text:
Abortion practice in the northeast Caribbean: "just write down stomach pain".
Keywords: abortion law and policy, abortion providers and services, abortion methods, Anguilla, Antigua, St Kitts, St Martin, Sint Maarten, Caribbean
Les particularites des petites iles et une jurisprudence coloniale heritee forment le decor de cette etude realisee en 2001-2003 sur la pratique de l'avortement dans plusieurs iles du nord-est des Caraibes : Anguilla, Antigua, St Kitts, St Martin et Sint Maarten. Des entretiens avec 26 medecins, dont 16 realisaient des avortements, ont montre que les medecins pratiquent des avortements en contravention avec la loi, et que ces services, toleres par les autorites et legitimises par les normes europeennes, representent l'essentiel des services d'avortement. L'avortement medicamenteux etait utilise sous surveillance medicale et par automedication. Les femmes voyageaient pour preserver leur anonymat, et pour acceder a une methode, un praticien ou une structure medicale de leur choix. Parfois, elles se contentaient d'une methode moins aceeptable si elles ne pouvaient se permettre une methode plus confortable. La legalite n'etait pas le principal facteur de choix. La plupart des praticiens trouvaient la situation satisfaisante. Neanmoins, les donnees de l'etude indiquent que les lois restrictives entravaient l'acces aux services et compromettaient la qualite des soins. Si les medecins ont peut-etre la possibilite et les connaissances requises pour pratiquer des avortements clandestins, les femmes n'ont pas de droit legal a ces services. Les entretiens suggerent qu'un nombre croissant de femmes avortent seules avec du misoprostol afin d'eviter les medecins, les honoraires eleves et la stigmatisation. L'Initiative des Caraibes sur l'avortement et la contraception organise des reunions, forme des praticiens et cree un forum en faveur de la depenalisation de l'avortement et de l'amelioration des soins.
Las exigencias de islas pequenas y un legado de jurisprudencia colonial crean el marco para este estudio de tres anos (2001-2003) sobre la practica de abortos en Anguilla, Antigua, San Kitts, San Martin y San Maarten. Mediante entrevistas a profundidad con 26 medicos, 16 de quienes efectuaban abortos, se encontro que los medicos autorizados para ejercer realizan abortos de manera rutinaria en contravencion de la ley. Estos servicios, tolerados por los gobiernos y legitimados por normas europeas, son el pilar de la atencion del aborto en estas islas caribenas. El aborto con medicamentos estaba practicandose bajo supervision medica y mediante automedicacion. Las mujeres viajaban para encontrar servicios anonimos y para tener acceso a determinado metodo, prestador de servicios o establecimiento de salud. A veces se conformaban con un metodo menos aceptable si no podian pagar por uno mas comodo. La legalidad no fue el factor determinante para el metodo seleccionado. Aunque la mayoria de los prestadores de servicios de aborto aceptaban la situacion actual como satisfactoria, nuestros hallazgos sugieren que las leyes restrictivas obstaculizan el acceso a los servicios y comprometen la calidad de la atencion. Mientras que los medicos tienen la libertad y los conocimientos para practicar abortos ilegales, las mujeres no tienen ningun derecho legal a estos servicios. Las entrevistas indican que un numero creciente de mujeres estan autoinduciendo abortos con misoprostol para evitar los medicos, las altas tarifas y el estigma publico. La Iniciativa Caribena de Aborto y Anticoncepcion esta organizando reuniones, capacitando a los proveedores y creando un foro publico a favor de la despenalizacion del aborto y el mejoramiento de estos servicios.
ABORTION laws in the Caribbean derive from a legacy of colonial jurisprudence and range from the most restrictive to the most liberal in the world. Travel between countries is a constant feature of life in most of the region. This paper reports on a study of current abortion provision, lawful and unlawful, within and across borders in the northeast Caribbean, using these historical and geographical markers as its frame, with particular attention to the exigencies of living on a small island and the influence of European laws on abortion providers.
Our initial criteria for choosing the islands on which to conduct this research included small size, geographical proximity, fluid borders and diverse legal systems. The two-country island of Sint Maarten [Netherlands Antilles] and St Martin [France] fit these criteria and served as a good starting point to assure inclusion of non-independent countries, often excluded from regional studies. We then added countries one by one as our interviewees provided names of abortion providers on other islands. By following those leads back and forth between islands, we arrived at a five-country case study.
The countries we included were Anguilla, a British Overseas Territory; Antigua, one of the two islands in the state of Antigua and Barbuda, independent since 1981; St Kitts, one of the two islands in the state of St Kitts and Nevis, independent since 1983; St Martin, French Overseas Department of Guadaloupe; and Sint Maarten, Kingdom of the Netherlands Antilles. Not counting the significant flow of unregistered migrants, approximately 200,000 people live in the five countries. Antigua, St Martin and Sint Maarten are frequent destination points for migrants, both legal and illegal, from the entire Caribbean region, especially Haiti, Dominican Republic, Guyana, Dominica and Jamaica.
Our study design is atypical in that it examines abortion practices in juridically separate health systems as one service network and includes interviews with licensed health professionals working in authorised medical facilities who provide abortions, whether they are legally permitted to do so or not. Since our ultimate aim was to contribute to an improvement in abortion care in the region, we sought to identify practitioners who were qualified, informed and potentially influential.
Abortion laws in the five countries reflect the colonial history and current political status of each country. Anguilla is largely autonomous in fixing its own laws. Antigua-Barbuda and St Kitts-Nevis are self-governing. As former British colonies, they operate against a background of English common law, some but not all of which has been changed. As Commonwealth members, certain judicial decisions taken in England may be applied. St Martin is governed by current French law. Sint Maarten's laws are set by the Netherlands for foreign policy and in the Antilles for most other matters, including health legislation. *
Identifying and conducting in-depth interviews with the main abortion providers and a representative sample of other physicians and health authorities in each country took place over a period of three years (2001-2003). Repeat interviews and convergence of material from different sources helped to assure validity of findings. We explained this was a study of abortion practices in the Caribbean aimed at laying the groundwork for regional cooperation to improve care; anonymity was assured. Eighty per cent of the doctors and nearly all the other health professionals were comfortable with being recorded; for the rest, responses were noted by hand. The interviews with physicians covered professional background, abortion law and policy, abortion facilities and methods used by them and by others on the island, obstacles to optimal care, risks and complications, specific issues related to migrant women and referrals within and across borders.
Our final sample of physicians included 12 obstetrician-gynaecologists, 11 family practitioners and three physician government administrators, of whom 16 were performing abortions, nine of them obstetrician-gynaecologists and seven family practitioners. Two of the 16 abortion providers were women. Seven did abortions only in a hospital, two in a hospital and their private office, and seven only in their private office. They were based in five government hospitals and two private hospitals. Of the ten who were not performing abortions, five had been trained and done so in the past.
Half of the abortion providers were trained in Europe or North America; the other half at the University of West Indies (Barbados and Jamaica campuses). Most of the Caribbean-trained physicians had done some or most of their postgraduate work in Europe, the United States or Canada. Given the laws on each island, only two of the 16 abortion providers were complying with legal guidelines. We have not specified the number of abortion providers in each country or their location, and use a generic masculine pronoun to refer to all physicians in order to assure anonymity. We present interviews as one set with physicians from Anguilla, Antigua and St Kitts, juridically similar contexts, to camouflage identities of individual abortion providers where stigma is especially strong. We also interviewed more than 30 health professionals, advisors or government officials, including five family planning workers (three of whom were nurse-midwives), seven government officials (including a Minister of Health and an Attorney General) and five pharmacists. We asked everyone to speak about their knowledge and opinion of abortion law and practice in their country.
We discussed the research at the onset and on a number of other occasions with women community leaders, government gender affairs officers and seven women's groups. Those meetings were critical to our project as a check on the relevance of the study to women's concerns, as a way to transmit research findings to their rightful beneficiaries and as part of the process of building an inter-island network of women committed to working for safe abortion in the Caribbean.
Sint Maarten: institutionalised tolerance of abortion
Upon arrival in Sint Maarten, we met with the staff of the Women's Desk, a government community centre. Three staff members informed us:
"Abortion is illegal in Sint Maarten ... No, the law is not a problem ... Everyone knows who is doing them. We don't talk about it, we can't talk about it since it is illegal and we are a government agency. Abortion ... is a taboo here."
A family doctor elaborated:
"Abortion is illegal, but tolerated. When Holland changed the law, the Dutch Antilles never put the new law into effect, but abortion is very tolerated ... because physicians know the Dutch law."
One of the main providers of aspiration abortion described how the central government of the Netherlands Antilles, located in Curacao, not only tolerates abortion but also visits facilities to check quality of care:
"We have a verbal agreement with the Curaqao Ministry of Health. An inspector came to visit from Curacao to make sure we were doing the procedure properly. I'd been really worried about their visit and then all they did was check my facility and ask about my technique. They know it is a needed service."
Another general practitioner was suspicious of the government's motives:
"Everyone knows it is done. It's an institutionalised toleration system. Safe abortions are available, also by gynaecologists at the hospital ... The Health Department here is totally aware of the situation but they don't acknowledge it.
They like to keep the situation illegal because then they could catch you. If anything goes wrong, they could prosecute ... it's a taboo situation ... But no, I'm not for legalisation, that would mean more controls, more delays. The system works fine the way it is."
