text:
|Home | About | Journals | Submit | Contact Us | Français
Cervical cancer (CCA) remains a health challenge nationally and globally. In the US, more than 12 000 women are diagnosed each year with invasive cervical cancer and more than 220 000 are living with a history of this diagnosis (ACS, 2003). This qualitative study aims to examine health related quality of life (HRQOL) from a culturally consistent framework.
Key-informant interviews (N=23) and focus group interviews (N=51) were conducted with a multiethnic sample of cervical cancer survivors (CCS) recruited from hospitals and clinics.
Content and theme analyses were conducted. Findings indicate that cultural and family factors often promote coping and well-being, but may foster delay in care seeking and self-deprecation, particularly among Latina and Asian CCS. Faith in God was relied on for comfort, strength and healing by many survivors, especially the African Americans and Latinas. Overall, our participants reported moderate HRQOL. However, persistent concerns included treatment side-effects; difficulties accessing quality care; inadequate health insurance, barriers to good physician-patient relationship such as language and doctors' time constraints; insufficient knowledge about CCA due to limited information from medical staff; lack of control over treatments; social support, family well-being, functional and work issues; and sexuality and relationship concerns. Socioeconomic status, ethnicity, cultural beliefs and practices, age and family support dictated the level of cancer-related burden.
Invasive CCA is primarily a cancer of women who are economically disenfranchised. Women with a CCA diagnosis are disproportionately challenged by lack of resources including quality, affordable health care and psychosocial services. CCS experience persistent medical, psychological, social, and relational concerns. Information concerning CCS is needed, particularly in Spanish, Vietnamese and Korean. There is an urgent need for further research to understand the risk factors, and the social and cultural mediators of cancer-related HRQOL for CCS.
Cervical cancer (CCA) remains a national and global health challenge. An estimated 12 000 women nationally and 1600 women in California will be diagnosed with invasive CCA this year (ACS, 2002, 2003). SEER incidence rates for invasive CCA among African American, Asian, Latino, and Caucasian women are 11.2, 12.1, 15.3, and 7, respectively, per 100 000 (NCI-SEER, 2001). Almost 4 200 US and 500 California women die each year due to CCA. California has the highest CCA rate: over 11% of the cases in the US (ACS, 2002) Among Caucasians, incidence and mortality rates have declined by approximately 60% over the past two decades, but regrettably, the mortality rate for African Americans has risen almost 10% between 1976 and 1997. The 5-year survival rate is lower for ethnic minority women: 72% for Caucasian and 58% for African Americans (ACS, 2002; NCI-SEER, 2001). Among Latinas and Asian Americans, incidence and mortality have increased in the past 5 years.
CCA, or cancer of the cervix uteri, is one of the more easily detected (via the Pap test) and highly treatable cancers. One of the major causes of CCA is malignant cell change resulting from untreated human papilloma virus (HPV) infection. Many more women are affected with this illness than are diagnosed with cancer. The primary cancer preventive strategies are early diagnosis and timely, appropriate medical care. Yet, each year thousands of women fall through the net of care and are diagnosed with invasive CCA or in situ CCA (stage 0 or CIN III) because the system poses such barriers to access and health education, particularly among underserved women. Invasive CCA is most prevalent among the socio-economically disadvantaged and medically underserved (Krieger et al., 1999; Liu et al., 1998). In the US and California, ethnic minorities are over-represented among the poor; a significant number of African Americans (23%), Asian/Pacific Islanders (10%), Latinos (21%) and Native Americans (32%) live below the poverty level (US Census Bureau, 2000). Although ethnic minority groups are the fastest-growing populations in California and the US (US Census, 2000), and experience greater incidence, greater morbidity and lower five-year survival rate, there is a paucity of cancer control research with ethnic minority and under-served patients (Aziz and Rowland, 2002), especially in the area of health-related quality of life of cancer survivors.
The body of literature on HRQOL and CCA is limited. Studies report data with mostly Caucasian women (samples typically 90% Caucasian), include various gynecological cancers in the samples and focus primarily on sexual functioning (Andersen, 1996; Schover, 1989; Shingleton and Orr, 1995; Thranov and Klee, 1994; Yeo and Perera, 1995). Padilla et al.'s (1992) HRQOL study with 100 women with gynecological cancers (including 38 with CCA) reported that identified mood states, ambiguity about illness-wellness state, danger-focused appraisal and mastery were key predictors of HRQOL scores. Some studies document persistent physical symptoms (pain, bowel and bladder problems) (Klee et al., 2000a) and psychosocial concerns (worry, depression, anxiety, inadequate social support) (Eisemann and Lalos, 1999; Klee et al., 2000b; Lambley, 1993) after CCA treatment, particularly radiation therapy. However, research on CCA specifically is insufficient, particularly with multi-ethnic and underserved samples. Most studies on ethnic minorities and CCA have focused on epidemiological issues (e.g. incidence, mortality) and screening (Morgan et al., 1996; Thomas et al., 1995). A few studies have explored health beliefs and/or QOL issues with diverse groups of cervical cancer survivors (CCS). A recent study with 50 Latina CCS found significantly higher levels of depression than in other cancer patients and community samples of Mexican-Americans and non-Hispanic Whites (Meyerowitz et al., 2000). Social support, general stress, family issues, relational and sexual issues, physical symptoms associated with treatments, and barriers to obtaining treatment are common concerns (Li et al., 1999; Meyerowitz et al., 2000; Nair, 2000; Ohaeri et al., 1998), particularly for ethnic minorities. Further, most participants wanted additional access to cancer-related support (support groups or individual psychotherapy) and additional information about CCA and treatments. Perceived social support from multiple family members was significantly associated with better adjustment. (Meyerowitz et al., 2000).
This qualitative study was designed to describe the cancer experience in a diverse sample of CCS: African American, Latina, Asian American and Caucasian women. UCLA IRB approval was obtained. Key informant and focus group interviews were conducted in the Greater Los Angeles area by bilingual research assistants with at least 3 years cancer-related research experience, and basic training in qualitative methodology and psychosocial oncology.
Twenty-three key informants were interviewed to gather information about CCA from health professionals who work with diverse ethnic communities. Interviews were guided by Dr Ashing-Giwa's previous work and a review of the CCA literature. Domains addressed included attitudes, beliefs, and knowledge about cancer, health-care system issues, and cultural and socio-ecological factors that influence the HRQOL outcomes of women with CCA (Table 1).
