text:
A lead-to-pacemaker adapter allows the use of a smaller diameter lead connector than that for which the pacemaker was designed. The pacemaker is shipped with the adapter installed. If the adapter is not to be used, provision is made for its easy removal. The adapter is shown and described for use in a unipolar lead system. The adapter permits direct electrical connection from the terminal pin electrode to the pacemaker connector block and its terminal set screw without the interposition of any intermediate connecting elements.
1. An adapter for use in a coping a generally cylindrical terminal electrode assembly to a device having a jack for receiving the assembly, the terminal electrode assembly being undersized relative to the dimensions of the jack, the adapter comprising:
a thin-walled tubular portion defining a hollow bore terminating in an end wall at a distal end thereof and an entry opening at a proximal end thereof, the outer diameter of the tubular portion being selected to match the inner diameter of the jack, the diameter of the tubular portion being selected to match the outer diameter of the terminal electrode assembly;
means for releasably latching the adapter within the jack of the device;
means for releasing the latching means and withdrawing the adapter from the jack, wherein the releasing and withdrawing means is detachable from the adapter; and
wherein the releasing and withdrawing means further comprises:
a tab extending from one side of the tubular portion outwardly past the entry opening; and
means defining a pair of notches located to establish a separation point to facilitate breaking off the tab from the tubular portion.
2. The adapter of claim 1, wherein the device is a pacemaker and the terminal lead assembly is connected to a heart stimulation lead.
3. The adapter of claim 1, wherein the releasing and withdrawing means comprises a severable lanyard and a tag linked to the tubular portion by the severable lanyard, the tubular portion having a hole at one end, the severable lanyard extending through the hole in the tubular portion and being attached to the tag.
4. The adapter of claim 3, wherein the tag is provided with indicia constituting instructions for use.
5. The adapter of claim 1, wherein the terminal electrode assembly includes a plug body having a pin electrode extending therefrom, and the jack includes a main receptacle portion for receiving the plug body and a pin electrode bore for receiving the pin electrode of the terminal electrode assembly, both the plug body and the pin electrode being undersized relative to the main receptacle portion and the pin electrode bore of the jack, the adapter further comprises:
end wall means defining an opening to permit the pin electrode of the terminal electrode assembly to pass through the end wall into the pin electrode bore.
6. The adapter of claim 5, wherein the plug body comprises a plurality of annular sealing rings and wherein the inner surface of the tubular portion is shaped to establish a seal with the sealing rings when the terminal electrode assembly is installed within the adapter in the jack.
7. The adapter of claim 5, wherein the device further comprises means for releasably gripping the pin electrode to retain the terminal electrode assembly within the jack.
8. The adapter of claim 7 further comprising a half-round electrically conductive tube extending beyond the end wall means for insertion into the pin electrode bore to provide support for the pin electrode when the pin electrode is clamped within the pin electrode bore by the gripping means.
9. The adapter of claim 8, wherein the gripping means comprises a set screw adapted to clamp the pin electrode within the pin electrode bore, and wherein the half round tube is adapted to cradle the pin electrode and establish a fit for the pin electrode within the pin electrode bore while enabling the set screw to clamp directly to the pin electrode.
10. The adapter of claim 9, wherein the tubular portion is a molded plastic tubular portion and the half-round tube is a stainless steel half-round tube integrally installed in the end wall means.
11. The adapter of claim 10, wherein the device is a heart pacemaker, and the terminal electrode assembly is part of a heart stimulation lead.
12. The adapter of claim 8, wherein the latching means comprises a retaining bump protruding outwardly from the tubular portion in the vicinity of the entry opening, and the jack comprises the means for engaging the retaining bump near the entry opening when the adapter is positioned within the jack.
13. The adapter of claim 12, wherein the retaining bump is oriented radially outward relative to the half-round tube, such that the half-round tube is located within the pin electrode bore on the side opposite the set screw when the retaining bump is latched within the engaging means of the jack.
14. The adapter of claim 13, wherein the jack has a generally planar transverse wall at an inner end of the jack, and the adapter end wall is generally planar and transverse to the longitudinal axis thereof, further comprising sealing means for providing a seal between the adapter and the jack.
15. The adapter of claim 14, wherein the sealing means comprises an 0-ring installed adjacent the inner end wall of the jack, the adapter being effective to compress the 0-ring to develop the seal when the retaining bump is engaged within the engaging means, thereby latching the adapter within the jack.
16. An adapter for use in coupling a terminal electrode assembly including a plug to a device having a jack for receiving the plug for electrical connection thereto, the plug having a lead pin of a first diameter extending from a plug body having a second diameter substantially larger than the first diameter, the jack including a lead pin receptacle having a third diameter designed to receive a lead pin of a size larger than the first diameter, a main receptacle portion having a fourth diameter designed to receive a plug of a size larger than the second diameter, and an electrode for making electrical contact between the lead pin and the device, the adapter comprising:
a generally cylindrical, thin-walled tubular portion defining an end wall at a first end and an entry opening at a second end of the tubular portion, the end wall having an opening matching the first diameter for permitting the lead pin to pass therethrough for connecting to the electrode of the jack when the adapter is inserted in position within the main receptacle portion and the plug body is inserted within the tubular portion.
17. The adapter of claim 16 further comprising means for releasably latching the adapter in position within the jack.
18. The adapter of claim 17, wherein the latching means comprises:
a engaging means near the entrance of the jack; and
a protruding member extending radially outward from the tubular portion near the entry opening thereof, the length of the tubular portion between the end wall and the protruding member being preselected to match the length of the main receptacle portion between the inner end thereof and the engaging means in order to establish an end wall seal between the jack and the adapter.
19. The adapter of claim 18 further comprising resilient sealing means located between the inner end of the main receptacle portion and the end wall of the adapter in a position to be compressed by the latching of the adapter within the jack.
20. The adapter of claim 19, wherein the sealing means comprises an 0-ring.
21. The adapter of claim 16, wherein the wall thickness of the tubular portion is selected to substantially fill the circumferential space between the plug body and the main receptacle portion.
22. The adapter of claim 21, wherein the inner diameter of the tubular portion is nominally equal to the second diameter, and the outer diameter of the tubular portion is nominally equal to the fourth diameter.
23. The adapter of claim 22 further comprising:
a set screw for releasably gripping the lead pin; and
a half-round tube extending axially from the end wall and defining an opening therein, the half-round tube being radially oriented to support the lead pin when the lead pin is clamped by the set screw.
24. The adapter of claim 17 further comprising removable means for withdrawing the adapter from its latched position within the jack.
25. The adapter of claim 24, wherein the removable means comprises a tab extending from the tubular portion at one side thereof, the tab being notched to define a break point for detachment of the tab from the tubular portion.
26. The adapter of claim 23, wherein the half-round tube is selectively dimensioned to fill one-half the space between the lead pin and the lead pion receptacle, thus preventing axial displacement of the lead pin when the set screw is tightened.
27. The adapter of claim 26, wherein the inner diameter of the half-round tube is nominally equal to the first diameter, and the outer diameter of the half-round tube is nominally equal to the third diameter.
28. The adapter of claim 26, wherein the removable means comprises a tag attached to the adapter by a severable link.
1. Field of the Invention
This invention relates to adapters for electrical connectors and, more particularly, to an adapter for electrically and mechanically coupling the terminal end of a pacemaker lead of one size to a pacemaker lead receptacle of another, larger size.
2. Description of the Related Art
Cardiac pacemakers, sometimes referred to as "pacemakers", are electrical devices that function to regulate the pace of the heartbeat. These vital therapeutic devices are surgically implanted in the patient's body, where they may remain for years. A typical implanted pacemaker operates by furnishing, through an electrical lead attached to the ventricle of the heart, stimulation pulses which the heart is not providing.
The pacemaker includes one or more plug-type receptacles into which the terminal electrode assembly of the electrical lead may be inserted when the pacemaker is implanted. The electrode is typically held in place in the plug receptacle of the pacemaker by a connector block and a set screw. This retaining set screw may be loosened to permit withdrawal of the terminal electrode assembly from the plug receptacle of the pacemaker, as, for example, when the pacemaker is to be replaced.
The terminal electrode assembly of the heart-stimulation leads customarily comes in different sizes. Those of more recent construction are undersized relative to earlier models. Likewise, the pacemaker receptacle which receives the terminal electrode assembly of the heart-stimulation leads comes in different sizes and varies significantly between manufacturers. In view of the fact that the installed heart-stimulation lead generally lasts longer than the cardiac pacemaker, it would be advantageous to be able to re-use the lead by adapting it to any given pacemaker model, independent of the particular size jack for the heart lead terminal electrode assemblies. This goal can be achieved by providing an adapter which is of the proper size to plug into the pacemaker receptacle and at the same time receive the implanted lead terminal electrode in a manner which establishes a reliable mechanical and electrical connection between the lead and the pacemaker.
