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All articles for '
Jason Collins Nba Player'
All the featured articles about Jason Collins Nba Player. News, articles, net worth profile, and all biography about Jason Collins Nba Player.
Jason Collins Net Worth
Jason Collins net worth: Jason Collins is an American professional basketball player who has a net worth of $16 million dollars. Jason Collins was born in Northridge, California, and went on to attend Harvard-Westlake School in Los Angeles. He established himself as a player to watch while in high school, and set a California rebound record. He went on to play college basketball for Stanford, ...
Jason Collins Signs with Brooklyn Nets As First Openly NBA Gay Player
Feb 24, 2014 – Jason Collins is officially the first openly NBA gay player and will play for the Brooklyn Nets. What do you think? WATCH MORE HIP HOP WIRED VIDEOS: SUBSCRIBE! FOLLOW US ON TWITTER: LIKE US ON FACEBOOK: VISIT OUR SITE: jason collins, nba jason collin
Openly gay Jason Collins signs deal with Brooklyn Nets
Feb 24, 2014 – Nearly 10 months after becoming the first openly gay NBA player, Jason Collins will finally get his chance to, well, play. With free-agent-to-be forward Glen. Jason Collins would be the first openly gay player in the NBA if he agrees to a deal with t
David Stern talks about Jason Collins' historic announcement
Apr 30, 2013 – Check out this interview with League Commissioner David Stern as he discusses the recent news of Jason Collins' announcement of being gay and the impact it could have on the league moving forward. About the NBA: The NBA is the premier professional ba
Jason Collins Gay -- Miami Dolphins Star Mike Wallace Tweets Homophobic Remark
Apr 30, 2013 – NBA player Jason Collins just announced he's gay, and it didn't take long for Miami Dolphins receiver, Mike Wallace, to tweet the first ignorant comment. Naturally it was followed by a horrible apology.
Howard Kurtz FIRED Over Jason Collins Error
May 4, 2013 – "The Daily Beast has fired columnist Howard Kurtz after he included an erroneous error in his story about NBA player Jason Collins' coming out, the news organization announced on Thursday. Earlier this week, Collins wrote an essay for Sports Illustra
Lance Bass, Dave Rubin, Cenk Uygur Discuss Jason Collins Coming Out and More | The Rubin Report
May 3, 2013 – Dave Rubin, Lance Bass and Cenk Uygur discuss Jason Collins announcement he is gay, government internet censorship, a new porn study and more. Bonobos is our official outfitter, get 20% off your first order with code TRR20! Topics include: -NBA Playe
Lance Bass talks One Direction and Jason Collins (Part 1) | The Rubin Report
Apr 30, 2013 – Dave Rubin, Lance Bass and Cenk Uygur discuss NBA player Jason Collins announcement that he is gay. Bonobos is our official outfitter, get 20% off your first order with code TRR20! Jason Collins coming out makes him the first openly gay athlete playi
Spike Lee talks about NBA player Jason Collins
May 1, 2013 – Movie director Spike Lee talks with CNN's Anderson Cooper about NBA player Jason Collins' coming out. For more CNN videos, visit our site at
Chris Bosh Reacts To Jason Collins Coming Out As Gay
May 3, 2013 – Veteran NBA player is the first openly gay professional athlete in the four major American sports and Chris Bosh has a few words about it... For more on this story, click here: SUBMIT THIS TO WORLD STAR: SUBSCRIBE! Twitter: Instagram: Tumblr: Faceboo
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Arnerich and Chen: Now's the time to invest in green
- Matthew Kish
- Staff Reporter- Portland Business Journal
- Email | Twitter | Google+
Imagine going back to 1986 and investing in Microsoft's initial public offering. That's the opportunity investors have when it comes to investing in green businesses.
Tony Arnerich and Dave Chen delivered the message as part of the keynote panel discussion at Friday's Sustainable Business Oregon awards luncheon.
Arnerich is CEO of Arnerich Massena, one of Oregon's largest investment advisers with nearly $17 billion in assets under management.
Chen is founder of Portland-based Equilibrium Capital Group LLC and has a long history in the region as a respected venture capitalist and economic strategist.
Sustainable Business Oregon profiled Arnerich's plans for investing in green businesses in September 2011. Since then, Chen and Arnerich said conversations have gone from the abstract to the concrete.
|• More from Arnerich & Chen >>
• Meet the 2012 SBO Awards winners >>
One example: The Michigan Municipal Employees' Retirement System recent $180 million investment in a sustainable agriculture fund — The Equilibrium Capital-backed Australian Pastoral Funds Management — as an example of growing institutional investor interest in sustainability.
"We now have significant institutional backers," Arnerich said.
The problem: most of those backers are in Europe and Asia. The United States remains behind.
"The rest of the world gets it," Arnerich said.
Arnerich and Chen argued that investing in green business isn't about saving the planet.
"If you want to do philanthropy, write a check," Arnerich said.
The strategy is more of a demographic play. The world's population is around 7 billion people. By the end of the decade, that should exceed 10 billion.
Matthew Kish covers footwear, apparel, banking, finance and general assignment news.
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The group Law Enforcement Against Prohibition, an organization comprised of police officers, prosecutors, judges and other criminal justice professionals, endorsed Initiative 502 in Washington State. The initiative, if approved by voters, would legalize and tightly regulate marijuana for adults over the age of 21. From LEAP's endorsement.
Law Enforcement Against Prohibition Endorses I-502 in Washington
|By: Jon Walker Thursday March 22, 2012 5:17 pm
Marijuana Again Dominates President Obama's Online Forum
|By: Jon Walker Monday January 30, 2012 8:45 am
So far every attempt by Obama to directly reach out to young voters through some form of online question and answer system has resulted in young adults overwhelming voting to confront the President with questions about our government's marijuana policies. It happened with his transitional website Change.gov, his first Youtube townhall and with the White House's new "we the people" petition site. Now it's happened again.
Late Night: Obama Says Drugs Aren't a Health Issue, They're a Legal Matter
|By: Lisa Derrick Tuesday February 15, 2011 8:00 pm
While President Obama told Law Enforcement Against Prohibition member MacKenzie Allen, a retired deputy sheriff during an interview with the organization:
We have to think more about drugs as a public health problem
his comments on the new federal drug new budget show things in a different light.
Cop's Drug Policy Question to Obama #1 in YouTube Contest
|By: Michael Whitney Thursday January 27, 2011 9:47 am
MacKenzie Allen, the retired deputy sheriff and a currently a member of Law Enforcement Against Prohibition (LEAP), has the #1 question in YouTube's "Ask Obama" contest, in which President Obama will answer the top-voted questions in a live interview to be broadcast this afternoon from the White House. Allen's question got twice as many votes as the next-highest voted question.
Cannabis Reconsidered: From Escalating Punishment to Minimizing Harm
|By: Kathryn in MA Monday September 20, 2010 3:10 pm
If we all stand together, we can turn around a horrific status-quo by putting cannabis in the realm of health, not law enforcement. Persuade our community leaders to stand up and speak for humanity and humane practices. For voters unsure of the result of legalization, let's demand an immediate cease fire in the War on Drugs, to show that all hell will not break loose.
Prop 19: Cops, Prosecutors, Law Enforcement Support Marijuana Legalization
|By: Michael Whitney Wednesday September 15, 2010 9:45 am
In just the last several days, dozens of police officers, prosecutors, and other law enforcement officials have joined forces to endorse California's Prop 19 to legalize marijuana. Led by Law Enforcement Against Prohibition, the mostly former officials say that marijuana prohibition only fuels more dangerous crime by enriching Mexican drug cartels who put guns on American streets.
NORML: Full Legalization, Full Steam Ahead (Panel Liveblog with Michael Whitney and Neill Franklin)
|By: Teddy Partridge Thursday September 9, 2010 10:10 am
At the national conference of NORML (National Organization for the Reform of Marijuana Laws) here at the Governor Hotel, in Portland Oregon, our own Michael Whitney is on a panel this morning to talk about the marijuana legalization campaign.
Florida Law Enforcement Veteran Disputes George LeMieux's Claims About Marijuana Prohibition
|By: Jane Hamsher Thursday September 2, 2010 9:30 am
In a recent interview with Mike Stark, Florida Senator George LeMieux came down squarely against the rights of individual states to regulate marijuana, indicating that he was against both legalizing medical use and ending prohibition in general. He also believes that it's the appropriate role of the criminal justice system to deal with marijuana users.
LEAP Director Neill Franklin Backs National Black Police Association Endorsement of Prop 19: Legalizing Marijuana Will Cut Violent Crime
|By: Jon Walker Friday August 20, 2010 11:45 am
The money from illegal drugs has been providing a large and dependable financial pipeline to violent criminal organizations including American gangs and international drug cartels. In the last several years, the drug cartels in Mexico have killed over 28,000 people. By legalizing marijuana, it would deprive these criminal enterprises of a huge source of their funding.
Prop 19: National Black Police Association Endorses Marijuana Legalization
|By: Michael Whitney Thursday August 19, 2010 4:00 pm
Great news from our friends at Law Enforcement Against Prohibition: the National Black Police Association, a 38-year-old advocacy group for African American law enforcement professionals, has endorsed Prop 19, California's marijuana legalization initiative.


