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Family Practitioner, Primary Care Doctor
25 years of experience
25 years of experience
Woodward Park
7300 N Fresno St
Fresno, CA 93720 Phone number & directions
7300 N Fresno St
Fresno, CA 93720 Phone number & directions
License & Identifications
A medical license is required for a doctor to practice medicine in a particular state. Requirements vary by state but most require, at a minimum, post-graduate training in the doctor's specific specialty. An NPI number is a national identifier unique to an individual health care provider and is managed by the Center for Medicare & Medicaid Services (CMS).
Learn more about Dr. John Pia:
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Patient Reviews
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Specialties & Research
Dr. John Pia, MD is board certified in Family Medicine.
Education & Awards
Dr. Pia graduated from University of California at San Diego, La Jolla.
Dr. Pia has 2 hospital affiliations:
- Kaiser Foundation Hospital - Fresno
- Fresno Medical Center
Home > Find a Family Doctor > CA > Fresno Family Physicians > Dr. John Pia, MD
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- Additional Information
- Dr. John Michael Pia MD is a male Family Practitioner, has 25 years of experience and practices in Family Medicine.
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- Dr. John Pia has 1 office location.
Dr. John Pia practices Family Medicine near Fresno, CA.
See Fresno Family Physicians.


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Intimacies: Revelations: It hit me that living with a woman was a genuine alternative. It was absolutely terrifying
The time: Early Eighties The place: Manchester The person: Val McDermid, crime-writer and winner of the Golden Dagger award.
Val McDermid
Val McDermid is a Scottish crime writer
Wednesday 05 November 1997
It was complicated because for adolescent girls the reality of your emotional relationships lie in your female friendships. You might go out with a lad on Saturday night, but it's not real until you've discussed it in double Latin on a Monday morning. I thought we all felt intensely about our female friends, but it was just something you didn't talk about - like periods.
The first consciously public lesbian thing that I came across was The Well of Loneliness. That depressed me beyond belief. I thought: "I don't want to be a man, wear men's suits, be called Stephen, and I certainly don't want to slash my wrists. I can't possibly be a lesbian."
At university, I discovered the feminist movement and was exposed to real lesbians. I had a tutorial partner from another college in my second year at Oxford. She lived with another woman and didn't have a problem with it. That's when it hit me that this was a genuine alternative and one that felt extremely desirable. It was absolutely terrifying, I didn't know what to do. Where do you go, who do you speak to?
What clarified it all for me was falling in love with someone who fell in love with me. It made all the wondering and fear irrelevant. It was still scary, but at least we were in it together.
I didn't know how my friends would react. I'd read horror stories of people who came out and lost their friends, and I didn't even know how to start to explain. But being in love you walk around with a stupid grin on your face. You think you're being dead subtle; however, you're never out of each other's company and you sit and stare at each other across the table in the library when you're supposed to be working. Yet you're astonished that people notice! The first person I really came out to said: "Yes, so what, I knew."
Only one friend recoiled in horror. It really damaged out friendship. For another 12 years we didn't have any contact. We'd been very close and I think she felt threatened.
Telling my parents was a gradual process of getting them used to the fact that I was living with a woman. It was more acknowledged than spoken about.
I found it almost impossible to speak directly to my father. Fathers and daughters have a problem in this area. He'd listened to my lesbian play on the radio, but died before my lesbian crime novel was published. There was no hostility to my girlfriends, but actually talking about it was something he would have found very, very difficult. There was no pattern for emotional discourse in our family. It was all very buttoned up, Scottish and Presbyterian.
His death liberated me to be much more open with my mother. Now she is relaxed going on holiday with my partner's mother. Yet it is still difficult for my mother and I to say that we love each other. There's just an occasional embarrassed mumble at the end of a phone call.
I worked for The People newspaper, and tabloids are not noted for their liberal views on anybody's sex life - beyond it's all right to screw everything in sight if you're a man. It's more difficult for a woman in that kind of environment anyway. In 1979 there were 137 journalists working for the Mirror Group in Manchester and only two of us were women. I constantly had to demonstrate that I could do the job. It was hard enough being a woman, let alone a lesbian.
The assumption in the workplace is that everybody is straight, and people talk about what they did at the weekend with this easy assumption that everybody else is straight. It's very hard to find a point, without making it an issue, to be out. You have to ask how it will affect your relationship with the person who sits at the next desk who's a raging bigot - or your boss who's also a raging bigot. So for me, coming out at work was a gradual process. As I got to know them and they got to know me and they slowly developed a respect for me professionally, I let it be clear that the person I lived with was a woman.
There was an element who thought: "She's a tough ball-breaking woman, so she must be a dyke." I found the insecurity of the macho men amusing more than anything. I was confident of myself professionally and in my relationship, so that made it easier. If I was having problems it would have been very difficult.
I felt that the price of being out was far less than the price of the closet and what that would have done to my dignity and integrity. Hiding is not a grown-up thing to do.
