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Scientists living under an oppressive regime decide to clinically study the founders and supporters of evil regimes to determine what common factor is at play in the rise and propagation of man's inhumanity to man.
The church may not be able to remove demons but they sure can made fools out of men. As Jesus said demons can't exercise demons. If you read Matthew 19:4-9 you find that God doesn't allow divorce. He never did. Thus Jesus proved that by letting us know thatt if we put away out wife (divorce her) and she marries another man that man committs adultery because God doesn't allow divorce. Never did and never will because with God man and woman becomes as one flesh. To be truthful the Jews gave us divorce and not Moses as Jesus said for Moses never saw the promised land because they killed him. That's why Jesus showed us that Jerusalem killed it's prophets. Because the killed the prophet Moses and invaded the promised land killing every man, woman, and child that lived on it when God said for them to live in peace with them. They wrote the books that he supposedly wrote as such. A dead man can not write and the books was in the promised land when they were found which Moses never saw.
Are they sure there is demons in that guys home? He seems to be a hothead sueing a person over failing to do the impossible. Maybe he's got lava flowing under his home deep in the ground causeing him to overheat and to smell like rotten eggs. After all lava does release gases underground that rises to the surface and thus release pressure that is building up. If that's the case he shpould be thanking his god for sending those smelly demons as he calls them for a volcanic eruption would have probably destroyed his home and killed him. Californians suffered from those smelly demons a while back over a large area. If they hadn't they might have had a new volcano makeing it's appearance. They were lucky they smelled those egg smells as they called them. You can live with them but not with volcanic eruptions. A friend of mine found that out in spades recently. His boss hit the volcanic eruption button an blew up. He fired him. Now he's jobless. You can't live that way.
sheepdove, hi!... i`m lagging behind. (lucky to have caught your comment) i`ve never truly figured out this divorce story, i`m glad that you can fill me in. so what happens for a lady when her hub ditches her and she refuses to sign the divorce papers but the judge jumps in (or vice versa), i mean, you know what i mean. hugs
If you're referring to the story of Jesus talking about the puting away of a wife it's merely that he merely shows that if one should put a wife away it should be for fornication only for if she remarries the one who marries her commits adultery because she is still married to the prior husband for God doesn't recognize the divorce. As Jesus said it was Moses who gave them divorce and not God. As he said God made them as one flesh. And also let no man put them asunder. Jesus also said from the beginning it was not so (divorce). It only became so because Moses it to the Jews. Not God. But he also showed it is still not so to God with the remarriage to another being adultery. As to your refusal to sign since the judge plays as a god he can see you divorced even those you don't want to be just as the catholic church can play god and end a marriage by by decree itself. They ignore God's law and inforce their' forceing their's upon you. Even so you are still bound by God's law and not divorced from your husband even if they say you are. And remarriage only brings you into a life of adultery and them to if they remarry. As they say marriage is til death do you part to God as he makes you one flesh. The world makes you otherwise.
Jesus said we have follow God's doctrines and not the doctrines of man lindee-lou. Divorce is a doctrine of man. If one remarries after they divorce someone according to Jesus they commit adultery for under God's law they are still married. With God marriage makes one one flesh with another. Two becomes one. With Jesus showing it cannot be annulled man's made hisself out as god and annulled it even so thus proveing he serves Satan and that this is Hell. If one follows the doctrine of man Jesus condemns him to eternal Hell thus if one is divorced by man or their marriage is annulled by the church they cannot consider theirselves as not married anymore for God said otherwise. The church is Satan's Jesus shows. As is government. Both makes theirselves out as god. Both make theirselves out as master and forces their laws upon God's people. Both kills. God's people aren't forced by God to follow his doctrines. They aren't allowed to rule others or to kill them. Thus they get killed. Jesus said turn the other cheek and love thy enemy. Thus those that did so was killed. No one follows the laws given to us by him that are God's laws. They follow man's laws. Man's laws show might makes right. God's doesn't. With God's laws people are sheep. With man's laws they are wolves. Nobody wants to follow God's laws for no one wants to die and that's pretty much what happens to God's sheep. They get killed because thou shalt not kill. Thou must turn the other cheek and love thy enemy to be one of God's people. With Satan one can kill and thus protect theirself. Not with God. Thus man chose to follow the deceiver and is condemned to eternal Hell.
Umm... I'm thinking why isn't this in the funnies section? It really is hillarious.
Ditto that, Ruth. I guess we can assume that no one thought to put some bacterial treatments in his septic. That's what I do whenever the stinky demons show up around here. Works like a "charm."
What's really funny is how christians don't notice when they read their bible that Jesus only prefer that they divorce a woman already lost to Satan thru fornication rather than another since for them to remarry is committing adultery. Matthew 19:9 plainly shows it is adultery. And that means that God doesn't allow divorce. Only one allowed to be divorced by Jesus was one condemned to eternal Hell for fornication. What's really funny is that I'm not sure whot fornication is Ruth. So Ruth please fornicate and explain to everyone what it is you're doing so we'll all know what fornication is. That way we won't end up in Hell for fornicateing. Please explain how you fornicate.
Ruth dear most all of the women in America is divorced or have their marriage annulled by the church in the U.S. at one time or another. Therefore most all women in the U.S. according to Matthew 19 has been judged fornicators condemned to eternal Hell by the judges and church. To be divorced one must be a fornicator Jesus showed. He also showed that when a woman remarries she commits adultery and thus is condemned to eternal Hell for that. Accordiing to that it would appear that the judges and church doesn't like women since they judge most all women as fornicators and see them divorced or their marriages annulled. Man always looked down on woman and saw her as nothing and still does that shows.But since women put in for divorces and annulments as well it would seem that women look down upon women as well. Whatever fornication is the judges and church has accused almost all women of doing it by granting them their divorces and annulments. Has proclaimed them fornicators as such. Has made adulterers of most women. And the women blindly allows them to do so. Allows them to condemn them to eternal Hell. Thus the woman proves herself not even a helpmate as the bible said but as a sacrifical lamb sacrificed to The god of man Satan. That was Jesus actually shows us in Matthew 19.


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Bob Dylan 101: Bob Dylan
Singing from the Bible. Not God's Bible, but the bible of man – a common man – a desperate and dispirited man. His back broken – his faith swallowed up in a dustbowl of disease and disuse. Listen to the harp blowing like a train whistle. Woody's ghost? No, what we're hearing is the beginnings of a character named Bob Dylan wrapped in an American flag of hunger and thirst.
Understand he was learning – soaking in everything around him like a sponge – a Mynah Bird – a chameleon, and still there's something new – something not quite heard before. Just a boy from the Midwest and already a myth – a smoke ring – a magic swirling ship – a jingle jangle morning brought to fruition through faith, genius and an iron ore intellect.
Like Robert Johnson before him, Bob must have met the Devil down at the crossroads because the technical ability he amassed in just a couple of months when going back to Minneapolis in mid-May of 1961 and then returning to New York City is something to behold.
America the beautiful – America the mutt – America the profane and America the sacred. The music caught between Heaven and Hell – Mississippi and New York City. A rocking, rollicking train ride of great proportions and narrow alleyways. In fact this is Genesis following the beat of its own drummer.
Charles Cicirella

subset: commoncrawl


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Cancer Genetics Overview (PDQ®): Genetics - Health Professional Information [NCI]
This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http://cancer.gov or call 1-800-4-CANCER |
Cancer Genetics Overview
Purpose of This PDQ Summary
This PDQ cancer information summary for health professionals provides a framework for understanding the genetic basis of hereditary cancer. This summary is reviewed regularly and updated as necessary by the PDQ Cancer Genetics Editorial Board.
Information about the following is included in this summary:
- The features of hereditary cancer.
- The genetic counseling process.
- An extensive list of genetics resources available online.
The PDQ Cancer Genetics summaries contain level-of-evidence designations. These designations are intended to help readers assess the strength of the evidence in relation to specific studies or strategies. A description of how the level of evidence designations are made is described in detail in this summary.
This summary does not provide formal guidelines or recommendations for making health care decisions. Information in this summary should not be used as a basis for reimbursement determinations.
Many of the medical and scientific terms used in this summary are found in the NCI Dictionary of Genetics Terms. When a linked term is clicked, the definition will appear in a separate window.
The etiology of cancer is multifactorial, with genetic, environmental, medical, and lifestyle factors interacting to produce a given malignancy. Knowledge of cancer genetics is rapidly improving our understanding of cancer biology, helping to identify at-risk individuals, furthering the ability to characterize malignancies, establishing treatment tailored to the molecular fingerprint of the disease, and leading to the development of new therapeutic modalities. As a consequence, this expanding knowledge base has implications for all aspects of cancer management, including prevention, screening, and treatment.
