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As seemingly-sweet Rebecca Sutter Ewing, you couldn't help but feel like she was a lamb being led to the Southfork slaughter. But once it was shockingly revealed she was actually the daughter of JR's longtime ultimate nemesis Cliff Barnes (Ken Kercheval), we knew better than to underestimate how well she does fit into the family. And while it may have been a shocker to the viewers, Gonzalo knew all along who Rebecca's father was when she began filming.
"I knew before we shot the pilot," Gonzalo said in a conference call. "I remember getting the part and after we all met, and after reading the script and before we even took off to go to Dallas to shoot the pilot they let me in on the secret that I was a Barnes, but that was it. That was all they told me. They were like you're Cliff's daughter but don't play it and don't tell anyone. So that was what I got."
But when she was finally able to reveal her parentage, she played the personality switch expertly, still seeming sensitive and vulnerable despite her allegiance to Cliff. "I got to play so many levels of a character," she says. "I got to play so many different layers of this girl and I got to really be very diverse and really have all these feelings, like these true feelings. I mean, she was really playing three people. She was the con artist that she was with Tommy (Callard Harris), she is in love with Christopher (Jesse Metcalfe) and she's also behind the scenes of everything."
In fact, after the finale it was obvious she was not blindly following daddy's orders. She was the one who brought in Tommy after all, and ultimately, took his life. "She is Cliff Barnes's daughter," Gonzalo said. "She put together Tommy, and you basically realized she was the mastermind behind all of it. And at the end of the day she's trying to make her dad proud just like John Ross (Josh Henderson) is, just like Christopher is."
Rebecca's new parentage also casts an odd light on her relationship with Christopher, beyond the whole revenge thing. Even though they are not biologically related, they are indeed cousins by marriage. And her real name? Pamela Rebecca Barnes, the same as Chris' adoptive mother, Bobby's first wife and Cliff's sister. And despite the deception, she has developed real feelings for him.
"Yes the reality of it all is that I am married to my first cousin," she said. "Sure, not related by blood but it is kind of weird. It's interesting. It's interesting to know the reality of this role and I don't know where it's going and that's to be completely honest with you. The idea that she is married to her cousin, I don't know. I think she is in love with him. She really is in love with him, she fell for him. She fell for her mark as we like to call it. I do believe that Rebecca does have feelings for Chris, she did fall in love with him. But now I think the tables have been turned, the cat's out of the bag and she might be a bit pissed. So I don't know what the future holds, I really don't. I wish I did but I can only be blessed that the writers are so talented and they're so willing to write such beautiful storylines for myself and the rest of the cast. So I'm leaving it to their hands."
So now that we know who dear old dad is, what about mom? Possibly from the one-night stand he had back in the 80s? No one was really sure who that woman was. "My mom has not been addressed as far as me talking to anyone on the show," Gonzalo said. "I've read things about who Rebecca's mom is. Obviously there's so many websites and so many back stories and storylines from the original so I'm aware of who actually should be her mom but I haven't been told anything."
Season two begins filming next month, but Gonzalo is still unaware about how involved she has been with her father up until this point. "I don't know the back story," she says. "I believe - again it's all my imagination at this point - but yes, I do believe she did grow up hearing how the Ewings were bad and the Ewings took everything from the Barnes and the Ewings this and the Ewings that. So I think it's something you're raised with and whether you want it or not it's just engraved in your body and soul. I really would like to get into the center of what drove Rebecca to do everything she's been doing so far."
She is also unsure about where things will go with Christopher, especially after his hookup with Elena (Jordana Brewster). One thing she is sure of – Elena better watch her back, and anyone else who gets in her way. "Don't piss her off, she's got a gun," she joked. "I think at this point she knows that things are pretty bad with Christopher. I think that there might not be a way out. I don't want to say that she's fully going into the dark side. I don't know if she's fully going to go evil. I don't believe in villains. I believe that they're all coming from a place of truth. Whether you want to take that as good or bad that's your prerogative I guess. But I don't know. I think she always saw it coming. Elena has always been something very, very dear and special to Chris and she's not stupid. Rebecca's not a stupid girl. She's a very, very smart girl. She's a very calculating girl. She can be very manipulative. In a way she fooled everyone. She fooled Tommy, she fooled Chris, she fooled the audience, she fooled a lot of people so you can't underestimate this girl. I wouldn't want to be on the bad side of her."
That almost sounds like another character near and dear to the audience – JR. "Wow I could only hope and pray because that would be fun," Gonzalo said. "That's always how I saw her. My God I wish I could be in the writers' room right now and let you know, but that would be amazing. JR is a guy you love to hate for over 30 years. If I'm the female version, which I don't think I could ever reach such highs, but I will sure try. Yes I'm in."
Season Two of TNT's "Dallas" reboot returns January 28, 2013.
Want to get schooled on Dallas history? Read Soaps.com's Dallas Season Two Highlights and don't forget to read our Pretty Little Liars recaps each week.
Join Soaps.com on Twitter @soapoperafan, "like" Soaps.com on Facebook to dish on "Dallas," all the other soap operas, "Glee," "Grey's Anatomy," "Vampire Diaries," and "Venice The Series."
- Hollie Deese


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At 9-27, the Bobcats are the worst team in the league.
However, there is no such thing as a guaranteed win in professional sports.
Charlotte is a young athletic team who has given some of the Eastern Conferences top teams fits, including a 91-81 victory at Chicago.
The first key for Boston is to contest shots. The Bobcats shoot just 45 percent from the field and if shots aren't falling, it will likely lead to lapses on the defensive end and on the boards.
The second key is playing with energy. Many view this game as a potential "trap game." While it is certainly a possibility, having two days off, in which they didn't have to travel and playing at home, expect the Celtics to be locked in.
Doc Rivers is one of the best at exploiting mismatches and tonight he will have plenty of options to choose from. Getting everyone involved in the offense will help to keep the effort level high.
If the team is active and communicating on defense, they can impose their will, and perhaps force a young Charlotte team to submit.
The final key is not playing down to the Bobcats level. It is an athletic team and if the game gets sloppy and they are allowed to get out and run the floor, Boston will be in for more than they bargained for tonight.

subset: commoncrawl


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Scritti Politti
this wiki
Green Gartside (born Paul Julian Strohmeyer) (lead vocals)
Nial Jinks (bass)
Tom Morley (drums)
Matthew Kay (keyboards)
Scritti Politti were a post-punk band formed in 1977 in Leeds, UK. Their early material evinced a spiky yet melodic tendency: this latter facet developed further in the mid 80s, leading to chart success in both the UK and USA with tracks such as 'Oh Patti (Don't Feel Sorry For Loverboy)' and 'Absolute.' The name Scritti Politti was chosen as a homage to the Italian theorist Antonio Gramsci, with Gartside changing the original 'Scritti Polittici' to 'Scritti Politti' as he thought it sounded more rock and roll, like 'Tutti Frutti.'
thumb|320px|left|Scritti Politti's first release, the impetus for which they claim came from the Desperate Bicycles.Peel gave significant airplay to their self release on the St. Pancras label, 'Skank Bloc Bologna' (made with £500 borrowed from the drummer's brother): in this form, it sold 2,500 copies. The band were then signed by Geoff Travis to Rough Trade in 1979 and their debut amassed another 15,000 sales. They had a do-it-yourself attitude to their recordings: their hand-made record sleeves contained detailed breakdowns of production costs, including addresses and phone numbers of record pressing plants, and even their own Camden squat address for feedback.
They were added to the Gang Of Four and Joy Division' UK tour, but Gartside suffered a heart attack exacerbated by stage fright and anxiety, and rested the band for a year after finishing the dates.
Their DIY approach was something which seems to have to have appealed to John: he read out a letter he received from them on his 19 May 1980 show. However, their new, more commercial sound did not (they seem to have been marketed as a kind of thinking man's Duran Duran), and he appears to be rather dismissive of repeat Festive Fifty votes for their first UK hit, 'Sweetest Girl,' despite the track featuring Robert Wyatt on piano. Nonetheless, the band found fame and massive success with the Cupid & Psyche 85 LP and several more big hit singles until Gartside retired again late in the 80s. Scritti Politti's last LP to date ( a solo effort by Green) was White Bread Black Beer in 2006. In 2009 Gartside took part in a tribute concert to former Peel favourites The Incredible String Band and in 2012 appeared at a similar event devoted to the songs of another Top Gear regular, Sandy Denny.
Festive Fifty EntriesEdit
- 1981 Festive Fifty: 'The Sweetest Girl' #22
- 1982 Festive Fifty (All-Time): 'The Sweetest Girl' #27
- 1982 Festive Fifty (Annual): 'Asylums In Jerusalem' #18
- 1982 Festive Fifty (Annual): 'Faithless' #18
1. Recorded 1978-12-05. First TX 13 December 1978, repeated 11 January 1979, 20 March 1979. No known commercial release.
- The Humours Of Spitalfields / Knowledge And Interest / Doubt Beat / 5/12/78 [1]
2. Recorded 1979-06-20. First broadcast 04 July 1979, repeated 24 July 1979. Available on Work In Progress 2nd Peel Session (Rough Trade / St. Pancras) and Early (Rough Trade). Green appeared to have later disowned this, although Peel feared he had been misquoted [2].
- Messthetics / Hegemony / Scritt Locks Door / The New One
3. Recorded 1982-05-15. First broadcast 24 May 1982, repeated 07 July 1982, 12 August 1982. No known commercial release.
- Asylums In Jerusalem / A Slow Soul / Jacques Derrida
- 28 September 1978: Skank Bloc Bologna (7")' St. Pancras
- 02 November 1978: Skank Bloc Bologna (7") St Pancras
- 12 December 1979: 'Bibbly-O-Tek (12"-4 A Sides)' (Rough Trade / St. Pancras acetate)
- 18 December 1979: 'Doubt Beat (12"-4 A Sides)' (Rough Trade / St. Pancras acetate)
- 08 January 1980: 'Confidence (12"-4 A Sides)' (Rough Trade / St. Pancras)
- 17 January 1980: 'Scritt Locks Door (7"-Work In Progress 2nd Peel Session)' (Rough Trade)
- 21 January 1980: 'Hegemony (7"-Work In Progress 2nd Peel Session)' (Rough Trade)
- 28 January 1980: 'Bibbly-O-Tek (12"-4 A Sides)' (St. Pancras)
- 11 February 1980: 'Bibbly-O-Tek (12"-4 A Sides)' (St. Pancras)
- 19 February 1980: 'Messthetics (7"-Work In Progress 2nd Peel Session)' (Rough Trade)
- 04 March 1981: The "Sweetest Girl" (cassette – NME / Rough Trade C81) NME / Rough Tapes COPY 001
- 02 November 1981: 'The Sweetest Girl (7")' (Rough Trade)
- 16 November 1981: 'The Sweetest Girl (7")' (Rough Trade)
- 28 December 1981: 'The Sweetest Girl (7")' (Rough Trade) (1981 Festive Fifty #22)
- 14 April 1982: 'Faithless (7")' (Rough Trade)
- 19 April 1982: Faithless (7") Rough Trade RT 101
- 03 May 1982: 'Faithless (7")' (Rough Trade)
- 24 August 1982: 'Lions After Slumber (LP-Songs To Remember)' (Rough Trade)
- 31 August 1982: Gettin' Havin' And Holdin' (album - Songs To Remember) Rough Trade ROUGH 20
- 22 December 1982: 'The Sweetest Girl (7")' (Rough Trade) (1982 Festive Fifty (Annual) #27)
- 27 December 1982: 'Asylums In Jerusalem (LP-Songs To Remember)' (Rough Trade) (1982 Festive Fifty (Annual) #18)
- 28 December 1982: 'Faithless (LP-Songs To Remember)' (Rough Trade) (1982 Festive Fifty (Annual) #13)
- 07 May 1985: 'The Word Girl (LP-Cupid & Psyche 85)' (Virgin)
- scritti.net band site
- bibbly-o-tek fan site
- Wikipedia
- allmusic.com
- Furious.com: background to release of Skank Bloc Bologna


