of reacting to light
24 weeks, 601 grams – low end age of viability if cared at tertiary centers
Hearing evident
What parts of the fetus have developed by the 28th week?
End of 28th week:
Lung alveoli begin to mature
Retinal blood vessels are thin and extremely susceptible to damage from oxygen
What parts of the fetus have developed by the 32nd week?
Subcutaneous fat deposition begins
Active Moro reflex evident
Iron stores begin
What part of the fetus develops by the 36th week?
Body stores of glycogen, iron, carbohydrate and calcium are deposited
Soles of feet with one or two crisscross creases
What part of the fetus develops by the 40th week?
Active kicking; Fingernails extend over fingertips
Fetal Hgb begins convert ing to adult Hgb
Creases cover 2/3 of sole of feet
What timeframe is defined as the neonatal or newborn period?
Birth: 0 to 28 days (Neonatal Period)
Transition to extrauterine environment


text:
After Michael Vick's impressive 21-of-34, 284-yard and two touchdown performance in the Eagles victory over the Lions, Andy Reid says Kevin Kolb will start in week 3.
It's a curious decision -- one Reid called "not hard at all" -- but one that many figured the Eagles would make no matter how good Vick looked.
Kolb has been groomed for this role for the last four years so it's easy to understand Reid's motivations behind sticking with him. At the same time, Vick was awfully impressive over the last two games.
SB Nation's Bleeding Green Nation knows what will dominate the headlines but says having Vick play well isn't such a bad thing.
The Vick/Kolb discussions will of course dominate any and all talk surrounding the Eagles this week, and I think that's generally perceived as a bad thing. I don't see it that way. It's only a topic of discussion because Vick has been so surprisingly good, and there's absolutely nothing wrong with having the best backup QB in the NFL.
Reid says Vick will still be incorporated into the game plan next week.
Check out what Philly fans at Bleeding Green Nation are saying about Kevin Kolb and Michael Vick.


text:
PERU — With five bouts remaining Wednesday night, the Northern Adirondack wrestling team held a 30-23 lead over Peru.
The Indians, however, won those five and remained unbeaten in Champlain Valley Athletic Conference mat action with a hard-earned 45-30 victory.
High School Sports Magazine
"NAC wrestled tough tonight and we were happy to get out of there with a win," said Peru co-head coach Mike Hogan.
"We didn't wrestle very well and hopefully this will be a wake-up call for us."
Colin Hogan recorded a 2-0 win at 113, Ethan Feazelle a 4-0 decision at 120, Nick Forget a forfeit victory at 126, Tanner Phillips a big 10-5 decision at 132 and Jordan Bushey a pin at 138 to rally Peru.
Phillips' win came over Scott Kellett.
"Those two were in ninth grade when Kellett beat Tanner in the sectional finals at 96 pounds," said Hogan.
"It's a long and friendly rivalry between the two, but Kellett has been beating Tanner the last few years. Tonight, however, Tanner was able to win and it turned out to be a big win for us."
The best match of the evening featured two of the best wrestlers in the North Country, with the Indians' Troy Seymour emerging with a 2-0 decision over the Bobcats' Justin Kellett at 170.
"They weighed two kids in at 160 and Justin moved up to 170 to wrestle Troy," said Hogan. "It was awesome because those are two kids with over 180 career wins and two of the best wrestlers in the league. It was a match the fans wanted to see.
"It wasn't a high-scoring match, but it was still pretty neat. Troy got a reversal in the second period to take the lead and rode him the rest of the period. Then Troy rode him the entire third period to win."


text:
In California, 2010 started out much like many others for the public health detectives who keep an eye on infectious diseases.
But by the end of the year, 10 California babies were dead from whooping cough, aka pertussis, a highly contagious disease that's preventable by a vaccine.
Kathleen Harriman, PhD, MPH, RN, chief of the California Department of Public Health's vaccine preventable disease epidemiology section, says 9,477 confirmed, probable, and suspected cases of pertussis were reported to the state in 2010 -- the most in 65 years. Cases have surged in other states, too.
In eight of the California cases that resulted in deaths, the babies had been seen by their doctor or an emergency room doctor but were not initially diagnosed with whooping cough.
The stories were shockingly familiar to Mariah Bianchi of San Francisco.
In 2005, Bianchi lost her newborn son, Dylan, to pertussis. She had sought repeated medical attention for her own symptoms, fearful she would pass on whatever she had to her son, Cole, then 3, and to Dylan.
Once doctors began to suspect pertussis, little Dylan went downhill quickly. He died within 48 hours after doctors started treatment and hospitalized him. He was just over 2 weeks old. Cole recovered.
For Bianchi, the nine deaths were a turning point that increased her commitment to activism. She had joined the immunization coalition in San Francisco in 2009, but now also volunteers for the state coalition. She often shares her experience as she encourages parents to get and keep their children vaccinated, to get a booster shot themselves, and to make doctors aware of the symptoms of whooping cough.
"It breaks my heart that these nine babies' parents are going to have to live with that grief," says Bianchi, a critical care nurse. "It almost takes things like this to make people more aware."
The Whooping Cough Epidemic: Why Now?
Pertussis can cause serious illness at any age, with early symptoms such as a runny nose and mild cough lasting up to two weeks, and the coughing fits sometimes persisting for 10 weeks or longer. The infection is typically less severe in teens and adults than in babies.
Once the symptoms of the bacterial respiratory infection set in -- including the strong cough that leaves patients making a ''whooping'' sound as they try to catch their breath -- young infants in particular can deteriorate quickly, developing a high white blood cell count, respiratory distress, and deadly pneumonia.
All the California infants who died were under 3 months old and thus not fully protected against pertussis. The five-dose series of pertussis vaccine to protect against whooping cough typically begins at age 2 months, but sufficient protection isn't achieved until about the third dose, at around 6 months, experts say.