Genetic information provides a means to identify people who have an increased risk of cancer. Sources of genetic information include biologic samples of DNA, information derived from a person's family history of disease, findings from physical examinations, and medical records. DNA-based information can be gathered, stored, and analyzed at any time during an individual's life span, from before conception to after death. Family history may identify people with a modest to moderately increased risk of cancer or may serve as the first step in the identification of an inherited cancer predisposition that confers a very high lifetime risk of cancer. For an increasing number of diseases, DNA-based testing can be used to identify a specific mutation as the cause of inherited risk and to determine whether family members have inherited the disease-related mutation.
Throughout this summary, the term "mutation" will be used to refer to a change in the usual DNA sequence of a particular gene. Mutations can have harmful, beneficial, neutral, or uncertain effects on health and may be inherited as autosomal dominant, autosomal recessive, or X-linked traits. Mutations that cause serious disability early in life are usually rare because of their adverse effect on life expectancy and reproduction. However, if the mutation is autosomal recessive—that is, if the health effect of the mutation is caused only when two copies (one from each parent) of the mutated gene are inherited—mutation carriers (healthy people carrying one copy of the altered gene) may be relatively common in the general population. "Common" in this context refers, by convention, to a prevalence of 1% or more. Mutations that cause health effects in middle and older age, including several mutations known to cause a predisposition to cancer, may also be relatively common. Many cancer-predisposing traits are inherited in an autosomal dominant fashion, that is, the cancer susceptibility occurs when only one copy of the altered gene is inherited. For autosomal dominant conditions, the term "carrier" is often used in a less formal manner to denote people who have inherited the genetic predisposition conferred by the mutation. Refer to individual PDQ summaries focused on the genetics of specific cancers for detailed information on known cancer-susceptibility syndromes.
Increasingly, the public is turning to the Internet for information related both to familial and genetic susceptibility to cancer and to genetic risk assessment and testing. Direct-to-consumer marketing of genetic testing for hereditary breast and colon cancer is also taking place in some communities. This wider availability of information related to inherited cancer risk may raise concerns among persons previously unaware of the implications inherent in their family histories and may lead some of these individuals to consult their primary care physicians for management advice and recommendations. In many instances, the evaluation and advice will be relatively straightforward for physicians with a basic knowledge of familial cancer. In a subset of patients, the evaluation may be more complex, calling for referral to genetics professionals for further evaluation and counseling.
Correctly recognizing and identifying individuals and families at increased risk of developing cancer is one of countless important roles for primary care and other health care providers. Once identified, these individuals can then be appropriately referred for genetic counseling, risk assessment, consideration of genetic testing, and development of a management plan. When medical and family histories reveal cardinal clues to the presence of an underlying familial or genetic cancer susceptibility disorder (see list below),[1] further evaluation may be warranted. Refer to the PDQ summary on Cancer Genetics Risk Assessment and Counseling for more information about the components of a genetics cancer risk assessment.
Features of hereditary cancer include the following:
- In the individual patient:
- Multiple primary tumors in the same organ.
- Multiple primary tumors in different organs.
- Bilateral primary tumors in paired organs.
- Multifocality within a single organ (e.g., multiple tumors in the same breast all of which have risen from one original tumor).
- Younger-than-usual age at tumor diagnosis.
- Tumors with rare histology.
- Tumors occurring in the sex not usually affected (e.g., breast cancer in men).
- Tumors associated with other genetic traits.
- Tumors associated with congenital defects.
- Tumors associated with an inherited precursor lesion.
- Tumors associated with another rare disease.
- Tumors associated with cutaneous lesions known to be related to cancer susceptibility disorders (e.g., the genodermatoses).
- In the patient's family:
- One first-degree relative with the same or a related tumor and one of the individual features listed.
- Two or more first-degree relatives with tumors of the same site.
- Two or more first-degree relatives with tumor types belonging to a known familial cancer syndrome.
- Two or more first-degree relatives with rare tumors.
- Three or more relatives in two generations with tumors of the same site or etiologically related sites.
Concluding that an individual is at increased risk of developing cancer may have important, potentially life-saving management implications and may lead to specific interventions aimed at reducing risk (e.g., tamoxifen for breast cancer, colonoscopy for colon cancer, or risk-reducing salpingo-oophorectomy for ovarian cancer). Information about familial cancer risk may also inform a person's ability to plan for the future (lifestyle and health care decisions, family planning, or other decisions). Genetic information may also provide a direct health benefit by demonstrating the lack of an inherited cancer susceptibility. For example, if a family is known to carry a cancer-predisposing mutation in a particular gene, a family member may experience reduced worry and lower health care costs if his or her genetic test indicates that he or she does not carry the family's disease-related mutation. Conversely, information about familial cancer risk may have psychological effects or social costs (e.g., worry, guilt, or increased health care costs). Family dynamics also may be affected. For instance, the involvement of one or more family members may be required for genetic testing to be informative, and parents may feel guilt about passing inherited risk on to their children.
Knowledge about a cancer-predisposing mutation can be informative not only for the individual tested but also for other family members. Family members who previously had not considered the implications of their family history for their own health may be led to do so, and some will undergo genetic testing, resulting in more definitive information on whether they are at increased genetic risk. Some relatives may learn their mutation status without being directly tested, for example, when a biological parent of a child who is a known mutation carrier is identified as an obligate carrier. Founder effects may result in the recognition that specific ethnic groups have a higher prevalence of certain mutations, knowledge that can be both clinically useful (permitting more rational genetic testing strategies) or potentially stigmatizing. Testing may reveal the presence of nonpaternity in a family. There is the theoretical possibility that genetic information may be misused, and concerns about the potential for insurance and/or employment discrimination may arise. Genetic information may also affect medical and lifestyle decisions.
Refer to individual PDQ summaries for available evidence addressing all ancillary issues.
Genetic counseling is a process of communication between genetics professionals and patients with the goal of providing individuals and families with information on the relevant aspects of their genetic health, available testing and management options, and support as they move toward understanding and incorporating this information into their daily lives. Genetic counseling generally involves six steps:
1. | Family and medical history assessment. |
2. | Analysis of genetic information. |
3. | Communication of genetic information. |
4. | Education about inheritance, genetic testing, management, risk reduction, resources and research opportunities. |
5. | Supportive counseling to facilitate informed choices and adaptation to the risk or condition. |
6. | Follow up.[1] |
Genetic evaluation involves an interaction with a medical geneticist or other genetics professional and may include a physical examination and diagnostic testing, in addition to genetic counseling. The principles of voluntary and informed decision making, nondirective and noncoercive counseling, and protection of client confidentiality and privacy are central to the philosophy of genetic counseling.[1,2,3,4,5] Refer to the PDQ summary on Cancer Genetics Risk Assessment and Counseling for more information on the nature and history of genetic counseling.
From the mid 1990s to the mid 2000s, genetic counseling expanded to include discussion of genetic testing for cancer risk, as more genes associated with inherited cancer risk were discovered. Cancer genetic counseling often involves a multidisciplinary team of health professionals that may include a genetic counselor, an advanced practice genetics nurse, or a medical geneticist; a mental health professional; and various medical experts such as an oncologist, surgeon, or internist. The process of counseling may require a number of visits to address medical, genetic testing, and psychosocial issues. Even when cancer risk counseling is initiated by an individual, inherited cancer risk has implications for the entire family. Because genetic risk affects biological relatives, contact with these relatives is often essential to collect accurate family and medical histories. Cancer genetic counseling may involve several family members, some of whom will have had cancer and others who have not.
The impact of risk assessment and predisposition genetic testing is improved health outcomes. The information derived from risk assessment and/or genetic testing allows the health care provider to tailor an individual approach to health promotion and optimize long-term health outcomes through the identification of at-risk individuals before cancer develops. The health care provider can thus intervene earlier either to reduce the risk or diagnose a cancer at an earlier stage, when the chances for effective treatment are greatest. The information may be used to modify the management approach to an initial cancer, clarify the risks of other cancers, or predict the response of an existing cancer to specific forms of treatment, all of which may alter treatment recommendations and long-term follow-up.
Structure and Content of PDQ Summaries
PDQ cancer genetics summaries focus on the genetics of specific cancers, inherited cancer syndromes, and the ethical, social, and psychological implications of cancer genetics knowledge. Sections on the genetics of specific cancers include syndrome-specific information on the risk implications of a family history of cancer, the prevalence and characteristics of cancer-predisposing mutations, known modifiers of genetic risk, opportunities for genetic testing, outcomes of genetic counseling and testing, and interventions available for people with increased cancer risk resulting from an inherited predisposition.
The source of medical literature cited in PDQ cancer genetics summaries is peer-reviewed scientific publications, the quality and reliability of which is evaluated in terms of levels of evidence. Where relevant, the level of evidence is cited, or particular strengths of a study or limitations of the evidence are described.
