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A surgical instrument having an elongated shaft to which is attached an inflatable balloon, commonly referred to a "balloon dissector", for dissecting a desired layer of internal bodily tissue from remaining tissue layers to create an operative space is disclosed. Alternatively, an instrument without a balloon can be used to perform a manual dissection. In one embodiment, the instrument has a tissue-contacting element in communication with the shaft distal end, and at least a portion of the tissue-contacting element is transparent. The instrument is adapted to receive an endoscope through its shaft and extend to adjacent the tissue-contacting element. The endoscope is supported and positioned in an extension assembly. The instrument provides for visualization using the endoscope as the instrument is advanced through tissue, but prevents direct contact between the tip of the endoscope containing the lens and the tissue. The extension assembly also enables the endoscope to be adequately positioned and supported beyond the shaft distal end. When the instrument incorporates the balloon, the endoscope can extend into the lumen of the inflated balloon. In this way, improved visualization during use can be obtained.
1. A surgical instrument for dissecting internal bodily tissue, said instrument comprising:
a trocar cannula having a cannula housing and an elongate tubular sleeve extending distally therefrom for slidably receiving an endoscope therethrough, said tubular sleeve having a longitudinal axis and a distal end; and
an extension assembly connected to said sleeve distal end and extending distally therefrom, said assembly having a proximal end affixed to said sleeve distal end and a distal end having a restricting member positioned remote from said sleeve distal end, and a plurality of spaced apart extender arms connecting said assembly proximal end to said assembly distal end, said extender arms extending in a direction generally parallel to said sleeve longitudinal axis, wherein said extension assembly provides a passageway therethrough from said sleeve distal end between said extender arms to said assembly distal end for receiving and supporting an endoscope inserted through said assembly for positioning adjacent said restricting member, said restricting member blocking distal movement of said endoscope beyond said restricting member.
2. The instrument of claim 1 wherein said sleeve has an outer diameter, and said restricting member is in the form of a ring having a ring diameter less than said sleeve outer diameter.
3. The instrument of claim 2 wherein said extension assembly has no more than four extender arms.
4. The instrument of claim 3 further comprising an inflatable balloon surrounding said extender arms and said restricting member.
5. The instrument of claim 4 wherein said balloon has proximal and distal ends, said balloon proximal end is attached to said assembly proximal end, and said balloon distal end is in contact with said restricting member when said balloon is in a deflated condition.
This invention relates generally to a surgical instrument for creating an operative space during surgery. More specifically, it relates to such an instrument which creates this space by dissecting a desired layer of tissue from remaining tissue layers.
Tissue dissection to create space at a desired surgical site has been a focus of design engineers concentrating on the development of new surgical instrumentation. An increasingly popular method to dissect tissue involves inflating a balloon between adjacent tissue layers to separate those layers and create the desired space. Surgical procedures and instruments incorporating an inflatable balloon to carry out these procedures are described in U.S. Pat. Nos. 5,309,896 and 5,269,753; and published PCT International Application Nos. WO 92/212 95 and WO 93/097 22. Alternatively, dissection can be carried out manually without the aid of an inflatable balloon.
Another recent development in connection with surgical instruments is described in U.S. Pat. Nos. 5,271,380 and 5,334,150. These patents describe trocars for the penetration of bodily tissue. Unlike a conventional trocar in which the penetration of the tissue is performed blindly, the trocars described in these patents enable the user to simultaneously visualize the penetration of tissue as the trocar is advanced through the body wall. Trocars which enable simultaneous visualization are now referred to as "optical trocars". An optical trocar consists of a rigid tubular shaft to which is attached a transparent penetrating window. An endoscope for illuminating the surgical site and transmitting images of the site to the surgeon is received in the tubular shaft and extends adjacent the transparent penetrating window.
Unfortunately, the optical trocar described in the patents above may not always be ideal for creating needed operative space by carefully dissecting adjacent layers of tissue. In addition, the balloon dissectors currently available do not provide for simultaneous visualization as the surgeon is dissecting tissue.
Recently, General Surgical Innovations ("GSI") has shown a prototype product of what it refers to as the SPACEMAKER™ II Surgical Balloon Dissector. This dissecting instrument consists of a rigid hollow shaft to which is attached an inflatable balloon. The endoscope is insertable through the shaft, and the brochure accompanying this developmental instrument indicates that the endoscope is capable of providing for visualization during insertion as well as during balloon dissection. Unfortunately, when the endoscope may be inserted through the hollow shaft, the lens on the tip of the endoscope may be exposed to direct tissue contact as the instrument is advanced during insertion. The direct contact between the endoscope lens with the tissue and the lack of separation between them causes a significant deterioration of the visual capabilities of the endoscope, and therefore fails to satisfactorily address the problem of providing adequate visualization during the advancement of a balloon dissector. In addition, the position of the endoscope in relation to the inflated balloon is undesirable for optimum viewing. This is so because the endoscope is not readily supportable and positionable into and through a significant portion of the inflated balloon.
In view of these deficiencies inherent in the surgical instruments described in the references above, the surgical community needs a balloon dissector which satisfactorily enables the user to visualize during insertion, and to dissect the tissue when the balloon is inflated. The surgical community also needs an instrument which includes an elongate hollow shaft for receiving an endoscope to provide visualization during surgery, but also enables the user to position and support the endoscope significantly beyond the distal end of the shaft for optimum viewing.
In one aspect of the invention, the invention is a surgical instrument comprising an elongated tubular shaft having a distal end and a shaft longitudinal axis. A tissue-contacting element is in communication with the shaft distal end, and at least a portion of this element is transparent. An inflatable transparent balloon is attached to the shaft.
The surgical instrument of this invention enables the user to not only dissect tissue when the balloon is inflated, but also visualize the tissue as the instrument is advanced when an endoscope is positioned adjacent to the tissue-contacting element for viewing. Unlike GSI's SPACEMAKER™ II Surgical Balloon Dissector which may allow for direct contact between the endoscope lens and instrument tissue when the instrument is advanced, the device of this invention incorporates a tissue-contacting element preventing direct contact between the tip of the endoscope and the tissue. Since at least a portion of the tissue-contacting element is transparent, an endoscope inserted through the tubular shaft can transmit illuminated images received from the surgical site through the transparent portion of the window without requiring direct contact of the endoscope lens with the tissue.
In another aspect of the invention, the invention is a surgical instrument for dissecting internal bodily tissue. The instrument comprises a trocar cannula and an extension assembly. The trocar cannula has a cannula housing and an elongated tubular sleeve extending distally from the housing. The trocar cannula is adapted to slidably receive an endoscope through the housing and tubular sleeve. The tubular sleeve has a longitudinal axis and a distal end.
The extension assembly is connected to the distal end of the sleeve and extends distally from the sleeve distal end. The assembly has a proximal end affixed to the sleeve distal end and a distal end having a restricting member positioned remote from the sleeve distal end. A plurality of spaced apart extender arms connect the assembly proximal end to the assembly distal end. The extender arms extend in a direction generally parallel to the longitudinal axis of the sleeve. The extension assembly provides a passageway through it from the sleeve distal end between the extender arms to the assembly distal end for receiving and supporting an endoscope inserted through the assembly for positioning adjacent the restricting member.
Significantly, the extension assembly connected to the trocar cannula of the surgical instrument of this invention provides a supporting structure for an endoscope which is inserted through the trocar cannula and extends well beyond the distal end of the tubular sleeve of the cannula. The restricting member at the distal end of the extension assembly provides a positive stop to prevent further distal movement of the endoscope beyond the restricting member, and therefore facilitates the precise positioning of the endoscope during the tissue dissection procedure. In one preferred embodiment, an inflatable balloon is affixed to the distal end of the tubular sleeve of the trocar cannula and surrounds the extender arms and the restricting member of the extension assembly. This preferred instrument can then be used as a balloon dissector, and it has the advantage of enabling the user to supportably extend the endoscope significantly beyond the distal end of the tubular sleeve and into and through the lumen of the inflatable balloon. The comprehensiveness of the visual field and the visual acuity obtained when the endoscope is positioned in this way during a tissue dissection is significantly greater than that obtained using other balloon dissectors which have recently entered the public domain.
The surgical instruments of this invention can be used in any procedure where it is desirable to inflate a balloon to provide for the dissection of bodily tissue. Alternatively, they can be used to perform a manual dissection without the aid of a balloon where it is desirable to provide enhanced simultaneous visualization. The instruments can be used in conventional as well as endoscopic surgical procedures, although the instrument is particularly adapted for endoscopic surgical procedures such as laparoscopic hernia repair, laparoscopic bladder neck suspension, and lymph node dissections.