Informants were physicians, nurses, and health-care administrators knowledgeable about and involved with diverse cancer patients, and were recruited from community hospitals, health clinics, and cancer-related organizations. Informants were contacted by telephone and all agreed to participate in a 1 h, face-to-face, audio-taped interview to discuss the status of CCA in the communities they serve. Informed consents were obtained and the interviews followed a semi-structured, open-ended format.
Fifty-one women from four major ethnic groups participated in focus groups to (1) document women's cancer experiences and (2) further explore the issues identified in the key informant interviews. Topics included attitudes, beliefs, and knowledge about CCA, health-care issues, quality of doctor-patient relationship, and cultural and socio-ecological issues (Table 2).
Groups were organized according to homogeneous ethnic and/or linguistic groupings. Hospital and community health clinic directors were first contacted by telephone to assess interest and willingness to involve their group members or patients for a special focus group meeting. Individuals were sent written invitations from the agencies describing the focus group format and proposed incentives. Participants were recruited via a personal telephone call from agency representatives or via fliers posted at the agency. It was not possible to calculate participation or refusal rates as agency personnel did not record refusals.
Focus group size ranged from 4 to 10 individuals. Each audio-taped group lasted about 2 h and was held at the recruitment site to provide a familiar environment. The informed consent process and participant orientation were conducted during a meal. Women were encouraged to respond to all the issues raised, but were informed that they had the right to not respond to any issue. Participants sat in a circle to foster openness. At the end of the session, women were thanked for their participation and given a $20 grocery voucher.
Detailed summaries of each key informant interview and focus group discussion were conducted and selected quotes were transcribed verbatim. Discussions conducted in Spanish and Chinese were translated into English for analyses. Comprehensive content analysis was conducted using a tabular matrix pre-established from the domains of the questions.
Major themes were identified (see Appendix). Results from key informant interviews and focus group discussions will be discussed separately in order to fully present the information.
Twenty-three key informants (7 African American, 6 Asian American, 6 Latina, and 4 Caucasian) participated: 3 men and 20 women. On average, informants were 50 years old (range of 25–70 years) and had 19 years of cancer-related work experience (ranging from 2 to 35 years). Most held positions with administrative and clinical responsibilities (medical, psychosocial, or educational patient care). All had worked with diverse ethnic communities with varying socioeconomic status (SES), language abilities and length of time in the US.
The key informants described CCA's impact on women's lives as multifaceted. First, CCA and its treatments often profoundly affect women's overall health via infertility, morbidity, and mortality. Latinas were believed to bear the greatest burden, in that more Latinas are diagnosed, particularly at younger ages and more advanced stage, in part due to inadequate healthcare. Additionally, many patients experience negative psychosocial reactions, e.g. fear, shock, denial, anxiety, depression, anger, and shame due to the perception that CCA is associated with sexually transmitted diseases and promiscuity. When left unaddressed, the informants warned that these reactions may likely impact treatment-seeking behaviors, especially among women of color. Finally, some CCA treatments have left women burdened by infertility, negative body image, and feeling flawed as a woman and sexually undesirable. Unfortunately, these concerns are rarely voiced and addressed, as patients often feel uncomfortable and embarrassed. The informants agreed that a consistent, trusting relationship with their doctors must be established in order for CCS to present these concerns.
The primary socio-ecological factors were SES and language. Women of lower SES and limited English fluency, many of whom are recent immigrants and heads of households, have similar issues across ethnicity: less access to care, less knowledge about CCA and resources, more likely to be uninsured or under-insured, more likely to view the diagnosis as a death sentence, and to equate asymptomatic state with good health. For many, family and finances are prioritized over their own health. These factors create barriers to screening, care and treatment. Lower SES women have difficulty keeping treatment and follow-up care due to transportation problems, work circumstances (inability to take time off, threat of job termination, loss of wages), or lack of childcare. Frequent change of residence is another challenge to promoting timely treatment and follow-up care. Moreover, one African American informant noted that stigma associated with government assisted healthcare plans (e.g., MediCal) has turned African Americans away from utilizing such plans.
Social support was identified as another key socio-ecological factor. According to the key informants, Caucasian CCS view support from friends as most important, followed by family and spousal support. Also essential is balancing social support with independence (i.e. not becoming too dependent on the family/caregiver). For African American CCS, social support from family and friends is very important. However, many African American CCS are unpartnered and thus have one less source of support. Informants who work with Latina and Asian American CCS noted that these women view spousal support as essential; support from other family members and friends is also important. Family provides support through doctor's visits, transportation and medical compliance. For all CCS, children often provided powerful motivation to get well. However, family problems may also delay treatment seeking.
Most key informants agreed that beliefs in communities of color that CCA is a contagious, sexually transmitted disease stigmatizes those with the illness. Some cultural beliefs and practices may increase women's vulnerability to gynecologic illness (e.g. douching after intercourse to prevent pregnancy and infection). Additionally, CCA screening (e.g. yearly pap-smears) are shunned by some Latina and Asian women because it is unacceptable to expose women's genitalia or discuss sexual health concerns.
Culture also affects how CCS cope with the illness. Key informants observed that African-, Asian- and Latina- American CCS, particularly the less acculturated, often do not question doctors about diagnosis or treatment. Beliefs in the superiority of alternative medicine (i.e. home remedies, herbs) over Western modern medicine exists across some ethnic groups, particularly with older, lower SES and/or more recently immigrated women. An increasing number of women across ethnicity incorporate complimentary and herbal medicines into their treatment. Across ethnicity, spirituality and religion are also important. Use of prayer to cope with CCA is very common. However, informants suggested that religious beliefs could also impose undue burden on CCS (e.g. belief among many Latina and Asian American CCS that cancer results from divine punishment). Among the very religious, the idea that God will heal them without medical support was prevalent, leading to serious negative outcomes.
Another barrier to healthcare identified was the doctor-patient relationship. Informants reported that people of color as a whole harbored substantial distrust of providers and disenchantment with services due to history, personal experiences (e.g. lack of continuity of care) and others' negative experiences. An African American informant noted, 'A lot of African American women are aware that racism impacts the quality of care received.' Latina key informants reported that older Latinas feared being used as 'guinea pigs' by the medical establishment. Informants believed language and communication problems contributed to this sentiment, as patients often feel intimidated by doctors and embarrassed about asking questions. They are not usually encouraged to ask questions nor are they actively involved in the treatment decision-making. Communication barriers, lack of cultural sensitivity, and limited time spent with patients created impediments to care and treatment adherence for ethnic minority women. Informants urged doctors to treat CCS with dignity and coordinate care with other providers to increase compliance.