One such adapter is disclosed in U.S. Pat. No. 4,583,543 of Peers-Trevarton. The device of that patent, however, is relatively complex in structural design, constituting a separate receptacle for the undersized terminal electrode assembly of the heart lead and a corresponding separate adapter terminal electrode assembly to couple into the full size pacemaker jack. Essentially, the adapter is constructed with the portion which couples to the pacemaker being configured like the large size terminal electrode assembly for which the pacemaker is designed.
What is presently desired is a simplified adapter which provides a match between the disparate sizes of the lead terminal electrode assembly and the pacemaker receptacle while facilitating the integrity of the connection between the pacemaker receptacle and the undersized terminal electrode assembly of the heart lead. The adapter of the present invention fulfills this need as a device which is easier and more economical to manufacture than those which are known in the prior art, as well as being at least as reliable in use.
In brief, arrangements in accordance with the present invention are in the form of a generally cylindrical, tubular sleeve having outer diameter dimensions matching the inner diameter dimensions of the pacemaker jack and inner diameter dimensions matching the outer diameter dimensions of a smaller size (undersized) terminal electrode assembly, including the axial pin electrode, of an implanted heart lead. For example, the diameter of the pacemaker receptacle may be 6 millimeters while the outer diameter of the lead connector is 3.2 millimeters. The outer diameter of the adapter of the present invention is then nominally 6 millimeters, to fit within the 6-millimeter inner diameter of the pacemaker receptacle, while the inner diameter of the adapter of the present invention is nominally 3.2 millimeters so as to receive the undersized terminal electrode assembly with the same fit and support that would be afforded if the pacemaker were manufactured to fit a terminal electrode assembly of 3.2 millimeter size.
In accordance with an aspect of the invention, the adapter is formed with a protruding bump strategically located to snap into a hole or recess near the entrance of the pacemaker receptacle bore in order that the adapter may be retained in the pacemaker head by latching it in place for use. It is contemplated that the adapter will be installed in the pacemaker when it is shipped from the factory. The adapter is retained in position until the pacemaker is unpacked for ultimate use. In case the pacemaker is to be used with a full size terminal electrode assembly of mating dimensions, in which event the adapter is not needed, the adapter is provided with means to facilitate its removal from the pacemaker. In one exemplary embodiment, this removal mechanism is in the form of an extending tab which can be used to disengage the latching protrusion from the pacemaker receptacle and pull the adapter out of the receptacle for ready removal and disposition. In another exemplary embodiment, the removal mechanism is a flexible ring with a tag attached. This tag may bear suitable indicia in the form of instructions as to how the adapter may be used or removed, and it also serves as a handle which may be used to draw the ring taut in disengaging the adapter from the pacemaker receptacle.
In one particular arrangement, an 0-ring is provided to fit between the inner end face of the adapter and the inner end face of the pacemaker receptacle bore. This 0-ring effectively serves as a seal by being brought under compression when the adapter is snapped into place and held by the latching mechanism.
A better understanding of the present invention may be realized from a consideration of the following detailed description, taken in conjunction with the accompanying drawing in which:
FIG. 1 is a schematic diagram indicating how the adapter of the present invention is used in conjunction with a pacemaker having a jack of one size and a heart lead terminal electrode assembly of a different, smaller size;
FIG. 2 is a perspective view, partially broken away, indicating how the adapter is positioned within the pacemaker receptacle;
FIG. 3 is a view similar to that of FIG. 2, showing an alternative embodiment of the adapter;
FIG. 4 is an end view of a pacemaker showing an adapter of the present invention in position within the pacemaker receptacle;
FIG. 5 is an enlarged view of the upper portion of the pacemaker of FIG. 4, partially broken away to show a sectional view taken along the line 5--5 of FIG. 4; and
FIG. 6 is a further enlarged view showing details of the connector block and set screw that comprise that portion of the jack used to retain the heart lead pin electrode.
As indicated in the schematic exploded view of FIG. 1, an adapter 10 of the present invention is shown in juxtaposition between a pacemaker 12 having a large or full size receptacle or jack and an undersized terminal electrode assembly 14. As better shown in FIG. 2, the pacemaker 12 has a main body portion 20 and a head portion 22. The head portion 22 is fashioned with a jack 24 comprising a main receptacle portion 26 and a pin receptacle portion 28. The main receptacle portion 26 is adapted to receive the proximal end of a full size terminal electrode assembly while the pin receptacle portion 28 receives the pin electrode extending from either a full-sized or an undersized terminal electrode assembly. The smaller size terminal lead assembly 14 is of the unipolar type and is exactly like the full size terminal lead assembly for which the pacemaker 12 with jack 24 is designed. As described and claimed herein, the smaller size terminal electrode assembly will be referred to as "undersized". This should be understood as referring to an electrode assembly like that for which the jack is designed, but smaller in size and unable to couple properly with the jack without some sort of adaptor. The terminal electrode assembly 14 is shown with a pin electrode 18 and three sealing rings 16 which are designed to seal the main receptacle portion of the pacemaker jack in which it is inserted.
The adapter 10 is generally tubular in shape and includes a generally cylindrical body 30 which tapers at the open end to an extension 32. A pair of notches 34 are located between the extension 32 and the body 30, the purpose of which will be described below. The adapter 10 is preferably injection molded of a rigid biocompatible plastic which is transparent, such as the material sold under the trademark Polysulfone by Amoco. It is closed at the distal end 36 defining an end face 38 from which an electrically conductive shell portion 40 in the form of a half-round tube extends outwardly. The shell portion 40 is a separate metallic member which is molded as part of the adapter 10 during the molding process.
The adapter 10 has on its underside a retaining bump 42 provided for latching the adapter 10 in place within the jack 24. The main receptacle portion 26 of the jack 24 has a small hole or recess 44 near the outer opening thereof along its bottom side. When the adapter 10 is inserted in place within the jack 24, the retaining bump 42 engages within the recess 44, as best shown in FIG. 5.
The inner end face 46 of the jack 24 is generally planar and orthogonal to the axis of the main receptacle portion 26. An 0-ring 48 is installed adjacent the inner end face 46 prior to positioning of the adapter 10 in place within the jack 24. As indicated in FIG. 5, the O-ring 48 is compressed between the end face 38 of the adapter 10 and the inner end face 46 of the main receptacle portion 26 when the adapter 10 is inserted far enough for the retaining bump 42 to latch within the recess 44. This latching mechanism maintains the compression of the O-ring 48, thereby establishing an effective fluid seal between the adapter 10 and the inner end face 46 of the main receptacle portion 26.
As shown in FIGS. 5 and 6, the shell portion 40 extends into the pin receptacle portion 28 of the jack 24. FIG. 6 shows an enlarged view of the arrangement for retaining the terminal electrode assembly 14 in firm mechanical and electrical coupling to the pacemaker 12. That pin electrode 18 is electrically connected to an internally threaded metal connector block 50 which is part of the head portion 22 of the pacemaker 12. A socket recess set screw 52 is threaded into a connector block 50 until the flat tip of the set screw 52 contacts the pin electrode 18. Because the shell portion 40 is open at the top, this contact is established directly between the pin electrode 18 and the set screw 52, as well as the underside of the shell portion 40 and the connector block 50, just as though the pin electrode of a larger size terminal electrode assembly were inserted directly into the jack 24 without the interposition of an adapter. The shell portion 40 serves to provide support on the underside for the pin electrode 18, such that no axial misalignment occurs when the set screw 52 is tightened, thus maintaining the integrity of the lead seal within the adapter. Thus, the electrical connection of the pin electrode 18 of the terminal electrode assembly 14 via the connector block 50 and set screw 52 is exactly the same as if no adapter were involved, considering that a full size assembly would be used. This circuit connection does not depend upon any other electrically conducting elements of an adapter for its circuit integrity, as do some of the known prior art adapters which serve a similar function.
The pacemaker is intended to be shipped from the factory with the adapter 10 installed. A removal tab 60, which is formed by the extension 32 (FIG. 2), serves to facilitate withdrawal of the adapter 10 if the physician elects to use the original larger size jack 24 of the pacemaker 12 directly with a full size terminal lead assembly. If the adapter 10 needs to be removed when the pacemaker 12 is to be installed, the outer end of the adapter 10 is flexed slightly by lifting on the removal tab 60, lifting the retaining bump 42 out of the recess 44 and withdrawing the adapter 10 from the jack 24. Conversely, if the adapter 10 is to be used in the coupling of an undersized terminal electrode assembly into the jack 24, the removal tab 60 is flexed manually at the notches 34 and broken off at that point, leaving the adapter 10 captive and free of any extension beyond the open end of the main receptacle portion 26.