FIG. 1 is a perspective of an assembly including the surgical instrument of this invention configured as a balloon dissector shown in a deflated position.
FIG. 2 is a perspective view of the assembly where the balloon dissector is shown in an inflated position.
FIGS. 3-5 are side elevational views, partially broken away, showing how the assembly is used to dissect internal layers of tissue to create an operative space on a surgical patient.
FIG. 6 is an exploded perspective view of the assembly.
FIG. 7 is a partial side elevational view of the assembly with portions broken away to disclose the method of inflating the balloon dissector.
FIG. 8 is a cross-sectional view of the extender arms of the extension assembly which forms a part of the preferred balloon dissector as taken along section line 8--8 of FIG. 7.
FIG. 9 is an enlarged side view illustrating the abutting relationship between the distal end of the endoscope and the restricting member at the distal end of the extension assembly as seen along view line 9--9 of FIG. 8.
The preferred surgical instrument of this invention includes an assembly 10 having a balloon dissector 11 as the primary component. The assembly is best illustrated in FIGS. 1, 2, and 7. The assembly consists of two primary components. These components are the balloon dissector 11 for the dissection of internal bodily tissue to create an operative space during a surgical procedure, and an endoscope 12 in cooperation with the balloon dissector to provide simultaneous visualization during the surgical procedure as the dissector is advanced through tissue and the operative space is created.
The balloon dissector consists of a conventional trocar cannula 13, an extension assembly 14 to position and provide support for an endoscope, and an inflatable balloon 15. The trocar cannula has a cannula housing 16 providing a passageway to an elongated tubular sleeve 17 extending distally from the housing. The housing contains a conventional stop-cock valve 18 to selectively provide for the flow of a pressurized fluid such as air from a suitable external source through the housing and sleeve into the balloon. The tubular sleeve 17 of the cannula is sized to slidably receive an endoscope. The sleeve has a distal end 33, and the sleeve defines a longitudinal axis designated as "L" in FIG. 6.
The extension assembly 14 is attached to the distal end of the tubular sleeve of the cannula. The extension assembly has proximal and distal ends, 19 and 20, respectively, and provides a passageway 34 from the proximal end to the distal end to receive, position and support the endoscope 12 protruding from the distal end of the tubular sleeve. The assembly proximal end is shaped as a short tube 21 which can be removably or permanently secured within the internal diameter of the tubular sleeve as illustrated in FIG. 7. Alternatively, it can be secured externally to the outer diameter of the sleeve.
Three extender arms 22 extend from the short tube 21 at the proximal end of the extension assembly and terminate at the distal end of the extension assembly. Although three arms are shown, it may be desirable to construct the extension assembly with four arms to provide enhanced support without appreciably sacrificing optical quality during visual observation using the endoscope. The extender arms 22 are displayed generally parallel to the longitudinal axis L of the tubular sleeve of the cannula, and therefore do not obstruct the passageway when the endoscope is inserted into and through the extension assembly.
The extension assembly is desirably composed of a resilient plastic so that the extender arms provide resiliency without sacrificing needed support. This resiliency in turn provides needed flexibility as the instrument is advanced during surgery. The extender arms are connected at the distal end of the extension assembly with a restricting member in the form of a ring 23. The ring has an internal diameter smaller than the internal diameter of the tubular sleeve of the cannula and of the endoscope 12. The ring therefore blocks distal movement of the endoscope at the distal end of the extension assembly to facilitate the desired positioning of the endoscope (see FIG. 9).
In one preferred embodiment, a tissue-contacting element 24 is fastened to the distal end 20 of the extension assembly adjacent the ring 23. The tissue-contacting element is a transparent, hollow cone which acts as a window for the endoscope and helps to prevent direct contact between the endoscope and internal bodily tissue as the instrument is advanced during a surgical procedure. The cone has a blunt tip 25 to ensure atraumatic blunt tissue dissection and is positioned on the extension assembly so that it is symmetrical about the longitudinal axis of the tubular sleeve.
The endoscope is a conventional, fully-integrated rigid endoscope which provides the delivery of light into the body from an external source and transmits images from the illuminated body cavity to the surgeon at an eye piece or a video monitor, whichever is desirable. The endoscope is releaseably inserted into the trocar cannula and through the tubular sleeve of the cannula. It protrudes beyond the sleeve distal end into the passageway and structural support provided by the extension assembly. In this particular embodiment, the endoscope can be inserted distally until it abuts not only the ring 23 at the distal end of the extension assembly, but also an internal annulus 26 of the tissue-contacting element adjacent the ring. When a light source is activated, the light is delivered through the endoscope and exits the distal end of the endoscope. The light travels through the transparent conical window of the tissue-contacting element and is emitted into the body cavity to provide illumination. The illuminated images from the body cavity are reflected back through the window and are transmitted through the endoscope to provide the surgeon with the illuminated images in the conventional manner. The endoscope is securely supported and positioned within the extension assembly, and the tissue-contacting element provides a barrier between the tissue as it is being dissected and the distal end of the endoscope.
To provide further support and precise positioning of the endoscope within the extension assembly, the trocar housing 16 includes a locking assembly 27 affixed to the cannula housing 16. The locking assembly has a latch 28 to secure the endoscope in a desired position during use. This locking assembly is described in more detail in co-pending application Ser. No. 08/382,462, filed Feb. 1, 1995.
The last component of the assembly incorporating the balloon dissector is, of course, the inflatable balloon 15. The balloon is preferably made of a puncture-resistant, distensible material compatible with human tissue. Preferably, the balloon is composed of a silicone elastomer. The balloon has a proximal end 29 affixed to the distal end of the tubular sleeve of the cannula. Alternatively, if the extension assembly 14 is affixed to the outer diameter of the tubular sleeve, then the proximal end of the balloon can be attached to the extension assembly proximal end. The proximal end of the balloon can be attached using conventional methods such as heat sealing. The extension assembly and the tissue-contacting element protrude into the lumen of the balloon, and therefore the balloon completely surrounds and envelopes these components. The distal end of the balloon 30 fits snugly over the tissue-contacting element when the balloon is in a deflated position.
As illustrated in FIG. 7, the balloon is inflated when the stop-cock valve mounted on the trocar cannula is turned on to permit the passage of pressurized air in the direction of the arrows through the tubular sleeve and into the lumen of the balloon to inflate the balloon. Once the balloon is inflated, the stop-cock valve is turned off, and the balloon will maintain its inflated condition until it is desired to deflate the balloon. At this point, the source of pressurized air is removed, and the stop-cock valve is once again turned on to allow the air inside the inflated balloon to escape through the tubular sleeve and out of the stop-cock valve of the trocar cannula. Although the inflated balloon is illustrated as a spherical balloon, other desired shapes can be used, and the shape of the balloon is not an essential feature of this invention.
In an alternative embodiment (not shown), the assembly does not include the tissue-contacting element, and the endoscope simply abuts only the ring at the distal end of the extension assembly for desired support and positioning of the endoscope.
The use of the assembly including the balloon dissector during a surgical procedure to dissect internal bodily tissue for the creation of an operative space is illustrated in FIGS. 3-6. An exposed portion of a surgical patient 31 is illustrated. The exposed portion of the patient includes internal layers of bodily tissue 32. To dissect away certain layers of the tissue from other layers, the assembly is inserted through the outer layers of the skin and advanced in a direction generally parallel to the adjacent layers of the internal bodily tissue. Concurrently with the advancement of the assembly through the tissue, the surgeon will visualize the advancement using the endoscope. Once the surgeon has advanced the assembly to the desired position within the bodily tissue, the balloon is inflated through the cannula sleeve to further separate the adjacent layers of tissue. Significantly, the protrusion of the endoscope well beyond the sleeve distal end into and through the extension assembly greatly enhances the visual field for the surgeon as the dissection progresses. The visual clarity and comprehensiveness of the visual field is appreciably greater than what it would be if the endoscope did not extend beyond the sleeve distal end, or if the extension assembly were replaced with a tubular extension.
After the balloon is sufficiently inflated to separate the tissue, the balloon is then deflated. The assembly including the balloon dissector may then be removed from the patient, and another trocar cannula 35 can be introduced into the patient where the space has been created (see specifically FIG. 5). The surgeon can then perform therapeutic or diagnostic procedures within the operative space created using the new trocar cannula as a passageway for other surgical instruments.
This invention has been described in connection with a specific preferred embodiment. The descriptions provided to illustrate this embodiment should not be used as a basis for a narrow or limited construction of the language set forth in the appended claims. Quite the contrary, the appended claims should be interpreted broadly because one skilled in this art can readily envision numerous additional embodiments which have not been specifically described but nevertheless would fall within the scope and spirit of the claimed invention.
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subset: commoncrawl