text: VANCOUVER, BC - Victoria's Spencer Robinson has been appointed Head Coach of the TrueBlue BC Rugby Under-15 boys provincial team for the upcoming summer season. A Level Three NCCP certified coach with experience at the high school, club, provincial and national levels, Robinson will be working alongside assistant coach Mike Jamieson. "BC Rugby is delighted to have Spencer Robinson on board as Head Coach of the U15 boys program," said BC Provincial Coach and Development Manager Dave Brown. "Spencer's playing and coaching background will provide players with a great experience. He has worked previously with our senior women's provincial program and more recently with the Island Tide U14 rep teams at the BC Summer Games." Coaching alongside Robinson will be Mike Jamieson who led the Fraser Valley U14 boys rep side to a 2012 BC Summer Games title in Surrey last July. Jamieson has coached at Elgin Park Secondary for three years and in 2013 saw the junior boys program go undefeated as Surrey and Fraser Valley champs. For the upcoming summer, Jamieson will also be the Fraser Valley West U15 PRCs head coach. Both coaches feel that this is a vital age group in a rugby player's development and are excited by the opportunity and challenge they face in preparing these young athletes. "This is another vital step down the road of any player's rugby education and Mike and I are happy to play a small part in that journey," Robinson said on behalf of himself and Jamieson.TrueBlue BC Rugby U15s Selection ProcessRobinson and Jamieson will be scouting for talent at the inaugural U15 Provincial Regional Championships event set for June 22-23rd at UBC's Wolfson Fields. The coaching staff will then invite the top U15 players to a preparation camp set for July 2nd-4th, before making their selections for the provincial team. The TrueBlue U15 Provincial Team will then be entered into the U16 B2Gold Provincial Regional Championships where they will compete against rep sides from across the province on the weekend of July 5th-7th.-30-


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By tully | "Boredom at Its Boredest" by Michael Tully January 26, 2007 at 5:45AM
If I were forced to make a list of my all time favorite movies, TROLL 2 would stand firmly alongside such classics as MCCABE & MRS. MILLER, BLUE VELVET, DAYS OF HEAVEN, COME AND SEE, A WOMAN UNDER THE INFLUENCE, and THE BICYCLE THIEF. When it comes to the 'camp' genre (i.e., movies that are so bad they're good), nothing compares to TROLL 2. I actually began writing a book in the late 1990s called "The Ethics of Troll 2," but I only finished three chapters. One day I hope to finish it. The world needs that book.
One thing I've never done, however, is watch TROLL 2 on a big screen in an actual movie theatre. I didn't think it would ever happen, actually.
And then I get a phone call, just after midnight, from Wingo (who, it should be noted, is responsible for the music in two of Sundance's most talked about films, SNOW ANGELS and GREAT WORLD OF SOUND--way to go, hotshot). He asked me if I was sitting down, because he had big news. Then he told me about this.
Ladies and gentlemen, it simply does not get any better than this. The Alamo Drafthouse Theatre. Midnight, Thursday, February 1st. Free. Drago Floyd's TROLL 2 on the big screen. But that isn't all. How about a post-film Q&A with none other than Joshua, Mr. Waits, and Arnold?! ARE YOU FUCKING KIDDING ME???!!!
If I didn't have to go to Maryland for my goddaughter's Christening next weekend, I would buy a plane ticket this very second. I still might (provided I can get back to Maryland by 11am Saturday morning). This night could very well rival my discovery of Lynch's Lumberton a few months ago. The thought of it makes me want to hug the planet.
But I can't be there. At least I don't think I can be. Which blows very big bubbles.
If you live in Austin (ahem, ahem, I'm talking to you David Lowery), do NOT miss this event. Please go, and please write about it for me, so I can feel like I was there.
Zach Carlson, will you marry me???


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Lucky Palms, Sunlit Tides, and The Sims 3 Late Night – Via SimGuruSarah
Via SimGuruSarah
Our reader Nathanial has completed Lucky Palms' and Lunar Lakes' Box & CD Art. We previously posted on his completion of Sunlit Tides, and now you can have the complete collection!
I have uploaded all the images to my Flickr account, so click here to view & download!
After seeing the introduction film I was amazed by this new world. What would I do first? Playing with a new family? Creating a family by myself? Where was the Wishing Well and where could I find the infamous casino? These questions were going around in my head and my eyes were bigger than normally. This world was fantastic!
On July 13th, SimGuruSarah mentioned that there was an issue with the launcher when uninstalling Lucky Palms. Today, she has updated the post with some new information.
Thread Link – Thanks Aznsensei!
We have discovered an issue that can occur when uninstalling Lucky Palms. If you uninstall Lucky Palms an error can occur that causes the launcher to crash on start-up.
We are working on a fix for this issue. In the meantime, if you plan to uninstall Lucky Palms please remove the World and be sure to uninstall the Heavenly Bells Slanted Columns individually via the Launcher (see steps below)
If you have uninstalled Lucky Palms and you are encountering a crash please delete the DCCache folder found here: Electronic Arts\The Sims 3
This will remove all installed content, but it will resolve the crash and you will be able to reinstall content via the launcher.
If you have any questions please post here and we will do our best to help.
To uninstall Lucky Palms:
1. Got to the Installed Content tab in the Launcher.
2. Search for the Heavenly Bells Slanted Column and select these assets – there are 3 – individually in the Launcher.
3. Find and select the check box for the Lucky Palms world as seen below.
4. Select the Uninstall button and wait for the uninstall success confirmation dialogue.
The Sims 3 Lucky Palms is the newest world to The Sims 3 Store, released on June 28, 2012. Lucky Palms is a world that is very different from other released store worlds such as Hidden Springs or Lunar Lakes, as we finally received a desert world other than the desert world in The Sims 3 World Adventures. Lucky Palms is far different from Egypt in World Adventures, by a lot in fact, because Lucky Palms includes way more for your Sims to do, plus your Sims can actually live and work in Lucky Palms.
The world has a unqiue story to it just like all other worlds in The Sims 3. While I won't go into too much detail on the story, at one time the world had many lakes but a few of the lakes have dried up around a part of the world, which your Sims can also live near. Lucky Palms comes in two versions, a standard edition and a gold edition. The difference between them is that the standard edition does not include The Lucky Simoleon Casino where the gold edition does. By having the casino it allows for your Sims to make a little extra simoleons (gold).
Starting A New Game
Since Lucky Palms was a new world, it was time to start a brand new game! I knew a little bit about what to expect from seeing the multitude of screenshots and reading the information, and also attending the live chat, but seeing the world in person through my own eyes I was very impressed. While the screenshots do show a lot of the great detail that went into the world, the screenshots don't show everything. In fact the screenshots don't even do justice once you've seen the world in a new game.
Via The Sims 3 Community Blog
Mike True is a jack of alltrades – sometimes a modeler, sometimes a texture artist, and always a builder.He created the terrain in Lucky Palms as well many of the lots. Mike, can youtell us what it was like to work on the lots in this world and which ones areyour favorites?
Read More »