However, I get annoyed about being described as a lesbian novelist. I am inevitably, to some extent, representative of my community, but I am an individual too. I was accused of selling out when I created my heterosexual heroine - Kate Brannigan. These people did not understand the commercial imperatives of the marketplace and the necessity of writers to eat. My local bookshop sells five times as many copies of my Lindsay Gordons [lesbian amateur sleuth] from the crime section shelves as they do from the gay and lesbian section. I forced myself out of the ghetto.
Because I am in the public arena, people know I am a lesbian before they shake my hand. Sometimes I wish it was not the first thing they knew about me, because they make judgements that are often based just on having seen Oranges Are Not the Only Fruit on the TV. I think: "Hang on, I'm probably much more like you than not like you."
I have heard it said that lesbians make crime writers because in the conventions of a crime novel, the detective is in some way an outsider. For much of our growing-up period, adolescence and young adulthood, the experience of being an outsider has been very strong. Particularly woman of my generation understand what it is to feel like a freak who doesn't belong. I suspect this is something I draw on when I write about the hunter, who is outside the rest of society because we turn to them to save us, and the hunted who by their anti-social behaviour are excluded.
I want to carry on writing books with both heterosexual and homosexual protagonists because I want my writing to reflect the world I live in and not just one corner of it. I certainly don't think of myself as an "ism". My partner has a very affectionate tendency to prick my balloon from time to time and remind me of who I am and where I come from. We have a standing joke in our house: "You're not an international lesbian cultural icon here!"
Interview by Andrew G Marshall
Val McDermid's new book is `The Wire in the Blood', published on 6 November by Harper Collins (pounds l6.99).
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subset: commoncrawl


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Premium quality with a touch of class, that is the broad description of this particular brand of saddle. Showman saddles have been making affordable, top quality western saddles since 2001. Showman are mainly known for their renowned range of stunning show saddles. These beautiful saddles have created a massive following from horse lovers of all ages due to their unique carved leatherwork and intricately crafted silver accents and not to mention their affordable price. Showman saddles are produced to accomodate today's many different riding styles and their saddles are individualy produced for each market such as roping saddles, pleasure saddles, barrel saddles, cutting and reining saddles and also their hugely popular show saddles.
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Holiday Emotions can Fuel Creativity
* As the holiday season and year end approach, some of us can experience all kinds of heightened emotions. Mixed with the joyful anticipation of festivities and gatherings of friends and family can come sad thoughts about a myriad of disappointments and losses.
In my own experience, embracing my deep emotions and subsequent reactions has resulted in a wide range of creative benefits that include articles, artwork, television shows, podcasts, books and poetry.
I believe that if we identify our feelings and reactions–and if we explore the reasons for them–we can turn our insights into opportunities that fuel raw creativity. As example, without self-editing (at least in first drafts), I fired off "Just Let me F***n Dance!" a few days after taking my teenagers to a holiday concert where, embarrassed, they kept whispering to me to sit down. Reading that particular item of poetry to audiences inspired the most wonderful discussions among participants who were moved to share their own stories. Can you imagine the conversation with my late, beloved 90 year old mother-in-law about the poem's title? I love to share that, too, because its description has become a piece of comedy on its own.
So, as the holiday season approaches, let's welcome the depths of our emotions. Let's mine our reactions and express them. Let's use our insights as springboards for infinite creativity. Let our feelings fuel the development of music, plays, movies, poetry, dances, performances, paintings, sculptures, pottery and quilts. As I see it, powerful reactions can lead to exceptionally powerful creativity.
Creativity consultant Nellie Jacobs is an artist and author whose revised e-book edition of Grading the Teacher-a best-seller first published by Penguin Books-is now available in most e-reader formats (Kindle: http://www.amazon.com/dp/B00K1OKH4O & Kobo: http://store.kobobooks.com/en-CA/ebook/grading-the-teacher). Website: http://www.nelliejacobs.com
Grading the Teacher is now an E-book specially reduced
Are you a parent with school-age children?
Are you a teacher at any level?
You may be interested in "Grading the Teacher: A Parent/Teacher Guide, reduced next week to $.99.
Follow the links for details>http://gradingtheteacher.com/2014/05/31/grading-the-teacher-only-99-cents-june-4th/
Keeping Motivated and Completing Projects
Ever since leaving the formal "job" of elementary school teacher in the 70's to become a stay-at-home mom, I have developed all kinds of non-traditional creative initiatives.
Some suggestions I practice to keep myself motivated and complete projects may be useful to you:
- Infuse your working space with inspiring quotes, photos, posters, music, or knick-knacks:
Imagination will often carry us to worlds that never were.
But without it we go nowhere.
Carl Sagan
- It's so easy to dwell on failures, so make a point to emphasize your accomplishments. Find a place to proudly display examples of your own creativity. Refer to it as often, especially when you are feeling frustrated and "down".