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The rivalry between the Ravens and Patriots impacts the relationship between John Harbaugh and Bill Belichick. The two coaches have been friends for years, but they have to be careful during conversations, not to reveal too much about their teams. Belichick was asked about his relationship with Harbaugh during his Friday press conference.
"It would be a lot better if we didn't have to play each other every year," Belichick said. "I have a lot of respect for John. John's another guy that kind of started like I did – started as a special teams coach. As he and I have talked about, I think that's a great way to learn the game of football. You learn situation football, you learn the kicking game, you learn how field position and all of those things relate to the other aspects of the game. I'd love to have a closer relationship with John if we weren't in the same competition."
Harbaugh and Belichick have often tangled when the stakes were extremely high. The Ravens and Patriots have met in the last two AFC championship games, and Sunday's matchup will have huge playoff implications.
At some point down the road, Harbaugh and Belichick may go out to dinner and reminiscence about their meetings. However, that will not happen this weekend.


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Carmarthen school's Gangnam Style sensation
Posted: December 27, 2012|
PUPILS and staff at a Carmarthen school have become an internet hit with their own version of the hit single Gangnam Style.
More than 5,000 people have watched the spoof of the song on Youtube by Korean pop star Psy.
It was performed by
Queen Elizabeth High School sixth form pupils, staff and canteen staff.
The video was part of the school's festive pantomime held last month before breaking up for the Christmas holidays
Even the school's head teacher Peter Spencer and deputy Allan Carter joined in the fun to perform when two pupils ask in the video if they'd "like to Gangnam with us sirs?"
Pupils are dressed in a range of fancy dress outfits in the video from Santa to the Hulk, Batman and the Joker, along with comedian Keith Lemon.
The school has a Christmas pantomime every year at the end of term which is written, performed and organised by sixth form pupils.
The video was played in between scenes of this year's show.
In the story Psy is revealed as the villain who kidnapped staff and pupils in order to make a new epic music video.
Pupils then performed the Gangnam dance as they walked off stage where it cuts to the video as they're told to spread Gangnam Style around the school.
br>For the full story and pictures, see the Carmarthen Journal on January 2.


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At the very mention of the name of Pec pod Sněžkou many skiers think of the wonderful panorama of the main ridge of the Krkonoše Mountains, reigned over by the highest Czech mountain. They think of the perfectly groomed slopes of all difficulty levels, the excellent facilities for snowboarders, and the perfect cross-country trails with absolutely breathtaking views. Pec pod Sněžkou is simply one of the top ski resorts in the Czech Republic and an ideal place for a dream winter holiday full of active movement, fun and discovery.
+420 499 736 375
The ski resort of Pec pod Sněžkou is located in the eastern part of the highest Czech mountains, the Krkonoše, Pec itself is also known as a gateway to the most beautiful parts of the area, including Sněžka and its surroundings. In addition to the 11 groomed slopes and a Freestyle park, it offers everything you need for an unforgettable stay. It has a wide array of hotels, guest houses, good restaurants, and also places for sporting activities. In the evenings you can play tennis or squash, take a swim, head to the fitness centre, or perhaps take a romantic ride in a horse-drawn sleigh.
The total length of the slopes in Pec pod Sněžkou is more than 11 kilometres. For a burst of adrenaline coming from a fast descent on challenging terrain, the best place is the black slope on Hnědý vrch II (meaning Brown Hill II). Less experienced skiers often criss-cross their way down one of the seven red slopes. And for beginners there is a choice of three blue slopes. On three of the slopes you can also enjoy evening skiing. If you also would like to try some other winter sport experiences, on the slopes you can rent an inflatable innertube and try snowtubing. In Pec you will also find a popular bobsleigh track.
Are you bringing a snowboard instead of skis on your holidays? That's a great idea! At the ski resort in Pec pod Sněžkou you can enjoy an excellent ride at one of the most expansive snow parks in the Czech Republic, with a variegated rugged surface with boxes, rails, big airs, platforms and a jibbing zone. As befits a first-rate ski resort, Pec pod Sněžkou offers all the amenities for a flawless winter getaway on the slopes, including ski equipment rentals, a ski school, repair shops, ski taxis, babysitting, and plenty of places where you can eat well or pleasantly warm up with coffee or mountain herb tea.
There is no better starting point from which to explore the Krkonoše National Park than Pec pod Sněžkou. You can set off on foot or cross-country skis to discover the mystery of one of the most rugged places in Europe, abounding in alpine wonders. If you're a cross-country enthusiast, you can link up with the famous Krkonošská magistrála, which will reward your athletic effort with stunning views of this kingdom of nature.


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Goat Cheese and Balsamic-Roasted Cherry Crostini
These easy, delicious crostini are topped with juicy balsamic-roasted cherries and tangy goat cheese. More
These easy, delicious crostini are topped with juicy balsamic-roasted cherries and tangy goat cheese. More
Radicchio, a hearty bitter lettuce, becomes remarkably sweet and succulent when charred over a live fire. Served with a drizzle of good olive oil and saba—a sweet wine-based condiment—along with a sprinkle of gorgonzola cheese, it's the best vegetable you've never grilled. More
Roasted green beans transition easily to this room temperature salad, maintaining their crunch beneath a balsamic vinaigrette. Finished with blue cheese and hazelnuts, it's a simple dish with showy results. More
Roasted green beans are swathed in balsamic vinaigrette and stippled with hazelnuts and crumbled blue cheese. More
In this sherbet, the balsamic and strawberries are up front and center on the initial taste but it finishes with the tang of buttermilk. More
Although this drink is served over ice, it still packs a toasty punch thanks to the layers of warm flavors. More
The perfect answer to early fall: Pork loin rubbed with fennel makes an ideal companion for sticky, glazed balsamic vegetables. More
Bright, fruity, with mellow tartness and sweetness, this strawberry balsamic sauce is ready for a multitude of uses. More
Balsamic-glazed ham and basil peas lend a springtime feel to this festive meal. More
Leave it to carnivores Vinny Dotolo and Jon Shook, the fearless chefs behind the meat-centric LA restaurant Animal to give us a platter of blackened, sticky ribs, as documented in Adam Roberts' new book, Secrets of the Best Chefs. I'm calling this rib sauce black magic from now on. More
Heinz's new Balsamic Vinegar Ketchup sounds like a winner, right? Upping the balscidity (new word) in lieu of the traditional distilled white vinegar gives it a mild kick without completely throwing off the familiar taste of ketchup. This is actually a pretty big move for Heinz, a bastion of ketchup tradition; they haven't released a new flavor in about a decade. (Remember green ketchup in the early 2000s?) More
This is a bright, fresh, and impressively fruity ice cream that rises above the strawberry pack. A touch of balsamic vinegar adds sweet complexity and some of the acidity lost by cooking the fruit. More
A last-minute drizzle of balsamic adds a tart glaze to these crispy sprouts. More
Shallots and acorn squash are roasted with balsamic vinegar and rosemary to get a sweet and sour taste. More
These grilled fig sundaes are a perfect transitional dessert. Shades of summer are represented though scoops of ice cream and burstingly sweet figs that are grilled, preferably before the grill is retired for the season. Fall come through with the rosemary skewers that the figs are threaded onto and deeply sweet and sour balsamic "fudge" sauce made from vinegar reduced with red wine and sugar. The dish is finished with a sprinkle of sea salt and cracked black pepper, savory elements that tie together the sweet and tart notes of this gorgeous early fall sundae. More
Note: This recipe can easily be scaled up or down, and lasts forever in the fridge. If you have plastic squeeze bottles, there's no need to first whisk in a bowl—construct the dressing in the bottles using the same ratio... More
In this delicious season of grills, salads, and farm-fresh produce that needs almost no altering, the only thing that's missing is the right accent. Something subtle, but with a little flair—a secret weapon, ready to wow picnickers at your next potluck and the neighbors you're always tossing meat on the barbie for. Good thing infused vinegars, oils, and salts exist. More
The idea for this jam came about for three reasons. One, last Saturday was the first time this spring that strawberries appeared at my local farmers' market. Two, I recently invested in a really nice bottle of aged balsamic vinegar. And three, I had some fresh thyme in my fridge that was about to go bad. More
This jam is insanely delicious; equal parts sweet and sophisticated. The balsamic vinegar adds depth of flavor and brings out the juicy, sunny taste of the strawberries. And the thyme, oh the thyme! It provides an addictive, lemony, herby essence.... More
Note: Muscadines are a variety of red grape from the Southeastern United States. If unavailable, any red grape variety will do.... More


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Email information is followed by @css.edu unless otherwise noted.
Dr. Olsen is the dean of the School of Education and has served as president of the State Chapter of the Minnesota Association of Colleges for Teacher Education (MACTE). She is an active member of the CAEP Accreditation Council and the TEAC Inquiry Brief Commission. She is nationally certified as a school psychologist, and worked for over 20 years in Wisconsin and Minnesota public schools. Jo is also a Minnesota licensed psychologist and worked as a mental health therapist in private practice for several years, specializing in child/adolescent issues and family systems. Prior to coming to CSS, she was an assistant professor in the Department of Education; School Counseling; and School Psychology at the University of Wisconsin-Stout. At UW-Stout she taught graduate courses, supervised school placements and developed a distance learning supervision model for interns. She has an Ed.D. in educational leadership, M.S. in school psychology, and B.S. in psychology and sociology.. Her professional interests include educational leadership, organizational change, online teaching and learning, behavioral interventions, positive school climate, family systems and play therapy.
Gail has 15 years of elementary education teaching experience, 5 years as an elementary classroom teacher and 10 years as an elementary media generalist. She received a B.A. in elementary education from Central College in Pella, Iowa, and an M.L.S. from the University of Iowa. Gail is the graduate teaching licensure coordinator for the Duluth campus and also teaching courses in that program as well as the online teaching and educational technology certificate programs. Her educational interests include teaching the adult learner, as well as 21st century teaching and technology practices.
Betty is associate professor in the School of Education. She served as Chair of Education for eight years and now teaches graduate and undergraduate courses in research methods, critical thinking, Universal Design for Learning, and special education/inclusion. Previously she was at the University of Minnesota-Twin Cities, as a researcher, administrator and consultant. Her publications are on disability in higher education, organizational change, teaching action research, authentic instruction, and technology in teacher education. Betty has a B.A. in English, M.S. in special education, and an Ed.D. in educational leadership. Her interests include fostering high quality intellectual work in K-12 education, qualitative research methods, and professional development of teachers.
Dr. Chery Takkunen is an associate professor and Chair of Graduate Education Programs for the School of Education at The College of St. Scholastica. Dr. Takkunen oversees the Master of Education and the Graduate Teaching Licensure programs. Her Ph.D is from Capella University where she focused on educational technology. She received a B.S. in elementary education from the University of Minnesota, and an M.Ed. in science and math education from The College of St. Scholastica. She is a licensed Minnesota K-12 administrator and K-6 teacher. Previously, Dr. Takkunen taught at Churchill Elementary School in Cloquet, MN. She has served on the Minnesota Digital Learning Plan Committee, Minnesota Innovations Council, and the Minnesota Academic Standards Committee for Mathematics. Her research and teaching interests include innovation and leadership, online learning, computer science education, educational technology, and teacher education.


text: Tyler Lewis tried to stay positive as his role was reduced and his minutes disappeared. "I knew my opportunity would come," Lewis said. His opportunity came Saturday, with point guard Lorenzo Brown sidelined with an ankle injury, and the freshman delivered with 16 points and five assists in 36 minutes.