FIG. 3 shows an adapter 10' for insertion in the jack 24 of a pacemaker 12. The only difference between the adapter 10' of FIG. 3 and the adapter 10 of FIG. 2 is the mechanism which is provided for withdrawing the adapter from the jack 24 if it is not to be used. Instead of the detachable extension 32 of FIG. 2, a thin flexible plastic lanyard 66 is shown extending from a tag 68 through a small hole 70 in an end 72 of the adapter 10'. After threading the hole 70, the lanyard 66 is returned to the tag 68 where it is gripped by a clamp 74. The tag 68 may be provided with indicia 76 in the form of text or graphics which may serve as identification of the model of the pacemaker 12, instructions for use including removal of the adapter 10', or any other information which is desired.
With the arrangement of FIG. 3, if the adapter 10' is to be used in the jack 24 of the pacemaker 12, the lanyard 66 is simply cut and the tag 68 with the severed lanyard 66 is withdrawn and discarded. Conversely, if the adapter 10' is to be removed from the jack 24 of the pacemaker 12, the tag 68 and lanyard 66 are used as a handle to flex the outer end of the adapter 10' sufficiently to withdraw the retaining bump 42 from the recess 44 and then withdraw the adapter 10' from the jack 24 of the pacemaker 12.
Thus, arrangements in accordance with the present invention provide an improved adapter for accommodating an undersized pacemaker lead terminal electrode assembly and a pacemaker having a jack which is designed for a full size terminal electrode assembly. The adapter is preferably formed of plastic by injection molding, is economical and simple to manufacture and achieves a high integrity electrical and mechanical connection between the terminal electrode assembly and the pin retaining mechanism within the pacemaker. With the adapter in position within the pacemaker, an effective fluid seal is established from the terminal electrode assembly to the interior surface of the adapter and from the outer end of the adapter to the end of the pacemaker main receptacle, thereby protecting the electrical circuit connection between the terminal pin electrode and the internal pacemaker lead connector from the environment. The adapter is latched in position within the pacemaker jack by a simple latching mechanism which also prevents the adapter from rotating within the pacemaker, thus positioning the pin adapter properly so that the pacemaker set screw clamps the pin electrode effectively. The adapter is designed to be installed in the pacemaker when shipped from the factory and is provided with a simple means for withdrawing the adapter from the pacemaker jack in the event that it is determined that the adapter is not needed when the pacemaker is installed.
Although there have been described hereinabove specific arrangemens of a device for adapting a pacemaker lead to a pacemaker in accordance with the invention for the purpose of illustrating the manner in which the invention may be used, it will be appreciated that the invention is not limited thereto. Accordingly, any and all modifications, variations or equivalent arrangements which may occur to those skilled in the art should be considered within the scope of the invention as defined in the appended claims.
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text:
Mozart Concert and Dinner at Stiftskeller in Salzburg
Dine at the oldest restaurant in Europe, Stiftskeller St. Peter, while listening to the music of Mozart. Enjoy a delicious three course candlelit dinner, prepared as it would have been in the 17th and 18th centuries, while local opera singers and musicians perform some of Mozart's finest work.
- 3-course meal at the oldest restaurant in Europe, Stifskeller St. Peter
- Meal prepared and presented exactly like it would have been in the 18th century during Mozart's time
- Hear Mozart's best-known works performed by local musicians and opera singers dressed in period costumes
Recent Photos of This Tour
Diner concert au Stiftskeller ...Photo by: Pascal G
01 2015
dessertPhoto by: Keith S
07 2014
dinner concertPhoto by: Keith S
07 2014
The tablePhoto by: Melissa T
07 2014
The Dining RoomPhoto by: Melissa T
07 2014
A humerous rendition of ...Photo by: Denise T
04 2014
Salzburg 230Photo by: Julie H
12 2011
DSC04733Photo by: AnnAnn
05 2011
Mozart concertPhoto by: Olivia Z
Poland, 08 2009
Mirabell Palace & GardensPhoto by: Anonymous
07 2009
Mozart Dinner & Concert ...Photo by: Anonymous
07 2009
Candlelight dinner at ...Photo by: Anonymous
06 2008
PerformersPhoto by: Anonymous
06 2008
Mozart Concert and Dinner at ...Photo by: Anonymous
06 2008
Dinner and ConcertPhoto by: Anonymous
06 2008
Mozart Concert at ...Photo by: Anonymous
06 2008
What You Can Expect
Let yourself by transported into the Salzburg of Mozart's time, complete with the colorful costumes and culinary delights so popular in the last 18th century. Allow yourself to be whisked off into a world of enchantment, be a guest of Mozart!
This evening includes a delicious 3 course candlelit dinner, prepared according to traditional recipes from Mozart's era. The most popular compositions of W. A. Mozart are performed in candlelight by local musicians in historical costumes including two opera singers and musicians performing "A little night melody" as well as with arias and duets from operas "Don Giovanni", "Le Nozze di Figaro" and "The Magic Flute".
Stiftskeller St. Peter is situated in the heart of Salzburg's old town, and the "oldest restaurant in Europe". It was first documented in the year 803, during Charlemagne's visit. A brilliant experience - don't miss it!
Enjoy a delicious three course candlelit dinner, prepared according to traditional recipes from the 17th and 18th centuries.
You will dine where the monks created the oldest restaurant in history, sampling delicacies of the old world, in the enchantingly lit Stiftskeller St. Peter. Each course will be served in the intermissions so you can savor the moments, music and beauty of this amazing baroque room.
- Lemon soup with quark rosemary dumpling and a cream foam on top
- Roasted capon (kind of chicken) breast with pumpkin ball, semolina strudel and vegetables from Father Prior´s garden
- Semi-freddo honey parfait with two different fruit sauces
The menu is subject to change, and vegetarian dishes are available upon request (at time of booking).
Customer Reviews
June 2015
This tour was amazing!
June 2015
It was great!

subset: commoncrawl


text:
A population-based breast cancer screening programme was implemented in the Central Denmark Region in 2008–09. The objective of this registry-based study was to examine the association between socio-demographic characteristics and screening participation and to examine whether the group of non-participants can be regarded as a homogeneous group of women.
Participation status was obtained from a regional database for all women invited to the first screening round in the Central Denmark Region in 2008–2009 (n=149,234). Participation data was linked to registries containing socio-demographic information. Distance to screening site was calculated using ArcGIS. Participation was divided into 'participants' and 'non-participants', and non-participants were further stratified into 'active non-participants' and 'passive non-participants' based on whether the woman called and cancelled her participation or was a 'no-show'.
The screening participation rate was 78.9%. In multivariate analyses, non-participation was associated with older age, immigrant status, low OECD-adjusted household income, high and low level education compared with middle level education, unemployment, being unmarried, distance to screening site >20 km, being a tenant and no access to a vehicle. Active and passive non-participants comprised two distinct groups with different socio-demographic characteristics, with passive non-participants being more socially deprived compared with active non-participants.
Non-participation was associated with low social status e.g. low income, unemployment, no access to vehicle and status as tenant. Non-participants were also more likely than participants to be older, single, and of non-Danish origin. Compared to active non-participants, passive non-participants were characterized by e.g. lower income and lower educational level. Different interventions might be warranted to increase participation in the two non-participant groups.
Keywords:Screening; Mammography; Non-participation; Socio-demography; Inequality
Breast cancer screening has been proven to reduce breast cancer mortality [1,2]. Although recent years have been characterized by discussions on the effectiveness of the programme [3], several health authorities, including the Danish, recommend regular screening for breast cancer. By law, all Danish women aged 50–69 must be offered biennial free-of-charge breast cancer screening by the region where the woman is resident [4].
A high participation rate across the target group is essential for the screening programme to be effective [4]. Therefore, non-participation becomes an important issue for health care planners. The associations between socio-demographic factors and non-participation have been studied for many years, and in most studies non-participation is associated with older age, being an immigrant, unemployment, being unmarried, low income, and being a tenant [5-12]. Mixed results have been found in relation to educational level [7,9,12,13] and distance to screening site [8,14-16].
Many studies have included only a limited number of socio-demographic factors and have not been able to draw a full picture of the often complex associations between socio-demography and non-participation. Except from a few studies [5-8], the studies conducted so far have typically relied on self-reported data on mammography uptake or socio-demographic data [9-13,16,17], and only two studies, based on the same study population, have been conducted in a Danish context [7,18]. Research in Denmark is of particular interest and importance due to a high relative breast cancer mortality compared to comparable countries [19].
Apart from Aro et al.,[17], no studies have to our knowledge explored to what extent the non-participant group comprises a homogeneous group of women. Women may have different motivations and reasons for non-participation. For instance, a woman might decide not to participate because she believes the harms of screening exceed the benefits. Contrary, other women might lack the resources to participate or even decide whether to participate or not. The ability to distinguish between the different groups of non-participants will therefore be important in order to perform group-specific interventions.
