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Kia announced the electrified version of the 2014 KIA Soul (Urban Passenger Vehicle) is scheduled to arrive sometime in 2014. KIA only made the announcement about the impending arrival of the 2014 KIA Soul EV and very little else. Expect to see overtly skinny rodents advertising the 2014 KIA Soul EV soon.
"Eco-consciousness already comes standard on the all-new Soul with 85-percent of its materials able to be recycled at the end of its lifespan, and the Soul EV will further demonstrate Kia's engineering capabilities as well as our commitment to producing vehicles with reduced environmental footprints," said Orth Hedrick, executive director of product planning, KMA. "The Soul has always been a terrific choice for drivers in urban environments, and the all-new version's blend of technology, refinement, style, improved dynamics and value has allowed us to create a car that is as efficient as it is fun to drive."
It sounds like KIA is aiming for a unique looking Soul rather than an all new vehicle (a-la Nissan Leaf). Expect to see an updated KIA Soul with a few obvious signs of electric power - namely, a lack of an exhaust pipe. It looks like the basis of the new vehicle will underpin the 2014 KIA Soul EV. If that's the case, I can attest to the solid 2014 KIA Soul's platform.
"Kia's first EV in the U.S. will combine the Soul's funky and iconic design with new styling cues aimed at improving aerodynamics and distinguishing it from non-EV Souls" - - KIA Mwdia
I enjoyed my time with the 2014 KIA Soul and I think KIA is smart to bring out an electric vehicle. I have to wonder, why not opt for a more aerodynamic vehicle like the KIA Rio5? With that said, it will be intriguing to see what KIA comes up with.
Look for more information about the 2014 KIA Soul EV to be announced at an upcoming auto show.


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Freeware / Desktop Utilities / Shedko Badges v1.5
Imagine a program, which will forever change your notion of desktop icons. A program, which in a blink of an eye will assist you in searching lost files or imperceptible folders. A program, so simple and clear to use, and in the same time functional and innovative.
Shedko Software in association with Va-deam's Lab presents 'Badges'.
Badges - the program, allowing placing handy emblems upon familiar Windows icons. From now there is no need to invent sophisticated file names, to drag icons to different corners of the screen or to seek new ico-files for having fast access to a folder with recent projects or with latest images. Place a badge on the desired icon and you will notice it immediately!
10 different kinds of badges, each represents its own semantic category: certified, cool, danger, delete, distinguished, favourite, important, new, personal and web. This will satisfy even exacting users. The quantity of the placed badges is unlimited.
Key Features:
+ Custom themes support. Badges uses special format SBZ as themes. These files are automatically associated with the program and are fully-processed (intuitive drag'n'drop). Want to create your own theme? Check out the 'Badges Icon Design Guidelines ', delivered in English and Russian languages.
+ Seamless integration with Windows Explorer and core services. Badges adds handy items both to contextual menus and also to the file/folder properties tab. You can use simultaneously both options, but there is an opportunity to turn off unwanted one.
+ Interaction with all Windows applications.
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Family centered care means working together with you and your family to make decisions regarding your individualized care. When you add this philosophy to medical and nursing expertise and partnerships with world-renowned academic medical centers, you have an ideal blend of skill and compassion.
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NFL Team Report - Buffalo Bills - INSIDE SLANT
Turns out Florida State's EJ Manuel was the Bills' highest-rated quarterback in the draft - hands down.
Manuel, who is 6-4, 237 pounds, had the largest hands (10 3/8 inches) and longest arms (35 inches) of any of the quarterbacks that worked out at the NFL Scouting Combine. In listing their criteria for what it would take for a quarterback to be successful in Buffalo dealing with cold, wind and rain blowing in off Lake Erie, general manager Buddy Nix and coach Doug Marrone highlighted "strong arm."
But they took it a step further.
"We started talking about the quarterbacks, and we went back and researched all the teams that played in the Northeast in the bad weather and all the success they had with quarterbacks and the common traits that they had," Marrone told SiriusXM NFL Radio and reported via the team's website, buffalobills.com. "They were big and had big hands and were able to throw the ball in tough weather and that's what we were looking at."
Mother Nature even had a hand in helping the Bills scout Manuel.
When he worked out privately for team personnel in Tallahassee, it was windy and raining and Manuel did very well, Marrone said.
The Bills made Manuel the first quarterback drafted, 16th overall and the only passer picked in the first round. West Virginia's Geno Smith went to the New York Jets in the second round, 39th overall. Smith did not perform well in the Jets home stadium in poor weather against Syracuse's Ryan Nassib in the Pinstripe Bowl, but apparently the Jets aren't concerned.
Of course, Manuel brings much more than just impressive physical traits to Buffalo, which in the NFL era had used a first-round pick on a quarterback just twice, Jim Kelly in 1983 and J.P. Losman in 2004. He was 25-6 as a starter and statistically was extremely productive while buying time with his legs and throwing when flushed from the pocket. He's also capable of operating the read option.
"I don't know if I would specifically talk about being able to run the read option, but just the ability to make plays with his feet is what I would concentrate on and that is what we looked at," Marrone said on draft day. "Take him out on the perimeter, elude the rush, make plays down the field with his eyes down the field. That's what we appreciate and look for in a quarterback."
Marrone indicated that veterans Kevin Kolb and Tarvaris Jackson would continue to operate with the first unit when team workouts resume and that Manuel will be brought along. But the general consensus is that Manuel will be Buffalo's starting quarterback sooner rather than later. That's the expectation on young quarterbacks today.
"I expect to come in and compete, I expect to come in and learn," Manuel said. "To me, the biggest thing is coming in and earning the respect of my teammates. I think the best way to do that is not do a lot of talking, just come in and try and learn as fast as possible."
Big hands but not a big ego.
NFL Team Report - Buffalo Bills - NOTES, QUOTES
--The Bills think they upgraded their questionable linebacker depth and talent thanks to a one-for-one trade with Indianapolis in which middle linebacker Kelvin Sheppard, a third-round pick in 2012, was swapped for outside linebacker/defensive end Jerry Hughes, a former first-round pick (31st overall) in 2010. Hughes made six starts last year and finished with 41 tackles and 4.0 sacks. Hughes played as an undersized defensive end for the Colts but the Bills view him as a strong-side linebacker who can also rush on passing downs.
--The Bills won a bidding war for troubled wide receiver Da'Rick Rogers, signing him to a rookie free-agent contract in the hours after the draft concluded. Rogers, 6-2, 216, failed multiple drug tests at Tennessee (marijuana related, he said) before transferring to Tennessee Tech. As a sophomore, he led the Volunteers with 67 catches, 1,040 yards and nine touchdowns. Last fall at Tennessee Tech, he had 10 touchdowns and 893 receiving yards. Rogers has been honest about his past and vowed to NFL teams he was willing to "change" and had been "humbled." The Bills had a very high draft grade on Rogers but drafted two other receivers instead, USC's Robert Woods and Texas' Marquise Goodwin. But Buffalo has showed a willingness to take chances on players with some red flags, including Oregon linebacker Kiko Alonso and Nevada safety Duke Williams.
--Also among 16 rookie free agents signed to round out their roster for training camp was quarterback Jeff Tuel of Washington State. Aaron Corp was released. The Bills scouted Tuel hard before the draft and like him as a developmental player. The 6-2, 221-pounder threw for 5,936 yards, 33 touchdowns and 25 interceptions in 26 college starts. Buffalo's three-day rookie mini-camp starts May 10.
--Bills president Russ Brandon, who talked of using sports "analytics" familiar more in baseball to help his club's scouting effectiveness, said such a department "per se" doesn't exist on the team. "It's another layer to any process when it comes to football," Brandon said. "But it'd be very focused on salary-cap management and everything we do on that front. It will never take away from the scouting process that we have in place now. It would be additional information that it will provide. As we move forward as an organization it's a priority for me. ... It's something that we've embarked on over the last couple of years and we have people that are focused on it but we don't have a complete department per se."
--The Bills turned some heads on draft day by using a sixth-round pick on a kicker, NCAA career scoring leader Dustin Hopkins of Florida State. Thirteen-year NFL veteran Rian Lindell is just 36 points shy of breaking Steve Christie's team career scoring mark of 1,011 points but it's clear he'll have to fight to keep his job.
"It means he's got to compete, I would say," said general manager Buddy Nix when asked what Hopkins' presence means for Lindell. Coach Doug Marrone said he's not opposed to keeping two kickers, one for kickoffs and the other for field goals and extra points, "if I didn't feel comfortable with someone being able to do both." The Bills started off last year with a kickoff specialist, John Potter, but he was eventually let go. The team also replaced their all-time punter, Brian Moorman, with rookie free agent Shawn Powell, who set the team's rookie punting average mark at 44.0 yards.
QUOTE TO NOTE: "Not concerned. Obviously it's an opportunity, as I mentioned earlier, it's an asset (franchise tag) that we have in our holster. He has the opportunity to wait until he's comfortable. We'll continue that dialogue. You always want to have all your guys here, but we understand the situation and we'll just keep working through it." -- Team president Russ Brandon on whether he's concerned that FS Jairus Byrd won't be signed to a long-term deal.
NFL Team Report - Buffalo Bills - STRATEGY AND PERSONNEL
A closer look at the Bills' picks:
Round 1/16 -- EJ Manuel, QB, 6-4, 237, Florida State
No team studied quarterback prospects as hard or thoroughly as Buffalo in what was considered a weak class. But in making Manuel their starter of the future, perhaps this season if he can beat out veterans Kevin Kolb and Tarvaris Jackson, the Bills get the biggest, fastest (4.55) and one of the smartest quarterbacks available. Manuel will need work, like developing the ability to read the entire field and make his progressions. But his size and versatility as a runner and passer gives new coach Doug Marrone a major building block.
Round 2/41 -- Robert Woods, WR, 6-0, 190, USC
On the heels of taking their quarterback, the Bills added one of the elite receivers in college football in Woods, who finished as USC's career receptions leader with 252. After a monster junior year (111 receptions, 1,292 yards, 15 touchdowns), his production dropped as a senior but that was more a product of team injuries and quarterback Matt Barkley's struggles. Runs a 4.43 forty and should be able to step right in and contribute in Buffalo's spread offense that will utilize three and four wides.
Round 2/46 -- Kiko Alonso, ILB, 6-3, 238, Oregon
The Bills desperately need to get stronger up the middle (31st vs. the run) and were willing to take a chance on Alonso, who wasn't a full-time starter until his senior year and has a history of off-field problems. Had 81 tackles including 14 for loss last fall. With his size and foot speed, Bills hope he can run and cover and be a three-down player while helping their run defense improve.
Round 3/78 -- Marquise Goodwin, WR, 5-9, 179, Texas
A very intriguing player who adds to the team's overall speed. Was the NCAA long jump champion who competed at the 2012 London Olympic Games. Clocked a 4.34 dash time for scouts and also impressed the Bills with his desire and ability to block, which will earn him playing time if he can do that at the NFL level. Was a four-year football player at Texas and wound up playing 50 games. Joins a team where jobs are open at wide receiver.
Round 4/105 -- Duke Williams, S, 5-11, 201, Nevada
A sure-handed tackler who appeared in 50 college games and recorded 292 tackles, including 18 that saved touchdowns the past two seasons. He has a very good chance of making the roster with Bills parting ways with strong safety George Wilson and because of his versatility. He can play either strong safety, corner or nickel corner. Plays with an "edge" and Bills' 22nd-ranked defense desperately needs to get meaner.
Round 5/143 -- Jonathan Meeks, S, 6-1, 210, Clemson
Another player to add to the competitive mix at safety, either free or strong. Has great foot speed (4.49) to go with his size. Notched 62 tackles and two interceptions at school where Bills scouts have a lot of connections.
Round 6/177 -- Dustin Hopkins, K, 6-2, 193, Florida State
NCAA career points leader with 466 who has the potential to replace veteran star Rian Lindell. Converted 88 of 112 field goals for the Seminoles, including 9 of 15 on tries from 50 yards and beyond. Strong on kickoffs with average hang time of 4.5 seconds. A freak athlete, who ran 4.71 and did 20 bench press reps at 225 pounds.
Round 7/222 -- Chris Gragg, TE, 6-3, 244, Arkansas
With veteran Scott Chandler recovering from ACL surgery, the Bills covered their bases by using a pick obtained in the Rams trade. Gragg was a top prospect entering his senior year but was limited to five games due to a knee injury of his own. Had a breakout junior year, averaging 12.6 yards on 41 catches and was a strong blocker. Can fill the H-back role in Buffalo's scheme. Very good value at this spot.
FRANCHISE PLAYER: S Jairus Byrd (tendered at $6.916 million).
TRANSITION PLAYER: None.
--DE Spencer Johnson is a backup quality talent, who has just 14 sacks in nine NFL seasons, the last five in Buffalo. He has been a part of some of the worst defenses in Bills history. They can do better.
--WR Ruvell Martin is a 6-4 target who has just 24 catches over the past four NFL seasons bouncing between four teams. Not a high priority to retain.
--FB Corey McIntyre is a powerful blocker for the team's strong runnng game who does his job with no complaints. Should return for his sixth season.
--LB Kirk Morrison was a healthy inactive for 12 games before being released and re-signed. His career is at a crossroad and he's not likely to return.
--QB Tyler Thigpen has thrown just 13 passes in a backup role for two seasons. The team is revisiting its entire quarterback situation and Thigpen probably falls no better than fourth on the depth chart.
RESTRICTED FREE AGENTS: None.
EXCLUSIVE RIGHTS FREE AGENTS: None.
--C Colin Brown: Potential RFA; $1.445M/2 yrs, $25,000 SB.
--RB Tashard Choice: UFA; 1 yr, terms unknown.
--TE Dorin Dickerson: ERFA; 1 yr, terms unknown.
--QB Tarvaris Jackson: Potential UFA; $2.25M/1 yr, $500,000 SB.
--CB/KR Leodis McKelvin: Potential UFA; $20M/4 yrs.
--LB Bryan Scott: Potential UFA; terms unknown.
--DT Alan Branch: UFA Seahawks; $3M/1 yr.
--LB Jerry Hughes (trade Colts).
--QB Kevin Kolb: FA Cardinals; $6.1M/2 yrs, $1M SB/$1.25M RBs.
--LB Manny Lawson: UFA Bengals; $12M/4 yrs, $3M SB/$4.6M guaranteed.
--LB Nick Barnett (released/failed physical).
--QB Ryan Fitzpatrick (released/post-June 1 designation).
--DE Chris Kelsay (retired).
--WR Donald Jones: Not tendered as RFA/Patriots; $4.155M/3 yrs, no SB/$435,000 report/RB each year.
--G Andy Levitre: UFA Titans; $46.8M/6 yrs, $10.5M SB.
--CB Terrence McGee (released/failed physical).
--LB Shawne Merriman: UFA; retired.
--DE Kyle Moore: UFA Bears; 1 yr, terms unknown.
--WR David Nelson: Not tendered as RFA/Browns; 1 yr, terms unknown.
--T/G Chad Rinehart: UFA Chargers; terms unknown.
--LB Kelvin Sheppard (traded Colts).
--S George Wilson (released).