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Category Archives: Perishables
OPA By Litehouse Named Dressing of the Year
The Association for Dressings & Sauces (ADS) named Opa by Litehouse Feta Dill Greek Yogurt Dressing the Dressing of the Year at its annual meeting this … Continue reading
George Hurst from Roundy's is 2014 Mango Retailer of the Year
The National Mango Board (NMB) has honored George Hurst of Roundy's Supermarkets as its 2014 Mango Retailer of the year. Each year, the NMB selects … Continue reading
Fruigees Launches Fruit and Vegetable Squeeze Pack Snacks at Meijer Stores
Fruigees, the maker of organic fruit and vegetable snacks in squeeze packs, announces the brand's official launch into Meijer retail stores throughout the Midwest. … Continue reading
Jarlsberg Targets Snack Market with Jarlsberg Minis
Jarlsberg Cheese introduces Jarlsberg Minis, described as a snack-size cheese treat. Available in 5-count bags, for individual sale or in bulk, Jarlsberg Cheese Mini's are in a display-ready … Continue reading
Plum Organics Expands Into Adult Snacks with Launch of Plum Vida
Plum Organics, an organic kids nutrition company, has announced its foray into the adult snacking category with the launch of Plum Vida. Available in … Continue reading
Tosca Introduces RPC for Eggs
Tosca has introduced a reusable plastic container (RPC) for packing, shipping and displaying individual cartons of eggs. Featuring its SmartWall design, the retail-ready package simplifies re-stocking … Continue reading
Seassentials Crab Meat Brand Hits the Market
The London-based branding agency CLIP has unveiled its newly designed packaging for Seassentials. The value brand belongs to Blue Star Foods, which is an international company … Continue reading
Apple Growers Launch Snapdragon Apple in Wegmans
The New York Apple Growers (NYAG) will be launching the SnapDragon apple in all Wegmans' stores starting in November. Known for its crispy texture combined … Continue reading
PMA Honors Packaging Excellence with PMA Impact Awards
One of the most anticipated events from last week's PMA Fresh Summit is the PMA Impact Awards: Excellence in Packaging. This year's awards received more than … Continue reading
Natural Delights To Host Medjool Date Festival
The Yuma Medjool Date Festival is around the corner. Attendees can learn about first-hand, the history, harvesting practices and fun facts behind the world's oldest … Continue reading
California Avocado Commission Announces Contest Winners
The California Avocado Commission (CAC) announced the retailer winners from its 2014 5-Star Performance Program at the PMA Fresh Summit. Participants in CAC's 5-Star … Continue reading
Molly's Milk Truck Launches Almondmilk Beverages
Molly's Milk Truck Beverages is debuting its café-style almondmilk beverages in select retail location in the New York City metropolitan area. Continue reading
CMI Puts Queen Bee Apples in a Pouch Bag
CMI has announced the national rollout of its new pouch bag line for Queen Bee apples, a brand of Honeycrisp apples. The program launched … Continue reading
Ready Pac Honored during Midnight Mission Gala
Ready Pac Foods was honored by The Midnight Mission during this year's Golden Heart Awards Gala. Held on September 30th at The Beverly Wilshire … Continue reading
Tribe Hummus Finds Inspiration at the Farmer's Market
Tribe Hummus is launching a Farmer's Market line, a collection of hummus flavors inspired by fresh tastes and colors of the farmer's market. A permanent extension … Continue reading
Pear Bureau Northwest Launches Fresh Consumer Ads
Pear Bureau Northwest (USA Pears) is launching a consumer advertising campaign this season, using print ads to help boost pear consumption and increase the … Continue reading
Boulder Organic! Announces New Name and Manufacturing Facility
The Boulder Soup Works brand has a new label, and a new shingle…the company announced that it has changed its name to Boulder Organic!, … Continue reading
Houweling's Tomatoes Wins 2014 Cool Planet Award
Houweling's Tomatoes received a 2014 Cool Planet Award (Agriculture Sector) in recognition of the company's efforts in sustainability, relating to energy conservation and efficiency. The … Continue reading
Disney Introduces Frozen and Spider-Man Branded Apples
Frozen and Marvel's Spider-Man branded apples by Sage are the latest additions to Disney Consumer Products (DCP). The brand continues to introduce new "better … Continue reading
House Foods Introduces Tofu with DHA Omega-3
House Foods, a premium tofu purveyor since 1983, is pleased to introduce House Foods Tofu with DHA Omega-3. Available this fall, House Foods representatives state that … Continue reading
Naturipe Farms Expands its Fresh Fruit Snack Packs
Naturipe Farms is adding to its Ready to Eat fresh fruit snack pack line. With re-designed packaging to include more product visibility and clear messaging … Continue reading
Tribe Hummus Releases New Limited Batch Flavor
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Inline Plastics announces the introduction of their improved one piece round clamshell bowls, the enhanced version of the company's breakthrough Safe-T-Fresh line of products. The … Continue reading
Clear Lam Packaging a Finalist for 2014 PMA Impact Award
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The Twelve CaesarsPaperback Penguin Classics
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- Publisher: PENGUIN CLASSICS
- Format: Paperback | 464 pages
- Dimensions: 128mm x 196mm x 24mm | 340g
- Publication date: 18 December 2007
- Publication City/Country: London
- Illustrations note: maps
- Sales rank: 4,443
Product description
As private secretary to the Emperor Hadrian, the scholar Suetonius had access to the imperial archives and used them (along with eyewitness accounts) to produce one of the most colourful biographical works in history. "The Twelve Caesars" chronicles the public careers and private lives of the men who wielded absolute power over Rome, from the foundation of the empire under Julius Caesar and Augustus, to the decline into depravity and civil war under Nero and the recovery that came with his successors. A masterpiece of observation, anecdote and detailed physical description, "The Twelve Caesars" presents us with a gallery of vividly drawn - and all too human - individuals.
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Author information
Gaius Suetonius Tranquillus was probably born in AD69 - the famous 'year of the four Emperors'. From the letters of Suetonius' close friend Pliny the Younger we learn that he practiced briefly at the bar, avoided political life, and became chief secretary to the Emperor Hadrian (AD117-38). Suetonius seems to have lived to a good age and probably died around the year AD140. James Rives teaches in the area of Classical Studies at Stanford University. Professor Rives is currently serving as Review Editor for Phoenix, Journal of the Classical Association of Canada.


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The 16th
Annual Official Gay Easter Parade
Deja Deja-Vue' & Johnny Passion
(Photo by Larry Graham)
Easter Sunday, April 5, 2015 @ 4:30pm
benefiting Food For Friends
2015 Sponsorship Form
The parade showcases the fashion and creativity of the entire GLBT community with gentlemen in summer suits/tux with hats, and ladies in Easter suits/dresses with Easter hats.
6th Annual Bunnies in The Big Easy Good Friday, April 3
The always fun and sexy 6th Annual Bunnies in The Big Easy is set Good Friday, April 3, 7-9:30pm, at the private home of Kim Smith in the Marigny, complete with heated pool and some of the best bunny bodies in town. $35 advance tickets ONLY limited to 100 tickets. Hosted by GEP Board's Tony Leggio and Rona Conners, get your tickets or call Tony at 504.252.5476.
The evening includes:
> Buffet, Vodka Cocktails, Wine & Beer Bar, Non-Alcoholic Beverages
> Dance to the jams by DJ Mark Louque
> Pet the boys and feed them Peeps in our "adults only" Petting Zoo
> Buy your Rubber Duckies for a chance to win a fabulous grand prize
> Experience the biggest and boldest in Bonnet Couture from costume designer Allán Herrera and bonnetista Megan CW modeled by our hottest bunny bodies in town
> Bring your very best bonnet for a special "guests only" Bonnet Contest!
> Incredible Live Auctions plus many more surprises!
16th Gay Easter Parade Rolls thru French Quarter April 5 led by Johnny Passion & Deja Deja-Vue'
Easter Sunday, April 5, will see the 16th Annual Gay Easter Parade roll through the streets of the historic French Quarter. Led by Easter Grand Marshals XVI Johnny Passion and Deja Deja-Vue', some 29 carriages, wagons and trolleys will be joined by two bands, seven walking groups and 10 vehicles, kicking off at 4:30pm sharp.
The parade route starts at the Armstrong Park Arch, down N. Rampart to Toulouse, u-turn on Toulouse, back down N. Rampart to St. Ann, right on St. Ann, left on Bourbon, right on Esplanade, right on Royal, right on St. Louis, right on N. Rampart, ending at 834 N. Rampart, GrandPre's.
Sponsored by Ambush Magazine, the parade showcases the fashion and creativity of the entire LGBT+ community with gentlemen in summer suits/tux with hats, and ladies in Easter suits/dresses with Easter hats. The parade minus expenses benefits Food For Friends, a vital service of NO/AIDS Task Force, and for the past 13 years, the parade has raised over $202,414 for charity.
All parade entries must have been registered by March 20, and checkin is Sunday, April 5 with Gay Easter Parade's Steve Patrick inside at GrandPre's, 834. N. Rampart, between 2:30-3:45pm for the Pre-Parade Party and Checkin/Lineup. All carriages, wagons and trolleys will be boarded between 3:45 and 4:20pm, followed by vehicles and walking groups. Parade rolls at 4:30pm sharp. The Post-Parade Party and Buffet will begin at 6pm at GrandPre's.
Sponsors as of press time include Presenting ($2,500) Ambush Magazine; Platinum ($1,000) EGM XV Todd Blauvelt, James B. May & EGM XVI Deja Deja-Vue', Friday Night Before Mardi Gras;
Gold ($500) Noel Twilbeck & Glen Kahrman, EGM XII Gary Vandeventer, Christian Rogers & Jonathan Reazin, Ken GrandPre'/GrandPre's, EGM XII Elizabeth Bouvier, EGMs VIII Michael Elias & XIV Tommy Elias/The Corner Pocket, Wedon Brown/Something Different NOLA Mid Century Modern Furniture & Design, Ron Iafrate/Chef Ron's Gumbo Stop & Pub, Krewe of Amon-Ra;
Silver ($250) EGM XIII Darwin Reed & EGM VII Opal Masters, Scott Vincent & Scott McRae, Sharlene Macesa/A-MED Ambulance Inc., EGM IX Safonda Peters & EGM XV Stuart Nettles, Dwain Hertz & Eugene Theriot, EGM XIII Rhonda Roget & David Roget, EGM IV Electra City & EGM XI Tittie Toulouse/The Four Seasons, Tanzanika Ruffin/Pelican Bay Restaurant, Rachel Bufkin & Sharon Barreca, Jeff Palmquist & Coca Mesa, Bobby Vallecillo, Wood Enterprises, Holly Bryson & Debbie Reynolds, Patrick Zabatta/In Commemoration of the NYC Wedding of Tittie & Electra Toulouse, Avita Pharmacy, The Glitter Girls, Misael Rubio/Quartermaster Deli, Karen & Gene Riggleman;
Bronze ($100) Paul Melancon, EGM XIV Starr Daniels & Justin Moffatt, Nick Olivares & Roy Smith, Errol C. Rizzuto, Freddie Guess, Tulane Ave Bar, EGM V Princess Stephaney, EGM X Tony Leggio, NACE/National Association For Caterers & Events, Robert W. Cook & John Zeringue, Miss Louisiana Leatherette 2008 Solitaire, King Cake Queen XXI Barbara Ella, Jeremy Weinburg, Pastor Shelly Planellas/New Covenant Church NOLA, Peter & Frank Abbruscato, Big Easy Sisters, EGM II Larry G. Bagneris, EGM IX Orlando Aloe, LGBT+ Archives Project of Louisiana, Michael Durocher, Bourbon Pride, Helene Berot, Suzii Gaitan & Frank J. Wingerter IV/SuziiFrank Bowties, Mina Hernandez & Nan Owings, Jeffrey L. Laws, Jo-Jo Holdings LLC;
In Kind/Venue Cutter's, GrandPre's, Oz New Orleans, Double Play, Four Seasons, Larry Graham-www.GrahamStudioOne.com. Information and sponsorship forms available at www.GayEasterParade.com.