Creating evidence-based summaries on cancer genetics is challenging because the rapid evolution of new information often results in evidence that is incomplete or of limited quality. In addition, established methods for evaluating the quality of the evidence are available for some but not all aspects of cancer genetics. Varying levels of evidence are available for different topics, and PDQ summaries are subject to modification as new evidence becomes available. As in other areas of medicine, testing and treatment decisions must be based on information that sometimes falls short of the optimal level of evidence. Recognizing the limits inherent in certain observations will alter the weight given to recommendations based on that evidence and serves to keep our minds open to new improved information, as it comes along.
The quality of evidence depends on the appropriateness of the study to the question being evaluated and on how well the study was designed, implemented, analyzed, and interpreted. For evaluating outcomes of both medical and social interventions, the strongest evidence is obtained from well-designed and well-conducted randomized clinical trials. For evaluating other questions, particularly those related to the prevalence of gene variants and inherited syndromes and determining the clinical validity of genetic tests, the strongest evidence is obtained from well-designed descriptive studies. Particular elements of study design, such as the nature of the population studied or the duration of observation, may be crucial to assessing the quality of a study.
During the early phases of research in a new area, information relevant to the needs of patients and clinicians may come from work at all levels of evidence, including well-designed quasi-experimental studies (nonrandomized, controlled single-group, pre/post, cohort, time, or matched case-control series) or nonexperimental studies (case reports, clinical examples, qualitative or narrative studies, or theoretical work). Such research may yield information important to patients and clinicians, who must make management decisions before full data on the risks and benefits of cancer genetic testing are available. In addition, such work helps to inform future research using more rigorous designs.
Study Populations
The level of evidence required for informed decision making about genetic testing depends on the circumstances of testing. Evidence from a sample of high-risk families may be sufficient to provide useful information for testing decisions among people with similar family histories but is likely to be insufficient to make early recommendations for, or decisions about, testing in families with less dramatic histories or in the general population. Even among people with similar family histories, however, other contributing genes or different exposures could modify the effect of a gene mutation in different families. In evaluating evidence, the most important consideration is the relevance of the available data to the patient for whom a genetic assessment is being considered. In summaries addressing the cancer risk associated with genetic polymorphisms and mutations, the study populations used for each risk assessment will be noted, according to the following categories.
1. | Population-based. |
2. | Proxy for population-based. (The study population selected is assumed to be generally representative of the population from which it is drawn. For example: Persons participating in a community-based Tay-Sachs screening program, as a proxy for persons of Jewish descent.) |
3. | Public recruitment of volunteers, e.g., using a newspaper ad. |
4. | Sequential case series. |
5. | Convenience sample. |
6. | An affected family or several families. |
Use of Levels of Evidence
The PDQ editorial boards use a ranking system of levels of evidence to help the reader judge the strength of evidence linked to the reported results of a therapeutic strategy. For any given therapy, results of prevention and treatment studies can be ranked on each of the following two scales: (1) strength of the study design and (2) strength of the endpoints. Together, the two rankings provide a measure of the overall level of evidence. Screening studies are ranked on strength of study design alone. Depending on perspective, different expert panels, professional organizations, or individual physicians may use different cut-off points related to overall strength of evidence in formulating therapeutic guidelines or in taking action; however, a formal description of the level of evidence provides a uniform framework for the data, leading to specific recommendations.
There are varying levels of evidence related to screening, prevention, and treatment that support a given summary. The summaries are subject to modification as new evidence becomes available. The strongest evidence would be that obtained from a well-designed and well-conducted randomized controlled trial. It is not always practical, however to conduct such a trial to address every question in the fields of cancer screening, prevention, and treatment.
Evidence related to screening
The PDQ Cancer Genetics Editorial Board has adopted the following definitions related to screening:
- Screening is a means of accomplishing early detection of disease in people without symptoms of the disease being sought.
- Examinations, tests, or procedures used in cancer screening are often not definitive but sort out persons suspected of harboring a clinically occult cancer from those in whom a cancer is not likely to be present.
- Diagnosis of disease is made after a work-up, biopsy, or other tests are completed in pursuing symptoms or following positive detection procedures.
Five requirements should be met before it is considered appropriate to screen for a particular medical condition as part of routine medical practice:[1,2]
1. | The medical condition being sought must cause a substantial burden of suffering, measured both as mortality and as the frequency and severity of morbidity and loss of function. |
2. | A screening test or procedure exists that will detect cancers earlier in their natural history than when diagnosis is prompted by symptoms, and this test must be acceptable to patients and society in terms of convenience, comfort, risk, and cost. |
3. | Strong evidence exists that early detection and treatment improve disease outcomes, particularly disease-specific survival. |
4. | The harms of screening must be known and acceptable. |
5. | Screening must be judged to do more good than harm, considering all benefits and harms it induces, as well as the cost and cost-effectiveness of the screening program. |
In order of strength of evidence, the levels for screening studies follow:
1. | Evidence obtained from at least one well-designed and well-conducted randomized controlled trial. |
2. | Evidence obtained from well-designed and well-conducted nonrandomized controlled trials. |
3. | Evidence obtained from well-designed and well-conducted cohort or case-control analytic studies, preferably from more than one center or research group. |
4. | Evidence obtained from multiple time series, with or without intervention. |
5. | Opinions of respected authorities based on clinical experience, descriptive studies, or reports of expert committees. |
Evidence related to cancer prevention
Prevention is defined as a reduction in the incidence (or the rate) of new cancer, with the goal of reducing cancer-related morbidity and mortality. Examples of prevention strategies include smoking cessation, avoidance of excessive exposure to sunlight (ultraviolet) or ionizing radiation, surgical removal of an at-risk target organ before cancer develops, and use of medications (e.g., tamoxifen for breast cancer risk reduction).
For each prevention-related summary of evidence statement, the associated levels of evidence are listed. In order of strength of evidence, the five levels are as follows:
1. | Evidence obtained from at least one well-designed and well-conducted randomized controlled trial that has:
2. | Evidence obtained from well-designed and well-conducted nonrandomized controlled trials that have:
3. | Evidence obtained from well-designed and well-conducted cohort or case-control studies, preferably from more than one center or research group, that have:
4. | Ecologic (descriptive) studies (e.g., international patterns studies, migration studies) that have:
5. | Opinions of respected authorities based on clinical experience or reports of expert committees (e.g., any of the above study designs using invalidated surrogate endpoints). |
In assessing a genetic test (or other method of genetic assessment, including family history), the analytic validity, clinical validity, and clinical utility of the test need to be considered.[3]
Evidence related to treatment
For each treatment-related summary of evidence statement, the associated levels of evidence are listed. In order of strength of evidence, the five levels are as follows:
1. | Evidence obtained from randomized controlled trials. | ||||||||||||||
2. | Evidence obtained from nonrandomized controlled trials. | ||||||||||||||
3. | Evidence obtained from cohort or case-control studies.
4. | Evidence from ecological, natural history, or descriptive studies. | ||||||||||||||
5. | Opinions of respected authorities based on clinical experience, descriptive studies, or reports of expert committees. |
Analytic Validity
Analytic validity refers to how well the genetic assessment performs in measuring the property or characteristic it is intended to measure. In the case of family history, analytic validity refers to the accuracy of the reported family history information. In the case of a test for a specific mutation, analytic validity refers to the accuracy of a genetic test in identifying the presence or absence of the mutation. The analytic validity of a genetic test is affected by the technical accuracy and reliability of the testing procedure and by the quality of the laboratory processes (including specimen handling).
The assessment of analytic validity is complex for some genetic tests. For example, a panel test is designed to evaluate a particular set of mutations (e.g., the Ashkenazi founder mutations in the BRCA1 and BRCA2 genes), and the analytic validity of the different components of the test may vary. Some genetic tests involve evaluating the DNA sequence of portions of a gene to determine whether any mutations are present (including mutations not previously identified). The sensitivity and specificity of these sequencing tests may vary with the laboratory techniques employed, the proportion of the gene tested, and the structural nature of the mutations present in the gene.
Clinical Validity
Clinical validity refers to the predictive value of a test for a given clinical outcome (e.g., the likelihood that cancer will develop in someone with a positive test) and is primarily determined by the sensitivity and specificity with which a test identifies people with a defined clinical condition within a given population. Sensitivity of a test refers to the proportion of persons who test positive among all those who actually have a clinical condition; specificity refers to the proportion of persons who test negative from among all those who do not have the clinical condition. In the case of genetic susceptibility to cancer, clinical validity can be considered at two levels:
1. | Does a positive test identify a person as having an increased risk of cancer? |
2. | If so, how high is the cancer risk associated with a positive test? |
Thus, the clinical validity of a genetic test is the likelihood that cancer will develop in someone with a positive test result. This likelihood is affected not only by the presence of the gene mutation itself but also by any other modifying factors that might affect the penetrance of the mutation (e.g., the mutation carrier's environmental exposures or personal behaviors) or by the presence or absence of mutations in other genes. For this reason, the clinical validity of a genetic test for a specific mutation may vary in different populations. If the cancer risk associated with a given mutation is unknown or variable, a test for the mutation will have uncertain clinical validity. A summary of definitions of concepts relevant to understanding clinical validity and other aspects of cancer genetics testing has been published.[4] The test should be evaluated in the population in which the test will be used.
