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Publications (37)214.03 Total impact
Article: Awareness of Cancer Susceptibility Genetic Testing The 2000, 2005, and 2010 National Health Interview Surveys[Show abstract] [Hide abstract] ABSTRACT: Genetic testing for several cancer susceptibility syndromes is clinically available; however, existing data suggest limited population awareness of such tests. To examine awareness regarding cancer genetic testing in the U.S. population aged ≥25 years in the 2000, 2005, and 2010 National Health Interview Surveys. The weighted percentages of respondents aware of cancer genetic tests, and percent changes from 2000-2005 and 2005-2010, overall and by demographic, family history, and healthcare factors were calculated. Interactions were used to evaluate the patterns of change in awareness between 2005 and 2010 among subgroups within each factor. To evaluate associations with awareness in 2005 and 2010, percentages were adjusted for covariates using multiple logistic regression. The analysis was performed in 2012. Awareness decreased from 44.4% to 41.5% (p<0.001) between 2000 and 2005, and increased to 47.0% (p<0.001) in 2010. Awareness increased between 2005 and 2010 in most subgroups, particularly among individuals in the South (pinteraction=0.03) or with a usual place of care (pinteraction=0.01). In 2005 and 2010, awareness was positively associated with personal or family cancer history and high perceived cancer risk, and inversely associated with racial/ethnic minorities, age 25-39 or ≥60 years, male gender, lower education and income levels, public or no health insurance, and no provider contact in 12 months. Despite improvement from 2005 to 2010, ≤50% of the U.S. adult population was aware of cancer genetic testing in 2010. Notably, disparities persist for racial/ethnic minorities and individuals with limited health care access or income.
- [Show abstract] [Hide abstract] ABSTRACT: We thank the contributing authors and the anonymous reviewers who made this special issue possible. We hope that this issue will stimulate more research at the frontline of translational cancer genomics, behavioral science, clinical care, and public health.
- [Show abstract] [Hide abstract] ABSTRACT: Knowledge of family cancer history is essential for estimating an individual's cancer risk and making clinical recommendations regarding screening and referral to a specialty cancer genetics clinic. However, it is not clear if reported family cancer history is sufficiently accurate for this purpose. In the population-based 2001 Connecticut Family Health Study, 1019 participants reported on 20 578 first-degree relatives (FDR) and second-degree relatives (SDR). Of those, 2605 relatives were sampled for confirmation of cancer reports on breast, colorectal, prostate, and lung cancer. Confirmation sources included state cancer registries, Medicare databases, the National Death Index, death certificates, and health-care facility records. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated for reports on lung, colorectal, breast, and prostate cancer and after stratification by sex, age, education, and degree of relatedness and used to estimate report accuracy. Pairwise t tests were used to evaluate differences between the two strata in each stratified analysis. All statistical tests were two-sided. Overall, sensitivity and positive predictive value were low to moderate and varied by cancer type: 60.2% and 40.0%, respectively, for lung cancer reports, 27.3% and 53.5% for colorectal cancer reports, 61.1% and 61.3% for breast cancer reports, and 32.0% and 53.4% for prostate cancer reports. Specificity and negative predictive value were more than 95% for all four cancer types. Cancer history reports on FDR were more accurate than reports on SDR, with reports on FDR having statistically significantly higher sensitivity for prostate cancer than reports on SDR (58.9% vs 21.5%, P = .002) and higher positive predictive value for lung (78.1% vs 31.7%, P < .001), colorectal (85.8% vs 43.5%, P = .004), and breast cancer (79.9% vs 53.6%, P = .02). General population reports on family history for the four major adult cancers were not highly accurate. Efforts to improve accuracy are needed in primary care and other health-care settings in which family history is collected to ensure appropriate risk assessment and clinical care recommendations.
Article: U.S. Geographic Distribution of Prevaccine Era Cervical Cancer Screening, Incidence, Stage, and Mortality[Show abstract] [Hide abstract] ABSTRACT: Cervical cancer prevention programs are being reconfigured to incorporate human papillomavirus (HPV) testing and vaccination. To define priority areas for prevention efforts, we examined the geographic distribution of cervical cancer screening, incidence, stage, and mortality in the United States, prior to the introduction of HPV-based prevention technologies. County-level cervical cancer incidence data from 37 central registries were obtained from Surveillance, Epidemiology, and End Results and North American Association of Central Cancer Registries. A spatial-temporal model that accounted for demographic and behavioral attributes was used to generate a complete view of county-level incidence from 1995 to 2004, including counties with missing data. Distribution of stage at diagnosis was examined by registry. Counties with high mortality and infrequent screening were identified using vital statistics and newly available county-level screening estimates. Compared with non-Hispanic whites and Asian and Pacific Islanders, incidence rates were higher among non-Hispanic black, American Indian and Alaska Native, and Hispanic women. Counties with infrequent screening often experienced elevated incidence and mortality rates and were located in states with suboptimal stage at diagnosis profiles. Affected areas included Appalachia, the southeastern Atlantic states, and the lower Mississippi Valley. Elevated death rates were experienced in central counties of large metropolitan areas. Geographic and racial/ethnic variability were evident in cervical cancer incidence and mortality. Women living in areas with endemic poverty would benefit from access to HPV-based prevention technologies. These findings provide a baseline for monitoring progress in cervical cancer control in the era of HPV-based prevention.
Article: US Physicians' Intentions Regarding Impact of Human Papillomavirus Vaccine on Cervical Cancer Screening[Show abstract] [Hide abstract] ABSTRACT: US cervical cancer screening recommendations have not changed since the human papillomavirus (HPV) vaccine introduction in 2006, but epidemiological and cost-effectiveness studies indicate that recommendations will need to change for fully vaccinated women. We evaluated physician intentions regarding HPV vaccine's impact on future screening. A nationally representative sample of 1212 primary care physicians was surveyed in 2006-2007 (response rate: 67.5%). Our study included 1114 physicians who provided Pap testing. Questions covered Pap test screening practices and intentions regarding HPV vaccine's impact on screening. Distribution differences were assessed using chi(2) statistics; multivariate analyses were performed. Overall, 40.7% (95% confidence interval (CI): 37.6-43.8%) of physicians agreed that the HPV vaccine will affect screening initiation, and 38.2% (35.0-41.5%) agreed that vaccination will affect screening frequency. Significant differences in responses were found by specialty; internists were more likely to agree that vaccination would impact screening than other specialties. Belief in the effectiveness of new screening technologies was associated with intention to change screening initiation (odds ratio (OR) = 1.66 (1.20-2.31)) and frequency (OR = 1.99 (1.40-2.83)). Adherence to current Pap test screening interval guidelines was associated with intention to change screening frequency (OR = 1.39 (1.01-1.91)). Many providers anticipate adjusting screening for vaccinated women, but a significant group believes nothing will change or are unsure. The present study provides important baseline data on intentions in the period preceding widespread vaccine diffusion and may help explain current and future trends in practice patterns.
Article: Cervical Cancer Screening With Both Human Papillomavirus and Papanicolaou Testing vs Papanicolaou Testing Alone: What Screening Intervals Are Physicians Recommending?[Show abstract] [Hide abstract] ABSTRACT: Guidelines recommend screening for cervical cancer among women 30 years or older 3 years after a normal Papanicolaou test (hereinafter referred to as Pap test) result or a combined normal screening result (normal Pap/negative human papillomavirus [HPV] test results). We assessed reported recommendations by US primary care physicians (PCPs) on screening intervals that incorporate HPV cotesting compared with Pap testing alone. From September 1, 2006, through May 31, 2007, we conducted a mailed survey of a representative sample of 1212 PCPs, of whom 950 performed Pap tests and recommended the HPV test for screening or management. The main outcome measure included self-reported data on timing of screening intervals for women with normal results using clinical vignettes. Among Pap test providers who recommend HPV testing, 31.8% reported that they would conduct the next Pap test in 3 years for a 35-year-old woman with 3 normal Pap test results. For a 35-year-old woman with a normal Pap test result and a negative HPV test finding, only 19.0% would conduct the next Pap test in 3 years. Most remaining physicians would conduct the Pap test more frequently. Most PCPs did not recommend a second HPV test or recommended the next HPV test at the same frequency as the Pap test. Physician specialty was strongly associated with guideline-consistent recommendations for the next Pap or HPV test. A lower proportion of PCPs recommend extending screening intervals to 3 years with an HPV cotest than those screening with the Pap test alone. Implementation of effective interventions and strategies that improve physician adherence to recommendations will be important for efficient screening practices.
Article: Prevalence of Family History of Breast, Colorectal, Prostate, and Lung Cancer in a Population-Based Study[Show abstract] [Hide abstract] ABSTRACT: A positive family history is a known risk factor for several cancers; thus, obtaining a thorough family cancer history is essential in cancer risk evaluation and prevention management. The Family Health Study, a telephone survey in Connecticut, was conducted in 2001. A total of 1,019 participants with demographic information and family cancer history were included in this study. Prevalence of a positive family history of breast, colorectal, prostate, and lung cancer for first- and second-degree relatives was estimated. Logistic regression was used to compare prevalence by demographic factors. A positive family history among first-degree relatives was reported by 10.9% (95% Confidence Interval, CI = 8.8-13.3) of respondents for breast cancer, 5.1% (95% CI = 3.9-6.7) for colorectal cancer, 7.0% (95% CI = 5.2-9.4) for prostate cancer, and 6.4% (95% CI = 4.9-8.3) for lung cancer. The reported prevalence of family history of specific cancers varied by sex, age and race/ethnicity of the respondents. Family history prevalence for 4 of the most common adult solid tumors is substantial and the reported prevalence varied by respondent characteristics. Additional studies are needed to evaluate tools to promote accurate reporting of family history of cancer.