14th Super Star Studded Drag Extravaganza Raises $3,894 for Gay Easter Parade/Food For Friends
All roads led to Oz on March 14 as Gay Easter Parade's 14th Super Star Studded Drag Extravaganza hit the stage! This is one event which unites the LGBT+ community bringing reigning gay Carnival royalty to the stage along with King Cake Queens and star celebrities, all together for one night only. GEP Board's Tony Leggio (EGM X) and Opal Masters (EGM VII) proved once again to be an unbeatable duo as ring masters for the evening with wild entertainment, incredible auctions, and loads of fun and laughter.
The show opened with the once a year performance of Easter Grand Marshal I Marsha Delain doing Martha Wash's "Proud." Next came reigning King Cake Queen XXII Aubrey Synclaire with a dazzler, followed by reigning Queen Amon-Ra L Opal Masters in all her splendor.
The first auction of the night was won by Clay Christian with a $150 bid for the Down the Bayou Wine Basket, donated by Rip's sister and friends.
That signaled the first live performance of the night by none other than reigning Easter Grand Marshal XVI Johnny Passion. And it was followed by another crowd pleaser from reigning Queen Narcissus I Vivian Loveride and hot Boy Narcissus doing a charming duet.
The next auction went home to EGM XI Chuck Turner and Bill Miller with a $180 bid for the Fleur de Lis Egg donated by EGM VIII Rona Conners.
Reigning Easter Grand Marshal XVI Deja Deja-Vue' tantalized the crowd next followed by the incomparable King Cake Queen XIII Raven Kennedy.
The next auction was taken home by NO/AIDS Task Force's John-Michael Alderson with a $150 for the Oz VIP Card & Bar Tab packaged donated by Oz.
King Cake Queen XIX Nicole Dubois was up next bringing down the house with her hilarious version of Miley Cyrus twerking!
One of the biggest auctions of the night went to Larry Anderson for the Giant Easter Basket bringing in $500 laden with liquor donated by Rip and Marsha, and EGM XVI Deja Deja-Vue', along with a half page color Ambush ad, and certificates/bar tabs from Crescent City Tour Booking Agency, The Golden Lantern, Kajun's Pub, and Two Guys Cutting Hair. It also included Vintage Gold Foil Bunny, and Elizabeth Taylor Sparkling White Diamonds donated by EGM VIII Rona Conners, Elegant Expressions Ocean Breeze Fragrance, and silver wine goblets donated by EGM XVI Deja Deja-Vue', and Easter candies donated by Rip and Marsha.
Reigning Miss Golden Lantern Monica Synclaire-Kennedy was up next on the hit parade.
This led up to the highly anticipated "Man I Feel Like A Woman" Put Pride Grand Marshal Adikus Sulpizi in Drag Auction. This hysterical transformation was only achieved with the professional help of Miss Gay America 2006 Nicole Dubois and all the various auction winners.
This auction brought in $25 for the Dress from John-Michael Alderson, $60 for Blush & Eye Shadow from Shawn, $40 for Lipstick from Solitaire, $25 for Eyelashes from Rhonda Roget, $25 for Earrings from Noel Twilbeck, $35 for Wig from Mr. Louisiana Leather Jason Ashford, $25 for Shoes from Rip Naquin
put on by Tony Leggio, $75 for Name That Queen "Sweet Sunshine" from Rip Naquin & NYC Guest, $50 for Song "Man I Feel Like A Woman" from Todd Blauvelt, and $40 in Stage Performance Tips, for a total of $410.
The excitement continued as reigning King and Queen Satyricon XIII Marshal Harris and Becky Allen took to the stage singing "Proud Mary" live with an assortment of back up dancers pulled from the audience.
Queen Armeinius XLVII DragZilla took command of the stage bringing Adele to life with "Skyfall" getting a rousing ovation from the crowd!
The show closed out with the one and only Big Easy Sisters' own NvSr Moana Moansalotts and NvSr Cathi Terr. But that wasn't all, they helped do the surprise, and last auction of the evening, of a 2014 Southern Decadence Religious Zealot Banner confiscated by the Gay Police. It went for $120 from William K. in Slidell.
The complete financial statement for the 14th Drag Extravaganza includes: 1,600.00 Door/Cash, 784.00 Stage Performance Tips, 150.00 Down The Bayou Wine Basket Auction,. 180.00 Fleur de Lis Egg Auction, 150.00 Oz VIP Card & Bar Tab, 500.00 Giant Easter Basket Auction, 120.00 2014 SD Religious Zealot Banner, 410.00 Put Adikus Sulpizi in Drag Auction, for a total of 3,894.00. There were no expenses for this event.
An additional $450 in sponsorships came in including one Silver ($250) from Holly Bryson and Debbie Reynolds, and two Bronze ($100) from Bourbon Pride and Helene Berot.
Past grand marshals include EGMs I Rip and Marsha Naquin-Delain, II Larry Bagneris and the late Miss Do Moreland, III Timm Holt and Teryl-Lynn Foxx, IV the late George Simons and Electra City, V Brett Messmer and Princesse Stephaney, VI James Swire and Lisa Beaumann, VII the late Doc Reed and Opal Masters, VIII Michael Elias and Rona Connors, IX Orlando Aloe and Safonda Peters, X Tony Leggio and the late Marcy Marcell, XI Chuck Turner and Tittie Toulouse, XII Gary Vandeventer and Elizabeth Bouvier, XIII Darwin Reed and Rhonda Roget, XIV Tommy Elias and Starr Daniels, and XV Todd Blauvelt and Stewart Nettles.
2015 Highlights
the "official" dish: 16th Gay Easter Parade Rolls thru French Quarter April 5 led by Johnny Passion & Deja Deja-Vue'; 14th Super Star Studded Drag Extravaganza Raises $3,894 for Gay Easter Parade/Food For Friends (see Page-4) Join Final 2 Major Fundraisers for Gay Easter Parade & Food For Friends (see Pages 8 & 10)
celebrazzi: Gay Easter Parade's 14th Super Star Studded Drag Extravaganza & "Man I Feel Like A Woman" Put Pride Grand Marshal Adikus Sulpizi in Drag Auction
snap paparazzi: 14th Super Star Studded Drag Extravaganza raises $3,894 for Gay Easter Parade/Food For Friends @ Oz
the "official" dish: First Two Gay Easter Parade Fundraisers bring in $11,419 for Food For Friends; 14th Star Studded Drag Extravaganza March 14 @ Oz (see Page-4) 13th Spring Fever Extravaganza March 21 @ Four Seasons; Remaining GEP Events (see Page-8)
celebrazzi: Gay Easter Parade's 5th Sponsorship Party & 7th Eggstravaganza
snap paparazzi: 5th Sponsorship Party raises $8,800 for Gay Easter Parade/Food For Friends @ Cutter's
snap paparazzi: 7th Eggstravaganza raises $2,619 for Gay Easter Parade/Food For Friends @ GrandPre's
the "official" dish: 16th Gay Easter Parade Fundraisers Kicks off Easter Season on March 1 & 6 (see Page-4)
spotlight feature: Misti Ates & Deja Deja-Vue' Chosen Easter Grand Marshals XVI; The Excitement Begins for 16th Gay Easter Parade Season (see Page-14)
2014 Highlights
the "official" dish: Gay Easter Parade Passes Goal, Raises over $31,300 for Food For Friends, Total Charity Donations Now over $202,414 (see Page-4)
the "official" dish: 5th Bunnies In The Big Easy Brings in $6,886 for Gay Easter Parade (see page 8)
snap paparazzi: 15th Gay Easter Parade 2014 led by Easter Grand Marshals XV Todd Blauvelt & Stuart Nettles (see Page-14)
celebrazzi: 15th Gay Easter Parade, 5th Bunnies In The Big Easy (see Page-16)
snap paparazzi: Some 30,000 Spectators Greet 15th Gay Easter Parade 2014 (see Page-24)
ambush paparazzi: 5th Bunnies In The Big Easy Raises $6,886 for GEP/Food For Friends @ Bourbon Vieux (see Page-34)
the "official" dish: 15th Purple Party Raises $3,816; 12th Spring Fever Extravaganza @ Four Seasons raises $3,695 (see Page-4); continued (see page 8)
celebrazzi: Fundraisers, Celebrations (see Page-6)
snap paparazzi: 15th GEP Purple Party Easter Grand Marshals Reception Raises $3,556 for Food For Friends @ Double Play (see Page-14)
snap paparazzi: 12th Spring Fever Extravaganza Raises $3,445 for Food For Friends @ Four Seasons (see Page-16)
the "official" dish: Spring Fever, Bunnies In The Big Easy Up Next; 12th Annual Spring Fever Extravaganza @ 4 Seasons; 5th Bunnies in the Big Easy April 18th @ Bourbon View; 15th Gay Easter Parade Easter Rolls Sunday, April 20 (see Page-4)
the "official" dish: 6th Eggstravaganza Raises $3,501 for GEP/Food For Friends; 13th Star-Studded Drag Extravaganza Raises $4,387 (see Page-8, 10)
celebrazzi: Eggstravaganza, Drag Extravaganza, Put Jeff Palmquist in Drag Feature Pics (see Page-16); snap paparazzi: 6th Eggstravaganza raises $3,501 for Gay Easter Parade/Food For Friends @ Grandpre's (see Page-18)
snap paparazzi: 13th Super Star-Studded Drag Extravaganza raises $4,387 for Gay Easter Parade/Food For Friends @ Oz (see Page-24)
the "official" dish: Gay Easter Parade Festivities in Full Swing; Sponsorship Party Raises $9,185; 13th Annual Super Star-Studded Drag Extravaganza; 15th Annual Purple Party Easter Grand Marshals Reception (see Page-4)
celebrazzi: Sponsorship Party Feature Pic (see Page-16)
snap paparazzi: Gay Easter Parade's 4th Sponsorship Party raises $9,185 @ Cutter's (see Page-24)
the "official" dish: End of Mardi Gras Heralds in "The Reason for The Easter Season" (see Page-4)
easter feature: Todd Blauvelt & Stuart Nettles to lead 15th Gay Easter Parade as Easter Grand Marshals XV (see Page-30) (see Pages 31-32)
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Bobby Creekwater - I Do That
Artist: Bobby Creekwater
Producer: I Am Invisible
Album: Revenge
Avg Rating: 3.0 ( 7 votes )
Never one to keep it anything less than one-hundred, Bobby Creekwater showcases his realness on I Do That, the latest leak off his forthcoming full-length. Opening with the assurance "I absolutely believe every motherf*cking thing I say, from the bottom of my heart," Creek proceeds to lace the smooth, string-driven boardwork of I Am Invisible with real talk on his life and career ambitions. Further freshness awaits fans of the ATL representative on long-awaited debut album Revenge, scheduled to arrive on store shelves July 4, Independence Day.
