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Midview West Elementary and Brookside High School were among the 122 Schools of Promise announced Tuesday by the Ohio Department of Education.
The designation recognizes student and staff achievement but carries no cash award or extra funding, according to department spokesman Patrick Gallaway.
William Emery, president of the board of the Sheffield-Sheffield Lake Schools, said everyone was tickled about the honor.
"We're very proud of the staff at the high school and the work they've done," Emery said.
Schools of Promise are closing achievement gaps for economically disadvantaged and minority students and outperformed schools statewide in the state accountability system. Results are based on data from the 2010-11 Local Report Cards issued by the state.
The 122 schools have excelled through rigorous coursework and a strong system of learning supports to help students succeed in urban and rural schools, according to a news release.
Besides Midview West and Brookside, Butternut Elementary in North Olmsted also was recognized by Superintendent of Public Instruction Stan W. Heffner.
"This is the 10th year for the Schools of Promise program and we continue to see students who meet high expectations despite the challenges they may face," Heffner said. "Although students in these schools come from a variety of ethnic and socioeconomic backgrounds, they prove that with the right learning supports, they can achieve at high levels. We celebrate their efforts, as well as their continued commitment to education."
Contact Cindy Leise at 329-7245 or firstname.lastname@example.com.


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AnnouncementsStudent Hunger Drive Chili Supper
The Thurgood Marshall Learning Center students and staff are hosting a Chili Supper on Wednesday, Oct 29 to collect donations for the Student Hunger Drive. The Chili Supper is from 4:30 p.m. – 6:30 p.m. in the school cafeteria. All food an monetary donations are welcome! Read More →
Marshall Chili Supper
On October 30, 2013 The Marshall Learning Center will be hosting its annual Chili Supper at 5pm-6:30pm in Room 12. All are welcome to attend. Read More →
Senior Parent Information Night
On October 30, 2013 the ISAC (Illinois Student Aid Commission) will be hosting a Senior parent information session, here at Marshall. The meeting will take place at 5pm-5:45pm in Room 18 . All parents of Seniors are welcome to attend. Read More →
Read More Posts From Announcements
NewsThurgood Reading Program Focused on Student Success (ARGUS)
Resources for Health Concerns
Two viruses have been in the local news lately: Enterovirus and Ebola. The Rock Island-Milan School District has posted resources on the school district web page with links to information from the Center for Disease Control and the Rock Island County Health Department for parents to review and become familiar with each disease. Read More →
Respect Survey
Parents: Please take our online Respect Survey! It's important for the Rock Island-Milan School District to know how our parents view respect in our school district and the building that their child attends school. Read More →
Read More Posts From News

subset: commoncrawl


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Head coach Dianne Nolan has Lafayette moving in the right direction into Sunday's Patriot League opener at two-time defending champion Navy.
Jan. 10, 2013
CENTER VALLEY, Pa. - Lafayette kept the Patriot League's positive momentum going entering conference play this weekend with a 49-47 win at Columbia Wednesday evening.
Sophomore forward Emily Homan tied the game high with 16 points and added 13 rebounds for the double-double in 28 minutes off the bench to pace the Leopards. Normally a starter, Homan was forced to start the game on the bench after being hit with a ball and momentarily injured during warmups.
Linnel Macklin added 10 points, Brya Freeland chipped in six assists and Danielle Fiacco blocked five shots in the win.
The Leopards (7-8) hung close in the first half, trailing by six points on two separate occasions before trailing 29-27 at the intermission.
Lafayette scored the first six points of the second half with Fiacco, Freeland and Macklin tallying buckets. A Homan layup put Lafayette up 39-32 with 15:13 to play.
The Lions rallied back and took a 46-43 lead with under eight minutes to play, forcing Leopard coach Dianne Nolan to call timeout.
Homan's layup allowed Lafayette to regain the lead 47-46 with 3:19 to play, and Fiacco's jumper in the paint gave the Leopards a 49-47 advantage with less than two minutes left.
Columbia had four cracks at the basket in the final 1:53 but came up empty on each try, including a missed 3 at the buzzer.
Games resume Saturday with the start of Patriot League play. Holy Cross hosts Lehigh and Bucknell goes to Army, both at 1 p.m., while Colgate visits American at 2 p.m. Lafayette goes to Navy Sunday at noon.
Saturday's three contests will be available live and free on Patriot League All-Access, while Sunday's tilt in Annapolis, Md., will air live on CBS Sports Network. Bob Socci will have the call, with Chris Spatola providing the analysis.
Lafayette 49, at Columbia 47


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By child windows, I'm referring to the options(/preferences) dialog, download prompt, XMarks sync. Anything that isn't a browser window, really.
A fresh install of firefox seems to align child windows in the centre of the window. After moving one of these windows, future windows will appear in the same location. Worse yet, if such a window appears whilst the browser is minimised, it starts appearing in the top-left of the screen.
I've also had an issue where the windows have appeared off-screen, whereby I had to use Alt + Space to move the window back to the screen.
How do I tell Firefox to place these windows according to its own rules again?
I plan to make a new profile once 4.0 is stable, but I haven't been able to find an answer otherwise. It's far too time-consuming to setup a new profile just to fix a window-location issue.