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Clarksville TN Online is the voice of the people of Clarksville Tennessee.We take you beyond the ordinary in local news and gives the Extras: diverse political coverage including individual opinion pieces and editorial work, activism, local and regional arts and theater, municipal and county news and events, and more.
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To submit Clarksville Tennessee area news, story leads, tips, or press releases send us an email
Sunday, December 7th, 2014 | Noon CST
Nashville, TN | LP Field | TV: FOX
Nashville, TN – This week the Tennessee Titans (2-10) play host to the New York Giants (3-9). Kickoff at LP Field (capacity 69,143) is scheduled for noon CST on Sunday, December 7th.
The game will be televised regionally on FOX, including Nashville affiliate WZTV FOX 17. Thom Brennaman will handle play-by-play duties, and David Diehl will serve as analyst. Laura Okmin will report from the sidelines.
Tennessee Titans running back Bishop Sankey (20) rushes during the first quarter against the Houston Texans at NRG Stadium. (Troy Taormina – USA TODAY Sports)
«Read the rest of this article»
Sunday, October 19th, 2014 | 1:00pm EDT/Noon CDT
Landover, MD | FedExField (85,000) | TV: CBS
Nashville, TN – The Tennessee Titans (2-4) travel to face the Redskins (1-5) this week. Kickoff at FedExField is scheduled for 1:00pm EDT/noon CDT on Sunday, October 19th.
The Titans and Redskins have met on only 11 prior occasions in the regular season, with the Titans holding a 6-5 advantage. In two appearances at FedExField, which opened in 1997, the Titans are 2-0, earning wins in 2000 and 2006. Meanwhile, the Redskins have won both matchups at LP Field in the same time period (2002 and 2010).
Tennessee Titans running back Leon Washington (29) catches a pass during warm ups prior to the game against the Jacksonville Jaguars at LP Field. (Jim Brown-USA TODAY Sports)
Sunday, September 14th, 2014 | Noon CDT
Nashville, TN | LP Field | TV: FOX
Nashville, TN – The Tennessee Titans (1-0) play their home opener this week against the Dallas Cowboys (0-1). Kickoff at LP Field (capacity 69,143) is scheduled for noon CDT on Sunday, September 14th.
Fans are encouraged to participate in the LP PENCIL Box School Supply Drive at the game.
LP PENCIL Box, a collaborative non-profit venture between PENCIL Foundation and LP Building Products, offers Nashville Metro teachers the opportunity to acquire school supplies for the city's most in-need children.
Tennessee Titans tight end Delanie Walker (82) catches a touchdown pass in front of Kansas City Chiefs cornerback Sean Smith (21) in the first half at Arrowhead Stadium. (John Rieger-USA TODAY Sports)
Nashville, TN – Today, Saturday August 30th, is the cut off for NFL teams to reduce rosters down from 75 players to 53. The Tennessee Titans released 20 players today including corner back Tommie Campbell and fan favorite wide receiver Marc Mariani.
The Titans placed defensive lineman Antonio Johnson on injured reserve and traded defensive lineman Lavar Edwards to the Dallas Cowboys for an undisclosed future draft pick.
Saturday, August 23rd, 2014 | 6:00pm CDT
Atlanta, GA | Georgia Dome | TV: WKRN
Nashville, TN – The Tennessee Titans (1-1) continue their preseason schedule this week with a trip to face the Atlanta Falcons (1-1). Kickoff at the Georgia Dome (capacity 71,228) is scheduled for 7:00pm EDT/6:00pm CDT on Saturday, August 23rd.
The trip to Atlanta could be the last chance for some to make a lasting impression. By 3:00pm CDT on August 26th, the roster must be trimmed from a maximum of 90 players to 75. The final cut to 53 players occurs on August 30th.
New Orleans Saints running back Khiry Robinson (29) is tackled by Tennessee Titans defensive end Kamerion Wimbley (95) as he carries the ball in the first half at Mercedes-Benz Superdome last week. (Crystal LoGiudice-USA TODAY Sports)
New Orleans, LA – With 19 seconds left in the game, Tennessee Titans quarterback Zach Mettenberger threw a pass to Marc Mariani that was deflected into the end zone and caught by Titans tight end Chase Coffman for a 1 yard touchdown.
It was too little too late for Tennessee as Maikon Bonani's onside kick was recovered at midfield by New Orleans Saints' Brandon Coleman sealing a 31-24 win over the Titans at the Mercedes-Benz Superdome.
Tennessee Titans quarterback Zach Mettenberger (7) throws against the New Orleans Saints during second quarter of a preseason game at Mercedes-Benz Superdome. (Derick E. Hingle-USA TODAY Sports)
Nashville, TN – The Tennessee Titans agreed to terms with wide receiver Marc Mariani on a one-year contract.
Mariani was selected by the Titans in the seventh round of the 2010 NFL Draft. The Montana wide receiver works well in the slot and is excellent in the return game.
He made an immediate impact in his rookie year as a returner, earning Pro Bowl honors after finishing second in the AFC and fourth in the NFL with a 12.2-yard punt return average and finishing fourth in the AFC with 25.5-yard kickoff return average. «Read the rest of this article»
Nashville, TN – The Tennessee Titans defense had something to prove after last week's performance against the Cincinnati Bengals. And prove it they did, holding the vaulted Atlanta Falcons offense led by Matt Ryan to only field goals in the first half. In fact, the Titans were able to sack Ryan five times.
The Tennessee offense started slow on their first two possessions before Jake Locker but together a 5 play scoring drive capped by a 7 yard pass to Nate Washington in the back of the end zone. This got the Titans going and they never let off the gas going on to beat the Falcons 27-16.
Tennessee Titans quarterback Jake Locker drops back to pass against the Atlanta Falcons Saturday night. (Don McPeak/USA TODAY Sports)
Saturday, August 24th, 2013 | 7:00pm CDT
LP Field | Nashville, TN | TV: WKRN
Nashville, TN – The Tennessee Titans (0-2) play their third preseason game this week, as they host the defending NFC South Champion Atlanta Falcons (0-2). Kickoff at LP Field (capacity 69,143) is scheduled for 7:00pm CT on Saturday, August 24th.
In 13 all-time regular-season meetings between the Titans and Falcons, the Titans hold a narrow 7-6 advantage that includes a five-game winning streak from 1993–2007.
Tennessee Titans quarterback Jake Locker (10). (Don McPeak/USA TODAY Sports)
Thursday, August 8th, 2013 • 7:00pm CDT
LP Field • Nashville, TN • TV: WKRN
Nashville, TN – The Tennessee Titans (0-0) open their 2013 preseason schedule this week at home against the Washington Redskins (0-0). Kickoff at LP Field (capacity 69,143) is scheduled for 7:00pm CDT on Thursday, August 8th.
The Redskins have visited LP Field on three previous occasions, twice in the regular season (2002 and 2010) and once in preseason (2007). In the all-time regular-season series, the Titans hold a slight 6-5 advantage.


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This week's affiliate training webinar focused on learning the basics of the AvantLink API, our robust and very powerful platform that nearly all of the AvantLink tools you use everyday are built on. The webinar included live examples of API calls and two complete demonstrations on how to set the API up and put it on a website, all on top of the usual account interface training segment.
And that would be what you're watching today, but it's not. That's because our webinar software randomly decided to delete the webinar recording after the training concluded. Thanks webinar software!
But fret not- below is a new and way better recap recording of the webinar and our webinar software wasn't able to delete this new copy. In this consolidated recap of the API, we look at what it can be used for, how to set it up, and what it actually looks like on a website. So download the webinar recap video using the big blue button below and set aside 20 minutes to get through the whole video. Don't forget that the live examples of the API tool are still available at chadwaite.com/avantlink/api.
If you're looking for training on the affiliate account interface, this webinar recap doesn't cover it. Any of our archived affiliate training webinars, however, will have the account interface training portion, so feel free to browse those.


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Almost 100 drink drivers caught in Cambridgeshire in December
Posted: January 03, 2014|
Fewer people were caught drink driving in Cambridgeshire this Christmas - but police are still disappointed.
Officers stopped more than 6,000 motorists and arrested 96 people, compared to 120 arrests last year.
The Christmas campaign ran from December 1 until December 31.
Sgt Chris Huggins said: "While it's encouraging to see fewer drivers arrested than last year, sadly any arrest is one too many.
"It appears our message is getting through, but it is always disappointing to see that there are still a number of motorists who think it is acceptable to drive while under the influence of drink or drugs.
"Not only were drivers being stopped as part of our Christmas drink drive campaign but also during routine daily patrols and at incidents.
"This work was not just about enforcement but reminding motorists that officers are on the roads 24/7 as a deterrent to those contemplating driving under the influence.
"Although the campaign is over, our work will continue as we strive to make the roads safer."


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Explores the basic functions of Adobe Photoshop 7, including layers, the healing and clone stamp tools, and filters.
Explores the newest features in Photoshop 7.
"I just wanted to thank you all for the best learning tools I've ever seen. My photography has improved by major steps—and people keep asking me how I've done it." —Frank R.
more from our members »


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We'd love to hear from our alums - let us know what you are doing, where you are. Please help us keep our contact information up-to-date by sending us your current email and mailing addresses. Click here to update your contact information.
We are asking that our alumni complete an Alumni Survey. The outcomes of the survey are important to accreditation. Please download the pdf of the Alumni Survey and complete it. Attach it to the following email address and let us know your opinions. Thanks!!