Written by richard on 04/20/11
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Education system overhaul?(28 Posts)
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|Property type
|Minimum Stay
|3 nights
2BR 2BA Condo -- Recently Remodeled, Tastefully Furnished and Fully Equipped End Unit that is Quiet, Light, and Airy, yet very Homey. Sleeps 4
This two-story condo has been recently painted, carpeted, with new ceramic tile and window coverings. It is an open, cozy, and furnished unit in a well-manicured, quiet complex that is just perfect for your stay. Only the sounds of birds and palm trees can be heard at this Mesa property, which is in close proximity to the Tempe/Scottsdale/Fountain Hills/Ahwatukee/Phoenix areas via Highways 101, 60, and the 202. Two great and new shopping malls—Tempe Marketplace and the Riverview—are within 1 mile of clustered condo complex. The new Cubs Stadium is within minutes.
The comfortable and tastefully decorated living/great room combination offers a 49" Flat Panel LG TV, fireplace, ceiling fan, vaulted ceiling, and an especially relaxed ambiance, furnished with Ethan Allen furniture. The master bedroom (upstairs) has a king bed, mirrored dresser, ceiling fan, and sitting/reading area along with a full-bath, vanity and large walk-in mirrored closet. The second bedroom (downstairs) has queen bed, beautiful armoire, hope chest for storage and good closet space. The third bedroom (downstairs) is set up as a den/office area and is furnished with a fine Ethan Allen chaise lounge as well as a beautiful Ethan Allen corner floor-to-ceiling desk unit, plus additional closet and storage space.
Each Guest stay is provided the following: shampoo, conditioner, lotion for each bath; & Soap for dishes, dishwasher, laundry/washer, kitchen soap pump, toilet paper (2 per bathroom), paper towels, and Kleenex.
This 1100 sq ft "end unit" can be rented for temporary housing, corporate housing, or as a seasonal/vacation rental. Please no pets and no smoking.
Utilities include: central air conditioning, heat, water, trash removal, plus cable TV and WIFI. Cap on power usage (air conditioning or heating) is $100/month.
The tastefully furnished condo has: Ethan Allen Furniture, 49" Flat-Panel TV, VCR/DVD player, a washer/dryer unit, vacuum cleaner, all bedding & linens, extra kitchen/bath towels, covered parking and a fenced community pool with Jacuzzi and barbeque grills a few steps away.
The fully-equipped kitchen and dining room has pantry, wooden table with 4 chairs, breakfast bar, dishwasher, refrigerator, microwave, stove, garbage disposal, pots & pans, dishes, silverware, glassware, coffee maker, toaster, and utensils.
Area Description
About 10-20 minutes Away: Sky Harbor International Airport, Arizona State University and Mill Street Shops; Riverview and Tempe Marketplace Malls; Tempe town Beach and Park, ASU's Gammage Center for Performing Arts, Spring Training Sites (Cubs, Giants, Angels, and A's), Phoenix Zoo and Papago Park, Phoenix Botanical Gardens, Upscale Chandler Fashion Square Mall, Scottsdale Fashion Square Mall, and Arizona Mills Outlet Stores, Casino Gambling Resorts (Harrah's and Ft. McDowell), Scottsdale restaurants and renowned Fifth Avenue shops, America West Arena (Phoenix Suns), Bank One Ballpark (Arizona Diamondbacks), Camelback Mountain and Superstition Mountain Hikes, the East Valley Flea Market, and much more.
Information on RENTAL RULES for Condo:
1. GENERAL INFORMATION. Check-in time is after 3 p.m. and check out is on or before 10 a.m. (Arizona time). This is a NON SMOKING condo unit. Pets are not permitted in condo unit under any circumstances.
2. DAMAGE/RESERVATION DEPOSIT. A damage/reservation deposit of $200 is required. This must be received within five days (or sooner) of booking the reservation. The deposit automatically converts to a security/damage deposit upon arrival. The deposit is NOT applied toward rent; however, it is fully refundable within (14) days of departure, provided the following provisions are met.
• No damage is done to condo unit or its contents, beyond normal wear and tear.
• No charges are incurred due to contraband, pets or collection of rents or services rendered during the stay.
• All debris and rubbish are placed in refuse container outside, and soiled dishes are placed in the dishwasher and cleaned. There are clean sheets for each bed, so please make sure there is a clean set of sheets for each bed upon departure.
• All keys except the lock-box key are left on the kitchen table and the condo is left locked.
• No linens and general content items are lost or damaged.
• NO early check-in or late check out.
3. PAYMENT. An advance payment equal to 50% of the rental rate is required sixty (60) days or sooner before arrival. The advance payment will be applied toward the unit rent. Please make payments in the form of money orders, cashier's checks or personal checks payable to Pattie Gibson and mailed to 7224 S. Sundown Circle; Littleton, CO 80120 (unless indicated otherwise). The advance payment is not a damage deposit. The rental balance is due fifteen (15) days or sooner before your arrival date.
Credit Card payments are accepted through the HomeAway website upon request. Please know that there is a 2.5% CONVENIENCE FEE associated with credit card transactions to be paid by the renter.
4. CANCELLATIONS. A sixty (60) day notice is required for cancellation. Cancellations that are made more than sixty (60) days prior to the arrival date are subject to a 5% cancellation fee or $100, whichever is greater. Cancellations or changes that result in a shortened stay or that are made within sixty (60) days of the arrival date forfeit the full advance payment and damage/reservation deposit. Cancellation or early departure does not warrant any refund of rent or deposit.
5. MONTHLY RESERVATION CANCELLATIONS. Monthly renters must cancel one hundred twenty (120) days prior to check-in. Monthly renters who make a change that results in a shortened stay must be made at least ninety (90) days prior to check-in.
6. MAXIMUM OCCUPANCY. The maximum number of guests in the condo is limited to four (4) persons. An additional charge or $10 per person per night for guests in addition to four (4) will be assessed.
7. FALSIFIED RESERVATIONS. Any reservation obtained under false pretense is subject to forfeiture of advance payment, deposit and/or rental money, and the guests will not be permitted to check in.
8. WRITTEN EXCEPTIONS. Exceptions to the aforesaid policies must be approved in writing in advance.
9. PARKING. Covered parking is available for one vehicle in Space #C-20 near the condo unit. Additional spaces, if needed, are available in uncovered available spaces. Any illegally parked cars are subject to towing; applicable fines/towing fees are the sole responsibility of the vehicle owner.
I love to travel and have used others seasonal rentals with success and much enjoyment. I've tried to provide in the coziness and relaxation of my Mesa condo an experience that I would want to have 'if I were the guest'.
I am a business and computer teacher (all levels--high school, community college, and university), have owned my own computer consulting company and am a seasoned textbook author of seven books.
I currently live in the Denver area (during non-snowy times) and in Mesa (during non-too hot times) with my husband, Ric, who is also a professor and I have two grown kids (and two great grandkids!)--all of whom make me very proud of their individual uniqueness and zest for life.
Pattie Gibson, Owner purchased this condo in 2000
I bought this property in 2000 and have used it personally for my two kids when they went to ASU and for myself during especially busy times in my life and after life events that turned my world around.
I have always felt peace upon entering the condo. It's small enough to be intimate; yet, big enough to have guests and friends over and fun times. I love it and feel good to be able to share it with those of like mind. I want my guests to really enjoy their stay and have a great time in the Valley of the Sun.
An easy walk and less than 3 blocks from the New Chicago Cubs Spring Training Complex in Mesa's beautiful Riverview Park. No parking problems. The Riverview Park is a popular, yet local, Water Park,with water play areas and the very popular 'Rope Tower'. Walking paths are abundant for strollers or the exercise enthusiasts!
Condo location centrally located literally on the Mesa/ Tempe border was the perfect location for a family vacation. The condo is a well maintained, comfortable home base for your Phoenix vacation. Approximately 3 blocks from the new Chicago Cubs spring training facility, the Condo has easy access to both Hwys 101 & 202. Complex has a unheated swimming pool- too cold for a Feb. swim - and hot tub. No onsite gym but a couple blocks away at the Riverside mall you'll find a full service commercial gym. Shopping and golf close by, loved Papago park - about 15 minutes away just north of ASU.
Condo was very relaxing and quiet. Very nice area, close to freeway and local resturants and shopping. Would definitely stay here again.