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China Petroleum & Chemical Corp., seeking to reverse a decline in oil reserves, is close to buying stakes in Nigerian onshore oil blocks from Total SA, for about $2.4 billion.
The French explorer, Europes third-biggest oil company, is seeking to divest $15 billion to $20 billion of assets from 2012 to 2014 in order to raise cash for oil and gas projects. Chief Executive Officer Christophe de Margerie has said most of that will come from the exploration and production division.
Chinas state-backed energy companies are seeking new oil and gas reserves abroad to feed it's growing economy.


text:
More New and Used
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Note: Supplemental materials are not guaranteed with Rental or Used book purchases.
Merriam-webster's Dictionary And Thesaurus
ISBN13:by Merriam-Webster
Merriam Webster Mass Market
Questions About This Book?
What version or edition is this?
This is the edition with a publication date of 5/1/2006.
What is included with this book?
- The Used copy of this book is not guaranteed to include any supplemental materials. Typically, only the book itself is included.
Two essential language references in one handy volume featuring nearly 60,000 alphabetical dictionary entries integrated with more than 13,000 thesaurus entries including extensive synonym lists. Clear and concise guidance including abundant example phrases. Based on the best-selling Merriam-Webster's Collegiate® Dictionary.


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July 25, 2013 | Volume 43, Number 29
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College Hockey:2001-02 Bowling Green Season Preview
I know noble accents
And lucid, inescapable rhythms;
And I know, too,
That the falcon is involved
In what I know.
Ice hockey is a game of irresistible beauty, combining the athletic with the aesthetic, power with form, brown with orange.
Ay, Ziggy Zoomba.
As one of the CCHA's two resident enigmas, the Bowling Green Falcons have yet to project a definite team persona. Yes, the Falcons play hard, and goaltender Tyler Masters has emerged as a netminder who can give the team a chance to be in every game, but Bowling Green has yet to establish itself as a team that can rise above the middle of the pack.
"We had a great run at the end of last year and we're looking to capitalize on that as we head into this new season," says Buddy Powers. "In the league, as I said before, every night the games are close. There are a awful lot of one-goal hockey games and if you can win those one-goal games you're going to have yourself a pretty darn good season."
After posting a 4-10-3 record through the first half of the 2000-01 season, the Falcons rebounded through the home stretch, finishing the second half with a solid 12-9-1 mark January through March.
The Big Sweep
During that second half, Bowling Green learned not only how to win, but how to win on back-to-back nights, sweeping Princeton, Rensselaer, Lake Superior, Ferris State, and Miami in two-game series; Princeton and Miami were road wins.
One factor that contributed to that turnaround was better defense in the second half, when the Falcons reduced opponent shots on goal. Masters, who saw more shots than any other goalie in the league last year (28.61 per game), earned his .922 save percentage. As the 2000- 01 season progressed, the BG penalty kill improved to .848, and a few players climbed out of the plus/minus deficit.
— Buddy Powers, on the tightness of the CCHA.
The Falcons will miss the defense and leadership of Doug Schueller, a senior who preached the never-say-die work ethic of the BG squad. It's up to returning blueliners Marc Barlow, Kevin Bieska, and Grady Moore to help the team build on that momentum from the end of last season.
And it wouldn't hurt for Bieska to stay out of the penalty box.
The Multifactorial Falcons
Bowling Green returns its top scorer in senior Greg Day, who last year realized his potential with 20 goals and 27 assists. Fellow senior Scott Hewson (9-20-29) was the third-leading Falcon scorer last season. Sophomores D'Arcy McConvey and Roger Leonard are also expected to contribute to the Bowling Green attack.
While the Falcons were a respectable fifth in the league in goals allowed per game (2.75), Bowling Green had a tough time putting the biscuit in the proverbial basket, averaging 2.67 goals per contest, the eighth-highest scoring team in the CCHA.
Powers knows of which he speaks when he mentions the one-goal games; of their nine second-half losses last season, five were decided by just one goal.
When Buddy Powers says, "I think on any night anybody can beat anybody," he's not just spouting a favorite CCHA cliche – that first "anybody" is Bowling Green, and that second "anybody" is, well, everybody else.
To Have and Have More
With Bowling Green, it's not a matter of discipline, not a matter of desire, not a matter of focus. Only consistency and making the most of the talent they have will help the Falcons fly out of the CCHA's bottom tier.
Score more goals. Stay out of the box. Have some fun.
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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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College Hockey:Bamford Appointed Interim ECAC Commissioner
CAPE COD, Mass. — The ECAC Board of Directors has announced the appointment of Stephen R. Bamford as Interim Commissioner.
Bamford began his tenure at the ECAC in August, 2000 and has served as assistant commissioner for officiating and compliance. Prior to the ECAC, Bamford was the director of athletics at Plymouth State University for 13 years.
Bamfordwill serve in the interim role until a newcommissioner is named andhe will then return to his assistant commissioner position.
The ECAC Board of Directors also named Wayne Dean, senior associate athletics director at Yale University and ECAC Board of Directors vice president aschair of thesearchcommittee.
Former commissioner Phil Buttafuoco resigned his position last month after seven-and-a-half years at the helm.
Although the governance of the Division I men's and women's ECAC Hockey Leagues separated from the ECAC prior to the 2004-05 season, the ECAC still administers Division III ice hockey leagues for the ECAC East, West and Northeast for the men and the ECAC East and West for the women.
A search committee will be named and charged by Feb. 15, 2006.
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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Latest in Articles
The Glory of God
from Keith Mathison Jul 14, 2009 Category: ArticlesThe year 2009 marks the 500th anniversary of the birth of John Calvin. A number of publishers are celebrating this 'Calvin Quincentennial' by releasing new books on the life, work, and teaching of Calvin. Among these are a new book titled Living for God's Glory: An Introduction to Calvinism by Joel R. Beeke. Dr. Beeke is well qualified to edit and co-author such a volume. He is the president and professor of systematic theology and homiletics at Puritan Reformed Theological Seminary and the pastor of the Heritage Netherlands Reformed Congregation in Grand Rapids, Michigan. He has written, co-authored, or edited over fifty books, and he has also written fifteen hundred articles for various publications, including Tabletalk. Keep Reading
The Pastor Scholar
from Philip Ryken Jul 13, 2009 Category: ArticlesAs far as John Calvin was concerned, almost nothing was more urgent for the church than the reformation of pastoral ministry. For centuries, most ministers had been shockingly ignorant of the Scriptures and thus ill-equipped to preach the gospel. As Calvin said in one debate with a Catholic cardinal (pretending to defend the Protestant cause before God): "Those who were regarded as the leaders of faith neither understood Thy Word, nor greatly cared for it. They drove unhappy people to and fro with strange doctrines, and deluded them with I know not what follies." Keep Reading
Longing for Fellowship
from R.C. Sproul Jul 12, 2009 Category: ArticlesWe speak of God as the immortal, invisible, all-wise God. This string of attributes gives some comfort and no small amount of dismay. Keep Reading
See the Heart of John Calvin
from Deborah Finnamore Jul 10, 2009 Category: ArticlesThough his name evokes powerful images—most of them being negative—John Calvin: A Heart for Devotion, Doctrine & Doxology, edited by Burk Parsons, offers a rich portrait of a man whose example and teaching remain vitally relevant today. In the preface, Parsons writes "above all Calvin was a man whose mind was humbled and whose heart was mastered by the Lord God Almighty. His life's prayer—'I offer my heart to you, O Lord, promptly and sincerely'—was an unwavering declaration of surrender to the Lord, whom he sought to love with all of his heart, soul, mind, and strength. Keep Reading
The Theologian
from R.C. Sproul Jul 08, 2009 Category: ArticlesThinkers in the ancient world sought to plumb the depths of ultimate reality. With that quest for ultimate reality came the birth of the discipline of philosophy. Some philosophers focused on one particular aspect of philosophy called metaphysics (ultimate being). Others focused their attention on epistemology (the science of knowing). Still others stressed in their investigation the basic principles and elements of ethics (the study of the good and the right). And others focused on the ultimate foundations for aesthetics (the study of the beautiful). One philosopher stood out as being deeply involved in the study of all of these matters as well as others. Keep Reading
Recreating the Tower of Babel
from R.C. Sproul Jul 05, 2009 Category: ArticlesThere are church buildings that are designed to give no hint of the building's true purpose as a house of worship. They're built to look more like town meeting halls. The chancel is no longer called the chancel, it's called the stage. The pulpit is not called a pulpit, it's called a lectern, and the congregation isn't called a congregation, but it's called an audience. Part of this is a desire to break through the old traditions that people have become inoculated against and no longer want any part of. In at least some cases, it is due to an abiding antipathy to beauty in worship, based on a desire to avoid an empty form of worship that is merely external. The church wants to exhibit that worship comes from the heart, not from external stimuli. Keep Reading
Signature in the Cell
from Keith Mathison Jul 03, 2009 Category: ArticlesIn 1991, Phillip Johnson published Darwin on Trial. In 1996, Michael Behe published Darwin's Black Box. In 1998, William Dembski published The Design Inference. While numerous other books on the subject have been published, these three books are considered landmark works in the discussion over intelligent design. Now there is a fourth. Stephen C. Meyer's new book, Signature in the Cell, may be the most persuasive case for intelligent design yet published. The timing could not be better, since 2009 is the 200th anniversary of Darwin's birth and the 150th anniversary of the publication of On the Origin of Species. Keep Reading
Farmers and the Rest of Us
from Gene Edward Veith Jun 30, 2009 Category: ArticlesMight there be a time when readers of the Bible will not understand -- without a host of reference books -- what a sower is? For most of the world's history, the majority of people made their living from the land. Today the number of family farms is dwindling. Farms have turned into factories. Tractors pulling seeders and tilling machines have replaced the figure of the sower who throws out seed from a bag. But whatever their agricultural techniques, we cannot do without farmers. Perhaps more clearly than any other profession, farmers exemplify the Reformation doctrine of vocation. Keep Reading
The Sense of Touch in Worship
from R.C. Sproul Jun 28, 2009 Category: ArticlesYears ago, I spoke at a service at a large church in California. After I finished preaching, the associate pastor invited everyone who would like to have prayer to come forward to the long kneeling bench across the front of the sanctuary, and seventy-five or eighty people responded. The minister then gave a closing prayer, but as he prayed he walked along the bench and touched each person on the head very gently. I thought, "This is remarkable. This is a recovery, in a sense, of the ancient tradition of having a physical touch that is a part of the worship service." Keep Reading
God's Will and Your Job (pt. 4)
from R.C. Sproul Jun 27, 2009 Category: ArticlesIn addition to the inner call of God, we recognize that there is such a thing as an external call to labor, a call that comes from people who request our services for their particular mission or purpose. We may be called by the church to be preachers or by a company to be foremen or shippers. Every time an organization places a want ad in a newspaper, a human call is going out for able workers to come and match their gifts and talents to a presented need. Keep Reading