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2011 13.3" Macbook Pro
Just felt like sharing that I am thoroughly enjoying my new Macbook Pro. I forgot what its like using a computer that actually works!
Haha yes it is takenj for granted how nice a completely operational machine is ;)
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Surfboard signage numbers accommodation
Try our Beach Cottages, Spa Cabins or a Powered Site on the waterfront. Call now to book.
02 4295 1123
Another CORE TOURISM MANAGEMENT property
Another Core Tourism Management property.
Closer to Sydney, stay at our park at Ellerslie (near Camden)
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Promote your Caravan Park, Business or Attraction here!Ads stay on our site permanently for a one-off cost.Multiple ad packages are available.Call us NOW!1800 605 198


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Cast: Anjali (actress), N. Santhanam, Oviya, Anjali (actress Born 1986), Vimal, John Vijay, Santhanam (actor), Shiva (actor), Ilavarasu
Producer: Vijay Ebenezer, Kushboo (actress), Ronnie Screwvala, Siddharth Roy Kapur
Director: Sundar C.
Writer: Sundar C., Badri (director), Sundar C
Release Date: 11 May,2012
Storyline: Kalakalappu is a 2012 indian tamil comedy film directed by sundar c. and produced by his wife kushboo sundar. it features vimal, shiva, anjali, oviya and santhanam in lead roles and music composed by vijay ebenezer. it was originally titled masala cafe, but was later renamed to kalakalappu. it is said to be inspired from the german film soul kitchen. Read on Wikipedia
Kalakalappu : Cast
Cast overview


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It has been recently revealed that a Florida man met with an accident when his e-cigarette battery blasted in his mouth. Terry Halmshaw, 57, was trying to kick smoking habit and used to smoke an electronic cigarette.
He was in his office at the time when the incident happened. His front teeth have been broken, a part of his tongue was also taken off and his face has also received burn marks. Not only this, his chair cushion also blasted, carpet and other office equipments were also damaged.
Terry was admitted at a hospital in Mobile, Alabama, and now has been released, informed Joseph Parker, who is Division Chief for the North Bay Fire Department. He said that the best way to explain Terry's condition is as if a fired rocket has been put in a bottle. After getting discharged from the hospital, Terry thanked firefighters, who helped him to reach at the hospital.
Electronic cigarette is one of the best ways to leave smoking habit. Thomas Kiklas, who is Co-Founder of the Tobacco Vapor Electronic Cigarette Association, explained that electronic cigarette looks exactly as a normal cigarette. It includes an atomizer which turns water into vapors which comes out when person smokes.
It is one of its kind incidents, said Thomas. Generally, such incidents does not happen as manufactures take proper care that plastic battery and its cartridge does not have any problem. Thousands and thousands of electronic cigarettes have been sold, but they have not heard about any such incident which has happened with Terry.
"There have been billions and billions of puffs on the cigarettes and we have not heard of this happening before", said Thomas. It is said that a complete investigation will be done in this regard, informed Parker.
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The Fender 12" speaker fits the Deluxe 112 Plus. 4 ohm. 100W.
Fender 12" Standard Replacement Speaker 4ohm 100w
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Its a speakerAs reviewed by JOHN RAFFAGHELLO II on 3/20/2012
Not a bad replacement, better than what was in the cab defibately,used to replace an extension cab speaker in my blues deluxe reissue. Has nice bass sound and handles well. No real complaints here the last speaker made a crapping noise...blown out. Id buy it again..1 of 1 people found this review helpful.Was this review helpful?Thank You for rating this review!
Awesome deal!As reviewed by TERRY KEMPLER on 2/14/2012
Great speaker for 1 x 12 cab if you like Eminence! At 4 ohms, you're going to get the most power from your amp - providing it's output is rated at 4 ohms minimal. I've put this speaker in three 1 x 12 cabs, and two 1 x 12 combos - mostly replacing stock speakers or Celestions which I personally find too bright for metal and rock. At $60, you get an Eminence Made in USA which produces great tones with cutting midrange and great crunch (extended low end).1 of 1 people found this review helpful.Was this review helpful?Thank You for rating this review!
The price is perfectAs reviewed by Dan on 2/12/2009
These fender speakers are really made by Eminence and are an excellent buy for the price and quality. It sounds bright and clear. And powerful.2 of 4 people found this review helpful.Was this review helpful?Thank You for rating this review!
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« How Will You Know When To Refer Me | Main | Systematically Flood Your Leads With An Education »
July 02, 2005
How To Move Up The Referral Food Chain
This post will smack some as a tad elitist or politically incorrect but, I'm about to explain a referral marketing fact of life.
People can only refer down the food chain (or maybe in the same food group)
What I mean by that is that is, if you are counting a person to refer the VP of sales for a Fortune 500 company, and that person is seen by the VP of Sales as vendor and not as an equal, good luck. Now, understand that in many cases this is simply a function of title, socioeconomic class or even age - but it's also a function of value.
Plenty of high level executives in your network may not be able to refer you to their peers because even their peers don't see them as valued partners. The food chain rewards value.
And the flip side of that! Plenty of seemingly lower level folks provide so much value in the networking relationships they create, doors open for them in mysterious ways.
With all this said, here's what I'm getting at:
- If you want to make contact with a higher level (title, income, celebrity status, thought leader, mover-shaker) of prospect you must move out of your current level of network and start breaking in to higher level networks. Quick, how many people in your current network group can and do refer you to executives that are seemingly out of your reach?
- If you want to break into a network seen higher than the ones you currently play in provide value. Give before your even ask in return. Prove your worth. Be a coach, consultant or information source that outshines all others and the doors to this higher network will open. And when they do, the referrals you receive will be a little higher on the food chain too.
Posted by John Jantsch on July 2, 2005 | Permalink
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Taps are being turned off for four days in a freezing far north-eastern Chinese city because of fears of contamination from a chemicals blast, triggering panic buying of bottled water and food, state media says. Water supplies were being halted in Ha... [Read More]
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The more circles you move in, the better. And other circles can be a back door to where you want to go. Perhaps the VP you want to reach is in a PTA with a friend of yours, or goes to a business group that your contact is in. Sometimes it is funny how that happens. For me it seems to happen when I don't try so hard at it, and just let things come about in their own time.
Posted by: Duncan | Jun 21, 2006 4:49:08 PM
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Posted by: cqkgjytmwg | Nov 27, 2007 4:34:09 AM
Just ran across this post, and it's a good one. Said very well. Congrats John!
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I live: in LA. I write: SugarHero.com and the About.com Candy site. I love: eating sugar and trail running.
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Mounted tambourine/cowbell placement and why?
If you use them, where do you mount your tambourine and/or cowbell?
I recently started using a mounted tambourine and cowbell combo for a couple of new songs in my playlist. I've tried positioning the tamb/cowbell mount where I've seen many other drummers put such items, near the hi-hat, above my rack toms, and other areas on the left half of my kit.
I have standard 5-piece kit with slightly off-set rack toms, both mounted on a stand over the left half of the bass drum. I found tamb/cowbell mount positions on the left-side awkward or crowded. I found that placing the tamb/cowbell mount to the right of my ride cymbal and just above my floor tom to be most comfortable. So that very well may be where I leave it, that area feels good to me. However, I've not noticed any other drummers mounting a tambourine or cowbell there.
So my question to those that have such items, where do you mount them? Why? Where else have you tried to mount them?
Re: Mounted tambourine/cowbell placement and why?
I flew the tamb off the hat stand....sometimes mounted to the rod but more often to a boom arm that had it positioned to the left of and a little higher than the hats. And the cow bell has either been mounted off the bass drum hoop or off a cymbal stand above the floor tom to my right.
Why? They were where I could reach them and they felt most comfortable, yet not in the way as they weren't used in every song.
Re: Mounted tambourine/cowbell placement and why?
It's been a while since I needed either, but when I did:
Cowbell off the right cymbal stand, so the bell is just above the ride.
I have long legs, and my knee rubs up against the bell if it's mounted off the bass drum.
Tambourine is off the hi-hat stand, just to the left of the hi-hat. So I can still play the hi-hat as normal, and do back beats on the tambourine with my left hand, or move my hand off the hit-hat and hit the tambourine that way.
Re: Mounted tambourine/cowbell placement and why?
Mounted just left of the high hat, tamborine just a bit higher than the hat, jam block just below it and then the cow bell below that. I also have a foot pedal mounted cow bell left of the high hat pedal and a hat trick mounted on the high hat.
Re: Mounted tambourine/cowbell placement and why?
thats a sweet setup! do you have a cover over the shells or are those the shells?
Re: Mounted tambourine/cowbell placement and why?
The last show I played with a tambourine and cowbell, the tamborine was mounted above the marimba, right next to the triangle, and the cowbell was mounted between the glockenspiel and timpani...
Re: Mounted tambourine/cowbell placement and why?
I keep my tamb and cowbell on the same rod off a stand that's near my hi hat. There's not a marimba in sight, I guess I'm not a virtuoso like SOME people...:P
Plus I have a larger bell on my bass drum hoop. Need my bells and tamb.
Chicks love cowbells, I've been told numerous times by women that they love it when I use the bell. Just last weekend a couple of 20 somethings were almost demanding it. Talking about my cowbell.
Re: Mounted tambourine/cowbell placement and why?
EDIT - to the OP, I have the tambourine above and slightly to the right of my hats, in between the hats and tom. I need it there because there are a couple songs on which I play sixteenths on it. The cowbell goes to the right of my ride, above the floor tom. Both mount to cymbal stands. In fact, I mount everything to two cymbal stands using clamps and arms.
Re: Mounted tambourine/cowbell placement and why?
Tamborine to the left and slightly below the hats. Cowbells to the right and above the hats. Jam block at 10 o'clock above the snare rim if used.
Re: Mounted tambourine/cowbell placement and why?
Tambourine / Cowbell.........what about the Chimes????? They are waaaaay more important
Re: Mounted tambourine/cowbell placement and why?
My tambourine is mounted to my hihat stand, and it sits to the left and below my hats. I like this positioning, since it allows me to play it in the same way I would my hats, and it just feels right to me. No cowbell. I hate the cowbell. I will never add a cowbell to my kit. In fact, it has even become a joke among my friends - they tell me if I'm ever a dick to them, they'll buy a cowbell, and mount it on my kit when I'm not home. Sure as hell keeps me in line...
Re: Mounted tambourine/cowbell placement and why?
Oh man I need a cowbell. Let's see, "Black Magic Woman" without a cowbell is not Latin sounding, "Suzie Q" without a cowbell is not Suzie Q. "Honky Tonk Women" is cowbell dependant, I use it on "Mustang Sally", and the Beatles "Baby You Can Drive My Car". I use it on "Chain of Fools" and on "Born on the Bayou" as well as "Take Me to the River". It really adds a lot to these songs. Not understanding the hate, especially when the women comment on it as much as they do. If the women like it, that's good enough for me. But hey, I can't stand the tone of a guiro so it's all preference.
Re: Mounted tambourine/cowbell placement and why?
I use 2 cowbells on my kit. Rarely at a gig though.
I have a small cha-cha bell on the bass drum and a mambo bell mounted off of a cymbal stand to my right so the cowbell sits just behind my floor tom.
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May 21, 2008
Cannes. The Headless Woman."Argentinian director Lucrecia Martel is nothing if not subtle," writes Peter Brunette in the Hollywood Reporter.
"As with Three Monkeys, the plot of this Argentine non-drama makes it sound more interesting than it is," writes Mary Corliss for Time. "The film is inert, visually tiring, utterly lacking in suspense; nothing changes except Onetto's hair color." Update, 5/22: "Few filmmakers use focus as effectively and incisively as Martel," notes Anthony Kaufman at indieWIRE. "Inspired by Martel's dreams and nightmares, The Headless Woman is moody, mysterious and suffused with ominous portents and subtle critiques of the bourgeoisie." Update, 5/23: For J Hoberman, writing in the Voice, this is "the Best Film in Competition Least Likely to Win a Prize." Updates, 5/25: Daniel Kasman, writing in the Auteurs' Notebook, finds Martel "refining her utterly precise sense of visual and aural exploration of psychology while keeping the scale of her film smaller than anything else she has done. If the eerie sense of off-screen space and subtle, active sound design in The Holy Girl suggested a director who could make a truly disturbing horror picture, Martel goes halfway to embrace a ghost story." Andrew O'Hehir talks with Martel for Salon. Update, 5/29: The Headless Woman is "one of the strongest of a very strong festival," writes Scott Foundas in the LA Weekly. "Shooting for the first time in wide screen, Martel effects a sense of spatial and temporal dislocation that is close to the phantasmagoric subconsciousness of a David Lynch or Luis Buñuel. As she films her saucer-eyed, peroxide-blond leading lady (Maria Onetto) from a distance, in and out of focus, reflected in glass, we too begin to feel that we aren't quite ourselves, that we are sharing in Veronica's dark, private, waking dream. Most critics, though, were too busy complaining about being confused by the film to realize that this was exactly the point."
Coverage of the coverage: Cannes 08. Last year: Cannes @ 60. And Cannes 06.
Posted by dwhudson at May 21, 2008 6:30 AM