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|Home > Dangers > Web 2.0 > Social Media
How to be Safe on Social Sites
Teach your child to:
Parents should search social networking sites their teens visit to see what information they are posting. Make sure you are added to your teen's "friend list" so you can view their information and verify that their profiles are set to private (as they should be!). If you're uncertain whether your child has a profile, do a simple online search by typing your child's name into a search engine like Google,or into the search option of the site in question.
How to Report Abuse on a Social Networking Site
"One of the most important questions to ask that teens really understand is: 'Are you willing to share this information in front of your school assembly? Have a discussion with them about what's appropriate and what's not. Look at their images and see if you think there's something that shouldn't be on the profile and then have them either remove it or let us know you're concerned and then we'll work with you."
— Hemanshu Nigam, Chief Security Officer, Fox Interactive Media and MySpace
This website is also funded in part through a grant from the Office of Juvenile Justice and Delinquency Prevention, Office of Justice Programs, U.S. Department of Justice. Neither the Department of Justice now any of its components operate, control, are responsible for, or necessarily endorse this Website (including, without limitation, its content, technical infrastructure, and policies, and any services or tools provided).


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Charles Gibson, a police officer with the Contra Costa Community College District, said people on the boat were awakened by other passengers and the crew as it began to sink.
Mexico searches for 7 Americans missing in boat accident →
Most "were in the water for over 16 hours," said Officer Gibson, who had gone on the fishing trip twice before. "We hope that the information is getting to our families that we are here and that we survived."


text: Shopping is our culture's single most important leisure activity. Everyone does it, everywhere and almost every day. For shopkeepers, their retail market is will be seeing drastic change. Those wishing to stay ahead of ruthless competition will be forced to create a strong brand name and individual identity for their businesses. Branding a Store shows how to make your shop a winner. Retail specialist Ko Floor translates more than 30 years of retail experience into a survival strategy for stores, explaining how to implement that plan to achieve an original and appealing retail enterprise. Ko Floor has worked for some of the biggest retailers, was retail director for the FHV/BBDO advertising agency, and now heads his own consultancy, Retail Factory. Has been advisor to Albert Heijn for 25 years, and also works for Gamma, Rabobank, Holland Casino, Schiphol Airport and leading chain stores in Germany, Scandinavia, Spain and South America. In this book, Floor discusses food as well as non-food retail sites in Europe and the U.S. and examines all the ingredients that go into creating a strong brand name. Variety, price, shopping convenience and enjoyment, charisma, shop design, advertising, personnel: the perfect mix guarantees distinctive positioning, an individual character and clear-cut communications. Branding a Store is a must-have for professionals who earn their living in the retail business, full of practical, effective tips on how retail stores can win the 'battle of the brands', a book to benefit retailers, manufacturers, ad agencies and retail training courses.


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I'm a fairly simple person. I enjoy a night out as much as staying home.
I go to church every Sunday, and teach Sunday School :) I believe in Jesus Christ as my Lord and personal Savior. He is my Rock and Salvation.
My family is my pride and joy. I am very close to my parents. Their love and sacrifices have made me the person I am today. My parents are pretty amazing, and have always been the backbone to my accomplishments. I hangout alot with my cousins and extended family seeing as they are almost all in NY.
I love animals and the outdoors. My 9 year old dog is apart of my family, and is spoiled rotten:) Music is passion of mine. Always listening or singing... I can probably tell you about myself through song lyrics;) I know almost every Biggie song by heart, so I'm partial to hip-hop and 80s/ 90s music, but can jam out to pretty much anything..
Love to random trips to the city as I am a go with the flow type of person, down for anything..
I'm in the nursing field, so my job keeps me busy and on my toes.
I'm easy to get along with, if you can make me laugh, then we're already friends. I enjoy the simpler things in life, and try to look the positive sides to every situation...city girl by heart, ready to move to new adventures...
Not looking for marriage right away, but open to meeting people and seeing where a relationship can lead, and if it doesn't.. its always nice to make friends.
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- Oakland Athletics ace Scott Kazmir headed to Houston
- Antonio Gates suspension: A look at Chargers tight ends who must step up
- Angels midseason grades: Turmoil overshadows reasonable start
- Greg Monroe to visit with Lakers, Blazers during free agency
- Matt Kemp hitting leadoff as Padres shake things up vs. Giants
- Padres promote Pat Murphy for remainder of the season
- Clippers acquire Lance Stephenson for Matt Barnes, Spencer Hawes
- Bud Black fired by Padres after nine seasons
- 3 takeaways from Seattle Seahawks OTAs
- Stephen Curry goes cold as Warriors fall to Cavs in OT, 95-93
Meet the Sports Out West Team
Meet the folks bringing the noise to Sports Out West
Michael C. Jones
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Twitter: @mikejonestweets
Michael C. Jones is a Southern California-based Sports journalist and editor. He has written for many notable platforms, both online and in print. These include Southern California's Press-Enterprise, Yahoo Sports, SB Nation and Examiner.com, among others. He brings knowledge and passion for sports up and down the West Coast.
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Keenan Actkins
Twitter: @bigdaddiek6
Keenan Actkins is an Arizona resident living in the Phoenix metropolitan area. He brings a wealth of sports knowledge and passion to the team with his unique insight and strong voice and opinion. He also contributes to Yahoo! Voices and has written for WoodyPaige.com.
Laramee Bishop
Laramee Bishop has lived in San Diego for over 20 years. She has worked with U-T San Diego as a multimedia sports producer and editor for TV, print, and web. Her previous work also includes writing for Quiksilver and TransWorld Media.
Derek Ciapala
Twitter: @dciapala
Derek Ciapala is an award-winning journalist who brings expertise and passion to West Coast sports. He has years of experience and has been published on many notable sites, such as Yahoo! Sports. Never afraid to explore a controversial issue, Derek's insight and thought-provoking content consistently generate substantial buzz and plenty of of sound discussion.
Rob Ekberg
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Rob hails from Southern California and has an MBA and a healthy thirst for analytics. He possesses an undying passion for West Coast sports and is the resident guru on all things MLB.
Bob Garcia
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Bob Garcia is a journalist from Southern California. Previously, he was a sports reporter for the award-winning newspaper, The Daily Sundial, at California State University, Northridge. He is active on Twitter and has a strong passion for Southern California sports.
Maxim Garshman
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Maxim Garshman was born and raised in the Bay Area. He is one of the most passionate experts on Bay Area Sports you'll find and brings great experience and knowledge of all things Bay Area into his sports writing.
Rohit Ghosh
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Rohit is an L.A.-based sports journalist who contributes to SB Nation's Silver Screen and Roll, AccuScore, and the Taxi Squad Show based out of Utah. He also runs his own sports blog, Metta Chronicles. Follow him on Twitter <a>@RohitGhosh</a> where he discusses AccuScore projection data, a variety of sports-related topics, and even some Jazz music.
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Olivia Hops is a San Diego-based journalist, reporter and producer who brings a fresh perceptive to the world of sports. Olivia has worked with U-T San Diego, U-T TV, Sports Illustrated, and other print and online publications. She is a football junkie whose true passion lies with the NFL.
Kapil Kashyap
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Kapil Kashyap is an NBA guru and expert on all sports Bay Area. He brings a unique writing style to the table and isn't afraid to take a stance in his writing. His credits include UC Berkeley's Daily Cal.
Timothy Lee
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Timothy Lee is a sports and video game freelance journalist born and raised in Southern California. He has written for publications like the Daily Breeze, RotoAnalysis, SB Nation, and IGN.com. You can find him tweeting or ranting about his Indiana Pacers most of the day.
Al Sacco
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Al Sacco is a passionate sports expert who knows football, baseball, basketball and hockey. He has spent his time as a sports journalist covering the 49ers as a staff writer for 49erswebzone.com and 49ersgab.com. He is also a contributor to Yahoo! Voices.
Nathaniel Reeves
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Nathaniel Reeves is a journalism student at the University of Washington, currently covering sports for The UW Daily in addition to Sports Out West. He has been closely following Seattle sports his entire life.
Rui Thomas
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Rui Thomas loves the NFL nearly as much as his mom and he thinks the NBA is amazing as well. He is published by Yahoo! Sports, FanNation, GoldenGateSports and Radiosurvivor.com and owns the Theruination.net. Rui grew up an obsessive fan of the Sacramento Kings and Oakland Raiders, but he sympathizes with every West Coast team.
Trent Warren
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Trent Warren is a sports journalist working on his degree in journalism and minor in business at the University of Oregon. Originally from San Diego, he has contributed for the Chula Vista Star News covering local prep sports, San Diego State Aztec football and basketball, and the San Diego Chargers. When he's not covering sports, he's running NCAA Division I track and field for the Ducks.
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Eldrick Bone was born and raised in Los Angeles and has devoted his professional life to revolve around sports. A journalism graduate of California State University, Northridge, Eldrick served as a sports writer, reporter and anchor for the school's broadcast news program, Valley View News. He was previously the host of the sports radio show, In the Sports Booth on SkidRow studios.