Using Danish registries, it was possible to conduct a large-scale study including all women invited to the first screening round in the Central Denmark Region and also to include many registry-based variables and thus not rely on self-report. The objective of this registry-based study was to examine the association between socio-demographic characteristics and screening participation and to examine whether the group of non-participants can be regarded as a homogeneous group of women.
The first screening round took place from 28 February 2008 to 31 December 2009 where women were offered a pre-booked mammogram appointment at one of the region's six screening sites. Appointment and site could be changed by the women who could also decline to participate. Non-participants received no reminders. A population-based study was performed including all women (aged 50–69) invited to the first screening round in the Central Denmark Region (n = 149,234).
According to Danish Legislation and the Central Denmark Region Committees on Biomedical Research Ethics (j.no.: 181/2011) the study did not need formal ethical approval, as it was based on registry data. The project was approved by the Danish Data Protection Agency (j.no.: 2009-41-3471 and j.no.: 1-16-02-31-11).
Inclusion and exclusion criteria
All women invited to the first screening round were eligible for inclusion. For the purpose of this study, however, the following groups of women were excluded: Women who had died in the time between sending out the invitations and the scheduled day of the mammography (screening date) (n = 110), and women who had migrated from the Central Denmark Region before the screening date (n = 123). Women registered in the Danish Cancer Registry with a breast cancer diagnosis prior to the screening date were excluded (n = 4,646) because the majority of them were enrolled in a post-cancer follow-up period and hence did not participate in the organised screening programme. Finally, 91 women were excluded since they were listed with a general practitioner (GP) located in the Capital Region of Denmark. This left data on 144,264 (96.7%) women for analysis.
Registries and variables
Data on participation was collected from a regional database containing administrative information. Participation was categorised as 'participants' or 'non-participants' based on whether the women participated in the first screening round or not. Non-participants were further divided into 'active non-participants' (ANPs), defined as women who actively called and declined participation, and 'passive non-participants' (PNPs), defined as women who stayed away without cancelling or rescheduling the appointment ('no-shows').
Data on socio-demographic variables was obtained from 'The Danish Integrated Database for Labour Market Research' (IDA) run by Statistics Denmark [20], which has been updated annually since 1980. The following variables from IDA were included: Educational level classified according to UNESCO classification as low (≤10 years), middle (11–15 years), and higher education (>15 years). Labour positions were classified as: 1. employed, 2. self-employed and chief executive, 3. unemployed or receiving supplementary benefits other than social welfare, 4. retired women, 5. social welfare recipients, and 6. others. Marital status was classified as married, living in a registered partnership, cohabitating, or being single. Ethnicity was categorised as Danish, immigrants from western countries, and immigrants from non-western countries, according to Statistics Denmark's definition of developed countries [21]. Residential ownership was divided into residence-owners and tenants. 'OECD-adjusted household income' in the year prior to mammography, adjusted for number of persons in the household [22], was used as an income measure. Based on tertiles and rounded off to the nearest 100 Euros, OECD-adjusted household income was categorised as: low (1st tertile, ≤34,600 Euros ), middle (2nd tertile, >34,600 to ≤53,200 Euros ), and high (3rd tertile, >53,200 Euros). From the National Vehicle Registry, information on the household's access to a vehicle was obtained and divided into access or no access. From The Danish Cancer Registry [23], all registered cancer diagnoses prior to the screening date were obtained, and all women with a prior breast cancer diagnosis were identified and excluded. The remaining women were divided into either 'no registrations of a cancer diagnosis' or 'registered with one or more cancer diagnoses (excluding breast cancer) prior to the screening date'. Women diagnosed with cancer prior to the age of 14 were categorized as 'no registered cancers' (n = 62).
Travel distance to screening site was calculated according to the Danish road network using ArcGIS Network Analyst (version 10.0) [24]. Geographical coordinates were used to locate each woman's residence on the date of her screening appointment and the coordinates were obtained from the Centralised Civil Register. It was possible to calculate the shortest driving route in km for 137,417 of the women (95.3%). Travel distance was categorised into: 1) 0–20 km, 2) >20-40 km, 3) >40-60 km, and 4) >60 km.
In Denmark 98% of citizens are listed with a general practice, which they must contact for medical advice [25]. From the 'Patient Registry', data on which general practice the woman was listed with at the screening date was obtained.
All registries could be linked by the women's unique civil registration number (CRN). A woman's socio-demographic position was described the year prior to the booking date. This means that for a women being assigned to screening in e.g. 2009, socio-demographic registries updated at the end of 2008 were used. Missing information on the registry-based variables ranged from 0% for the variables 'age' and 'participation' to 1.8% for data on 'residential ownership'.
Generalised linear models (GLM) with log link and the Bernoulli family regression models [26,27] were used to quantify the association between socio-demographic factors and screening participation. Restricting the analyses to the group of non-participants (n=30,453), the same method was applied to investigate whether ANPs and PNPs differed in terms of socio-demographic factors.
Initially, to check for multicollinearity between independent variables the mean Variance Inflation Factor (VIF) was calculated. Values above 10 indicate multicollinarity [28]. Following, unadjusted analyses were done with each independent variable. A multiadjusted model was also done, adjusting for statistically significant variables (p <0.01) from the unadjusted analysis. Prevalence ratios (PR) with 95% confidence intervals (CI) were used as association measures using robust variance estimates to allow for clustering of patients by general practice in both unadjusted and adjusted models [29]. Due to a high prevalence of the outcome measure (more than 20% non-participants), odds ratios tend to overestimate the association [26,27]. Age was calculated on the date of the screening appointment using the women's CRN containing date and year of birth. Statistical analyses were conducted using STATA version 12.
Sample characteristics
The participation rate in the first screening round was 78.9% for the final sample. Mean age for participants was 59.3 years and 60.0 years for non-participants. Table 1 shows the distribution of socio-demographic variables in terms of participation. Participants and non-participants were statistically significantly different (chi2 p <0.01) in all socio-demographic groups. Table 1 also depicts the distribution of PNPs and ANPs which was also significantly different in all groups (chi2 p <0.01). Mean age for PNPs was 59.4 years and 60.7 years for ANPs.
Table 1. Distribution of socio-demographic characteristics for participants (n=113,811), non-participants (n=30,453) and non-participants divided into active (n=14,529) and passive (n=15,924)
Associations between socio-demography and participation
Table 2 presents unadjusted and adjusted associations between participation and socio-demographic factors. No multicollinearity was observed between any of the independent variables with all VIF values ranging between 1.00-1.51.
Table 2. Unadjusted and adjusted prevalence ratios (PR), with 95% confidence intervals (CI) for associations between socio-demographic variables and screening non-participation
For most variables in the unadjusted model, statistically significant associations with non-participation were found. Especially women who were immigrants, older, unmarried, tenants, outside the workforce, had a low-level or a high-level education, a low income, and women with no access to a vehicle were more likely not to participate (Table 2).
In the fully adjusted model, most of the estimates decreased compared with the unadjusted analyses. The largest decrease was observed for 'non-western immigrants', 'low income', and single women. Having a previous cancer diagnosis was no longer statistically significantly associated with participation. Also, only belonging to the oldest age group was now statistically significantly associated with non-participation compared with the youngest group, and retired women were no longer statistically significantly more likely not to participate than employed women. An increase was observed among highly educated women in the adjusted model, indicating a 15% increased risk of non-participation compared with women with a middle level education. The association between distance and participation also increased compared with the unadjusted analysis and all categories in this variable were statistically significantly associated to participation in the adjusted model (Table 2).
Active and passive non-participants
The association between active and passive non-participants is presented in Table 3. In terms of multicollinearity, all VIF values were between 1.00-1.42. The unadjusted analysis showed that PNPs were more likely to be immigrants, unmarried, younger, social welfare recipients, unemployed, having a low-level education, a low household income, being tenants, having no access to a vehicle, and having a shorter distance to screening site than ANPs. ANPs were more likely to have had a previous cancer diagnosis.
Table 3. Unadjusted and adjusted prevalence ratios (PR), with 95% confidence intervals (CI) for association between socio-demographic factors and being passive non-participants (PNP)
In the fully adjusted model, all associations decreased or remained stable when compared with the unadjusted analyses. In relation to occupation, being unemployed and 'other' was no longer statistically significantly associated with non-participation. Contrary, all categories in 'distance to screening unit' were now statistically significantly associated to participation in the adjusted model. There was no statistically significantly association between the highest educated group and participation in neither the unadjusted or adjusted analysis (Table 3).