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Donald Trump is polling strongly as a presidential candidate, but new data published by Politico Magazine indicates he may be on shaky standing as a brand.
While Trump's business relies on wealthy customers who have the money to patronize his luxury hotels, resorts, and golf courses, a recent American consumer opinion survey noted plunges in the association of "Trump" with categories like "prestigious," "upper class," and "glamorous" ever since The Donald started running for president. Trump's brand also lost holds on "leader," "dynamic," and "innovative" while making gains in "traditional" — a negative category in the luxury business as spam and Idaho potatoes are also considered "traditional" by consumers.
The billionaire Trump might brush off complaints about his politics; he might even shrug off short-term commercial losses. But this plunge in brand status would be seen as a crisis in the offices of any major consumer-oriented company. Public companies often claim losses in net worth when customers turn against them because of a public relations disaster; they call it a decline in "goodwill." As a private corporation, the Trump Organization is not obligated to report any such a decline — or to report it accurately — but any CEO will tell you that a brand deterioration like this is likely to have a significant financial impact, affecting sales, borrowing and even efforts to attract high quality employees. [Politico Magazine]
Read more in Politico Magazine. Jeva Lange
The Pentagon will announce Monday a finalized plan for lifting the military's ban on transgender troops beginning in July. Each branch of the armed services will have a year to determine and implement any resultant changes to uniforms, housing, and recruitment.
The decision is the result of a working group established last summer by Defense Secretary Ash Carter, who said at the time he expected to see the ban go — provided the group did not produce evidence it would have an "adverse impact on military effectiveness and readiness."
Of the 1.3 million current members of the U.S. military, the Pentagon estimates around 2,500 are transgender and about 65 seek gender reassignment surgery each year. Skeptics of proposals to lift the ban have questioned whether the military will begin including reassignment services in its medical care for soldiers, an issue which was not the primary focus of the Pentagon's research to date. Bonnie Kristian
Take heart if you harbor princess aspirations — "tiaras are no longer the sole province of royalty," says Dana Thomas at The Wall Street Journal. The Georgian diamond floral tiara ($210,000) shown here helped trigger the craze when Downton Abbey's Lady Mary Crawley wore it for her 2012 wedding, but just in the past 12 months, fashion houses, including Saint Laurent and Gucci, have introduced glittering diadems into their collections. You could, of course, shop for affordable options, along with other "mere mortals." But London's Bentley & Skinner, jeweler to the queen, is offering 10 antique diamond and pearl tiaras starting at $39,000, including Lady Mary's 45-carat diamond garland. Until it's purchased, it can be rented for $2,100 a day.
A California man who rescued a family from an overturned vehicle has been billed $143 by paramedics for making sure he was OK, The Washington Times reports. First responders gave Derrick Deanda a bottle of water and checked his pulse after he smashed a window and freed four trapped passengers last fall. "A couple of months later I get a bill," Deanda said. "Makes you wonder why people don't want to stop to help at an accident scene."
The World Anti-Doping Agency (WADA) confirmed Friday that it had suspended the laboratory assigned to handle drug testing at the Olympic Games in Rio de Janeiro, Brazil. The decision, which comes just six weeks ahead of the opening ceremony, was based on a "'noncomformity' with international standards," The New York Times reports. The suspension took effect Wednesday, and the lab has 21 days to appeal the decision to the Court of Arbitration for Sport in Switzerland.
However, this isn't the first time the Rio lab has been suspended by the WADA. It last happened in 2013, a year prior to Brazil hosting the World Cup. While the WADA decided to reinstate the lab last year, after nearly $60 million was invested in its facilities and an additional 90 technicians were trained, it has deemed the lab still not up to snuff for the Olympic Games.
The lab will not be allowed to test blood and urine samples during its suspension. So, for now, drug tests are being sent to a lab outside of Brazil to be analyzed. The New York Times reports that it "was unclear Friday if the issue would be resolved — and the suspension lifted — in time for the Rio Games." Becca Stanek
A prominent gun-rights activist is calling on bars to limit alcohol sales so that customers can safely carry guns, The Huffington Post reports. "Control the amount of booze you sell, but don't make them sitting ducks," said Larry Pratt, executive director of Gun Owners of America, a group that criticizes the NRA for being too soft. "That's what gun-free zones do."
Motivational speaker Tony Robbins encouraged a bunch of people to walk on coals. They got burned.
Five people seeking to "unleash the power within!" ended up in the emergency room following motivational speaker Tony Robbins' hot coal-walk exercise in Dallas on Thursday. Dozens more were treated for burns on site, CBS News reports.
Robbins encourages his followers to "turn fear into power" by "storm[ing] across a hot bed of coals." "Once you start doing what you thought was impossible, you conquer the other fires of your life with ease," TonyRobbins.com explains.
At first hundreds of people were thought to have been burned when someone "not familiar with the fire walk observed the event and called 911 erroneously," Robbins Research International said in a statement. "While we are grateful to the quick and robust response from Dallas emergency services, only 5 of 7,000 participants requested any examination beyond what was readily available on site."
The head trainer for the Robbins' organization, Tad Schinke, agreed that five hospitalizations isn't so bad. "I've been doing events with Tony for 23 years," he said, "and while it may not look like that way, this was a successful event." Jeva Lange
Megyn Kelly reminded CNN on Thursday night that its newest hire, former Donald Trump campaign manager Corey Lewandowski, hasn't always been so nice to the folks who are now his coworkers. Lewandowski, Kelly pointed out during an episode of her Fox News show, "has had some very ugly language attributed to him when it comes to women and now he will be getting paid by Donald Trump one day and by CNN the next." (It was announced Thursday that Lewandowski had been signed by CNN as a salaried political commentator.)
Kelly also reminded viewers of a past incident between Lewandowski and CNN's Noah Gray. Last November, Lewandowski "threatened" Gray during a campaign event to "get back in the pen or he's f------ blacklisted." "Think about the CNN reporter, the one who he threatened," Kelly said. "I hope they don't bump into each other in the green room. That's going to be awkward. It's really remarkable."
Watch Kelly's full takedown — with additional remarks from media critic Howard Kurtz — below. Becca Stanek


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27 January 2014
With only 20 weeks to go until the 2014 World Cup kicks off, the British Beer & Pub Association (BBPA) has produced definitive guidance for pubs, to help ensure that this year's World Cup screenings are a success.
Read more
25 January 2014
Try these delicious creamy croquettes on a bed of wilted spinach with a poached egg and hollandaise sauce for a decadent breakfast or warming supper.
21 January 2014
The impressive English oak sideboard in the bar at Ringlestone Inn proudly proclaims: "A Ryghte Joyouse and welcome greetynge too ye all", and a "Truly traditional family welcome" is exactly what awaits you as you step back in time to the unspoilt, medieval, lamp-lit tavern.
Wine or coffee? That is the question for Canterbury City dwellers visiting The Shakespeare Wine and Coffee House, following the completion of a £180,000 redevelopment by Shepherd Neame.
18 January 2014
Use wild rabbit if you can get hold of it. It is leaner than farmed rabbit and has a fabulous, subtle gamey flavour and in many country locations you can pick them up very cheaply.
Contact us by email
Contact us by phone
Shepherd Neame LimitedThe Faversham Brewery17 Court StreetFavershamKent. ME13 7AXUnited Kingdom
Shepherd Neame is authorised and regulated by the Financial Conduct Authority for consumer credit regulated activities.


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Brooke Martin is one 14-year-old that dogs will be pleased to get to know for this teen inventor has just come up with the iCPooch (www.icpooch.com). Brooke devised the device not only to allow dog parents to video chat with their furry children, but also to dispense to them a tasty dog cookie. Pet parents can do this from any location with the push of a button on their smartphone, tablet or computer. The iCPooch launched this past week at the Global Pet Expo in Orlando, Florida. Martin's invention appeared in Booth 4688.
"I was Inspired to create iCPooch to reduce the separation anxiety that our family dog Kayla suffered from, and from which an estimated 13 million other pets in the U.S. suffer," said iCPooch Inventor and Founder Brooke Martin. "It was an honor to announce the launch of iCPooch at Global Pet Expo, among passionate pet enthusiasts. We are grateful for the tremendous support of our generous iCPooch backers and fans that have helped to bring iCPooch to everyone!"
Many schools these days assign some tremendous projects. Brooke Martin was one of the lucky few 8th graders to take her project serious enough to want to take it to market. Brooke was inspired to create the application because she wished to stay connected to her beloved Golden Retriever Kayla while she was away at school. She wanted to alleviate Kayla's separation anxiety. Because of this, Brooke entered her idea for iCPooch into a Startup Weekend competition, receiving the most votes of the 40 ideas presented. Next, Brooke earned a spot as a top-10 finalist in the national Discovery Education 3M Young Scientist Challenge (www.youngscientistchallenge.com) and ultimately the title of 1st runner up in "America's Top Young Scientist" competition. iCPooch progressed to bring its product to market with an extremely dedicated team, and the help of capital and Kickstarter funding.
Now Kayla feels less stressed knowing that she and Kayla can continue to interact all day long. Her bigger goal though was considering service men and women. Now they can interact with their dogs, too, while deployed thus reducing the anxiety that these dogs feel when their pet parents are gone for long periods of time.
While canines cannot tell time, it is the loss that they feel that bothers them. Busy families as well as college students can now interact with their dogs at any time in any place thanks to Ms. Martin.
The iCPooch key features include:
· Delivering a dog cookie with your tablet, smartphone, or computer from anywhere
· Two-way video chat with your dog
· Use the iCPooch all natural gourmet cookies or your own; device accommodates many different sized cookies.
· Connects to your home wireless network using a password-protected site. When you're away from home you can connect to your pet from anywhere by logging into the iCPooch site with your smartphone, tablet or computer and iCPooch will auto answer your home device for your dog.
· No monthly fees
· Easy setup. Download a free app from Apple's App Store or from the Google Play Store, register your device on our password-protected site and you're ready to go.
· Place a smartphone or tablet on the face of iCPooch.
· Use a desktop or laptop computer for video chat at home if you prefer.
· Tablet not included.
· Price $149
· Go to market timeline: spring 2014
For more information about this great device, visit iCPooch at: http://www.icpooch.com and view a product demo.
Like iCPooch on www.Facebook.com/icpooch; Follow iCPooch on www.Twitter.com/icpooch.