Does this "institutionalised tolerance" assure women access to services? We asked two of the hospital gynaecologists whether they set any conditions on a woman wanting to terminate a pregnancy and, if so, which ones. Their replies were revealing:
"I try to discourage women from having an abortion unless they have heavy social reasons. If a woman has sic or seven or eight children, okay, but if she has only two or three then I don't do the abortion."
"Officially we cannot do it unless there's a serious medical reason ... So some women go to family physicians on the outside ... and some go to the French side (of the island) where it is legal, and often these days what you see more is that they use Cytotec ... ** We are getting a lot of patients now with incomplete abortions."
This doctor blames the law that women are ending up in the emergency room with incomplete abortions. Most of them had self-administered Cytotec tablets to avoid confronting barriers to abortion care in medical facilities. Asked if he was in favour of legalisation, he declared:
"I think that a woman has a right to choose, and if you think women have a right to choose, then you better make it legal so that she can do it in a better way."
Crossing the border to St Martin: legal within fixed guidelines
Professionals and the people of Sint Maarten are very much aware that hospital abortion is legal and available just a walk away across the border in St Martin where, due to universal French medical coverage, health care is accessible to those who lack health insurance. At the hospital, French abortion law determines the type of service they will receive. St Martin is the only country in our sample that provides medical abortion with mifepristone, admininistering it under tight regulations in combination with the more widely available misoprostol. According to a hospital gynaecologist:
"The French law is very clear. All pregnancy terminations are done at the hospital. All eligible women, 30-40% of the total, get the medical method ... Most prefer it, though some prefer early surgical abortion because they know the pills are not so easy. All aspirations are performed electrically under general anaesthesia."
This physician did not know physicians working on the Dutch side, although he did know where women could go off-island for second trimester abortions:
"Over 14 weeks, we just say we cannot do it here, but under English law they can do it later than under French law, so maybe in (name of island), we're not sure, maybe they can go over there."
Women could and did go "over there", and so did we, where we learned that current English law did not, in fact, hold on the independent neighbouring island. The St Martin gynaecologist freely offered us the name of an off-island practitioner, while physicians elsewhere eventually gave us the names of providers of illegal abortions in St Martin.
Surgical abortion in a private office is against French law. In a certain sense, private abortions are more transgressive than those on the Dutch side of the island because: "The French law (unlike applications of Netherlands Antilles law) is very clear." One general practitioner, more hesitant than most to discuss his practice, admitted he had been doing abortions in St Martin for many decades, long before they were authorised, even in hospitals:
"I do aspirations by electric suction here in my office, I've got the machine, it's quick ... I do them only to eight weeks. If they are further along, I send them to the hospital."
Another private practitioner was firmly against doing aspiration abortions in a private office but felt quite comfortable giving drugs to induce abortion, even if it entailed procuring them under false pretenses:
"Never an aspiration in a private office, never, it is too dangerous ... Cytotec? It is a problem because the box has 60 tablets ... I give just two or three or four, so I buy it at the pharmacy as if it is for me (laughs) ... When the pregnancy is 10-12 weeks it works very well ... I tell them to put the tablets in vaginally--morning, evening, morning, evening for two days--then they come back to me and I check and usually they are done and then they don't have to go to the hospital." ***
Avoidance of the hospital was cited again and again as women's main reason for going to private practitioners, regardless of the fact that the abortions provided were illegal. Attending the French hospital meant risk of public exposure, general anaesthesia for aspiration abortions and usually some payment for non-residents.
Migrant women without legal residence papers were said to avoid public facilities either by going to private doctors or, increasingly, by buying misoprostol from underground distributors who carry the drug from one island to another. In a group interview with ten unregistered migrants, each of whom had had from one to four misoprostol abortions, there was a consensus that it was best to do your own abortion--despite sangro mucho, mucho dolor (lots of blood and pain)--to avoid the cost and visibility of going to a doctor. ([dagger])
Anguilla, Antigua and St Kitts: circumventing the law
Doctors in St Martin and Sint Maarten told us that women come for abortions from other islands to escape stigma and punishment at home. Anguilla, with the smallest population in our sample, is only a 20-minute, US$20 roundtrip boat ride away. A physician in Anguilla told us how women automatically flee home if they need an abortion:
"Patients beg us not to write the truth on their medical charts. If their church finds out they have had an abortion, they'll be expelled from the church. There is no privacy in the hospital, so once I tell a woman she's pregnant, I don't see her again, she will go to St Martin ... French or Dutch side."
We knew the Anguilla government had recently liberalised their abortion law, so we asked the medical director of the hospital whether there was an increase in service provision. His response was clear: "There is a new law here, but it is not being implemented."
We were able to identify abortion providers on the island, but they felt no greater liberty to practice openly than before the law had been amended. In a meeting with the Attorney General, we came to a better understanding of the social climate:
"The change in law was not intended to open up abortion for women here. It was recognised that there are certain circumstances that may be dangerous for the mother ... The culture of Anguilla would not permit abortion on demand. This is a Christian society. Laws from Great Britain are not our laws."
Although current British abortion law does not prevail in British Overseas Territories, it is called upon by some physicians to justify abortions. A gynaecologist who has worked on different islands explains:
"Basically there are two sets of laws. The dependent British territories have their own intrinsic laws that are passed by the government of the island. And then one can sort of operate under the mother-country laws. So in order for me to do a termination of pregnancy, I have to do it under British law ... As for the independent English-speaking Caribbean countries, well, they too come out of the British inheritance. It's not legal in most of them, except Barbados and Guyana, but it's tolerated because nobody is going to prosecute a doctor."
Clearly, doctors are privileged transgressors of the law. We asked a nurse in Antigua who had learned how to do manual vacuum aspiration whether she performed abortions. She laughed and shook her head: "Oh no. We nurses have a saying: 'What will save a doctor, will hang a nurse!'"
"There was a time when there were all these backstreet abortionists. One lady told me she went to a fisherman! What does a fisherman know about human anatomy? That's how desperate she was ... People used to end up with sepsis, really sick, and when I say sick, I've seen times you had to stay outside the room the smell was so bad. You don't see that anymore. Doctors realised that people were dying, or becoming infertile, and they decided, well, it was inhumane to let people suffer like that ... Now people go to the doctors and the doctors help them ... The church, they don't say anything about it because it isn't legal .. but it's not done as a cloak-and-dagger thing, it's done more or less openly, and safely."
If abortion is so open in Antigua, why does it remain illegal? We asked practitioners about obstacles to legal reform, and the response was always the same: "This is a very Christian society." Nonetheless, as one obstetrician-gynaecologist elaborated:
"Technically abortion is illegal in Antigua, but the law hasn't been a problem ... We (physicians) have gone to the government trying to seek legislation, and basically the government has backed off. They said, 'Look, it hasn't been a problem, what we do is turn a blind eye, but to legislate that abortion would be legal would cause too much problem with the Church.' This is a very Christian society."
A health administrator of an NGO agreed that the country was not ready for legal reform. He even expressed his concern that efforts to change the law could jeopardise existing services:
"If we try to push this legalisation business, we are just going to push the Church, the conservatives, the whole society against us, and the safe abortions that are happening are going to stop ... The Church knows about this ... I'm not going to ruin what works well here because our concern is the health of our women ... Down the line, legal. Right now, safe. This is our highest moral principle."
Whether by way of moral or scientific principles, abortion practitioners emphasised the legitimacy, if not legality, of abortion provision. When asked whether the criminal prohibition concerned him, a family doctor responded with the force of professional authority:
"We are medical professionals. We have the French Canadian Medical Association (opens his top drawer and pulls out a medical journal from the University of Montreal (7) with an article on misoprostol abortion protocols). You see, the medical profession respects us."
Controversies and constraints
On every island, misoprostol was the most controversial abortion method. Some practitioners considered it dangerous and others a safe alternative to surgical abortion. A family doctor, who said he would not do aspiration abortions directly, finds them easy after the woman has used misoprostol, since the cervix is then amply dilated. He explained his decision to supervise women's use of misoprostol:
"My first two years of practice, I refused to do it, and then they used to go right and left and come in with complications, and I said, let me help them, under my supervision ... I have a small suction machine for the 20-300% who need an aspiration. I don't want them to bleed, bleed, bleed."
Another physician, a long-time provider of first trimester aspiration abortions, was dismayed by the increase in misoprostol use, especially when the drug was sold by the tablet for profit by pharmacists:
"Aspiration abortion (up to 8 weeks) is safer than walking across the street ... I used to do up to six a day, but now it's cut in half due to all the Cytotec ... Pharmacists sell the tablets individually; they mark the price way up ... We know because there are lots of incomplete abortions showing up at the emergency room ... The gynaecologists at the hospital sent around a circular to all the pharmacists telling them to stop selling it."