Main findings
Approximately one in five women invited to the first screening round in the Central Denmark Region did not participate. This study indicates a social gradient in the participation as women outside the workforce, with a low income, from non-western countries, being unmarried, and not owning their home, and having no access to a vehicle were more likely not to participate. Nearly half of the non-participants had actively decided not to participate. When comparing passive non-participants (PNPs) with active non-participants (ANPs), the two groups differed distinctively from one another as PNPs were more likely to belong to the lowest social groups with e.g. low income and low education.
Strengths and weaknesses
Linkage of Danish registries using the unique CRN made it possible to conduct a large-scale study that included several complete variables with a high validity [30]. This population-based study included the entire population of invited women and was based on the first screening round. This makes this population favourable to study because no women were excluded on the grounds that they had previously actively chosen not to take part in the programme. The study used data on screening uptake and socio-demography from regional and national registries and did not rely on self-report. This minimised selection and information bias and enhanced the validity and generalisability of the study. The large number of included women ensured high statistical precision which made it possible to include several variables in the analyses without losing precision. Further, the study was able to exclude very precisely women who died before the screening date, moved out of the region or had previously been diagnosed with breast cancer. Finally, this study is of special interest as it is one of the first studies in this field to further investigate the group of non-participants.
Some weaknesses of this study should also be mentioned. Socio-demographic variables from IDA are updated once annually. It was chosen to use the datasets describing the women's socio-demographic characteristics the year prior to the screening date. However, socio-demographic variables such as marital status and occupation are dynamic and some women may e.g. have changed jobs during the study period which leads to misclassification. Further, the 'National Vehicle Registry' did not include leased cars and business cars, and the true prevalence of people having access to a vehicle might therefore be underestimated.
The calculated distance to screening site using the Danish road network and the women's residence gave exact estimates of the distances. However, the assumption that all women travelled from their home address may not be valid. Furthermore, 5.2% of the women rescheduled their appointment to another screening site which for some of the women may have been to a screening site near their workplace, but far away from their homes. However, excluding these women from the analysis did not alter the association markedly (data not shown).
Using Danish registries, various complete variables were possible to include in the study. However, residual confounding cannot be excluded, since other variables of importance may not have been included. E.g. family history of breast cancer and more psychologically related variables such as fear may be important in this context as well [31-33].
Comparison of participants and non-participants
Corresponding to results from a Swedish [6] and a Danish [7] study, our study found that both women with a low- and high level education were less likely to participate compared with women with a middle-level education. The association between a low-level education and non-participation may to some extent be explained by a lower ability among women with a low-level education to obtain, process, and understand health information [34]. Conversely, it has been suggested that women of a high educational level are more likely to use private mammography services which could explain the association between high education and non-participation [5]. However, this does not seem to be the case in Denmark [35]. Another explanation could be that highly educated women have followed the ongoing debate regarding benefits and harms of screening and decided not to participate. Finally, one reason could be that highly educated women more often have increased occupational responsibilities, and a lack of time could be a barrier to mammography screening participation [36]. In this study this hypothesis is supported by the fact that the group of self-employed and chief executives was less likely to participate compared with employed women. However, the association between education and participation is clearly not established and one explanation might be that non-participants do not comprise a homogeneous group of women as demonstrated in this study.
In this study and others [5,6,9], being outside the workforce was associated with lower participation rates. This could be due to increased social interaction and support from colleagues [6], but it could also be an indication of a poor health status of women outside the workforce [6]. OECD-adjusted household income has been suggested to be a more reliable measure of economic status than personal income [5]. Lower OECD-adjusted household income was associated with higher risk of non-participation in this study which corresponds with results from other studies [5,10,12]. Although associations between various socio-economic variables and participation have been indicated in many subpopulations and different health care systems [6,8,12,14,37,38], this study indicated that even in a health care system with universal coverage and no payment for mammography service, social inequalities in participation exist.
Married women were more likely to be participants which is in line with the findings of other studies [5,7,8,11] and could be explained by increased support and decision aid from their significant others. As shown in many studies [7,8,10,11], although not in all [5,13], older age was associated with a higher risk of non-participation. As concluded by many other studies [5-8], immigrants were more likely not to participate. This was especially the case for women with a non-western background and can probably be explained by linguistic, cultural, and religious barriers [37,38]. Interventions towards immigrants might be of great value in terms of increasing this particular group's participation rate. Long distance to screening site was associated with a higher likelihood of non-participation. Studies from both Europe and USA do not agree whether distance to screening site matters in terms of participation [8,14-16]. Since this knowledge might be of great value for public health planners, the mechanisms of this association should be studied further.
Comparison of ANPs and PNPs
To the authors' knowledge, only one study has previously explored whether the group of non-participants comprises one group with the same characteristics [17]. This present study clearly shows that ANPs and PNPs comprise two different groups of women with different socio-demographic characteristics. When ANPs called and declined participation, one could put forward the hypothesis that ANPs had made a deliberate decision of not wishing to participate whereas PNPs might fail to turn up due to lack of personal or practical resources. This hypothesis is supported by the results of this study indicating that PNPs are more likely to be of a low social status with e.g. a low-level education and a low income. To reach these two groups of non-participants, different interventions might be needed since fundamental demographic and economic characteristics vary within the groups. Also the ethics of targeting ANPs must be considered, given the fact that they may already have thoroughly considered their decision not to participate. However, more studies are needed to identify specific reasons for non-participation among the two groups of non-participants.
Despite the free-of-charge programme in Denmark, non-participation appeared to be determined by social disparities since non-participants were more likely to have low income, no access to vehicle, be unemployed, and not own their own home. Non-participants were also more likely to be older, single, and of non-Danish origin. Further, the group of non-participants comprised two different groups of women with different socio-demographic characteristics which clearly show the complexity of screening behaviour. Thus, passive non-participants were more likely to e.g. have low income and low educational attainment than active non-participants. Future interventions may profit from focusing on this social inequality and also from targeting the different groups of non-participants.
Competing interests
The authors declare that they have no competing interests.
Authors' contributions
AFP, BA, and PV conceived the idea. LFJ, PV, AFP, and BA contributed with input and critical revision of the statistical analyses and content of the paper. LFJ was primarily responsible for the statistical analyses and for drafting the manuscript. All authors read and approved the final manuscript.
The authors would like to thank the Department of Public Health Programs, Randers Regional Hospital, Central Denmark Region for delivering participation data on the first screening round and Statistics Denmark for delivering data as well. We also thank the Danish Cancer Society, the Novo Nordic Foundation, the Riisfort Foundation, the Health Research Fund of Central Denmark Region, and the Faculty of Health, Aarhus University for financial support.
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Pre-publication history
The pre-publication history for this paper can be accessed here:


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God's Story, Your Story: Youth Edition - eBookMax LucadoZondervan / 2011 / ePub$6.995 Stars Out Of 5 2 ReviewsAvailability: In StockCBD Stock No: WW16523EB
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Is there a story behind the daily drama of your life? Being a teenager isnt always easy. From homework to after-school jobs to having to think about the future, life can feel chaotic. But did you know that the chaos and confusion, as well as the joys and excitements you experience, are part of Gods ordered plan? In this teen adaptation of Gods Story, Your Story, bestselling author Max Lucado explores the divine narrative in the New Testament, as well as several contemporary examples, to show how your everyday life is part of Gods bigger redemption story, and that God is there, no matter what you may face in your life. Real teen responses and real-life application questions are also included to help you further connect Gods narrative to your own. Because Gods story is your storyand he is adding to your chapter every day.
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More than 120 million readers have been inspired by the words of Max Lucado. He lives with his wife, Denalyn, and their mischievous mutt, Andy, in San Antonio, Texas, where he serves the people of Oak Hills Church.
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Blooming with BooksBloomer, WIAge: 35-44Gender: female5 Stars Out Of 5What's your story?June 29, 2011Blooming with BooksBloomer, WIAge: 35-44Gender: femaleQuality: 5Value: 5Meets Expectations: 5This review was written for God's Story, Your Story: Youth Edition.GOD'S STORY, YOUR STORY (Youth Edition)
When HIS Story Becomes Yours
By Max Lucado
Max Lucado asks "what is the text (or story) of our lives?" We cannot look inside of ourselves to discover who we are, we must look at ourselves through God's eyes to discover what we can be!
Ordinary people can do extraordinary things when we join our story with God's. But we must pray for strength against Satan's attacks so we can complete our story.
The goal of every story is home, whether we are going home, improving home, or trying to keep home safe. This is much like the Christian life when we are striving for the perfect family and home, which can only be found with our Heavenly Father. To find the path we must listen for God's voice to lead us. God will never forsake us. Even if we make a wrong turn He will redeem our story through His on the cross. Because of the cross, the final chapter of our story - Death - becomes the introduction to our new life after death.
At the end of this book are review questions about each chapter to help the reader to grasp the principles put forth by Max. Each chapter has personal experience pieces by teens to expand on the points Max is making.