Clues to whether a particular familial cancer syndrome has a genetic basis can be derived informally, by inspecting the pattern of affected persons and unaffected persons in a series of families; or more formally, using an analytic technique known as segregation analysis. Segregation analysis provides quantitative data in support of, or against, the likelihood that a particular genetic mode of inheritance might explain the patterns observed in the study families.
Evidence that a particular gene might explain a specific cancer predisposition syndrome often derives initially from linkage studies that use collections of families meeting stringent clinical criteria for a specific cancer susceptibility syndrome. The demonstration of strong linkage of cancer susceptibility to a gene or genetic region in a pattern consistent with autosomal dominant inheritance provides evidence in support of both the mode of inheritance and the particular gene that might underlie the risk. Once linkage is established, a strong case for association between the genetic trait and disease can be made, even though the families used in the study may not be representative of the general population. The genetic trait measured in linkage studies is not always the causal factor itself but may be a genetic trait closely linked to it. Additional molecular studies are required to identify the specific gene associated with inherited risk, after linkage studies have determined its general chromosomal location.
Linkage studies, however, provide only limited evidence concerning either the range of cancer types associated with a mutation or the magnitude of risk and lifetime probability of cancer conferred by a mutation in less selected populations. In addressing these questions, the best information for clinical decisions comes from naturally occurring populations in which people with all degrees of risk are represented, similar to those in which clinical or public health decisions must be made. Thus, observations about cancer risk in families having multiple members with early breast cancer are applicable only to other families meeting those same clinical criteria. Ideally, the families tested should also have similar exposures to factors that can modify the expression of the gene(s) being studied. The mutation-associated risk in other populations, such as families with less dramatic cancer aggregation, or in the general population can best be assessed by direct study of those populations.
Clinical Utility
The clinical utility of the test refers to the likelihood that the test will, by prompting an intervention, result in an improved health outcome. The clinical utility of a genetic test is based on the health benefits related to the interventions offered to persons with positive test results. Theoretically, there are at least five strategies that might improve the health outcome of people with a genetic susceptibility to cancer:
- Correction of the underlying genetic defect (not currently available).
- Interventions to reduce the risk of developing cancer.
- Screening to detect early cancer or precancerous lesions.
- Specific treatment for syndrome-related cancers that differs from the treatment generally applied to the sporadic versions of the same cancer (not currently available).
- Interventions to improve quality of life.
Evaluation of interventions should consider their efficacy (capacity to produce an improved health outcome) and effectiveness (likelihood that the improved outcome will occur, taking into account actual use of the intervention and recommended follow-up). Sometimes genetic information may lead to consideration of changes in the approach to clinical management, based on expert opinion, in the absence of proof of clinical utility.
Genetic Resources
Health care providers who deliver genetic services, including genetic counseling can be located through local, regional, and national professional genetics organizations; through the NCI Web site Cancer Genetics Services Directory; and through the Gene Tests-Gene Clinics Web site. Providers of cancer genetic services are not limited to one specialty and include medical geneticists, genetic counselors, advanced practice genetics nurses, oncologists (medical, radiation, or surgical), other surgeons, internists, family practitioners, and mental health professionals. A cancer genetics health care provider will assist in constructing and evaluating a pedigree, eliciting and evaluating personal and family medical histories, and calculating and providing information about cancer risk and/or probability of a mutation being associated with cancer in the family. In addition, if a genetic test is available, these providers can assist in pretest counseling, laboratory selection, informed consent, test interpretation, posttest counseling, and follow-up. Please see the Table of Links at the end of this summary in printable view for the Genetic Resources URLs.
Clinical Genetics
Resource | Description |
GeneTests | Information for health professionals about hundreds of genetic tests and the laboratories performing those tests. |
Human Genome Epidemiology Network (HuGENet) | Network for sharing population-based human genome epidemiologic information. |
INFOGENETICS | Clinical practice tools. |
Online Mendelian Inheritance in Man (OMIM) | Catalog of human genes and genetic disorders. |
Consumer/Client: General Information
Resource | Description |
The DNA Files | Series of 14 1-hour public radio documentaries and related information. |
Dolan DNA Learning Center Gene Almanac | Variety of educational resources, including an interactive DNA timeline. |
FORCE: Facing Our Risk of Cancer Empowered | Provides support and information to individuals and families affected by hereditary breast and ovarian cancer through a toll-free help line, message boards, chat, and support groups. |
Genetics Education Center | Material for educators. |
Genetics Home Reference—National Library of Medicine | Consumer information about genetic conditions and the genes or chromosomes responsible for those conditions. |
Genetic and Rare Diseases Information Center | Information service for the general public, including patients and their families as well as health care professionals and biomedical researchers. |
Genetic Science Learning Center | Basic genetics, genetic disorders, genetics in society, and several thematic units. |
The Human Genome Project: Exploring Our Molecular Selves | Downloadable modules or online viewing of The Human Genome Project, including milestones, a talking glossary, classroom activities, and a 3-D computer-animated video on basic molecular biology. |
National Cancer Institute: Cancer Genetics Services Directory | Directory lists professionals who provide cancer genetics services (cancer risk assessment, genetic counseling, genetic susceptibility testing, and others). |
National Cancer Institute: Dictionary of Genetics Terms | Contains definitions for more than 100 terms related to genetics. |
The New Genetics: A Resource for Students and Teachers | Links to genetics education resources. |
Understanding Cancer Series (from the National Cancer Institute) | Primers on cancer genomics, genetic testing, genome-wide profiling, and other topics. |
Ethical, Legal, and Social Implications (ELSI), Policy, and Legislation
Resource | Description |
bioethics.net | Links to articles on genetics and bioethics. |
Bioethics Resources on the Web | Links to bioethics resources. |
Coalition for Genetic Fairness | Describes GINA's protections including a history of the legislation, key examples, and definitions. |
DNA Patent Database | Searchable database of U.S. DNA-based patents and patent applications issued by the U.S. Patent and Patent Applications Trademark Office. |
Ethical, Legal, and Social Issues (from the Human Genome Project) | Information, articles, and links on a wide range of issues. |
Genethics.ca | Information on the social, ethical, and policy issues associated with genetic and genomic knowledge and technology. |
Genetics and Public Policy Center | Information on public policy related to human genetic technologies for the public, media, and policy makers. |
Genome Technology and Reproduction: Values and Public Policy and Communities of Color and Genetics Policy Project | Two subprojects combined to form a 5-year project designed to provide policy recommendations based on public perceptions and responses to the explosion of genetic information and technology. |
HumGen International | Comprehensive international database on the legal, social, and ethical aspects of human genetics. |
NCSL (National Conference of State Legislatures) Genetic Technologies Project | Resources on a variety of genetics public policy and related issues for state legislators, legislative staff, and other policy makers. |
National Information Resource on Ethics and Human Genetics | Links to resources and databases on ethics and human genetics. |
National Information Resource on Ethics and Human Genetics: Annotated Bibliographies: Scope Note Series | Annotated bibliographies on various genetics and ethics issues. |
National Human Genome Research Institute (NHGRI) Policy and Legislation Database | Searchable database of Federal and State laws/ statutes, Federal legislative materials, and Federal administrative and executive materials about privacy of genetic information/ confidentiality; informed consent; insurance and employment discrimination; genetic testing and counseling; and commercialization and patenting. |
National Society of Genetic Counselors (NSGC) Code of Ethics | A statement to clarify and guide the ethical conduct of genetic counselors. |
THOMAS Legislative Information (from Library of Congress) | Searchable database of U.S. legislation (current and previous Congresses). |
Your Genes, Your Choices | Description of the Human Genome Project, the science behind it, and the ethical, legal, and social issues raised by the project. |
Family History Tools
Resource | Description |
American Medical Association: Family History Tools | Tools for gathering family history and links to resources. |
Family History: Resources and Tools | CDC's Web site devoted to using family history to promote health. |
National Society of Genetic Counselors: Your Family History—Your Future | Information on collecting a family health history. |
U.S. Surgeon General's Family History Initiative: My Family Health Portrait | Web-based family history tool, created by the office of the U.S. Surgeon General. |