- Set reasonable short and long term goals. Work towards them, follow through – and reward yourself when you achieve the difficult ones.
- If something doesn't work or presents a significant challenge, think why and then brainstorm how to turn it around and open your mind to 50 possibilities and opportunities.
- Hook up with some encouraging creative thinkers who will not only motivate you and one other but also will make you feel safe to explore your ideas.
- Let one thing lead to another. Here is how I have throughout my adult life: http://www.ignitingimagination.com/creativityconsultant.html
What do you do to keep yourself motivated and complete your projects?
Creativity consultant Nellie Jacobs is a Canadian award-winning artist and best-selling author whose creative initiatives-incorporating all the above suggestions-have been featured for decades by major national, regional and local media across the country. For more about Nellie's books, artwork, workshops and upcoming events, visit her website at http://www.ignitingimagination.com
Promoting Creativity
I wrote the following post for Creativity Calling, the March 2014 issue of the Creativity Coaching Association (CCA) newsletter:
It's one thing to be chomping at the bit, ready-finally-to inspire and change the world; it's quite another to let the world know you exist. These days, with a bit of imagination anyone engaged in the creativity field is in a terrific position to promote themselves and their creative passion. Countless platforms and websites offer simple tools to help you grow your network and achieve your goals.
If you haven't already done so, for very little time, money and research, you can start a blog or send out an e-newsletter to your network. (If it's too difficult to maintain regular postings, invite guests to contribute articles, or offer to write your own for other people's blogs.) Pitch editors of traditional or online publications with an idea for a regular daily, weekly or monthly column. (Have some samples ready for submission). Consider writing and self-publishing a short e-book that might, for instance, offer a step-by-step guide to your insights, experiences, or expertise. Speaking of specialties, prepare a course to teach in-person or online. Initiate and lead supportive groups. Post comments and share links on social media. Conduct interviews of creative individuals on a podcast series-or offer yourself as a well-informed talk show guest.
Creativity has become the buzz word used in ads, articles and media headlines around the world. The trick is to produce a 'hook' for a press release that will lead to a feature story. Plan events relating to current events or holidays. Identify a pressing public concern, its creative solution-and then act on it. As example, after internationally renowned creativity specialist Marci Segal read a 2001 newspaper banner that said creativity was in crisis, she was moved to establish World Creativity and Innovation Week April 15 (Leonardo da Vinci's birthday) to 21. Through networking and media coverage, WCIW is now celebrated in more than 40 countries worldwide!
Here's an idea to promote creativity AND yourself immediately. Use WCIW as a newsworthy reason to go out into the community to encourage individuals and groups to do something special to celebrate creativity. Approach businesses, schools, recreation centers, clubs, and public institutions to establish partnerships or guide creative projects. For great ideas, explore http://worldcreativity.wordpress.com. Add to the list!
Creativity consultant Nellie Jacobs is a Canadian award-winning artist and best-selling author whose creative initiatives-incorporating all the above suggestions-have been featured for decades by major national, regional and local media across the country. For more about Nellie's books, artwork, workshops and upcoming events, visit her website at http://www.ignitingimagination.com
What Price Friendship?
What you are about to read in the next paragraph is absolutely true. This conversation really happened. It puts a whole new perspective on friendship.
A friend (for this story, she's Mary) called the other day to tell me about her recent, bizarre experience. Since she was feeling increasingly uncomfortable with their interactions, she ended an 18-month friendship. Soon afterwards, Mary received an invoice for $8,500 from that ex-girlfriend for 'professional services' that included time spent during their telephone conversations and get-togethers.
After her initial shock, Mary picked herself off the floor and discussed the situation with her lawyer. They concluded there's no legal ground for this bill because there was never a verbal or written contract. Mary swears all their conversations were as friends: they each helped each other out.
Mary and I both agreed that true friendship represents a give and take relationship. In conversations, one person listens, the other responds. Then roles are reversed. Imagine the implications if we charged for countless hours spent listening to a friend in need of our ear, opinions, and well-meaning advice.
How do we settle on a fee? Is it dependent on our age, experiences, or the length or depth of friendship? Who decides that? Do we charge a professional therapist's fee for 45-50 minute sessions and bill extra if discussions go over the allotted time? Do we invoice after each conversation or weekly, bi-monthly or yearly? Do we add long-distance calls or travel costs? Perhaps we should consent to a contra: I'll give you this time if you give me back equal time. If so and the actual time, advice, or number of questions isn't equal, how might that resolved?
If you think about it, the ramifications could be far-reaching.
Getting back to my conversation with Mary, I offered her this insight: "Let me tell you something," I said. "Your problem is that you care too much."
"What do you mean?" asked Mary. "That's who I am. How can I care less?" A life-long journalist who is used to digging for facts, researching, and coming up with conclusions and solutions, Mary is also over-the-top passionate about expressing her feelings and opinions. I suspect her ex-friend was distraught about losing their connection – or she decided to invoice all her 'friends' hoping they would either cover the cost of her impending divorce or support her in her single afterlife.