This is a well written book that teen readers should appreciate and learn from. This would be appropriate as a gift or as a study book for a youth group.
Read it and discover the plot behind your story!
The Phantom ParagrapherTauranga, New ZealandAge: 18-24Gender: female5 Stars Out Of 5A Must read for all Teens/YAJune 14, 2011The Phantom ParagrapherTauranga, New ZealandAge: 18-24Gender: femaleQuality: 5Value: 5Meets Expectations: 5This review was written for God's Story, Your Story: Youth Edition.Review: God's Story- Your Story : The Youth Edition - Max Lucado - September 2011
I guarantee that if you call yourself a Christian, then there is no way that you have not heard of Max Lucado. As someone who has grown up with God and enjoyed reading Christian fiction and non-fiction , I have found that one of my favourite authors is Max Lucado as he writes in a style and language that young people can relate to.
"God rewrote the text of my life , when I opened the book of my heart to his eyes"
2 Samuel 22v 25.
Ever wondered how you can relate the Bible , something that was written over 2000yrs ago to your self today and what is happening around you ? In God's Story, Your Story Max Lucado takes us on a journey throughout the New Testament in search for how God's word can help shape you into who you are today and what paths to take in order to live and follow in his ways.
Each chapter takes us into a world of it's own from becoming a Superhero in God as Max likens it to Spiderman and Luke Skywalker , the chapter then focuses on a tale in the Bible , the first of Jesus's Birth with Joseph and Mary , the story is written in a way that you could also imagine that it was happening right now instead of over 2000yrs ago, also included which I love in these types of books are ancedotes from everyday teens and young adults - people who are just like you and me.
The book has bible verses scattered through and at the end of each Chapter has a prayer for us to read and thank God.
This is one book that I would recommend as a Bible study at a Youth Group or Young Adults Group as we could all discuss what each chapter meant for us etc.
As usual , a familiar occurence in Christian books both Fiction and Non-Fiction , at the back of the book are some discussion questions to think about, answer and reflect on each chapter.
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text:
Veal And Vegetables Stew With Fluffy Dumplings
|1 Pound, cut in 1 inch cubes
|All purpose flour
|1 Tablespoon
|3 Tablespoon
|Hot water
|2 3⁄4 Cup (44 tbs)
|Diced potatoes
|1⁄2 Cup (8 tbs)
|Diced carrots
|1⁄2 Cup (8 tbs)
|Chopped celery
|1⁄4 Cup (4 tbs)
|Chopped onion
|1⁄4 Cup (4 tbs)
|Bay leaf
|Worcestershire sauce
|1 Teaspoon
|3⁄4 Teaspoon
|1 Dash
|For fluffy dumplings
|Canned tomato sauce
|8 Ounce (1 Can)
|Canned peas
|1⁄2 Cup (8 tbs)
|All purpose flour
|2 Tablespoon
|Cold water
|1⁄4 Cup (4 tbs)
Coat meat with flour; brown slowly in hot shortening.
Add 2 1/4 cups water; cover and simmer (don't boil) for 1 hour.
Add potatoes, carrots, celery, onion, bay leaf, Worcestershire sauce, salt, and pepper.
Continue cooking 15 to 20 minutes or till meat is tender.
Meanwhile, prepare Fluffy Dumplings: Sift together 1 cup sifted all-purpose flour, 2 teaspoons baking powder, and 1/2 teaspoon salt.
Combine 1/2 CUP rnilk and 2 tablespoons salad oil; add to dry ingredients, stirring with fork just till flour is moistened.
Add tomato sauce and peas to stew; bring to boiling.
Drop dumpling mixture from tablespoon atop bubbling stew.
Cover tightly.
Reduce heat (don't lift cover) and simmer 12 to 15 minutes longer; remove dumplings and bay leaf.
In shaker, mix flour with 1/4 cup cold water.
Stir into stew; cook and stir till mixture thickens and bubbles.
Serve with Fluffy Dumplings.


text:
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Careful making fun of Myriam now, she's the one who's good with guns after all!
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Hundreds of Kurds marched in Beirut Sunday to demonstrate against Turkey's accusations against fighters in Kobani.


text:
Secondary menu
Pluto's demotion from "planet" status to "lame Kuiper Belt resident" ahem "dwarf planet"/"planetoid" continues to be the subject of deep nerd rage. Many of us who grew up with Pluto-as-planet feel that modern astronomers are messing with our childhood memories. Others just make shirts and move on.
Today I bring you C.G.P. Grey's beautifully reasoned discussion of why Pluto is or isn't a planet, what the Kuiper Belt is, the history of planets, and (most fundamentally) what the word "planet" has meant... READ ON
In this short animated video, Dr. Olivia Johnson of the Royal Observatory Greenwich (home of Greenwich Mean Time and the Prime Meridian) explains how scientists measure the universe using parallax, standard candles, and the Doppler effect. Got four minutes? Pick up some basic math. (Sorry, maths.)
Royal Observatory Greenwich is hosting an exhibit on Measuring the Universe through September. See also: Hank Green's explanation of how The Universe Has No Edge.
(Via... READ ON
At this year's Maker Faire, Adam Savage delivered a speech about "why we make" -- a discussion largely about how Savage gets kids interested in making things. But first, he started with a story about his exquisitely perfect Indiana Jones fedora. He begins: "This is a replica of Harrison Ford's hat from Raiders of the Lost Ark. Yes, one of the most important movies ever, it came out when I was 13 years old, [it] changed my life, gave me a new ... kind of action hero I fell in love with. And the same... READ ON
"Nothing I did, where the only reason for doing it was the money, was ever worth it except as bitter experience. Usually I didn't end up getting the money either. The things I did because I was excited and wanted to see them exist in reality have never let me down, and I've never regretted the time I've spent on any of them. The problems of failure are hard; the problems of success can be harder, because nobody warns you about them. The first problem of any kind of even limited success is the... READ ON
Kaiten-zushi is better known in the US as "conveyer-belt sushi" or a "sushi train." Sushi is placed on small plates, and the plates on a conveyer belt that runs around the restaurant. Patrons sit at a bar or in booths along the belt's path, picking off plates as they go by. Plates are generally priced according to a color scheme (at my local joint, light green is $1, orange is $1.50, then there's the dreaded and rare dark blue at $3!). At the end of the meal, plates are totaled up to calculate a bill.... READ ON
In this video, YouTube user nik282000 shows us what happens when lithium metal burns -- in slow motion. Using a 300fps camera (10x slower than realtime) and a macro lens, we can see the process of lithium burning, passing through several bizarre phases until it resembles a hunk of charred cauliflower. Have a look!
Note: things don't really get cool until just before the 2-minute mark. Give it time.
If you want a (shaky) view of what this looks like in realtime, check out some guy burning... READ ON
In 2009, students at Cambridge University genetically engineered E. coli bacteria, adding DNA sequences in order to create colors visible to the naked eye (standard E. coli does not have a pigment). The students called this new strain E. chromi, and it has limited uses today, primarily related to detecting pollution or other chemicals -- if the bacteria detects a chemical, it changes color.
That's all well and good, but how do we take this and go nuts with it, creating a Terminator-like dystopian... READ ON
As a little light science-ish fare for Friday, here's a TED Talk in which David Blaine explains his quest to hold his breath for a really, really long time. He goes through a variety of possible "trick" techniques (none of which worked), and discusses his much-publicized failure to escape from handcuffs during his "Drowned Alive" feat. But then he gets to the interesting stuff -- a seemingly credible story of how he trained to do a sustained breath-hold after breathing pure oxygen. This is a different... READ ON
Ze Frank has been making awesome internet videos since before that was a thing. Today, I have the honor to appear briefly* in his show Chase That Happy, which is concerned with how we get happy when we aren't. While the goal of life isn't to be happy all the time, perhaps it is to watch Ze Frank and hope that maybe, someday, he will blink.
Representative quote: "For example I discovered Happy Typing, where you type like a Crazy Secretary in a silent film. [Frank types crazily]" Content note:... READ ON
Today happens to be the birthday of tons of famous musicians. Here's a little roundup of tunes by Liberace, Jonathan Richman, Krist Novoselic, Janet Jackson, Richard Page, Robert Fripp, Boyd Tinsley, and The Beach Boys (whose album "Pet Sounds" was released today in 1966). Other notable musical birthdays today -- unfortunately left out of this wrapup -- include Pervis Jackson of The Spinners, Billy Cobham, Barbara Lee of The Chiffons, Simon Katz of Jamiroquai, and Ralph Tresvant of New Edition. I'm... READ ON
The plastic pink flamingo is the official city bird of Madison, WI.


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The official SQL Server AlwaysOn team blog.