Located along Rio Salado parkway adjacent to Riverview Park, the new Chicago Cubs Spring Training Par, which was dedicated on February 12, 2014 and is less than 3 blocks walking distance from this Condo Property!
|Rate Period
|Weekend Night
|Monthly *
2015 PRIME Cubs Spring Trng.
Mar 1 2015 - Mar 31 2015
3 night minimum stay
Off Peak
Apr 1 2015 - Sep 30 2015
3 night minimum stay
Oct 1 2015 - Feb 29 2016
3 night minimum stay
2016 PRIME Cubs Spring Trng.
Mar 1 2016 - Mar 31 2016
3 night minimum stay
|Cleaning Fee
|Refundable damage deposit
If you choose to pay by credit card, there is a HomeAway Credit Card Transaction Fee that you will be assessed, which is 2.5% of the total charges as stated on your Rental Contract. This transaction fee amount will be deducted from your Refundable Security Deposit at the end of your stay.
Unlike other months of the year, note that Guest Bookings for January 1 through March 31 (High Peak Time) require only 2 payments--50% down at time of booking and the remainder due 30 days prior to stay.
* Approximate monthly rate. Actual rate will depend on the days of the month you stay.
Payment is usually accepted in the quoted currency (USD) unless the currency and the amount is specifically agreed in advance with the owner / advertiser.


text:
Page 1
Monitoring the Implementation of Consultation Planning,
Recording, and Summarizing in a Breast Care Center
Jeffrey K. Belkora, Ph.D.*,
University of California, San Francisco
Meredith K. Loth, B.A.,
University of California, San Francisco
Daniel F. Chen, B.Sc.,
University of California, San Francisco
Jennifer Y. Chen, B.A.,
University of California, San Francisco
Shelley Volz, M.A., and
University of California, San Francisco
Laura J. Esserman, M.D., M.B.A.
University of California, San Francisco
OBJECTIVE—We implemented and monitored a clinical service, Consultation Planning,
Recording and Summarizing (CPRS), in which trained facilitators elicit patient questions for doctors,
and then audio-record, and summarize the doctor-patient consultations.
METHODS—We trained 8 schedulers to offer CPRS to breast cancer patients making treatment
decisions, and trained 14 premedical interns to provide the service. We surveyed a convenience
sample of patients regarding their self-efficacy and decisional conflict. We solicited feedback from
physicians, schedulers, and CPRS staff on our implementation of CPRS.
RESULTS—278 patients used CPRS over the 22 month study period, an exploitation rate of 32%
compared to our capacity. Thirty-seven patients responded to surveys, providing pilot data showing
improvements in self-efficacy and decisional conflict. Physicians, schedulers, and premedical interns
recommended changes in the program's locations; delivery; products; and screening, recruitment
and scheduling processes.
CONCLUSION—Our monitoring of this implementation found elements of success while surfacing
recommendations for improvement.
PRACTICE IMPLICATIONS—We made changes based on study findings. We moved
Consultation Planning to conference rooms or telephone sessions; shortened the documents produced
*Corresponding Author: 3333 California Street, Suite 265, San Francisco, CA 94118, Phone: 650 533-6965, Fax: 415 651-8574, Email:
Conflicts of Interest
The authors report no conflicts of interest.
Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers
we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting
proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could
affect the content, and all legal disclaimers that apply to the journal pertain.
NIH Public Access
Author Manuscript
Patient Educ Couns. Author manuscript; available in PMC 2009 December 1.
Published in final edited form as:
Patient Educ Couns. 2008 December ; 73(3): 536–543. doi:10.1016/j.pec.2008.07.037.
NIH-PA Author Manuscript
NIH-PA Author Manuscript
NIH-PA Author Manuscript
Page 2
by CPRS staff; diverted slack resources to increase recruitment efforts; and obtained a waiver of
consent in order to streamline and improve ongoing evaluation.
Audio-recording; Implementation; Question prompting; Coaching; Shared Decision Making;
1. Introduction
Breast cancer patients consult specialists to arrive at treatment strategies, choosing among
surgery, radiation, chemotherapy, hormone therapy, and biologic therapy. These treatments
offer reduction in mortality and recurrence risk, at the cost of increased risk of complications,
side effects, and long-term harm. As a means to effective information gathering and
participation in decisions, experts advise breast cancer patients to make a list of questions
before they attend their meetings with specialists; bring a friend to take notes; and make an
audio-recording of the consultation [1].
Researchers have systematically reviewed the evidence base surrounding such visit
preparation, audio-recording, and summarizing practices. Scott et al. found that providing
audio recordings and/or consultation summaries can increase patient knowledge and patient
satisfaction [2]. Kinnersley et al. found that "interventions before consultations for helping
patients address their information needs… seem to help patients ask more questions in
consultations" [3]. These and other reviews are not definitive, due to the relatively small
number of studies and the mixed results. However, as Kinnersley and colleagues point out, "In
terms of practice there are strong justifications unrelated to evidence-based medicine for
adopting a collaborative approach to the medical encounter, such as, for example, patient
preferences and moral imperatives" [3].
Indeed, based on our studies of visit preparation and recording [4–6], as well as evidence about
the benefits of very similar interventions [7,8], we began to pilot Consultation Planning,
Recording, and Summarizing (CPRS) in 1998 at the UCSF BCC. Since then, we have found
no research describing the routine implementation of visit preparation, recording, and
summarizing interventions as integrated components of a clinical service. While the
components have been shown in clinical studies to be satisfying to patients, and effective to
varying degrees in improving various patient outcomes, researchers do not know whether
integration into a clinic workflow is possible, how it affects patient measures such as self-
efficacy and decisional conflict, and whether integration into routine practice is acceptable to
physicians, schedulers, and staff affected by the interventions and can be sustained over the
long term.
We therefore monitored our implementation of Consultation Planning, Recording, and
Summarizing (CPRS) at the point in its evolution when we were integrating it more fully into
programs in our clinic. Our hypotheses were that CPRS could be integrated into clinical care
at our academic medical enter, that it would be associated with improvements in patient self-
efficacy and decisional conflict, that it would be acceptable to physicians, schedulers, and staff,
and that we could engage in continuous quality improvement to sustain and enhance the
implementation. Specifically, this study asked the following questions:
How many patients did we serve with CPRS?
What changes in decisional self-efficacy and decisional conflict did we observe in a
convenience sample of patients using CPRS?
Belkora et al.Page 2
Patient Educ Couns. Author manuscript; available in PMC 2009 December 1.
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Page 3
What aspects of CPRS should be continued, discontinued, or improved in order to
assure the ongoing success of the implementation?
2. Methods
2.1 Setting and Population
The UCSF Breast Care Center (BCC) is a multidisciplinary clinic in a university medical center.
In 2005, the BCC saw 599 breast cancer patients new to the clinic who consulted specialists
about treatment decisions over the course of 843 visits, with 44% of those visits being to 5
surgeons and 56 % to 9 oncologists. The average age in 2005 was 57 years. The distribution
of diagnosis by stage was 94 new patients with ductal or lobular carcinoma in situ (16%); 414
patients with stage 1–3 breast cancer (69%); 19 patients with metastatic disease (3%); and 72
patients with unknown/unrecorded stage (12%). The distribution of first treatment course was
32% lumpectomy, 21% mastectomy, and 20% chemotherapy. The ethnic/racial distribution in
2005 was 64.5% White, 18.5% Asian, 7.5% Hispanic, 6.5% African American, and 3.0%
Unknown/Other. Most patients had private (67%) or public (29.5%) insurance, with 3.5%
2.2 Study design, sample, and participants
The study consisted of prospectively planned field observations in which we qualitatively and
quantitatively monitored the process and impact of the CPRS service in the UCSF BCC through
record reviews, surveys, and interviews. Patients were eligible for CPRS if they had a
confirmed diagnosis of breast cancer, and were scheduled for an appointment at the UCSF
BCC regarding a treatment decision between March 1, 2005 and December 31, 2006, during
one of the two daily times when a CPRS staff member was available. We approached patients
to respond to efficacy surveys if they spoke and wrote English, and if our staff could approach
them to obtain informed consent and administer surveys without interrupting other visit
activities such as rooming, vital signs, patient history questionnaires, history-taking by
residents, or discussions with nurses and attending physicians.
We also studied physician, schedulers, and CPRS staff reactions to the implementation. We
included, over the study period, five surgeons and nine oncologists who saw breast cancer
patients in our clinic. We included the schedulers who acted as new patient schedulers for the
physicians, and the 14 CPRS staff that performed CPRS for the patients of the physicians. The
CPRS staff consisted of BCC employees participating in a premedical internship program after
graduation from college and before attending medical school. BCC faculty hire these interns
as research study coordinators, and assign them to the CPRS team for one day per week as a
means of enriching their internship experience with additional patient contact. The CPRS
staffing policies meant that one day per week per CPRS staff member translated into a capacity
of two CPRS service slots per day, one in the morning, and one in the afternoon.
We obtained ethics approval from the UCSF Committee on Human Research and the Human
Subjects Research Review Board of the Department of Defense, and obtained informed consent
from patients for study surveys.
2.3 Intervention and Procedures
Members of our study team had developed [4], evaluated [9,10], and begun to implement
[11] CPRS between 1994 and 2004. In 2005, we obtained a grant to better integrate CPRS,
along with other decision support programs, into the routine clinical care workflow at the UCSF
Belkora et al.Page 3
Patient Educ Couns. Author manuscript; available in PMC 2009 December 1.
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Page 4
After a needs assessment and program redesign phase featuring input from clinic physicians,
nurses, and schedulers, as well as our institution's risk management department, the Director
of the BCC decided that new patient schedulers would henceforth offer CPRS (along with other
supportive services) to breast cancer patients at the time they were scheduling their
appointments with physicians. We therefore amended the clinic scheduler job descriptions,
and established monthly meetings between the schedulers and the Decision Services team to
monitor the scheduling of CPRS.
Schedulers used a script we provided to describe CPRS to patients as a supportive service in
which a CPRS staff member would meet the patient at the clinic 60–90 minutes in advance of
their medical appointment, help the patient brainstorm and write down a list of questions for
the doctor, and then accompany the patient, audio-recording the medical appointment and
taking notes.