The circular was signed by the three gynaecologists of the government hospital (Box 1). It is careful to denounce indiscriminate use, wanton use, large doses, late use (implied by reference to a live fetus) and no reponsibility. On a subsequent visit to the island we asked one of the signatories whether correct use of misoprostol would make it acceptable, and he confirmed that the problem was not misoprostol per se, but lack of supervision. He himself did not hesitate to advise women for whom a surgical abortion was too expensive to try the tablets:
Box 1. Circular on the indiscriminate use of Cytotec We wish to express our concern about the indiscriminate use of Cytotec by some pharmacists and general practitioners to induce abortions. It seems that there is no awareness of the dangers of Cytotec as patients are being prescribed large doses of the Cytotec orally and/or vaginally repeatedly until some form of bleeding occurs to a greater or lesser degree. They are then being told to report to the Casualty Department when the abortion is occurring. We have long been seeing patients at the Casualty Department with several undissolved tablets still in the vagina; some patients still having a live fetus seen on ultrasound scan. In some cases bleeding is so severe as to require emergency blood transfusion with attendant risks ... The wanton use of Cytotec in the outpatient setting is a very dangerous practice. It is inviting disaster to suggest to these desperate women that they use those large doses of Cytotec to "help" them out of a situation and then send them on their merry way with no responsibility being taken for the possible sequences of events. As health providers we need to take care that our actions are helping and not hindering life preservation. Please be guided accordingly.
"Women have come to me and said, 'Doctor, I want to have a termination but I cannot afford the $1400 Eastern Caribbean [=US$560]). What can I do?' And I've said, 'This is what you can do, you can go to the pharmacist, they can give you these tablets, and if you have any problem you come back and see me."
He made sure to date their pregnancies and to tell them how many tablets to take. What he found more disconcerting than misoprostol abortions was the systematic performance of unnecessary dilatation and curettage (DetC) for early abortions and post-abortion bleeding, specifically at the government hospital where most women go. He explained how he performed aspiration abortions at the private hospital, where he had a certain degree of freedom, but was obliged to do DetCs for the same indications at the government hospital because simpler procedures were associated with illegal pregnancy termination:
"At the government hospital we do a D&C because we don't have the instruments to do aspirations ... Since it's a government hospital and terminations should not be done, they wouldn't order the instruments ... Most patients go to the government hospital because the doctor's fee, the anaesthesiologist's fee, all of those the patient doesn't have to pay."
We were told that on another island they also perform D&Cs; however, upon further enquiry we realised that they were, in fact, doing aspirations with a suction machine. The D&C terminology was technically inaccurate but legally irreproachable because the instruments were recognised for treatment of miscarriage.
Miscarriage is the most common and thinly disguised diagnosis for incomplete abortion. Sometimes doctors use the term on medical charts to camouflage a pregnancy termination. An obstetrician--gynaecologist on one island told us:
"On the operating list I write 'removal of retained products of conception' so it looks like a miscarriage."
Others call abortions miscarriages to facilitate reimbursement of costs for women. One hospital physician explained:
"Insurance companies cover miscarriage but not incomplete abortion. The company will call the doctor to go over the form--and they refuse coverage if the woman can't show she was being followed by a physician for a pregnancy prior to the miscarriage."
Also in private offices without insurance coverage, physicians share euphemistic language with their patients. A family doctor in Sint Maarten prefers the term "menstrual regulation" to "abortion", whether by aspiration or misoprostol. The term menstrual regulation is well-known in other parts of the world, (8) and this doctor is satisfied with the procedure:
"If you don't do a pregnancy test and you do a suction, it's not a suction for abortion, it's menstrual regulation. Same thing with Cytotec, it's not an abortion, it's menstrual regulation ... usually it works, and maybe it was really not an abortion at all, just a hormonal imbalance."
Another physician insisted: "I don't do abortions ... only medication". An obstetrician-gynaecologist likewise avoided the word abortion in his consultations with women:
"Women ask for something to 'bring on their period'. I have drugs to 'bring on their period', and don't even mention abortion or pregnancy termination."
Many health professionals expressed caution about their language, not only with women but also with colleagues, especially in writing out a referral for abortion. A family doctor who recently arrived on one of the islands told how he was making referrals to the gynaecologist for "pregnancy termination" until someone told him: "Just write down stomach pain."
Such linguistic codes betray the taboo of abortion, and also the complicity among doctors and between doctors and women patients. And yet, this taboo is harsher for women, who fear they'll be expelled from the church, than for abortion providers whose government turns a blind eye or sends a medical inspector to make sure they are doing the procedure properly. It would be wrong, however, to conclude that the physicians we interviewed are relaxed about breaking the law; some are aware that if anything goes wrong, the government could prosecute them, and others are ready with their defence should they ever be arrested. Restrictive laws reinforce social stigma. Both abortion seekers and abortion providers strategise to avoid punishment while trying to obtain or give the best possible care.
Women travelled to find anonymous services, and also to access a particular method, provider or facility. Sometimes they settled for a less acceptable method if they could not afford a more comfortable one. Significantly, legality was not the main determinant of choice. Women from Anguilla look for an abortion provider off-island to avoid condemnation at home. It costs only US$20 round-trip for a short boat ride from Anguilla to St Martin or Sint Maarten. Women from the Netherlands Antilles side may go to the French side if the abortion is less expensive, or if they want a medical abortion with mifepristone. Women from the French side sometimes go to the Dutch side if they prefer an aspiration abortion in a physician's office to a hospital procedure under general anaesthesia, or they get the same procedure at home from a private doctor practising illegally. Women from St Kitts often go off-island in search of anonymity, and women from Antigua seeking an abortion for a second trimester pregnancy, like women from all the islands, are likely to go to the one provider who does them.
Most of the physicians and health authorities we interviewed believe that abortions in their countries are safe and accessible and therefore see no reason for legal reform. We heard many times that the law was not a problem because abortion was done under medical supervision and was at least "relatively safe" or "quite safe", even "safer than walking across the street", whereas legalisation would bring "more controls, more delays". Although a few practitioners were outspoken in advocating abortion law reform, most accepted the current situation as satisfactory. Those practising within authorised guidelines in French St Martin likewise accepted the limits of their services, informally referring women off-island for second trimester abortion.
However, our findings suggest that restrictive laws were hindering access to services and compromising quality of care. Whereas doctors may have the liberty and knowledge to practice illegal abortions, women have no legal right to those services. It is thus the doctor who personally decides whether or not to serve any particular woman. Women seem to be self-inducing abortions with misoprostol more often than before to avoid doctors, high fees and the public exposure of institutional care. Some of them need emergency back-up care for incomplete abortion, as several informants reported. We learned that such post-abortion care is compromised by restrictive laws in certain government hospitals where DetCs, rather than the safer aspiration procedures, are performed because buying abortion equipment was not allowed.
Many physicians told us that they commonly misrepresent procedures and outcomes on medical charts, a camouflage aimed at protecting both themselves and women. However, if something goes wrong, there is no reliable documentation, clinical accountability or medical responsibility for patient well-being.
Nonetheless, licensed physicians are routinely providing abortions in contravention of the law, and their services are clearly the mainstay of abortion care on this set of islands. They justify systematically breaking the law through reference both to women's needs and to their connection, initially through medical education and training, with legal abortion in Britain, France and the Netherlands. Together with the exigencies of small island geography, this historical connection distinguishes the context of abortion provision in Caribbean countries from that in continental Latin America, (under which the Caribbean generally falls in global reports), which may give it common ground with island countries and former colonies in other regions.
Prohibitive 19th century European abortion laws were imposed on Caribbean colonies over a century ago and then discarded in Europe, where women now have access to safe, legal induced abortion. Caribbean health providers have moral as well as medical reasons to use their competence in the service of their own populations. Such conscientious transgression of unhealthy laws testifies to their determination and alliance with women.
After completion of the research, the Caribbean Initiative on Abortion and Contraception presented the findings to the participating health professionals, women's groups and policymakers and recommendations and implementation plans were drafted. The first outcome was an expert meeting in 2003 on abortion and contraception at the University of Picardie Jules Verne, Amiens, France, co-sponsored by Salud-promujer, University of Puerto Rico. The meeting took place in Europe to facilitate open exchange, especially for Caribbean abortion providers working under restrictive laws. Representatives from the five research sites and Puerto Rico presented papers, as did European and international experts. In the Caribbean, a series of meetings was organised (with support from Mama Cash) to set up a Women's InterIsland Working Group. At the same time, we developed collaborations with Gynuity Health Projects, Ibis Reproductive Health, Ipas and Population Council. An intensive clinical training programme was set up, run by Dr Marijke Alblas and financed by the World Population Foundation, for teaching manual vacuum aspiration and use of local anaesthesia in hospitals (where this is beginning to replace D&Cs), as well as educational sessions for doctors, nurses, family planning staff, women's groups, high schools students and policymakers.
In May 2005, we organised a conference in Antigua-Barbuda in collaboration with the above organizations on "Sale Abortion in the Caribbean: From Law to Practice". Participants carne from 14 Caribbean countries including Anguilla, Antigua-Barbuda, Barbados, Curacao, Dominica, Guadaloupe, Guyana, Jamaica, St Eustatius, Sint Maarten, Puerto Rico, St Kitts-Nevis, St Lucia, and Trinidad-Tobago. The meeting covered legal and clinical issues and culminated in a Declaration of Health Professionals, Scientists and Advocates For Decriminalisation of Abortion in the Caribbean (available on internet) and with the formation of a regional Working Group of Abortion Providers. By interlacing research, training and action, we hope to continue to make known the realities of abortion in the Caribbean while creating a public forum to de-stigmatise, decriminalise and enhance abortion care. ****
For more complete data and theoretical elaboration of this article, see (1) below. The research was authorised by the Institutional Review Board of the University of Puerto Rico Medical Sciences Campus (#9080105). It falls within the Caribbean Initiative on Abortion and Contraception, a project co-directed by the researchers and supported by grants from an anonymous donor and the Jesse Smith Noyes Foundation to Saludpromujer, School of Medicine, University of Puerto Rico, and by faculty of the University of Picardie Jules Verne, Amiens, France. Our gratitude for the insight, generosity and honesty of health professionals working for women's well-being in Anguilla, Antigua-Barbuda, St Kitts-Nevis, St Martin and Sint Maarten.