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Demonstrations Around Tunisia Oppose Tax Hikes in New Budget
By Emily Crane | Jan 8 2014demonstration ,Kef ,louage ,protest ,tax ,
Protests and demonstrations, including an attack on a police headquarters, broke out across Tunisia on Wednesday in response to tax hikes contained in the government's 2014 budget.
The budget contains several tax reforms affecting public and agricultural transportation vehicles, leading to protests in Tunisia's less-developed interior regions.
In Thala, protesters clashed with police forces. They stormed the police headquarters there, burned a police vehicle, and drove the police from the building, according to Majoub Kahri, a physician at the Kasserine Regional Center for Health. State-run news agency TAP reported two police officers were injured in the clashes; Kahri confirmed at least one.
In Kasserine, small pockets of protesters attempted to storm the ruling Ennahda party's regional headquarters and set fire to it, but they were dispersed by police forces on the site, according to Faycel Ennaceur of the Ennahda media office.
In El Kef, over 100 shared taxi (louage) drivers blocked the main road going through the city in protest against the new budget's hike in taxes on their vehicles. Adel Hanani, vice president of the Federation of Transportation in the UTICA employers' union, said the increase in taxes was only one of a long list of financial problems plaguing public transportation drivers.
Since the devaluation of the dinar after the revolution, cars have gotten impossibly expensive, Hanani told Tunisia Live. And the price of gas has gone up, the price of oil has gone up, the price of tires has gone up. All of these things have gone up in price by 28 percent. Plus the cost of insurance is always rising. And now they're adding more taxes. It's impossible.
The UTICA employers union has arranged a meeting with the ministers of finance, transportation, and interior as well as the presidency for Thursday morning to discuss amending the budget law.
I hope that at the end of this, we'll have succeeded in agreeing on terms that are agreeable for the drivers in this country, Hanani said.
Farmers across the country also took part in demonstrations Tuesday and Wednesday protesting Article 66 of the 2014 budget law that would require them to receive a state-issued license in order to qualify for tax breaks on their vehicles, according to Omar El Bahi, vice president of food products for the UTAP agricultural union.
50 percent of farmers are illiterate, how can the government expect them to get a license? El Bahi said.
In the past, farmers have benefitted from an 80 percent tax reduction on vehicles used to transport agricultural goods and rely heavily on this reduction to survive, El Bahi said. Obtaining the documents necessary for the license would be both costly and time-consuming, El Bahi said, and the farmers would not be able to get it in time to pay their vehicle taxes. Under the new law, this would then require them to pay the full tax on their vehicles, which outraged the farmers and sent them to the streets.
After negotiations Wednesday between the Ministry of Finance and the UTAP agricultural union, the ministry released a statement announcing that they had agreed to suspend the patent requirement for the time being and the farmers could continue to qualify for the tax reduction under the former system.
In the meantime, the UTAP agricultural union will meet with the Ministry of Finance to discuss making the patent requirement more feasible for farmers.
We're not against the license idea but it's a complicated idea, El Bahi said. The law wasn't written with farmers in mind.


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Source: The Cornwall Hotel Spa & Estate
The spa at the 4-star Cornwall Hotel Spa & Estate is "immediately therapeutic", according to Red magazine. For £49, you can get a spa day, including access to the facilities, a 50-minute treatment and a glass of prosecco.
10am-8pm Thu-Fri; 10am-7pm Sat-Wed until 31 Jul; 1-30 Sep