"Well, then," I responded, "maybe you should hand out a detailed friendship questionnaire in advance to each potential candidate. If you don't have time, I'm happy to create one for you. Tally the results. Then decide if you really do want to develop a closer bond. If you do, then you might think about negotiating a friendship contract at the beginning of the relationship, similar to a pre-nuptial agreement."
There was silence at the other end of the phone as Mary digested this incredible idea.
"And for spending time with you offering this very good advice," I went on, "I'll be sending you a bill for $50."
Mary didn't laugh. I think my friendship is really quite cheap, considering. What do you think?
Would you do this as, or to, a friend? What are your experiences?
Creatively Yours,
Best selling author Jacobs has chosen to designate every November 1st as International Acknowledgment and Appreciation Day (IAAD). For more details, visit: https://nelliejacobs.wordpress.com/2009/01/29/international-appreciation-and-acknowledgement-day-iaad-november-1/
Are you member or facilitator of a book club, study group, organization, educational institution or workplace?
"Making Opportunity Knock" provides excellent material for in-depth group discussion and debate as well as personal insights and self-discovery. For details, visit http://www.ignitingimagination.com/bestsellingauthor/makingopportunityknock.html
Website: http://www.ignitingimagination.com
Internet Radio Show: http://blogtalkradio.com/igniting-imagination
All episodes are numbered, archived, and available for your listening enjoyment anytime, anywhere.
Facebook: http://www.facebook.com/nelliejacobs
Linkedin: http://www.linkedin.com/in/nelliejacobs
Twitter: http://twitter.com/nelliejacobs
How Did Van Gogh Become Famous?
I was fortunate to visit the remarkable, thought-provoking Van Gogh exhibit at the National Gallery of Canada in Ottawa.
I came away with my mind spinning with all sorts of thoughts/inspiration/ideas. However, the particularly burning question that consumed me was how Van Gogh-who barely sold a painting in his lifetime-without current influence of social media became so famous in the years following his untimely death.
Curiosity overtook. I conducted intensive research (simply Googling "How did Van Gogh become famous?") and, to my surprise, I discovered two sites that begin to answer the question:
1. The Woman Who Brought Van Gogh to the World
2. Johanna van Gogh-Bonger
Barely a year after Vincent's death, his own brother and steadfast supporter Theo died. Theo's wife Joanna was left a widow with a baby, an art gallery – and an entire catalogue of her brother-in-law's paintings. Relying on her late husband's advice to keep the collection together, as well as the experience and support of trusted friends and experts in business, she set out to create a buzz….
Johanna's strategies were so successful over time they became what we would now refer to as viral.
Always curious about the road people travel towards their successes, I would love to know exactly how YOU created a buzz for your products and services? Share with readers your experiences, viewpoints, and suggestions in the comment section below.
Creatively Yours,
Are you member or facilitator of a book club, study group, organization, educational institution or workplace?
"Making Opportunity Knock" provides excellent material for in-depth group discussion and debate as well as personal insights and self-discovery. For details, visit http://www.ignitingimagination.com/bestsellingauthor/makingopportunityknock.html
Website: http://www.nelliejacobs.com
Internet Radio Show: http://blogtalkradio.com/igniting-imagination
All episodes are numbered, archived, and available for your listening enjoyment anytime, anywhere.
Facebook: http://www.facebook.com/nelliejacobs
Linkedin: http://www.linkedin.com/in/nelliejacobs
Twitter: http://twitter.com/nelliejacobs
Become a Friend/Follower on:


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Comment: Re:I am not reading that. (Score 4, Informative) 246 246
Haselton needs an article about basic statistics. The 95% confidence interval on the difference between the two proportions is 6% +/- 17%, i.e. the range from about -11% to +23%. This (a) demonstrates that the sample is indeed underpowered to distinguish the sort of effect sizes that Haselton appears to be interested in, and (b) demonstrates that a +20% difference in proportion, contrary to Haselton's assertion, absolutely falls within the range of true values that can't be ruled out at a standard level of statistical confidence given the outcome of this experiment.
see http://www.kean.edu/~fosborne/bstat/06d2pop.html for the basic statistics.
Comment: Re:Why Bennett is more annoying than he has to be. (Score 1) 291 291
Unfortunately I don't have the superior powers of the autistic mind to catalog and recollect all this detail about arcane topics, be they movie producers or minor bugs in cellphone software.
Comment: Re:Why Bennett is more annoying than he has to be. (Score 4, Funny) 291 291
Recently I met a gentleman whose profession was gathering up shopping carts in the supermarket parking lot, and he treated me to an extended discourse about the relative merits of the producers of the different Muppet movies. I recognized the classic signs of an autism spectrum disorder ("For example, a person with AS may engage in a one-sided, long-winded speech about a favorite topic, while misunderstanding or not recognizing the listener's feelings or reactions, such as a wish to change the topic of talk or end the interaction."), and for some reason, my thoughts turned to our old friend, Bennett Haselton.