- [Show abstract] [Hide abstract] ABSTRACT: Although family history of cancer is widely ascertained in research and clinical care, little is known about assessment methods, accuracy, or other quality measures. Given its widespread use in cancer screening and surveillance, better information is needed about the clarity and accuracy of family history information reported in the general population. This telephone survey in Connecticut examined coherence and completeness of reports from 1,019 respondents about 20,504 biological relatives. Of 2,657 cancer reports, 97.7% were judged consistent with malignancy (versus benign or indeterminate conditions); 79% were site specific, 10.1% had unspecified cancer sites, and 8.6% had "ill-defined" sites. Only 6.1% of relatives had unknown histories. Unknown histories and ambiguous sites were significantly higher for second-degree relatives. The adjusted percentage of first-degree relative reports with ambiguous sites increased with decreasing education and African-American race of survey respondents, and with deceased vital status of relatives. Ambiguous second-degree relative reports were also associated with deceased vital status and with male gender of respondents. These findings suggest that family history of cancer reports from the general population are generally complete and coherent. Strategies are needed to improve site specificity and thus maximize the utility of such information in primary care settings.
Article: Specialty Differences in Primary Care Physician Reports of Papanicolaou Test Screening Practices: A National Survey, 2006 to 2007[Show abstract] [Hide abstract] ABSTRACT: Cervical cancer screening guidelines were substantially revised in 2002 and 2003. Little information is available about primary care physicians' current Papanicolaou (Pap) test screening practices, including initiation, frequency, and stopping. To assess current Pap test screening practices in the United States. Cross-sectional survey. Nationally representative sample of physicians during 2006 to 2007. 1212 primary care physicians. The survey included questions about physician and practice characteristics and recommendations for Pap screening presented as clinical vignettes describing women by age and by sexual and screening histories. A composite measure-guideline-consistent recommendations-was created by using responses to vignettes in which major guidelines were uniform. Most physicians reported providing Pap tests to their eligible patients (91.0% [95% CI, 89.0% to 92.6%]). Among Pap test providers (n = 1114), screening practices, including number of tests ordered or performed, use of patient reminder systems, and cytology method used, varied by physician specialty (P < 0.001). Although most Pap test providers reported that screening guidelines were very influential in their clinical practice, few had guideline-consistent recommendations for starting and stopping Pap screening across multiple vignettes (22.3% [CI, 19.9% to 25.0%]). Guideline-consistent recommendations varied by specialty (obstetrics/gynecology, 16.4%; internal medicine, 27.5%; and family or general practice, 21.1%). Compared with obstetricians/gynecologists, internal medicine specialists and family or general practice specialists were more likely to have guideline-consistent screening recommendations (odds ratio, 1.98 [CI, 1.22 to 3.23] and 1.45 [CI, 0.99 to 2.13], respectively) in multivariate analysis. Physician self-report may reflect idealized rather than actual practice. Primary care physicians' recommendations for Pap test screening are not consistent with screening guidelines, reflecting overuse of screening. Implementation of effective interventions that focus on potentially modifiable physician and practice factors is needed to improve screening practice. National Cancer Institute, Centers for Disease Control and Prevention, and Agency for Healthcare Research and Quality.
Article: A Health Services Research Agenda for Cellular, Molecular and Genomic Technologies in Cancer Care[Show abstract] [Hide abstract] ABSTRACT: In recent decades, extensive resources have been invested to develop cellular, molecular and genomic technologies with clinical applications that span the continuum of cancer care. In December 2006, the National Cancer Institute sponsored the first workshop to uniquely examine the state of health services research on cancer-related cellular, molecular and genomic technologies and identify challenges and priorities for expanding the evidence base on their effectiveness in routine care. This article summarizes the workshop outcomes, which included development of a comprehensive research agenda that incorporates health and safety endpoints, utilization patterns, patient and provider preferences, quality of care and access, disparities, economics and decision modeling, trends in cancer outcomes, and health-related quality of life among target populations. Ultimately, the successful adoption of useful technologies will depend on understanding and influencing the patient, provider, health care system and societal factors that contribute to their uptake and effectiveness in 'real-world' settings.
- [Show abstract] [Hide abstract] ABSTRACT: In the US, federal and state behavioral surveillance systems routinely monitor self-reported sexual behavior and Papanicolaou (Pap) test use to identify high-risk populations, trends, and disparities and to guide and evaluate interventions for cervical cancer prevention and control. Clinical uptake of human papillomavirus (HPV) vaccination and testing necessitates the expansion of behavioral surveillance systems. Cervical disease is the main focus of HPV-related behavioral surveillance because of greater cancer incidence and mortality relative to other susceptible organs, and the availability of effective technologies for prevention and control. In the current study, a framework is presented for the types of behaviors to monitor, their conceptual and operational definitions, target populations, and evidence supporting the reliability and validity of self-report measures. An overview is also provided of 8 population-based and 2 provider-based data systems that are nationally representative and accessible for behavioral surveillance research. Ongoing surveillance at the national, state, and local level is critical for monitoring the dissemination of HPV technologies and their impact on reducing disparities in the detection of precursor lesions, incidence of invasive cancer, and mortality.
- [Show abstract] [Hide abstract] ABSTRACT: Population-based estimates of biological family size can be useful for planning genetic studies, assessing how distributions of relatives affect disease associations with family history and estimating prevalence of potential family support. Mean family size per person is estimated from a population-based telephone survey (n = 1,019). After multivariate adjustment for demographic variables, older and non-White respondents reported greater mean numbers of total, first- and second-degree relatives. Females reported more total and first-degree relatives, while less educated respondents reported more second-degree relatives. Demographic differences in family size have implications for genetic research. Therefore, periodic collection of family structure data in representative populations would be useful.
- [Show abstract] [Hide abstract] ABSTRACT: Blood transfusions may influence the recipients' cancer risks both through transmission of biologic agents and by modulation of the immune system. However, cancer occurrence in transfusion recipients remains poorly characterized. We used computerized files from Scandinavian blood banks to identify a cohort of 888,843 cancer-free recipients transfused after 1968. The recipients were followed from first registered transfusion until the date of death, emigration, cancer diagnosis, or December 31, 2002, whichever came first. Relative risks were expressed as ratios of the observed to the expected numbers of cancers, that is, standardized incidence ratios (SIRs), using incidence rates for the general Danish and Swedish populations as a reference. All statistical tests were two-sided. During 5,652,918 person-years of follow-up, 80,990 cancers occurred in the transfusion recipients, corresponding to a SIR of 1.45 (95% confidence interval [CI] = 1.44 to 1.46). The SIR for cancer overall decreased from 5.36 (95% CI = 5.29 to 5.43) during the first 6 months after transfusion to 1.10 or less for follow-up periods more than 2 years after the transfusion. However, the standardized incidence ratios for cancers of the tongue, mouth, pharynx, esophagus, liver, and respiratory and urinary tracts and for squamous cell skin carcinoma remained elevated beyond 10 years after the transfusion. The marked increase in cancer risk shortly after a blood transfusion may reflect the presence of undiagnosed occult cancers with symptoms that necessitated the blood transfusion. The continued increased risk of tobacco- and alcohol-related cancers suggests that lifestyle and other risk factors related to conditions prompting transfusion rather than transfusion-related exposures per se are important to the observed cancer occurrence in the recipients.
- [Show abstract] [Hide abstract] ABSTRACT: Transfusion safety rests heavily on the health of blood donors. Although they are perceived as being healthier than average, little is known about their long-term disease patterns and to which extent the blood banks' continuous efforts to optimize donor selection has resulted in improvements. Mortality and cancer incidence among blood donors in Sweden and Denmark was investigated. All computerized blood bank databases were compiled into one database, which was linked to national population and health data registers. With a retrospective cohort study design, 1,110,329 blood donors were followed for up to 35 years from first computer-registered blood donation to death, emigration, or December 31, 2002. Standardized mortality and incidence ratios expressed relative risk of death and cancer comparing blood donors to the general population. Blood donors had an overall mortality 30 percent lower (99% confidence interval [CI] 29%-31%) and cancer incidence 4 percent lower (99% CI 2%-5%) than the background population. Mortality rates and cancer incidence were lowest for outcomes that are recognized as being related to lifestyle factors such as smoking or to the selection criteria for blood donation. Blood donors recruited in more recent years exhibited a lower relative mortality than those who started earlier. Blood donors enjoy better than average health. Explicit and informal requirements for blood donation in Scandinavia, although mostly of a simple nature, have successfully refined the selection of a particularly healthy subpopulation.
Conference Paper: Recruitment of participants to a familial cancer study: Balancing privacy protection and research quality[Show abstract] [Hide abstract] ABSTRACT: Inclusion of relatives of individuals at risk for or diagnosed with disease is critical for many public health studies. Debate exists about how to recruit relatives in a way that both protects their privacy and allows for reasonable participation rates. To inform the debate, empirical data is needed. This research evaluates an investigator-driven recruitment strategy enabling index subjects to first discuss the study with relatives. We assessed whether index subjects' willingness to permit investigators to contact relatives was associated with their own and their relatives' demographic characteristics. In 2001, we conducted a random digit dial phone survey in Connecticut to determine the accuracy of family cancer history reported by 1,380 index subjects (response rate=70%). After obtaining a family roster of 1st and 2nd degree relatives, a random sample was invited to participate. The majority of index subjects (65.1%) contacted at least one relative to discuss the study, although non-whites were less likely to do so than whites (OR=0.52 [0.32-0.84]). Furthermore, 67.4% gave investigators permission to contact some or all sampled relatives for an interview. After adjustment for educational level, index subjects were more likely to give investigators permission to contact relatives with a history of cancer (OR=1.19 [1.08-3.37]), and those with whom they had a supportive relationship (OR=5.13 [2.66-9.92]). Overall, 90% of the 717 relatives whom the investigators were given permission to contact agreed to participate. The recruitment strategy we examined appears effective for population based research, as high proportions of index subjects were willing to give investigators contact permission.