Genome Research
Resource | Description |
BLAST Search (part of the Ensembl Project; see below) | Search protein or DNA sequence against metazoan genomes. |
The Cancer Genome Anatomy Project (CGAP) | Access to all CGAP data and biological resources. |
CancerGenes | Combines gene lists annotated by experts with information from key public databases such as Entrez Gene, COSMIC, and iHOP. |
Cancer Genome Workbench (CGWB) | Integrates clinical tumor mutation profiles with the reference human genome to improve the accuracy of mutation identification. |
Chromosomal Variation in Man | Searchable database of literature citations on chromosomal variants and anomalies. |
Ensembl (Joint software project between the European Bioinformatics Institute and the Wellcome Trust Sanger Institute) | Data sets resulting from an automated genome analysis and annotation process. |
Genome Channel | Java viewers for human genome data. |
Genome Sequencing Center: Homo sapiens Maps | Links to clone and accession maps of the human genome. |
KMcancerDB | Human gene mutation database with graphical display of molecular information for cancer-related genes. |
National Center for Biotechnology Information: Genomic Biology | Views of chromosomes, maps, and loci; links to other NCBI resources. |
Online Mendelian Inheritance in Man (OMIM) | Catalog of human genes and genetic disorders. |
International HapMap Project | A variety of ways to query for SNPs in the human genome. |
UCSC Genome Bioinformatics | Reference sequence for the human and C. elegans genomes and working drafts for the mouse, rat, Fugu, Drosophila, C. briggsae, yeast, and SARS genomes. |
Health Professional Practice and Education
Resource | Description |
Centre for Education in Medical Genetics | Develops, provides, and evaluates genetics education opportunities and resources. |
Centre for Genetics Education | Education and service resources for patients and professionals. |
Dolan DNA Learning Center Gene Almanac | Interactive multimedia genetics education resources. |
Essentials of Genetic and Genomic Nursing: Competencies, Curricula Guidelines, and Outcome Indicators, 2nd edition | Establishes minimum basis to prepare the nursing workforce to deliver competent genetic and genomic-focused nursing care. |
Evaluation of Genomic Applications in Practice and Prevention (EGAPP) | Provides an evidence-based review of genetic tests and other genomic applications that are in transition from research to clinical and public health practice in the United States. |
GenEd Project | Information about the project, news, and links to previously published research on European aspects of genetic services. |
Genetics in Clinical Practice: A Team Approach | Interactive virtual genetics clinic with case scenarios and case discussions. Target audience is primary care professionals. |
Genetics Education Center | For educators interested in human genetics and the Human Genome Project. |
Genetics Education Program for Nurses (GEPN) | Sample genetics nursing course syllabi and other genetics educational opportunities and resources for nurses. |
Genetics in Primary Care | Training program curriculum materials. |
Genetics in Psychology | American Psychological Association's genetics site. |
Genetics and Your Practice | Online modules for health care professionals designed for exploration of a topic rather than a sequential presentation of material. Includes fact sheets and sample clinical forms. Free registration required for access. |
Medical School Core Curriculum in Genetics | Medical school course competencies, skills, knowledge, and behaviors that should be covered in a genetics curriculum developed by the Association of Professors of Human and Medical Genetics and the American Society of Human Genetics. |
National Coalition for Health Professional Education in Genetics (NCHPEG) | Core competencies in genetics and reviews of education programs. Descriptions of available instructional resources, courses, and institutes. |
Six Weeks to Genomic Awareness | Webcast of six lessons in genomics for public health professionals. |
Institutional Review Boards (IRBs)
Resource | Description |
Genetic Testing and Screening in the Age of Genomic Medicine. New York State Task Force on Life and the Law. | Includes general and state-specific information in a bulleted report. |
Pharmacogenetics: Ethical Issues. Nuffield Council on Bioethics. | Includes a section discussing the use of pharmacogenetics in clinical trials. |
Protecting Human Research Subjects Institutional Review Board Guidebook, Chapter V, Section H: Human Genetic Research. Office for Human Research Protections. | Discusses many issues that continue to challenge IRBs investigators, and policy makers today. |
Professional Organizations: Genetics
Resource | Description |
American Board of Genetic Counseling (ABGC) | Information about certification of genetic counselors. |
American Board of Medical Genetics (ABMG) | Information about medical genetic training programs and certification of geneticists. |
American College of Medical Genetics (ACMG) | Resources, policy statements, and practice guidelines about medical genetics. |
American Society for Human Genetics (ASHG) | Resources, projects, and policies concerning human genetics. |
Genetics Nursing Credentialing Commission (GNCC) | Information about credentialing of genetics nurses. |
Genetics Society of America (GSA) | Links to teaching Web sites, general educational courses, and journals and publications about genetics. |
International Society of Nurses in Genetics (ISONG) | Resources to help nurses incorporate new knowledge about human genetics into practice, education, and research. |
National Society of Genetic Counselors (NSGC) | Information about genetic counseling: practice guidelines, links to genetic counselors, and genetic discrimination resources. |
Risk Assessment
Resource | Description |
Harvard Center for Cancer Prevention: Your Disease Risk | Personalized estimation of cancer risk and tips for prevention. |
JamesLink: Personalized Cancer Risk Assessment | Interactive tool that estimates cancer risk by reviewing patterns of cancer in a family. |
My Generations | Interactive tool that estimates cancer risk by reviewing patterns of cancer in a family. |
National Cancer Institute: Breast Cancer Risk Assessment Tool | Interactive tool for estimating a woman's risk of developing invasive breast cancer. |
National Cancer Institute: Colorectal Cancer Risk Assessment Tool | Interactive tool for estimating the risk of developing colorectal cancer in a 50- to 85- year old non-Hispanic white man or woman. |
National Cancer Institute: Melanoma Risk Assessment Tool | Interactive tool for estimating an individual's absolute risk of developing melanoma. |
Online Gene Mutation Prediction Programs
Resource | Description |
HuGE Risk Translator | Calculates the predictive value of genetic markers. |
MRC Human Genetics Unit, Edinburgh | Predicts the likelihood of mutations in one of the mismatch repair genes in persons with colon cancer. |
The Penn II Risk Model | Estimates the probability that an individual has a BRCA1 or BRCA2 mutation. |
PREMM1,2 Model: Prediction Model for MLH1 and MSH2 Gene Mutations | Estimates the probability that an individual carries a mutation in one of the mismatch repair genes. |
Search Engines Specializing in Genetics and Genomics
Resource | Description |
Catalog of Published Genome-Wide Association Studies | An online catalog of SNP-trait associations from published genome-wide association studies for use in investigating genomic characteristics of trait/disease-associated SNPs. |
Genetics Resources on the Web (GROW) | Information related to human genetics, with a particular focus on genetic medicine and health. |
Georgetown University: National Information Resource on Ethics and Human Genetics | Search engine for literature on specific issues related to ethics and human genetics. |
HuGE Navigator | An integrated, searchable knowledge base of genetic associations and human genome epidemiology. |
United States Government Agencies
Resource | Description |
Centers for Disease Control and Prevention: National Office of Public Health Genomics | Information on how human genomic discoveries can be used to improve health and prevent disease, including links to many resources. |
Department of Energy Office of Science: genomics.energy.gov | Genomics educational resources. |
Department of Health and Human Services | Links to publications and materials available for purchase or download from the HRSA Information Center. |
Genetic Modification Clinical Research Information System (GeMCRIS) | Information about human gene transfer trials registered with NIH. |
National Cancer Institute | NCI's summaries of cancer genetics–related information. |
National Human Genome Research Institute | Research, policy, ethics, education, and training information and resources about genetic and rare diseases. |
National Institute of Environmental Health Sciences (NIEHS): Environmental Genome Project | Information on project to improve understanding of human genetic susceptibility to environmental exposures. |
Get More Information From NCI
For more information, U.S. residents may call the National Cancer Institute's (NCI's) Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237) Monday through Friday from 9:00 a.m. to 4:30 p.m. A trained Cancer Information Specialist is available to answer your questions.
The NCI's LiveHelp® online chat service provides Internet users with the ability to chat online with an Information Specialist. The service is available from 9:00 a.m. to 11:00 p.m. Eastern time, Monday through Friday. Information Specialists can help Internet users find information on NCI Web sites and answer questions about cancer.
For more information from the NCI, please write to this address:
NCI Public Inquiries Office |
Suite 3036A |
6116 Executive Boulevard, MSC8322 |
Bethesda, MD 20892-8322 |
The NCI Web site provides online access to information on cancer, clinical trials, and other Web sites and organizations that offer support and resources for cancer patients and their families. For a quick search, use the search box in the upper right corner of each Web page. The results for a wide range of search terms will include a list of "Best Bets," editorially chosen Web pages that are most closely related to the search term entered.