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Cumbler, Ethan MD; Castillo, Leilani BSN, CNN, RN; Satorie, Laura BSN, RN; Ford, Deborah BSN, OCN, RN; Hagman, Jan MS, RN; Hodge, Therese COMT; Price, Lisa MD; Wald, Heidi MD, MSPH
University of Colorado School of Medicine, Anschutz Medical Campus, Aurora.
Correspondence: Ethan Cumbler, MD, Acute Care for the Elderly Services, University of Colorado Hospital, 12701 E 17th Ave, Mail Stop F782, Aurora, CO 80045 (firstname.lastname@example.com).
The authors thank Brian Bandle, Denise Alison, Bill Mramor, Marie Andrews, and Lindsay Klingman.
The authors declare no conflicts of interest.
Accepted for publication: April 17, 2013
Published online before print: May 10, 2013.
Hand hygiene occurs at the intersection of habit and culture. Psychological and social principles, including operant conditioning and peer pressure of conforming social norms, facilitate behavior change. Participatory leadership and level hierarchies are needed for sustainable patient safety culture. Application of these principles progressively and significantly improved hand hygiene compared with the hospital aggregate control. Changes to hand hygiene auditing and response processes demonstrate ability to improve and sustain adherence rates within a clinical microsystem.
THE CENTERS FOR DISEASE CONTROL AND PREVENTION reports hospital adherence to hand hygiene as abysmal.1 Observational studies find rates of 5% to 81%.1 A 2010 systematic review confirmed median adherence of only 40%, with lower rates being seen in intensive care units, by physicians compared with nurses, and before compared with after patient contact.2 Even a recent, well-designed, randomized controlled trial of infection control was hampered by poor adherence to hand hygiene, with only 69% adherence demonstrated in an intensive care unit trial to reduce the spread of resistant bacteria.3 The World Health Organization, The Joint Commission, and professional societies have called for increased hand hygiene compliance by health care workers.1,4,5
Conceptually, nonadherence occurs at the intersection of the system, the individual, and the local culture. System-level barriers include time pressure from inadequate staffing, lack of availability of sinks, and poor placement of alcohol-based hand antiseptics.2,6 There also are provider-level barriers to effective adherence, which can include deficits in education on proper hand hygiene techniques and indications to perform hand hygiene.7 Clinician attitudes toward the product's effect on their own skin and provider characteristics such as low self-efficacy predict poor adherence.8–10 It is increasingly recognized that elements of the social environment can influence hand hygiene adherence, in a positive or negative fashion, including role models, leadership buy-in, social pressure, and cultural norms.8,9 Relatively little attention has been paid to the psychological and cultural determinants of hand hygiene and how to operationalize interventions on these factors in applied quality improvement (QI).2
Failure of hand hygiene fundamentals directly impacts the ability to reduce iatrogenic infection. Hand hygiene represents the foundation of hospital infection control measures and is incorporated into bundles of interventions to reduce catheter-associated bloodstream infections, urinary catheter infections, Clostridium difficile infection, and spread of drug-resistant organisms such as vancomycin-resistant enterococci and methicillin-resistant Staphylococcus aureus.7 While study design limitations make it difficult to isolate the impact of hand hygiene alone on hospital-acquired infections, hand hygiene is widely thought to be the most important factor in reducing nosocomial infections.11 Mathematical models suggest that an increase in hand hygiene adherence from 60% to 80% can reduce the rates of infection by multidrug-resistant organisms by 8%.12 Research demonstrates that improvements in hand hygiene rates are correlated with reductions in a variety of hospital-acquired infections including central line and urinary catheter infections.13
Addressing systems-based barriers appears to be effective in improving adherence. Introduction of, and ready access to, alcohol-based hand antisepsis increases compliance with hand hygiene.2,14 In contrast, educational initiatives may be capable of transiently increasing adherence rates, but efficacy is limited and maintaining the gain is challenging.6,13 Observation and feedback have been demonstrated to be an effective method of improving hand hygiene performance.13,15,16 Prior publications suggest that participation in audits and delivering feedback by all unit staff members can create a positive influence on each individual's awareness of his or her own hand hygiene behavior.16 Limited evidence supports the use of positive reinforcement and rewards in improving hand hygiene adherence. One study found a 15.5% increase in adherence with the use of stickers as token positive reinforcement paired with deferred small monetary and meal rewards.6 However, as a sole intervention, this also lacked a sustained effect over time.6
Our premise is that infection control is first and foremost a product of habit amenable to change and that unit culture will be the dominant factor that promotes and sustains improvement. Psychological principles are rarely used explicitly in studies on improving hospital-acquired infections.2,17 We describe the application of generalizable psychological principles to improve hand hygiene as a means to reduce iatrogenic infections as part of a unit-based QI program.
On the study unit during the first quarter of 2010, the rate of urinary catheter–associated infection was 4.8 per 1000 catheter-days. Central line infection was 4.3 per 1000 line-days. The average rate of adherence to hand hygiene on the unit for the first 2 quarters of 2010 was only 78%. In September 2010, the unit convened a Leadership Committee of frontline staff, including nursing, physicians, social work, therapists, and quality staff, interested in performing metric-driven QI.
The interprofessional committee attempted to reduce iatrogenic infections by increasing hand hygiene rates from the baseline rate of 78% to more than 90%. Interventions would be proposed during monthly meetings, based on ongoing performance evaluation of monthly results and 6-month rolling averages. Interventions were adopted by consensus of the committee.
We performed a unit-based QI initiative with an untreated control group using pre- and posttest samples. The study unit was the 13-bed Acute Care for the Elderly Medicine Unit of the University of Colorado Hospital. Unit nursing staff consisted of 23 registered nurses, 5 certified nursing assistants, and 4 advanced care partners (nursing students who are certified nursing assistants). On the unit, a sink with soap dispenser is located immediately inside each patient room, and 2 sinks are located in the unit hallway along with 1 immediately inside each room. Dispensers of alcohol-based antisepsis agents were mounted immediately outside of every patient room. The hospital-wide aggregate performance on hand hygiene was used as a control to assess whether improvements were a product of temporal changes or systemwide improvements unrelated to this unit-based initiative. The University of Colorado Hospital is a 425-bed urban tertiary care hospital and the major teaching affiliate of the University of Colorado School of Medicine.
The primary outcome was hand hygiene adherence rate, with a secondary outcome of catheter-associated urinary tract infection and catheter-associated central line infection rates. To assess the primary outcome, the behavior of interest was presence or absence of a hand hygiene event (alcohol-based waterless antiseptic agent or soap and water hand washing) by any direct patient care provider for an appropriate trigger. Appropriate triggers included entering or leaving a patient room (hand hygiene was required even if no patient contact occurred). A hand hygiene event was also required before, and after removal of, gloves for insertion of central venous catheters or urinary catheters. The World Health Organization's Five Moments for Hand Hygiene was used as an educational tool and framework for audit triggers.18
Monthly hand hygiene audits were reported to the hospital infection control department by every inpatient unit. A minimum of 75 observations in a month were required for audit results to be included in the analysis. Audits were performed using hospital policy definitions of adequate hand antisepsis or hand washing with soap and water. If hands were not visibly soiled, hospital policy recommended an alcohol-based waterless antiseptic agent for routine hand hygiene. Soap and water hand washing is recommended over the use of alcohol-based hand antisepsis by policy for certain situations (including hands visibly soiled, contact with body fluids, and Clostridium difficile contact precautions).
Hand hygiene was audited as adherent if performed correctly by use of the alcohol-based antiseptic on all surfaces of the hand, or by soap and water washing for a minimum of 15 seconds. Audit observations would occur immediately after an appropriate trigger such as entering or leaving a patient room. Any event that would be a trigger for a hand hygiene event, per hospital policy, not accompanied by correct use of the alcohol-based antiseptic or washing with soap and water was audited as a nonadherence event. After the start of direct feedback, nonadherence events with correction after feedback continued to be recorded as nonadherence events. There were no limits on how many adherence/nonadherence events could be audited by the provider or per patient admission.
Performance of the unit was delivered as part of the quality dashboard to the interprofessional unit leadership team on a monthly (hand hygiene rates) or quarterly (infection rates) basis. Hospital-wide performance was included in this report, reflecting the aggregate performance on every inpatient unit.
We used 2 methods to evaluate the effect of the intervention on the primary outcome. First, as is common in QI, we used a statistical process control approach. Run chart analysis was used to look for nonrandom change as a result of the initiative. In general, if 5 consecutive data points are in a consistent trend, or if 6 consecutive points are all above the baseline, then this represents a process alteration resulting in a significant change with a P value of less than .05.19 Second, we used conventional statistical methods. To do so, we calculated the mean hand hygiene adherence on the intervention unit and hand hygiene adherence hospital-wide for both the pre- and postintervention periods. The means were compared using a t test. All analyses were carried out using SAS version 9.0 (SAS Institute Inc, Cary, North Carolina). This project was carried out as a QI initiative and did not meet the definition of research per the US Department of Health and Human Services Regulations.
We used Lewin's theory of change to guide interventions.20 To move from the current state to the desired state, a clinical microsystem must move through 3 phases. An opportunity for unfreezing the current state must be realized, mechanisms for change must be implemented, and processes must be refrozen in the desired state. Leadership style influences culture and performance, and the product of QI cannot be divorced from the social milieu in which it is occurring. On an individual level, operant conditioning can be used to re-form habits congruent with a desired behavior.
A mismatch between the perception of being a unit that excelled in the conscientious and meticulous care of patients and objective data demonstrating staff members were not living up to their own expectations creates "dissonance." In response to cognitive dissonance, individuals will seek to either rationalize away the conflicting views, or the dissonance can drive fundamental change to bring perception and reality back into harmony.21 We used the cognitive dissonance produced by the quality performance metrics and the affirmative choice of this as a metric for targeted change by the team as the driver for unfreezing. Consistent with Lewin's work, we used a participative "democratic" leadership model to select interventions for implementation.
To create change related to the culture of hand hygiene on the unit, we implemented a series of interventions over a 9-month period: (1) real-time feedback—change from surreptitious auditing to immediate feedback and request for correction for all observed nonadherence events; (2) shared responsibility for hand hygiene—change from audits by a single infection control champion to random assignment of auditing responsibility to all members of the nursing staff; (3) level hierarchy—follow-up communication by unit leadership for failure to correct or repeated nonadherence by any individual, regardless of role or rank; and (4) punishment and rewards—delivery of nonadherence "tickets" and reinforcement of adherence with individually wrapped hard candy "lifesavers."
The first intervention was to raise awareness of hand hygiene adherence through immediate feedback. To allow individuals to recognize their personal adherence rate, the goal was to have any observed nonadherence event be pointed out in real time. In effect, this would promote a transition of the act of hand hygiene from an unconscious act, not fully habituated, to conscious awareness. Psychological principles explain the impact of this intervention.22 It uses the power of peer pressure through immediate feedback on hygiene performance at the level of the individual.
Prior practice had been to assign a single "champion" who performed surreptitious audits of hand hygiene adherence. The process was changed such that the champion now assigns any unit staff member to be the auditor of the day. In essence, the unit is always under observation, and any staff member could be the observer.23 An important effect of the new system of rotating auditors is the shared responsibility for monitoring hand hygiene on the unit. This is thought to influence the staff member's own hand hygiene awareness on days in which he or she is not responsible for auditing.16