(1.) Pheterson GI in collaboration with Yamila Azize. Safe Illegal Abortion: An Inter-Island study in the Northeast Caribbean. A Working Paper of the Caribbean Initiative on Abortion and Contraception. In English, Spanish and French at <www. saludpromujer.org>.
(2.) Cook RJ, Dickens BM. Abortion laws in Commonwealth countries. International Digest of Health Legislation 1979; 30(3):395-502.
(3.) Cook RJ, Dickens BM. Issues in Reproductive Health Law in the Commonwealth. London: Commonwealth Secretariat, 1986.
(4.) Costa SH, Vessey MP. Misoprostol and illegal abortion in Rio de Janeiro, Brazil. Lancet 1993;341:1258-61.
(5.) Special Issue Medical Abortion. Journal of the American Medical Women's Association 2000;55(3 Supplement).
(6.) Reproductive Health Technologies Project and Gynuity Health Projects. Consensus Statement: Instructions for Use--Abortion Induction with Misoprostol in Pregnancies up to 9 Weeks LMP. Expert Meeting on Misoprostol, Washington DC. 28 July 2003.
(7.) Le Cahiers de Formation Medical Continu. Obstetrique-Gynecologie. Universite de Montreal. 16 May 2001.
(8.) Begum FS. Saving lives with menstrual regulation. Planned Parenthood 1993:30-31.
* For texts of laws, including English translation of the French and Netherlands Antilles penal code abortion articles, see Working Paper. (1) For extensive analysis of Commonwealth abortion law, see Cook and Dickens. (2,3)
** Cytotec is the brand name in the Caribbean of misoprostol, that is used extensively in many countries to induce (and self-induce) abortion. The earliest reports came from Brazil, (4) and were followed by numerous clinical studies of safety and efficacy, (5) and scientific meetings to agree on safe protocols. (6)
*** In 2004, after completion of this study, physicians in private practice with hospital affiliations were authorised by French law to supervise medical abortion until 49 days LMP with the fixed two-drug protocol, mifepristone and misoprostol. Aspirations remain legal only at the hospital.
([dagger]) Due to the delicacy of the subject, the women did not want to speak to us directly but talked to a trusted nurse, who told them about the study. They said they didn't dare to show their faces in a conversation about abortion since it is illegal.
**** For information on the Caribbean Initiative, see: <www.saludpromujer.org>.
Gail Pheterson, (a) Yamila Azize (b)
(a) Associate Professor, Psychology Department, Faculty of Social Sciences, University of Picardie Jules Verne, Amiens, France. E-mail: firstname.lastname@example.com
(b) Senior Researcher, Director, Saludpromujer, Department of Obstetrics and Gynecology, School of Medicine, University of Puerto Rico, San Juan, Puerto Rico
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Factory 383/4-speed. Nicely restored in original color combination with no modifications. Super clean body and chassis, strong-running engine, restored interior. A really nice car... More
For sale in our St. Louis Showroom is a 60s survivor a 1966 Dodge Polara. This one owner 4 door classic has 77821 actual... More
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The Coronet was a full size car from Dodge and what started off in the mid-50's as the lowest trim line available eventually became... More
This 1966 Dodge D-Dart Factory Lightweight has a 273 C.I. (275 HP) Holley 4BBL V8, 4 Speed Manual Transmission w/ Hurst Shifter, 8 3/4''... More
We've had a few of these pretty mid-60s Mopars recently, and this 1966 Dodge Coronet 500 might be the nicest yet. The bright red... More
Super clean and straight 1966 Coronet 440 Coupe with the 383/330hp matching #'s engine and torque flite automatic transmission. When we bought the car... More


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FIFA officials were arrested by Swiss authorities with a plan to extradite them to the U.S. to be tried on corruption charges. CONCACAF president Jeffrey Webb is among those charged, though Sepp Blatter is not.
Top Headlines
- Free agent centerback Oguchi Onyewu training with NYCFC
- Southampton parts ways with Cody Cropper
- Herzog adds Orlando City's Turner to U.S. U-23 roster for Toulon
- FIFA officials arrested on corruptions charges filed by U.S. federal court
- MLS Ticker: Martins returns to training; Finlay expected to play with broken toe; and more
- SBI MLS Power Rankings: Week 12
- U.S. Open Cup Third Round Preview: NASL joins the fray
- Sources: Avaya Stadium to host 2016 MLS All-Star Game
- Götze, Özil, Schweinsteiger headline Germany squad to face USMNT
- 2015 MLS Homegrown Game to feature Club America U-20s
- SBI MLS Goal of the Week: Lucas Pittinari
- Video: All 100 of Chris Wondolowski's MLS regular season goals
Key Soccer Sites
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MLS Team blogs
SBI Story Calendar
MLS Beat Sites
- Boston Globe Soccer (New England Revolution)
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SBI Leading TopicsAmericans Abroad Aron Johannsson Charlie Davies Clint Dempsey CONCACAF CONMEBOL David Beckham David Carney David Moyes English Premier League Houston Dynamo John Anthony Brooks John Brooks Jozy Altidore Juan Agudelo Julian Green Jurgen Klinsmann Landon Donovan Los Angeles Galaxy Major League Soccer Manchester United MLS MLS Expansion NASL NBC New England Revolution New York Red Bulls NWSL Orlando City Orlando City SC Portland Timbers Premier League San Jose Earthquakes soccer Soccer on TV Stoke City Terrence Boyd Tim Howard Tom Sermanni Tottenham U.S. Men's National Team USL PRO USMNT Women's Soccer World Cup
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DMV to Internet-less New Yorkers: Get in Line
By Jared Chausow
By Katie Toth
By Elizabeth Flock
City Hid Facts From Feds About Rikers
By Albert Samaha
Flood Wall Street Gets Pepper Sprayed and Arrested
By Anna Merlan
By Jon Campbell
Report Sheds Light on Anti-Muslim Bias
By Jon Campbell
Rikers Island Lawsuits Over Diabetic Care
By Albert Samaha
You can find them and dozens of other women mired in the excruciating morass of dating at "Ladies Day," a seminar run by therapist and author Pat Allen. Allen, a California-based psychologist and self-help guru, does relationship-oriented therapy and expounds on her dating theories in audio tapes and pamphlets. But the bright-orange-haired 64-year-old is probably best known for Getting to "I Do," her 1995 book that guides womenand, at least according to the flap copy, mentoward snagging a mate.
Getting to "I Do" has much in common with Ellen Fein and Sherrie Schneider's better-known retro dating guide, The Rules: Time-Tested Secrets of Capturing the Heart of Mr. Right, though Allen dismisses her competition as "too man-hating." She takes issue with the likes of Rule Seven, "Don't accept a Saturday night date after Wednesday," which the Rules authors ground in the assumption that the man who eventually wants to marry you will not wait until the last minute to ask you out. According to Allen, however, "Real men don't put up with that stuff. My men don't call on Wednesday because they're in Japan closing a deal."
Whether or not her clients indeed attract "real" or jet-setting men (a matter very much open to debate), some of them are really devoted to Allen's teachings, which she says have resulted in over 2000 marriages. Much of her road map to "I do" tends to involve the same Rules-style games that feminists hoped had gone the way of foot-binding. Like Rule 17, "let him take the lead." Allenwho is on her fourth marriagerecommends deference as the key to marrying what she calls a "masculine man." That means not speaking first, not challenging his ideas, letting him make the plans, and waiting until he initiates sex.
If such counsel smacks of plain old-fashioned sexism, Allen doesn't seem to care. She's only too happy to distance herself from "women's lib," which she says has caused only problems in the love realm. Nevertheless, she's added a few caveats to the classic heterosexual power dynamic that help her fend off charges that she is completely essentialist and regressive. Most important, Allen says, it's not necessarily the woman who takes the back seat and stokes the man's ego, but whoever chooses to be the "feminine energy" in a relationship. So her ideas can theoretically be put to use by "feminine men" and "masculine women," as well as in gay relationships.
However, at this particular seminar (and, one suspects, at most of them) all the participants seem to be striving to perfect a traditionalsome would say outdatedfemale role in relationships with men. Sitting in the conference room of a borrowed midtown office, single women offer up dating stories featuring the classic doggy guys: the cheater, the shlump, the commitment-phobe. And women in relationships fret about where they're headed. Allen seems to have practical solutions at the ready for even the most desperate of them.
The lovelorn, in turn, are grateful even before they've had a chance to put her advice to the test. That's because the desperation in this circle of well-groomed women (some of whom trot off to Saks during the lunch break) is as much about the need for guidance in a chaotic dating world as it is about "Mr. Right." Ann, for instance, feels an immense sense of relief just having hit upon Allen's romantic instruction, though she has yet to tie the knot. She has traveled to California several times to attend the workshops and uses Allen as a phone therapist. "Since I was a little girl, my goal was to be in a committed, monogamous, married relationship," says the 47-year-old. "Now I'm out there putting my cards on the table."