There are also many other places to get materials and information about cancer treatment and services. Hospitals in your area may have information about local and regional agencies that have information on finances, getting to and from treatment, receiving care at home, and dealing with problems related to cancer treatment.
The NCI has booklets and other materials for patients, health professionals, and the public. These publications discuss types of cancer, methods of cancer treatment, coping with cancer, and clinical trials. Some publications provide information on tests for cancer, cancer causes and prevention, cancer statistics, and NCI research activities. NCI materials on these and other topics may be ordered online or printed directly from the NCI Publications Locator. These materials can also be ordered by telephone from the Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237).
Changes to This Summary (12 / 04 / 2009)
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.
Added the Understanding Cancer Series as a consumer/client resource that contains information on cancer genomics, genetic testing, genome-wide profiling, and other topics.
More Information
- PDQ® - NCI's Comprehensive Cancer Database.
Full description of the NCI PDQ database.
- PDQ® Cancer Information Summaries: Adult Treatment
Treatment options for adult cancers. - PDQ® Cancer Information Summaries: Pediatric Treatment
Treatment options for childhood cancers. - PDQ® Cancer Information Summaries: Supportive and Palliative Care
Side effects of cancer treatment, management of cancer-related complications and pain, and psychosocial concerns. - PDQ® Cancer Information Summaries: Screening/Detection (Testing for Cancer)
Tests or procedures that detect specific types of cancer. - PDQ® Cancer Information Summaries: Prevention
Risk factors and methods to increase chances of preventing specific types of cancer. - PDQ® Cancer Information Summaries: Genetics
Genetics of specific cancers and inherited cancer syndromes, and ethical, legal, and social concerns. - PDQ® Cancer Information Summaries: Complementary and Alternative Medicine
Information about complementary and alternative forms of treatment for patients with cancer.
This information is intended mainly for use by doctors and other health care professionals. If you have questions about this topic, you can ask your doctor, or call the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237).
Date Last Modified: 2009-12-04


text:
Polenta Squares with Bolognese Topping
From Woman's Day
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Nutritional Information
(per serving)
Calories | n/a |
Total Fat | 0 |
Saturated Fat | 0 |
Cholesterol | n/a |
Sodium | n/a |
Total Carbohydrate | 0 |
Dietary Fiber | 0 |
Sugars | n/a |
Protein | n/a |
Calcium | -- |
John Uher
Total Time: 20 min
Prep Time: 20 min
U.S. | Metric | Conversion chart |
- 1 quart(s) (4 cups) milk
- 1/2 teaspoon(s) salt
- 1/4 teaspoon(s) pepper
- 1.5 cup(s) yellow cornmeal
- 1/2 cup(s) grated Parmesan
- 1/2 cup(s) shredded fontina cheese
Bolognese Topping:
- 1 tablespoon(s) olive oil
- 1/2 cup(s) chopped onion
- 1/2 cup(s) shredded carrot
- 1 package(s) (1 1⁄4 lb) Italian turkey sausage, removed from casings
- 1 can(s) (14 1⁄2 oz) petite cut diced tomatoes with garlic and olive oil
- Garnish: chopped parsley
- Coat a 15 1⁄2 x 10 1⁄2-in. rimmed baking pan with nonstick spray.
- Make Polenta: Heat milk, 1 cup water and the salt and pepper in a large saucepan over medium-high heat until simmering. Whisk in cornmeal and cook, whisking constantly, 3 minutes, or until thick and smooth. Remove from heat; stir in cheeses. Immediately pour into prepared pan; spread evenly. Cool; cover and refrigerate 30 minutes, or until firm.
- Meanwhile, make Bolognese Topping: Heat oil in a nonstick medium skillet over medium-high heat. Add onion and carrot; sauté 2 minutes until soft. Add turkey; cook, breaking chunks into small pieces, 6 minutes, or until no longer pink. Add tomatoes and their juices; cook 1 minute to blend flavors.
- To serve: Heat broiler. Line a baking sheet with foil. Cut polenta into 10 rows lengthwise, 7 rows crosswise. Place squares on prepared baking sheet. Broil 3 in. from heat source 5 to 6 minutes until polenta is browned. Spoon 1 teaspoon warm topping on each square. Place on a serving platter. Garnish with parsley.
Tips & Techniques
Can be made through Step 3 up to 1 day ahead. Cover and refrigerate Polenta and Bolognese Topping separately. Reheat Topping in microwave or on stovetop, then proceed as directed. Save any leftover Bolognese Topping to serve with pasta.
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Despite my insatiable urges to slaughter digital monsters, I don't consider myself a violent person. I've never been in a real physical fight, nor do I plan or want to. But I'm no saint; I don't totally remove myself from any kind of physical conflict. I probably say "hit him!" while watching a hockey game more than recommend my team shoot or score. I've watched UFC, professional wrestling and even some boxing matches. The preparation, technical skill and thrill of competition sweeps over me when watching the combatants, but that isn't anything special or unique. I still don't want to be in their position, nor do I lack empathy when I discover the short and long-term injuries these athletes suffer in the name of entertainment. READ MORE
Strategy games have taken many forms over the years. From running a successful business to conquering territories or taking the fight directly to your opponents in real-time battles, it has everything you would want and then some. Now, you might be asking, "what if I want a strategy game that lets me carefully plan my escape from a highly secure prison?" First, that's an oddly specific question which somehow only relates to this particular review. Second, The Escapists is the game for you.
While it could be described as a puzzle game as much as a strategy game, The Escapists is all about learning the ins and outs of your temporary confinement and finding a way to successfully break free.
As I made my way across a shallow river, my foot slipped, I cracked my head against a rock and floated downstream on the current. Upon regaining consciousness, I suddenly found myself beset by bandits. How many, you ask? I won't know until the dealer reveals the next card, but with my luck, it won't be good for me. In Hand of Fate, a unique blend of deck-building, action-RPG and choose-your-own-adventure, my luck is rarely good. READ MORE
Graham and Jeremy bust out a SNES Mouse to show off this totally-in-English-but-never-released-overseas title from Nintendo and Game Freak, Mario & Wario. See how it basically set up the mobile puzzle game template in the early '90s!
New episodes of Gaijin Guide are posted every other Wednesday.
I want to like Raven's Cry. Actually, I take that back. I like the naval combat in Raven's Cry. Actually, I take that back. I like the naval combat in Raven's Cry when I turn down all of the graphical options as low as they go to bring the frame rate to a reasonable level. I expect the seas to be choppy. My system exceeds the recommended specs handily, and running at medium settings produces a pirate-themed slideshow. READ MORE
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Level 99 Games has now done something similar, taking its World of Indines, most notably seen in its BattleCON Street Fighter-style fighting games, and exploring one of its key locations: Argent University. READ MORE
When looking at the lineup of games published by NIS America, hToL#NiQ: The Firefly Diary doesn't exactly fit in. You're expecting to see more anime-styled RPGs and strategy games with a lot of humor and assorted silliness. You're expecting to see months of gameplay and a sensibility that seems out-of-place among most Western titles but right at home on a system like the Vita. You're expecting to see exploding penguins.
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text:
Shining Mountain Waldorf High School guides adolescents on a journey of discovery to find their place in the world.
We educate individuals to realize capacities of lively independent thinking, artistically-cultivated feeling, and moral courage for responsible action.
We strive with adolescents to develop this full measure of human potential that allows for the recognition of one's lifework and service to humanity.
At Shining Mountain Waldorf High School we recognize that adolescence is an important stage of human development. A profound transformation takes place, and powerful inner forces are unleashed. Young people consciously begin to forge their own identities and discover their own values. Vestiges of childhood fall away, and adulthood slowly comes to meet them. Ideals and aspirations arise in the young person, and the adolescent needs to have these ideals affirmed. Adolescents long for a sense of connection to the world and for meaningful relationships.
For those who want more out of their education, Shining Mountain offers the breadth and depth of a liberal arts education at the high school level. Courses are challenging and draw on all aspects of your being – artistic, intellectual, emotional, physical, scientific, mathematical, musical, creative, and spiritual. Socially, you have the best of both worlds: close friendships that span the entire student population in the High School and connections to students at other schools. Your relationships at Shining Mountain form life-long bonds with peers and faculty alike. Teachers will take a personal interest in you and how you are doing. If you have a special interest or talent you wish to develop, the faculty is happy to find ways to support you. When you are looking ahead beyond high school, our college counselor will provide one-on-one guidance to get you to the college or university of your choice or to create an alternative career plan.
In addition to ensuring academic rigor, Shining Mountain Waldorf High School provides a safe, healthy learning environment in which your teenager can explore the many facets of his or her personality, yearnings to contribute to the world, and peer connections.