Repeat nonadherence, or failure to correct, prompted a written response by the unit medical director and the nurse manager to the offending individual regardless of rank or role. Rotating auditors performing real-time correction has potential to violate perceptions of hospital hierarchy. In response to correction events, defensive behavior, or rarely frankly unprofessional behavior, was observed. Such events included examples of a senior attending physician rounding with his team failing to perform hand hygiene after having a nonadherence event pointed out by a certified nursing assistant. For a culture of patient safety, every individual should be an equal in ability to raise concerns about unsafe behavior. If episodes of willful nonadherence are ignored or minimized, the message sent to unit staff is counterproductive. The agreed-on written response was jointly delivered by the unit medical director and the unit nurse manager. Subsequent high-level responses also enlist the head of hospital-wide infection control to individuals who are repeat offenders, fail to correct, or respond unprofessionally. Rather than keep these episodes quiet, every staff member on the unit knows about the response to unprofessional individuals.
For the final interventions, we began giving out "tickets," small cards with a stop sign and strongly worded instruction to immediately correct behavior, for observed nonadherence events. The tickets do not come with consequences other than the pressure inherent in the public correction. They serve as social punishment.22 Individuals, by and large, do not like being singled out for failing to adhere, creating motivation to attend to hand hygiene to avoid this negative social interaction.
Maintaining a positive culture is critical for sustaining improvements. Nonadherence tickets have potential to create a negative culture, and a ceiling effect may be experienced as higher rates of adherence lead to fewer opportunities to maintain awareness. In response, "positive tickets" were created to recognize adherence events. This promotes conditioned reinforcement and allows the auditor for the day to have many more positive than negative interactions.22 Later, the reward of individually wrapped "lifesaver" candy was provided for observed adherence events, creating what is, in effect, operant conditioning.22 The positive effect on the individual being rewarded, and perhaps on unit culture, created by intermittently rewarding with a small sweet treat is less prone to wane with time.22 The interventions represent new standard operating procedures on the unit, which increase the probability that the improvements will sustain at the new level (refreezing).
Hand hygiene adherence has progressively improved from a baseline of 78% in the first half of 2010 to 97.2% in the second quarter of 2012 (Figure). Analysis of the run chart reveals that changes are not consistent with random variation, with 7 consecutive quarters above the baseline performance at the same time as hospital average performance remained unchanged.
Next, we examined mean pre-post intervention changes. During the preintervention baseline period (January 2010-June 2010), the study unit's mean hand hygiene adherence (78%) was 7.9% lower than that of the entire hospital (86%) This difference was not statistically significant (P = .12). Over the entire intervention period (October 2010-June 2012), the mean hand hygiene adherence on the study unit (90%) was 6.6% higher than that of the entire hospital (83%). This difference was statistically significant (P = .0005). There has not been a single iatrogenic infection on the unit for the 2 years since the beginning of this QI initiative.
Hand hygiene is a sociocultural phenomenon that occurs at the intersection of individual habit and the cultural norms of the unit. The strength of this series of interventions is derived from utilization of simple psychological principles to enhance patient safety. Four structural changes to hand hygiene observation and subsequent response resulted in a substantial absolute increase in hand hygiene adherence, and the results have proven durable. Because these elements are now built into the standard work of the unit, they are less subject to the transient rises in adherence, which can be a result of episodic educational initiatives. Simple, inexpensive interventions such as this can be maintained with minimal resources or additional staff time.
Some important limitations of this work deserve mention. External validity is challenging for studies involving culture change, which are inextricably linked to local factors. The impact of role modeling by influential staff members on the leadership team may have created changes that are specific to this milieu. It was not possible to objectively verify the interrater reliability of auditor assessments. There is potential for discomfort in delivering negative feedback to change auditor behavior. This initiative was performed on a smaller unit within the hospital, and it is interesting to consider whether culture change is more difficult when attempted with a larger population. Prior research demonstrates the impact of role models and local culture on provider behavior, and attempts to use these same interventions on larger units or hospital systems need to consider how to take these factors into consideration.23,24 A small unit with participation by senior clinical staff and physician faculty may have lower barriers to culture change. That said, even large complex organizations are composed of clinical microsystems from which effective practices can be disseminated.25 Unit infection incidence was low, and it is not possible to draw firm conclusions from reduction in iatrogenic infection rates. With those caveats in mind, the positive slope of hand hygiene improvement from the baseline for the unit compared with the steady rate of adherence at a lower level of performance for the rest of the hospital supports that these interventions were creating meaningful change.
Immediate feedback takes awareness from the level of the unit to the level of the individual and changes hand hygiene from unconscious to conscious behavior. Rotating staff assignment to perform observations may alter their own hand hygiene behavior and can be a potent tool in its own right. Peer pressure and conforming norms can be harnessed to drive improvement through social punishment and intermittent immediate rewards. Visible support from leadership early in confronting unprofessional responses to the initiative is needed to effectively level the hierarchy. Hand hygiene adherence at the level of the individual is a product of habituated behaviors and should be interpreted in the context of the social milieu but is amenable to change using simple psychological principles.
clinical audit; culture; feedback; hand washing; infection control; psychology
© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
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MC Frontalot welcomes your crush notes, apology demands, and alarming bulletins that you forgot to check on snopes prior to forwarding. Put the word bandersnatch somewhere in your subject heading and it will be easier for Front to rescue your mail should it be kidnapped by his spam-hating bot squad. firstname.lastname@example.com
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The Sturgenius holds down the northern part of the Frontalot Northeastern Drummers Association. He is sometimes available for live or studio gigs throughout New England. email@example.com
Vic-20 is Front's latest live action ivory tickler. Also, he has the voice of an angel. His indie career is in full swing. email@example.com
Baddd Spellah is a frequent collaborator of Front's and a mighty, mighty beatsmith. firstname.lastname@example.com
Contact the booking hotline. We know that hotlines are usually phone numbers, but this one is an email box. We will get back to you right away. email@example.com
If you're looking to bring the unspeakable glee of Frontalot's live nerdcore hip-hop revue to your club, convention, or other venue, here are some data points for you:
MC Frontalot was born in 1973. The fronting has increased exponentially since. platinum albums find MC Frontalot threatening retirement. His legion of fans will sob quietly to themselves.
Journalists and nerdcore historians in need of more thorough biography data are encouraged to request access to the press page.
Do you know of interviews or articles or reviews or segments or frothily fawning featurettes that indicate the existence of MC Frontalot yet are not listed here?
Clue us via email.
Needless to say: MC Frontalot will not spam you with enticing offers for penis extension secrets and offshore pharmaceuticals. He will not tip you off to hot penny stocks or beg you to help him launder US$177,000,000.00 that he picked up while running a government office in Chad. He does not care how much you could be saving on your mortgage.
Also, he will not share your address with unsavory internet types or Homeland Security.
Alternately, send a mail to firstname.lastname@example.com.
Watch for the confirmation mail! It is probably junked already.
This is the announce-o-list for MC Frontalot, now running on good 'ol mailman at frontalot.com. It will contain notices of new song postings, live performances, notable media appearances, and things that Front discovers near the back of his fridge. To get you started: the milk was very old. But it is gone now.
Mails will arrive with firstname.lastname@example.com in the from: field and firstname.lastname@example.com in the to: field. If this perplexes your spam filters, you will not receive list traffic. Possible solutions include putting both those addresses in your address book, altering filter rules manually, and hitting the entire internet with a cudgel.
Visit the Archive to see prior postings to the list.
To unsubscribe, get a password reminder, or change your subscription options, enter your subscription address:
Would you like to suggest a question for the FAQ? Well, you can't. But soon there will be a little submission form for that very purpose, and Valued Suckers will sort out their favorite ones for Front to answer in this very space.
Keep an eye out. Or just be on the mailing list (see above).
Q. Shouldn't it be spelled M.C. Front-a-Lot?
A. No. But feel free to proofread the rest of the site for me.
Q. Aren't there like thousands of nerdcore rappers these days?
A. Please don't exaggerate. It is true, though, that there are many; scores, if not hundreds. You can browse the Wikipedia entry on nchh for those deemed "notable" by someone who typed things into Wikipedia.
Q. Aren't there famous(er) rappers who are nerdcore?
A. Well, sure, if you accept the criterion that rappers are nerdcore just because Front lists them in his FAQ. Bear in mind that none of these have publicly admitted to being entirely geeked out, and some may even consider themselves cool: MC Paul Barman, Del (particularly in Deltron 3030), MF Doom, Doctor Octogon, MC 900 Foot Jesus, Blackalicious (though only in rare moments such as Alphabet Aerobics and Chemistry Calisthentics).
Q. Are there any internet superstars who are not rappers who MC Frontalot likes to listen to?
A. Only a few: Add, The JBB, Frankie Big Face, Kompressor, Drew, Bradsucks, Baddd Spellah, Brother Machine, actually everyone on Indie Pop Cares A Lot, and Andrew Ayers.
Q. If Front were a real nerd wouldn't he tell us which web comix to read?
A. In fact, he would! And they'd be Diesel Sweeties, White Ninja, Dr. McNinja, Cat and Girl, Achewood, Eat My Comix, Overcompensating, Toothpaste for Dinner (also Married to the Sea), Jerk City, Scary Go Round, Exploding Dog, and Goats. You already read Penny Arcade. It is hard to avoid mentioning certain comics that are not (primarily) web comix. So here's those: Perry Bible Fellowship, Tom The Dancing Bug, everything by Tony Moore, Dan Clowes, Dame Darcy, James Kochalka, Jim Woodring, Julie Ducet, Chris Ware, Craig Thompson, Dave Cooper, Charles Burns, Seth, Peter Bagge, Ben Katchor oh duh and Garfield.
Q. Can I be MC Frontalot's friend on a social networking site?
A. Yes! Try him at his MySpace (and his fan-run music profile there). But be careful for your eyes. MySpace has so much ugliness. You can try him at Facebook, too. Or just follow his Twitter.
Q. MC Frontalot, how do I use the internets?
A. It's easy and fun! First, install Firefox. Then get all of the FF extensions that Frontalot treasures: DownThemAll, Firebug, Flashblock, IE Tab, MouseZoom, and Xmarks. This will give you access to "web sites." Next, get a gmail account and start sending everyone you know lists of lawyer jokes that you found on the "web sites." Alternately, get a POP or IMAP account somewhere and use a mail client (Front hates all mail clients too much to recommend one). For advanced internets usage, you'll want to have FlashFXP, BitTorrent (or probably Vuze), a Usenet client (Front's fave, NewsGrabber, has been out of print for a while), WinSCP, UltraVNC, Pidgin, and mIRC. Oh, if you're using an OS named after a cat... I don't know, maybe they still make Fetch? They definitely make Boot Camp to help your computer do normal things.
Q. Why does the text look all blocky and shitty at frontalot.com?
A. WinXP: Maybe you don't have font smoothing turned on. Right-click on the destop, choose Properties > Appearance > Effects, then check "Use the following method..." and select ClearType. I can't believe I'm giving you tech support. Also, I heard WinXP doesn't exist any more. Hooray!@!
Q. Can I put MC Frontalot on my internet radio show/personal-use mix CD/answering machine message?
A. Yes, but only if you do all three.
Q. I saw MC Frontalot posting on the [fark/somethingawful/etc] forums. Was that really him?
A. Maybe! Maybe not. It is hard to tell, because internet. You can ask him, if you want, he will tell you if he ever posted somewhere before, and then you won't have to wonder.
Q. Didn't there used to be a Media section? With hilarious fakery?
A. Sure did! It's hidden here, and two of the articles are still broken.
Q. Did Front really convert Edward Gorey's lettering into a typeface?
A. Yup. Long-ass time ago.
Q. Isn't MC Frontalot just a cheesy rap parody novelty act, worth barely a moment's smirking half-appreciation?
A. Ya moms is a cheesy rap parody novelty act, worth barely a moment's smirking half-appreciation! No more questions.
Q. I thought you said no more questions.
A. Okay, one more.
Q. What's the future of Public Enemy?