Article: Risk of cancer after blood transfusion from donors with subclinical cancer: a retrospective cohort study[Show abstract] [Hide abstract] ABSTRACT: Although mechanisms for detection of short-term complications after blood transfusions are well developed, complications with delayed onset, notably transmission of chronic diseases such as cancer, have been difficult to assess. Our aim was to investigate the possible risk of cancer transmission from blood donors to recipients through blood transfusion. We did a register-based retrospective cohort study of cancer incidence among patients who received blood from donors deemed to have a subclinical cancer at the time of donation. These precancerous donors were diagnosed with a cancer within 5 years of the donation. Data from all computerised blood bank registers in Sweden and Denmark gathered between 1968 and 2002 were merged into a common database. Demographic and medical data, including mortality and cancer incidence, were ascertained through linkages with nationwide, and essentially complete, population and health-care registers. The risk of cancer in exposed recipients relative to that in recipients who received blood from non-cancerous donors was estimated with multivariate Poisson regression, adjusting for potential confounding factors. Of the 354 094 transfusion recipients eligible for this analysis, 12,012 (3%) were exposed to blood products from precancerous donors. There was no excess risk of cancer overall (adjusted relative risk 1.00, 95% CI 0.94-1.07) or in crude anatomical subsites among recipients of blood from precancerous donors compared with recipients of blood from non-cancerous donors. Our data provide no evidence that blood transfusions from precancerous blood donors are associated with increased risk of cancer among recipients compared with transfusions from non-cancerous donors.
- [Show abstract] [Hide abstract] ABSTRACT: Polymorphisms in glutathione-S-transferase (GST), N-acetyltransferase (NAT) 1, and CYP1A1 genes have been suggested as susceptibility factors for esophageal and gastric adenocarcinomas, but have not been consistently linked to elevated risks. In a population-based case-control study, we examined risks in relation to polymorphisms of the following genes: GSTP1; GSTM1; GSTT1; NAT1; and CYP1A1. Histologically confirmed incident cases, ages 30-79, were identified in three US locations. Population controls from the same catchment areas were frequency matched to expected age and sex distributions of esophageal and gastric cardia adenocarcinomas. DNA was extracted from buffy coat for PCR-based assays, with interpretable genotyping results obtained from 209 controls, 67 esophageal adenocarcinomas, 60 gastric cardia adenocarcinomas, and 56 noncardia gastric adenocarcinomas. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated among whites, adjusting for age, sex, and study center. In all histologic subgroups, ORs were somewhat elevated for the GSTP1 Val/Val genotype (versus Ile/Ile), although 95% CIs included 1.00. The respective ORs for esophageal, cardia, and other gastric adenocarcinomas were 1.73 (0.75-4.02), 1.46 (0.57-3.73), and 1.22 (0.48-3.09). No consistent patterns of elevated risk were associated with the null GSTM1 or GSTT1 genotypes, one or two copies of NAT110 or 11 alleles, or CYP1A1 Val/Val or Ile/Val genotypes (versus Ile/Ile). Additional research in larger samples is needed to further assess polymorphisms and their interactions with epidemiologic risk factors, particularly for esophageal adenocarcinoma, which has been increasing markedly in incidence.
Article: Carotenoid and tocopherol estimates from the NCI Diet History Questionnaire are valid compared with multiple recalls and serum biomarkers[Show abstract] [Hide abstract] ABSTRACT: To improve the measurement of usual dietary intake, the National Cancer Institute developed a cognitively based Diet History Questionnaire (DHQ), which has been validated against four 24-h dietary recalls (4 24-HR) for energy, macronutrients, and several vitamins and minerals. This analysis used data from The Eating at America's Table Study (EATS) to determine the validity of estimates for carotenoids and tocopherols from the DHQ. Over the course of a year, 163 participants provided 1 or 2 blood samples and completed the DHQ and 4 24-HR. For both the DHQ and the 4 24-HR, crude correlations between serum and diet were modest to strong for the provitamin A carotenoids (alpha-carotene, beta-carotene, beta-cryptoxanthin), low to modest for lycopene, and very low for lutein. The individual dietary tocopherols were weakly correlated with the serum tocopherols, but vitamin E from food and dietary supplements was strongly and positively correlated with serum alpha-tocopherol and strongly and inversely correlated with serum gamma-tocopherol for both instruments. Adjustment for energy, BMI, smoking status, serum total cholesterol, and serum triacylglycerol did not appreciably change the correlations. Using the method of triads, validity coefficients for the DHQ were comparable to the 4 24-HR and were especially strong for alpha-carotene, beta-cryptoxanthin, lutein + zeaxanthin, and total vitamin E in men and gamma-tocopherol and total vitamin E in women. In this study, there was no advantage of 2 blood samples over 1, suggesting reasonably stable ranking of individuals for these biomarkers, which is important for large epidemiologic studies that typically obtain only 1 blood sample for biomarker status.
Article: A population-based binational register for monitoring long-term outcome and possible disease concordance among blood donors and recipients[Show abstract] [Hide abstract] ABSTRACT: Even with appropriate donor deferrals and advanced screening tests, the risk of disease transmission through blood transfusion cannot be completely disregarded. Efficient monitoring of possible disease transmission between blood donors and recipients should be an important component of a comprehensive haemovigilance system. We assembled the Scandinavian Donations and Transfusions (SCANDAT) database, with data on virtually all blood donors and recipients who have been registered at least once in any of the computerized local blood bank databases in Sweden and Denmark since the start of computerized registration in 1966. The records of these individuals, with their entire computerized donation and/or transfusion histories and all donor-component-recipient connections, were linked to nationwide population and health registers to attain essentially complete follow-up for up to 36 years regarding reproduction, hospital morbidity, cancer, and death. After data cleaning, the database contained 1,134,290 blood donors who contributed 15,091,280 records of donations and 1,311,079 recipients who received 11,693,844 transfusions. The data quality in the existing data sources was satisfactory. From the data obtained from local blood banks, 4.6%, 1.6%, and 6.4% of the person, donation, and transfusion records, respectively, had to be discarded after review of the legitimacy of recorded values, and comparisons with independent, external databases. It is possible to use existing computerized data, collected in routine health care, in haemovigilance systems for monitoring long-term outcome and disease concordance in blood donors and transfusion recipients.
Article: The Impact of Acculturation on Awareness of Genetic Testing for Increased Cancer Risk among Hispanics in the Year 2000 National Health Interview Survey[Show abstract] [Hide abstract] ABSTRACT: Previous studies suggest disparities in use of preventive cancer services among U.S. Hispanics are partly explained by knowledge and access factors. One area of emerging interest is uptake of genetic counseling and testing services by underserved populations. This study aims to estimate the percentage of Hispanics in five ethnic subgroups who are aware of genetic testing for inherited cancer risk, and to assess the influence of acculturation factors primarily related to language on test awareness. Weighted data from 4,313 Hispanic respondents (age >25 years) in the year 2000 National Health Interview Survey were analyzed. Overall, 20.6% of Hispanics had heard of genetic testing for cancer risk, with percentages highest among Puerto Ricans (27.3%) and lowest among Mexicans (14.3%). Completing the interview in Spanish and English [odds ratio (OR), 0.52; 95% confidence interval (95% CI), 0.35-0.78], or only Spanish (OR, 0.60; 95% CI, 0.42-0.86), was inversely associated with test awareness (reference group, only English). Having an intermediate (OR, 0.66; 95% CI, 0.48-0.90) or low (OR, 0.63; 95% CI, 0.39-1.01) level of English language preference was also inversely associated (reference, high level) whereas being born outside the United States was weakly associated (OR, 0.80; 95% CI, 0.57-1.11). Estimates were adjusted for age, education, ethnicity, parents' cancer history, health care access, and selected health behaviors and beliefs. Results of this national survey indicate that acculturation factors related to language may affect cancer genetic test awareness in Hispanics. These factors must be taken into account when informing individuals about the role of genetics in cancer risk and providing cancer genetic health services.
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Gold as Light, Light as Gold: The Tooling of Metal Leaf from Simone Martini to Pisanello, from Mimesis to the Anagogical at Metropolitan Museum of Art
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- Sierra LeoneFoodFunding via Association for Rural Development (ARD)
Alope 11 GroupSierra LeoneFoodFunding via Association for Rural Development (ARD)
Sadimdin GroupSierra LeoneFoodFunding via Association for Rural Development (ARD)
Makarimal Akhlakh Gpe 18 Group
Dieynaba has over 30 years of experience in her sector. She is requesting a loan in order to increase her working capital. This loan will be used to purchase fish that she will then resell. Dieynaba is married, and the income she earns will enable her to pay for the education of her children and to pay for various household bills. Dieynaba begins working at 5:00 in the morning and finishes at 2:00 in the afternoon. She wants to increase her earnings in order to better manage the household expenses. Dieynaba would like to someday purchase a canoe in order to travel for her business.
Additional Information
About UIMCECThis loan is administered by UIMCEC, a Kiva Field Partner in Senegal since 2008. UIMCEC is a government-regulated microfinance institution whose mission is to improve the revenue and well-being of families through access to financial services, allowing principally women and young adult micro-entrepreneurs living in rural and semi-rural areas to develop their revenue-generating businesses and supporting them in becoming financially self-sufficient.
This is a Group Loan
In a group loan, each member of the group receives an individual loan but is part of a larger group of individuals. The group is there to provide support to the members and to provide a system of peer pressure, but groups may or may not be formally bound by a group guarantee. In cases where there is a group guarantee, members of the group are responsible for paying back the loans of their fellow group members in the case of delinquency or default.
Kiva's Field Partners typically feature one borrower from a group. The loan description, sector, and other attributes for a group loan profile are determined by the featured borrower's loan. The other members of the group are not required to use their loans for the same purpose.
About Senegal
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Success!! The loan was 100% repaid
- Repayment Term
- 15 months (Additional Information)
- Repayment Schedule
- Monthly
- Pre-Disbursed:
- Jan 28, 2013
- Listed
- Jan 29, 2013
- Currency Exchange Loss:
- Possible
- Ended:
- Mar 17, 2014


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Kitsuné Tee
"Monuments" Tee Shirt
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The world's three greatest cities are memorialized on this grey mélange tee shirt. Silk screen-printed with monuments of Tokyo, New York and Paris, the tee pairs nicely with cutoffs now, layers under a V-neck cardigan when the weather cools.