Book Review: Security Without Obscurity 51 51
How FBI Informant Sabu Helped Anonymous Hack Brazil 59 59
After his arrest in mid-2011, Monsegur continued to organize cyber attacks while working for the FBI. According to documents and interviews, Monsegur passed targets and exploits to hackers to disrupt government and corporate servers in Brazil and several other countries. Details about his work as a federal informant have been kept mostly secret, aired only in closed-door hearings and in redacted documents that include chat logs between Monsegur and other hackers. The chat logs remain under seal due to a protective order upheld in court, but in April, they and other court documents were obtained by journalists at Motherboard and the Daily Dot.'
Comment: Re:For real this time? (Score 1) 293 293
You are overlooking the interesting bit, though:
The team then verified its findings by analysing images from the same area on March 5, three days before the plane disappeared.
"The wreckage wasn't there prior to the disappearance of MH370," Mr Pope said.
Um yeah, I think this is easy to explain
Comment: Re:Help us fix the mobile app scrolling (Score 1) 384 384
One thing that does it (nexus 4/chrome) is a "fling" quickly followed by a touch. Normally the second gesture "catches" the inertial scroll and stops it, but in the slashdot mobile site it tends to be registered as a touch on whatever was scrolling past the finger. I think the same thing sometimes happens for two flings in a row (when it seemed like the first didnt register, but it was just laggy) or a fast fling followed by a touch & hold or slow drag.
Comment: Re:uhh (Score 2) 881 881
Sam Wang is a professor of neurobiology, not statistics. Also, the article does not refer to his predictions but to those of Nate Silver, who predicts only an 86% chance of Obama winning, notwithstanding the incorrect calculations using his data in the random anonymous script linked to the story.
Comment: Re:97.7% (Score 5, Informative) 881 881
The 538 website publishes the marginal probabilities of each state's outcome. The random anonymous script that is linked in this story just takes the product of these to compute the joint probability of Obama winning a particular set of states. This is of course a mistake. The probability that Obama wins Pennsylvania and Ohio is not the product of the probability that he wins each state separately, unless those two events are statistically independent. Of course, in reality and in the 538 model, they are not -- if Obama loses Pennsylvania he is also more likely to lose Ohio. I think this mainly accounts for the difference between the 538 prediction and the "prediction" of the random anonymous crap that the story links.


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[Thought Questions for The Mission of Jesus May 5, 2015] 1. To seek and save the lost. How well do these words of Luke define the mission of Jesus? Do we need a sense of dedication like this in our lives as well? Did Jesus know who was lost? Did He know where they were? … [Click to read more …]
Category Archives: SSLessons
Although Jesus came to seek and save those lost in sin, He never forces anyone to accept the salvation He offers. Salvation is free and available to all, but one must accept the free offer in faith, which results in a life in conformity with God's will. The only time we have for such an … [Click to read more …]
The return home (Luke 15:17-20) was a journey of repentance. The journey began when he came to himself. Recognition of where he was, in comparison with what his father's home was, drove him to arise and go to his father. The prodigal son returns home with a four-part speech that defines the true meaning of … [Click to read more …]
Hailed in history as the most beautiful short story ever told on the forgiving nature of love, the parable of the prodigal son (Luke 15:11-32), narrated only by Luke, may well be called the parable of the loving father and two lost sons. One son chose the lawlessness of the distant land over the love … [Click to read more …]
Read Luke 15:4-7. What does this tell us about God's love for us? Why is it so important to understand that it was the shepherd who went looking for the lost sheep? In a world that can appear uncaring and indifferent to us, this parable reveals a startling truth: God loves us so much that … [Click to read more …]
Read for This Week's Study: Luke 15:4-7, Luke 11-32; Luke 16:19-31; Luke 18:35-43; Luke 19:1-10. Memory Text: The Son of Man has come to seek and to save that which was lost (Luke 19:10, NKJV). If we were to write a mission statement for Jesus, we could not do any better than to repeat His … [Click to read more …]
South Korea – Song Sungsub: Wherever Song Sungsub goes, people follow-sometimes with stares, other times with their feet-and that's OK with him because he has a message to share. The idea began when I was distributing literature door-to-door, Sungsub explains. We can give [the literature], but of course some people just throw it out. One … [Click to read more …]
Further Study: The soul that turns to God for its help, its support, its power, by daily, earnest prayer, will have noble aspirations, clear perceptions of truth and duty, lofty purposes of action, and a continual hungering and thirsting after righteousness. By maintaining a connection with God, we shall be enabled to diffuse to others, … [Click to read more …]


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Prices and availability are subject to change from the time and date that you print this page.