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Dept/Div. Contact: Planning Division - (209) 577-5267
• • •Description: A lot-line adjustment is required to move a property line between two or more existing adjacent lots or parcels without creating a new lot.
Examples: A lot-line adjustment may be used whenever minor adjustments are needed to a given lot or lots. For example, if one property owner wishes to purchase a portion of an adjoining lot, a lot-line adjustment can be used to move the property line to the new location, increasing the size of one parcel, and decreasing the size of the other. The overall number of parcels may be reduced by a lot-line adjustment, however no new parcels may be created.
A lot-line adjustment application will need to be submitted. Once the application packet has been determined to be complete, most projects will take 30-45 days to process.
Where to submit:
Planning Division
1010 Tenth Street, 3rd Floor [Directions]
(209) 577-5267
What to bring:
- 1 Lot-Line Adjustment Application Packet, containing:
- Application Form, signed by property owner(s)
- Agreement, signed by property owner(s) (notorized), submitted along with original notary(ies)
- 8-8.5" x 11" detailed drawing of property(ies) involved; drawing to reflect existing and proposed details
- Legal Property Descriptions: prior to and following lot-line adjustment
- Clerk-Recorder Fee (special instructions noted in Lot-Line Adjustment Application Packet)
- Payment for Lot-Line Adjustment Fee
Information/Forms: (#LLAA)<%=getForms("#LLAA")%>
All application packets must be received by a Planning Technician or Planner to determine if all submittal criteria have been met. A staff member will be assigned to work with the applicant(s); the application will be reviewed for completeness and referred to pertinent agencies to determine zoning compliance.
If the resulting lots conform to the City's zoning regulations, and if no problems are found with the agreement or property descriptions, the lot-line adjustment will be approved by Planning Divisions staff; however, documents cannot be recorded with the County Clerk-Recorder until the appeal period has passed.
As noted in the Lot-Line Adjustment application packet, there is a 15-day appeal period in which parties may challenge staff's decision.
Final Action
After the required 15-day appeal period, the Secretary of the Planning Commission signs the Certificate of Approval. The City will record the agreement and the Certificate of Approval with the County Clerk-Recorder.
These documents are provided in PDF Format. You must have a PDF viewer in order to open these documents. Click here for the free Adobe Acrobat viewer.<%=getForms("#LLA")%>
Contact our Planning Division at (209) 577-5267.<% If instr(strURL,"aspscripts/pfp.asp") then %>