Our High School teachers are specialists who sharpen the growing intellectual skills of the adolescent and affirm their ideals through a carefully crafted curriculum. Yearly themes engage students in a developmentally appropriate way, both in content and teaching approach.
Through community service, students experience that they can make a difference in the world and enjoy a healthy relationship to the world at large.
Practical and fine arts, drama, and music further engage adolescents in healthy activities that nurture their need for self-expression and creative contribution. Competitive sports offer opportunities for team building and provide yet another arena for our young men and women to explore their potential.
My years at Shining Mountain made me more openly curious towards life, more philosophic, and spiritually minded. I appreciate the broader picture of everything and the sense of things being interconnected, which came with the curriculum.
Scott Coulter, Class of 1997


text:
Phelan-McDermid Syndrome
National Organization for Rare Disorders, Inc.
It is possible that the main title of the report Phelan-McDermid Syndrome is not the name you expected. Please check the synonyms listing to find the alternate name(s) and disorder subdivision(s) covered by this report.
General Discussion
Phelan-McDermid syndrome is a rare chromosomal disorder in which a portion of the long arm (q) of chromosome 22 is missing (deleted or monosomic). Although the range and severity of symptoms may vary, Phelan-McDermid syndrome is generally thought to be characterized by low muscle tone, normal to accelerated growth, absent to severely delayed speech, moderate to profound mental retardation, and minor dysmorphic features. A rare number of cases with much smaller (submicroscopic) deletions of 22q13 are reported to result in mild developmental delay Current research indicates that the inability of the gene involved to produce sufficient protein for normal functioning (haploinsufficiency) may be responsible for most of the neurologic symptoms (developmental delay and absent speech) associated with this disorder.
Chromosome Disorder Outreach, Inc.
P.O. Box 724
Boca Raton, FL 33429-0724
Tel: (561)395-4252
Fax: (561)395-4252
Email: firstname.lastname@example.com
Internet: http://www.chromodisorder.org
UNIQUE - Rare Chromosome Disorder Support Group
P.O. Box 2189
Surrey, Intl CR3 5GN
United Kingdom
Tel: 44 0 1883 330766
Fax: 44 0 1883 330766
Email: email@example.com
Internet: http://www.rarechromo.org
Chromosome 22 Central
237 Kent Ave
Ontario, Intl P4N 3C2
Tel: 705-268-3099
Email: firstname.lastname@example.com
Internet: http://www.c22c.org
Genetic and Rare Diseases (GARD) Information Center
PO Box 8126
Gaithersburg, MD 20898-8126
Tel: (301)251-4925
Fax: (301)251-4911
Tel: (888)205-2311
Email: firstname.lastname@example.com
Internet: http://rarediseases.info.nih.gov/Default.aspx
22q13 Deletion Syndrome Foundation/Phelan-McDermid Syndrome
c/o Greenwood Genetic Center
6 Doctors Drive
Greenville, SC 29605
Tel: (864)250-7944
Fax: (864)250-9582
Email: firstname.lastname@example.com
Internet: http://www.22q13.org
For a Complete Report
For a Complete Report
This is an abstract of a report from the National Organization for Rare Disorders, Inc. ® (NORD). A copy of the complete report can be obtained for a small fee by visiting the NORD website. The complete report contains additional information including symptoms, causes, affected population, related disorders, standard and investigational treatments (if available), and references from medical literature. For a full-text version of this topic, see http://www.rarediseases.org/search/rdblist.html


text:
Mountbatten is the family name originally adopted by a branch of the Battenberg family during World War I because of rising anti-German sentiment among the British public. On 14 July 1917, Prince Louis of Battenberg assumed the surname Mountbatten (having rejected an alternative translation, "Battenhill")[1] for himself and his descendants and was created Marquess of Milford Haven.[2] The name is an Anglicisation of the German Battenberg, a small town in Hesse. The title of count of Battenberg, later prince of Battenberg, was granted to a morganatic branch of the House of Hesse-Darmstadt in the mid 19th century.
Prince Philip of Greece and Denmark, the consort of Queen Elizabeth II, adopted the surname of Mountbatten from his mother's family in 1947, although he is a member of the House of Schleswig-Holstein-Sonderburg-Glücksburg by patrilineal descent.
Current holder of the marquessate[edit]
The current head of the Mountbatten family is the great-grandson of Prince Louis I, George Mountbatten, 4th Marquess of Milford Haven, who was born in London on 6 June 1961.[3] He has a son named Henry, born in 1991.[4]
Notable Mountbattens[edit]
The sons of Princess Beatrice and Louis's brother, Prince Henry of Battenberg — Prince Alexander and Prince Leopold — also took the new surname, with Alexander being made Marquess of Carisbrooke.[5]
Prince Henry of Battenberg's eldest daughter, Carisbrooke's sister, Queen Ena of Spain, never assumed the English form, however.[6]
The best-known of Prince Louis I's descendants were his youngest son, Admiral Louis Mountbatten, 1st Earl Mountbatten of Burma, and the former's grandson, son of Louis's daughter Princess Alice of Battenberg: Prince Philip, Duke of Edinburgh, who is now husband of Queen Elizabeth II.[7] Another daughter to Louis I, sister to Princess Alice and to the Earl Mountbatten of Burma, and aunt to the Duke of Edinburgh, was Queen Louise of Sweden.[citation needed]
Prior to his marriage in 1882, Prince Louis I had an affair with the actress Lillie Langtry. According to his son, the Earl Mountbatten of Burma, Louis was the father of Langtry's only child, Jeanne Marie Langtry, born some months later.[8] However, other sources indicate another putative father.
Royal Mountbattens[edit]
In 1952, on the accession of Queen Elizabeth II, there was some dispute regarding the dynasty to which descendants of Elizabeth and Phillip would belong. Queen Mary (the new Queen's grandmother) expressed her aversion to the idea of the House of Mountbatten succeeding the House of Windsor as the royal dynasty to Prime Minister Winston Churchill.[citation needed]
Queen Mary's objection was partly based on the fact that Prince Philip was in fact a Prince of Greece and Denmark by birth, the son of Prince Andrew of Greece, and only descended from the Battenberg family through his mother, Princess Alice of Battenberg.[9] He was a member of the sovereign, originally ducal, House of Schleswig-Holstein-Sonderburg-Glücksburg, which had attained royal status in Denmark (1863), Greece (1863), and Norway (1905). Prince Philip had only taken the more "English-sounding" surname of Mountbatten, a translation of his mother's original German name, when joining the Royal Navy, on the advice of his ambitious uncle, Earl Mountbatten.[10] Queen Mary was also of the generation which considered a morganatic surname—the Battenberg family is a morganatic branch of the House of Hesse-Darmstadt—to carry some stigma, and therefore did not want it to be the name of the British Royal House. Her attitude may have been influenced by her own origins; although Queen Mary's mother was a British royal princess, her father, Francis, Duke of Teck, was the child of a morganatic marriage, and for most of his life carried only the honorific Serene Highness. As such, he was considered somewhat declassé by strict royalists, something that may have rankled Queen Mary to some degree.[citation needed]
Winston Churchill raised the matter in Parliament where it was decided that the name of the Royal House would remain Windsor, as decreed in perpetuity by Queen Mary's husband, King George V.[citation needed] The principle of strict patrilineality was applied in the succession of Queen Victoria, of the House of Hanover, whose offspring were of the House of Saxe-Coburg and Gotha, or Wettin, after their father, Prince Albert. If this case were repeated, the descendants of Elizabeth and Philip should belong to the House of Schleswig-Holstein-Sonderburg-Glücksburg.
However, under an ambiguously worded Order in Council issued in 1960, the name Mountbatten-Windsor is apparently the personal surname of some of the descendants of Queen Elizabeth II and Prince Philip. It differs from the official name of the British Royal Family or Royal House, which remains Windsor.[11][not in citation given]
The change of surname obviously does not apply to members of the royal family not descended from Prince Philip—the Dukes of Gloucester and Kent, for example.
The Order specifically applies to those descendants of the Queen and Prince Philip not holding Royal styles and titles but in practice it is used by all, as exemplified at the marriages of the Prince of Wales and the Princess Royal, when both used Mountbatten-Windsor in their entries in the marriage registers.[12][unreliable source?]
See also[edit]
- Battenberg family
- Mountbatten-Windsor
- Mountbatten class hovercraft
- Mountbatten Medal
- The Mountbatten School And Language College
- Mountbatten Internship Programme
- Edward Iwi
- ^ Hough, Richard (1984). Louis and Victoria: The Family History of the Mountbattens. Second edition. London: Weidenfeld and Nicolson. p. 317. ISBN 0-297-78470-6.