The consensus among the key informants was that cultural factors and socio-ecological contexts influenced women's HRQOL and how they define and cope with CCA. Informants agreed that poverty was the main contributor to CCA diagnoses and poor outcomes. Poverty dictated several risk factors including lack of knowledge about CCA and treatments, uninsured or underinsured status, and limited access to timely, appropriate healthcare. Informants noted that many patients, particularly ethnic minority and underserved, often lack empowerment, knowledge and time to navigate the complex health care system. Informants identified support as a major buffer against stress for all CCS, and emphasized the need to increase support structures (patient advocates, social workers) within the health care system. They acknowledged the major role of religious beliefs and practices in coping, both positively and negatively, especially among ethnic minorities. Finally, they highlighted the need for the health care system to enhance cultural sensitivity and employ bilingual staff to improve quality of care.
The 51 CCS participated in 7 different focus group meetings: Chinese group (n=6); mixed Asian group including 3 Thai and 1 Japanese women (n=4); Caucasian group (n=5); African American group (n=10); and three Latina groups (n=26; 8–9 per group). The Chinese and Latinas groups were comprised of less acculturated, monolingual women and were thus conducted in the women's native languages.
Table 3 describes participants' demographic and diagnostic characteristics. All the African Americans were diagnosed with cervical dysplasia; all Caucasians, 80% of Latinas and 50% of Asian Americans had CCA. A third of Asian Americans and almost 40% of Latinas did not know the stage at diagnosis. The African Americans were the youngest (mean age of 33 years) and Caucasians the oldest (mean age of 56 years). Almost all Asian Americans were married versus less than half of Latina, 20% of African American, and 40% of Caucasian CCS.
Table 2 lists the domains covered in the focus group discussions. Major themes are also presented in the Appendix.
The women discussed various strategies to recovery. African Americans stressed timely medical care and trust in God. Asian American CCS cited religious faith, family support, complying with doctors' recommendations, attending check-ups, and sustaining normal routines as most important in recovery and coping. Proper surgery and treatment were most important for survival for the Latina CCS. They were motivated to get well through a positive attitude, religious faith, family support, and the desire to see their children grow up. However, some had great difficulty coping with the diagnosis. One Latina stated:
At first I refused to accept the diagnosis and I went to Mexico to get a second opinion and saw three different doctors but unfortunately they all gave me the same diagnosis. It took time for me to accept it but I wanted to make sure of the diagnosis and the results were not a mistake.
Caucasian CCS spoke of being educated about the illness and proactive in the treatment. Also helpful was enlisting support from doctors and other CCS, and maintaining normal routines:
After my gynecologist called me and said that I had cancer, I immediately asked for a second opinion. I had my tissue samples from the biopsies reviewed. Then, I went on the internet and got as much information as I could get, talked to other doctors and friends that were doctors that knew about cancer. I kind of knew what to do and it also… psychologically gave me something else to focus on rather than feel despair.
Participants across ethnicity expressed the importance of support from immediate and extended family. Mothers, spouse/partners, and children were the principal sources of support. Family members frequently accompanied patients to appointments and performed household chores. A Japanese survivor recalled:
My mother was really there for me. She cooked a lot of meals and went with me to my appointments even a year later.
Many Latina survivors were dependant on their spouses for providing emotional as well as financial stability. This was poignantly stated by one woman:
I'm very fortunate to have my husband's support emotionally and with family care. Without him I'm sure I wouldn't be feeling as I feel today… me siento segura (assured and secure) or talking with others about my cancer experience.
However, one African American woman was reluctant to go to her family for support:
I don't say much to family because I don't want them to know much particularly when I didn't get that much information from doctors. My family can't help me so I don't want sympathy. Why tell people? Keep it to yourself.
Moreover, friends were important sources of emotional support and information for Caucasians.
All the African Americans agreed on the importance of (a) prayer and of seeking God's guidance and assistance in coping with the illness, and (b) doctors as God's instruments in healing. One patient explained that both are involved in healing:
A lot of people think that they shouldn't go to the doctor. They do things such as take herbs or steam treatments instead. It's important to use prayer and ask God for assistance… put it in His hands either way it goes. God knows the end result before you do.
Similarly, faith was a significant means of coping with the illness and pain for the Asian American CCS. One Chinese survivor explained, 'You can tell God when you are in pain, and you get support from Him.'
Latina CCS found support and relief through church and religious faith. They likewise experienced comfort and peace in prayers. Latina and Asian American CCS held a strong sentiment that the condition is beyond their control and in God's hands. Thus, they were able to feel at peace by turning the situation over to God and accepting God's will. One Latina stated:
If He doesn't want me to be here on earth anymore there is nothing I can do about it and I will accept God's decision whatever it'll be.
Many Caucasian CCS also discussed the importance of spirituality, support from clergy, as well as practicing visualization and relaxation to promote healing.
While the African Americans believed in the importance of seeking prompt medical care for any body changes, they indicated that many in their community tolerate severe symptoms before seeking medical attention. They stressed that patients need to speak up for themselves because doctors often do not provide much information. They also believed that they have some control over their body and illness by practicing cleanliness and disinfecting behaviors (e.g. douching):
You do have control over things when you notice things are different about your body. You don't want to ignore this. It is important to take care of this by going to the doctor and get medication. [However], no one has total control over things. You try to be brave and have a better handle of [the disease].
Asian American CCS deemed controlling one's mood as important in handling a major illness, specifically having a positive attitude, maintaining a sense of peace, and avoiding stress. While some Chinese CCS believed that illness could be controlled through proper diet, physical activity, controlling one's mood, and following doctors' advice, other Asians felt frustrated over developing CCA despite a healthy lifestyle. The more acculturated CCS felt that women need to be involved in their medical treatment by asking questions and educating themselves.
Latina CCS discussed the importance of the following in handling CCA/dysplasia: (1) be informed about the illness, get treatment, and be actively involved in one's care; (2) practice healthy behaviors (better diet and better hygiene after sex); (3) seek family support; and most importantly, (4) accept God's will because one does not have much control over cancer.