Such earnest gratitude allows some to overlook Allen's occasional looniness. While she makes frequent references to scientific and self-help literature, she uses these valid sources to support far-out theories, like the idea that it's more difficult to talk to right-handed men. Or that women who stay too long in the "male" role make themselves vulnerable to chronic diseases. Or that masculinity is determined in utero by the quantity of hormones that bathe the fetus. (One woman actually asks whether she might assure her child's manliness by drinking the hormones during pregnancy.)
But most women seem to value Allen for her more practical tips. When she suggests staring into the eyes of a love interest for a full five seconds, several women scribble down the number. And clearly her emphasis on not having sex without "prenegotiating your sexual deal" is taken quite seriously. After she announces that "women aren't built to sleep around," a series of questions about other sex acts follows, and Allen clarifies that anything is okay "as long as you don't let it inside you." She then leads the class in a vow: "I promise I will never let that magic wand in unless I negotiate with its owner about monogamy, continuity, and commitment."
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What is Reverend Parris' personality throughout The Crucible?
1 Answer | Add Yours
Reverand Parris displays a few personality traits throughout the play. In Act 1, Parris is portrayed as a greedy man who cares more about his reputation than he does about his own daughter. In this act, he is praying and seems to be worried about Betty's well-being but when explaining his worry to other characters, he constantly mentions how his congregation will see him if witchcraft is found in his house. In Act 3, Parris can be described as bossy, pushy, and annoying. As the trials progress, he is always in the way of the judges and tries to almost act as a judge to the point that Danforth says to him, "Mr. Parris, I bid you be silent." In Act 4, Parris changes a bit; he is still worried about his reputation but when he realizes that his life may be at stake, he becomes fearful that someone will kill him.
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Call for abstracts: Pacific Undergraduate Research and Creativity Conference
Encourage all undergraduate students who have been involved in research or original creative activity this year to submit their abstract more
Healing power of music to be explored at conference
For 75 years, University of the Pacific has educated music therapists who have become leaders in their field. They will gather Saturday at a symposium to celebrate this legacy. more
Regents Approve Three Programs to be Housed at New San Francisco Campus
Graduate programs in Audiology, Food Studies and Music Therapy will expand the University's offerings in San Francisco more
Black History Month 2014 media sources
University of the Pacific faculty and staff are available to comment on topics connected to Black History Month, from diversity in higher education to the role of the arts in social justice more
SoundImageSound 10 Celebrates First Decade
The SoundImageSound Festival of New Music and Visual Image again brings audiences some of the best work being done by artists from around the world who blend sound and visual image into a multi-sensual experience more
Conservatory Alumna Elected to Leadership in the American Music Therapy Association
On Monday, January 6th, AMTA announced that Jennifer Geiger has been elected by their membership to the Board of Directors as President-Elect. more
Resident Artist Series featuring Igor Veligan, Patricia Shands, Darren Chan, Tom Knific, and The Merling Trio
The Merling Trio more
A Singing Success: Opera Production Takes First in National Competition
National Opera Association honors Pacific Opera Theatre's performance of "The Merry Wives of Windsor" with top prize more
Music Education at Pacific celebrates 100% placement for 2013 graduates
The Music Education program at Pacific's Conservatory of Music has achieved a 100% placement rate of their graduates for more than 16 years thanks to an oustanding curriculum and dedicated faculty. more
Brubeck Institute Jazz Quintet Salutes Jazz Diplomacy in Nation's Capital
Performing in the first-ever U.S.-Russian Rising Stars Jazz Band, the BIJQ continued Dave Brubeck's legacy of promoting international understanding through music and culture more


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We're in the middle of a couple big transitions in our life. My husband got a job; we moved across the country. I'm very pregnant; since it's high-risk in several ways, we're expecting anytime from now until May 1.
With the move, a lot of opportunities opened up for me to start using Montessori approach at home with my 19m old. For example, we bought the Learning Tower immediately. I've been able to buy more shelves and spread out his toys, organizing them a little better too.-- It really helps to have the space for things.
But, I've also found that I'm having trouble keeping up with my ideas and goals. One of the reasons is that this pregnancy is high-risk and requires a lot of extra doctor appointments and monitoring; I'm also taking things easy (as easy as possible while caring for a toddler). But I'm not sure a newborn in the house won't take up just as much time and energy.-- Though admittedly, I'll probably be in a happier, more playful mood.
The tuition for a Montessori preschool won't be easy for us to afford. But, I'm feeling very guilty that my son isn't getting the opportunities he deserves at home. I keep telling myself that $5000-$8000 (which is tuition depending on how many half-days per week and which school) would purchase a lot of materials and resources for the home. Of course, I'm not taking full advantage of the materials that we already own.
We are touring two Montessori preschools next week (for enrollment starting next September). But I won't be submitting any applications until I'm more certain that we want to send my son to a school next year. Part of me worries that in 6months, I'll have managed to get things under control and up to my standards at home so I won't want to send him to preschool at age 2.
I'd really appreciate comments and suggestions from all perspectives.


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AOTA's mental health legislation introduced in the House.
Everything you need to know if you're thinking about a career in occupational therapy.
Find out what is happening at AOTA and how to get involved.
Find out about OT's role with the care of individuals with spinal cord injury.
About Us
AOTA's Regulatory Affairs Department advocates for fair coverage and payment policies for occupational therapy by Medicare and other public and private payers.
Department staff analyze statutes, regulations, legislative activity, agency guidance, and court decisions relating to the reimbursement of health care services and supplies. We draft responsive comment letters, provide input to federal agency staff, challenge problematic coverage policies, and craft educational materials for members. We also provide support with Congressional advocacy efforts and strategize regularly with coalition partners on policy matters. Staff members regularly compose articles for trade and scholarly publications and electronic fact sheets for members. Focus areas for the Department include: compliance with Medicare Part A and B rules, payment reform, post-acute care bundling, the therapy cap and concomitant policies, coding and billing, quality reporting, and cost-effectiveness.
We are available to address member questions regarding regulatory and reimbursement matters, as well as to present at state and national conferences.
Who We Are
Contact Us
We can be reached at firstname.lastname@example.com.
Senate Votes on Therapy Cap Repeal Amendment and New Payment Reform Law
Medicare Part A Law and Policy Update Slides from AOTA Annual Conference (PDF)
Therapy Cap Repeal in Play as Congress Moves Forward on Medicare Reform
Health Care Payment Learning and Action Network
AOTA Provides Accountable Care Organization (ACO) Recommendations to Medicare


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StartUpHire is the place to find AP Specialist jobs. Review the list of AP Specialist career opportunities to the left. These AP Specialist jobs represent some of the most rewarding careers available.
You can refine your job search for AP Specialist career opportunities by adding a job title, company name, or keyword to the search box above … or click the "Advanced Search" link for more options.
Don't see the employment opportunity you're looking for? Check back soon for more AP Specialist jobs, or sign up for an email alert (link below) to receive periodic updates on new AP Specialist jobs.
Finance Foster City, CA, United States Zuora is seeking an AP Specialist/GL Accountant who will support the operational needs of the organization. This role helps design, administer and drive key processes that facilitate procure-to-pay processing, manage compliance activities4/27/2015 Foster City, CA Save This Job
Tracking Code 108-093 Job Description The Staff Accountant will support the Accounting Department related to processing vendor invoices, communicating with vendors and executing check runs, as well as assisting with customer order entry, generating customer invoices and5/5/2015 Lexington, MA Save This Job
We are seeking an energetic and enthusiastic AP specialist who has a proven track record of success to join our growing team! This person will be a self-starter, who is organized, very detail oriented and a team player. Responsibilities will include: Process daily AP invoices5/14/2015 Emeryville, CA Save This Job
Location:Overland Park, KS - OPK Position #:789 DESCRIPTION JOB SUMMARY The Accounts Payable (AP) Specialist I is responsible for auditing incoming carrier invoices and processing them for payment. They will research disputed charges and coordinate resolution with the3/28/2015 Overland Park, KS Save This Job
About Us At AppDynamics, our Application Intelligence Platform helps today's software-defined businesses proactively monitor, manage and optimize the most complex software environments. All in real time, and all in production. With cloud and on-premise deployment flexibility,3/30/2015 San Francisco, CA Save This Job
Location:Overland Park, KS - OPK Position #:774 DESCRIPTION JOB SUMMARY: The (AR/AP) Specialist - is responsible for auditing incoming Foreign Agent invoices/SOA and processing them for payment. They will research disputed charges and coordinate resolution with the3/28/2015 Overland Park, KS Save This Job
Legal, Finance, Facilities & Admin San Francisco, CA, United States Send Jobvite Accounts Payable Specialist San Francisco-based Zoosk is searching for an Accounts Payable Specialist to join our accounting team. As we continue to grow we seek individuals to join our team to5/29/2015 San Francisco, CA Save This Job
Location:Audubon, PA Job Code:APSCA0215 Description As an Accounts Payable Specialist your responsibilities will include processing high volume vendor invoices, miscellaneous payment requests and employee expense reports. The job requires the individual to be a team player with3/25/2015 Audubon, PA Save This Job
Space Exploration TechnologiesWork to advance the course of human history and pave the way to Mars.SpaceX is a US based advanced technology company founded by residing CEO and CTO, Elon Musk. SpaceX builds rockets and spacecraft from the ground up including cutting edge5/13/2015 Hawthorne, CA Save This Job
Job Type: Contract-to-Hire Location: San Mateo, CA Department: Finance Since 2003, RingCentral has been breaking down the communication barriers created by complex on-premise hardware. RingCentral delivers cloud business communications solutions that frees people to work the4/27/2015 San Mateo, CA Save This Job
Requisition Number15-0044 Post Date1/27/2015 TitleAccounts Payable Clerk CityDenver StateCO Description Envestnet, Inc. (NYSE:ENV) is a leading independent provider of technology-enabled investment and practice management solutions to financial advisors who are independent, as4/26/2015 Denver, CO Save This Job
Location : Eatontown NJ US 07724 % of Travel Required : None Job Type : Student Intern Shift/Hours : First Shift (Day) Career Level : Student (Undergraduate/Graduate) Education : High School or equivalent Skill : Banking/Financial -> Administrative Support Administrative Support4/26/2015 Eatontown, NJ Save This Job
FLSA Classification: Exempt Department: Accounting Location: Palo Alto, CA Reports to: Corporate Controller Summary: The Senior Accounting Manager is responsible for all areas relating to financial reporting. This position currently reports to the Corporate Controller, and will4/13/2015 Palo Alto Save This Job


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This book totally defines your true nature: how to get in touch with it, and be guided in your life through it. Your True Nature is that part of you that is above conditioning, reaction and confusion. It is pure. It is your real potential. To the degree that we can be honest with ourselves, cut the rhetoric and separate our emotions from our truth, is the degree to which we can live authentically and in peace with life.