7/2/2015 4:13:14 AM. For Customer Service, please call 800.933.9904
Okay, so maybe it's not like seeing your name in lights, but it's almost as fun. Each letter is constructed of vintage-style men's shirt patterns. Spell your child's name or a favorite saying. Hang on the wall, a door or the end of a bed.
Part of the See Your Name in Varsity Font Wallpaper Collection
White Hanging Shoelace
Length: 3 Yards 108"W
Details, details
- Spell your child's name or a favorite saying
- Hang on the wall, door or the end of a bed
- Letters also make great gift tags
- Colors and patterns are specific to each letter and cannot be chosen
- Do not place near crib
- Some letters may be no longer available
Extras! Extras!
- Antique White hanging shoelace sold separately
At The Land of Nod, nothing is more important to us than providing safe, high-quality products to you and your family. We believe that kids' products should be able to handle everything kids throw their way (literally and figuratively). That's why all of our products have an 18-year quality guarantee. And, hopefully, your kids will no longer be sleeping in bunk beds by then.
Who's there?
Heywood who?
Heywood you open the door.
Wallpaper Letter Shoelace
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I would be a bad mum... if I still lived in Germany! Or: differences in traditions and guidelines(444 Posts)
I am German, but have lived in the UK for 10 years. In fact, I had somehow acquired a husband, a house and a baby at pretty much exactly 10 years after arrived on an Easyjet flight with one suitcase . Said baby is now almost eight months old.
But that's not relevant here...
What is relevant is the fact that I am a terrible mum! Yes I am! At least if I am judge myself against German guidelines on weaning.
In the UK, the three rules seem to be:
1. Start around six months of age.
2. Avoid salt and sugar.
3. Don't give honey and nuts (ok, and a couple of other things, but the list is small).
And then, there is of course BLW vs. purees etc.
In Germany, BLW seems to be something that nobody has ever heard of. Even friends who have had babies recently seem to be utterly puzzled when I mentioned that some parents don't give their baby any purees at all.
I'm doing a mixture of purees and finger food, having the little one eat what we eat whenever possible. But according to German guidance, I seem to have got it wrong, because, apparently, babies should have
-A potato – vegetable – meat – puree at lunchtime
-A milk – cereal – broth in the evening
-And a cereal – fruit broth in the morning
Ahem, fail!!! My pancakes with blueberry compote in the morning (which we only have occasionally, by the way) just don't pass muster.
There are all kinds of other rules and guidelines as well, e.g. that that you should add rapeseed oil (no olive oil before one year!) to certain foods and how much and, oh yes, no yogurt before 10 months (fail!) etc. etc.
Sometimes, dear MNers, I am glad I am living in the UK! I don't do well with rigid rules. Even the Pampers website has completely different guidance on weaning, when you look at the UK and the German version.
But this made me think… if you are from another country, or have raised a child in another country, what differences have you noticed in the guidance given and in the practice around birth, food, sleep, toilet training etc. as compared to the UK?
I am just asking this out of interest! It'd be great to hear your stories!
Oh god the hissing sound for toilet training Indian babies. I got that advice from numerous aunts. It didn't work for a second with DD (must be the French and Brit sides of her playing it off), but lord it worked like a charm on me. DF finally admitted to having trained me with it.
You've all seen recent pictures of Prince George visiting Wellington, I'm sure. He is in tiny thin cotton summer shorts. Kate is wearing a coat. It's about 15 degrees there. There would be some serious tutting if they did this in Scandinavia.
All the kids here in NZ are still in shorts, no school jumpers until after Easter and shoes, well nobody needs those. Definitely a culture difference from some of the 'wrap them up' nations. Having seen Kate in a coat though, it might set a trend!
I understand the choice of the car seat has raised some eyebrows in NZ as well though?
Yes, and no. The advice group Plunket (a bit like HVs) recommend rear facing seats until the child is two or until they get too tall (NZ children are a long-leggedy lot). Little George is going into a forward facing seat. Plunket shrugged saying it was the parents' choice. A lot less angst here (but good car safety advice in the face of very weak law on the subject) and all advice can get the 'Yeah, nah' treatment.
I was actually thinking; hm, I wonder if prince George has some nice wool clothes or if he only wears cotton
Frankly given the fact that Prince George is surrounded by a massive entourage and cavalcade, they could have him in a vintage 1970s car seat with only one strap and he probably wouldn't come to any harm. They ain't much for them to hit, surely?
Another English parent in NZ here. By British standards I am a bad parent because -
- my two DDs don't own winter coats
- I let them go outside wearing next to nothing if they want to, including no shoes
- if they misbehave, I bark at them until they behave
- I don't worry to much about breaking them, or them breaking themselves
- they are welcome to try to solve their own problems before involving me
- I don't think girly pink stuff is an inevitability
- if they don't eat what I give them, they're welcome to go hungry
- I don't expect them to turn into monsters on their 13th birthdays.