Style # 502814287
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You will not need a Dalmatian coat to look good in this Cruella de Vil costume! The Women's Sassy Disney Cruella De Vil Costume comes complete with a black dress made of a polyester blend with Velcro closure for the dress in the back, and a Dalmatian patterned nylon panel on the bottom of the dress which adds a nice detail to this officially licensed costume. The polyester shrug is white with a Dalmatian print collar and the shoulders and sleeve cuffs are lined with faux fur. Also included is a pair of red gloves and a wig of synthetic black and white hair attached to a mesh netting for a comfortable fit. Cruella De Vil remains one of Disney's most popular villains and was played by Oscar winner Glen Close in the live action film! Get this great look for a surprising and fun Halloween costume!
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Beaumont/Port Arthur
In a last-ditch attempt to thwart a Texas Education Agency takeover, the Beaumont Independent School District filed for a restraining order barring the state agency from intervening at the school district after state investigators identified multiple egregious "failures" on the part of the BISD Superintendent Timothy
Police in Orange are investigating yet another incident at the Best Price Motel at 2610 Interstate 10 West. This time, a guest at the motel was arrested for lighting a pile of clothes on fire in one of the rooms.
Police arrested an Orange woman for aggravated robbery and evading detention after she allegedly dragged a woman trying to keep hold of her bag during a purse-snatching near 10th Street and Polk Avenue at about Noon on May 9.
An elderly Nederland resident was beaten and robbed on May 9 at his home in the 700 block of South 4th Street, police report.
Drivers heading to work in Port Arthur should expect road delays Monday morning, May 12 as the Port Arthur Police and Texas Department of Transportation will closing off several southbound lanes on Highway 69 to reconstruct an accident that occurred on May 2.
Several southbound lanes of Highway 69 will be closed starting at 9 a.m. and will be remain so for 2 to 3 hours. There will only be one lane open on Highway 69 South, so motorists heading into Port Arthur should expect delays.
While we harbor no disrespect for the Wall Street Journal who called us "that scrappy little paper from Southeast Texas," we prefer to think of ourselves as simple seekers of the truth. We're of the opinion that headlines and sound bites never tell the whole story. Our readers demand all the facts, facets and flavors of every story or event. And, they expect to be informed, educated and stirred to action.
For this week's New York Times crossword puzzle, pick up a copy of this week's The Examiner on newsstands now.


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Home > Lifestyle > Women > Beauty
Wednesday, 23 July 2014
by patsy kam
Looking your best: The maximiser will lift your best assets, giving you a svelte figure.
With the many buka puasa bazaars around this month, the last thing we need to hear is the word "diet". Especially with the Raya celebrations next week and that scrumptious rendang calling out for us, it's going to be really hard to resist all the festive food and stay in shape. Well, here's how we can cheat: shapewear!
Triumph's latest Cool Sensation Summer 2014 collection is a modern ensemble of lingerie specifically designed to "beat the heat", keeping women feeling cooler, fresher and dryer all day. It's designed to keep our "wrong bulges" in all the right places, too.
Made with an innovative cool and airy fabric for increased ventilation and extra "breathability", the collection features the advanced Cool Sensation fabric, said to reduce body temperature by 1.27°C, and guaranteed to keep you fresher and dryer.
The Shape Sensation pieces are crafted specifically to refresh your curves – and your confidence. The designs bring glam back into the world of shapewear as they tone, firm and smoothen your body while you're wearing the lingerie.
The high-performance Shape Sensation series is made from advanced shaping fabrics for instant curve control, which is supposed to help you achieve a flawless, svelte appearance. The fabric also offers the dual benefit of providing antibacterial qualities and prolonged comfort.
Triumph also has specially moulded bra cups featuring layers of aerated fabric that's designed to let the body breathe, facilitate better air flow and promote comfort. The unique tailored-cup design provides extra support and added lift for a rounder, more youthful bust shape.
The label's best-selling favourites are included in the new season's collection, such as the popular Butterfly Bra which comes with soft, patented memory cushion pads that mould perfectly to individual body contours to provide a perfect, super-smooth fit and maximum support. Its unique 45° symmetry and specially angled side panels ensure added stability and extra support for a slimmer, smoother silhouette, to ensure you can walk out in cool confidence for every occasion.
There's a whole host of stunning bra and brief sets to choose from, be it the hot favourite T-shirt bra with smooth tone-on-tone striped satin-finish prints that come in in aqua, rose pink, deep blue and soft neutrals, or the luscious lace-trimmed pieces with adjustable tie-up cleavage centres.
Maximiser Cleavage-On-Demand now comes with a panel that gives you a sense of security while still allowing you to "customise" your cleavage! By the way, while the external shapewear may do wonders to help you keep it all in, we recommend that you still keep exercise in your vocabulary to help the extra calories accumulated after all that feasting move along!
The new collection is available at all major department stores and Triumph boutiques. Prices start from RM199.90 for a bra and RM 49.90 for briefs.
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Ladies, embrace your beautiful self
Beautifully accessorised
For a hopping great time where else but Kangaroo Island!
Ronaldo strikes shoot-out winner as Real crowned kings of Europe
Johor Ruler visits his secondary school principal for Teacher's Day
Lines at checkpoints in KLIA now moving smoothly
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: [Idea]
Pokemon Apricot
View Single Post
March 16th, 2013 (10:20 AM).
Radical Raptr
Join Date: Mar 2011
Location: everywhere
Age: 21
Gender: Male
Nature: Sassy
Posts: 1,121
Personally I like the idea of female only gameplay haha, Games seem to be male dominated, more so with Pokémon. You never see a female only game that has attractions to both genders, but you do see the opposite, so thats a nice little unique thing you have going on.
As for your game, eevee is nice, but why would the Professor have it? Personally you may want to tie Cedar in with Rowan, as in, close friends, or assassitant or something, since Rowan is an evolution specialist, and would explain why Cedar would have an eevee
another thing, Ben looks like a girl haha, unless ben is a girl, then I apologize
Anyway, This game sounds really cool! And I cant wait to see what you do with it
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Talents View in Talent Calculator
- Desperate Prayer
- Body and Soul
- Surge of Light
- Void Tendrils
- Divine Insight
- Halo
- Words of Mending
Desperate Prayer
2 min cooldown Instant
Heals the caster for 34,808.
Body and Soul
Your Power Word: Shield and Leap of Faith also increase your target's movement speed by 60% for 4 sec.
Surge of Light
Your healing spells and Smite have a 8% chance to make your next Flash Heal instant and cost no mana. Can accumulate up to 2 charges.
Void Tendrils
1% of base mana
30 sec cooldown Instant
Summons shadowy tendrils, rooting up to 5 enemy targets within 8 yards for 20 sec or until the tendril is killed.
Divine Insight
Your Heal and Prayer of Healing have a 40% chance to make your next Prayer of Mending not trigger its cooldown and jump to each target instantly.
30 yd range 3.59% of base mana
40 sec cooldown 1.5 sec cast
Creates a ring of Holy energy around you that quickly expands and grows in power, up to 30 yds away. Heals allies for up to 9,903, with the greatest effect at 25 yds.
Words of Mending
Your healing and shielding spell casts grant you a stack of Word of Mending. When you gain 10 stacks of Word of Mending, your next targeted healing or shielding spell also casts a Prayer of Mending at them.
Major Glyphs
Glyph of Purify
Discipline, HolyPassiveYour Purify spell also heals your target for 5% of maximum health when you successfully dispel a magical effect or disease.
Glyph of Circle of Healing
HolyPassiveYour Circle of Healing spell heals 1 additional target, but its mana cost is increased by 35%.
Glyph of Deep Wells
HolyPassiveIncreases the total amount of charges of your Lightwell by 2.
Minor Glyphs
Glyph of the HeavensPassiveYour Levitate targets will appear to be riding on a cloud for the duration of the spell.
- Desperate Prayer
- Phantasm
- Insanity
- Void Tendrils
- Power Infusion
- Halo
- Clarity of Power
Desperate Prayer
2 min cooldown Instant
Heals the caster for 34,808.
Activating Fade removes all movement impairing effects and prevents your movement speed from being reduced for 5 sec.
Consuming Shadow Orbs transforms your Mind Flay into Insanity, and your Mind Sear into Searing Insanity, for 1.91 sec per Shadow Orb consumed. These spells deals 100% additional damage.
Void Tendrils
1% of base mana
30 sec cooldown Instant
Summons shadowy tendrils, rooting up to 5 enemy targets within 8 yards for 20 sec or until the tendril is killed.
Power Infusion
2 min cooldown Instant
Infuses the Priest with power for 20 sec, increasing haste by 25% and reducing the mana cost of all spells by 20%.
30 yd range 1% of base mana
40 sec cooldown Instant
Creates a ring of Shadow energy around you that quickly expands and grows in power, up to 30 yds away. Deals up to 11,245 Shadow damage to enemies, with the greatest effect at 25 yds.
Clarity of Power
Your Mind Spike, Mind Sear, and Shadow Word: Death deal 40% additional damage to targets not affected by your Shadow Word: Pain or Vampiric Touch. Also reduces the cooldown on Mind Blast by 3 sec and makes it instant cast.
Major Glyphs
Glyph of Reflective ShieldPassiveCauses 70% of the damage you absorb with your own Power Word: Shield to reflect back at the attacker. This damage causes no threat.
Minor Glyphs
Glyph of Dark Archangel
ShadowPassiveWhen you apply Devouring Plague to a target, you take on the form of a Dark Archangel for 8 sec.