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Ben Landing was a great teacher and mentor who was blessed with a creative, fertile mind and a photographic memory. But he was a lot more than an intellect. He was REAL-very human and sincerely interested in his trainees and colleagues. He was reserved, but had a great sense of humor, often subtle, as with everything else about him. His modest demeanor and lack of arrogance made him approachable and easy to talk to. He was available to his trainees at any time. But he was no saint. He had enough foibles to make him interesting and human. He did not like administration or administrators. He was generous, but often to a fault. He smoked too much. His dichotomy of greatness and understated elegance is rarely encountered. We who had the privilege of working with him will not forget the legend or the man. Ben Landing's passing is sad, but his life was exhilarating.
Beverly Dahms
Ben was a Gentle Man, slow to speak ill of others, fast to respond to the needs of others, and always available to participate, at his own expense, in meetings anywhere in the world. He amazed us with the depth and breadth of his knowledge, apparently never having forgotten a case, an anecdote, or a name in his entire life. Always able to put a novel spin on any conundrum, to place anatomical analysis on a physiological and functional basis, and to spot the abnormality we mortals had overlooked. Few if any of us were able to get close to Ben the Man, but all of us loved Ben the Teacher, Ben the Role Model, Ben the Inspiration.Yet part of Ben still lives in hundreds of us, and will be passed on to those we teach.
Bruce Beckwith
Ben was a legend in his own time and his passing leaves a tremendous void. But his legacy is phenomenal testimony to what one individual can accomplish, not only through his own research, but also through the mentoring of so many pediatric pathologists. I would not be surprised if Ben taught directly or indirectly a third of the pediatric pathologists in the entire world. Although far smarter than most of us and armed with a photographic memory, he was a gentle man of patient manner and never elevated his stature by denigrating his colleagues and trainees. He will be sorely missed, but dearly remembered.
Henry Krous
(You may wish to reread Founders of Pediatric Pathology: Benjamin Harrison Landing by Beverly Dahms in Perspectives in Pediatric Pathology 1997;20:1-13)
If you wish to add a few words, an anecdote, or a comment to this memorial page,please email to Robert Ruiz.


text: Rotation Key Mod 06 Dec 2012 The Rotation Key Mod 1.4.5 for Minecraft 1.4.5 By MinecraftGood Minecraft Mods 0 Comment The Rotation Key Mod 1.4.5 – Download Rotation Key Mod for Minecraft 1.4.5. Hello minecraft fans! At its core, this mod adds a new key-binding for simple block rotation. If they key (Ctrl by default) is held down while placing a block, the block will be oriented in an alternate way. If the key is held down while Read More


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The Greece captain, who has 100 caps to his name, will relaunch his career with Salonika.
"PAOK announces that as an agreement has been reached with the player Kostas Katsouranis. The international ace will be wearing the club's black jersey from January 2013 and for the next 1.5 years," PAOK said in a statement on Tuesday.