It's so much easier being a no nonsense Kiwi parent than a fussy wussy Pommy parent
I absolutely agree Toadin the hole. I'm much keener on the parent by neglect approach. Was obviously born in the wrong country.
I'm Estonian and have 20month old DS (born here in the UK) and here I often feel like i'm the odd one wrapping him up when all kids around us seem to run around with no hats or coats (that would be early spring, which to me still feels cold).
However having just recently been to Estonia DS was the only kid around NOT wearing a hat - in JUNE!! (Ok, it was not very warm, but still not THAT cold).
An Estonian friend recently had a baby and was advised never to put baby to sleep on her back!! Babies should sleep on their side apparently to avoid choking to death.
In the UK I was advised never to put my son to sleep on his side as to avoid him accidentally rolling on his stomach and choking to death.
I was watching a French TV show recently and they had an "expert" come in to talk about co-sleeping. He was very insistent that only breast feeding mothers should do it, because there is something in their hormones that means they don't sleep as deeply and are more in tune with the baby. Surely this is total bollocks?!
Oooooh. Love this thread! Having spent the last 3 months on holiday living with DP's parents in Norway with our DS 7mo I can pick up a few.
- yoghurt : (the packet says " 10 months in Norway, 6mo everywhere else") so DMIL doesn't buy it / I buy it myself.
- BLW : DP and his parents are petrified he'll choke every time I give him something hard. It doesn't help my case that every time he is given a piece of bread he pukes. So DP doesn't like me doing it at all.
- shoes: DS is walking with our help, which is a great pain because in Norway they don't buy shoes until 12mo so all shoes are too big.
The good points are that they are very open about breastfeeding, do it anywhere. They also have the baby in the same room for about a year (he's still with us until we get back to the UK and get a new flat - then he's out!). They also say 6mo for weaning as well.
They also like to let their babies sleep outdoors, we can't do that here as it's a farm and the cats will jump on him, but I do that in the UK - I know from my experience as an au pair in France that this would be frowned upon.
I'm not conceived as a bad parent here though, just relaxed.
Haven't RTWT, but has anyone mentioned that great American baby-care aid, the snot-sucker? It's a little tube with a rubber bulb on one end. Squeeze the bulb, put tube up infant's snotty nose, let go of bulb. Out come the bogeys. Eugh.
The Americans I knew were aghast that we didn't have these back in the UK.
They also had the most wonderful teething gel which numbed the fingertip of the parent applying it, never mind the baby's gum. I think it contained lignocaine. I seem to remember slapping it on mouth ulcers for instant and lasting relief.
e have snot suckers in France. I leave it up to DH, it gives me the boak.
Dinah, glad it's not just me!
I have snot suckers (UK) but this is an actual tube that I suck.
Yeah we're talking actual tubes here too.
Chrome - I've heard that its a lot safer for bf mothers as they sleep lighter - but not sure whether it was a credible source or not!
I have absolutely loved reading this thread and roared at points. My parents moved to England (just from Scotland) and even there experienced huge differences (this would've been 70's).
I was fed what my parents ate from around 4 months old, albeit mushed up, English mums were using jars and baby rice (which my mum hadn't heard of)
home made soup was frowned upon.
I wasn't wrapped up warmly enough in the winter (my mum felt the weather to be mildly autumnal compared to a 'proper' snowy winter in Scotland).
Myself and then dB were put out in pram in garden to nap (too cold)
She was criticised for breastfeeding dB
She cooked every day from fresh a proper evening meal, meat and 2 veg plus bread and butter plus pudding (she was at the other mums only serving beans on toast or sandwiches for the main meal of the day for the kids but then cooking for the adults)
She was and still is convinced going out with wet hair causes pneumonia!
The best remedy for teething is whisky!
I've lived in a few European countries plus a friend now lives in Italy (but her kids are teens) but I had dd in Germany.
Pregnancy was...interesting. I'd had 2 mc before inc one in Germany. Did my own research admittedly so in addition to no alcohol, soft cheeses or runny eggs or Mayo I also went caffeine and as far as possible additive free.
We holidayed in Germany for a weekend and the things I was avoiding caused many confused looks on the faces of waiters!! Especially no Mayo (ime they put Mayo on just about every savoury dish!)
I did this before actually falling pregnant as a cautionary thing as you don't know you're pregnant straight away. No alcohol was fine never been a big drinker but I got bad withdrawal symptoms from stopping drinking 6-8 cups of strong German coffee daily to none at all (oops!)
To be fair the ante natal care was amazing. They kept a very close eye on me. But this might have been because of my history. What I think should happen everywhere is pregnant mums carrying their info (mutterpass). I fainted several times and this meant that especially before I was showing, people knew straight away I was pregnant, blood type etc.