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The Iowa men' basketball team will face off against Big 12 representative Texas in one semifinal game of the 2K Classic benefiting the Wounded Warrior Project.
The Hawkeyes and Longhorns and will square off at Madison Square Gardon on Thursday, Nov. 20, and Syracuse and California will follow in the other semifinal. The announcement was made by the University of Iowa recently.
All four schools will play a pair of regional games on their respective campus before heading to the Big Apple for the semifinals. Iowa-Texas tips off at 6 p.m. and the Golden Bears and Orange will meet at around 8:30 p.m. Both games will be aired by ESPN2.
The championship game will feature the two winners on Friday, Nov. 21. The tip off for the 2K Classic final will follow the consolation game at 4 p.m. and the title game will be shown on ESPN2 and the consolation contest is either on ESPN2 or ESPNU.
Iowa and Texas have played four times on neutral floors, with each team winning twice. The Hawkeyes won in 1992 and 2004, while the Longhorns have won the last two meetings in 2005 and 2009, both of which were in Kansas City, Mo.
The Hawkeyes lead the all-time series with California, 6-4, and Iowa has beaten Syracuse in both of their meetings in 1957 and 1980.
Iowa beat California 83-80 in the longest game in Iowa basketball history in 1960. The Hawkeyes needed four overtimes to claim the win.
Iowa last visited Madison Square Garden in the 2013 National Invitation Tournament. Iowa beat now Big Ten representative Maryland in the semifinals before falling to the Big 12's Baylor in the title game.
Iowa, Texas, California and Syracuse have combined to play in 109 NCAA Tournaments.
Suggested Links
- Iowa Basketball: Hawkeyes get commitment from three-star small forward
- Iowa Basketball: Hunted Hawkeyes lose third straight game
- Iowa Basketball: Marble selected 56th in NBA Draft, will play for Magic
- Iowa Basketball: Men's season ends after disappointing defensive effort
- Iowa Basketball: JUCO All-American inks scholarship with Hawkeyes


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The 27th summit of the Supreme Council of the Gulf Cooperation Council (GCC) concluded in Riyadh today. Custodian of the Two Holy Mosques King Abdullah bin Abdulaziz opened the summit, known as the Sheikh Jaber Summit, in a ceremony yesterday.
In a final communiqué, the Supreme Council said that the summit reviewed the achievements in all areas since the last meeting in Abu Dhabi, and conducted a comprehensive assessment of regional and international political and security issues.
On steps toward GCC economic integration, the Supreme Council accredited a unified guide for controls on imported food, an important requirement for a GCC customs union. The Council also instructed that the necessary measures should be taken to announce the establishment of the GCC common market by the end of 2007.
Further studies are needed for the establishment of a monetary union with a single currency as well as for an integrated water and railway grid, the communiqué said. It endorsed a study on a peninsula shield force submitted by King Abdullah. The Council was also briefed on the steps needed to allow Yemen to integrate into the GCC economies.
The communiqué highlighted the GCC's firm renunciation of terrorism in all its forms. Terrorism is a global crime that requires regional and international cooperation to combat it, the Council said. The communiqué also stressed that terrorism is an extremist phenomenon that has nothing to do with religion or identity, and that all peoples are responsible for confronting the causes of terrorism.
On the issue of Iran, the Council reiterated its call for a peaceful resolution of the crisis and called on Iran to continue dialogue and cooperation with the International Atomic Energy Agency (IAEA). It also urged Iran to consider the environmental aspects of the issue.
In related matters, the Council renewed its call for a Middle East free of weapons of mass destruction, and commissioned a joint study on the use of nuclear technology for peaceful purposes according to international criteria. It also urged Israel to sign the Nuclear Nonproliferation Treaty.
On Iraq, the Council expressed its profound sadness at the deteriorating situation there and denounced all terrorist actions, killing and sectarian violence in the country. It called for the support of Iraq's unity, sovereignty, identity and independence. It also emphasized the need for non-interference in Iraqi internal affairs. National reconciliation is the solution to Iraq's problems and a basic requirement for stability, the Council stated.
Turning to the Palestinian issue, the communiqué strongly condemned Israel's aggressions against the Palestinian people. The Council stressed its support for the Palestinian people and called on the international community to end the repeated Israeli attacks. It affirmed the need to convene an international conference to halt Israel's attacks and to restart the peace process according to the Abdullah peace plan, the Road Map for peace and international law.
The Council called on the Palestinian leadership to exert more efforts towards establishing unity and to speedily form a national unity government. It welcomed the cease-fire between Israelis and the Palestinians as an important step towards dialogue and the resumption of the peace process.
The communiqué said that a just and comprehensive peace in the Middle East will only be achieved by the establishment of a viable Palestinian state with Al-Quds as its capital and with the Israeli withdrawal from the Syrian Golan Heights and the Shebaa Farms in southern Lebanon.
The Council concluded that the absence of a just solution to the Palestinian issue and the suffering of the Palestinian people have aggravated disputes in the Middle East, and called on the international community to make resolving the conflict a priority.
On Lebanon, the Council strongly denounced the violence there and the political assassination of Lebanese Industry Minister Pierre Gemayel. Such actions increase tension, it said. The Council reiterated its support for Lebanon and called on the Lebanese people to unify in order to overcome the current critical situation.
Turning to Sudan, the Council expressed regret for the ongoing humanitarian tragedy in Darfur and urged the Sudanese government and the various warring factions to opt for dialogue in the national interest. The international community should assist Sudan in resolving this issue, the Council said, noting that the Sudanese government has taken a number of positive steps.
The Council called on warring factions in Somalia to negotiate a resolution to their differences; urged the United Nations to address the issue of missing Kuwaiti POWs; and reiterated its support for the UAE's claim to the Tunb islands and Abu Musa. It also renewed the term of office for GCC Secretary-General Abdulrahman Al-Attiyah for three years, effective April 1, 2008.