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Methods, systems and devices are described for new modes of ventilation in which specific lung areas are ventilated with an indwelling trans-tracheobronchial catheter for the purpose of improving ventilation and reducing hyperinflation in that specific lung area, and for redistributing inspired air to other healthier lung areas, for treating respiratory disorders such as COPD, ARDS, SARS, CF, and TB. Trans-Tracheobronchial Segmental Ventilation (TTSV) is performed on either a naturally breathing or a mechanical ventilated patient by placing a uniquely configured indwelling catheter into a bronchus of a poorly ventilated specific lung area and providing direct ventilation to that area. The catheter can be left in place for extended periods without clinician attendance or vigilance. Ventilation includes delivery of respiratory gases, therapeutic gases or agents and evacuation of stagnant gases, mixed gases or waste fluids. Typically the catheter's distal tip is anchored without occluding the bronchus but optionally may intermittently or continuously occlude the bronchus. TTSV is optionally performed by insufflation only of the area, or by application of vacuum to the area, can include elevating or reducing the pressure in the targeted area to facilitate stagnant gas removal, or can include blocking the area to divert inspired gas to better functioning areas.
1. A method of ventilating a patient, the method comprising:
placing a percutaneous transtracheal ventilation catheter in an airway of the patient so that the catheter is anchored to allow extended use without vigilance and so that the patient's airway is patent to allow spontaneous breathing around the catheter;
attaching the catheter to a ventilator external to the patient, wherein the ventilator is a wear-able ventilator; and
ventilating the patient through the catheter by delivering gas at a positive pressure and flow rate sufficient to increase lung pressure.
2. An apparatus for ventilating a patient, the apparatus comprising:
a ventilation catheter with a distal and proximal end, wherein the distal end is configured to be anchored in the patient's airway for extended use wherein the catheter does not occlude the airway, and wherein the proximal end is configured to be attached to an external ventilator, and comprising at least one lumen extending the length of the catheter, and
a wear-able ventilator, comprising a gas delivery supply and a gas removal source coupled to the at least one lumen at the proximal end of the ventilation catheter, wherein the ventilator is configured to supply gas at a positive pressure and volumetric flow rate sufficient to increase lung pressure.
3. A method for directly ventilating a subject, comprising:
placing a continuously indwelling catheter in a subject's bronchial tree beyond the lobar bronchus, wherein the catheter has a distal end and a proximal end, wherein the distal end is adapted to be anchored in the bronchus of the lung compartment, and wherein the catheter is adapted to remain in place for extended periods without clinician vigilance;
connecting the proximal end of the catheter to a wear-able ventilation source external to the patient, and wherein the ventilation source includes a gas removal source and a gas delivery supply, and wherein the catheter is configured to provide gas delivery and gas removal through the catheter; and
ventilating the patient through the catheter by delivering gas at a positive pressure and rate sufficient to increase lung pressure.
4. A method for directly ventilating a patient using a wear-able ventilator, via an indwelling catheter placed in the patient's airway, the method comprising:
anchoring a distal end of the catheter within the patient's airway so that the catheter can remain in place for extended periods without vigilance;
connecting a proximal end of the catheter to a wear-able ventilator external to the patient, wherein the ventilator includes gas removal source and a gas delivery supply; and
ventilating the patient through the catheter by delivering gas at a positive pressure and flow rate sufficient to increase lung pressure.
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mucolytic agents, surfactants, beta-agonists, anti-inflammatories, steroids, antibiotics, vitamin derivatives, vasodilators, viral vector agents, mono-clonal antibodies, chemotherapeutics, radioactive isotopes, stem cells, and combinations thereof.
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a percutaneous transtracheal ventilation catheter configured to be placed in an airway of the patient, wherein the catheter is configured to be anchored to allow extended use without vigilance and so that the patient's airway is patent to allow spontaneous breathing around the catheter;
a ventilator external to the patient, wherein the ventilator is a wear-able ventilator, and wherein the ventilator is configured to ventilate the patient through the catheter by delivering gas at a positive pressure and flow rate sufficient to increase lung pressure.
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57. An apparatus for ventilating a patient, the apparatus comprising:
a ventilation catheter with a distal and proximal end, wherein the distal end is configured to be anchored in the patient's airway for extended use, wherein the catheter does not occlude the airway, and wherein the proximal end is configured to be attached to an external ventilator, and comprising at least one lumen extending the length of the catheter, and
a wear-able ventilator, comprising a gas delivery supply coupled to the at least one lumen at the proximal end of the ventilation catheter, wherein the ventilator is configured to supply gas at a positive pressure and volumetric flow rate sufficient to increase lung pressure during an inspiration phase of the patient and wherein the ventilator is configured to deliver gas through the second lumen to assist in the removal of CO2-rich gas during an expiration phase of the patient.
58. The apparatus as in
wherein the at least one lumen of the ventilation catheter comprises at least two lumens,
wherein a first lumen is adapted for gas delivery and comprises a first gas delivery port at the distal end of the catheter, wherein the first gas delivery port is oriented and adapted to direct gas being delivered by the first lumen toward the lung,
wherein a second lumen is adapted for gas delivery and comprises a second gas port near the distal end of the catheter, wherein the second gas port is oriented and adapted to direct gas being delivered by the second lumen away from the lung,
wherein the ventilator is adapted to deliver ventilation gas through the first lumen during inspiration,
and wherein the ventilator is adapted to deliver gas through the second lumen during expiration.
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86. A method for directly ventilating a patient via an indwelling catheter placed in the-patient's airway and using a wear-able ventilator, the method comprising:
anchoring a distal end of the catheter within the patient's airway so that the catheter can remain in place for extended periods without vigilance;
connecting a proximal end of the catheter to a wear-able ventilator external to the patient, wherein the ventilator includes a gas delivery supply; and
ventilating the patient through the catheter by (i) delivering gas at a positive pressure and rate sufficient to increase lung pressure during an inspiration phase of the patient and (ii) delivering gas at a positive pressure and rate sufficient to assist in the removal of CO2-rich gas during an expiration phase of the patient.
87. The method as in
wherein the catheter comprises at least two lumens;
wherein a first lumen is adapted for gas delivery and comprises a first gas delivery port at the distal end of the catheter, wherein the first gas delivery port is oriented and adapted to direct gas being delivered by the first lumen toward the lung;
wherein a second lumen is adapted for gas delivery and comprises a second gas port near the distal end of the catheter, wherein the second gas port is oriented and adapted to direct gas being delivered by the second lumen away from the lung;
wherein the ventilator is adapted to deliver ventilation gas through the first lumen during the inspiration phase of the patient;
and wherein the ventilator is adapted to deliver gas through the second lumen during the expiration phase of the patient.
This application claims Provisional Patent Application No. 60/479,213 as a predicate application with the respective priority filing date of Jun. 18, 2003.
Not Applicable
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Small Entity Concern
U.S. Pat. Nos. 4,825,859; 4,838,255; 4,850,350; 4,967,743; 5,000,175; 5,134,996; 5,186,167; 5,193,533; 5,255,675; 5,460,613; 5,513,628; 5,598,840; 5,791,337; 5,904,648; 6,227,200; 6,520,183; 6,575,944; 6,575,944; U.S. Published Patent Applications: 20010035185; 20020179090.
The present invention relates to the field of respiratory therapy and specifically to the field of lung ventilation to treat a variety of pulmonary diseases.
Lung diseases are the number one category of diseases and a leading cause of death worldwide. Some lung diseases, such as Chronic Obstructive Pulmonary Disease (COPD), Acute Respiratory Distress Syndrome (ARDS), Severe Acute Respiratory Syndrome (SARS) and cystic fibrosis (CF) usually require some form of ventilation assistance or delivery of therapeutic agents in order to clinically improve the patient.
COPD in particular effects tens of millions of people and is one of the top five leading causes of death. COPD is a spectrum of problems, including bronchitis and emphysema, and involves airway obstruction, lung elasticity loss and trapping of stagnant CO2-rich air in the lung. Emphysema, the worst form of COPD, occurs when there is a breakdown in the elasticity in the lung changing clusters of individual alveoli into large air pockets, thereby significantly reducing the surface area for gas transfer. In some cases air leaks out of the compromised walls of the minute airways to the periphery of the lung causing the membranous lining to separate and forming large air vesicles called bullae. Also due to elasticity loss, small conducting airways leading to the alveoli become flaccid and have a tendency to collapse during exhalation, trapping large volumes of air in the now enlarged air pockets, thus reducing bulk air flow exchange and causing CO2 retention in the trapped air. Mechanically, because of the large amount of trapped air at the end of exhalation, known as elevated residual volume, the intercostal and diaphragmatic inspiratory muscles are forced into a pre-loaded condition, reducing their leverage at the onset of an inspiratory effort thus increasing work-of-breathing and dyspnea. Also, areas with more advanced emphysema and more trapped air tend to comprise the majority of the chest cavity volume and tend to fill preferentially during inspiration due to their low elasticity, thus causing the healthier portions to be disproportionately compressed rather than inflating normally during inspiration and receiving their share of inspired air. In emphysema therefore more effort is expended to inspire less air and the air that is inspired contributes less to gas exchange.
ARDS is a respiratory insufficiency caused by a variety of underlying problems such as lung injury, infection, edema, or atelectasis. SARS is a sudden respiratory insufficiency and appears to be caused by a viral infection. CF is a genetic condition in which airways secrete copious amounts of mucus and are inflamed.
Conventionally prescribed therapies for COPD and ARDS and sometimes SARS and CF include pharmacological agents (beta-agonists, aerosolized bronchodilators, anti-inflammatories and mucolytics), supplemental long term oxygen therapy (LTOT) delivered nasally or via tracheotomy, BiLevel Continuous Positive Airway Pressure (BiPAP), which lowers work of inspiration by providing a steady stream of pressure, Tracheal Oxygen Gas Insufflation (TGI), described by Christopher, JAMA 1986; 256: 494-7, which reduces CO2 content in the upper airways thus allowing higher O2 concentrations to reach the distal airways, respiratory muscle rehabilitation, pulmonary hygiene, such as lavage and percussion therapy, lung volume reduction surgery (LVRS) and lung transplantation (LX). These therapies all have certain disadvantages and limitations with regard to effectiveness, targeting accuracy, risk or availability. Usually, after progressive decline in lung function despite attempts at therapy, patients become physically incapacitated or sometimes require more invasive mechanical ventilation to survive in which case weaning from ventilator dependency is often times difficult. Conventional invasive ventilation modes include Continuous Mechanical Ventilation (CMV), Synchronized Intermittent Mechanical Ventilation (SIMV), Positive End Expiratory Pressure (PEEP) therapy, and high frequency jet ventilation (HFJV).
Some newer ventilatory methods have been studied in the attempt to improve treatment of COPD and ARDS. One such method described by Fink, J Resp Care Pract April 1999; 71 is ventilation of a lung with gases of low molecular weights and low viscosity, such as helium-oxygen mixtures or nitric oxide, in order to decrease gas flow resistance and lower surface tension in distal airways and alveolar surfaces, thus increasing oxygen transfer across the alveolar surface into the blood. Another new method includes liquid perfluorocarbon ventilation which can displace mucus in distal airways while still conducting oxygen thus improving gas flow. Another method never successfully commercialized is Negative End Expiratory Pressure (NEEP), which helps remove CO2-rich gas during the exhalation cycle. These invasive methods typically ventilate COPD and ARDS patients more effectively then conventional invasive ventilation modes and may improve weaning, but they are significantly limited in efficacy because they can not easily be provided as chronic treatments and are not target specific. Rather they are inherently designed to treat the whole lung from the upper airway and hence do not address the significant problem of hyperinflation and areas of trapped stagnant gas, nor the problem of maldistribution of inspiratory gas volume.