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UA Baseball Game Notes (Kentucky Series)
2010 Player Game-By-Game Stats
April 8, 2010
ALABAMA CRIMSON TIDE (20-9, 4-4 SEC) at KENTUCKY WILDCATS (19-11, 2-7 SEC)April 9-11, 2010 * Cliff Hagan Stadium * Lexington, Ky.
Radio: Crimson Tide Sports NetworkPlay-by-Play: Chris StewartStation: Crimson Tide Sports Network WFFN-FM (95.3)
Alabama Starting PitchersGame 1 32 Adam Morgan (LHP, 7 GS, 4-0, 3.60 ERA) Game 2 40 Jimmy Nelson (RHP, 7 GS, 4-0, 2.52 ERA)Game 3 TBA
Kentucky Starting PitchersGame 1 15 Logan Darnell (LHP, 7 GS, 3-2, 4.50 ERA)Game 2 34 Taylor Rogers (LHP, 7 GS, 3-3, 5.31 ERA) Game 3 17 Alex Meyer (RHP, 7 GS, 4-2, 7.64 ERA)
TODAY'S GAME: Alabama hits the road for the second time in three weeks when the Crimson Tide travels to Lexington, Ky., to face the Kentucky Wildcats in a three-game Southeastern Conference series at Cliff Hagan Stadium. The series begins Friday, April 9, at 5:30 p.m. (CDT). The two teams will also meet on Saturday, April 10, at 5:30 p.m. (CDT) and Sunday, April 11, at 12 p.m. (CDT). No. 19 Alabama (20-9, 4-5 SEC) has split a pair of midweek games with in-state foes UAB and Jacksonville State. The Tide posted a 10-4 win in 11 innings on Wednesday night at Jacksonville State, scoring six runs in the 11th inning for its 20th win of the season.
HEAD COACH Mitch Gaspard: Alabama head coach Mitch Gaspard is 20-9 (.690) in his first season as the Crimson Tide's head coach. Overall, he has compiled a 231-137 (.627) record in seven seasons as a head coach. He was named the school's 30th head coach on Tuesday, Sept. 1, 2009, replacing Jim Wells, who retired after 15 seasons. Gaspard begins his 10th overall season with the Crimson Tide baseball program this spring, after serving two stints as an assistant coach under Wells from 1995-2001 and 2008-09, where he helped land some of the nation's top recruiting classes. Gaspard spent six years as the head coach at Northwestern State, where he compiled a 211-128 (.622) record from 2002-07. He led the Demons to a pair of Southland Conference championships, one SLC Tournament title and a berth into the 2005 NCAA Baton Rouge Regional.
THE RANKINGS: Alabama is ranked in four of the six major polls this week, including Rivals.com (19th), Baseball America (24th), the USA Today/ESPN Coaches (25th) and National Collegiate Baseball Writers Association (25th).
ALABAMA TIES NCAA RECORD: Alabama tied an NCAA and SEC record and set the single-game school record with six sacrifice bunts in its 10-4 win over Jacksonville State on April 7. Taylor Dugas tied the individual school record with two sac flies, while Jon Kelton, Josh Rutledge, Codt Trotter and Brock Bennett had one each. The six sacrifice bunts ties the NCAA record held by five other schools. Alabama also tied the SEC record with six sac bunts. South Carolina also had five sac bunts against Arkansas on March 8, 2004. Alabama broke the school record, previously set against Vanderbilt on March 26, 2005.
ON THE ROAD AGAIN: Alabama is 4-5 (.444) on the road this season, winning a three-game series at College of Charleston and was swept at Arkansas. Alabama is hitting .270 (81-for-300) with three home runs and 41 RBI in nine games. The Tide has scored 51 runs and collected 23 extra base hits. Rutledge leads the team with a .450 (18-for-40) batting average in nine road games with two home runs and seven RBI. Kelton is hitting .444 (10-for-18) on the road with seven runs scored, three doubles and five RBI. Wilson has seven RBI in nine road games, despite a .161 batting average. Alabama has outscored the opposition 9-2 in the first inning, but has been outscored 18-10 in the fourth, fifth and sixth innings. The pitching staff is 4-5 with four saves and 4.76 ERA. The staff has worked 79 1/3 innings and allowed 45 runs (42 ER) and 89 hits with 65 strikeouts and 29 walks. Kilcrease has been the most consistent pitcher on the road this season, posting a 1-0 record and .245 ERA. He has worked 11 innings and allowed three runs and eight hits with 10 strikeouts and four walks. Alabama is fielding .970 on the road with only 10 errors in nine games. UA opponents have turned 14 double plays, compared to only three for the Tide.
NCAA STATS LEADERS: Alabama sophomores Jon Kelton and Taylor Dugas are among the NCAA Division I baseball statistical leaders when the NCAA released its weekly baseball statistics Tuesday, April 6. Kelton leads the nation with a .607 on base percentage, while Dugas is second nationally with a .598 on-base percentage through games of Sunday, April 4. As of April 5, Kelton had reached base 51 times in 84 plate appearances this season, including 22 hits, 20 walks and nine hit by pitch. Dugas has been on base 73 times in 122 plate appearances, including 43 hits, 28 walks and two hit by pitch. In addition, Dugas leads the SEC and ranks seventh nationally with a .467 batting average. He is also seventh in walks (28) and 10th in walks per games (1.04). He is also the seventh toughest Division I hitter to strikeout this season. Dugas has three strikeouts in 92 at-bats or one strikeout for every 30.7 at bats through April 4.
JAX STATE RECAP: Alabama swept a two-game, home-and-home series with Jacksonville State this season, winning 7-3 in Tuscaloosa on March 30 and 10-4 in 11 innings at Jacksonville on April 7. Alabama hit .333 (25-for-75) in the two-game series with three doubles, 14 RBI and 17 runs scored. Senior Cal Tinsley went 3-for-5 with four RBI in the two games. Junior Josh Rutledge and senior Clay Jones had four hits each. The Tide pitching staff went 2-0 with a 2.70 ERA. The UA bullpen was stellar against the Gamecocks as the relievers allowed three runs (2 ER) and seven hits with 13 strikeouts. Alabama used a six-run 11th inning to post a 10-4 win at Rudy Abbott Field in Jacksonville on April 7. Tinsley went 3-for-4 with two doubles, two runs scored and four RBI in the win. Junior RHP Nathan Kilcrease pitched four scoreless innings in relief for the win. On March 30, Taylor Dugas had a two-run single in the Tide's three-run second inning UA posted a 7-3 win. Freshman right-hander Trey Pilkington was the winning pitcher with two scoreless innings of relief.
UAB RECAP: Alabama was swept in its two-game season series by UAB for the third time (1990, 2001 and 2010) in series lore and the first time since 2001. Alabama was outscored 17-8 in the two games and hit just .258 (17-for-66) against the Blazers with four doubles and seven RBI. Clay Jones was 5-for-8 (.625) in two games, including a 4-for-4 performance on April 6. Josh Rutledge went 4-for-5 in the March 31 loss at Regions Park. The Crimson Tide pitching staff went 0-2 with a 6.88 ERA in the two losses. The pitchers worked 17 innings and allowed 17 runs (13 ER) and 26 hits with 11 strikeouts and three walks. UAB outscored Alabama 11-2 in the first four innings and hit .342 (26-for-76) in the two games. The Crimson Tide stranded 22 base runners in the two losses and hit into six double plays, including four in its 11-4 loss in Tuscaloosa on April 6. UAB scored eight runs in the third and fourth innings en route to an 11-4 win in Tuscaloosa, its first at the Joe since 2001. Merritt Bowden's three-run double capped a five-run fourth as the Blazers built an 8-1 lead. UAB took a 2-0 lead in the second inning on solo home runs by Luke Stewart and Ryan Ussery and stretched that lead to 4-1 after six innings. The Blazers scored two more runs in the eighth inning to take a 6-3 lead.
KENTUCKY SERIES: Alabama holds a 52-31 lead in the series, which dates back to the 1925 college baseball season. Although the two schools first met in the 1920s, they did not play each other on an annual basis until 1986. Alabama dominated Kentucky in the early stages of the series, winning the first five meetings and 10 of the first 12 games. The Crimson Tide also beat the Wildcats three games to one in the 1950 SEC Playoffs. Three of the four games were contested in Tuscaloosa. Former Alabama basketball coach C.M. Newton was a pitcher on UK's 1950 squad that lost to Alabama. The Crimson Tide and Wildcats met only 24 times prior to the SEC adopting its divisional schedule in 1986. Since then, the two teams have met 59 times over the last 25 years. Alabama swept the 1986 series in Lexington, winning three-high scoring games. In game two of the series, Alabama posted a 19-7 extra-inning win and set the school record for most runs in an extra inning, scoring 12 runs in the eighth. The Tide swept UK in Lexington in 1990 and the Cats returned the favor the following year in Tuscaloosa. Alabama beat UK four times in 1996, winning the regular-season series in Lexington and posting two wins at the SEC Tournament in Hoover. In 1997, UK lefty Scott Downs beat Alabama 9-2 for the Cats lone win and stopped Roberto Vaz's then-school record 32-game hitting streak in the process. From 1996-2005, Alabama won all eight regular-season series. UK snapped that streak in 2008 with a three-game sweep in Lexington and won four of the five meetings with the Tide that season. UK also beat Alabama 9-3 in an SEC Tournament game that began well after 11 p.m. and ended shortly before 2 a.m. the next day. The Tide snapped its four-game losing streak with a 13-4 win an elimination game two days later. Alabama is 15-6 against Kentucky in the last 21 games, with four of the six losses coming in 2008. UK swept the regular-season series in Lexington and then handed UA a 9-3 loss in the first round of the SEC Tournament in Hoover. Alabama is 28-15 in games played in Tuscaloosa, winning the last five series (1997-2009). The Tide holds a 20-13 series lead in Lexington and owns a 4-3 mark at neutral sites. Alabama coach Mitch Gaspard will be making his coaching debut against UK. Kentucky coach Gary Henderson is 1-2 against the Crimson Tide.
KENTUCKY SCOUTING REPORT: Kentucky (19-11, 2-7 SEC) opened the season by winning 10 of its first 11 games, including a seven-game winning streak. Since then, the Wildcats have gone 9-10, including seven losses in nine SEC games. UK is hitting .291 (295-for-1013) on the season with 42 home runs and 197 RBI. The Wildcats average 7.2 runs and 9.8 hits per game. The offense is built around speed and power. In addition to the 42 home runs, UK has 68 stolen bases in 83 attempts this season. The Wildcats average 2.27 stolen bases per game. Senior utility man Gunner Glad (.364, 7 HR, 30 RBI), sophomore outfielder Chad Wright (.355, 2 HR, 23 RBI) and senior infielder Chris Bisson (.340, 2 HR, 18 RBI) are the top three hitters in UK's talented lineup. Sophomore outfielder Cory Farris, sophomore infielder Andy Burns and Glad share the team lead with seven home runs. On the mound, UK sports one of the nation's top pitching staffs. The Cats own a 19-11 record with six saves and 4.48 ERA. UK opponents are hitting only .271 and average 5.2 runs and 9.4 hits per game. The weekend rotation will consist of junior left-hander Logan Darnell (7 GS, 3-2, 4.50 ERA), freshman lefty Taylor Rogers (7 GS, 3-3, 5.31 ERA) and sophomore right-hander Alex Meyer (7 GS, 4-2, 7.64 ERA). The bullpen is anchored by three more outstanding arms in sophomore righty Braden Kapteyn (6 G, 1-0, 1 SV, 0.00 ERA), junior left-hander Mike Kaczmarek (8 G, 1-0, 1.59 ERA) and junior right-hander Matt Little (13 G, 1-1, 2.96 ERA, 4 SV). Kentucky owns a .964 fielding mark this season and has committed 44 errors in 30 games. Junior infielder Taylor Black leads the way with 13 errors. UK has also turned 31 double plays, more than one per game.
2009 ALABAMA-KENTUCKY SERIES RECAP: Alabama won two out of three from Kentucky last season and has now won four straight home series against the Wildcats. The Crimson Tide hit .239 (22-for-92) in the series with two home runs and 13 RBI. Senior RF Kent Matthes (.444, HR, 2 RBI) and Wilson (.400, RBI) led the Tide at the plate. UK hit .275 (28-for-102) with four home runs and 17 RBI. Alabama scored 11 of its 15 runs in the series opener. The Tide compiled a 5.67 series ERA in 2009 (27 IP, 28 H, 19 R, 17 ER, 12 BB, 17 K) against the Wildcats. UK sported a 4.68 ERA (25 IP, 22 H, 15 R, 13 ER, 6 BB, 32) and turned in a 6:1 strikeout to walk ratio. After allowing 11 runs in the opener, UK held UA to four runs in the final two games.
Alabama 11, Kentucky 6 (Apri 24, 2009 - Sewell-Thomas Stadium - Tuscaloosa)Jake Smith's grand slam highlighted a seven-run eighth inning as Alabama rallied for an 11-6 win in the series opener. Smith's grand slam off Clint Tilford gave the Tide an 8-6 lead. Alabama would score three more runs in the inning, capped by Josh Rutledge's two-run single. The Crimson Tide had taken a 4-3 lead when Matthes hit a two-run home run off James Paxton with one out in the sixth. UK scored twice in the seventh and once in the eighth for a 6-4 lead before the comeback. Nathan Kilcrease (2.2 IP, 2 H, 1 R, 2 K) was the winning pitcher for Alabama. Smith finished the game with two hits and five RBI.
Kentucky 11, Alabama 1 (April 25, 2009 - Sewell-Thomas Stadium - Tuscaloosa)Chris Rusin's dominating performance on the mound helped UK to an 11-1 win in game two of the series. The lefty allowed one unearned run and seven hits in the complete-game win, with nine strikeouts and no walks. UK scored five times in the fourth inning to take a 7-0 lead and added four more runs in the seventh for the easy win. Chris Bisson went 2-for-4 with two runs scored and three RBI, including a bases-loaded triple in the five-run fourth inning. Chris McLendon went 2-for-3 with two runs scored and three RBI, including a three-run homer in the seventh.
Alabama 3, Kentucky 2 (April 26, 2009 - Sewell-Thomas Stadium - Tuscaloosa)Alabama right-hander Adam Scott and UK right-hander Alex Meyer turned in a rare Sunday pitcher's duel as the Tide eked out a 3-2 win in the series finale to win its fourth straight home series over the Cats. Alabama took a 1-0 lead with an unearned run in the fifth inning. Taylor Dugas struck out to lead off the inning but reached second base when the UK catcher Michael Williams could not handle the third strike and then threw wildly to first base. Ross Wilson's two-out single put the Tide on the board. Alabama stretched its lead to 3-0 with two runs in the eighth. Dugas singled and scored when Brandon May was hit by a pitch with the bases loaded to make it 2-0. Rutledge singled and scored on Jake Smith's sac fly to make it 3-0. Braden Kapteyn's two-run home run in the ninth off Adam Scott pulled the Cats to within 3-2 before Smith retired the final three hitters for the save. Scott (8 IP, 8 H, 2 ER, 2 BB, 2 K) was the winner, while Meyer (7 IP, 4 H, 3 R, 2 ER, 1 BB and 11 K) took the loss.
NEXT GAME: Alabama and Kentucky meet in game two of this three-game series on Saturday, April 10, at 5:30 p.m. (CDT).