- ^ Duffy, Michael. "Who's Who: Prince Louis of Battenberg." 6 Mar. 2004. Prince Louis of Battenberg Biography. First World War.com. Retrieved on 16 July 2007
- ^ Lundy, Darryl. "thePeerage.com." 15 May 2006. Lundy, Darryl. "George Ivar Louis Mountbatten, 4th Marquess of Milford". The Peerage.[unreliable source?]. Retrieved on 16 July 2007.
- ^ Lundy, Darryl. "thePeerage.com." 10 May 2003. Lundy, Darryl. "Henry Mountbatten, Earl of Medina". The Peerage.[unreliable source?]. Retrieved on 16 July 2007.
- ^ Mills, T.F. "Land Forces of Britain." 25 Sept. 2004. Prince Alexander, Marquess of Carisbrooke[dead link]. regiments.org. Retrieved on 16 July 2007.
- ^ Mills, T.F. "Land Forces of Britain." 1 July 2003. Ena Queen of Spain[dead link]. regiments.org. Retrieved on 16 July 2007.
- ^ "H.R.H. Prince Philip, Duke of Edinburgh." Members of the Royal Family[dead link]. The Royal Family. Retrieved on 16 July 2007.
- ^ Daily Telegraph, 27 September 1978; Evening News, 23 October 1978
- ^ "50 Facts about the Duke of Edinburgh." The Queen's Golden Jubilee[dead link]. The Royal Family. Retrieved on 16 July 2007.
- ^ Buyers, Christopher. Mills, T.F. "Land Forces of Britain." 2 Mar. 2006. Prince Philip, Duke of Edinburgh[dead link]. regiments.com. Retrieved on 16 July 2007.
- ^ "Kings and Queens of the United Kingdom." The House of Windsor[dead link]. The Royal Family. Retrieved on 16 July 2007.
- ^ "In Memory Of Diana Frances (Princess of Wales) Mountbatten-Windsor." Online Tribute. The Eternal Portal. Retrieved on 18 July 2007.


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Hi All,
I recently bought an x reg Ford Focus Ghia. It has been running well, but I have recently noticed a squeaking noise coming from the front driver side, especially when I turn corners. The car doesn't seem to run any worse. When I bounce the front passenger and driver side car when parked, it makes an annoying squeaking noise.No squeaking coming from the rear when I do the same! Is this something to do with the suspension Bushes? If so, is this an expensive job to replace, a common problem or just something else completely?
Many thanks


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Where Beauty Junkies Get Their Fix American BEAUTYLIVESHERE SALON
FEBRUAR Y 2009 Search GO
Inside this issue:
» Editor's Note
» Top News & Stories
» Product Deals
Editor's Note
I've been a trade editor for almost 20 years, so I'm used to being snubbed at press breakfasts and product launches by consumer editors from magazines like Vogue and Elle. Most of them have never heard of American Salon, even though we've been in print since 1877, longer than any other magazine except
Harper's Bazaar. Still, we're a business-to-business magazine. I guess you could say we're the low man on the editorial totem pole. Our advertisers don't pay in excess of $150,000 a page and we don't have millions of subscribers, just 118,000 of them. That's why you won't find me sitting in the front row at fashion week wearing
Prada. Of course, Vogue Editor in Chief Anna Wintour will be decked out in designer duds when show season gets underway this month. Me, I'll be wearing Chicos. The company's sophisticated, casual-to-dressy clothing appeals to my inner fashionista, and the price is right for an editor who isn't pulling in $2 million a year. I will never forget the look on Wintour's face when I had to practically crawl over her to get to my seat at fashion week one season. If I recall, she was wearing a huge fur coat and her signature oversize sunglasses, even though we were in a heated tent at Manhattan's Bryant Park. I was probably wearing my Chico's Travelers, knit separates that emerge from your suitcase looking just like they did when you put them in.
By the time you read this, I'll be schlepping to the Fall '09 sho ws in my Ugg boots, but I've only just begun to report on the Spring '09 shows. Next month you'll find a free DVD called Front Row Spring/Summer '09 Runway Hair Trends in your issue of American Salon. Former M TV News Team correspondent SuChin Pak will be taking you behind the scenes at fashion week in Ne w York City, Milan and Paris. Pak interviewed influential personalities such as fashion designer Peter Som, Kelly Osbourne, fashion photographer Nigel Barker and supermodel Stephanie Seymour, who commented on the trends they saw on the runway and how the hair completes the overall look. You can also catch Pak on Planet Green, the Discovery Channel's new television net work about the environment. She'll be co-hosting
G Word, a daily, hour-long program. —Marianne Dougherty, editor in chief, email@example.com
Top News & Stories
Rolfsalon Hosts Green Appreciation Party Rolfsalon hosted a Luxury Guest Appreciation party featuring Pure Ology products for more than 100 clients and guests in October in Wilmette, IL. Rolfsalon's party not only demonstrated client appreciation through raffles, party favors and discounts, but also educated guests on how they can act a little "greener" by choosing eco-friendly brands like Pure Ology. Guests were then treated to a hair show where stylists used PureOlogy products and Redken's new Spotlight Collection on eight models to demonstrate the products' versatility. —J.H.
Colomer USA recently promoted Barry Holmes to vice president of the Colomer USA salon division, Jacquie Johnson to vice president of sales for CND and Kimberley Natale to lead CND's global marketing efforts.
Andis Company named Gary Stanczyk as vice president of sales. In this ne w position, he will be responsible for sales in all of Andis' markets in the United States and Canada. Stanczyk joined the company in 1999 as vice president of retail sales. JACQUIE JOHNSON Stila Cosmetics announced the promotion of Deanna Kangas as president and chief executive officer. Prior to her promotion, Kangas served as chief marketing officer at Stila since January 2008.
Spilo World wide appointed Nadia Deering as director of international sales. In this new position, Deering will oversee existing international accounts and expand the company's presence into additional countries worldwide. —N. P.
DEANNA KANGAS top
Product Deals
Let It Shine
The new, lightweight Shine On leave-in treatment from JOHN MASTERS ORGANICS uses organic sea kelp to soften hair and add natural-looking shine and volume. johnmasters.com
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Visual version control for designers. Designing for the Retina display. iOS Photoshop Actions & Workflows. Codrops. A proof-of-concept effect recreation of the animation seen in a prototype app by Marcus Eckert.
The idea is to flip a grid item in 3D, expand it to fullscreen and reveal some associated content. We've created two demos with a vertical and a horizontal rotation. read more Some inspiration and ideas for item transitions considering different scenarios and use cases, including a small component, a full-width image header and a product image with a transparent background. State transitions are done using CSS Animations. read more. Design showcase of the best looking iPhone/iPad app icons, app interfaces, app websites & resources. iPhone 4 GUI PSD (Retina Display) Thanks for you patience on this one.
It took a good deal longer to complete given the sheer size and level of detail the retina display has. It wasn't a simple scale-up from the last file. It was clear as we created it that Apple has spent a lot of time considering how each element should be translated to such a dense resolution. What were single pixel elements are now two or three pixels thick and effects are exaggerated to become visible. App Icon Template. How To Design A Gorgeous Big UI Button In Photoshop. In this tutorial we're going to be creating a gorgeous and modern user interface button suitable for the web or a mobile interface design.
We'll be using a handful of Photoshop techniques that are bound to come in handy for more than just creating buttons; in fact, the techniques we'll be using are often used in most UI elements. Step 1. 50 tips for designing brilliant iOS apps. 1 A touchscreen interface might be flexible and intuitive, but it's not perfect.
Consider what people are doing while they're using your app, and how they're holding the device. Remember that fingers cover a much greater area than you might expect, and are far from accurate at selecting items. 2 Take a device-centric approach to design: don't just think about the size of the screen, but also where and when it will be used. The peak hours of iPad usage for entertainment purposes might be 8-11pm, before bed, whereas an iPhone might be used standing in the bus queue or in a coffee shop. Designing Icons - 35 tutorials. Every person who is using internet must watch the icons, because icons are the part and parcel of every site and we can say that icons also make some extra attraction in your site.
Icons not only play an important role for a website but also in many fields of the graphics designing. If you are also a designer then today I am going to provide you something interesting and valuable, so now for your icon designing isn't a big deal you can easily improve your designing skills, below you can see the 35 creative and useful tutorials for all the people who want to have icon designing skills at their finger tips.
USB Hard Drive Device Icon – Photoshop Tutorial USB Hard Drive Device Design. Weirdsgn. iOS Fonts. 45 iPad iOS Interface Showcase - Inspiration. Apple released the new ipad few weeks ago and within a week, it reached 3 million sales!
That's a staggering amount of iPad being sold. With such a huge consumer based, it's no brainer to say that the iOS apps demand will certainly increase dramatically. However, there are already over 500,000 apps (and still counting) in Apple appstore, your newly built app can be buried in it!


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