- Health226380
- Mana160000
- Intellect 3236
- Spell Power 4287
- Multistrike 3.02%
- Spirit 1124
- Crit 10.50%
- Haste 8.66%
- Mastery 14.25%
- Versatility 4.61%
- Intellect 3236
- Spell Power 4287
- Haste 8.66%
- Crit 10.50%
- Mastery 14.25%
- Multistrike 3.02%
- Versatility 4.61%
- Strength 843
- Agility 1067
- Intellect 3236
- Stamina 3773
- Damage 399–601
- Attack Power 0
- Speed 2.67
- Spell Power 4287
- Mana Regen 7833
- Armour 609
- Dodge 3.00%
- Parry 0.00%
- Block 0.00%
- Crit 10.50%
- Haste 8.66%
- Mastery 14.25%
- Spirit 1124
- Bonus Armor 0
- Multistrike 3.02%
- Leech 0.00%
- Versatility 4.61%
- Avoidance 4.20%
Recent Activity
- Earned the achievement Where's the Mailbox? for 5 points.
- 13/07/2015
- Earned the achievement Set Sail! for 5 points.
- 12/07/2015
- Earned the achievement Gate of the Setting Sun for 10 points.
- 12/07/2015
- Earned the achievement Siege of Niuzao Temple for 10 points.
- 12/07/2015
Player vs. Player
- 493 Honourable kills
Challenge Mode
Raid Progression
Last updated on 23/01/2016


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Lombank Building
11,138pages on
this wiki
this wiki
|For the Lombank offices in Downtown Los Santos, see Lombank Tower.
The Lombank Building is a high-rise office building in Grand Theft Auto V. It is located at the intersection of Boulevard Del Perro and Bay City Avenue in Del Perro, Los Santos. The tower is based on the California Bank & Trust Building, also known as 100 Wilshire, a 21-story, 300 ft (91 m) building in Santa Monica, California.
It is one of the main offices of Lombank in Los Santos, a bank with branches in Liberty City and owned by the Bank of Liberty.
- In GTA San Andreas, a replica of the same building can be found in Rodeo, Los Santos, near the Rodeo Hotel.
- Although the interior is inaccessible, pedestrians can be found inside the building.
- A health pack is located at the bottom of the building, next to Bluff Tower Office Complex.


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Ice cream mech by BrotherOstaviaWatch
©2013-2016 BrotherOstavia
Warm up done today. Missing doing one of this sketchy guys.
Photoshop CS6 and Wacom Intuos4.
Photoshop CS6 and Wacom Intuos4.
"Objective obtained...returning to base"
MY ICECREAM >:c
This is a good piece overall but I'm faving it MAINLY because of that hilarious juxtaposition! XD
D'awww~ it's adorable
Ice cream!!!!!!!
ICE CREAM!!!! Everyone loves ice cream, ideal way to cool off in the heat of battle. Ha ha, nice one, Brostavia...
i was like oh cool, then i noticed he had a icecream cone xD THEN I WAS LIKE ZOMG!!!!!
Everything is better with ice cream!
>:3 truth! especially when it involves.... COOKIE!!! *showers you with cookies* 8D HAVE THESE!!!
AWWWW so cute!
I'm really fond of that head design for some reason. I don't know why it just looks good
Looooool! The ice cream does it for me.
haha love the silhouette!
That's how I feel when I get ice cream!
awesome job!
Ideal way to cool off after a hot fight
Look cool and love the ice cream
Me: That droid looks costly?
Salemans: It can even make icecream while killing your enemies, Sir.
Me: Shut up and take my monies...
Love your work, great design and good bit of silliness to keep the mood light.
Green paint, must be a Halo!
Pure AWESOME.
"No cherry on top for you!" *BLAM*
Such a sweetheart.
Such a sweetheart.
Does it also play the ice cream truck jingle as it walks around the battlefield brutally murdering its enemies? I hope it does.


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Highway Patrol Troopers released the name of the person involved in an early morning accident that sent one man to the hospital.
Troopers say 20-year-old Brandon Causey ran off the right side of Sand Ridge Road and struck a tree before the car rested in a ditch.
Causey was taken to New Hanover Medical Center and treated and released.
Troopers say they're still investigating, but say preliminary evidence shows operator error could be the cause of the crash.
Troopers say road conditions do not appear to be a factor in the accident.
Dispatchers in Onslow County say at least one person was injured in a wreck near Sand Ridge Elementary School in Hubert.
The wreck happened around 2:45 a.m. Friday on Sand Ridge Rd.
Dispatchers said at least one person was injured but couldn't release further details.
We will update the story as soon as we are able to get more information.


text:
Key things you need to know aboutDr. Sagins:
Dr. Sagins' Experience
Research training, expertise and qualifications
Dr. Sagins' Specialties
- Internal Medicine
- View all 2 Specialties and 2 board certifications
More About Dr. Sagins' Background
Hospital Quality
The right hospital is as important as the right doctor
- Memorial Medical Center
- 701 North 1st Street
- Springfield, IL 62781
- Abraham Lincoln Memorial Hospital
- 200 Stahlhut Dr
- Lincoln, IL 62656
9 Facts About Hospital Quality
Patients' risk of dying during a hospital stay for heart bypass surgery could be 87.4% lower, on average, at a hospital rated 5 stars compared to a hospital rated 1 star for that procedure. Choosing the right hospital is critical to your health. View Slideshow
Patient Satisfaction
Patients' feedback on their experience with Dr. Sagins
Likelihood of recommending Dr. Sagins to family and friends is 5 out of 5 5 1 2
See More Survey Results
8 Facts About Patient Satisfaction Surveys
Patient satisfaction surveys provide a standardized way of reporting about healthcare experiences. But there can be more than meets the eye when reviewing scores. Here's what you should know
Appointments & Offices
Check insurance plans, locations and make an appointment
Accepting new patients?
- Yes
- 311 8th St
- Lincoln, IL 62656
- (217) 735-9555
- Directions
- Prepare for Your Appointment
- Springfield Clinic
- Springfield Clinic
- 800 N 1st St
- Springfield, IL 62702
- (217) 528-7541
- Directions
- Prepare for Your Appointment
7 Tips to Prepare for Your Appointment
The key to a successful appointment is communication. To get the most out of your visit, prepare ahead of time so you can lead the conversation with your doctor. These 7 tips will get you ready
Oops, you entered a bad link for Dr. Sagins!
The link you entered contains bad characters or identifiers. Please enter the link exactly as it appears in your email or text message.
Thank You
This confirms that we have received your survey about Dr. Sagins. Please note: Your insights will help other patients make informed decisions. Please note: it may take 1 business day for your survey response to appear.
Thank You
Our records show that you have already confirmed your survey for Dr. Sagins. Please note: it takes 24 hours for your survey results to show up on the doctor's profile.


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Nivea Q10 Age Defying Hand Lotion 30ml
Product Description
Do you want a hand cream that effectively cares for your skin's natural beauty and helps fight first signs of ageing?
Try NIVEA® Q10 Anti-Age Hand Cream.
This powerful Q10 Plus hand cream is enriched with skin's own coenzyme Q10 and helps prevent first signs of skin ageing.
Product Information
- Brands: Nivea
Return To Address
Beiersdorf UK Ltd.,
Country of Origin
Beiersdorf UK Ltd.,
Package Type
Aqua, Glycerin, Cetyl Alcohol, Stearyl Alcohol, Stearic Acid, Isopropyl Palmitate, Octocrylene, Glyceryl Stearate SE, Hydrogenated Coco-Glycerides, Glyceryl Glucoside, Creatine, Ubiquinone, Dimethicone, Butyl Methoxydibenzoylmethane, Phenoxyethanol, Sodium Carbomer, Methylparaben, Trisodium EDTA, 1-Methylhydantoin-2-Imide, Linalool, Citronellol, Butylphenyl Methylpropional, Benzyl Alcohol, Alpha-Isomethyl Ionone, Limonene, Parfum
- Tesco Price Match
- ** Matched to Tesco's standard retail price on 31-May-2016 at 03:56. See our Terms and Conditions for full details.
- Disclaimer
- These summary details have been prepared for information purposes only, and are designed to enhance your shopping experience on the Ocado website. While we have taken care in preparing this summary and believe it is accurate, it is not a substitute for your reading the product packaging and label prior to use. You should note that products and their ingredients are subject to change. If you do require precise ingredient information you should consult the manufacturer, whose contact details will appear on the packaging or label.
- Ocado is therefore unable to accept liability for any incorrect information. Where this description contains a link to another party's website for further information on the product, please note that Ocado has no control over and no liability for the contents of that website.
- You should also note that the picture images show only our serving suggestions of how to prepare your food - all table accessories and additional items and/or ingredients pictured with the product you are purchasing are not included.
- This data is supplied for personal use only. It may not be reproduced in any way whatsoever without Ocado Limited's prior consent, nor without due acknowledgement.


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The Food Bank manages four Farmers' Markets – times and locations listed below.
All markets are open to the public. The Farmers' Market Stand accepts cash, EBT (food stamps), AZFMNP and WIC vouchers as well as credit and debit cards.
Tuesday 8:00am - 12:00pm
Monday 3:00pm - 5:00pm
Thursday 4:00pm - 7:00pm
Please note that the summer hours (May-Sep) are now in effect for the Santa Cruz River Farmers' Market.
Learn more about our innovative Community Foods Consignment program, where small farmers and home gardeners sell their produce at the markets on consignment.
Shop Local and Support the Community Food Bank! Find fresh, sustainably grown foods while supporting local farmers and producers. The market offers Arizona fruits and vegetables, plants, flowers, eggs, honey, free-range meat, baked goods, bath and body products and more!
Enjoy entertainment and educational events including live music, cooking demonstrations, gardening workshops, and children's activities. Bring your friends, family, and neighbors- a great way to get to know your community!
Community Food Bank Farmers' Markets accept cash, credit/debit, and EBT (food stamps). Stop by the Information Table to process run your card in exchange for market tokens or vouchers. All vendors accept Arizona Farmers' Market Nutrition Program (AZFMNP) coupons and WIC Vouchers for fresh fruits and vegetables.