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College Hockey:Montoya Tops CSS Goalie Rankings
TORONTO — Michigan goalie Al Montoya is the top rated goaltender on the Central Scouting Service's end of season North American rankings, the first such distinction for a college player since Rick DiPietro in 2000. Meanwhile, North Dakota forward Drew Stafford tops the list of current and incoming college hockey skaters on the CSS rankings.
Stafford, who had to opt-in to this year's NHL Draft, ranks seventh on the list. He's followed among skaters by Michigan State defenseman A.J. Thelan (11) and North Dakota forward recruit Travis Zajac (15). There is a separate ranking for European skaters and goaltenders.
(Complete CSS List of College players)
Stafford will still only be 18 as of Sept. 15, which means he had to formally opt-in to the draft. In the past, that meant he relinquished NCAA eligibility, but thanks to a recent ruling by the NCAA, that is no longer the case. Nineteen-year olds do not have to opt in.
No. 1 on the list of North American skaters is left wing Andrew Ladd of the WHL's Calgary Hitmen, followed by Medicine Hat (WHL) defenseman Cameron Barker. The No. 1-ranked European skater is Alexander Ovechkin, who has been targeted as a potential No. 1 overall pick since he was 16 years old. The Washington Capitals own the first pick in the draft.
Though there is only one college player in the rankings' top 10, compared to three last year — Thomas Vanek, Ryan Suter and Zach Parise — there are nine in the top 30, two more than last year. In addition to the three mentioned above, there is Minnesota forward recruit Blake Wheeler (17), Dartmouth defenseman Grant Lewis (21), opt-in Notre Dame defenseman Wes O'Neill (23), recently-departed Boston College forward Adam Pineault (25), Michigan State forward David Booth (27) and incoming Minnesota forward Kris Chucko (29).
Twelve more college or college-bound players are in the next thirty on the rankings, though four of them — incoming Colorado College forward Scott McCulloch (40), incoming Denver forward Paul Stastny (49), Michigan forward and 2003-04 USCHO.com Rookie of the Year T.J. Hensick (50), and Bowling Green defenseman Jonathan Sigalet — have chosen not to opt-in to the draft. Tops among the draft-eligible in that group are Clarkson recruit Shawn Weller (32) and Cornell recruit Raymond Sawada (33).
Among goalies, only one other college-bound player is in the top ten; Boston College recruit Cory Schneider stands at No. 7. Only Notre Dame's David Brown (25) played in the NCAA last year and is on the list, besides Montoya.
(Get full NHL Draft coverage, including complete CSS Rankings and order of selections, from NHL.com)
This year's NHL Draft will be held June 26-27 in Raleigh, N.C. Last season, a record nine current or incoming college players were selected in the first round, a figure unlikely to be matched this season.
The following is a self-policing forum for discussing views on this story. Comments that are derogatory, make personal attacks, are abusive, or contain profanity or racism will be removed at our discretion. USCHO.com is not responsible for comments posted by users. Please report any inappropriate or offensive comments by clicking the "Flag" link next to that comment in order to alert the moderator.
Please also keep "woofing," taunting, and otherwise unsportsmanlike behavior to a minimum. Your posts will more than likely be deleted, and worse yet, you reflect badly on yourself, your favorite team and your conference.


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"It's just crazy that you don't know the depth of someone's power until their funeral."
This episode may mark the death of Hannah's writing career and her patience. Girls brings its spectacular and dark cringe-comedy to a funeral and paddles on through to the end with one of the season's strongest episodes yet, especially in the character development department. An only child can be a force to be reckoned with. Strong opinions, self-entitlement, perfectionists, idealistic, and often a little lonely. Hannah has the best and worst successive days of her life in one episode and she goes through all of the demanding motions, compelling her to turn into a twister of destruction. It's true that the best times always accompany the worst of times--this is when they both overlap. Hannah sees her misfortune as a complete damnation, but there is plenty of opportunity here. Solipsism, rigid self-idealism and entitlement does not mesh well with this kind of momentary derailment. Being an only child may have Hannah acting out without considering other people's situations and concerns, because she's never really had to. And this is likely just the beginning. It's hard not to see Hannah in a disastrously ugly light in this half-hour, but in some ways one can't totally dismiss her candor. She's stuck, but not immobilized. Hannah has plenty of room to wedge her way out of this situation. However, as with Girls, vapid idealism takes precedent over constructive action. If it's not going Hannah's way then no one will be happy. "Only Child" presents Hannah and company with some real, harsh and ugly obstacles for them to tussle with for the rest of the season.
Hannah takes David's funeral and turns it into a networking event. And it may lead to her getting her up and comings. It's no mistake that Hannah more than usually has good intentions and honestly believes herself to be appropriate in how she maneuvers the many complexities of adulthood. Still, one has to wonder where her sense of self-awareness has disappeared to in the opening scenes of the episode. Here, Hannah's frivolities take off and rip up a funeral already soaked in potent ridiculousness. Hannah meets David's wife/widow--a surprise to everyone--and in-between various embarrassments and being mistaken for someone of great importance, Hannah discovers that all of David's projects are being cancelled, immediately sending our protagonist on a truly insensitive spiral to find a new publisher. I'm of the cynical sort, making a prediction that the editor Hannah received from David's angered widow will actually end up destroying Hannah's reputation as a writer, but maybe I'm getting too ahead of myself. Mostly because Hannah is likely to do a good enough job at destroying her writing reputation on her own.
Hannah finds herself lucky enough to get a bit of an upgrade with her new publisher, in a meeting full of what seems like false promises that are too good to be true--and a lot of practiced laughter. Someone needs to inform Hannah, that they're not laughing with you, honey; they're laughing at you. You're their entertainment…for now at least. There is a part of Hannah that is very much aware of this, but her desperation to get her work published trumps her own dignity at the moment. When this new publisher mentions turning Hannah's e-book into a very real, physical book, she is almost instantly their puppet; Hannah's laughing along with them just because. When you're young and desperate to make your mark in the world, these things happen. And here Hannah is bombarded with hollow laughter and is reduced to a female writer stereotype rather than the strong writer she is (or thinks she is). It's a ridiculous situation to be in…when you're making progress, but not in the ideal way that you want. Sure, the perceived end result is ideal, but not the "struggle" of getting there. That alone is frustrating. Then later add on the double-whammy that Hannah is legally unable to use any of the work she's produced in any way for at least three years and you've got one hell of a stressful situation. But does the only child, Hannah deal with it all in a mature, adult fashion? Of course not. This is the episode where Hannah, Adam and Caroline are at their most childish--reduced to toddlers in a weird, unstable way.
Speaking of the Sackler siblings, the two continue to falter into titanic arguments that stem from old childhood troubles that obviously were never dealt with. And leave it to Hannah to grossly emulate Dr. Phil and make some self-interested attempts in working things out between the two. It makes for one of the most equally compelling and comedic pieces of character development and story progression--it plants seeds for further possible storylines and developments--great set-up for the final scenes of the episode (and the rest of the season) that pack a surprising punch and leaves one questioning the state of some of Hannah's relationships, especially her romantic relationship with Adam. What's great about these Dr. Phil Hannah scenes is that a lot of Adam and Caroline's issues with one another seem like a lot of projection and even Hannah is able to point that out when Adam critiques Caroline about her lack of ambition and cluelessness of her life direction. This is how we discover that Adam and Caroline are almost one in the same, the only difference is that Caroline's disposition is exaggerated due to her mental illness. Let's be honest, we've seen Adam zip in and out of things he was passionate about in one moment only to dismiss it and find something new. It's not that different from Caroline's rapid jumps in motivation to eventual stagnation. Since we've met Caroline a few episodes ago, her special brand of "crazy" has been compared to Hannah's and appropriately so. They both kind of cancel each other out and give one another a weird balance--up until Hannah faces a crisis of her own.
Hannah has found Caroline's crazy mildly charming and it has also given her much opportunity to play mediator and fixer--all things that allow her to be in some position of power, at least in the eyes of those close to her. Caroline has thrown Hannah and Adam's dynamic up in the air and rearranged it like a disheveled apartment. Now the pair can't walk amongst their environment without facing various bumps in their path. Caroline has outlined how different Hannah is from Adam and possibly how destructive Hannah might be to his personal growth. And that is what is most distressing to Hannah on top of everything else. It's weird because both Hannah and Caroline have a way of utilizing their relationship with Adam as a crutch. Hannah and Caroline's sister relationship explodes at the very end of this episode and proves that Hannah is unable to really handle having a sibling, even though she earlier insists she always wanted one. Here, Hannah dismisses Caroline in a harsh and flippant manner simply because she's having a bad day--okay, one of her worst days, but Hannah lets her state of crushed idealism get the better of her. At this moment, she'll be a self-destructive twister more than a respected creative writer in New York.
And that's the thing: Hannah is a creator and a writer, but she's not convinced that she can create something else beyond her much un-anticipated memoir. Does everything really have to be about her, specifically? I find it interesting that Hannah deems herself as such a master individual of creativity--someone so concerned about documenting emotion--but she was unable to process the death of her mentor and publisher, David. Also, Hannah is unable to see the opportunity laid out before her to prove herself as a real creative genius. So, while she is left complaining, raving and wanting respect as a writer, Hannah isn't really being a writer. Nor is she taking this setback as a set-up. Hannah barely even makes the effort to speak to Adam about how she and Caroline ended things. Being the only child, Hannah apparently expects Adam to be at least moderately happy about Caroline's departure; however, there is an inseparable bond between siblings that is inherent and doesn't break just because someone says when. But would a only child stereotype understand that? Not this one. Not Hannah. Hannah wants to be the center of Adam's attention. But with Caroline around, that can't happen. So someone's gotta go. It's also interesting to note that Adam is more and more becoming a rescuer. It's something he seems to take pride in, but this also means that Hannah may not be that special after all. What's even weirder is that it seemed as though Hannah was sort of battling with Adam on being the acclaimed rescuer of the crazy sister. Caroline may be unhinged, but she may have spoken eccentric truth to stupid…
Elsewhere, Shoshanna finds herself in the weird position where she is partially rethinking her plans to be a young woman of sexual and academic success. There are flaws in her perceived system and she's just now starting to feel the pressure. All the while, Jessa continues to be a stagnant figure in her life--a sort of fallow role model. Shoshanna is in the midst of her college career and has many vital pieces moving all at once. The struggle is real, apparently. What I and most people love about Shoshanna is that she tells the bitter truth in such a shallow valley girl manner that people don't really take her words all that seriously. When Shoshanna insists that Jessa and the other girls around her are doing nothing with their lives in the way Shoshanna sees herself in her ambitious, but mostly unrealistic fifteen year plan, Jessa poses a very important question to quickly maneuvering youth: What happens after the fifteen year plan? Shoshanna is totally dismissive of the question, a trait that unfortunately sticks to a fast-paced, shallow youth like glitter glue. But at the same time, Jessa takes Shoshanna's candor about her fifteen year plan and applies it to herself in her own eccentric way; she makes a quick decision to work at a baby boutique. It's a new kind of fifteen year plan. Jessa continues down her twisted little road of self-discovery. I've missed seeing Jessa and Shoshanna feed off of each other's backhanded wisdom. Glad to see it make a prominent return…
Can we all just sit around and talk about just how perfectly un-perfect and horrid Marnie and Ray are for each other? This is one hundred percent a-okay and more, finally putting these two characters on board to really do something significant this season. Not to mention the fact that these two have had some simmering sexual tension boiling since the show's inception. Behind all the hate and disgust for one another's personal dispositions--Marnie's judgmental attitude and need for validation in lieu of personal growth and Ray's searing pessimistic wisdom. One thing is certain, this pairing is going to be really fun to watch grow or self-destruct. Either way it will be quite a ride. Wouldn't it be poetic justice--or injustice--that Marnie and Ray end up working out more than anyone else? It makes near perfect sense that Marnie and Ray would find each other after the respective breakups, both of which blindsided them and thrusted them into a world of self-dependence--only one of them are truly thriving at it, while the other flounders and insists that they are actually empowered being alone.
The whole romantic development (I doubt that's the best way to describe it) comes about when Marnie rushes over to Ray's renovated apartment to receive a brutal self-assessment from the wisest, oldest friend she has. None of this escalates in a way that is unrealistic, which is surprising, just considering how cartoonish this territory could have become. Ray's observations, while harsh are spot-on, helping flesh out the character of Marnie, making sense of the current and previous situations she's been dealt. Marnie and Ray are playing a game of truth or dare with each other by falling into each other's unstable arms for some sort of emotional support. They're filling a hole that will likely lead to a mostly unhealthy journey of self-discovery for both. If this episode is any indication, this pairing should be thoroughly entertaining and thoroughly surprising, no matter what occurs next. Oh, and did anyone else laugh out loud at Marnie's comment concerning Ray's excessive use of underwear. Yep, these two might be the next best thing about this season, either that or Marnie's new kitten best friend!
This episode of Girls hits all the right marks comedic, dramatic and all the whatevers that are in between. The same can be said for Lena Dunham's performance here, displaying all the ups and downs of her reeling new stressful situation. The fifth installment succeeds as the best installment of the season thus far. It's thought-provoking in the comedic sequences and cringe-worthy in the real-life dramatics and many moving character dynamics. Everything is up in the air and it's nerve-wracking and makes for surprising comedy bliss, no matter how many times one might wince while watching Hannah falter and fail with every other success she makes. One step forward and three steps back. This kind of occasional derailment should make a champion out of anyone. However, by examining Hannah's tactics in dealing with her latest misfortunes, she'll likely perish, while all of her personal relationships do the same. "Only Child" gets 5 out of 5 stars!
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© Patrick Broadnax 2014