The Caucasian CCS likewise believed that one does not have much control over getting cancer. However, they found it helpful to gain a sense of control by gathering more information, practicing healthy behaviors (dieting and exercising), and being involved in their treatment.
Cultural beliefs shaped the women's feelings about illness and health outcomes. Most had theories about causes of the cancer. Asian American and Latina CCS believed that being married, monogamous or older translated into lower risk for CCA. Stress and poor diet, on the other hand, were thought to be causes. While Caucasian, African American, and Asian American CCS were more likely to attribute some responsibility to their partners, Latina CCS were more likely to assign blame to themselves, to view cancer as a form of punishment and a death sentence, and traditional herbs and diet as curative:
The day after my diagnosis I went to visit my father, I held his hand and asked him for his forgiveness if I had been disrespectful or failed in something. He wondered why I was doing that but I preferred to keep quiet.
Traditions have a lot to do with our behavior today and attitudes towards getting informed about any other disease but particularly about cervical cancer, because in the Latino community a topic related to female organs is a sexual issue to be considered a taboo. It is something not discussed even within the family.
Most of the women of color believed that 'keeping clean' or douching/washing before and after sex prevents CCA. A Latina survivor stated:
I think cervical cancer can be controlled, if we wash before and after having sex, and if we watch what we eat, maybe we can prevent getting it. Women with cervical cancer should avoid having intercourse which can cause infections.
Additionally, the African Americans were taught to partake in low fat diet, exercise, and regular doctor's visits to keep healthy. The Asian women described general health practices taught by their families: avoid certain foods, eat fruits and vegetables, and promptly treat symptoms.
Recurrence of the cancer, metastasis, and early death were common fears across ethnicity. Latinas were concerned about leaving their families without caregivers, while Caucasians expressed fears about painful deaths, isolation, and the unknown. Worry about daughters developing cancer was discussed by the Latinas. The African American CCS attributed some of their fears to lack of information received from doctors. Additionally, many were concerned about doctors' lack of sensitivity during pelvic examinations. Besides fear of deterioration of their condition, the CCS indicated that pain and fatigue from the illness were also disruptive. One African American noted that intense pain associated with dysplasia has made her life more difficult.
Most of the African American and Caucasian CCS expressed feeling damaged and worn out after the diagnosis. One African American CCS confided:
My body is gross. I don't feel clean until I find out what is wrong with me. I bathe a lot and scrub down there.
Asian and Latina CCS were extremely concerned with illness and treatment effects on fertility and appearance (hair loss). Loss of fertility was particularly distressing for women who had not yet had children. One Japanese survivor lamented:
You grow up thinking you'll have kids. Now you won't. What is my role as a woman, I ask myself? What is different from a man?
While concerns about physical appearances existed across ethnicity, Latinas expressed more negative feelings about their bodies after surgery (abdominal scars, adverse effect on self-image and self-worth as women), and deep concerns about the impact on their relationships:
Nothing will be the same. My body won't be the same because they removed my ovaries, fallopian tubes, and womb.
In general, CCS felt that younger women are more affected than older women. Additionally, the dysplasia survivors expressed little femininity and body image concerns.
Some single African Americans experienced loss of libido in part due to fear that sex would worsen their condition. Those with sexual desires often had difficulty finding partners. Married African Americans reported forcing themselves to have sex with their husbands. One woman's comment exemplified the group sentiment:
I have no sexual desire. I force myself. He's just on top of me and I wait until he's finished.
Most of the Asian American dysplasia survivors did not feel their relationships were adversely affected. However, some disclosed problems, such as lack of libido and pain. Additionally, fears about injuring or aggravating the affected area adversely affected the frequency and quality of sexual relations. According to a Japanese survivor:
It is a psychological thing. You're just afraid. It's just such a delicate area. You think about when it would hurt. We're intimate but it is not the same. You are afraid when you visualize what is going on in there. What are you going to disrupt? As a married couple, you want to give, but you're not as free. The love is the same, but the quality of the sexual activity went down.
The Latina CCS discussed how the perception of women with hysterectomies as 'incomplete' and 'lacking sexual desire' resulted in stigma and abandonment by their sexual partners:
Two months after my diagnosis my husband left me for another woman. It has been a nightmare for me not only because of the diagnosis but also because my ex-husband's woman constantly calls to insult me that I'm not good as a woman anymore, that I can no longer have children and that I will die from cancer.
Some Latina CCS reported positive effects of CCA, including stronger relationships, ability to end bad relationships, and relief from not having to engage in sex:
After my cancer diagnosis over a year ago, I decided to leave [my partner] before he did it to me. Even before my diagnosis, we were having problems because of his alcoholic habits and I would not want to be a bother or to be insulted as a woman. It also has been a relief not having to worry about pleasing him sexually.
Caucasian CCS experienced many physical symptoms from the illness and treatment that made it difficult for them to enjoy sexual intimacy. Single women found it hard to date after diagnosis and treatment. Sexual problems resulted in relational difficulties among the married women.
African Americans, Caucasians, Latinas, and more acculturated Asians all believed women need to be proactive, educated, and involved in their health care. Most of the monolingual Asian Americans, however, preferred doctors to make the decisions for them. The majority of the women of color did not seek second opinions.
Overall, Asian Americans expressed more satisfaction with support received from doctors and in their relationships with doctors than the African Americans, Latinas, or Caucasians. One Chinese survivor noted, 'The relationships are very good. Doctors are caring for us. We feel comfortable.' Although some African American CCS felt their doctors were congenial, they were dissatisfied with their insufficient explanation of test results:
My pap was abnormal and the doctor called and simply said it would be addressed during my next visit… when I asked, they said I had pre-cancer cells but [the doctor] didn't explain what that was.
Another African American survivor recalled her experience and frustration in vivid terms:
Just because they told me there is nothing there, I don't believe it. I want to see what they are doing and taking out of me. When I got the colposcopy, they put that yellow stuff in me. I was wearing pantiliners and noticed snuff looking stuff. I called the doctor because I didn't know if my insides were coming out. I thought I was going to die. They said that it comes from the medicine. They treat us like cattle and didn't tell me beforehand that that will happen.
Another common complaint was doctors' lack of sensitivity during physical examinations. One African American survivor put it eloquently:
When [doctors] insert instruments …don't just stick it up there. I'm not a prostitute. I'm not wide open. My body is a temple.