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Yesterday, Kiefer Sutherland caught wind that Party Down is getting that movie adaptation everyone wants. He then looked to the sky and screamed, "What about that 24 movie that only I want?"
Well, Kiefer got his, too. Like Party Down, the film will be a direct continuation of the series finale. Also like Party Down, very few people saw the series finale, so maybe they'll give us one of those "Previously…on 24" montages that lasts for 43 minutes, showing the audience so many double agents, betrayals, and "dammits" that their eyes will begin to bleed.
Kiefer is touting an April filming date, despite the fact that the project hasn't announced a director, nor has a script been approved by Fox. Mere details, I'm sure.
The film will once again follow Jack Bauer around during one of his trademark cuh-razy days, but with a run time of around 90 minutes, rather than the 18 hours. They might want to rethink that, though. Theater owners could make a killing off concessions should they make the movie 18 hours long.
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Cassandra Misreads the Book of Samuel: (and other untold tales of the phrophets)
Cassandra Misreads the Book of Samuel: (and other untold tales of the phrophets)
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In Cassandra Misreads the Book of Samuel, Gidon Rothstein brings alive the learning and wisdom of the ancient biblical texts for the modern reader. Through the use of short stories and a novella, Rothstein's insightful and creative retellings of the classic myths of the Prophets of the Old Testament bring hope, inspiration, and a message that the lessons of the past still have relevance in today's secular world. Cassandra Misreads the Book of Samuel grapples with the best and worst of human nature, family dynamics, deathbed regrets, and murder. Told in a modern idiom with wit, mystery, and with a narrative flair worthy of the best in the inspiration and spirituality genres, Cassandra teaches lessons for modern times that both educate and entertain.
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Gidon G. Rothstein
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2 of 2 found the following review helpful:
Profiting from the Prophets
Feb 11, 2009
By Val Karan PhD LLC
How refreshing it is to encounter a rabbi with impeccable credentials as a religious and secular scholar who can recast tales from the classic books of the prophets so that his students can gain a more imaginative, invigorating and inspiring perspective of the nature of prophecy. Rabbi Dr. Gidon Rothstein has both rabbinical ordination as well as a Ph.D. in Jewish history from Harvard. He first burst on the publishing scene in 2005 with a novel entitled Murderer in the Mikdash. Students in Jewish schools are all taught to believe in the coming of the Messiah or anointed one. Rothstein's first book is set in Jerusalem after the Messiah has arrived, revealing a startling but factually valid portrayal of what life might be like in the post messianic era.
Prophecy is another fundamental belief of Judaism. Maimonides, the medieval Jewish philosopher, has described prophecy as "an emanation sent forth by the Divine Being through the medium of the Active Intellect, in the first instance to man's rational faculty, and then to his imaginative faculty." Jewish philosophers have been less clear about the nature of prophecy. Opinions vary among scholars; some, for example, believe that prophets are individuals of superior character and temperament who, through deliberate preparation and effort, attain a state of heightened clairvoyance. Others believe prophets are ordinary individuals, not necessarily Jews or even humans, who are often unprepared for any such experience.
What is clear to all is that God implants into the prophets extraordinary and suprarational messages, often in dreams or trances. Such prophecy can be literally dangerous to one's health and well-being. Prophets require strong levels of courage in the face of frequent public condemnation and repudiation of their messages.
While there is a tradition that prophecy ended after the deaths of Haggai, Zachariah and Malachi, it seems clear to Maimonides that there is an obligation to listen to a legitimate prophet for all time. By this definition, the prophecy meter is still actively running; hence, as Rothstein believes, study of the prophets is intensely relevant even today. In his preface, Rothstein describes his mission of "getting God's Word heard and heeded" by drawing his reader to "reconsider again the project of prophecy and its legacy."
To do this, he parades before us at close range such luminary prophets of the Bible as Samuel, Obadiah, Hosea, Isaiah, Jeremiah, Malachi, Zachariah, Haggai, and even Moses. We have a ringside seat to ancient dramas which suddenly have a very contemporary sound. Besides the prophets, Rothstein creates a cast of characters, some real and some imagined, all of whom talk with modern argot. We witness the prophets from the inside out, struggling to deliver their message amidst suspicion, doubt, and enmity.
Rothstein's writing style has definitely improved since his first book. His stories scintillate with irony, and he is concentrating more on descriptions of scenes and characters as well as credible dialogue. There is still some unevenness in the rhetoric; some sentences must be reread to be deciphered, for example, when Rothstein introduces names or events from nowhere into the narrative: "Baruch, son of Neriah, sighed again," is a clause in the very interesting tale of Jeremiah with no previous mention of said Baruch.
Sad to say, the tale that was least satisfying to me was the longest one and the one upon which the entire book is named. The story of Cassandra does deserve some notoriety because it highlights that prophecy was not limited to Jews. However, I would have preferred less attention paid to Cassandra and ancient Troy and more speculation about other Hebrew prophets such as Ezekiel.
Rothstein takes some backhanded swipes at my profession of psychology in several tales. For instance, the first sentence in the first story "You Can't Change Human Nature" which is set at the time of the exodus from Egypt begins with the intriguing statement, "Experts claimed family dinners brought everyone closer." The same story ends with "The experts didn't know squat." In "Doomsday Meteor is Coming" set in modern times, we are introduced to characters who ridicule the notion of studying the brainwaves of religious people to "revolutionize the psychology of religion."
Rather than try to defend the field of psychology against the attacks of Rothstein, I can readily admit that psychologists have little to offer in helping us understand such paranormal experiences as prophecy. To be sure, psychologists from the very beginning have shown interest in Biblical figures; Freud himself penned Moses and Monotheism. Nowadays, psychologists are less speculative and more apt, as I did in my doctoral study, to focus on observable behaviors, To be sure, parapsychology is a recognized discipline in my field that seeks to investigate the existence and causes of psychic abilities using the scientific method. For over a hundred years, researchers have conducted many experiments to test for evidence of precognition and psychokinesis, extrasensory perception, and remote viewing. The results, nonetheless, show no scientific justification for the existence of parapsychological phenomena.
Unless you include the fascinating research by Robert Rosenthal and Lenore Jacobson which demonstrated the "Pygmalion Effect" with teachers and students, namely, that biased expectancies can essentially affect reality and create self-fulfilling prophecies as a result, we truly don't know squat when it comes to prophecy (and maybe a lot of other things, as well).
That being said, I can safely make one prediction that I'm quite sure will materialize: Rabbi Dr. Gidon Rothstein will continue to produce quality literary works, and the best is yet to come!
1 of 1 found the following review helpful:
A Bit Of Biblical Fanfic
Jan 23, 2015
By Jacqueline "sf/f writer"
Just as with fiction written by fans of a TV show, these stories leap off into a world built around the assumption that the reader is familiar with the Classic literature such as the story of Troy and the Middle East when the Biblical Prophets advised Kings.
If you bring a knowledge of the Bible to these stories you will slide easily into this alternate universe and right out again seeing everyday reality in a new light. This collection is unique. There is no way to explain it. Just read it. You will never forget the experience.
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In this Foundations of Photography, Ben Long shows photographers how to develop a black and white vocabulary and explains the considerations to take into account when shooting for this medium. The course follows Ben as he goes on location and explains what makes good black and white subject matter and how to visualize the scene in terms of tonal values and contrast rather than color. Along the way, he demonstrates some exposure strategies for getting the best images. Back at the computer, Ben demonstrates techniques for converting the resulting photos into black and white using Photoshop and other imaging tools, and offers tips on printing and output.
There won't be a lot of technical difference between your black-and-white and color shooting, but there is a little bit of camera configuration that you need to consider. First, should you shoot RAW or JPEG? Ultimately, the big difference between RAW and JPEG is not one of image quality. RAW does not yield better images than what you can get from JPEG. You won't see more sharpness. In fact, straight out of the camera, RAW images will probably be less sharp than JPEG images. If you're shooting color, you won't have more vibrant color in your images, nor will you get more dynamic range--that is, the range from the darkest to lightest tones that the camera can capture.
What RAW will get you is the ability to perform edits that are simply not possible with JPEG files. Now this doesn't really matter to us for black and white, but with RAW files, you can change the white balance of an image after you shoot, something that's not possible with JPEG. What is useful for us is the ability to very often recover overexposed highlights when shooting with RAW. RAW also allows us to perform more edits to our images before certain ugly types of artifacts appear. Because you tend to do a lot of editing to black-and-white files, pushing colors around very specific gray tones, this extra editability is very welcome.
So I highly recommend shooting in RAW if your camera allows it. Your camera might also have a black-and-white mode on it. If you're a Nikon shooter, you might have a black-and-white picture control, while Canon shooters might have a black-and-white picture style. Other cameras might have their own equivalent of black-and-white mode. Now a lot of people think, "Oh, this is great. I don't have to wonder what my color world looks like anymore. I just put my camera in black-and-white mode and I see it right there on the screen." Alas, there is no such thing as a free lunch, or free black-and-white visualization.
I am going to heartily recommend that you do not use the black-and-white modes on your camera, for a couple of reasons. First, as we've already discussed, there is no objective rule for what shade of gray corresponds to a particular color. The same color image can be converted to black and white in many different ways. Now what your camera shows you as a black-and-white when you're shooting with a black-and-white mode is just one possible interpretation of that color scene, and it may not be the one you had in mind. I don't want that camera's stock, probably kind of blah, black-and-white conversion recipe to limit your thinking of what can be done with a particular scene.
You might think, "Oh, that shoot is going to be really good in black and white," and shoot it in your camera's black-and-white mode and then look at the that camera-generated version, be kind of under-whelmed, and give up on that scene when in fact, it could be a very good black-and-white picture with a better black-and-white conversion. Second, if you're shooting RAW, all this black-and-white mode stuff is irrelevant anyway because that black-and-white conversion step that your camera is doing is a post-processing function and only works on JPEG images. Still, some cameras will show you a black-and-white review in black-and- white mode, even when you're shooting RAW, but your RAW file will still come in as color.
Finally, even if you're shooting JPEG, I don't recommend these modes for the additional reason of editability. As I already mentioned, there is a finite amount of editing that you can do to an image before certain types of ugly artifacts appear, and black-and-white conversion in camera will use up some of that editability. If you then want to do additional edits to improve the camera's conversion, you'll have far less latitude in your image to work with. Most importantly, learning to visualize in black and white is not that hard, so you simply don't need that crutch of a black-and-white preview.
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Title IX
Seeking Counseling
What kinds of emotional responses are common for someone who has been raped?
Unwanted sexual experiences (of any kind) can elicit many reactions. You may feel guilt, shame, shock, sadness, anger, confusion, worthlessness, self-doubt, fear, loss of trust, helplessness, or numbness. There's no "right" or "wrong" way to feel after a sexual violation. In addition to your feelings, you may notice poor concentration, nightmares, changes in eating or sleeping habits, excessive crying, mood swings, anxiety or worry, or sexual problems. Another area of concern in the aftermath of a sexual assault involves spiritual issues.
Many victims (mistakenly) believe they should "just forget it and move on with life." This may work temporarily, but in the long term feelings will surface and need to be addressed. Please keep in mind that it is never too late to talk to a counselor. Some people aren't ready to share their story for days, weeks or even years. You can take your time and decide to talk about it whenever you are ready.
Is there psychological counseling available on campus?
Yes, SU has counselors available to meet with students, and all are experienced in helping people heal from traumas such as rape. Counseling services are free and confidential, and there are both male and female counselors available. You can call 863-1252 to make an appointment with a counselor. The counseling service is located in the Charles and Elizabeth Prothro Center for Lifelong Learning, Suite 200, in the same suite as the nurse.
If I tell a counselor what happened to me, will they have to report it to the University or the police?
No. Confidentiality laws protect the conversations you have with a counselor, and no report will be made to campus police or to administrators without your written consent. You may talk to a counselor about your options, and he/she will help you to make decisions about what you want to do – whether it's to do nothing, to file criminal charges, or go through the campus disciplinary process.
What will meeting with an SU counselor be like?
Your first appointment with SU Counseling Services starts with some brief paperwork, including a checklist of your current concerns and information about our confidentiality policies. Texas law is very strict about confidentiality, and anything you talk about with one of our counselors is protected by this law (with a few exceptions regarding safety of a child or vulnerable adult or an assault by someone in the counseling profession).
Your initial meeting with a counselor may be 50 minutes long, and is an opportunity to share whatever is on your mind. You can choose to reveal as much or as little information about your situation as you'd like. Near the end of the session, you and the counselor will discuss together what your options are and what you'd like to do next. For some students, just coming in once feels like enough; other students choose a period of short-term counseling to work on concerns about the sexual assault and how it has affected their emotional well-being and relationships.
If I'm not comfortable seeing a counselor on campus, are there any off-campus options?
Yes. Williamson County Crisis Center (Hope Alliance)) has a 24-hour hotline you can call to discuss your concerns (800-460-SAFE). They will inform you of free and confidential counseling options that they offer at their center in Round Rock. Similar services are also available in Austin at SafePlace (512-267-SAFE).
Another option is to seek counseling from a mental health provider in your hometown or in the Austin/Georgetown community. There are psychologists, social workers, and licensed professional counselors who specialize in treatment of traumas such as sexual assault. If you would like to pursue medication treatment of your symptoms, you can consult with a psychiatrist. You can obtain a referral to a private therapist from either the Williamson County Crisis Center or the SU counselors. If you'd like to use your insurance benefits to cover therapy, you can bring the list of approved therapists from your insurance provider and a counselor can assist you in finding a referral.
If you've made a police report regarding your sexual assault, you may qualify for Texas' Crime Victims' Compensation Fund to help pay for your counseling and/or medical costs.
If you are not yet ready to talk to a counselor, there are also national hotlines that provide information and support about sexual violence issues. Austin's SafePlace has a hotline (512-267-SAFE) and a website with lots of information (www.austin-safeplace.org/info.htm). RAINN (Rape, Abuse & Incest National Network) has a 24 hour hotline (800) 656-HOPE and a website (www.rainn.org).
I have a lot of spiritual questions about what happened to me. Is there someone I can talk to who specializes in these concerns?
It is very common to have spiritual or faith concerns in the aftermath of a sexual assault. Common concerns include questions about virginity or whether the assault was some sort of punishment. Many victims wonder what role God or their faith can play in their healing and recovery.
Dr. Beverly Jones is the University Chaplain. She is trained to provide spiritual and moral support to students of all faiths, including students who are not affiliated with any particular church or religion. They will listen as you talk about what happened (you can share with them as much or as little as you feel comfortable), and they will help you to sort out issues that make you feel fearful, angry, or embarrassed. All discussions with Religious Life are completely confidential and are free. Students may consult with Religious Life before seeking further guidance from their own spiritual leader or tradition. They can also help you find local resources in your particular faith, or refer you to a pastoral counseling service.
The Religious Life office is located in the Howry Center, or you can make an appointment by calling (512) 863-1527.
I am in need of medical or psychological care for the aftermath of the rape – can I get any help in paying for this?
As the victim of a violent crime, the injury you received because of the assault may require medical and/or psychological care. While the local police department will pay for the emergency medical exam and the rape kit (as long as you file a report), you may also ask the State of Texas to reimburse you for any medical, emotional, or financial losses you suffered as a result of being the victim of a violent crime, even if the physical or emotional problems do not develop immediately. This is called the Crime Victims' Compensation (CVC) program.
To qualify for the CVC, the crime must occur in Texas or be committed by a Texas resident. The crime must be reported to the police within a "reasonable period" after the incident. You must file for compensation within three years of the crime. Finally, the crime victim must have cooperated fully with law enforcement officials in the investigation and prosecution of the case. Total claims must not exceed $50,000.
To find out the qualifications and application procedure in detail, please contact the Office of the Attorney General at 1 (800) 983-9933 or www.oag.state.tx.us/victims/cvc.shtml.