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Today being Earth Day (Have you checked out the HUGE list of Earth Day Freebies Yet??) - Kindle is offering 4 Kids eBooks about recycling, taking care of the earth and going green at just $1.99 each!
This would be a good way to sit down with your child and focus on what Earth Day is about.
- Thanks PandorasDeals
Please note that Amazon's prices fluctuate and can change at any time. Be sure to verify current price before placing your order. Find more great Amazon Deals in our Amazon Category!


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Baseball's Weekend Series With La Salle Moved To Philadelphia
March 20, 2014
AMHERST, Mass. - UMass baseball's three-game Atlantic 10 series against La Salle, originally scheduled to be played in Amherst, has been moved to Philadelphia, Pa., due to field conditions at Earl Lorden Field. The Minutemen will now take on the Explorers in a three-game set at Hank DeVincent Field, beginning with a 3 p.m. contest on Friday, March 21.
The teams will then square off at 1 p.m. on Saturday, March 22, and at Noon on Sunday, March, 23.
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Traffic information services
- Published:
- 05 November 2013
- Modified:
- 18 April 2014
With these Dutch-language links, you can find up-to-the-minute traffic information for The Hague and surroundings.
Verkeersjournaal on Omroep West: In 2 minutes you will get an overview of current road closures plus other large ongoing road maintenance projects in The Hague region. You can tune into the hourly broadcast of the Verkeersjournaal (Traffic News) on Omroep West, the public broadcasting station for South Holland north. Go to www.omroepwest.nl/programmas/verkeersjournaal
Verkeers Informatie Dienst: Up-to-the-minute 24-hour a day satellite information about mobility and traffic delays in the Netherlands. This Dutch-language website offers a Twitter service, RSS feed, mobile application and films on YouTube. Go to www.vid.nl.
ANWB: Here you can find the current traffic situation for the whole of the Netherlands, including the largest cities. The ANWB route planner on the website offers detailed route planning. Go to: www.anwb.nl/verkeer


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With The Fault In Our Stars making theater aisles run wet with tears, another tail of young love marred by a health crisis is on the way. Chloe Moretz stars in If I Stay, based on Gayle Forman's best-selling book that is generally regarded as a cut above the rest of the YA field. So should we go ahead and order up an extra box of Kleenex for this? Sure looks like it.
A new "prologue trailer" (Is this a thing now?) for the film has been released, and it looks like a definite weeper. Moretz stars as Mia Hall, a musical prodigy trying to decide whether to pursue her dreams and attend Juilliard, or pursue a different life with the guy of her dreams. When a terrible accident leaves Mia in a coma, she has an out-of-body experience and must decide whether to soldier on or give up and die. Fun stuff.
Directed by R.J. Cutler with Jamie Blackley, Joshua Leonard, Mireille Enos, Stacy Keach, and Liana Liberato co-starring, If I Stay opens August 22nd.


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"Ted Gup's A Secret Gift is a soulful, fascinating and ingenious book."
–Ian Frazier, Author and Writer for the New Yorker
"Wrenching stories of suffering, loss, endurance, humility and gratitude…[A] compelling tale."
–Kirkus Review
"...the amazing mystery of a beneficent but complicated grandfather who comes straight out of Dickens. This book is a gift in itself."
–David Maraniss, Author & Writer at The Washington Post
"[Ted] has found a moving and telling story of the Great Depression in an old suitcase and marvelously brought it to life."
–Evan Thomas, Author and Newsweek Editor
"A deeply researched, poignant, and inspiring account of how ordinary people endured the singular hardships of the Great Depression."
–Gay Talese, Bestselling Author
"...a story both engrossing and haunting, the kind of book that stays with you, warming your thoughts for days to follow."
–Deborah Blum, Pulitzer Prize Winner
"During these difficult days when we thirst for stories of kindness, decency and selflessness, 'A Secret Gift' is just what the nation needs."
–Dave Isay, founder of StoryCorps
Ted on CBS Sunday MorningTed Gup's 80 year-old mother handed him a suitcase labeled "Memoirs" filled with letters dated the same week in December 1933, all addressed to someone named Mr. B. Virdot. Rita Braver tells has the story of a mysterious benefactor who in the Great Depression, sent gifts to those in need.
Watch the Intro