Physicians at the BCC were already accustomed to CPRS due to the prior period of
development, piloting, and ad-hoc (i.e. non-integrated) implementation [11–13]. During the
study period there was a maximum of 8 and a total of 14 CPRS staff, since the study period
spanned two fiscal years during which some interns went on to medical school and new interns
arrived. We offered the CPRS training at the start of each fiscal year in a 3-day workshop led
by the Director of Decision Services (JB) and featuring assistance from second-year interns
(including JC, DC, ML). The CPRS trainees learned, through lectures and role-plays, to
administer a Consultation Planning prompt sheet (see Table 1), and to paraphrase and
summarize patient questions into Consultation Plans (Table 2) and physician responses into
Consultation Summaries (Table 3). Trainees learned to word-process these documents on
portable computers, print copies for patients, family members, and attending physicians, and
store copies on a secure clinic file server. Trainees also learned to audio-record the physician
visits using digital audio recorders, burn compact discs for patients after their visit, and store
electronic copies on the secure clinic file server as required by the UCSF Risk Management
department. We enjoined the trainees from providing medical advice or information as part of
the CPRS encounter, and monitored their compliance with these and other CPRS procedures
and policies, documented in a 247-page reference guide, during weekly staff meetings [14].
2.4 Outcomes, measures, and instruments
For study question 1, as a measure of the degree to which we were able to deliver CPRS we
counted how many patients received the services and compared this to our capacity.
For study question 2, as a means of measuring changes in decision self-efficacy and decisional
conflict in patients we administered the Decision Self Efficacy (DSE) and Decisional Conflict
(DCS) scales to patients before, during, and after their visits. See Figure 1. The DSE and DCS
are Likert scales with acceptable levels of validity and reliability documented in similar studies
and similar settings [15,16]. The DSE measures patients' confidence in their ability to
participate in decision making [17]. The DCS measures the level of decisional conflict
perceived by the patient [18].
For study question 3, over the study period, we were interested in which program design
elements physicians, schedulers, and CPRS staff felt were acceptable and should be continued;
which were unacceptable and should be discontinued; and which required improvement and
should be modified as a means of improving the sustainability of CPRS. The instrument for
measuring this outcome consisted of semi-structured interview guides based on the Critical
Incident Technique [19], including probes regarding the program infrastructure, policies,
processes, techniques, and tools.
Belkora et al. Page 4
Patient Educ Couns. Author manuscript; available in PMC 2009 December 1.
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Page 5
2.5 Data Collection, Management, and Analysis
Study Question 1—Schedulers used the clinic scheduling system to schedule CPRS sessions
with patients. We compared the total number of completed CPRS sessions to the number of
available CPRS slots based on a capacity of two per day, one in the morning and one in the
Study Question 2—Physicians requested that we avoid disrupting the flow of patients
through the clinic, so we administered our study surveys only when it was convenient, i.e.
when patients were not needed by the clinic. For testing the null hypothesis of no change in
DCS or DSE score against the alternative of a significant change, we used a two-sided matched-
pair t-test of significance at the 0.05 level.
Study Question 3—In order to collect interview data, during regular clinic meetings we
probed for physicians, schedulers, and CPRS staff to provide specific best and worst cases of
how CPRS had performed in the past with respect to the program goals, and what aspects of
the service to continue, discontinue, or change. We stated the program goals as helping patients
list their questions and retain records of the answers provided by their physicians. We obtained
input from physicians at their weekly multidisciplinary review meeting, and monthly and
weekly input from the schedulers and CPRS staff during their respective regular meetings with
the Director of Decision Services (JB). The study team reviewed notes from these meetings,
and discussed program changes during weekly Decision Services management meetings. The
Director of Decision Services made the final decisions on program design, and documented
them in the Decision Services Reference Guide, a 247 page manuscript that summarizes the
policies and procedures for the program [14].
3. Results
Study Question 1
278 patients received CPRS over 22 months. We estimated that our maximum theoretical
capacity during this period was approximately 880 CPRS service units, meaning that the
exploitation rate was approximately 32%.
Study Question 2
We approached 38 patients (out of 278, 13%), all female, to answer DSE and DCS surveys.
These patients met the physician criteria of not being engaged in other clinic activities such as
filling out patient history forms or being roomed by nurses. One patient withdrew from CPRS
all 37 and was also not surveyed, leaving 37 survey respondents. Their ages ranged from 35–
77, with a median of 57. Most of the patients had graduated from high school and attended
some college (n=29, 83%). Twelve (32%) had lobular or ductal carcinoma in situ (stage 0); 15
(41%) had invasive lobular or ductal cancer (stages 1–3); eight (22%) had metastatic cancer
(stage 4); 1 (3%) had no cancer and 1 (3%) had colloid cancer.
Among these respondents, CP was associated with an increased DSE score of 0.29 (mean 3.24
to 3.53, mean effect size 0.29, standard deviation for the change of 0.34, standardized effect
size of 0.85, 95% confidence interval from 0.18 to 0.41, p<0.001),. CPRS combined with the
doctor's consultation was associated with a reduced DCS score of 0.75 (mean 2.78 to 2.03,
mean effect size −0.72, standard deviation for the change of 0.75, standardized effect size of
0.96, 95% confidence interval from −0.97 to −0.46, p<0.001).
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Study Question 3
Physicians endorsed CPRS, which they saw as helping patients organize and clarify questions
before the medical appointment; giving physicians a preview before the visit so they could
strategize in advance about how to conduct the consultation; and helping ensure that all of the
patient's questions were addressed during the appointment. Physicians also felt that interns
were effective as CPRS staff, and supported continuing the arrangement under which clinic
research assistants were assigned to CPRS duties one day per week.
Physicians thought we should discontinue the practice of conducting CPRS in exam rooms
while patients were waiting. Physicians felt that this occasionally disrupted the clinic processes
of rooming the patient and taking vital signs, and frequently exacerbated clinic delays by tying
up overbooked clinic exam rooms. They also suggested that we make the practice of having
physicians review each Consultation Summary optional, and instead make it clear to patients
that the summaries and recordings were provided by CPRS as a convenience for patients, were
not necessarily reviewed by physicians, and could contain errors and omissions.
Physicians proposed that CPRS staff change their practices so that Consultation Plans and
Summaries be more succinct. They felt that Consultation Plans should run 1–2 pages, and
Summaries 2–3 pages.
The schedulers also endorsed the continued implementation of CPRS. They reported that
patients particularly resonated with being offered an accompanier to take notes and audio-
record the medical appointments. However, the schedulers felt that they could not reliably offer
CPRS since this required spending more time with patients and they were chronically behind
on their phone calls and scheduling tasks. Therefore, in order to promote increased exploitation
of CPRS, the schedulers suggested that the CPRS staff identify, through the clinic scheduling
system, those patients with upcoming appointments on days when there were still available
CPRS slots, and call those patients until the slots were filled.
Schedulers also reported that the timing of CPRS was often a barrier to scheduling the service
for patients coming from far away or for patients who had an early morning appointment.
Therefore, schedulers requested that CPRS staff be available to conduct Consultation Planning
by telephone with such patients.
The CPRS staff also endorsed the continued implementation of CPRS. They cited the
opportunity to work closely with patients and make a positive contribution to patient care at
the BCC.
The CPRS staff did wish to modify certain aspects of the program related to waiting for
physicians. Specifically, after completing their Consultation Planning duties, CPRS staff
frequently had to wait in the clinic for the attending physician to conduct the medical
appointment. The CPRS staff found that they could not make productive use of this time, which
could range from minutes to hours, depending on clinic delays, because they needed to monitor
the physician's location and intercept them to give them the patient's Consultation Plan before
the start of the appointment. They requested a better process for identifying when they needed
to be back in the clinic room to take notes and audio-record, so that they could complete other
work assignments while waiting.
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4. Discussion and Conclusion
4.1 Discussion
We asked questions about the number of patients provided with the service, levels of decisional
self-efficacy and decisional conflict among survey respondents, and aspects of program design
that should be continued, discontinued, or modified.
Study Question 1—We found that 278 patients were provided with CPRS over the study
period, compared to our CPRS capacity in that period of 880, a service exploitation rate of
32%. On one hand, we were pleased that this novel and complex program reached 278 patients
over 22 months. On the other hand, we were concerned that we were not able to serve more
patients. We were also concerned that our initial design, which relied on record-keeping by
overloaded schedulers, did not generate adequate records of recruitment. Therefore we could
not tell whether our program was under-utilized due to poor recruitment or whether many
patients were declining the service.
We also learned that the relatively low exploitation rate of 32% meant that our CPRS staff, the
premedical interns, were not working at capacity. Meanwhile the new patient schedulers were
overloaded. While in theory the new patient schedulers are the ideal people to offer and
schedule CPRS for patients visiting our clinic, in practice we concluded that we need to balance
the workload across CPRS staff and new patient schedulers.
Study Question 2—In a convenience sample of respondents, Consultation Planning was
associated with improvements in pre/post measures of decisional self-efficacy, and CPRS in
conjunction with the doctor's visit was associated with a reduction in decisional conflict. Due
to constraints in our study design, namely that we agreed to physician requests not to disrupt
the clinic workflow, we were only able to approach and consent 13% of the CPRS service
recipients. Therefore we interpret these findings as preliminary findings that helped us pilot
two promising program evaluation measures. Our findings of improvement are in line with
other studies that have examined the effect of decision support on and decisional conflict
[20]. We learned that patients in our sample had a relatively high baseline level of decision
self-efficacy, 3.24, which constrains the amount of improvement we can detect. At the same
time, the standardized effect size for decision self efficacy was large, 0.85, and indicates that
decision self-efficacy, having established good psychometric properties of reliability and
validity, may also be sensitive to this intervention.
Patients in our sample started with an average decisional conflict score of 2.78, which is
consistent with people at risk for delaying decisions due to their confusion about which course
of action is best. After seeing their doctors and receiving the CPRS intervention, decisional
conflict levels had fallen to 2.03, which is consistent with people making and following through
on decisions [16]. We therefore learned that the direction and magnitude of change in decisional
conflict is consistent with the instrument's norms, and that it may be worthwhile to use this
outcome measure in further studies of CPRS.