I also visited friends living in France when I was about 7 months pregnant. My wedding ring wasn't fitting so I'd stopped wearing it but ended up wearing it on a chain as my friend was getting awkward comments about my being an 'unmarried mum'. This was only 15 years ago, but rural France. I also got strange looks from the waiters there re what I wasn't eating but especially not drinking wine.
Had dd in German hospital, induced but eventually emergency c-section. Apparently the healthcare staff had not heard of gas & air or SIDS. Baby was poorly so in scbu at first. Hospital boiling but baby still wrapped in several blankets and covered in an overstuffed quilt as I'd not dressed her warmly enough (I kept removing blankets etc as she was melting!).
As my milk didn't come in immediately they bound my breasts and fed me 'milk producing' tea (as pp have said Germans seem to have a tea for whatever ails you) 3 times a day.
No rooming in I found strange
Also no curtain round bed so whole room privy to any examinations
Given a warm bean bag thing to hold against tummy for c section pain but also pain meds and the bag thing did help.
They were surprised dh visited daily and that we'd visit dd ' she's being perfectly well taken care of'
After going home yes loads of comments of not wrapping her up warm enough.
But breastfeeding was encouraged and very much the norm in public.
We moved to England before she was 6 months old.
Again I noticed more the difference between my parents advice and my English in laws. (Now ex)
According to in laws-
Shouldn't breastfeed after 12 weeks and never in front of anyone but dh
Should be 'topping up' with ff and water in summer
'Cooled boiled water' cured everything baby had
Never mind controlled crying, baby should instantly fit in with your routine inc not 'getting used to getting picked up every time she cries'.
Weaning with baby rice in bottle from 2 months
Also being from a Celtic family kids are expected to
entertain/amuse themselves.
Be outdoors as much as possible.
Not be fussy eaters
Know their alphabet, numbers and can write own name before starting school.
As several pp have said fascinating thread
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Amanda Peet - Premiere 2012
Posted by webspace2000 on Dec. 07, 2009
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The authors have no funding, financial relationships, or conflicts of interest to disclose.
Facial Plastics and Reconstructive Surgery
Temporoparietal fascia free flap for pharyngeal coverage after salvage total laryngectomy†
Article first published online: 6 DEC 2011
DOI: 10.1002/lary.22477
Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.
The Laryngoscope
Volume 122, Issue 3, pages 523–527, March 2012
Additional Information
How to Cite
Higgins, K. M., Ashford, B., Erovic, B. M., Yoo, J. and Enepekides, D. J. (2012), Temporoparietal fascia free flap for pharyngeal coverage after salvage total laryngectomy. The Laryngoscope, 122: 523–527. doi: 10.1002/lary.22477
- †
Publication History
- Issue published online: 21 FEB 2012
- Article first published online: 6 DEC 2011
- Accepted manuscript online: 26 NOV 2011 12:04AM EST
- Manuscript Accepted: 1 NOV 2011
- Manuscript Revised: 24 OCT 2011
- Manuscript Received: 2 OCT 2011
- Abstract
- Article
- References
- Cited By
- Reinforcement;
- temporoparietal free flap;
- fistula rate;
- radiotherapy;
- laryngopharyngectomy
The aim of this study was to assess whether the use of the temporoparietal fascia as a free flap for pharyngeal closure reinforcement reduced the incidence of pharyngocutaneous fistula (PCF) in the salvage setting.
Study Design:
Consecutive case series.
After research ethics board approval, 12 patients who required salvage laryngectomy, including reinforcement coverage of the primarily closed pharyngeal defect with temporoparietal fascia as a free tissue transfer, were analyzed.
One (8%) out of 12 patients experienced pharyngocutaneous fistula that responded with conservative wound packing.
The PCF rate of 8% is significantly better than in similar salvage cases without flap coverage. Moreover, our PCF rate is comparable to the results shown for the pectoralis major muscle flap. The most obvious benefit of the temporoparietal fascia free flap for pharyngeal coverage in salvage laryngectomy is a reduced PCF rate with diminished donor-site morbidity, including cosmetic outcome, shoulder girdle function, and chest deformity.


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N.J. police quarrel over ticketing quota claims
Some officers have come forward saying that there are certain numbers they have to meet, while others reject the claim
By Julia Terruso
EAST ORANGE, N.J. — Seven members of the East Orange Police Department said during in-person interviews that in the past two years, and most aggressively in recent months, the chief has instituted a quota system, demanding more summonses, arrests, pedestrian and motorist stops with little justification.
Determining whether East Orange is using quotas in an attempt to bring in more income or simply uses data to promote proactive policing in a high-crime city is a gray area confronting departments nationwide. In Camden, the police union recently filed a suit against the city alleging unfair punishment for refusing to meet quota.
Chief William Robinson, a 30-year-veteran with the department who became chief in 2011, said he does not set or encourage quotas and says officers are misinterpreting his push for aggressive policing. He says the complaints come from a faction of malcontents who "don't want to work eight hours for eight hours pay."
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