Matt Neerincx from the SQL Server Data Programmability team discusses installing thelatest AlwaysOn features for ADO.NET. Demonstrates how to install the ADO.NET updatesand use the features with SQL Server Management Studio and Visual Studio.
Sorry the current video is corrupted at about 3 minutes, I'm working to get this fixed.
Hi folks, I fixed the video. Note that we just released the .NET Framework 4.0.3 and I recommend you install this update versus the 4.0.2 mentioned in the video. The .NET Framework 4.0.3 has some additional fixes for the MultiSubnetFailover feature to support connecting to clustered named instances as well as some performance improvements for failover.
where do you download 4.0.3 from? and do you need to install on Web servers only? is there a VS2010 also?
The URL is here msdn.microsoft.com/.../hh854775
Likewise you can search by KB number, the numbers are below:
Download the Design-time Update; for more information, see KB2600214
Download the Run-time Update; for more information, see KB2600211
Download the Multi-Targeting Pack; for more information, see KB2600213
To answer your other question:
To update VS2010, install the Design-time update. This enables intellisense for ApplicationIntent and MultiSubnetFailover keywords as well as 4.0.3 targeting ability for VS.NET.
The run time update has to be installed anywhere you run code that uses the ApplicationIntent or MultiSubnetFailover keywords. So for example if you have a Reporting Server you would need to apply this patch to the Reporting Server host to enable uploading reports that use these connection string keywords.
Likewise, if you have an IIS web application you need to apply run time update to get IIS applications to use the keyword.
You would also install this on your development box or any machine that you want to use SSMS to connect using these keywords. The Design-time Update only has to be applie


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A wave of repression by the Sisi regime the past two years has been matched by a rise in Islamist attacks. Following the car bomb in Cairo Monday, both sides are likely to up the ante.
The group's claims that it wouldn't treat religious minorities in Syria savagely if it comes to power aren't holding up in reality.
Gen. Ray Odierno said in an interview aired today that a massive US military effort in Iraq would defeat the Islamic State – and leave them hanging unless Iraqi politicians changed course.
There are troubling signs that training efforts in Iraq haven't been going well. And a lack of US manpower doesn't appear to be the reason.
Probably not. But an amicable agreement between the IMF, Germany, Greece and others on handling the country's massive debt is likely to take more time.
The alleged killer of nine parishioners at a black church in Charleston, SC, appears to have been inspired by a website dedicated to framing white Americans as victims of African-Americans.
For neo-Nazis and white supremacists, a Rhodesian flag is more than just decoration.
Michael Oren, a former Israeli ambassador to the US, has launched a broadside against the Obama administration.
US President Barack Obama smiles after being asked whether the events of the past few days constituted his 'best week,' as he and Brazilian President Dilma Rousseff hold a joint news conference in the East Room of the White House in Washington, Tuesday.
There are troubling signs that training efforts in Iraq haven't been going well. And a lack of US manpower doesn't appear to be the reason.
Egypt's tourism has taken a beating in recent years, and the attack at Luxor's Karnak temple complex, one of its most famous archeological sites, won't help.
After years of revolt and turmoil, Egypt is in a period of historic oppression. And world powers like the United States are pretty much OK with that.
America has been groping for a successful strategy in Iraq for more than a decade, but the realities on the ground keep getting in the way.
The so-called Islamic State may be getting most of the headlines. But there's another rebel group on the move in Syria, one that works with the US-backed Free Syrian Army, that is also cause for concern.
Here are five key takeaways from the allegations that US prosecutors hope will send some of the world's most powerful and wealthy soccer officials to jail.
As the story unfolds, anything is possible. But for now, embattled FIFA President Sepp Blatter and his allies are circling the wagons.
The nine current and former FIFA officials arrested today could be the tip of the iceberg.
With the fall of Ramadi, the 'new' Iraqi Army continues to crumble. In its place sectarian militias are coming to the fore.
Baghdad's war against the Islamic State does not appear to be going as well as US officials have led many to believe.
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Windows can't access registry information
On our user workstations, every couple of hours we get an App Log entry for Userenv, Event 1000, User System, which...
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reads: "Windows cannot access the registry information at domain.netsysvoldomain.netPolicies{31B2F340-016D-11D2-945F-00C04FB984F9}Machineregistry.pol with (5)."
This error is strange in that the user can access the policy file directly, so this appears to be a problem just on startup. I have tried to chase this down but to no avail. The most prevalent reference is to DNS but we have no DNS issues that I can find.
This may be a Registry permissions issue. The reason you may only be seeing the problem once is because it is only being accessed once at startup or login. Search on any keys in the Registry that match the listed GUID and see if they have the proper permissions set on them.
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Originally written on NESN.com | Last updated 12/8/12
The troublesome Achilles injury that knocked David Ortiz out of the Red Sox' lineup last season and cut down his attempt at a return is still bothering the slugger. Ortiz said Friday that he is still not working out normally, according to Peter Abraham of The Boston Globe. "At this point, not yet," Ortiz said. "Very soon." Ortiz was optimistic that he would be ready in February, when position players return, but was still noncommittal. "I hope so. Hopefully," he said. While Abraham reports that Ortiz's offseason regimen isn't necessary off-track — he usually starts hitting again in January — the injury has taken longer to heal than anyone would like. Ortiz was originally hoping to jump back into the lineup last summer after a trip to the 15-day disabled list. After a short return, though, he re-aggravated the injury. He spent the rest of the season recovering and trying various treatments. Ortiz, who was about the only hitter who was consistently on track for Boston last year, recently signed a two-year deal with the Red Sox.
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Microsoft and Mozilla Browser Security Fight: They're Both Wrong
Microsoft and Mozilla have been squabbling over whose browser is more secure--but both companies are likely wrong.
What Bill Gates Has Said About Steve Jobs Through the Decades
Bill Gates and Steve Jobs have been competitors and friends for decades. Here's a look at some of the things Gates has said about Steve Jobs through the years.
Outlook Add-In Zendio Tells You When Recipients Read Your Emails
Zendio reports which emails have been read, and which haven't.
Apple's iCloud May Mean Stormy Weather for Windows 8
Well before Windows 8 is released, Apple will have a robust cloud service that is at least as capable as--and possibly more capable than--the one that Microsoft will release.
Internet Explorer's Market Share Declines, Spelling Trouble for Microsoft
A browser is everyone's primary gateway to the Internet, and if Microsoft can control the gateway, it can route people to its services rather than have them head to a competitor.
Xobni's Smartr Inbox for Gmail Integrates Email and Social Networking
This free add-on for Chrome, Firefox, and Safari lets you integrate Facebook, Twitter, and LinkedIn with Gmail.
Send Links Without Opening Email With Email This! Firefox Add-on
Use Firefox add-on Email This! to send Web links via email when you're viewing a Web page.
Researcher Claims Windows Phone 7 Snoops On Users' Locations
When it was discovered that the iPhone secretly reported users' locations, Microsoft claimed Windows Phone 7 did not do the same thing. But now a security researcher claims otherwise.
Windows 8: A Deep Dive into the Developer Preview
After spending several days using Microsoft's new OS on a PC, what will you find?
Microsoft Looks to Join Apple as World's Biggest App Censor
Microsoft says the only apps allowed to run in Windows 8 will have to be downloaded from Microsoft's own app store.
Encrypt your e-mail to keep it from prying eyes.
HTC Chief: iPhone Suffers From 'Your Dad Uses It' Syndrome
The acting president of HTC America claims that iPhones are "not that cool anymore."
Analysis: Intel and Microsoft, once best friends, have become grudging "frenemies."
Microsoft Says Windows 8 Ribbon is Here to Stay
Microsoft's Windows Live president makes it clear that, while he understand why some people might not be happy about the ribbon, it's not going anywhere.
PowerDesk�� 8 Professional is the easy, fast and expert way to organize and manage the files, digital photos, MP3s and web images on your PC. With far more features and functions than the standard Windows file manager or other file management software, PowerDesk�� 8 Pro gives you the tools to search, edit, delete, copy, move, sort, zip, label, view, convert and more! 6 Powerful File Utilities for the price you'd normally pay for 1! FTP - Access PowerDesk FTP in an easy-to-use, drag-and-drop interface and view FTP sites as though they were ordinary folders! Once youve set up your favorite FTP sites, connecting with them is just 1-Click away. PowerDesk now supports Secure FTP! Sync Manager - Compare and synchronize the contents of two folders. Especially useful for work on files that are shared between two computers, its also useful for backing up files and much more! Size Manager - A powerful utility that shows you where and how the space on each of your drives is being used. Using Size Manager makes it easy to efficiently manage drive storage space. Dialog Helper - Enhances Open dialog boxes and Save dialog boxes by adding a selection list for previously opened files and folders. It also provides a file viewer pane that supports over 150 file formats. Dialog helper also allows fixed dialogs to be easily resized. Archive Manager - Easily compress and expand files from over 30 popular compression formats. See within archives to view entire file lists, selectively view the contents or extract selected files with a simple drag and drop operation. File Finder - Quickly locate forgotten files with a powerful "search engine" type tool. Search by keyword, file type, size, or date range and see the "hits" displayed in a single-line reference. Search inside Zip files, archives, emails and attachments too!