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Divide up your space and give your classroom a fun new look with this car room divider panel. The panel slides into your space connectors or gate (sold separately) to make separating the room easy. The car shape brings a bold look to your classroom or daycare facility and is reversible with red on one side and yellow on the other-- primary colors that your young students will love!
Made of birch laminate, this car panel is durable enough to last year after year in your classroom or daycare.
Fully assembled. This product has been Greenguard certified to support better indoor air quality for schools, libraries, churches and public spaces.


text:
The tracks at MySQL Connect 2013 will cover the critical topics facing developers today on the most-popular open-source RDBMS, MySQL. Sessions will be led by many of the leading experts from around the world. What you need to know, what you want to know, what you have to know: you'll find it here.
How should you architect and develop your MySQL-based applications? What are the latest trends and best practices? Get answers to those questions and more by attending this track's presentations.
MySQL is the leading database in the cloud and a key component of many big data platforms, with Hadoop vendors estimating that 80 percent of their deployments are integrated with MySQL. Join us to gain expertise in unlocking new big data insights with MySQL and running the world's most popular open source database in the cloud.
Already the leading Web database, MySQL has become the leading cloud database, offered by the vast majority of cloud services providers. Organizations of all sizes are rapidly evolving toward relying on cloud computing, and sessions in the Cloud Computing track give you the expertise you need to develop, deploy, and manage MySQL-based applications in the cloud.
Want to become a superstar MySQL DBA or DevOps engineer? This track's content provides the tips you need to boost your productivity as well as best practices from some of the planet's premier MySQL professionals. MySQL 101 sessions will also be offered to beginners.
Data is the currency of today's Web, mobile, social, and enterprise applications. Ensuring data is always available is a top priority for most organizations, and using the right high availability and replication strategy can make a huge difference. This track's sessions cover technology selection, architecture, and best practices for high availability and replication.
Are you looking to confer the best performance and scalability to your MySQL-based applications? Explosive growth in data volumes and velocity are pushing the boundaries of database scalability. This track will teach you how to power the most demanding applications.


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Athough natural gas cars are considered to be both economical and reliable, they are still proving to be a hard sell on Long Island according to New York State's DMV, which reports that only 760 out of 2 million registered vehicles there run by natural gas. A separate survey by the Greater Long Island Clean Cities Coalition (from 2012), however, puts the number of cars closer to 900. In turn, only 1% of the entire US fleet of vehicles are now hydrogen-powered, with most of those used by utility companies, buses and government cars.
The main hold-back for increasing sales can be put directly to the lack of refilling stations, notes Ford, which offers more natural-gas vehicles than anyone else across the country. In fact, there are only 12 re-fueling stations currently available to the public on Long Island, with another 12 privately owned.
Ford reports that it sold 15,000 hydrogen-powered vehicles last year. The company now has a line of 8 gas-powered trucks on the market for 2014, ranging from its popular F-series pickups to small Transit Connect delivery vans and chassis for school buses and RV's.
"We've seen the business effectively doubling each year," stated Jon Coleman, fleet sustainability and technology manager for Ford Motor Co. However, he does admit that it costs between $6,000-$8,000 to have modifiers added to fuel tanks and fuel lines and unique fuel injectors for each car or truck when a customer chooses the option.


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Skydiving.com now has a network skydiving location serving Marshall and Lyon County in Minnesota. Call Skydiving.com at 1-800-617-7948 for details, free information and specials on skydiving in Marshall, MN today!
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text:
March 15, 2002
Top-seeded Kansas is preparing for its second-round Midwest Regional game as if Kirk Hinrich will not in the lineup.
"I'd say it's doubtful," forward Nick Collison said. "He can barely walk today."
The all-Big 12 guard sprained his left ankle near the end of the first half of the Jayhawks' 70-59 first-round victory over No. 16 seed Holy Cross on Thursday night. He didn't participate in Friday's closed session in preparation for Saturday's game against No. 8 Stanford, and coach Roy Williams said if the game had been Friday then Hinrich would have been unavailable.
But he has been able to discard his crutches. Williams said he'll decide after the shootaround Saturday whether Hinrich will be able to participate in pregame warmups. Hinrich was not made available for comment Friday.
"Last night, I thought he had absolutely no chance," Williams said. "He says it feels better and he is walking without a limp, but I can't believe what he tells me."
Stanford (20-9) will only count Hinrich out when he's not on the court for the opening tip. Coach Mike Montgomery said Kansas (30-3) will do the "same thing, not quite as well" without Hinrich.
"They have a great system and the pieces fit in the system and it's a very solid, proven system," Montgomery said. "But we're figuring on him playing."
When Hinrich went down, Williams said it was like losing three players. Hinrich is averaging 15.2 points, 5.2 assists and 4.8 rebounds, and is a 46.5-percent 3-point shooter.
"There's no question that Kirk is our most valuable player in one aspect in that he can play so many spots," Williams said. "His ability to run the floor, we don't have anybody else that can simulate that, that can give us that same look.
"You lose your best perimeter defender, you lose the guy that makes your break go, you lose your backup point guard and you lose a guy who can shoot and penetrate."
If Hinrich can't play, Williams said he'll give freshman Keith Langford his first career start. Langford is averaging 7.5 points and three rebounds in 20 minutes a game.
"Keith gives us some things, the ability to rebound and slash to the basket," Williams said. "It changes our team a great deal, but at the same time they're not going to give us a three-day break."
By R.B. FALLSTROM
AP Sports Writer


text:
Permanent URL to this publication: http://dx.doi.org/10.5167/uzh-35869
Bettschart-Wolfensberger, R; Semder, A; Alibhai, H; Demuth, D C; Aliabadi, F S; Clarke, K W (2000). Cardiopulmonary side-effects and pharmacokinetics of an emulsion of propofol (Disoprivan) in comparison to propofol solved in polysorbate 80 in goats. Transboundary and Emerging Diseases, 47(6):341-350.
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The aim of this study was to determine whether any pharmacokinetic or pharmacodynamic differences exist in goats between propofol in its currently licensed form (Disoprivan) and a new 1% solution of propofol (NSP) containing polysorbate 80. Nine goats received, on two different occasions in a randomized double-blinded order, 4 mg/kg propofol intravenously (i.v.; Disoprivan or NSP). To detect differences in cardiopulmonary effects and pharmacokinetics, the Wilcoxon signed rank test for paired data was used. In the NSP group the duration of initial apnoea was significantly longer, and 6 and 12 min after drug application PaO2 levels were significantly lower than in the Disoprivan group. Mean cardiovascular parameters did not differ significantly between the groups but in the NSP group in six goats marked changes in blood pressure occurred: systolic arterial pressures fell to a minimum of 40-60 mmHg within the first 10 min. This was followed by a marked increase in blood pressure, with maxima exceeding 300 mmHg. In the NSP group the half-life of propofol was significantly longer, the clearance rate was smaller and the areas under the drug concentration-time curves were larger than in the Disoprivan group. The cardiopulmonary side-effects of NSP suggest that propofol dissolved in polysorbate 80 is not a suitable alternative to the current formulation of propofol.
12 citations in Web of Science®
15 citations in Scopus®
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Additional indexing
|Item Type:
|Journal Article, refereed, original work
|Communities & Collections:
|05 Vetsuisse Faculty > Institute of Veterinary Pharmacology and Toxicology
|Dewey Decimal Classification:
|570 Life sciences; biology
|Deposited On:
|09 Nov 2010 17:17
|Last Modified:
|05 Apr 2016 14:15
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A plugged duct usually feels like a tender lump in the breast. It may be warm and have some redness over the lump.
Plugged ducts can happen when milk is not drained well from the breast. This can happen when there is too much pressure inside the breast.
Pressure outside the breast may also cause a plugged duct. A few examples:
Breastfeed more frequently, starting with the breast with the lump. It may help to have your baby's nose or chin pointing to the blockage.
You should call a certified lactation consultant (IBCLC) or health professional trained in lactation support if you are not improving within 24 hours. Plugged ducts can lead to mastitis. If you are having flu-like symptoms (achy, fever, chills) and a red, hot area over the lump or red streaking, call your doctor to get antibiotics.
For additional information on this Health Topic, call the Center for Breastfeeding Medicine at 513-636-2326.
Last Updated 10/2015
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