Latina CCS also expressed a number of concerns: lack of continuity of care, embarrassment and doctor insensitivity during pelvic exams, insufficient time with doctors, language barriers, and long wait for appointments. Sentiments shared included:
It took hours for [my doctor] to see me and even then I was only seen for a few minutes because he did not have the time to listen to me. He only reviewed my chart and recommended that I make an appointment to go back and see him. To me that was and still is frustrating.
I don't speak English and the doctors don't speak my language so how can I or anyone who does not have the ability to communicate be assured they are getting the proper care? We have to depend on a translator and still feel like they are not asking what we really want to ask the doctor.
It is uncomfortable and embarrassing to be seen by a stranger especially for this particular exam. We are not raised like that and those are private issues. It interferes with getting care and we wait until it is completely necessary, maybe that contributes to having a higher risk of getting the disease.
The male doctor is too rough. I felt like I was dying.
Immigration status was also a concern for undocumented Latina and Asian women. Fear of being reported to immigration officials inhibited receipt of certain services. Additionally, they felt that removal of language barriers would improve their relationships with providers.
Latinas and Caucasians agreed that one's financial and insurance status affect quality of care. Education and knowledge about CCA also influenced care. These CCS felt that educating women about post-surgery issues (e.g. pain, psychosocial concerns) were lacking and needed. Caucasian CCS related both positive and negative relationships with their doctors:
We had a good relationship. He was very young, but he was also very comforting. I found the doctors to be wonderful and they remind you to have your check-ups and taking my meds.
Some doctors like to play God and they won't say when they did something improperly. The way I found out that a doctor could do a pap smear incorrectly is by reading the pathology report that I got in my medical file. I was surprised at how many times my doctor didn't get the correct sample when I had already been diagnosed and treated. The smear would come out inconclusive and he'd say, 'You're fine, just come back in 2 or 3 months.' But he wouldn't say anything else.
When it was obvious that I had cancer, I went to see my gynecologist. I had a pap smear which they said was inconclusive. And it horrified me to realize that I had a huge tumor in my cervix and the pap smear didn't detect it. I went to two doctors who didn't give me complete and accurate exams. The cancer was already so advanced. I was in complete pain and unable to walk. I got a female doctor…she did everything right. Two days later I saw an oncologist.
The African Americans did not experience much doctor support. Often the only recommendation given was for follow-up tests. However, they would like to have received health practice-related recommendations. All the participants reported attending the follow-up appointments. While all the Asian American CCS reported following doctors' recommendations, they did not feel that their doctors provided any special help. Some Chinese survivors' reported their doctors recommended increasing water intake and exercise, and applying ointment (for dysplasia). About 30% of Latinas followed doctor's recommendations (e.g. diet) and abstinence for dysplasia. Many were more willing to comply after seeing other CCA patients who became disabled as a result of non-adherence to treatment. While some reported receiving support from doctors and others reported receiving none, notably none of the Latinas were informed about cancer support groups.
The African American and Latina CCS believed lack of money or insurance results in poorer quality of treatment. One African American stated:
I went to a hospital one time and the nurse treated me very rude when she thought I didn't have health insurance. But when she found out I did, she became more friendly and helpful.
Another African American related how she was passed over in a clinic where most of the staff and patients were Latino. The Latina CCS believed that doctors at low-cost clinics were less competent, less professional, and unable to provide continuity in care. Translators were often unavailable or poorly trained. Similarly, Caucasian CCS felt that in less expensive clinics, where gynecological doctors are also obstetricians, pap tests are less thoroughly conducted and results not carefully reviewed. The Asian American CCS did not perceive any barriers and/or discriminatory treatment in accessing care, even those who were uninsured.
Competing demands (work, household chores, finances, commitment to family and children) placed considerable stress on the women. The African American survivors' experiences included:
Kids, taking the kids to school, taking care of things for me and the kids, and not having enough time to sleep. It's very hard to manage day to day. The cervical dysplasia has affected my life because I am in a lot of pain.
I want to get my medical situation dealt with which has added to my overall stress. I also stress about budgeting.
One Asian self-professed 'workaholic' discussed the difficulties in avoiding insufficient sleep and overwork. A few Asian women related strategies for dealing with stress:
Talking with my friends, then I will feel better. Talking to my husband and friends will help.
The Latina CCS faced many stressors: becoming incapacitated, being dependent on others, and ultimately unable to care for their children. Depression and anxiety resulting in insomnia were not uncommon. Several 'felt empty' after the surgery. Many were plagued with intrusive thoughts about the illness. Several participants discussed efforts to keep things from their families to avoid burdening them. Experiences included:
I have faith and believe in God. I pray and ask Him to give me health and if it is not possible to cure me, to give me more time—enough to take care of my eleven-year-old daughter who needs me.
I'm very worried. I don't want to end up in a wheel chair, depending on someone else. I have a handicapped son who totally depends on me and my mother lives with me and if something happens to me, who will care for them? Most of the nights I'm sleepless and often cry alone. I don't want my family to know how I really feel and keep my feelings to myself but it's hard to maintain the calm, it is very stressful for me.
The Caucasian CCS discussed the possible role of stress in cancer and/or recurrence. However, some found it hard to live less stressfully. On the other hand, several mentioned positive changes as a result of CCA. One Caucasian explained:
It made me stronger. My goals and priorities changed, I want to 'give back' to society.
A few felt lucky that they survived, and that losing their uterus is a small price to pay.
Many African American, Caucasian and Asian American CCS did not consider their neighborhood a source of stress. However, a number of Latinas and a few of the African American and Asian American CCS voiced dissatisfaction with neighborhood quality and safety. Some Asian survivors were concerned about possible carcinogenic effects of pollution. With few exceptions, most Latina CCS were concerned about neighbors' perceptions of them after the illness. They feared shame and embarrassment, as well as social isolation.
In general, Latinas were uncomfortable disclosing private matters to coworkers/supervisors, concerned about being unable to perform job duties, and feared losing their jobs and being unable to provide for their families. Most African Americans did not disclose the illness to their supervisors; most did not believe that their employers would be supportive. One African American woman had to stand up for herself in front of her supervisor:
An insensitive supervisor didn't want to give me the day off but I knew the law and she gave me the day off.