The cost of separating ourselves from nature is being recognised. The human cost of separating people from what is true and natural within them is becoming unquestionable. Our respect for humanity as a global family means we are returning to respect nature. This is inseparable from the quality of the environment we live in, both internal to ourselves and external in the world at large.
Knowing yourself, your True Nature, is a great contribution to this quest for a better life and a better world. This work invites you to look beyond the conditioning of your culture, your corporation and your family to find what is REAL within you. It invites you to explore your True Nature.
Chris Walker is a leader in the field of personal change through higher consciousness: applying the ancient laws of nature to modern times. With over 30 years helping people change, he writes his books with both the wisdom of the ages and the discipline of well seasoned hands on personal guide. Walker lives in Sydney, Australia but spends much of his life on the road working with clients which include: Indigenous communities, Federal Governments, Fortune 500's and individuals looking for fast, clear conscious change.
Chris spends 3 months of the year working with groups up high in the Himalayas of Nepal. In his writing Walker draws on his MBA and BE as well as numerous qualifications in Eastern arts including: Yoga, Meditation, Shiatsu, Zen, Reiki and others. This is the unique diversity you get in his books; however, Walker's real inspiration is nature. A passionate student of the ancient laws of nature, Chris spends every moment he can outdoors in the wild. This, he believes, is the connection to nature we must all cherish in order to sustain our personal humanity.
This is Chris's 21st book on the Universal Laws of Nature.


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SANDY, Utah— LA Galaxy head coach Bruce Arena spoke to the media after the club's scoreless draw in their Western Conference Semifinal first leg against Real Salt Lake.
(On the physical play…)
ARENA: An ugly game. Lopsided in calls as the fouls were called two to one in our favor. I'm sure not if that is good or bad, but it made for one crappy game, that's for sure.
(On the officiating…)
ARENA: It is what it is. It's been like that all year and it's not going to change for the playoffs.
(On Jaime Penedo and his overall thoughts on the game…)
ARENA: Jaime did well, but it was a sloppy game with the altitude, the wind and the field conditions made for a difficult game. To get out of here scoreless means that we have to lay it on the line next week at home.
(On if he's pleased to head back to StubHub Center needing a win…)
ARENA: We have to win the game. We'll have to find out Sunday night [if it is a good position or not]. We'll see.
(On if the Galaxy have to adjust next week in the second leg…)
ARENA: It was a bad game with the conditions and maybe too many fouls were called. It was just a sloppy game. I think next week the game will look a lot different.
In the latest edition of the Insider Update, I provide a 60 second breakdown the first leg of the Western Conference Semifinal against Real Salt Lake.
Check it out.
CARSON, Calif. -- Real Salt Lake knocked the LA Galaxy out of the postseason in 2013 and the memory of that playoff exit remains with the club.
In the latest edition of the LA Galaxy Insider Breakdown, I look at the three reasons that the Galaxy will be ale to overturn the result.
Check it out above.
CARSON, Calif. –The addition of Los Angeles Football Club to MLS in 2017 may not change much for LA Galaxy club president Chris Klein, but LA's players admit that they hope a new rivalry will be born in Southern California.
After the dissolution of Chivas USA earlier this week, MLS unveiled the powerhouse ownership group of LAFC—a "working title" and not the team's official name—at a press conference along Sunset Boulevard on Thursday. The group included many of the same faces that took ownership of the Dodgers several years earlier including Lakers great Ervin "Magic" Johnson.
While not much is known about what the team once they finally take the field in two years, Galaxy captain Robbie Keane said that he was excited to see the club join MLS.
"I think it will be exciting. What I will say about Chivas is that when you're around the dressing room and locker room and you see these guys walking and people in the background, unfortunately they've lost their jobs, you know? For me it's a shame," said Keane. "Maybe the league could do something about that. But I think it's exciting for the league. I'm sure if they get a new team, whatever they call it, it'll get more [players] that want to come here. I'm excited about it.
"I think it's good though because we need a fierce rivalry. If you look at Seattle and Portland, they're good rivalries. With Chivas, I wouldn't really call that a rivalry, to be honest with you," he added. "We were in the same building, but with the declared attendance what they had … I'm used to playing these derby games where you had 60,000 people throwing abuse at each other, which is good in a friendly way. We didn't really have that hear, hopefully we can have that with the new team.
Landon Donovan agreed that the addition of LAFC in 2017 will only enrich the local soccer landscape.
"I think it's great. This city, when Chivas were good, it made this rivalry good and made it special for everyone," Donovan said. "Obviously they've had a tough time with a lot of different things over the years, but I think having a chance to have new ownership obviously a new brand and a new team is fantastic for this market. I think it can only bring positives."
LA Galaxy II's season is over, but Los Dos continued their offseason by picking up a 3-1 victory over the U.S. Under-18 squad at StubHub Center on Thursday.
Chandler Hoffman, Alejandro Covarrubias and Jaime Villarreal scored for Los Dos while San Jose Earthquakes Academy Amir Bashti.
Four Galaxy Academy players played for the U.S. U-18's: forward Adrian Vera, center back B.J. O'hara, goalkeeper Bennett Sneddon and forward Rob Knights.
CARSON, Calif. -- Robbie Keane says that he's ready to go for Saturday's match against Real Salt Lake after missing out on the LA Galaxy's regular season finale last week.
Keane told reporters on Friday that a hamstring strain prevented him from taking part in LA's 2-0 defeat to Seattle Sounders FC, but admitted that he expects to be fit in time for the first leg of Western Conference Semifinal against Real Salt Lake on Saturday.
"I trained last couple of days and my hamstring seems okay. Obviously I would have played. I think [people] know me well enough now to know that I will not to stay out of games unless it's legit," said Keane. "I should be okay for Saturday."
Head coach Bruce Arena echoed Keane's optimism stating that the Irishman has no intention of missing out on the playoff game.
"Robbie could play if he had a broken leg," Arena joked. "It was just precaution to hold him out. Come to think of it, I wouldn't say he could play with a broken leg, but he would try anyway."
Having Keane back in the squad is a major boost for the Galaxy after a frustrating performance against Seattle that saw LA dominate in shots, but fail to find the back of the net. And with the captain back to full fitness -- plus Omar Gonzalez returning from suspension -- the Irishman believes that the Galaxy are well-equipped to make a deep playoff run.
"I think we're more prepared [than 2013]," said Keane. "[We have a] better squad of players, more experienced players who understand how the playoffs go."
The LA Galaxy will have some competition for Los Angeles in two years.
On Thursday, MLS unveiled "Los Angeles Football Club" which will join MLS for the 2017 season. The move comes just days after the league officially disbanded Chivas USA.
Watch the press conference above.
CARSON, Calif. –The Swedish soccer world was shaken on Wednesday with the announcement of the passing of former national team star and Elfsborg head coach Klas Ingesson due to bone marrow cancer.
A member of Sweden's teams at the 1990 FIFA World Cup and the 1994 team that finished third, Ingesson enjoyed a lengthy professional career that included stops at IFK Göteborg (Sweden), Mechelen (Belgium), PSV Eindhoven (Netherlands), Sheffield Wednesday (England), Marseille (France) as well as IBari, Bologna and Lecce (Italy).
Despite being diagnosed with multiple myeloma in 2009, Ingesson continued his coaching career and in 2013, he coached Stefan Ishizaki in what was the current Galaxy midfielder's final season in Sweden.
"When anyone passes away it is a terrible thing but it hurts more when you're so close to that person," Ishizaki told reporters on Wednesday. "Klas was a fantastic human being, a fantastic player back in the day and a great coach.
"He was one of those men that spread joy around him, always had a happy face, and had a keen soccer mind. He was one of the true greats in Swedish soccer over the years and he'll be missed."
When Ishizaki was first approached by the Galaxy back in 2013, it was Ingesson who allowed the midfielder—a long tenured member of the club—to speak with LA and eventually orchestrate a move to MLS.
"I talked to him last year and sought his advice. Of course, he wanted me to stay with Elfsborg and help rebuild the squad for a new year, but he said, 'I understand that you have to go and do your own thing.'