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The charges were dropped against Merling yesterday. Why? Because his girlfriend moved back to South Carolina and police were unable to contact her and serve her with a subpoena to testify against him. Given the lack of evidence without her testimony, the state decided not to file charges.
And yet Merling has said he's been talking with her.
And now that his mysterious injury has healed itself (just in time to coincide with the charges being dropped! How remarkably coincidental!), he may make a return to the team next week.
Home » Unlabelled » More on Merling
Wednesday, November 17, 2010
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Attends Eden Prairie (Minn.) High School...played for head coach Mike Grant...spent three years at Ardrey Kell High School in Charlotte, N.C., before his family relocated to Minnesota...four-star recruit by ESPN, Rivals and Scout.com...SuperPrep and PrepStar All-American...listed as the No. 23 offensive tackle prospect in the nation by MaxPreps and 26th by Scout.com...ranked 34th and 36th by Rivals.com and ESPNU, respectively...three-year varsity letterwinner...earned first team Associated Press all-state honors as a senior...first team Star Tribune and KARE 11 all-metro selection...also earned first team all-Charlotte, all-Mecklenburg and Southwestern 4A all-conference honors as a junior at Ardrey Kell...also lettered in basketball...parents are Jeff and Judi Davidson...has one younger brother, Alex...father played football at Ohio State from 1986-89 and three years in the NFL with the Denver Broncos (1990-92)...grandfather also played football at Ohio State from 1961-64 and was a first round draft pick of the Buffalo Bills...born in Columbus, Ohio...full name is Nicholas James Davidson.
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"The residents who live here, according to the parable, began noticing increasing numbers of drowning people caught in the river's swift current and so went to work inventing ever more elaborate technologies to resuscitate them. So preoccupied were these heroic villagers with rescue and treatment that they never thought to look UPSTREAM to see who was pushing the victims in."
Learn what is hurting your feet and your performance, and how to finally train your feet the way they were meant to be.
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By Art Horne
In a follow up from a previous post (Up The Chain It Goes), additional evidence supporting the relationship within the kinetic chain has emerged from south of the equator. In a study out of South Africa examining the link between available dorsiflexion and mechanical low back pain researchers found a statistically significant decrease in ankle dorsiflexion ROM and associated reporting of low back pain (Brantingham, 2006). With the vast majority of adults suffering from low back pain at some time in their life, (some reports are up to 85%) and 80% of people reporting foot problems during their lifespan, it's not a surprise to see that these two conditions may very well be related.
Let's take a closer look:
Methods: " The study was a blinded, 2-arm, non-randomized clinical study involving 100 subjects with chronic or recurrent mechanical low back pain (intervention group) and 104 subjects without chronic mechanical low back pain (control group) between the ages of 18 and 45. A blind assessor performed weight-bearing goniometry of the ankle and big toe and the navicular drop test on all subjects in both groups."
Results: "An independent t-test (inter-group) revealed a statistically significant decrease in ankle dorsiflexion range of motion in individuals with chronic mechanical low back pain."
Conclusions: "This study's data found that a statistically significant decrease in ankle dorsiflexion ROM, but not flatter feet, was associated with subject report of chronic mechanical low back pain disorders."
Discussion: "The findings of this blinded study support previous reports suggesting that decreased ankle dorsiflexion may be a factor in chronic mechanical low-back pain. There was no clear association found between decreased hallux ROM and mechanical low back pain in this study. If these findings are confirmed through additional studies, exercise and manipulation therapy to increase ankle range of motion could become an important consideration in the treatment of some patients with mechanical low back pain disorders."
Hmmm, if only we had some additional studies….
Perhaps this will help.
During a routine exit physical, 60 division one athletes were assessed for available weight bearing dorsiflexion bilaterally as described by Bennell et al in 1998 (inclinometer was replace by Clinometer app for ITouch) to examine limitations in this movement. Ten athletes with limited weight bearing dorsiflexion (less than 4 inches from knee to wall) volunteered for follow up evaluation and manual treatment. Out of the initial 120 measured ankles, 47 ankles (21 right, 26 left) demonstrated limited weight bearing dorsiflexion range of motion.
Athletes were then asked to walk normally in their athletic shoes while wearing an in-shoe pressure sensor (Tekscan) and through an optical measurement system (Optojump). Each athlete then underwent a general manual therapy intervention aimed to improve ankle dorsiflexion, followed again by the same gait analysis and pressure mapping data capture.
Gait Cliff Notes: optimal gait should have two mountains with a trough between them. The first mountain represents heel strike to midstance, the trough representing the mid-stance phase, and the second mountain being propulsion from full foot contact to toe-off.
Easy right? Good.
Note: The second mountain should almost always be higher than the first.
Pre-treatment (RED):
Notice how the first mountain is slightly higher than the second – this is BAD!
Remember from our cliff notes: the second mountain should be higher.
Post-treatment (GREEN):
Notice change in toe off from pre- to post-treatment which specifically targeted patient's limited dorsiflexion? The second mountain is now higher than the first. That's a GOOD thing!
Awesome right?
Better yet – athlete was measured 3 days post treatment and improvement in Dorsiflexion range of motion stuck! Try doing that with a slant board stretch.
See Art Horne and Dr. Pete Viteritti discuss these and other changes at the foot and ankle, and how to assess and address soft tissue and bony restrictions in their presentation at the 2012 BSMPG Summer Seminar May 19-20th in Boston.
Bennell KL, Talbot RC, Wajswelner H, Techovanich W, Kelly DH and Hall AJ. Intra-rater and inter-rater reliability of a weight-bearing lunge measure of ankle dorsiflexion. Australian Journal of Physiotherapy. 44;175-180.
Brantingham JW, Gilbert JL, Shaik J, Globe G. Sagittal plane blockage of the foot, ankle and hallux and foot alignment-prevalence and association with low back pain. J of Chiropractic Medicine. 2006; 4(5); 123-127.
With recent season ending ACL injuries to New York Knicks Iman Shumpert, and Chicago Bull's point guard Derrick Rose coming on the same day, (not to mention Eric Maynor from the Thunder and Spanish Star Ricky Rubio earlier this season) discussion has arisen as to how these terrible injuries could have been avoided. Although the possible contributing factors are endless, ranging from previous injury to simply fatigue, one area worth shedding more light on, especially in the case of young Rose, is the implication of the kinetic chain as a whole.
Let's start at the ground and work our way up.
I think we'd all agree that the big toe is a big deal. But how closely are we looking at this "pivotal" body-ground juncture?
In a study by Munuera et al, researchers found that "Hallux interphalangeal joint dorsiflexion was greater in feet with hallux limitus than in normal feet. There was a strong inverse correlation between first metatarsophalangeal joint dorsiflexion and hallux interphalangeal joint dorsiflexion." (Munuera et al, 2012).
TRANSLATION: People with abnormally stiff or limited motion at the great toe had excessive motion at the joint just distal.
If you don't have mobility where you need it, you'll surely get it somewhere else.
Let's move up the chain shall we?
In a study by Van Gheluwe and his group, researchers looked at how a stiff or limited great toe joint changes the way we walk. In their study, "two populations of 19 subjects each, one with hallux limitus and the other free of functional abnormalities, were asked to walk at their preferred speed while plantar foot pressures were recorded along with three-dimensional foot kinematics. The presence of hallux limitus, structural or functional, caused peak plantar pressure under the hallux to build up significantly more and at a faster rate than under the first metatarsal head. Additional discriminators for hallux limitus were peak dorsiflexion of the first metatarsophalangeal joint, time to this peak value, peak pressure ratios of the first metatarsal head and the more lateral metatarsal heads, and time to maximal pressure under the fourth and fifth metatarsal heads. Finally, in approximately 20% of the subjects, with and without hallux limitus, midtarsal pronation occurred after heel lift, validating the claim that retrograde midtarsal pronation does occur."
TRANSLATION: if you have a limited motion in your great toe, pressure changes will occur – increase pressure changes will cause pain over time (think blister on your foot).
And pain changes the way we move – period.
Let's take a look at the ankle.
In an article by Denegar et al, the authors outline the importance of regaining normal talocrural joint arthrokinematics following an ankle injury. The authors note,
"All of the athletes we studied had completed a rehabilitation program as directed by their physician under the supervision of a certified athletic trainer, and had returned to sports participation. Furthermore, all had performed some form of heel-cord stretching. None, however, had received joint mobilization of the talocrural complex. Despite the return to sports and evidence of restoration in dorsiflexion range of motion, there was restriction of posterior talar mobility in most of the injured ankles. Posterior talar mobilization shortens the time required to restore dorsiflexion range and a normal gait. Without proper talar mobilization, dorsiflexion range of motion may be restored through excessive stretching of the plantar flexors, excessive motion at surrounding joints, or forced to occur through an abnormal axis of rotation at the talocrural joint." (pg. 172)
TRANSLATION: I repeat, Without proper talar mobilization, dorsiflexion range of motion may be restored through excessive stretching of the plantar flexors, excessive motion at surrounding joints, or forced to occur through an abnormal axis of rotation at the talocrural joint." (pg. 172)
If you don't have normal ankle motion, and specifically at the talus, your ankle motion (although appearing normal) is probably coming from other joints and/or in a combination with foot pronation.
But just because you have some extra motion doesn't mean you're doomed right?
But, excessive motion without the ability to control that motion certainly does. So where does knee control come from? The Hip!
But hip strength, control, and neuromuscular timing is seldom appreciated, and in the case of the basketball athlete it is certainly poorly measured, especially after ankle injury.
In a study by Bullock-Saxton, researchers investigated muscle activation during hip extension after ankle sprain and showed a changes in timing of muscle activation in the ankle sprain grouped compared to the non-injured group.
"the results highlight the importance of the clinician's paying attention to function of muscles around the joints separated from the site of injury. Significant delay of entry of the gluteus maximus muscle into the hip extension pattern is of special concern, as it has been proposed by Janda that the early activation of this muscle provides appropriate stability to the pelvis in such functional activities as gait." (pg. 333)
In another study examining ipsilateral hip strength/weakness after the classic ankle sprain, researchers demonstrated that subjects with unilateral chronic ankle sprains had weaker hip abduction strength and less plantar flexion range of motion on the involved sides (Friel et al., 2006)
"Our findings of weaker hip abductors in the involved limb of people with chronic ankle sprains supports this view of a potential chronic loss of stability throughout the kinetic chain or compensations by the involved limb, thus contributing to repeat injury at the ankle." (pg. 76)
"If the firing, recruitment, and strength of the hip abductor muscles in people with ankle sprains have been altered because of the distal injury, the frontal-plane stability normally supplied by this muscle is lacking, and the risk for repeat injury increases. Weak hip abductors are unable to counteract the lateral sway, and an injury to the ankle may ensue."
TRANSLATION: Ankle sprains cause neuromuscular changes up the chain and specifically in the hip. If this weakness is not addressed after an ankle injury," frontal-plane stability normally supplied by this muscle is lacking."
Of course suggesting that the above points are exactly the reason for which Rose suffered his injury is certainly a stretch and not the intention of this post, nor is it to question the treatment that he or any other NBA player received prior to their devastating injury (for the record, the Chicago Bulls Sports Medicine and Strength Staff are regarded as one of the very best in the league). What I am suggesting however is that examining athletes and patients with the use of advanced technology to determine a state of readiness to participate, and/or examine more closely changes in gait and neuromuscular firing is certainly worth pursuing, especially in light of the ever-rising salaries within professional sports. A quick look is certainly worth the small investment.
One thing is for sure, ACL injury is not limited to teenage females or only seen on the soccer pitch.
Previous Posts:
The NBA Should Have Learned From The NFL - Injuries On The Rise
Did The NBA Lock-out Ultimately End Chauncey Billups' Career?
1. Dr. Bruce Williams: Hit the ground running: Appreciating the importance of foot strike in NBA injuries
2. Dr. Bruce Williams: Breakout Session: Restoring Gait with evidence based medicine
3. Art Horne and Dr. Pete Viteritti: Improving Health & Performance - Restoring ankle dorsiflexion utilizing a manual therapy approach
4. Dr. Tim Morgan: Biomechanics and Theories of Human Gait: Therpeutic and Training Considerations
5. Jose Fernandez: Advanced Player Monitoring for Injury Reduction
Munuera PV, Trujillo P, Guiza L, Guiza I. Hallux Interphalangeal Joint Range of Motion in Feet with and Without Limited First Metatarsophalangeal Joint Dorsiflexion. J Am Podiatr Med Assoc. 102(1): 47-53, 2012.
Denegar, C., Hertel, J., Fonesca, J. The Effect of Lateral Ankle Sprain on Dorsiflexion Range of Motion, Posterior Talar Glide, and Joint Laxity. J Orthop Sports Phys Ther. 2002; 32(4):166-173.
Van Gheluwe B, Dananberg HJ, Hagman F, Vanstaen K. Effects of Hallux Limitus on Plantar Foot Pressure and Foot Kinematics During Walking. J Am Podiatr Med Assoc. 96(5): 428-436, 2006.
Bullock-Saxton, J. E., Janda, V., & Bullock, M. I. (1994) The Influence of Ankle Sprain Injury on Muscle Activation during Hip Extension. Int. J. Sports Med. Vol. 15 No. 6, 330-334.
Friel, K., McLean, N., Myers, C., & Caceres, M. (2006). Ipsilateral Hip Abductor Weakness After Inversion Ankle Sprain. Journal of Athletic Training. Vol. 41 No.1, 74-78
Smith RW, Reischl SF. Treatment of ankle sprains in young athletes. Am J Sports Med. 1986;14:465-471.
So often ankle dorsiflexion or should I say a lack thereof, is pointed at as the underlying culprit for a variety of movement impairments … and rightfully so. A lack of true talocrural motion can cause havoc up the chain involving itself in a variety of impairments including anterior tibial pain, patellofemoral pain and general low back pain to only name a few.
However, the actual limiting factor causing this lack of osteokinematic motion may be multi-factorial and if clinicians are hoping to address this limitation over the long haul with permanent change the exact location and tissue responsible for this restriction must be clearly identified and addressed with a specific intervention to match the specific tissue.
With regards to soft tissue restrictions there are only 6 possible structures that can limit this motion, and these are:
1. Soleus2. Posterior Tibialis3. Flexor Hallucis Longus4. Flexor Digitorum Longus5. Posterior Talofibular ligament6. Posterior Tibiotalar Ligament
The gastrocnemieus, although probably the very first structure that comes to mind, does not limit true dorsiflexion in function (that is unless you participate in ski jumping or speed walking, and then you need to include this in your assessment), since the knee is almost always flexed when the ankle is asked to express dorsiflexion in function, such as walking, running, squatting, lunging, stepping, jumping and landing.
Now that's some dorsiflexion!
Remember, in order for your tibia to pass over your talus, and your talus to move between the tibia and the calcaneus we need to think of what pathology or dysfunction is not allowing the above mentioned tissues to lengthen. More often than not, fibrotic adhesions within the muscles or fascial restrictions are to blame, with the filet mignon of tissue treatment choice being an Active Release Technique. Although lesser cuts of treatment choices allow tissues to mobilize at times, rarely can a foam roller or tennis ball address a specific adhesion like a skilled clinician and the appropriate manual release technique. That's not to say one is wasting their time or shouldn't employ the soft tissue mobilization techniques that they are allowed to use given their credentialing or state laws, but understanding when to refer to a specialist with a very specific skill set is the difference between a butter knife a ninja – both may get the job done but we all know which one we'd rather have on our side.
So how does one differentiate between these tissues?
Because the Soleus and Posterior Tibialis are the two usual suspects and responsible for the majority of problems when it comes to ankle dorsiflexion limitations, these two will usually require the majority of your focus both in evaluation palpation and treatment.
However, both the Flexor Hallucis Longus and the Flexor Digitorum Longus can limit dorsiflexion and should be excluded to be sure that they are not involved. To exclude these two structures from your list of possible dysfunctional contributors simply ask the patient to maximally dorsiflex their ankle while keeping their heel on the ground.
1. Gently pick up the great toe off the ground into extension. If there is slack and the patient does not indicate an increase in symptoms then the FHL is more than likely not involved.2. Repeat tissue testing by selecting the toes and pulling them into extension. If there is slack and the patient does not indicate and increase in symptoms then the FDL is more than likely not involved.
To identify the underlying tissue whether it be the soleus or posterior tibialis requires some discernable palpation skills.
Did I make a permanent change?
Charlie Weingroff calls it the "Audit Process" while others such as good friend and colleague Pete Viteritti simply calls it, test-treat-retest. If the correct treatment choice was matched to the correct tissue choice and location then a marked improvement in range, function and/or pain levels should occur.
If minimal or no improvements were made than the following may have occurred:
1. You applied the correct treatment to the wrong tissue (tissue adhesion was within the posterior tibialis and you treated the soleus for example), or2. You applied the incorrect treatment to the correct tissue (pressure was too light and thus was not sufficient to break up the underlying scar tissue), or3. The limiting factor was not soft tissue but instead an osteokinematic "misalignment" or a position fault as described and made famous by Brian Mulligan (more Mulligan in a future post).
Summary: The most important step in any treatment approach starts with first identifying the correct pain generator or dysfunctional tissue involved. Without a correct place to start, all treatment options will fail to make a lasting change.
© 2016 Boston Sports Medicine and Performance Group, LLC