Similarly, most Asian Americans did not disclose the illness to their employer/supervisor. Of those who did, none reported receiving support. However, several indicated that disclosing the illness to co-workers was helpful. One Chinese survivor mentioned:
Discussions with coworkers helped a lot because they may know somebody who had the same thing and can tell you what to do, what to expect, and how to deal with it. Among 2 or 3 of us, we talk it out. If their friends share the same illness, they will share what they know. They can give us comfort.
One Caucasian CCS reported that she was forced to retire early. Others reported having to reduce work during surgery and recovery period. Several Asian and Caucasian women felt that co-workers treated them as if they were now more fragile and limited in their abilities. Overall, none of the women reported being discriminated against as a result of their illness. However, a few Latina participants were uncertain how such discrimination would be recognized.
Many women experienced depression due to worry about the illness, social isolation, and lack of physical activity. Other concerns included fear of passing CCA to daughters and treatment-related side effects (hair loss, pain, fatigue, and urinary incontinence). African Americans were concerned about preventing recurrence, available treatment options, and staying healthier overall as well as financial situation, family responsibilities, and emotional well-being. Some Chinese CCS related concerns about lack of finances, particularly feeling shame in having to ask for assistance:
I will be more secure if I have more money. Because I'm not working, I have to ask my husband for money…But he makes a big fuss. I feel bad for myself.
The Latina CCS were most concerned about their family's health and emotional well-being, followed by their own health and financial problems.
Among all women, family support, spirituality, and quality of medical care were very important to recovery and coping; however Caucasian women stressed the importance of the relationship with medical staff, while African American, Asian American, and Latina women emphasized the salience of spirituality, prayer and family. All women agreed that family support was essential to emotional well-being and treatment adherence. Unfortunately for some African American, Latina, and Caucasian women, families did not provide adequate support.
Overall, the CCA diagnosis and its treatments left many survivors with moderate to poor HRQOL and psychosocially burdened. The CCA experience was profoundly shaped by medical characteristics (e.g. stage at diagnosis, treatment, pain) and contextual factors (e.g. cultural and socio-ecological aspects). Findings indicate that cultural and family factors promote coping and well-being, but may foster delay in care seeking and self-deprecation, particularly among Latina and Asian CCS. Women of color in particular, relied on faith and God for comfort, strength and healing; many believed that their faith determines the CCA outcome.
There were common systemic concerns regarding quality of care and delay of health care, particularly for women of color and lower-income women. These survivors experienced tremendous difficulties with access and quality of care; navigating the health care 'Goliath'; inadequate insurance; barriers to good physician-patient relationship, such as language and doctors' time constraints; inadequate knowledge about CCA due to insufficient information from medical staff; and feeling a lack of control over their health care management and treatments.
Additionally, some medical (e.g. illness outcome, recurrence) and physical concerns were reported (e.g. persistent pain, numbness in the abdominal area and leg, bowel and urinary problems). In the functional domain, socioecological issues related to CCA and its treatments were prevalent. These included high cost of treatments, worry about job loss, and worry about financial and overall welfare of the family. Psychosocial issues (e.g. isolation, anxiety, depression, friendship relationships and support), spirituality (e.g. faith, punishment); marital and relational challenges (e.g. fidelity, quality and longevity of relationship); fertility, sexuality (e.g. sexual self-evaluation, desire and enjoyment), womanhood (e.g. self-definition, lacking uterus), body image issues (e.g. desirability, attractiveness) were important and persistent concerns. These survivors expressed a need for more resources specifically afforable follow-up medical care, research, patient advocacy and support groups.
CCA affects women across all ethnic groups, however ethnic minority and socio-economically disadvantaged women are disproportionately afflicted. Several risk factors for psychological problems among CCS include lack of social and medical support, younger age, Latina ethnicity, and limited socioeconomic resources.
This study is limited because it draws on retrospective data from a convenient sample. Further, the generalizability of the findings is limited due to the small sample sizes. Additionally, due to snowball and flier recruitment methods, there is no record of the response rate and the characteristics of the non-responders.
In conclusion, there is a dearth of research that targets HRQOL, including psychosocial well-being, with CCS. Cultural and socio-ecological factors have not been adequately studied in cancer control research, and may be particularly pertinent to ethnic minority and low-income populations (Ashing-Giwa, 1999 a, b, manuscript under review). Given growing incidence rates in some geographic areas and increasing evidence of negative psychosocial sequelae of CCA and its treatments, it is imperative that further studies are conducted with larger, more diverse samples. Research designs should include qualitative and quantitative methods to access valuable cultural and contextual information regarding the survivorship experience. Oversampling of ethnic minority CCS is essential given higher incidence rates and possibly greater psychological distress.
The findings reflect persistent concerns in the physical and psychosocial domains presented in the literature with Caucasian women. However, the results document even greater physical and psychosocial challenges for lower income and Latina CCS. The burden of socio-ecological stress further exacerbates poor HRQOL outcomes. Moreover, these survivors reported health-care system problems that resulted in negative treatment sequelae, some of which could be avoided. The CCS and the key informants highlighted the need for health professionals to better explain procedures related to diagnosis and treatment of CCA. Enhanced communication will increase understanding, trust and adherence. Information about CCA and HRQOL is urgently needed in Spanish and Asian languages. Media, including the African American media, can be an effective medium to spread awareness and understanding of CCA and its treatments, particularly for younger women. The findings from this exploratory study highlight the pressing need for more research on the HRQOL of diverse populations of CCS. The results can inform future investigations on HRQOL, psychosocial burden and health disparities among CCS. There should be a marked increase in the attention paid to CCA because 'reducing cancer-related health disparities' and increasing quality of cancer care are central to the National Cancer Institute's (NCI) mission (NCI, 2002). In conducting this study, the stories of many remarkable, resilient women with CCA were brought to light.
This study was supported by a grant from the California Cancer Research Program (#2110008).
See the Appendix Table in the Figures and Tables section.
PubMed Central Canada is a service of the Canadian Institutes of Health Research (CIHR) working in partnership with the National Research Council's national science library in cooperation with the National Center for Biotechnology Information at the U.S. National Library of Medicine(NCBI/NLM). It includes content provided to the PubMed Central International archive by participating publishers.


text:
Stockings babes beautySecretary girl with big boobs sits on a table playing with pussy
Blondes miniskirt pantiesSlutty blonde plays a funny solo in a kitchen with a cucumber
FlashingFlashing hotel
Big tits milf realityMilfs with big fake boobs get fucked really hard by their boss
Deepthroat group sex brunetteAfter a rapid prayer, this mormon plumbs his three wifes.