Some additional devices and techniques have been invented with the aim of improving efficacy. U.S. Pat. No. 6,575,944 describes a catheter that is used for medication delivery through an endotracheal tube. That invention is good for pharmacological therapy on a mechanically ventilated patient, however the invention does not address the significant ventilation needs of the diseased lungs such as trapped gas and hyperinflated lungs.
U.S. Pat. No. 6,520,183 describes a catheter used to block on lung and delivery anesthesia to the other lung. That invention and other like it can only be used for one lung ventilation, almost always for surgery. That invention can be used in the unintended use of shunting ventilation to one lung, if the other lung is too diseased, however this usage would have significant limitations in that lobar or segmental sections of lung could not be individually blocked; hence this therapy would not be selective at all.
U.S. Pat. Nos. 6,227,200; 5,791,337; 5,598,840; 5,513,628; 5,460,613; 5,134,996; and 4,850,350 all describe catheters used for intermittently accessing and suctioning the trachea and main stem bronchi during through a tracheal tube during mechanical ventilation. That invention does not address the severe ventilation problems of the diseased lung, such as trapped air, hyperinflation, and poor airflow and perfusion distribution.
U.S. Pat. No. 5,904,648 describes a catheter for blocking airflow to one lung in order to ventilate and deliver anesthesia to the other side while the blocked side is being operated on. Again, that invention does not address improving ventilation and gas exchange.
U.S. Pat. Nos. 5,255,675 and 5,186,167 describe a catheter placed in the trachea through which the trachea is insufflated with oxygen. In clinical practice that invention and others like it have been proven to reduce the amount of CO2 in the lung and thus improve ventilation, however because the therapy described in this invention can inherently only be applied to the upper airways, it does nothing to improve the significant hyperinflation, air trapping and airflow and perfusion maldistribution of diseased lungs, and thus the therapy is severely limited. Indeed this therapy has not been well received clinically because the amount of benefit does not justify the added attention required.
U.S. Pat. No. 5,193,533 describes an invention similar to U.S. Pat. No. 5,255,675 in which high frequency ventilation is administered to the trachea to improve oxygenation. That invention has been proven clinically useful during short term medical procedures because the lung can be effectively mechanically ventilated at lower pressures but it is not useful as a subacute or chronic therapy as it does not reduce the air trapping, hyperinflation, or airflow and blood perfusion maldistribution.
U.S. Pat. Nos. 4,967,743; 4,838,255 and 4,825,859 describe a catheter for suctioning and ravaging the airways. That invention is limited to managing the airway integrity and pulmonary hygiene and is not suited for directly improving the underlying causes of air trapping, hyperventilation, and air flow maldistribution in the lung.
U.S. Patent Application 20020179090 describes an aspiration catheter for removing phlegm from a lung. This invention is only useful in airway management and is not suited for directly improving the underlying causes of air trapping, hyperventilation, and air flow maldistribution in the lung.
U.S. Patent Application 20010035185 describes a nasal-pharyngeal catheter for delivering breathing gases to the pharynx to supplement regular ventilation or breathing. That invention is incrementally more effective than LTOT in that the gases are delivered more effectively but unfortunately the technique can not directly improve the underlying causes of air trapping, hyperventilation, and air flow maldistribution in the lung
It must be emphasized that an effective ventilation treatment should ideally target specific areas of the lung that are most diseased yet all the methods described in the prior art employ ventilation on the entire lung as a whole, rather than on targeted lung areas that are more diseased. Therefore, all known ventilation modes allow trapped CO2 to persist in the worst effected areas of the lung and allow these areas to remain hyperinflated with the CO2-rich air, thus taking up valuable space in the chest cavity and compressing other potentially contributory lung areas. Other inventions or conventional therapies are either to traumatic, too transient, not site-specific, too experimental or not effective. The present invention disclosed herein addresses these shortcomings as will become apparent in the later descriptions.
The present invention disclosed herein takes into consideration the problems and challenges not solved by the aforementioned prior art methods. In summary, this invention accomplishes (1) effective and direct cannulation of the lung area requiring treatment for a targeted site-specific treatment, (2) provides the option of sub-chronic or chronic treatment without the vigilance of a clinician, either in the hospital setting or in the home-care setting, and can be titrated accordingly, (3) is atraumatic, (4) improves hyperinflation and stagnant gas trapping in the distal spaces, (5) improves the maldistribution of airflow and blood perfusion, and (5) is cost effective.
The present invention provides a method for directly ventilating an area in a lung to improve the gas exchange in that area, typically for the treatment of COPD, although other respiratory diseases, such as ARDS, SARS, CF and TB may also benefit from this approach. The method, Trans-Tracheobronchial Segmental Ventilation (TTSV), is performed by (a) catheterizing the lung area with an indwelling catheter that can be left in place for extended periods without the vigilance of a clinician, and (b) ventilating the lung area via the catheter by delivering a ventilation gas and/or therapeutic substance such as a gas, liquid, solid or plasma, during an insufflation phase and removing waste and mixed gases from the area during an exhaust phase. The scientific principles employed to accomplish TTSV are fluid dynamics, the physical laws of mass transfer, i.e., gas and tissue diffusivity, gas concentration gradients and pressure gradients, as well as the physical laws of collapsible tubes and hemoglobin biochemistry laws.
In a preferred embodiment of the present invention the feeding bronchus of the targeted lung area is catheterized with an indwelling catheter anchored in the bronchus such that it can remain in place for extended periods without being attended by a person. The catheter enters the bronchial tree from the upper airway, either through an artificial airway such as a tracheal tube or through a natural airway such as the nasal passage or through a percutaneous incision such as a cricothyrotomy and is advanced to the targeted LUNG AREA through the bronchial tree with endoscopic or fluoroscopic guidance, where the tip is anchored in the airway. For ventilation and hygiene considerations, the catheter entry point into the body typically includes a self-sealing and tensioning connector that controls fluid from escaping from around the catheter shaft, but which permits the catheter to slide axially to compensate for patient movement or for elective catheter repositioning. The tensioning connector also serves to prevent inadvertent dislodging of the catheter's distal end anchor from the bronchus. In accordance with this embodiment the catheter includes at least one lumen through which the ventilation or therapeutic gas is delivered or insufflated directly into the targeted lung area and through which CO2-rich mixed gas is removed or exhausted from the targeted area. Gas removal from the area is typically enhanced by applying vacuum, as opposed to passive exhaust, however a low vacuum level is applied to avoid the collapse of airways and trapping gas behind the then collapsed airways. Optionally the segmental ventilation gas delivery/removal cycle is synchronized with the breathing pattern of the complete lung either during natural breathing or during mechanical ventilation but can also be asynchronous. The primary segmental ventilation parameters, flow, pressure and frequency, are regulated so as to create the desired volume delivery to the targeted area, or alternatively the desired pressure delivery to and in the targeted area, or still alternatively the desired gas composition in the targeted area or perfusion network thereof. The segmental ventilation parameters are measured to facilitate such regulation and to maintain safe conditions such as to prevent barotrauma.
Still in accordance with the preferred embodiment of the present invention, the fluid delivered to the targeted area may include standard breathing gases such as filtered air-oxygen mixtures, or may include therapeutic gases, such as helium, helium-oxygen mixtures, nitric oxide, other low molecular weight gases and gases enriched with particalized medicants, or may include liquids such as perfluorocarbons. Hereafter, the various fluids potentially used in TTSV will be referred to as simply 'ventilation gas'.
Still in accordance with the preferred embodiment of the present invention, the proximal end of the catheter is kept external to the patient and is connected to a segmental ventilation gas control unit. The gas control unit comprises a supply of ventilation gas, or alternately an input connection means to a supply thereof, and comprises the requisite valves, pumps, regulators, conduits, sensors and control electronics to control the desired pressure and/or flow delivery of the gas and to control the desired pressure in the lung area. The gas control unit may comprise a replaceable or refillable modular cartridge of compressed or concentrated ventilation gas and/or may comprise a pump system that receives ventilation gas from a reservoir and ejects the ventilation gas into the catheter at the desired parameters. The gas control unit further comprises fail-safe over-pressure relief mechanisms to protect against inadvertent lung barotrauma. The gas control unit also typically comprises a negative pressure generating source and control system also connectable to a lumen in the catheter for the previously described gas removal phase, i.e., exhaust phase, of the gas control unit ventilation cycle. The gas control unit may be configured to be remove-ably or permanently attached internally or externally to a standard lung ventilator, in the case of performing gas control unit on a mechanically ventilated patient, or may be an independent unit optionally to be worn by an ambulatory patient, in the case of performing TTSV on for example a home-based naturally breathing patient. It is appreciated that the gas control unit will have the requisite control and monitoring interface to allow the user to control and monitor the relevant parameters of the TTSV, as well as the requisite power source, enclosure, electronics, etc.
In an optional embodiment of the present invention, an average pressure is created in the targeted lung area which is slightly elevated compared to the average pressure in the remainder of the lung. This is achieved by measuring and regulating the lung area and TTSV parameters accordingly. The purpose of the elevated pressure is four fold: (1) it will facilitate a dilitation of the distal airways to facilitate communication of the ventilation gas with the otherwise poorly communicating lung lobules and alveoli; (2) it will facilitate CO2 displacement out of the elevated pressure area into areas of lower pressure due to simple flow and pressure gradient laws; (3) it will facilitate displacement of CO2-rich gas out of very distal areas through collateral channels at the alveolar and lobular level into neighboring lung areas; (4) it will increase the rate of ventilation gas diffusion across the alveolar surface into the blood due to higher gas partial pressures, obeying diffusivity laws and hemoglobin biochemistry laws. Conversely, the average pressure created in the targeted area can also be regulated to produce a slightly lower average pressure than the remainder of the lung, in order to facilitate volume reduction of the targeted hyperinflated area.
TTSV can be performed by delivering ventilation gas to the targeted area but without applying an active exhaust phase as opposed to the previously described active exhaust phase. Or, alternatively, active insufflation and expiratory phases can simultaneously co-exist, rather than alternating between phases. Still alternately gas delivery and active gas exhaust can be continuous or semi-continuous rather than alternating with discrete phases of off and on. In any case, insufflation gas pressure and flow can be delivered continuously, variably, intermittently at low frequency, <20 cycles/min., intermittently at medium frequency, 20-50 cycles/min., intermittently at high frequency, >50 cycles/min., or synchronized with the patient's breathing cycle in order optimize the airflow fluid dynamics of TTSV. In the case of non-active expiration, the CO2-rich gas is simply displaced by the insufflation gas and exits the targeted lung area passively due to concentration and pressure gradients. It can be appreciated that the possible combinations of pressure amplitudes and frequency profiles of both delivered and exhausted gases are extensive, but all must comply with the following fundamental and critical principle that is unique to the present invention: The regulated parameters must produce a decrease in stagnant gas in the treated area, produce an increase in beneficial gas in the treated area, avoid excessive or unsafe pressure and volume increases in the treated area, and ideally reduce the volume in the treated area to redistribute inspired air to other healthier lung areas.