"He allowed me to take this adventure to join MLS and I will be forever grateful for him allowing me to leave," he continued. "A lot of coaches come into their first full season and want to build a new team and many of them would have said that 'you can't go.' But he gave me this opportunity to come to MLS and I'll be forever grateful."


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So, I'm in search of a chiropractor and have not been to one in ages. Any advice on what to look for? I have a hard time trusting that particular field, as it makes me nervous that with one quick move my neck could be broken.
So, I'm in search of a chiropractor and have not been to one in ages. Any advice on what to look for? I have a hard time trusting that particular field, as it makes me nervous that with one quick move my neck could be broken.
I've only been to one and was referred by my mother! She was referred by her hairdresser.
Who do you know that you could ask? And make an appointment for a brief interview, not a treatment, so you know his/her treatment philosophy.
Leu goes to a traditional "bone crusher" chiropractor. Mine uses a Thompson something-or-other table for most adjustments, which is much gentler. He also uses traditional chiropractic techniques for some adjustments--it just depends on the patient's needs.
It's times like these that I wish I drank coffee. My brain needs a jump start this morning and water just isn't cutting it!
I think i found some one. You know, I haven't been in ages, so the price seems to have gone up drastically, but that could also be due to living near a bigger city.
I found them on a spine physician website and they are part of the American Academy of Spine Physicians. Not that that means much to me.
The office visit for my chiropractor has increased about $10 over the past 10 years--most of it during the past five years. It was $38 for OOP for my last batch of adjustments. Think of it as an all-inclusive price: one visit includes as many adjustments as are necessary. :)
Is that with insurance?
I asked what a normal visit costs here and they said close to $200. I found an internet special coupon that will bring the price to $75. That just seems like a lot. Maybe it's the first visit stuff.
With insurance my guy charges my $30 copay but without insurance he only charges $39.
Ducky I think maybe that is for a first-time analysis. I hope for you anyway!
The best part about my Chiro is he is TOTALLY into WDW and even wears Disney scrubs. He talks the whole time about where we've been since our last visit and he really gets DH excited about WDW so I don't mind when DH says he needs an adjustment!
xxoo Rosie
Let's hope so. Thanks for the insight. I will be happy to eventually be working again and have health insurance.
The $38 is OOP without insurance. My insurance only covers contracted chiropractors--and mine isn't contracted with them. But I refuse to switch!Originally Posted by foreverducky, post: 74932
The $200 should be for the initial visit. Mine took a lot of x-rays and still works from them, so it's been a one-time expense for me. Some probably take periodic x-rays, depending on the patient and issues.
Before you commit, ask the price of a regular office visit.


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God's Undertaker: Has Science Buried God?Paperback
Free delivery worldwide
Dispatched in 2 business days
When will my order arrive?
- Publisher: Lion Books
- Format: Paperback | 226 pages
- Dimensions: 138mm x 214mm x 12mm | 220g
- Publication date: 1 September 2009
- Publication City/Country: Oxford
- Edition statement: New Updated ed.
- Illustrations note: black & white illustrations
- Sales rank: 7,423
Product description
If we are to believe many modern commentators, science has squeezed God into a corner, killed and then buried him with its all-embracing explanations. Atheism, we are told, is the only intellectually tenable position, and any attempt to reintroduce God is likely to impede the progress of science. In this stimulating and thought-provoking book, John Lennox invites us to consider such claims very carefully. Is it really true, he asks, that everything in science points towards atheism? Could it be possible that theism sits more comfortably with science than atheism? Has science buried God or not? Now updated and expanded, God's Undertaker is an invaluable contribution to the debate about science's relationship to religion.
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Author information
John Lennox is Professor of Mathematics at the University of Oxford and Fellow in Mathematics and Philosophy of Science at Green Templeton College. He lectures on Faith and Science for the Oxford Centre for Christian Apologetics. He has lectured in many universities around the world, including Austria and the former Soviet Union. He is particularly interested in the interface of Science, Philosophy and Theology. Lennox has been part of numerous public debates defending the Christian faith. He debated Richard Dawkins on "The God Delusion" in the University of Alabama (2007) and on "Has Science buried God?" in the Oxford Museum of Natural History (2008). He has also debated Christopher Hitchens on the New Atheism (Edinburgh Festival, 2008) and the question of "Is God Great?" (Samford University, 2010), as well as Peter Singer on the topic of "Is there a God?" (Melbourne, 2011). John is the author of a number of books on the relations of science, religion and ethics. He and his wife Sally live near Oxford.
Review quote
"A brilliantly argued re-evaluation of the relation of science and religion, casting welcome new light on today's major debates. A must-read for all reflecting on the greatest questions of life." --Alister McGrath, author, "Glimpsing the Face of God"
Table of contents
Chapters: *War of the worldviews *The scope and limits of science *Reduction, reduction, reduction... *Designer universe? *Designer biosphere? *The nature and scope of evolution *The origin of life *The genetic code and its origin *Matters of information *The monkey machine *The origin of information


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Comment: Re:So... (Score 1) 550
by ortcutt (#22637954) Attached to: Daylight Saving Time Wastes Energy
Article 1, Section 8
Our Founders realized that establishing conventional standards was a core governmental activity. If you don't like the local time that is our government established, you are free to ignore it. See how far that gets you.The Congress shall have Power... To coin Money, regulate the Value thereof, and of foreign Coin, and fix the Standard of Weights and Measures;


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Mining blast: 3 dead, more casualties feared
More News from Jonas Cabiles Soltes
PARACALE, Camarines Norte—There is a mining disaster in this town but authorities cannot yet determine its magnitude because no miner wants to speak.
On Wednesday night, the Camarines Norte police confirmed the death of at least three small-scale miners.
But the local government on Thursday expressed fear that the number of casualties could be higher as at least seven mining pits had been flooded by seawater after a blasting accident on Wednesday.
The accident happened in a seaside village of Palanas, just 2 kilometers from the town proper, where at least 100 mining pits are located. Some exceed depths of 20 meters.
Senen Inocalla, administrative officer and aide of Paracale Mayor Romeo Moreno, said officials received a report that a dynamite blast in one of the pits in Palanas on Tuesday punctured at least seven pits and brought seawater rushing into them.
Senen said no body has yet been found, however. She said the mayor kept watch during retrieval operations on Wednesday. They continued until yesterday.
According to Senen, miners themselves were conducting the retrieval operations. Miners who dived into the pits in search of bodies said pieces of debris, including ores in sacks and pieces of wood, were blocking the entrances to the pits, making the search more difficult.
Senen said the municipal government sought help from the regional civil defense office of Bicol. Expert divers are needed, she said.
"No miner here would speak," said Senen. She said officials are not discounting the possibility that there could be more casualties.
One of the mining pits was already stinking on Thursday afternoon and flies were all over the place.
As of yesterday, many of the pits are still under water. Senen said the municipal government had recommended the dismantling of the mining pits.
Camarines Norte Gov. Edgardo Tallado in a previous interview said that while he discouraged unlicensed small-scale mining in Paracale, there was virtually nothing he could do about it.
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6:35 am
Mon December 16, 2013
Oklahoma Inmate Wants His Death Penalty Commuted
OKLAHOMA CITY (AP) — An Oklahoma death row inmate scheduled to be executed next month wants the state Pardon and Parole Board to commute his death sentence.
A clemency hearing is scheduled Monday for 38-year-old Michael Lee Wilson, who was convicted of first-degree murder in the beating death of a Tulsa convenience store manager. Wilson's execution is set for Jan. 9.
Wilson wants the board to commute his sentence to life in prison.
Wilson was one of four men found guilty in the Feb. 26, 1995, beating death of 30-year-old Richard Yost. Yost was found bound and beaten on the floor of the convenience store's cooler. Authorities say he was struck dozens of times with a baseball bat.
Two co-defendants have been executed for the crime. The fourth was sentenced to life in prison.


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Demoncy Lyrics
(1-32 of 32 song lyrics)
Selected popular Demoncy song of Wednesday, June 3 2015 is "Final Battle For Our Once Glorious Midgard".
Submit Lyrics
Top Demoncy Albums
click on the album covers to see the lyrics inside the album
Enthroned Is the Night
Joined In Darkness
Related Demoncy Links
Demoncy wiki
Demoncy twitter
Knighthood Of The Moonlit Realm lyrics
Final Battle For Our Once Glorious Midgard lyrics
The Dawn Of Eternal Damnation lyrics
Commencement Of The Dark Crusades lyrics
Denial Of The Holy Paradise lyrics
In Winters Ancient Slumber lyrics
Blood Moon Of Naingoroth lyrics
Rebirth By Moonlight lyrics
The Eternal Winter Shall Never Fade lyrics
Abysmal Shores Of The Darklands Beyond The Sun lyrics
Sepulchral Wispers lyrics
Shadows Of Tthe Moon (the Winter Solstice) lyrics
Winter Bliss lyrics
Hypocrisy Of The Accused Heavens lyrics
Spawn Of The Ancient Summoning lyrics
Into The Twilight Mists lyrics
Joined In Darkness lyrics
Angel Of Dark Shadows lyrics
The Darkbringer lyrics
The Obsidian Age Of Ice lyrics
The Ode To Eternal Darkness lyrics
Night Song lyrics
Risen From The Ancient Ruins lyrics
Full Moon Twilight lyrics
Ascension Of A Star Long Since Fallen lyrics
Empire Of The Fallen Angel lyrics
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My Kingdom Enshrouded In Necromantical Fog lyrics
Within The Sylvan Realms Of Frost lyrics
Hidden Path To The Forest Beyond lyrics
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Related Information for Demoncy
USA Black Metal band spawned by Ixithra (Profane Grace, Mysterian, Raven's Bane) in 1988. Currently signed to Forever Plagued Records. Discography: Impure Blessings (Dark Angel of the Four Wings) Demo, 1991 Faustian Dawn Demo, 1993 Commencement of the Dark Crusades Demo, 1996 Within the Sylvan Realms of Frost Full-length, 1999 Joined in Darkness Full-length, 1999 Faustian Dawn / Within the Sylvan Realms of Frost Best of/Compilation, 2002 Performing Live (Indianapolis, 07.15...