Facials interracial threesomesATTACKED BY 3 MONSTER BBC
Brunettes gym babesBusty vixen gets banged by her muscular fitness instructor
Smoking120 smoking wife
Mom mother wifeRocks
Glasses milf stockingsThe jerking Teacher
Babes big tits lesbianMy Son's gf
Big boobs lingerieSucking to the top
Extreme teen humiliateBrutal humiliation
Wife shared friendWife shared with friend
Asian ffm pov (point of view)Two Asian Girls Teamed Up And Sucks The Cock
European french italianDrunk girl cheated on her husband
Arab black and ebony interracialSexy Arab girl enjoying BBC
Cute girl hardCute girl hard nipples at gyno exam
Blowjob couple doggystyleTeen gal with small tits gets the best pleasure for pussy
Lesbian amateur pantiesFoxy bbw chicks gets pleasure of hot lesbian games
Mature mature amateur grannyMature slut shows off her needy cunt gets it slammed
Homemade first timeNervous first time amateurs
Nude beach bodyshotsNude beach body shots & hotel orgy
Big blond blondesHorny white girl takes monster cock
Creampie surprise cumCreampie surprise - kyra steele
Bbc (big black cock) blowjob ebonyHuge Black Dick Squirts All Over Ebony's Face
Sweet twinks 69Twink love
Hardcore interracialTaking bbc 2
Big tits blonde bustyMy mom The banger
Black horsecock cumBbc breeding white bottom
Cuckold interracial wifeHusband films petite wife on bbc
Amateur cuckold interracialSlutty White Wife fucked by big black cock
HomemadeSexy white wife sucking a big black cock
Amateur cuckold interracialHusband Shares Redhead Wife with BBC
Amateur cuckold interracialWhite Wife Carrie and BBC Cuckold Hubby
Big blow blowjobsWifes sucking bbc
Monster cock hugeBig black cock on white milfs compilation bbc cuckold party
Bbc (big black cock) blonde interracialBig Boobs White Girl Ready To Fuck With Two Guys
Cream pie cuckold interracialBBC Seeding White Wife.
Amateur cumshots granniesSucking for a good cum
Amateur cuckold interracialYoung White Wifey Bangs Negro Pal & Hubby Tapes
Amateur blondes homemadeBlonde white wife with black lover
Amateur cuckold interracialWhite Wives Help GOP Induced Recession by Banging Negros!
Asian public realityWoman In White Outfit Sucks Cock In Train Car
Big cock homemadeWife gives into bbc lover. pathetic husband films.
Blondes cuckold interracialYoung Blonde Wife gets BBC & Hubby Smiles!
Amateur homemade interracialWhite Wife wants Round Two with a Heavy Cream Pie
Bbw big ass chubbyBlack Chick With Big Ass Rides A White Cock
InterracialWhite wife meets black lover in jamaica
Homemade amatuer realMature amateur wife sucks and fucks in a car with facial cumshot
House wife milfHot horney house wife milf fucks herself with a dildo close up
Amateur homemade interracialCreamy White Wife gets a pie from her BBC lover
Blowjobs handjobs interracialHillbilly White Chick Sucks Black Cock
Blowjobs matures milfsWife sucks her husband ,
Classic retro vintageA Wife Sucks On The Cock Of Her Ebony Husband
Homemade home videoRiley wants to cheat
Amateur webcamWebcam Babe Looks Disinterested At The Camera
Creampie mom motherSlut wife fucks bbc for her husband
Lingerie thong stockingsElegant babe in white nylon stockings craves for rough pussy fuck
BisexualsHusband helps his wife with BBC
Amateur brunettesMan nextdoor fuckin my wife
Asian bus publicAsian Slut Sucks A Cock On Her Knees In A Bus
Public reality upskirtOutside Upskirt Peeks At Amateur Asian Gals
Sissy cocksucker queerWhite trash sissy whore wendy jane cocksuckin
Blondes brunettes coupleMischievous lesbian sluts lick pussies at the back seat
Homemade big cockSubbmissive wife sucking first black cock
Interracial cuckhold amateurWife sucks fucks big black cock gets creampie while hubby videos
Mom wife housewifeJayma ried cheats
Facials interracialCollege Student Impaled on BBC
Big tits milf stockingsSultry Cougar Takes On Two Dicks At Once
Blowjob missionary outdoorHot White Chick Gets Fucked Outside On The Grass
Amateur car realityRandom Blonde Decides To Suck A Guy Dick
Bra thong small titsChick sucks cock of her coach in the gym and gets nailed
Amateur interracialShe Loves The BBC

subset: commoncrawl


text:
I asked him how it was possible to feel baby way down by my bladder and then again up above my belly button. He giggled real evil like and held his hand up with 2 fingers. :eek: I said no, no no. Cause I've had 3 U/S's so far. What's the odds of TWO being in there? Slim to NONE! He thinks he's ohh so cute though. Seriously though, How can I feel it that low and that high at the same time? Baby isn't that BIG yet!!
DH Has jokes!
5 posts / 0 new
Thu, 05/12/2011 - 17:21#1
DH Has jokes!
Thu, 05/12/2011 - 17:41#2
Either it was a twitch or maybe there are 2! I swear I feel movement close to my ribs, but I know there is no way that it's the baby...just twitching or phantom movement from my last pregnancy. LOL!
Thu, 05/12/2011 - 19:39#3
I think that sometimes when baby pushes on something, it sets off a chain reaction. I'll feel it several places, including up near my liver, etc.
Thu, 05/12/2011 - 22:18#4
I had a dream of twins lastnight. I would actually be happy but my dream panicked me pretty bad. Babies can play tricks on you like that though. If you have had an u/s it is pretty unlikely but it happens that they miss it. Ya never know!
Fri, 05/13/2011 - 05:05#5
the chain reaction bit seems probable to me....


text:
Relevant offers
All Blacks
Ma'a Nonu has confronted enough adversity to take most challenges in his stride.
This week is no different. You'd never know he is preparing for an Australian onslaught in Sydney.
With his future secure at the Hurricanes next year, Nonu now seems content in every way. He knows the next 18 months will probably form the closing chapter of his coveted New Zealand career and he's clearly determined to savour each and every moment.