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May 28, 2016
One local MMA fighter is getting the opportunity of a lifetime. Sonny 'El Loco' Luque has been invited by world-known trainer, Andreas Michael, to train in Sweden. Right now, Luque is training for his next fight, set for June 14th. He'll take on Ricardo 'El Loco' Arreola in Monterrey, Mexico. After the fight, he plans to go to the All-star gym in Stockholm, Sweden to train. He said this opportunity gives him a new drive to continue with his career.
Click Here to access the online Public Inspection File
Viewers with disabilities can get assistance accessing this station's FCC Public Inspection File by contacting the station with the information listed below. Questions or concerns relating to the accessibility of the FCC's online public file system should be directed to the FCC at 888-225-5322, 888-835-5322 (TTY), or firstname.lastname@example.com.


text: Mark Cosgrove 2016-05-30T01:36:00-04:00 Mark Cosgrove http://www.huffingtonpost.co.uk/author/index.php?author=mark-cosgrove Copyright 2008, HuffingtonPost.com, Inc. HuffingtonPost Blogger Feed for Mark Cosgrove Good old fashioned elbow grease. Folk + Noir = Folk Noir, It's a Coupling So Good That if it Didn't Exist We'd Surely Have to Invent It... tag:www.huffingtonpost.com,2015:/theblog//3.6859866 2015-03-12T19:01:49-04:00 2015-05-12T05:59:01-04:00 Mark Cosgrove http://www.huffingtonpost.com/mark-cosgrove/ Throughout April award-winning independent cinema Watershed is exploring Folk Noir in cinema from the roots of this hybrid film genre that lie in Terence Malick's stunning debut Badlands and stretch to cinema's most recent screen revisit - the timeless, cautionary tale that was Jeff Nichol's Mud set amidst the American Deep South. This is Filmic, a unique collaboration between St George's Bristol, a Georgian church turned leading concert hall celebrated for the bell-like clarity of its acoustics, and Watershed. It is a different kind of film and music festival dedicated to pursuing the notion of 'the filmic', whether connected to an actual film or in a musician's head. Along the way the violent and bloody folk-tradition ballads of the American West have been transplanted to the far reaches of the Australian outback via the darkly literate imagination of musician Nick Cave in The Proposition. And if Badlands is the template for American Folk Noir then The Wicker Man's amalgamation of horror and pagan rituals with infectious folk music, sets the mould for a distinctly British take on the genre. This is the second half of Filmic - an explorative two-month long season celebrating the creative connections across film and music. Music and film were of course inextricably linked from the early days of cinema. What excites and surprises me about this creative relationship is how musicians are constantly influenced by film or have found scoring for film a source of inspiration for their own creativity. Filmic 2015 is not only a celebration of the rich relationship of film and music but also brings together an impressive range of respected UK and international musicians from Matt Johnson of The The to The Handsome Family who all hold film and cinema close to their own creative practice. So why not combine a film and a music performance to get a properly dark slice of Americana? Hip flasks of whisky and bourbon not required but, perhaps, appropriate... Full programme and ticket information can be found at: www.watershed.co.uk/filmic #FILMIC2015]]> Conversations about Cinema: The Impact of Conflict tag:www.huffingtonpost.com,2015:/theblog//3.6563530 2015-01-28T11:24:55-05:00 2015-03-30T05:59:01-04:00 Mark Cosgrove http://www.huffingtonpost.com/mark-cosgrove/ Last year we launched Conversations about Cinema in partnership with Bristol University, which took the shape of an introduction in the cinema followed by an informal discussion in the café bar. This has opened up conversations on subjects as varied as the historical roots of the slave trade (12 Years a Slave) the situation in the Middle-East (Omar) Dostoyevsky and Cinema (The Double) and demonstrated an appetite from audiences to engage in meaningful debate. This year we have widened the Conversations in partnership with other independent cinemas, online and through social media to open up engagement to audiences across the UK and to explore a specific theme: how film and filmmakers address the impact of conflict. The Impact of Conflict theme arose out of 2014's commemoration of the start of WW1. This centenary was of course cause for reflection on the scale and impact of that war and the immense global repercussions, which still ripple to this day. You just have to think about the recent screen adaptation of Vera Brittain's Testament of Youth to see our continued interest in stories emanating from WW1. The impact of war, any war, is not confined to the period between dates but goes wider and deeper; it shapes people, society, places and politics: as I write this, The Chilcott Inquiry into the 2003 Iraq War is causing political fallout and Clint Eastwood's American Sniper divides audiences in its portrait of one man's experience of that war. As a subject, conflict has always drawn filmmakers, whether driven by political or social ideals, or inspired by more humanitarian concerns. Now, however, with conflicts continuing across the globe, the political resonance of film is becoming ever more significant as a mechanism for observation and reportage, a means to document, a medium for comment and protest, a tool for learning and understanding, and for opening up discussion and debate. Through such films as the forthcoming portrait of the 60s civil rights fight in Selma, the search for reconciliation in The Look of Silence and Timbuktu's revealing drama of the recent radical jihadi insurgency in Mali, Conversations about Cinema will focus on a variety of themes including racial tension, human rights violation, extremism, migration and displacement. Again whilst writing this I read reports from America that Selma illustrates that the civil rights struggle is not over, whilst Timbuktu has been pulled from cinemas in Paris then reinstated because the powers that be realised it was not advocating terrorism but rather critiquing it - further evidence that film, whether about a historical or contemporary conflict, has the power to open up meaningful debate and discussion. It seems to me now, more than at any other time in its brief history, film, rather than being an escapist form of entertainment is opening up rich seams of issues about our world and which can engage audiences' appetite for discussion, debate and dialogue. Join in on the conversation at conversationsaboutcinema.co.uk and @convocinema Conversations About Cinema: Impact of Conflict is a BFI FAN initiative led by Watershed with QFT and Chapter Arts, supported by the BFI's Programme Development Funds from the National Lottery.]]> Too Many Films....Not Enough Time: Reflections on Rotterdam and Berlin Film Festivals tag:www.huffingtonpost.com,2014:/theblog//3.4902221 2014-03-05T05:39:50-05:00 2014-05-05T05:59:01-04:00 Mark Cosgrove http://www.huffingtonpost.com/mark-cosgrove/ http://hopeforfilm.com that already this year there are more films made than he would be able to see in his lifetime. At one point in a discussion about European funding for film I found myself thinking "Could we have a five year moratorium on filmmaking?" Remember butter mountains and wine lakes ? In a pre digital world this volume of films would be filtered in a number of ways. First they were on 35mm and both expensive to make and move around. Secondly, the lay person/audience would not have known of all the films shown at festivals as reporting was of a rather different order in the pre-digital world. Thirdly, films would be bought/sold to territories and only these films would become known to the general audience in that territory/country. There would be a small - and I mean small - amount of cinephiles who would maybe know a bit more. In a post digital world everyone knows everything and the films themselves are theoretically available right here, right now; after all they are already in a digital format. I remember telling a colleague, a researcher from HP labs in Bristol that I had seen this amazing film in Cannes - it was Alexander Sokurov's Russian Ark (you can work out the date.) His response as he poured over his computer was "where can I watch it ?" That day, as David Bowie knows - but the film industry is finding out - is here. Also the amount of bloggers, tweets and online coverage of festivals such as Berlin and Rotterdam is, to understate, extensive. But how do you know where to look and what you might find? At Rotterdam I attended two events which for me demonstrated both a possible answer to those questions but also the dilemma film culture currently finds itself in. The first was a discussion about how Festivals might position themselves to make available films which do not get picked up for distribution to wider international audiences. The proposal was to beam them into cinemas with linked Q&As with the filmmakers during the period of the festival. A great way of getting more films out wider but....... aren't there already enough films available? The second was a discussion with some experienced eminent Film Festival Directors including Rome's Marco Muller about what they see as the challenges for film festivals in this post digital era. An idea that was mentioned by Viennale's Hans Hurch struck a chord: in an ideal world he would like his festival to be 20 titles which he as director feels are the most interesting films currently in circulation. However the internal engine and irresistible logic of festivals - more films= more admissions=bigger impact=more income + stronger sponsorship possibilites - makes reducing scale counter intuitive. What Hurch was hinting at is a curated festival which articulates a curatorial attitude and provides a route for audiences through contemporary film culture. In this post digital era of everything now, where these hundreds if not thousands if not hundreds of thousands of films will be readily available on digital platforms, how can audiences navigate? And, how can we professionals who run cinemas play a part in making sense of the multitude of possibilities. Increasingly I think we need to think of ourselves as curators - not programmers, schedulers or selectors - but as people whose choices provide a critical, in both sense of the word, pathway through contemporary film culture. In that spirit then: I saw 30 films in Berlin. If i had my own mini festival these are the five essential films I would show and why. '71 Dir Yann Demange Television director Yann Demange's dynamic feature film debut. Triptyque Dir Robert Lepage/Pedro Pires Cinema as meditation, and on themes of mental health, art and memory History of Fear Dir Benjamin Naishtat A Ballardian study of fear and social breakdown from post crash Argentina and striking feature debut Kidnapping of Michel Houllebouq Dir Guillaume Nicloux Off the dial exploration and exemplary documentary of Houllebouq's philosophy. Macondo Dir Sudabeh Moertezai Another excellent debut feature which portrays experience of asylum seeker through eyes of young Muslim from Chechnya. Mark Cosgrove is Cinema Curator at the Watershed in Bristol: www.watershed.co.uk]]> African Cinema: From Margins to Mainstream? tag:www.huffingtonpost.com,2012:/theblog//3.2143631 2012-11-16T08:53:35-05:00 2013-01-16T05:12:01-05:00 Mark Cosgrove http://www.huffingtonpost.com/mark-cosgrove/ Of that total two were from Africa: The documentary Benda Bilili about the Congolese street musicians rise to international stardom and from Chad Mahamat-Saleh Haroun's Screaming Man a richly observed film about family life and the relationship between fathers and children. That represents less than 0.004% of films released in cinemas in the UK in 2011: A startling statistic given more magnitude given that Africa is a pretty big continent. There is a bigger piece of research to be done as to why this is the case, for example we know that most countries are dominated by Hollywood, economics obviously have a key role in film production. Indeed both films listed above