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3XN has just sent us some new photographs and information on the soon to be completed hotel and conference center. Designed by the Danish firm, it is first step of the long-anticipated extension of the Bella Center; Copenhagen's famous Congress Center. The upgrade of Bella Center intends to add an urban feeling to the place, and the extension should benefit from Bella Center's perfect location: Situated between the old city core and Orestad; Copenhagen's growth center, Bella Center is connected to two important worlds of activities, and furthermore it's close to the Metro as well as the Copenhagen Airport.
Skidmore, Owings & Merrill, LLP (SOM) has been awarded the commission to develop a Master Plan within Danang, Vietnam. SOM's preliminary plan for a sustainable residential community at the edge of the city is aspiring for an ecologically sensitive development.
The project site covers an area of 375 hectares along the Cu De River at the northern edge of the City of Danang. The Plan incorporates a wide range of uses organised into a series of distinct districts, including a series of residential neighbourhoods, a Village Centre, a Business District, and an Education, Sports and Leisure District.
A design consortium including BIG won the international design competition for a new 27.000 m2 cultural complex in Albania, consisting of a Mosque, an Islamic Centre, and a Museum of Religious Harmony. The capital Tirana is undergoing an urban transformation which includes the restoration and refurbishment of existing buildings, the construction of a series of new public and private urban structures, and the complete reconceptualization of Scanderbeg Square. This important square is the site of the new cultural complex.
The American Institute of Architects' (AIA) Housing and Custom Residential Knowledge Community, in conjunction with the Office of the Secretary of the U.S. Department of Housing & Urban Development (HUD), recognized three recipients of the 2011 AIA/HUD Secretary Awards. The categories of the program include (1) Excellence in Affordable Housing Design (2) Creating Community Connection Award (3) Community-Informed Design Award (no recipient selected this year) (4) Housing Accessibility - Alan J. Rothman Award. These awards demonstrate that design matters, and the recipient projects offer examples of important developments in the housing industry.
The jury for the 2011 AIA/HUD Secretary Awards includes: Katherine Austin, AIA, (chair), Katherine Austin Architect; Luis F. Borray, Assoc. AIA, U.S. Department of Housing & Urban Development; Claire Conroy, Residential Architect Magazine; Regina C. Gray, U.S. Department of Housing & Urban Development; Mike Jackson, FAIA, Illinois Historic Preservation Agency; Luis Jauregui, AIA, Jaurequi, Inc. and Marilys Nepomechie, FAIA, Florida International University.
The International Living Future Institute and the National Trust for Historic Preservation Bestow Top Honors and $75,000 to Paris team for "visionary pragmatism"
The International Living Future Institute today announced the winners of the Living City Design Competition, which it hosted in partnership with the National Trust for Historic Preservation, at Living Future '11. The competition called for teams worldwide to create powerful visualizations of how existing cities might be transformed to achieve and transcend the Living Building Challenge 2.0, the built environment's most rigorous performance standard. More than 80 teams submitted entries, addressing 69 different cities spanning 21 countries. Submissions were evaluated based on their ability to capture the attention and imagination of a broad audience and reassess assumptions about a future filled with high-tech, ecologically dislocated cities. Rather than constructing new cities from scratch, submissions also focused on the premise that a "living" future will rely on retrofitting the existing built environment and regenerating the evolutionary capacity of life. "Each of the entries represented the crucial first steps in redefining our urban ecosystems and how they work in tandem with their natural environment," said Jason F. McLennan, CEO of the International Living Future Institute and a member of the seven-person jury panel that selected the winners. "This process was at least as important as the impressive end results."
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Corrections officials in Ohio say convicted Cleveland rapist/kidnapper Ariel Castro is believed to have committed suicide in his cell Tuesday night.
They say he was found hanged around 9:20 p.m. ET at the Correctional Reception Center in Orient, Ohio, a short distance southwest of Columbus.
Castro was serving a life sentence for holding three women captive in his Cleveland home for more than a decade.
Officials say medical staff at the prison tried to revive Castro. He was pronounced dead at a hospital around 10:50 p.m. ET.
Castro was moved to the prison in Orient for his safety. He first was sent to the Lorain Correctional Institution for processing.
In July, Castro pleaded guilty to hundreds of charges including kidnapping and rape. He was sentenced in August to life in prison plus 1,000 years.
Amanda Berry, Gina DeJesus, Michelle Knight and Berry's 6-year-old daughter were rescued from Castro's home in May. They had disappeared separately between 2002 and 2004.On Aug. 7, Castro's house was torn down.
"Two local contractors destroyed the house and hauled the debris away, on their own dime," Brian Bull reported for WCPN. "City Councilman Matt Zone said every last shred of Castro's house is going to be pulverized and discarded."
The house was demolished as part of a plea deal that spared Castro from a possible death sentence.
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Ariel Castro, Ohio Man Who Held Women For Years, Is Dead