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Racket Squad - The Salted Mine (1951)
Capt. John Braddock of the Racket Squad risks life and limb in this episode to help an old friend who has been conned out of money by phoney mine owners.
To Download or Embed this video, go to this link.
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Aug 27, 2010 9:05 AM
Sometimes you have to overlook the fact that someone came late to the party and be glad they showed up at all. That's how we're feeling about Mumford & Sons: Sigh No More ($5). Released earlier this year, this album of awesomeness needs to find its way to your iPod last week. This folk rock band from merry old England brings some serious goodness on "Little Lion Man," "Winter Winds," "The Cave," and "Roll Away Your Stone." Warning - you may be inspired to pick up a banjo.
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The AWARDS-BA³ Distribution, SCM & ERP Software Solution has a number of key software modules available, as outlined below. You can choose the best combination of these ERP, Distribution and Warehouse Management modules to suit your current business needs. Should these needs change in the future, leading to the requirement for new modules...then all you have to do is ask for them.
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"What would ultimately be necessary would be a breakdown of the nation-state system - because I think that's not a viable system. It's not necessarily the natural form of human organization; in fact, it's a European invention pretty much. The modern nation-state system basically developed in Europe since the medieval period, and it was extremely difficult for it to develop: Europe has a very bloody history, and extremely savage and bloody history, with constant massive wars and so on, and that was all part of an effort to establish the nation-state system. It has virtually no relation to the way people live, or to their association, or anything else particularly, so it had to be established by force. And it was established by centuries of bloody warfare. That warfare ended in 1945 - and the only reason it ended is because the next war was going to destroy everything. [1]
"The capitalist or bourgeois class is no longer capable of guiding the uninhibited development of science and technology - again because these objectives now clash with the profit motive. Capitalism has proved incapable of transcending fundamental weaknesses such as under-utilization of productive capacity, the persistence of a permanent sector of unemployed, and periodic economic crises related to the concept of "market" - which is concerned with people's ability to pay rather than their need for commodities. Capitalism has created its own irrationalities, such as vicious white racism, the tremendous waste associated with advertising, and the irrationality of incredible poverty in the midst of wealth and wastage even inside the biggest capitalist economies, such as the United States of America [2]
"The nation-state system was exported to the rest of the world through European colonization. Europeans were barbarians basically, savages: very advanced technologically, and advanced in methods of warfare, but not culturally or anything else particularly. And when they spread over the rest of the world, it was like a plague - they just destroyed everything in front of them. They fought differently, they fought much more brutally, they had better technology - and they essentially wiped everything else out. [1]
"The American continent's a good example. How come everybody around here has a white face, and not a red face? Well, it's because the people with white faces were savages, and they killed the people with red faces. When the British and other colonists came to this continent, they simply destroyed everything - and pretty much the same thing happened everywhere else in the world.
"Because of Columbus's exaggerated report and promises, his second expedition was given seventeen ships and more than twelve hundred men. The aim was clear: slaves and gold. They went from island to island in the Caribbean, taking Indians as captives. But as word spread of the Europeans' intent they found more and more empty villages. On Haiti, they found that the sailors left behind at Fort Navidad had been killed in a battle with the Indians, after they had roamed he island in gangs looking for gold, taking women and children as slaves for sex and labor. [3]
"Now from his base on Haiti, Columbus sent expedition after expedition into the interior. They found no gold, but had to fill up the ships returning to Spain with some kind of dividend. In the year 1495, they went on a great slave raid, rounded up fifteen hundred Arawak men, women, and children, put them in pens guarded by Spaniards and dogs, then picked the five hundred best specimens to load onto ships. Of those five hundred, two hundred died en route. The rest arrived alive in Spain and were put up for sale by the archdeacon of the town, who reported that, although the slaves were "naked as the day they were born," they showed "no more embarrassment than animals."
"So the process of colonization was extraordinarily destructive, and it in turn imposed the European nation-state system on the world, kind of a reflection of internal European society, which of course was extremely hierarchical and unequal and brutal. And if that system continues, I suppose it will continue to be hierarchical and unequal and brutal. [1]
"Europeans used the superiority of their ships and cannons to gain control of all the world's waterways, starting with the western Mediterranean and the Atlantic coast of North Africa. From 1415, when the Portuguese captured Ceuta, near Gibbraltar, they maintained the offensive against the Maghreb. Within the next sixty years, they seized ports such as Arzila, El-Ksar-es-Seghir, and Tangier, and fortified them. By the second half of the fifteenth century, the Portuguse controlled the Atlantic coast of Morocco and used its economic and strategic advantages to prepare for further navigations which eventually carried their ships round the Capeof Good Hope in 1495. After reaching the Indian Ocean, the Portuguese sought with some success to replace Arabs as the merchants who tied East Africa to India and the rest of Asia. I the seventeenth and eighteenth centuries, the Portuguese carried most of the East African ivory which was marketed in India; while Indian cloth and beads were sold in East and West Africa by the Portuguese, Dutch, English, and French. The same applied to cowry shells fro the East Indies. Therefore, by control of the seas, Europe took the first steps towards transforming the several parts of the Africa and Asia into economic satellites [2]"
[All the text in this submission are by the authors listed, not by me. During a recent swim workout, I literally conceived this theme and assembled this exerpted conversation between these great thinkers. - LBD]
[1] Noam Chomsky. Understanding Power. The New Press, 2002
[2] Walter Rodney. How Europe Underdeveloped Africa. Howard University Press, 1972
[3] Howard Zinn. A People's History of the United States 1492-Present. HarperCollins, 1980