were part or fully financed through Europe. However it is quite a figure to reflect upon. Given that cinema along with television are two of the most important and influential platforms through which we get images presented to us and understand the world it is surely significant that images of Africa are limited: limited to either conflict, crisis or natural history. The refreshing thing about Mahamat Saleh Haroun's A Screaming Man was that it told an African story from an African filmmaker: a rare phenomenon for UK audiences to see. There is however no shortage of African films and African themed film festivals. Just Google African films and see the list that comes up. Our own festival in Bristol, Afrika Eye, is one such festival. The aim of the festival's organisers is to present just some of the new work coming out of Africa and over a weekend in early November we had sell out audiences and positive responses to the range of work screened. One such success was festival opening film by Senegalese director Moussa Toure's La Pirogue which played in competition at this year's Cannes Film Festival and which to date has no UK distributor prepared to invest in it to get it wider into UK cinemas. Another aim of the festival is to build direct links with some of the African filmmaking communities and to work proactively not only to get their stories onto screens in the UK but also to explore possible co-production opportunities and develop creative exchange. This has been done primarily through attendance at some of the key African Film Festivals such as Panafrican Film and Television Festival of Ougadougou and the Durban International Film Festival. However an exciting development in this year's Afrika Eye was to use the infinite possibilities of digital technology to make that collaboration across continents more tangible. In the session African Interactive we had on screen in Watershed's cinema in Bristol three practitioners live from ihub in Nairobi discussing with Bristol filmmakers and festival curators the shared issues and challenges of developing films and getting their stories onto cinema screens. The power of this moment was to have on screen a live image and sound of very real African filmmakers and creative practitioners discussing how we get more African stories told and disseminated and made me feel that we might just be able to make inroads into increasing that shameful figure of 0.004% African films released in the UK?]]> Encounters Short Film and Animation Festival: Bristling with Creativity tag:www.huffingtonpost.com,2012:/theblog//3.1915269 2012-09-26T05:09:32-04:00 2012-11-25T05:12:01-05:00 Mark Cosgrove http://www.huffingtonpost.com/mark-cosgrove/ At the festival's heart is promoting, profiling and platforming new talent: Future Encounters drew together 10 distinctive voices from the festival programmes which offer new cinematic visions: remember you read about them here first! In this digital era talent no longer needs to gravitate to the centre - long gone are the days when pounding the streets of Soho was part of a filmmakers apprenticeship - to get a foot in the film industry door. In the new digital landscape talent can appear anywhere. The equation has changed: the centre (the industry) now has to find the talent: they are as likely to be in Paignton and Kinlochbervie as they are in London. To that end FilmWorks was launched at Encounters a networked regional talent development initiative with partners in Sheffield (Showroom) and Nottingham (Broadway) and funding from Creative England. This groundbreaking initiative in talent development with live transmition of talks and events across the partner venues whilst working with locally based film producers to train and mentor. (Julie Lockhart whose most recent film was Aardman's The Pirates! In An Adventure With Scientists is Watershed's professional partner). The aim is to develop regionally based film talent and help generate self supporting cross regional networks sharing skills and experiences: critically fostering a creative local environment where talent can grow without feeling that 'old' need to move to London. The event at Encounters featured award winning animator Peter Lord discussing where his ideas come from alongside first time feature director Katarzyna Klimkiewicz. The talk can be viewed here http://www.filmworks.org.uk Another element of FilmWorks and something which the Encounters festival encapsulates is the sharing of skills across production and exhibition. As we know thanks to digital that the old models are being challenged. The film industry was based on the silo'd factions of production, distribution and exhibition. Very little exchange of ideas and practice would happen between these sectors. Rather the main form of exchange would be financial - what deal are we getting? Now however those boundaries are becoming more porous and discussions becoming more interesting. It was inspirational then to hear from experienced industry professionals such as legendary producer Jeremy Thomas who has worked with directors ranging form Nic Roeg and Bernardo Bertolucci to David Cronenberg and Miike Takashi, award winning documentary filmmaker Kim Longinotto and cinematographer Lol Crawley who all generously shared their hard earned insights with the next generation of filmmaking talent. The above talks will be published at: http://www.watershed.co.uk/dshed/category/talks-watershed Encounters award are winners listed at: http://www.encounters-festival.org.uk ]]> Media, Magic and Mayhem: Reflections on 30 Years of Watershed tag:www.huffingtonpost.com,2012:/theblog//3.1574441 2012-06-06T12:48:34-04:00 2012-08-06T05:12:10-04:00 Mark Cosgrove http://www.huffingtonpost.com/mark-cosgrove/ Almost clairvoyant in its pursuit of digital technology as a cultural form, it is really only now, as I reflect on the past three decades in Watershed's life, that we can see the aspirations and vision of our founders truly realised: a vision in which cultural enterprise and technological innovation come powerfully together to nurture and inspire talent and build connected audiences. Today's digital era is challenging existing business models while redefining the relationship between cultural venues and their audiences. Consumers no longer accept a passive one-way broadcast and now expect proactive two-way dialogue. So for Watershed, and core to its development, we are constantly looking for new ways to engage with younger audiences, offering them talent development opportunities as well as rich cultural experiences. How are we doing this? I have been looking at the range of work we now do in this area ranging from cinekids screenings and workshops for 8-12-year-olds, developing the cultural producers of the future for 18 -25-year-olds, to setting up school partnerships for media literacy workshops across Bristol. We're also working with universities, local councils and schools to develop Citizen Journalism projects for teenagers reporting live from the Olympic sailing and Cultural Olympiad activities in Weymouth. More recently we have launched FilmWorks, a pilot regionally networked talent development scheme for over 18s with partners in Sheffield and Nottingham to identify talent in the English regions. The aim is to not only develop participants' knowledge and skills of the film industry but begin to network them regionally and nationally: building the pathways for them to see beyond the local into the global. To help us celebrate our 30th we've asked some of the UK's leading film and cultural practitioners to share with us what Watershed means to them. "The Watershed was central to my understanding of the history and possibilities of cinema," said Iain Canning, Producer, The King's Speech/Shame. "Without it I wouldn't have been inspired to produce the films that I have made, and for that I am incredibly grateful. Looking forward to another extraordinary 30 years." I wasn't aware that Iain had any connection to Bristol until he came with fellow producer Gareth Unwin for a preview of The King's Speech (at this point no one could imagine the success it would go on to achieve) In conversation I discovered he was born in Bedminster, a solid working class part of Bristol. His family came along to support their son at the screening. A year and an Oscar later he came back, again with his family, to show his new film Shame. Later, Iain said to me that it was the cultural scene in Bristol during the mid/late '90s - which included the sound and international success of Bristol bands Portishead and Massive Attack that made him realise you could be from Bedminster and aim internationally. Iain's work is testament to that with offices in Sydney and London. Beyond film, Watershed has stayed true to its pioneering mission to develop digital media within the arts, with the creation of Pervasive Media Studios, described by director Clare Reddington as "the best place in the world to work" because "we do all we can to encourage collaboration between different artists and digital creatives," a wide range of which will be showcased as part of the 30th birthday celebrations. Charlie Burton, now commissioning editor for GQ and formerly associate editor at Wired magazine adds that "Watershed - particularly the Pervasive Media Studio - has never failed to impress in its drive to identify future culture, and the innovative and exciting ways with which it explores that new territory." Talent development, working with young people and enabling collaborations across different mediums is at the very heart of what we do and believe in. We're encouraging new audiences to see more culturally diverse work, with the very real possibility that those cinekids, future producers and citizen journalists could be the next Portishead or Iain Canning... Follow the celebrations at http://www.watershed.co.uk/30]]> Julius Caesar, Angelina Jolie and Me - A Week at the Berlinale tag:www.huffingtonpost.com,2012:/theblog//3.1288995 2012-02-21T19:00:00-05:00 2012-04-22T05:12:01-04:00 Mark Cosgrove http://www.huffingtonpost.com/mark-cosgrove/ In his introduction to the catalogue, festival director Dieter Kosslick drew attention to the fact that it was one year since the Arab Spring; something that was addressed by a number of films across the programme. He also observed the urgent need to ensure freedom of expression for artists - another theme close to the festival's heart. These two strands found outstanding manifestation in two documentaries: The Reluctant Revolutionary and Ai Weiwei: Never Sorry. This year it felt like truth was much stranger and more emotionally engaging than fiction: documentaries were getting to the heart of the matter more directly than drama. Sean McAllister's The Reluctant Revolutionary follows Kais, a tourist guide in Yemen, as the revolution unfolds. His work is already perilous and drying up because of the Taliban and when a protest camp sets up in 'Change Square' in Yemen's capital Sana'a, Kais is non-committal partly feeling this is bad for tourism. Over time he begins to get involved and engaged. Film-maker McAllister is either a fool or brave or possibly both because he is obviously the only foreigner around, wondering in a volatile environment with secret police mingling amongst the crowds of protesters. What he captures is extraordinary with access conventional media flinch from. When the state troops shoot into the crowds the camera follows Kais into the makeshift hospitals. The scenes are devastating. But the mood of change and resilience is evident as it is in the charming reluctant revolutionary Kais. The art of Chinese artist Ai Weiwei is inextricable from his politics and for a Chinese artist, that can be life - or at least liberty - threatening. Ai Weiwei's work is not confrontation for the sake of it but draws attention to the state's wilful dismissal of its own people. This is most apparent in the 2008 Sichuan earthquake where the state never issued the names or numbers of fatalities, many of whom were children because of ill-built schools. Ai Weiwei and colleagues documented and published the names of nearly 5500. Later he would make an installation in the front of an art gallery with 5500 school bags. In this documentary, you get a real sense of the