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Yueyang Featured Food:
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Junshan Yinzhen tea is the famous tea of Yueyang. Cook fresh chicken with Yinzhen tea can keep the tender of chicken while create the faint scent of tea.
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Yes, but only in very limited circumstances. You only have to prove you have 1 year's tuition fees and £1,640 (i.e. living costs for 2 months) if:
Please note that if your visa has expired on the date of your new visa application you will not benefit from this reduction.
- How much money do I need to show for my student visa?
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You can now invite anyone to meet at your favorite Starbucks.
Limited-time feature
38 year old man | Humble, TX, USA | Seeking women 28-35 within 50 miles
Active within 24 hours
Don't blame me. I voted for Romney!
It may be kind of cliche to say that i'm laid back and the genuine southern gentleman but that's the truth. I love God and my family and i'm looking to meet people of the same demeaner and ideals. There is only so much that can be said here so hopefully I'll get a chance to talk more one on one. I used to think that being dorky and nerdy as a little kid was a bad thing. However as I've grown and matured I've learned that it's the dorky and nerdy quirks that really highlight our personalities and give everyone a look into who we really are once the veil is removed. I like to surround myself with people that are comfortable in their own skin and don't have to put on a show to make themselves the center of attention. I've also become sort of a gym rat lately. Not so much for the egotistical aspect but because as I've gotten older I've started to take more seriously the health aspect of life. I enjoy being able to do things now that I couldn't do a year or so ago. I've gotten much better at healthy eating and I try to live a fairly active lifestyle. What matters most to me now are the little things that tend to get overlooked so easily. I love getting that phone call from my family (I know, kinda dorky) and hearing that they are doing well as well as talking with my little nephew. I don't have any kids myself yet but from interacting with the little ones in my family I know that I do want them. Ok well that's it for now. I hope there are some amazing people on here that hopefully have some of the same interests.
Alumni connections , Cooking , Dining out , Gardening/Landscaping , Hobbies and crafts , Movies/Videos , Music and concerts , Exploring new areas , Playing cards , Playing sports , Political interests , Religion/Spiritual , Travel/Sightseeing , Video games , Watching sports
Baseball, Basketball, Billiards / Pool, Bowling, Football, Golf, Hockey, Running, Swimming, Tennis / Racquet sports, Walking / Hiking, Weights / Machines
I exercise 3-4 times per week.
I like Dogs, Fish
Don't go out a ton but I love finding little small eateries or the other unknown treasures throughout the city.
The University of Alabama, Tuscaloosa, AL
Favorite things... ok. Music- Dave Matthews, TV Show- Firefly, Movie- Tombstone maybe. I used to live in Lake Tahoe and would love to be able to travel more and that would be at the top of the list.
Outdoor activities such as disc golf, golf, floating the river, etc. I'm over the whole bar scene and would be much more comfortable with a good movie on the big screen and a fire in the fireplace (even though it's always hot here).
Hmmm, it's been a while. Any suggestions?
Z{{Cta}} {{#if HasMoreInfo}} ?{{CtaSecondary}} {{/if}}
|What he is looking for
|6'1" (185cms)
|5'1" (154cms) to 5'9" (175cms)
|Body type:
|Athletic and toned
|Slender, Athletic and toned
|No preference
|Dark brown
|No preference
|No Way
|No Way
|Social Drinker
|Social Drinker, Moderately
|Other profession
|No preference
|$50,001 to $75,000
|$25,001 to $35,000, $35,001 to $50,000, $50,001 to $75,000, $75,001 to $100,000, $100,001 to $150,000, $150,001+
|Never Married
|Never Married, Currently Separated, Divorced
|Have kids:
|Wants kids:
|Definitely, Someday
|White / Caucasian
|Latino / Hispanic, White / Caucasian
|Christian / Other
|Christian / Catholic, Christian / LDS, Christian / Protestant, Christian / Other
|Bachelors degree
|Some college, Associates degree, Bachelors degree, Graduate degree, PhD / Post Doctoral


text:
Mon-Fri: 7am-1am EST / Sat-Sun: 7am-11pm EST
ApplianceKenmore Range
Level of DifficultyEasy
Time to do repairLess than 15 mins
Age of ApplianceMore than 10 years
1 out of 2 people found this instruction helpful
First I removed the two screws that hold the element in place, I then pulled the element out about three inches, and it shorted out on the main panel of the back of the range. I then went to the breaker box and flipped the switch so I could tell my wife "Yes, I had turned the power off."Disconnecting the two wires and reconnecting them was a simple operation after I cleaned my pants from the electrical short.Re attaching the two-screw panes to hold the element in place finished the project.
Help other customers find the most helpful instructions.
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Part Number: PS249247
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Victoria Beer: Mexico's Best-Kept Secret Debuts
Victoria beer, touted as "Mexico's best-kept secret," makes it debut in Texas today, months after its first stateside release in Chicago. While publicists call its Illinois launch "successful," Chicago brewhounds are slightly less enthusiastic.
"I hadn't heard of Victoria beer before your mention of it," the Chicago Beer Society's president Glenn Rice e-mailed in response to my inquiry about its reception. "Maybe it is a well-kept secret in Chicago as well."
So perhaps Victoria hasn't yet cracked the beer aficionado market. But it's immensely popular with immigrants from Mexico, where the beer's been sold since 1865. Described as "a Vienna-style lager beer that combines a unique copper color with a perfectly balanced taste and a smooth, crisp finish," Victoria was available only on the black market until this year.
"Sometimes Mexican groceries have a few bottles stashed away and sell them at exorbitant prices when someone has a birthday etc.," a poster on Chowhound's Outer Boroughs board wrote in a 2009 comment. "It is good beer."
According to a press release, Victoria will be sold in Dallas "at select on- and off-premise retail accounts targeted to both Hispanic and General Market beer consumers." A "Find Victoria" website has not yet been updated to include Texas locations, but the company's sure fans will track down the brew.
"We believe the authentic history combined with Victoria's distinct flavor will drive long-term appeal and position us for instant success," a release quotes Bill Hackett, president of Crown Imports, Texas, as saying.
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Illinois Public Media
All articles tagged Lifestyle
Fewer Arrests and Citations For Unofficial St Patrick's Day
Champaign Starts Up Minor League Baseball Exploratory Committee
Author Wes Moore Talks About Meeting the Other Wes Moore
Dress Code a Possibility in Some Danville Schools this Fall
Champaign Sesquicentennial Celebration Ends with Thursday Night Bash
State Budget Cuts May Hit Immigrant Assistance Hard
News-Gazette to Run Civil Union Announcements
Same-Sex Couples Can Now Get Civil Union Licenses in Illinois
U of I Professor's Study Links Obesity to Surge in Vehicle Use
East Central Illinois Doesn't Follow Trend in Annual County Health Rankings
Maple Syrup Fair Time in Parke County, Indiana
Justice Dept. Drops Defense Of Anti-Gay Marriage Law
Winter War Gaming Convention Opens in Champaign
Report on Civic Engagement Says Illinoisans are Faring Poorly
Legislation Seeks to Extend Immigration Rights to Same-Sex Couples
Compromise Sought in Dispute Between Champaign Library and Tolono, Mahomet Libraries
New Center in Rantoul Serves as a Resource for Migrants
Urbana is Named Officially Bicycle-Friendly
U of I Religion Professor Is Dismissed For Views On Catholicism
WILL Highlights
Brian Moline named WILL 'Morning Edition' host
Longtime WDWS sports and talk host will join WILL Radio staff on June 1.
Concussions more likely in practices than games
Parents worry about a child getting a concussion in the heat of competition, but they also need to be thinking about what happens during practices.
Ken Burns' 'The Civil War' returns to PBS Sept. 7
Award-winning series is newly restored in high-definition to air 25 years after original broadcast.


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Héctor Ramos
almost 3 years ago
Héctor Ramos
almost 3 years ago
The Parse JavaScript SDK should work fine with jQuery Mobile. We don't yet have any jQuery Mobile-specific documentation, but you have two options:
You can ignore the whole Backbone aspect of the Parse SDK and just use the classes we provide in your app in whichever way you prefer. You don't have to use routers and collections and all that just to use Parse. You can follow our Developer Guide, which will show you how to simply create and save objects to our servers.
Or, you can build your jQuery Mobile app using Backbone, but replace Backbone.Model with Parse.Object, Backbone.Collection with Parse.Collection, etc. There is a third-party tutorial that walks you through the Backbone part, and we have a guide for converting an existing Backbone app to use Parse.