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Rexus PST-3 20/24pin Power Supply Tester
The Rexus Power Supply Tester is constructed of sturdy aluminum and allows you to check to see if a power supply is working properly in seconds. An easy to read LCD display on top of the tester shows you the detailed voltage information on each of the voltage rails, and the Power Good (PG) value in milliseconds. Not bad for something that costs ~$20 at numerous retailers.


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A Living Will also called an Advance Directive is a legal document that is ideally signed while the person is in good health.
The purpose of a living will is to have your wishes about your medical treatment written down legally in the event of being incapacitated.
When you are critically ill, have a terminal illness, or in a vegetative state that is permanent and you can't communicate with others an advance directive document tells the doctors and your family about your wishes for the medical treatment wanted or if you decline any medical treatment if you are dying.
Anyone who does not want to be hooked up to a ventilator or any other life saving medical equipment needs to let it be known and the living will is the best way to assure your wishes are followed through to the end.
You can speak with your health care provider and discuss any questions you might have about a living will and any treatments you might wish to have and those you do not want performed.
After your advanced directive (living will) document is drawn up and signed it would be a good idea to give a copy to a family member in case of an emergency and a copy to your personal physician to put in your file in case of the need.
Having a Living Will can save your family members a lot of unnecessary grief. As in the above video.
Online Legal Documents
Or call: (800)962-7490


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2 Aug 07:05 2007
GroupWise 7.0.2 GWIA Post HotPatch 1a - Rev A. 7.0.2HP
Scott Robinson <scottlist <at> tss.qld.edu.au>
Anyone got this to install? I keep getting a application fault when trying to run install.exe to update the files. I need it to (hopefully) resolve an abend introduced with 7.0.2! Turning off DEP doesn't resolve it, and no-one has made any comments in the Knowledgebase or Novell Forums AFAIK. Thanks in advance! Scott -------------------------------------------------------------------- Founded in 1901, TSS is an Anglican Day and Boarding School for boys on the Gold Coast from Prep Year to Year 12. Please visit www.tss.qld.edu.au for information regarding future opportunities at the School. If this message is not intended for you and you have received this in error, please disregard and contact The Southport School on +61 7 5531 9911. Corporation of the Synod of the Diocese of Brisbane trading as The Southport School. CRICOS: 00523F --------------------------------------------------------------------


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TEMPE, Ariz. – Single-game tickets for Arizona State University's home game with No. 23 Wisconsin on Sept. 14 at Sun Devil Stadium will go on sale this week.
The non-conference matchup against the Badgers, 2012 Rose Bowl runner-ups, kicks off at 7:30 p.m. PT and discounted tickets are available as part of an appreciation night for First Responders and the Granite Mountain Hotshots, Tempe residents and employees, and ASU faculty and staff.
A portion of all proceeds will be going to the 100 Club of Arizona, which will also be accepting donations at the game, and the Arizona Highway Patrol Association.
"This night is a way for us to celebrate the community that supports us against the backdrop of an unparalleled atmosphere with the returning Big 10 champion playing in SDS," Vice President for University Athletics Steve Patterson said.
Fans are encouraged to keep their maroon and gold attire in the closet as this is the third annual Blackout Game inside Sun Devil Stadium. In preparation of Sparky welcoming the Badgers to Tempe, he needs the help of every Sun Devil fan in the Valley to stomp out their menacing vermin mascot Bucky by helping to get the word out via social media using the hashtag #BlackoutBucky.
Sun Devil Club members can purchase tickets beginning today, and they will become available to subscribers of Devils' Insider on Tuesday and followers of Sun Devil Athletics' social media outlets on Wednesday before being offered to the general public on Thursday.
First Responder Appreciation Night/ Granite Mountain Hotshots Recognition
SDA will honor the 19 Granite Mountain Hotshots, and three First Responders, including DPS Officer Tim Huffman, Bradley Harper of the Phoenix Fire Department and Daryl Raetz of the Phoenix Police Department, each of who lost their lives in separate incidents this past May.
First responders can receive a 40-percent discount on tickets and raise money for charity by contacting their respective employers for distributed promo codes. Organizations and businesses that wish to purchase the discounted tickets or haven't received the distributed promo codes can call SDA sales consultants Aaron Ostrovsky at (480) 727-3536 or Harris Berger at (480) 727-3527.
First Responder Night also includes a pregame festival with fire extinguisher training, classic police cars and a vehicle from Southwest Ambulance, and the Department of Public Safety's Share the Road presentation.
A pre-game ceremony on the field will feature a moment of silence and the ringing of the Victory Bell 22 times in honor of those fallen. Sparky will also do 19 push-ups each time ASU scores regardless of the actual score, and SDA is working with both teams to wear a No. 19 helmet decal during the game.
The Sun Devils also recognized the Granite Mountain Hotshots at Camp T this past Friday. The wide receivers and defensive backs were the last group of Sun Devils to hike up Mt. Kush and they brought up a white t-shirt bearing the words "Arizona Remembers, 6-30-2013, from all the Arizonians to all the firefighters, we thank you!"
City of Tempe
All Tempe residents and those who work in the city can buy discounted tickets to the game using a promo code that has been mailed to residents in the July edition of Tempe Today Newsletter or distributed to Tempe Chamber of Commerce member businesses.
Faculty & Staff Appreciation
ASU faculty and staff can use their Sun Card to purchase discounted tickets to the game and are also eligible for a 20 percent discount on season tickets.
Single-game tickets for the team's Sept. 5 season opener against Sacramento State are on sale now. There are several ways to buy tickets earlier than the on-sale dates for the remaining five home games, including becoming a season ticket holder.
Season ticket holders can currently purchase discounted single-game tickets at any time other than on the day of each game.
Tickets start as low as $25 or buy a Raising Cane's Family Tailgate Pack, which includes four single-game tickets and four Raising Cane's meal vouchers. Group rates for more than 15 people can also be purchased. The special $10 section is no longer available.
Be sure to arrive early each game for the second year of Devil Walk, which begins 2 hours 15 minutes before kickoff inside Wells Fargo Arena, and will once again feature the 2013 team, the highly acclaimed ASU Sun Devil Marching Band, the Spirit Squad, special videos and highlights, and more.
Students who are not season ticket holders will have the option to buy single-game tickets beginning the week before each home game. Click here to learn more about Sun Devil Student Season Tickets, which includes all home football and men's basketball games, as well as other benefits.
Single-Game Ticket On-Sale Schedule (Sun Devil Club Members/Mondays):
No. 23 Wisconsin - August 19
No. 24 USC - September 2
Colorado - September 16
Washington - September 23
No. 25 Oregon State - October 21
Arizona - November 4
Single-Game Ticket On-Sale Schedule (Devils' Insider Subscribers/Tuesdays):
No. 23 Wisconsin - August 20
No. 24 USC - September 3
Colorado - September 17
Washington - September 24
No. 25 Oregon State - October 22
Arizona - November 5
Single-Game Ticket On-Sale Schedule (Social Media Followers/Wednesdays):
No. 23 Wisconsin - August 21
No. 24 USC - September 4
Colorado - September 18
Washington - September 25
No. 25 Oregon State - October 23
Arizona - November 6
Single-Game Ticket On-Sale Schedule (General Public/Thursdays):
No. 23 Wisconsin - August 22
No. 24 USC - September 5
Colorado - September 19
Washington - September 26
No. 25 Oregon State - October 24
Arizona - November 7