cat and mouse confrontation between artist and state until finally, he is arrested. Released after 81 days, he is fined $2.5m, banned from meeting people and using the internet. It is moving to see ordinary Chinese people leave money at Ai Weiwei's door - the power of the artist evident. The artist himself could not be at the screening having restricted movements imposed on him, however he managed to arrange for fortune cookies to be handed out to each audience member, which contained a unique message from Ai Weiwei to share. Mine read "You can delete the words but you cannot delete the facts" and was immediately sent into the Twittersphere. Where fiction really did matter, was somewhat surprisingly in the hands of the glamorous Hollywood star Angelina Jolie. The red carpet razzmatazz was very much in evidence when the "Brangelina" road show hit town to the extent of preventing me from getting into Angelina's own film as she had the paparazzi captivated. However she does not pull her punches in her film In the Land of Blood and Honey, which attempts to depict the horrors, inflicted on women in the 1990s Bosnian war. Whilst it dramatically slides towards melodrama at the end, the first half of the film brings us face to face with the horrific abuses of Muslim women in the conflict. Similarly, Philippines director Brillante Mendoza's Captive started off with a bang, throwing Isabelle Huppert as well as the audience into the hands of terrorists in a dramatisation of the 2001 incident when Muslim terrorist group Abu Sayyaf took a number people hostage from a Filipino island resort. The first hour is compelling, disorientating filmmaking giving a glimpse into the ordeal. However, the film flags in the second half. I later discovered that the director had intended the film to be three hours. Longer would have actually been better, allowing the film to more fully explore the relationship between captors and captives, the tedium and terror of over a year in captivity. Documentary and fiction were satisfyingly brought together in the Taviani Brothers' Caesar Must Die, a compelling testament to the transformative power of art that went on to win the top prize at this year's festival. Prisoners in an Italian jail perform Shakespeare's Julius Caesar and through the process realise and understand more about their own condition. One prisoner observes: "ever since I discovered art this cell has truly become a prison." The 80-year-old veterans Taviani Brothers effortlessly merge drama, fiction, documentary and real life. Through immersion in the drama of Shakespeare, the prisoners discover more about themselves and their world. Similarly we, Berlinale festivalgoers, immerse ourselves in films and discover more about our world and ourselves.]]> Encounters International Film Festival - Mapping the Renaissance in Filmmaking tag:www.huffingtonpost.com,2011:/theblog//3.1095083 2011-11-15T19:00:00-05:00 2012-01-15T05:12:01-05:00 Mark Cosgrove http://www.huffingtonpost.com/mark-cosgrove/ This reveals itself in the quality and ideas that emerge whilst working my way through the short films. Yes, there are some poor films - whether amateurish or lacking direction or poorly scripted. These however are easy to notice, as indeed are the exceptionally good ones. It's funny that both extremes reveal themselves immediately. It's the ones in between that are the challenge. (More of that dilemma later.) It does feel to me that despite recession, austerity, and depression taking up the slack, there is a sense of confidence and urgency within the global filmmaking community to explore ideas through short filmmaking and to communicate their visions. Subject matter ranges from the effects of an earthquake on a small village in Peru to the effects of mental fragility on a man in Iceland. In one breath you can move from a single take where the past taunts the present to a rich complex film where the past haunts the present or from a lyrical dream to harsh reality and from a harsh dream to lyrical reality. All the genres are covered: from comedy to horror, sometimes in the same film! It is at festivals like Encounters that we can begin to see the new and the next generation emerge. If you take the current critical successes in the feature world of We Need to Talk About Kevin directed by Lynne Ramsay and Wuthering Heights directed by Andrea Arnold, both those directors emerged through and were known by the short film world before they made the transition to feature films. In fact both of them won awards at Encounters for their short films. In order to profile and promote this next generation we have established a Future Encounters - our very own stars to watch. This year it includes filmmakers such as Karni and Saul who are currently developing a project with Will Self, Douglas Hart formerly of Jesus and the Mary Chain who has made an wonderful observation of the relationship between a father and son in Long Distance Information and which stars Peter Mullan. Also from the UK included is animator Jessica Ashman who has just won a Scottish BAFTA for her film Fixing Luka. Further afield, Iranian born Danish director Behrouz Bigdeli's film To all my Friend is one of the most passionate and energetic depictions of multiculturalism in modern Europe and Icelandic director Bokur Sigthorsson's exceptional thriller Come to Harm. All of these are names to remember. However, whilst we rightly celebrate these films and their makers I can never escape the twinge of guilt about the ones that got away. In my watching spree - usually mid-August - I always think about the guy who famously didn't sign The Beatles. His foolish lack of foresight sits heavy on my shoulder as I go from film to film discarding some, putting forward others, swapping it all around. In the final stages this can become a heightened state of anxiety, the bead of sweat forming as I possibly consign John, Paul, George and Ringo to the "not selected". So this year I am doing a one-off special entitled The Programmer's Fear of Missing the Masterpiece wherein I will screen two films which were in the programme up until the 11th hour. I will be discussing with the filmmakers - who have kindly agreed to take part - their experience of filmmaking and festivals. So if you want to take the pulse of the next generation of filmmakers either come to Bristol between the 16-20 November or go online to www.encounters-festival.org.uk. And if you want to experience some micro short filmmaking go to www.depict.org. ]]>


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I want to compliment Bill Hand on his column �Charging buffalo reenter Yellowstone� in the April 6 paper. Not since reading Mark Twain�s essay on �Fenimore Cooper�s Literary Offenses� in my college days, have I had such a knee-slappin, snort-laughin good times reading a �by� line. He makes social commentaries and local history so �Clemenseque� that I feel, at times, I�m reading new copy�from the ol� Hannibal stern-wheeler capt�n himself ... always sharp, witty, and nippin� at someones heals ... That kind of prose, in and of itself, can be penned by most news staff on occasion, but Bill spins his yarns consistently from that same quality Craven county whole-cloth, week after week ... at home or on vacation. I enjoy reading something fresh, interesting, local and without the cayenne-bite of politics ... Bill�s column has a humorous, crafty hand (no pun intended) on New Bern�s memorable in-laws and out-laws ... present day �gotta mentions� and hopefully future comments on whether Yellowstone buffalo, shot from newly erupting volcanoes, fly as well and far as cannon artillery.
Bob Hadley, New Bern
Location, ST | website.com


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To begin, I'm sorry this is so long. Does anyone else have experience with ear infections and no fever? Both times by son has had an ear infection, he has not been running fever. We just noticed there was less sleep and constant crying. He has been really congested(stuffy nose and hard cough) for a couple of weeks. We took him in when it first started and he didn't have RSV or an ear infection at the time. The cough and nose has not gotten better and now, in the last 3 days, he has really been fussing and refusing to sleep but about 30 minutes at a time. He sleeps mostly through the night but during the day, he doesn't want to take a nap. I hate to run to the doctor every time he gets a runny nose but shouldn't it be clearing up? UGH! I have a cool mist humidifier going and I do the nasal drops and saline solution. It's just so hard to tell if he is just being fussy or if it is an ear infection. I'm a FTM so I feel really stupid asking if there are ways of telling if he has a ear infection without running to the doctor every time he gets really fussy? We've checke for teething but his gums don't show signs of it. He's very happy at the sitters and today she said he was really fussy and didn't want to lay down. That's what gets me thinking he might have an infection. Any positive advice would be helpful.
No fever
Comments (3)
you can wait it out to see if he gets a fever---use the Motrin and Tylenol.
Sorry I didn't post back sooner to you, but at least for the future, our DD very rarely had a fever with ear infections. It wasn't until these last few infections that a fever was even a symptom. The second DD would get congested I had learned to take her to the pediatrician to find she had double ear infections. So a fever is not necessarily a sign of ear infection.
Amanda - Adoring wife to Steve and proud mommy to lovable Marra
Sometimes my DS gets a fever, sometimes not. It always follows congestion though. This present infection started with a very runny, congested nose on April 22 (when he just got off antibiotics), that turned into a doc visit on May 2 with a chest infection and nebulizer treatments and back to the doc on May 7th for 9 month check up and left ear infected and right ear full with fluid. No fever or anything the entire time. He was extremely fussy a few nights and once I saw the congestion I knew an ear infection was coming. I think he was off antibiotics for 3 weeks before another infection. And he was seen by a doc on Sunday - ears clear, Friday infection.


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What does EMCA stand for?
EMCA stands for Emeralda Marsh Conservation Area (Florida)
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On July 26, 1757, Benjamin Franklin made his second entry into London. Almost a quarter of a century earlier he had arrived as the disappointed protégé of a whimsical lieutenant governor; now he was the official agent of a legislature determined to bend the proprietor to its will. Then a nobody, he had been grateful for the advice of a Quaker merchant; now he was a chieftain of the Quaker party and, as deputy postmaster general, a royal official as well. In 1724, alone and poor, he had tried without success to meet Sir Isaac Newton. In 1757, a member of the Royal Society, he contemplated meeting the many friends he had gained through his lively correspondence. Behind him lay the factional disputes of provincial politics, so inimical to his conciliatory nature. That would be the domain of his legislative lieutenant, Joseph Galloway, a handsome, socially prominent lawyer, just the age of William Franklin. Galloway was elected to the Assembly in 1756 through a bit of Franklinian subterfuge, and he had proven to be a trusty aide whose legalistic, provincial outlook could be expected to keep him at his assigned task.
While Galloway wrestled with public affairs and the reformist Quakers confronted their consciences and their colleagues, Franklin confidently strode into the London arena, center of an empire at war. "Mr. Franklin's popularity is nothing here," Thomas Penn wrote in response to Richard Peters' warnings. "He will be looked very coldly upon by great People." The


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Tips to Alleviate Dry Eyes
Studies show that dry eyes are one of the most common eye problems throughout the United States. Dry eyes are caused by a lack of quality tear production, and are most common in both men and women ...View Article
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