In a second general embodiment of the present invention, regulation of the pressure in the ventilated segment is further facilitated by occluding the annular space between the catheter and the feeding bronchus of the ventilated segment. This embodiment further facilitates control of the pressure and gas concentration in the targeted lung area particularly in gravitationally challenging situations, for example when a non-gaseous substance is used in the ventilation fluid, or when a low molecular weight gas is used.
In a third general embodiment of the present invention, TTSV of targeted lung area is performed using gas removal only, rather than both gas delivery and gas removal. In this embodiment can be accomplished by applying, via the catheter, a vacuum to the area, or can be accomplished by creating a venturi effect by establishing a high velocity gas jet of positive pressure in the proximal direction to entrain gas out of the targeted lung area. The vacuum created by these later embodiments is typically very low level to avoid bronchial collapse, which may be determined by measuring gas flow and adjusting the vacuum level accordingly. Again, this form may be continuous, intermittent or variable and can be synchronized with the breathing cycle. It is understood that either form of gas evacuation will include the appropriate modifications to the gas control unit previously described.
In forth general embodiment of the present invention, a ventilation gas is delivered via the catheter into the targeted area for a desired period after which a vacuum is applied via the catheter to the bronchii feeding the targeted area also for a desired period. The vacuum amplitude is selected to collapse the bronchii thus trapping the ventilation gas in the area. Mixed gases are forced out during the ventilation gas delivery phase and also a portion of mixed gases are sucked out of the conducting airways immediately before their collapse at the beginning of the vacuum phase. The sequence is repeated successively until a predominant concentration of ventilation gas and minority of native gas occupies the area.
In a fifth general embodiment of the present invention, in order to improve ventilation in the lung as a whole, a segment which is not contributing much to gas exchange is blocked with an occlusive catheter to shunt inspired gas to other areas of the lung that are less diseased. Known as Trans-Tracheobronchial Segmental Shunting (TTSS), this embodiment can be useful considering that the more diseased less elastic areas preferentially fill with inspired air which does not reach the alveoli because of the large amount of stagnant trapped gas. TTSS can be performed continuously, semi-continuously, dynamically, or intermittently, or synchronized with the patients breathing cycle. TTSS can also be performed concurrently with some level of active gas removal using vacuum, and therapeutic gas or agent delivery into the blocked targeted area through the TTSS catheter. TTSS can also be performed with intermittent removal of the shunt but without removal of the catheter.
It should be noted that in some applications and embodiments of this invention, the TTSV or TTSS procedure is performed as a temporary palliative procedure with dramatic clinical benefit during the actual therapy but with a dissipating benefit after the therapy is discontinued. In other applications and embodiments, TTSV or TTSS is performed during mechanical ventilation to more effectively ventilate a patient, for example acutely to wean a patient from ventilatory support, or subchronically or chronically to improve ventilation in ventilatory-dependent patients. Still in other cases, TTSV or TTSS is performed on a naturally breathing patient as a chronic therapy either continuously or intermittently in order to provide clinical benefit lasting periods of weeks or even years. In this later embodiment, the catheter may be removed after a treatment while leaving a hygienic seal at the percutaneous access point, and a new catheter later inserted for a subsequent treatment. A guidewire might be left in place to ease subsequent re-catheterization. It should also be noted that the TTSV or TTSS procedure may be performed simultaneously on different lung areas or sequentially on the same or different lung areas. It should also be noted that TTSV or TTSS can be extremely useful for gradually reducing bulla in bullous emphysema, particularly if a stream of low molecular weight gas such as HeliOx is insufflated into the targeted lung area and mixed gases are removed with aspiration. Finally it should be noted that the TTSV or TTSS procedure can be performed on a relatively few large sections of lung, for example a lobe or a few lobar segments on patients with heterogeneous or bullous emphysema, or can be performed on many relatively small sections of lung, for example twelve sub-subsegments on patients with diffuse homogeneous emphysema. The procedure and treatment can even be performed on an entire lung by catheterizing a left or right mainstem bronchus, or both lungs by catheterizing the trachea.
As previously noted no methods exist in the prior art wherein a poorly functioning lung area with trapped CO2-rich gas is more effectively ventilated by directly delivering ventilation gases to that area and/or removal of CO2-rich gas from that area, or of bronchial shunting of inspired air from a local lung area to other lung regions.
It should be noted that while preferred and optional embodiments of the present invention are described, there are other useful embodiments not specifically stated but are implied as part of the present invention which combine various features of the described embodiment.
FIGS. 1 and 1A-1D describes the anatomy of a lung and placement of the TTSV catheter.
Referring to
Typical gas delivery and gas suction parameters depend on the area being treated and the clinical conditions. During mechanical ventilation, gas delivery can range from 0.1 to 1.5 lpm and 8 to 40 cmH2O at the lobar segment level and 1.0 to 10.0 lpm and 10 to 50 cmH2O at the tracheal level. Gas evacuation can range from 0.1 to 1.5 lpm and −5 to −40 cmH2O at the lobar segment level and 1.0 to 10.0 lpm and −10 to −50 cmH2O at the tracheal level. During spontaneous ventilation, flow can range from 0.05 to 1.5 lpm and 3 to 20 cmH2O at the lobar segment level and 1.0 to 10.0 lpm and 5 to 30 cmH2O at the tracheal level. Gas evacuation can range from 0.05 to 1.5 lpm and −3 to −20 cmH2O at the lobar segment level and 1.0 to 10.0 lpm and −5 to −30 cmH2O at the tracheal level. Frequencies can range from 1 to 120 cycles per hour if being used intermittently, and 2 to 120 cycles per minute in oscillatory mode, and 1 hour to indefinite durations for continuous mode.
Typical diameters of the TTSV catheter depend on the lung area being targeted. Some exemplary dimensions follow: Lobar segment: OD=2.0-3.5 mm; Lobar subsegment: OD=1.5-2.5 mm; Lobar sub-subsegment: OD=0.5-1.0 mm. TTSV catheter gas insufflation lumen diameters are typically 0.25-1.0 mm and gas exhaust lumens, if separately present, are typically comprise an area of 0.8-4.0 mm2, preferably greater than 2.0 mm2 to avoid mucous plugging. Catheter lengths are typically 120-150 cm. Anchoring forces are typically 1-10 psi and occlusion forces, if occlusion is utilized, are typically 0.2-0.5 psi. Anchors and occlusive member diameters depend on the targeted bronchial level and are up to 25 mm for main stem bronchus cannulation, 20 mm for lobar bronchus cannulation, 12 mm for segmental bronchi and 3 mm for sub-subsegmental bronchi cannulation when fully expanded. Proximal entry point tensioning forces typically produce 0.5-1.5 lbs of axial tension. The percutaneous plug is typically a soft rubber or thermoset material such as silicone. Some examples of catheter materials are; the shaft extrusion typically comprised of a thermoplastic or thermoset material such as nylon, PVC, polyethylene, PEBAX or silicone; the non-occlusive anchor typically comprised of a stainless steel or Nitinol wire; the inflatable occlusive member comprised of a highly compliant plastisol, silicone or urethane; connectors typically comprised of PVC, polysulfone, polypropylene or acrylic.
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text:
Is inflation irrelevant in financial planning? Pt. 1
By Roccy Defrancesco
The Wealth Preservation Institute
Once the client's risk tolerance has been decided, inflation is irrelevant when discussing whether to allocate a client's money into stocks, mutual funds, bonds, fixed annuities, or other wealth-building tools to use in retirement.
Stereotyping financial planners (FPs)--what's the stereotype of an FP? An advisor with one or more securities licenses (or an RIA) who believes the best way to grow money is through the use of a "properly balanced mix of stocks, bonds, and mutual funds."
The stereotype also includes my belief that most securities licensed advisors and RIAs do not understand the proper use of fixed indexed annuities (FIAs) as protective wealth-building tools.
What is inflation? Inflation is when the prices of most goods and services continue to creep upward. It is measured by the Consumer Price Index. For example, gas in 1988 cost $1.08. Today it costs $2.80.
Continuing the stereotype -- a typical financial planner sits down with a client and asks many questions including:
- How many years until you want to retire?
- In today's dollars, how much do you need each year after tax to live on when you retire?
- How long do you think you will live?
- What do you expect as an average rate of return over the next 30 years?
- How much money do you have right now to invest for your retirement?
- What is your investment risk tolerance?
- 5 years
- I have no idea; but if I were to guess, I'd say $30,000 a year pre-tax
- I have no idea; but if I were to guess, 95
- 6 percent
- $310,000 (in a 401(k) plan)
- Conservative
Question: How is the typical FP going to help this client reach his/her retirement goal of $30,000 pre-tax every year in retirement (using only the 401(k) money)?
In order to be able to remove $30,000 pre-tax every year from the 401(k) (or IRA after the client retires in 5 years) and not run out of money before age 95, the current $310,000 401(k) account balance must grow at a gross rate of 7.5 percent every year for 30 years (netting a 6 percent ROR after applying a 1.5 percent annually for expenses). How can an FP generate a "guaranteed" return of 7.5 percent gross every year for 30 years? Can it be done with a properly balanced mix of stocks, mutual funds, bonds, and CD/money market accounts? The answer is could happen, but it can't be guaranteed.
However, remember, this client has a conservative risk tolerance. That would mean the client won't be in stocks and mutual funds. Most FPs will counsel this client to invest in bonds and CDs/money market accounts. What are the chances that a conservative bond/CD/money market portfolio will return 7.5 percent gross throughout the next 30 years? The answer is about zero.
What about inflation?
I haven't even discussed inflation yet. Inflation over the last 30 years has been approximately 3.5% a year. Extrapolating these numbers out five years for the example client, he/she would need to withdraw $35,631 from his account at age 75 to keep up with inflation. Continuing with the extrapolation, at age 85, the client would need to withdraw $50,260 to keep up with inflation and at age 90, the amount would be $59,694.
There are three classic ways my example client is going to be able to retire in the manner he/she wants (with $30,000 in today's dollars to spend when he/she turns 70):
1. Earn a higher rate of return on money invested than a conservative portfolio will allow
2. Save more before retiring
3. Spend less in retirement
Let's assume the client can't possibly save more money over his/her next five earning years before retirement. How is the FP going to grow this client's wealth so he/she can have $30,000 a year in pre-tax income in retirement starting at age 70? In other words, how can an advisor help this client deal with inflation?
The answer is the advisor can't help this client reach his retirement goals or help him "deal with inflation" given his conservative investment philosophy and the amount of money available to grow and be used for retirement.
Let me rephrase the previous statement: The FP could try to generate the returns needed on the money in the 401(k) plan; but in order to do so, the client will have to buy stocks/mutual funds that fall into a moderate or even aggressive category (remember the client is conservative). The inflation discussion
Once a client decides what his risk tolerance is for growing wealth for retirement, the only reasons to discuss inflation are: 1) to decide if more money needs to be saved, or 2) if the client should mentally prepare to spend less in retirement.
So, inflation is "relevant" when discussing financial planning to bring to light the reality of a client's situation. Inflation can be used to motivate clients to save more or reassess how much money they will actually have to live on (adjusted for inflation) in retirement.
What's my issue with how many FPs deal with inflation?
Many FPs use inflation as a reason for clients to invest in more aggressive investments.
Also, many FPs shun the use of fixed indexed annuities (FIAs) as a retirement tool because they say the caps "limit the products ability to keep up with inflation." In most instances, those with this opinion are wrong.
Let me state again, once a client has chosen his/her risk tolerance, inflation is irrelevant when choosing which types of investments to use.
If the client has a conservative investment stance, an FP will recommend bonds, money market/CDs, and fixed annuities.
Just because the numbers using a conservative investment philosophy won't keep the client's income up with inflation, does that mean the client should all of a sudden shift his/her investment stance to a moderate or aggressive one? No.