Study Question 3—Overall, physicians, schedulers, and patients endorsed continued
implementation of CPRS. Physicians felt that the primary benefit for them was getting a
preview of patient questions and concerns as a result of the Consultation Planning process.
Physicians recognized that patients also appreciated each of the CPRS components, and thus
were willing to cooperate with the process. However, physicians did not want clinic processes
(e.g. rooming patients) to be affected by CPRS.
CPRS staff members experienced one of the implications of physician reluctance to modify
clinic processes in order to accommodate CPRS. Physicians often run behind schedule. The
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CPRS staff would time their first intervention, Consultation Planning, to conclude at the time
the medical appointment was due to begin. If the physician was running late, the CPRS staff
member faced an uncertain waiting period before the next interventions, Consultation
Recording and Summarizing, were due to begin. The physicians, running late, could not be
counted on to come and get the CPRS staff member from their desk in a clinic back office. So
CPRS staff members would wait in the hallway to intercept the physician dashing from the
one exam room to the next. This led to unproductive waiting.
Schedulers were caught in an organizational bind. They had agreed, during needs assessment
and program redesign interviews, with the practice manager's suggestion that they offer CPRS.
As a result, the practice manager added CPRS scheduling to their job descriptions. But because
of competing demands on their time, the schedulers could only schedule approximately 32%
of CPRS capacity. One of the schedulers insisted that they all wanted to offer CPRS more
often, but explained during a monthly meeting with the Decision Services team, "My other
tasks are higher priority. I will get written up in a flash if I don't call a patient back or have
patient materials ready when they're needed." The scheduler was referring to written
complaints lodged by supervisors or physicians in cases of non-performance of critical duties.
4.2 Conclusion
Our CPRS implementation was successful in delivering evidence-based interventions to 278
breast cancer patients over a 22 month period. The implementation can be enhanced with
changes in the program's screening, recruitment and scheduling processes; locations; delivery;
products; and techniques for productive use of staff waiting times.
4.3 Practice Implications
As suggested by new patient schedulers, we have diverted some of our CPRS staff time, which
was underutilized due to unscheduled slots, to engage in screening, qualifying, and recruiting
patients for CPRS. As a result, in 2007 we operated at 51% exploitation of our CPRS capacity,
up from 32% during the study period.
In order to collect more complete data on the CPRS implementation, we have now sought and
obtained a waiver of consent from our Institutional Review Board so that in the future we may
survey CPRS patients routinely without disrupting the clinic workflow.
In order to eliminate the use of clinic exam rooms for CPRS, as requested by physicians, we
have identified reservable rooms around the Cancer Center where we conduct Consultation
Planning. We are also beginning to investigate the effects of providing Consultation Planning
over the telephone so that the CPRS staff does not encounter space limitations and so that
patients do not need to come into clinic 60–90 minutes early.
In response to physician concerns about the length and detail of the documents generated by
our program, we have modified our training to emphasize paraphrasing and summarizing
techniques so that CPRS staff are able to limit Consultation Plans to 2 pages and Consultation
Summaries to 2–3 pages.
Physicians did not always have enough time to review every CPRS document, so we have
worked with our institution's Risk Management department to create a disclaimer that makes
it clear that our summaries and recordings are provided as a convenience and may contain
errors and omissions.
In order to address CPRS staff requests that their wait times be more productive, we are
experimenting with giving patients radio devices and asking them to page their CPRS staff
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member to come take notes and audio-record the visit, as soon as the physician arrives for the
medical appointment.
Based on the findings from this study, and other investigations, the Agency for Health Research
and Quality has featured our implementation of CPRS as one of the first 100 Innovation Profiles
in its Innovation Exchange [21]. The entry in the Innovation Exchange describes additional
features and lessons learned from this implementation.
In addition to training premedical interns to provide CPRS at UCSF, we have trained cancer
resource center employees and volunteers around Northern California to offer CPRS, with
promising results for patients and CPRS staff [22] We continue our search for what is effective
and sustainable in translating into practice the growing body of research about visit preparation,
audio-recording, and summarizing. We invite inquiries and collaboration on these topics.
Role of Funding
The Foundation for Informed Medical Decision Making (grant 0015) and United States Department of Defense
(DAMD17-03-0481) provided funding for this study. During the analysis and reporting phase of the study, Dr. Belkora
was also supported by a career development award from the National Institute of Child Health and Human
Development (NICHD) and the Office of Research on Women's Health (ORWH), grant number 5 K12 HD052163.
The funding sources had no involvement in any aspect of the study.
The authors wish to thank the patients, physicians, administrators, premedical interns, and employees of the UCSF
Breast Care Center. We also thank Karen Sepucha for ongoing collaboration related to decision support at our Breast
Care Center; Martha Daschbach for assistance with regulatory compliance; the staff of the Fishbon Library for research
assistance; Pam Derish for scientific writing instruction; and Dan Moore for statistical advice.
1. Weiss, M. Seven minutes! How to get the most from your doctor visit. New York: Western Publishing;
2. Scott JT, Harmsen M, Prictor MJ, Entwistle VA, Sowden AJ, Watt I. Recordings or summaries of
consultations for people with cancer. Cochrane Database Syst Rev 2003:CD001539. [PubMed:
3. Kinnersley P, Edwards A, Hood K, Cadbury N, Ryan R, Prout H, Owen D, Macbeth F, Butow P, Butler
C. Interventions before consultations for helping patients address their information needs. Cochrane
Database Syst Rev 2007:CD004565. [PubMed: 17636767]
4. Belkora, JK. PhD Dissertation in Department of Engineering-Economic Systems & Operations
Research. Stanford University; Stanford, CA: 1997. Mindful collaboration: Prospect mapping as an
action research approach to planning for medical consultations; p.
5. Sepucha K, Belkora J, Tripathy D, Esserman L. Building bridges between physicians and patients:
Results of a pilot study examining new tools for collaborative decision making. J Clin Oncol
2000;18:1230–8. [PubMed: 10715292]
6. Sepucha K, Belkora J, Mutchnick S, Esserman L. Consultation planning to help patients prepare for
medical consultations: Effect on communication and satisfaction for patients and physicians. J Clin
Oncol 2002;20:2695–2700. [PubMed: 12039932]
7. Butow PN, Dunn SM, Tattersall MH, Jones QJ. Patient participation in the cancer consultation:
Evaluation of a question prompt sheet. Ann Oncol 1994;5:199–204. [PubMed: 8186168]
8. Ford S, Fallowfield L, Hall A, Lewis S. The influence of audiotapes on patient participation in the
cancer consultation. Eur J Cancer 1995;31A:2264–9. [PubMed: 8652254]
9. Sepucha KR, Belkora JK, Tripathy D, Esserman LJ. Building bridges between physicians and patients:
Results of a pilot study examining new tools for collaborative decision making in breast cancer. J Clin
Oncol 2000;18:1230–8. [PubMed: 10715292]
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10. Sepucha KR, Belkora JK, Mutchnick S, Esserman LJ. Consultation planning to help breast cancer
patients prepare for medical consultations: Effect on communication and satisfaction for patients and
physicians. J Clin Oncol 2002;20:2695–700. [PubMed: 12039932]
11. Aviv, C.; Sepucha, K.; Belkora, J.; Esserman, L. Using action research to improve collaboration
between breast cancer patients and physicians: Creating the program for collaborative care. In:
Kronenfeld, J., editor. Research in the sociology of health care: Changing consumers and changing
technology in health care and health care delivery. New York: Elsevier Science; 2001. p. 207-229.
12. Sepucha K, Belkora J, Aviv C, Mutchnik S, Esserman L. Improving the quality of decision making
in breast cancer: Consultation planning template and consultation recording template. Oncol Nurs
Forum 2003;30:99–106. [PubMed: 12515987]
13. Sepucha K, Belkora J. Putting shared decision making to work in breast and prostate cancers: Tools
for community oncologists. Commun Oncol 2007;4:685–689. 691.
14. Belkora, J. Decision services reference guide. San Francisco, CA: 2007.
15. Cranney A, O'Connor AM, Jacobsen MJ, Tugwell P, Adachi JD, Ooi DS, Waldegger L, Goldstein
R, Wells GA. Development and pilot testing of a decision aid for postmenopausal women with
osteoporosis. Patient Educ Couns 2002;47:245–55. [PubMed: 12088603]
16. O'Connor AM. Validation of a decisional conflict scale. Med Decis Making 1995;15:25–30.
[PubMed: 7898294]
17. Ottawa Health Research Institute. User manual for decision self-efficacy. [Accessed on: July 22,
2004]. http://decisionaid.ohri.ca/eval.html
18. Ottawa Health Research Institute. User manual for decisional conflict. [Accessed on: July 22, 2004].
19. Flanagan JC. The critical incident technique. Psychol Bull 1954;51:327–58. [PubMed: 13177800]
20. O'Connor AM, Stacey D, Entwistle V, Llewellyn-Thomas H, Rovner D, Holmes-Rovner M, Tait V,
Tetroe J, Fiset V, Barry M, Jones J. Decision aids for people facing health treatment or screening
decisions. Cochrane Database Syst Rev 2003:CD001431. [PubMed: 12804407]
21. AHRQ Health Care Innovations Exchange, Innovation profile: Personalized support improves
patient-physician communication and enhances decision making for breast cancer patients. AHRQ
Health Care Innovations Exchange. [Accessed on: May 2, 2008]. [Web site].
22. Belkora J, Edlow B, Aviv C, Sepucha K, Esserman L. Training community resource center and clinic
personnel to prompt patients in listing questions for doctors: Follow-up interviews about barriers and
facilitators to the implementation of consultation planning. Implementation Science 2008;3:6.
[PubMed: 18237380]
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Figure 1.
Flow chart showing sequence of interventions, including surveys for a convenience sample of
patients. CPRS denotes Consultation Planning, Recording, and Summarizing.