Articles by Preston GrallaNext Page
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(SEATTLE) Jan. 19, 2015 – WHAT A "NUTS GAME" to cover on rainy Sunday after a rather marathon-long , ongoing 11-day work week. The heavily-favored Seattle Seahawks (as we all know) struggled through the first three quarters of their matchup against the old-school Packers. After covering the Seahawks during the 12th-man induced very loud season, I was so surprised to see how squelched-silent the 12th Man was during the first 3/4 of the game. While not perfect early in the season, I had NEVER seen the Seahawks struggle so much during a game this late this year where the Seahawks' offense, including four interceptions by the usually unflappable QB Russell Wilson, appeared to be losing the game in a "small-ball-playing" Green Bay team. And it was working. Pretty decisively.
And then in the fourth quarter's 11th hour, the Seahawks recovery of an on-side kick seemed to be the start of an avalanche of events that ended up in a 22-22 tie game that pushed this playoff matchup into overtime playoff decision play. While the fourth-quarter Seahawks seems like a feral animal backed into a corner defending itself, the "overtime Seahawks" that we saw seems to revive the polish of a jelled-team that not only had a new momentum to win this game, but it showed the mettle that a truly talented team (with heart) looks like in the defense of a National Championship. I was in the left corner of the endzone when Seahawks placeholder John Ryan executed a near-perfect fake placement for field goal kicker Steven Hauschka and instead, tossed the ball into the hands of undrafted wide receiver, and Seattle-local Jermaine Kearse for the game clinching touchdown, the 68,500+ "12th men/women" in CenturyLink Field WENT NUTS! And I am so grateful to have been there to capture Kearse scoring the winning touchdown and then tossing the ball into the endzone crowd that have supported the 'Hawks through this unpredictable season.
Unlike while I was deployed overseas last year where I watched Super Bowl XLVIII with my fellow Washington Army National Guardsmen at 2am in Camp Arifjan, Kuwait, I am extremely grateful for being there with my sports photojournalism colleagues for this year's hometown, capstone match.
Can you imagine that AFTER THIS GAME, I went and shot another photo assignment in Kent, Wash. of the company that manufactures the NFC Championship team T-Shirt? Sheez! #BreakingNews #NoRestForTheJournalismWicked
Photos by Anthony P. Bolante / www.TheImageArsenal.com (c) 2015. FOLLOW me: @TheImageArsenal


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By now we're used to hearing about Michelle Obama's lavish vacations courtesy of the American taxpayer, but Judicial Watch really wants to know the details about the First Lady's fancy adventure to Spain in 2010.
A conservative legal group is suing the U.S. Air Force for access to first lady Michelle Obama's travel records from a 2010 vacation to Spain.
Judicial Watch filed suit Tuesday in the United States District Court for the District of Columbia for access to all records pertaining to an August 2010 vacation taken by the first lady and her daughters — including cost estimates and passenger manifests.
"Evidently, American taxpayers were stuck with a sizable bill so Mrs. Obama could tour around Spain with her family and friends, This administration, as a supposed steward of taxpayer dollars, has an obligation to disclose the full costs of the Obama family's luxury trip," said Judicial Watch president Tom Fitton in a statement.
Most transparent administration ever, right?
|Katie Pavlich is the Editor at Townhall.com. Follow her on Twitter @katiepavlich. She is a New York Times Best Selling author. Her new book Assault and Flattery: The Truth About the Left and Their War on Women, will be published on July 8, 2014.
"Mamas, don't let your babies grow up to be brainwashed government dependents. Buy this book!" says Michelle Malkin.
"This is a thorough and gutsy book that should help set history straight." - Mark Levin
Buy Katie's book today and help us keep the pressure on the Left.
Author Photo credit: Jensen Sutta Photography
California Governor Signs New Law Effectively Mandating Vaccines in Schoolchildren | Christine Rousselle


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BMW 530i Problem Report
BMW 530i Hood latch sticks/binds
(2 reports)
same problem with hood latch cable and had it replaced. - Visitor
Hood release lever stops coming out when release pulled from within driver compartment. This requires using needle-nose pliers or a screwdriver to pull the lever out from between the grill panel. The hood release mechanism and cable need to be kept oiled/greased or they dry up and seize. In my case I was able to spray with WD-40 real good - both the mechanism and the cable anywhere that I could find it exposed. After working the lever in the car a bit it freed up. I then wiped the excess WD-40 from the hood latch mechanism and coated with some white lithium grease. Seems to work fine now. - wcraft


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I have a great hackney pony for sale. He is 18 years old, utd on shots, wtc and is a sweetheart. He is looking for his forever person. I recused him and…$150
12 yr old grey standardbred gelding. His owners have had a loss of income due to an injury so are selling this boy, I know him personally & have taken…$1,200
Arrowhead Stables proudly offers Texas Impulse "Tex"Â� for sale. Tex is a 14 year old, 15.0hh bay gelding. Tex is AQHA registered with amazing bloodlines…$5,000
For sale or lease Big beautiful 10yr old bay TB gelding. Ace is a nice mover and has no vices. He will jump 3ft with a rider and has free jumped up to…$3,200
If you want COLOR, this guy has lots of it!! What a super cute gelding! Spartan is a joy to ride.. W,T,C in the ring, point and go in any direction you…$2,800
This mare is STUNNING! Pepper is one Classy mare! She is an All Around kind of gal! If you want to go out for a nice trail ride or have some fun on cows…$3,950
Cleopatra is a beautiful 4yr. old Thoroughbred Mare!!!!!! She has NEVER been on the track. She has stood in a field her whole life just being taken care…$2,000
Widdle is a very honest mare and has fabulous ground manners. Winning combination of NATURAL IMPULSION, BEAUTIFUL MOVEMENT, AND DESIRE TO PLEASE! Top notch…$2,500


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INTX: The Internet & Television Expo
Cable Show 2013 Exhibit Sales Now Open
Joy Sims
September 27, 2012
Just a quick reminder: premium exhibit floor locations and sponsorships are now available for The Cable Show 2013, taking place June 10-12 in Washington, DC. With special promotions available for new and returning exhibitors, we're making it easier than ever to do business in and around the multi-billion dollar communications industry. But you'll need to…


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Welcome to TalkBass, the Premier Bass Player Community and Information Source. Register a FREE Account to post and unlock tons of features!
- Last Activity:
- Jul 6, 2015 at 1:27 PM
- Joined:
- Apr 2, 2010
- Messages:
- 1,419
- Likes Received:
- 128
- Trophy Points:
- 63
- Gender:
- Male
- Home Page:
- http://bit.ly/1gJwDLx
- Location:
- Minneapolis
- Occupation:
- Musician
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Male, from Minneapolis
back in the saddle again Jul 18, 2014
- skwee was last seen:
- Jul 6, 2015 at 1:27 PM
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- Gender:
- Male
- Home Page:
- http://bit.ly/1gJwDLx
- Location:
- Minneapolis
- Occupation:
- Musician
- Current Setup:
Fender Jaguar Bass Deluxe (Sunburst)
Dean Playmate Acoustic Bass Guitar
GK MB112 amplifier
Yamaha FG700S Folk Dreadnought
POS Squier Electric Guitar
Crate GFX-15 guitar amp
Ozone midi controller
Macbook Pro 15"
various percussion
Pedal stable:
Philosopher's Bass; Digitech Bass Synth Wah; DoD bass flanger; DeltaLab metal distortion; EHX switchblade; EHX Voicebox (still learning)
- Favorite Genres:
- ambient, early music, film and video game scores, rock, opera, electronica
- Gigs and Ensembles:
Freelance singer: from major opera companies to Birdland. Choir Director; Composer/Arranger/jack of many musical trades.
St. Paul-based cover band: http://on.fb.me/1qHu5Bk
- Previously Owned Gear:
Peavey Dyna Bass (1985)
Peavey Combo 300 Amp
Some short-scale p-bass that my cousin sold me. Looked like Stryper. Couldn't tell you the brand.
- G.A.S. List:
Fender Modern Player Telecaster Bass
Knock-around P/J or a Xaviere p-bass
- Influences and Teachers:
- Influences: Händel, Rush, Björk, classic rock, bubblegummy pop, Jeff Buckley
- Hobbies and Interests:
- Music, Myth, Microbrew
Signaturedm dm dm dm dm dm dm dm
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