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Consolidated Guidance About Materials Licenses: Guidance for Agreement State Licensees about NRC Form 241 "Report of Proposed Activities in Non-Agreement States, Areas of Exclusive Federal Jurisdiction, or Offshore Waters" and Guidance for NRC Licensees Proposing to Work in Agreement State Jurisdiction (Reciprocity): Draft Report for Comment (NUREG-1556, Volume 19, Revision 1)
This NUREG-series publication was issued for public comment. The comment period is now closed.
On this page:
Download complete document
Publication Information
Manuscript Completed: June 2013
Date Published: August 2013
Prepared by:
L. Cuadrado
C. Z. Gordon
M. R. Simmons
G. M. Warren
Office of Federal and State Materials and
Environmental Management Programs
This technical report contains information intended to provide program-specific guidance and assist applicants and licensees in preparing applications for a general license under Title 10 of the Code of Federal Regulations (10 CFR) 150.20, "Recognition of Agreement State Licenses," by describing the types of information needed from the licensee to complete NRC Form 241, "Report of Proposed Activities in Non-Agreement States, Areas of Exclusive Federal Jurisdiction, or Offshore Waters." This report should be used in preparing requests for NRC Form 241; however, the guidance contained in this report does not represent new or proposed regulatory requirements. It is intended for use by Agreement State licensees, NRC licensees, and NRC staff, and it will also be available to Agreement States. This document also provides contact organization guidance to NRC licensees who wish to work in Agreement States.


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Photos of the frozen Niagara Falls are making their way around Facebook and Twitter, but is the famous tourist attraction really iced over?
The recent "polar vortex" did cause some record low temperatures in the U.S. recently, but it wasn't enough to cause a completely frozen Niagara Falls.
Instead, the falls partially froze over on the U.S. side, but continued to flow otherwise. Word of the frozen falls wasn't a hoax, but many of the photos were not recent.
Watch a video of the partially frozen falls here.
Many of the photos on the Internet, including the one on the left from @GaryB0718 Twitter, are old images from past deep-freezes. The photos were stunning, but they weren't recent. Some dated back to 2007 and others were from 2012.
Reuters photographer Aaron Harris took some photos of the partially frozen portion of the Niagra Falls on January 8, 2014, giving a more accurate look at the icy falls.
Opinionated Nation states that other than the partially frozen U.S. side of the falls, "everything looks just fine via the live webcam at this popular tourist attraction."
Niagara Falls is flowing as usual today, with a few icy remnants left behind.
Suggested Links
- Eagle grabs baby video goes viral: YouTube hoax fools 5 million viewers
- Jon Bon Jovi is dead? RIP Jon Bon Jovi celebrity death hoax on Twitter
- Is Adam Sandler dead? Another celebrity death rumor tops Google trends
- Actor Paul Walker confirmed dead, hoax rumors continue
- Morgan Freeman Newtown quote is Facebook hoax


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Several BYU Cougars of note were not selected at NFL Draft 2014 and so they signed free agent deals on Saturday, May 10. The most notable of the Cougars who went undrafted was wide receiver Cody Hoffman who was thought to have been ticketed as a late round selection.
Instead, Hoffman will have to show off what he can do as a free agent. He signed with the Washington Redskins, fueling speculation that he may have been better off leaving early for the NFL Draft last year when he had the chance -- as opposed to staying in school for his senior year.
Nevertheless, Hoffman had a huge senior year -- and a stellar collegiate career at BYU -- for which BYU head coach Bronco Mendenhall expressed his gratitude for Hoffman and the other three BYU stars who signed free agent deals on Saturday.
The other three players included safety Daniel Sorensen -- who had an amazing NFL Combine -- and signed with the Kansas City Chiefs. Defensive lineman Eathan Manumaleuna inked a free agent deal with the New York Giants and linebacker Spencer Hadley put that Las Vegas episode behind him and will give a pro career a try with the New Orleans Saints.
"I'm proud of what each of these young men have accomplished," Mendenhall said in a press release. "I'm grateful for their many contributions to BYU and our football program and excited they have earned these opportunities with the NFL."
Though Hoffman wasn't selected in the draft process this year, he seemed sort of nonplussed about it all on his Twitter page, which instead contained a lot more enthusiasm than players who were selected at NFL Draft 2014 -- like Utah cornerback Keith McGill -- but who dropped on the draft board before their name was called.
"I'm taking my talents to Washington DC to play for the Redskins!" Hoffman tweeted on Saturday after getting a phone call from the Redskins. For all four Cougars, their free agent deals represent a second chance to prove that teams made a mistake in not drafting them.
Suggested Links
- BYU Cougars football: Kyle Van Noy selected 40th overall by Detroit at NFL Draft
- BYU Cougars football: NFL draft stock for wide receiver Cody Hoffman is fading
- BYU football: Wisconsin series a sign that independence is working
- BYU Cougars football signs Nebraska transfer Harvey Jackson for 2014 season
- BYU Cougars football: Why the Cougars fell to rival Notre Dame again


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From Mayo Clinic Jacksonville, Jacksonville, Florida; Johns Hopkins University School of Medicine, Baltimore, Maryland; and Research Institute, St. Luke's Hospital, Bethlehem, Pennsylvania.
Acknowledgment: The authors thank Gloria M. Petersen, PhD, for critical review of the manuscript.
Grant Support: By the National Institute for Diabetes and Digestive and Kidney Diseases, National Institutes of Health (Dr. Picco); Harvey M. and Lyn Pancoe Meyerhoff Center for Inflammatory Bowel Diseases; Glaxo Institute for Digestive Health (Dr. Picco); and the Allan Guerreri Family Fund (Dr. Picco). Dr. Bayless receives support from the Meyerhoff Center for Inflammatory Bowel Diseases, the Peter and Cynthia Rosenwald Fund, and the Steven A. Mullaney Fund.
Requests for Single Reprints: Michael F. Picco, MD, PhD, Mayo Clinic Jacksonville, 4500 San Pablo Road, Jacksonville, FL 32224.
Current Author Addresses: Dr. Picco: Mayo Clinic Jacksonville, 4500 San Pablo Road, Jacksonville, FL 32224.
Dr. Goodman: Johns Hopkins University Department of Medicine, 550 Building, 600 North Wolfe Street, Baltimore, MD 21287.
Dr. Reed: Research Institute, St. Luke's Hospital, 801 Ostrum Street, Bethlehem, PA 18105.
Dr. Bayless: Johns Hopkins University Department of Medicine, Blalock 461, 600 North Wolfe Street, Baltimore, MD 21287.
Background: The term genetic anticipation is used when genetically transmitted disease manifests at increasingly younger ages with each succeeding generation: that is, if the offspring of patients develop the disease, they will tend to do so at an earlier age than their parents. In some monogenetic disorders, genetic anticipation has a biological basis in expanded genetic triplet repeats; however, some have claimed that it occurs in polygenic disorders, such as Crohn disease, in which its mechanism cannot be explained.
Objective: To show how apparent changes in age at diagnosis of Crohn disease between generations, which could suggest genetic anticipation, can be an artifact of inadequate analysis based on age at diagnosis in cohorts that have not been followed for a sufficiently long time.
Design: Comparison of ages at diagnosis of Crohn disease among different birth cohorts, before and after adjustment for observation time.
Setting: Meyerhoff Center for Inflammatory Bowel Disease, Johns Hopkins Hospital, Baltimore, Maryland.
Patients: 928 consecutive outpatients with Crohn disease.
Measurements: Trends in age at diagnosis of Crohn disease among birth cohorts were determined by calculating Pearson correlation coefficients and performing Kaplan–Meyer analysis before and after adjustment for observation time. Adjustment for observation time was performed by ensuring that the time during which all included patients were at risk for Crohn disease was equal and that all patients had developed disease by the end of the risk period.
Results: Mean age at diagnosis decreased by approximately 5 years with each subsequent 10-year birth cohort on the basis of crude cross-sectional data that could suggest genetic anticipation between generations. However, after adjustment for observation time, the age at diagnosis decreased minimally, if at all, with each successive generation.
Conclusions: Apparent genetic anticipation can be explained by observational biases without invoking any additional genetic influences. Claims for genetic anticipation must be based on methods that properly account for the duration of observation in all persons being studied.
* < 0.001 for comparison of mean age at diagnosis between parents and children at all centers. Baltimore = Johns Hopkins University, Baltimore, Maryland; Belgium = Service d'Hepato-Gastroenterologie, Liège, Belgium, and Hôpital Huriez, Lille, France; CCFA = Crohn's and Colitis Foundation of America, New York, New York; Oxford = Radcliffe Infirmary, Oxford University, Oxford, United Kingdom.
Both ages decrease with each successive birth cohort ( < 0.01, trend test), and age at diagnosis is significantly correlated with birth cohort ( = −0.71; < 0.001) and attained age ( = −0.958; < 0.001). Whisker bars represent 1 SD.
An apparent 5-year decrease in median age at diagnosis in each successive birth cohort was observed ( < 0.001, log-rank test for equality of survivor functions ).
Adjustment was made by restricting the analysis to patients in whom disease was diagnosed before 41 years of age and who had lived for at least 40 years. The birth cohorts overlap and are indistinguishable.
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