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A composite ventilation tube is disclosed which is specifically useful for ventilating the middle ear. The tube assembly includes an outer tube formed of inert, slightly flexible material, such as Teflon or polyethylene, which includes an elongated thin-walled tubular section having a central bore and a plurality of axially spaced, angularly staggered transverse openings. A flange is formed at one end of the tube, the plane of the flange being disposed at an acute angle relative to the axis of the tube with at least one portion of the flange terminating closely adjacent to the tubular wall. A cylindrical piston fits within the tube and includes a slightly enlarged head engaging the open, outer end of the tube. The piston is formed of porous polyethylene having pores of the order of 20 to 50 microns.
1. A composite ventilation tube assembly for the middle ear, said composite ventilation tube comprising:
an outer tube formed from a slightly flexible inert material, said outer tube including:
a thin-walled tubular section having a central bore extending completely therethrough;
an outwardly extending flange formed at one end of the tubular section; and
a plurality of transverse openings formed in the walls of said tubular section in fluid communication with said central bore;
a piston member formed of microporous plastic material, said piston member including:
a stem portion disposed within said tubular section and in frictional engagement therewith; and
a head disposed outwardly of said bore and adapted for engagement with the end of said tubular section;
said piston member being displaceable axially outwardly away from said flange in response to buildup in pressure within the middle ear.
2. The composite ventilation tube of claim 1 in which said piston member is formed of porous polyethylene.
3. The composite ventilation tube of claim 2 in which said piston member has pores of the order of 20-50 microns in size.
4. The composite ventilation tube of claim 1 in which said flange is disposed at an angle relative to the axis of said bore.
5. The composite ventilation tube of claim 1 in which said openings are spaced longitudinally along said tubular section and are disposed at staggered angular positions around the wall of said tubular section.
6. The composite ventilation tube of claim 5 in which said flange is of generally U-shaped outline configuration and terminates closely adjacent to the wall at an apex region of said tube and extends at substantially greater distances from said tube at other portions of said wall.
This invention relates to medical devices and is particularly directed to ventilation tubes. More particularly, the present invention relates to ventilation tubes for the middle ear. The ventilation tube is adapted to be inserted through the tympanic membrane to provide ventilation through that membrane to the middle ear and to provide means for equalizing pressure between the middle ear and outer ear.
It has become common practice to treat various problems of the middle ear by providing some means of continuously aerating the middle ear through the tympanic membrane. This has been accomplished by inserting ventilation tubes through the tympanic membrane or through a bony area adjacent thereto. Various ventilation and drain tubes which have been previously proposed are shown in U.S. Pat. Nos. 3,530,860; 3,807,409; 3,871,380; 3,916,873; 3,948,271; 3,982,454 and 3,976,081. These prior art ventilation tubes are each subject to one or more serious defects which it is the object of the present invention to overcome.
More particularly, one of the principal defects of the prior art ventilation tubes is that they do not effectively seal off the inner ear from the entrance of water. If water enters the inner ear through such a tube, it can lead to aggravated middle ear infection. As a consequence, patients who have heretofore been fitted with inner ear ventilation tubes have been restricted in their activities, particularly those involving water. Thus, such patients could not normally go swimming.
A still further difficulty with prior art ventilation tubes is that they provided no ready means for changing the filter element. For example, if a tube has been in place for a substantial length of time, the tympanic membrane may tend to grow into the tube. With prior art ventilation tubes, it was necessary to replace the entire tube which consumed a substantial amount of time and entails considerable discomfort to the patient.
The principal object of the present invention is to provide a novel ventilation tube for the middle ear which is effective to provide optimum aeration of the inner ear, but which will prevent water from entering the middle ear. Thus, a person fitted with the present ventilation tube can participate in their full range of normal activities, including swimming, without developing an aggravated inner ear infection due to the entrance of water into that cavity.
Another object of the present invention is to provide a novel middle ear ventilation tube which is easily inserted and yet will remain in place for long periods of time, e.g., in excess of six months, sufficient for treatment of many problems of the middle ear.
A still further object of the present invention is to provide a ventilation tube for the middle ear which utilizes only a minimum amount of material disposed within the middle ear and which does not result in any objectionable pressure on the wearer's eardrum.
A still further object of the present invention is to provide a composite ventilation tube including an outer tube which is the sole member in contact with the user's tissue. The composite tube further includes an inner piston-like member which selectively permits air flow while preventing passage of water. This inner piston is normally shielded from contact with the user's tissue and, hence, does not irritate it even if its material would normally be an irritant.
Yet another object of the present composite ventilation tube is that the piston can be removed while leaving the outer tube in place. Thus, the piston can be displaced outwardly by a pressure build-up in the inner ear to automatically alleviate some of the user's discomfort. Moreover, the piston can be removed and replaced if the patient's tympanic membrane should start to grow into the pores of the piston. Since the outer tube remains in place, replacement of the piston can be done rapidly and without discomfort to the patient.
The present invention is predicated upon the concept of providing a composite ventilation tube for the middle ear comprising an outer tube including thin-walled tubular section having a central bore and a plurality of axially spaced, angularly staggered transverse openings. In the preferred embodiment, the tubular section is of a circular cross-section and has a transverse flange formed at one end thereof. An axial bore extends through the entire length of the tubular member and through the flange which is adapted to be disposed within the middle ear in abutment with the tympanic membrane. The outer tube is made from a material, such as polyethylene or Teflon, which is compatible with human tissue.
In accordance with the present invention, the flange is disposed at an acute angle, preferably of the order of 45�, with the axis of the tube. This flange is preferably U-shaped with one edge terminating closely adjacent to the wall of the tube, the edge extending generally at right angles to the major diameter of the tube. The outline configuration of the flange is of a generally U-shape. I have empirically determined that this flange configuration is effective, with a minimum amount of material in the inner ear, to retain the outer tube in place over substantial periods of time.
The outer tube carries a porous piston-like inner member which permits air to pass between the outer and inner ears, but prevents water from entering the inner ear. In a preferred embodiment, this piston member is formed from porous polyethylene having pores of the order of 20-50 microns in size. The inner member includes a cylindrical stem portion which fits within the outer tube and an enlarged head which engages the end of the tube to limit inward movement of the piston member. This head provides a ready means for grasping the piston and for removing it while leaving the outer tube in place.
These and other objects and advantages of the present invention will become more readily apparent from a consideration of the following detailed description of the drawings illustrating a preferred embodiment of the invention.
FIG. 1 is a sectional view of an ear as viewed from the right side of the head, the ear being fitted with a composite ventilation tube assembly of the present invention.
FIG. 2 is a side elevational view of a composite ventilation tube assembly embodying the present invention.
FIG. 3 is a cross-sectional view taken along line 3--3 of FIG. 2.
FIG. 4 is a longitudinal cross-sectional view of the composite ventilation tube assembly of FIG. 2.
One preferred form of composite middle ear ventilation tube assembly 10 constructed in accordance with the principles of the present invention is illustrated in FIGS. 2 and 3, and the manner in which such a tube is inserted in a patient's ear is shown in FIG. 1. The composite tube assembly includes an outer tube 11 made of a suitable material which is inert, compatible with human tissue and slightly flexible, such as polyethylene or Teflon.
As shown in FIG. 2, the outer tube 11 comprises an elongated tubular section 12 and a flange 13 extending transversely of one end of the tubular section. The tubular section 12 is preferably of circular configuration and is relatively thin-walled. An axial bore 14 extends the complete length of the outer tubular member through both tubular section 12 and flange 13. Tubular section 12 is provided with a plurality of transverse, or radial, openings 15 of approximately one millimeter in diameter. Openings 15 are spaced axially along tubular section 12 and also are arranged at progressively staggered angular positions. While the exact dimensions of the tube may vary, one preferred embodiment is approximately one centimeter long. It will be appreciated, however, that the tubular section can be cut off to the length required and, hence, in use may have a shorter length, e.g., 5-6 millimeters. The outer diameter of the tube section 12 is approximately two millimeters. The inner diameter of the tubular section 12 is approximately 1.1 millimeters.
As is best shown in FIG. 2, flange 13 extends transversely of one end of tubular section 12. The flange is disposed at an acute angle to the axis of the tube and central bore 14. This angle is approximately 45� to the axis of the tube. Flange 13 does not extend a uniform distance outwardly from the tubular section 12. Rather, at the apex region 16 of the tube the flange terminates closely adjacent the tubular wall. One edge 17 of the flange extends in a direction generally tangential of the wall in the apex region. The outline configuration of the flange is generally U-shaped with side walls 18 extending generally perpendicular to edge 17. The side edges 18 are interconnected by an arcuate edge 20. In the preferred embodiment, the thickness of the flange decreases slightly from edge 17 toward edge 16. However, it is contemplated that a flange of uniform thickness can be employed if desired.
The composite ventilation tube assembly further includes a piston member 30. Piston member 30 is configurated to form a stem portion 31 of cylindrical cross-section and an enlarged head 32. Stem portion 31 is of substantially the same inner diameter as the diameter of bore 14 and the length of the stem portion is approximately the same as the minimum length of bore 14. Consequently, when the stem 31 is inserted in bore 14, it substantially fills the bore and is frictionally held in place against accidental dislodgement. Head 32 is of larger diameter than the bore 14 and is preferably of slightly larger diameter than the outer diameter of the tubular section 12. When the piston member is assembled with the outer tubular member, head 32 is adapted to abut the end wall 25 of tubular section 12 to limit the amount of insertion of stem 31 into the tubular member.
Piston member 30 is formed of a microporous plastic material which permits passage of air, but does not permit passage of water. Suitable forms of microporous plastic materials are produced by Porex Division of Glassrock Company of Fairborn, Georgia, and General Polymeric Corporation of West Reading, Pennsylvania. This material is formed by compressing particles of polyethylene resin to form a material having interconnected open cell structures with pores of the order of from 20-50 microns.
In use, the composite ventilation tube is adapted to be inserted in a hole formed in the tympanic membrane 22 of a patient's ear. This membrane separates the outer ear canal 23 from the middle ear 24. After insertion, the outer tube 11 is pulled gently outwardly until flange 13 fits snugly against the tympanic membrane. In this position, the composite tube is effective to provide aeration from the middle ear with air passing through central bore 14 and radial openings 15 of the outer tube and through the porous openings in piston member 30. In the event that it is desired to remove piston member 30, it is only necessary to grasp head 32 and withdraw the member outwardly until stem 31 becomes disengaged from bore 14. The outer sleeve 11 remains in place. Piston member 30 can be replaced, or a new one inserted, by merely pressing stem 31 inwardly through bore 14 of the outer tube until head 32 engages the end of the tube.
The present tube is advantageous in that there is a minimum amount of material disposed within the middle ear. Nevertheless, the present outer ventilation tube is effectively retained in place for a long period, e.g., in excess of six months, before it is ejected from the ear. This time is sufficient for the treatment of many conditions. The inner piston member 30 is likewise held in place by its frictional engagement with the outer tube. Nevertheless, if excessive pressure should build up in the inner ear, piston 30 can be displaced outwardly to afford relief to the patient. The present tube provides optimum aeration of the ear and is effective to continue to provide aeration, while at the same time preventing entrance of water into the inner ear even if the patient is engaging in water sports, such as swimming.
From the above disclosure of the general principles of the present invention and the preceding description of a preferred embodiment, those skilled in the art will readily comprehend various modifications to which the invention is susceptible. Therefore, I desire to be limited only by the scope of the following claims.
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