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Table 1
Consultation Planning Prompt Sheet
The CPRS staff member uses the high level prompts as open-ended probes to elicit patient questions, and if the patient cannot think of questions, together
they review the secondary prompts to stimulate patient questions. The staff member then summarizes the patient questions and concerns in a separate
word-processed document (see Appendix 2)
Situation – What are your questions or concerns about your situation?
What do you know about your situation? Questions about key facts? Diagnosis? Test reports? Pathology report? Anything unusual?
Choices – What are your questions or concerns about what you can do?
What can you do? Questions about tests? Active monitoring (no further treatment)? Treatment options? Second opinions? Clinical trials? Complementary
therapies? Newest treatments? Most proven treatments? Most aggressive treatments? Least aggressive? Middle ground treatments? Remedies for side
effects? What to stop doing? What to start? Decisions to make now? Decisions to make later? Past decisions to revisit?
Objectives – What are your questions or concerns about what you want?
What do you want? Goals for doctor's appointment? Goals for treatment? Preferences about length and quality of life? Regarding quality of life: what to
continue/protect? (e.g. relationships, work, hobbies, daily activities, body image, sexuality, child-rearing, etc.)? Preferences about timing, frequency,
duration, intensity, location, costs of treatment? Concerns about interactions with other treatments or medical conditions? Hopes? Fears? Unspoken
thoughts or feelings? Learning preference: visual or auditory or other type of learner? Preferred approach to decision-making: holistic or analytical?
Qualitative, informal (e.g. talking about pros and cons, journaling/writing)? Quantitative, formal (e.g. rating and weighting? statistical number-crunching)?
Somewhere in between? (e.g. filling out a table)? If quantitative: interested in survival/recurrence/complication rates for each choice? Prefer rates to be
explained in numbers (e.g. 60% ten-year survival rate) or words (e.g. more likely than not to survive)? Level of effort to expend in analyzing decision?
People – What are your questions or concerns about the people involved in your decision?
Who can help? Questions about where else to go for advice or information or support? How do you want this doctor involved in your treatment decisions?
Other doctors? Other people (e.g. who come to appointments)? Whom do you want to have a voice in analyzing your decisions (i.e., seek their input)? A
vote (involve them in arriving at a final decision)? Visibility (keep them informed)? Who else do you need to talk to? Anyone to exclude?
Evaluation – What are your questions or concerns about how each choice affects each objective?
How does each choice affect each objective? Questions about specific choices and specific objectives? Baseline prognosis (prognosis with no further
treatment)? How choices will affect survival, recurrence (e.g. rates for patients like you?) How choices will affect quality of life? Likelihood of
complications, short and long-term side effects? Best-case scenario, worst case, most likely (e.g. in terms of survival, quality of life) for each choice?
Decisions – What are your questions or concerns about arriving at a decision?
Which choice is best? What are the next steps? Who will do what, when, where, why, how? What resources can help overcome any barriers to next steps?
If undecided/unready: Timeline/deadline for arriving at a decision? Priority relative to other commitments? Resources for gathering information/data
about how choices affect objectives? Who can help (revisit People above)? What do you want (revisit Objectives above)?
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Table 2
Example Consultation Plan [names and identifying details redacted]
Using a portable computer, a CPRS staff member created a word-processed list of questions and concerns by summarizing and paraphrasing the patient's
verbal statements during the Consultation Planning interview just before the medical appointment. The patient approves the staff member's summary and
signs a Service Agreement form indicating that these are the patient's own questions and that the staff member has not provided advice or information.
The CPRS staff member then prints copies of the Consultation Plan for the patient, accompaniers, and the physician to review before and during the
I was diagnosed with breast cancer in August and had surgery a month later, followed by radiation
I want to understand the following terms on the pathology report:
Moderately differentiated infiltrating carcinoma
Surgical margins free of tumor – does that mean that there is none for 1/2 cm around edges?
I am currently on Arimidex.
If I need chemotherapy, what are the options?
Least aggressive therapies? Most aggressive?
What does Dr. Smith recommend and why?
Neulasta along with chemotherapy?
Any further tests?
OBJECTIVES For treatment
• •
Avoid side effects such as leukemia, heart issues, infections. I am concerned about dosage and getting large amounts all at once, as well as
their long-term effects on my body.
• •
If I end up doing a brutal kind of chemotherapy, I want to get it on a Friday to recover so I can go back to work on Monday.
• •
Work occupies my mind, I want to continue working if I am to receive chemotherapy. I work with kids, I am concerned about my immune
system getting weakened by chemotherapy.
For appointment
• •
I like being told the facts and details. I will analyze them and ask questions until I completely understand the answer. I want the rationale for
needing chemotherapy before I decide to proceed.
• •
I like facts, numbers, charts.
I have a friend who will drive me up here on Fridays if necessary. My daughter is supportive.
Why do they recommend taking Arimidex for only 5 years?
Is there a way to receive chemotherapy gradually over a longer period of time? I would prefer receiving chemotherapy this way, if I do need it. Are
infections due to a "jolt to system" from chemotherapy? Is gradual delivery as effective? If I do need chemotherapy:
I would like to understand the benefits vs. risks of chemotherapy.
I would also like to learn about recovery and side effects of chemotherapy.
I will decide whether I need chemotherapy based on my discussion with Dr. Smith. I will decide within the next 24/48 hours. I will take into account my
daughter's opinion.
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Table 3
Example Consultation Summary [names and identifying information redacted.]
Using a portable computer and digital audio-recorder, a CPRS staff member takes notes and records the consultation. Afterwards, the CPRS staff member
creates a word-processed summary of the physician's responses to the questions and concerns listed on the patient's Consultation Plan. The CPRS staff
member sends a copy of the Consultation Summary to the patient, along with a compact disc containing the recording of the visit.
Infiltrating ductal carcinoma breaks through duct membrane and invades breast tissue. Your closest margin is 0.5 cm, others are 2.0 cm.
No chemotherapy
Stay on Arimidex, maintain weight, exercise
Come to UCSF once every 4–6 months for monitoring, have mammograms done here
4 cycles of Adriamycin + Cytoxan (AC)
1 dose every 3 weeks, each dose takes about 90 min
4 cycles of Taxotere + Cytoxan (TC)
We can try to get authorization for you to receive Neulasta on day 2 at home. Depends on insurance and cost (oftentimes insurance requires that Neulasta
be given at an infusion center).
No further tests anticipated. If you do decide to go on AC, we need to do an echocardiogram or a MUGA scan on your heart to determine how well it
Gather enough information to make an informed decision about whether to undergo chemotherapy.
Oncologists in your area for Neulasta shots: Dr. X and Dr. Y
The practice assistant will contact you to schedule chemotherapy if you decide to do it at UCSF
Chemotherapy vs. no chemotherapy
Adjuvant output (10-year risk estimate – based on cases similar to yours from various databases.)
24.5% risk of recurrence without any treatment besides surgery and radiation
12.5% risk of recurrence if taking aromatase inhibitor
9.4% risk of recurrence if taking chemotherapy plus aromatase inhibitor
So Adjuvant! estimates an overall 2.6% reduction in 10-year risk from chemotherapy
Chemotherapy Options
Adriamycin + Cytoxan (AC)
Side effects from adriamycin: hair loss, nausea, vomiting, fatigue
Small (1%) chance of damaging the heart by affecting strength of muscle responsible for contractions
Taxotere + Cytoxan (TC)
Possible side effects: hair loss, body aches, fever, neutropenia (low blood counts) = risk of infections.
Neulasta causes bone pain.
Are you comfortable with idea that you have 15–19% risk of recurrence in next 10 years without doing chemotherapy? Is it worth it to do chemotherapy
for a 3% benefit in recurrence? That is the key issue.
I would recommend chemotherapy, since you are young and healthy. We usually start chemotherapy within 6–8 weeks of surgery but would definitely
want to start within 3–4 months after surgery
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Honorable or Dishonorable
View Single Post
Archived Post
Lt. Commander
Join Date: Dec 2007
Posts: 120
# 29
Originally Posted by
Do you view waiting in cloak, watching a Federation player conduct PvE, and attacking him when his shields are down, dishonorable or honorable?
If you do view it dishonorable, why?
And if you disapprove of such an action, and saw a Klingon player doing it, would you black list him?
I have an objective to complete. The Borg are an obstacle, Starfleet is an obstacle. And since Starfleet ships are better suited to fighting Borg compared to a lone Bird of Prey, I'll let Starfleet clear the Borg, then I'll clear Starfleet. It's a valid tactic when scanning nodes, which we'll be unable to scan while cloaked after the update.
I think too many people are getting their ideas of "honor" and "Klingon Honor" mixed up.


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- Capture all the flavours of summer in this easy to make salad that uses summer salad vegetables and provides a texture and surprising punch finish with the rocket, fresh chilli and garlic complimenting the sweet watermelon. ...Tuesday 17 March 2015


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I bet you heard by now that Bush is trying for more troops in Iraq
more money wasted and more lives lost more grief and congress says no way.
I'm for the congress Bush plan is totaly worthless .
he over spent the buget and his war happy come on let's face it it's time call our troops home and time call this stupid event off.
and what I heard every one is counting down the days and hours the day Bush leaves office, we seen him go to hero to zero.
this stupid Iraq thing is getting too dam old and very tiring and sicking.
His father was never like this at all , when his father was in office it was kick butt and leave the troops was not Iraq that long, But Gezzz Bush jr he's making another long war like one when Nixon was in office.


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Editors' Note: The download button opens the iTunes App Store, where you may continue the download process. You must have iTunes installed with an active iTunes account in order to download and install the software. This download may not be available in some countries.
Publisher's Description+
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What's new in this version:
- Market improvements- new Intro- updated Facebook integration- simplified PayPal setup- lots of UX improvements and bugfixes


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T-Mobile lands on list of most innovative companies for 2014
Though we witness it routinely, the subtle brilliance of T-Mobile's approach to wireless is sometimes lost on us all. A wholly different approach, T-Mobile's 'Uncarrier' method drives the competition mad, and often leaves them scrambling to keep pace. On top of winning over customers, T-Mobile has now been recognized for their efforts.