"When I left the Canes I didn't know where I was heading in terms of Super Rugby but my sole purpose was to make the All Blacks. Every time, every year," he said. "Despite people talking about me changing franchises I wanted to play good rugby.
"I try and keep my standards high to be in this side. There will come a day when you're not going to be in this team. When you're not, the feeling changes, so for me it's about enjoying it while you can. It's never been a chore. I've always had to fight to be fit and help my body be the best it can."
Twenty tests against Australia and the lure of the Bledisloe Cup still holds true. Don't underestimate its place or importance to this team, or the country as a whole.
Since 2008, Nonu has only lost three of those encounters and on many occasions terrorised numerous Wallaby midfield combinations.
"There has been a lot of onus on the Bledisloe Cup. For us as a team we're trying to reach new heights. Australia have won seven in a row. We know that. They know that. And we've won 17 in a row. It comes down to who wants it more. The team that has less errors and is the most composed will probably win."
This week the 32-year-old lines up against Brumbies playmaker Matt Toomua and in-form centre Adam Ashley-Cooper, but it would not surprise to see him repeatedly directed back on the inside channels towards Kurtley Beale, not a noted defender.
"They talk about Beale not being a great defensive player but I think he's worked hard in the last couple of years. He's an attacking weapon. We saw that this year with him playing probably his best Super Rugby season at second-five. We know Toomua is pretty good defensively."
Collectively, the All Blacks realise they were poor in the opening test of the year against England. While that same danger of rust also exists this week, an over-riding sense is they are more than ready to reassert their dominance, place one hand on the Bledisloe and clinch the tier-one world record in the process.
"We talked about the level of expectation in terms of where we were in June. It wasn't where the All Blacks' standard should be. As you saw in the first test, a lot of us took for granted coming off Super Rugby, thinking we could just roll over and perform as All Blacks," Nonu said.
"A lot of us haven't had a lot of rugby in the past month so we've worked hard on our physical fitness. The preparation has to be key to hit the line at 8pm in Sydney. We want our skills to be crisp. We want our physicality to be dominant and we want our minds to be ready."
Like many of his team-mates, Nonu has been here before.
- Stuff
Sponsored links
Steve Hansen extends All Blacks coaching deal to 2019 World Cup
Tony Smith: NZOC backs a loser in supporting IOC's buck pass on Russia
New Zealand athletes content as they move into Rio Olympics village
Rio de Janeiro mayor offers a kangaroo to appease Australian Olympic village concerns
Danny Lee finds his form too late at Canadian Open
Southland riders help New Zealand finish top-of-the-world at the Junior Track Cycling World Championships
Gael Monfils wins first title in over two years with victory at Citi Open in Washington DC
Ravichandran Ashwin stars as India thrash West Indies in first test
Kiwi sportsman Jason Lee 'kidnapped' in Brazil
Jesse Ryder smashes quick century but can't save Essex
In-form Jordan Ngatai in line to pick up NZ Breakers roster spot for ANBL season
Britain's BAR wins America's Cup World Series at Portsmouth as Team NZ struggle
International Olympic Committee won't ban Russia from Rio 2016 Olympics
Faces of Innocents: Agnes Ali'iva'a was let down by those she trusted before death
Steve Hansen extends All Blacks coaching deal to 2019 World Cup
House prices could fall 11 per cent by late 2019, as building catches up: Infometrics
Horror house raises concerns about CYF handling of young family
Kiwi sportsman Jason Lee 'kidnapped' in Brazil
Polly Gillespie: 'I was not a good wife'
Kate Middleton versus Pippa Middleton: an engagement ring analysis
This easy hack can save you kilojoules without you realising it
Steve Hansen extends All Blacks coaching deal to 2019 World Cup
Explosion in German city of Ansbach 'caused by device' - mayor
I saw you write Allah in a text: Misunderstanding on flight leads to friendship
Corrections failing Maori, needs drastic culture change - claim
House prices could fall 11 per cent by late 2019, as building catches up: Infometrics
Three disabled men sue Government for more than $100,000 each
Rio Olympics athletes' village deemed uninhabitable two weeks before opening ceremony
Faces of Innocents: Lisa Hope was killed the night before she was to be reunited with her mother
Wellington apartment with makeshift cubicle bedrooms labelled 'unlivable' by students
Massive waves close roads and destroy seawall amid weather chaos in Wellington
Richard Hoagland spent two decades raising a family using a dead man's name
Horror house raises concerns about CYF handling of young family
Tiger mauls woman to death in Chinese safari park
Kiwi sportsman Jason Lee 'kidnapped' in Brazil
Disgruntled Cathay Pacific passenger rips roof off plane looking for locker space
Who was the best-performed All Blacks forward on the northern tour?


text:
Lyrics Depot is your source of lyrics to Abandonement by Bif Naked. Please check back for more Bif Naked lyrics.
Abandonement Lyrics
Artist: Bif Naked
Album: Superbeautifulmonster
Oh, You packed me away in the trunk of your car
You drove me so fast and so far
I tried to fight, but its too hard
My only momento is this car
Where were you when i need you?
Somethings missing and I cant breath.
Where were you?
Where were you?
Somethings missing
You abandoned me
When you look deep into my mind
That is so tired and weak from this light
On the ferge of fear all of the time
I feel like you left me to die
Where were you when I needed you
Somethings missing and I cant breath
Where were you?
Where were you?
Somethings missing
You abandoned me
Shaking in my boots
You shook me down
You never took me down
Shaking my foundation not to be found
Never to be found
Where were you?
Where were you?
You abandoned me
You abandoned me
You abandoned me (x6)
Bif Naked Lyrics
Bif Naked Superbeautifulmonster Lyrics
More Bif Naked Music Lyrics:
Bif Naked - Anything Lyrics
Bif Naked - Canadians Lyrics
Bif Naked - Half A Day A Week Lyrics
Bif Naked - I Died Lyrics
Bif Naked - Lucky Lyrics
Bif Naked - Stumpy the Mouse Lyrics
Bif Naked - Test Lyrics
Bif Naked - Zoinks! Lyrics


text:
Suns out, Guns Out! We all love going to the beach to fool around - sometim...
Elizabeth Rage takes you through the steps to create the Enchantress look f...
On this episode, Master Chalk Artist Chris Carlson takes on an epic Star Tr...
Just two friends out for a stroll
A sweet doll
no comments
In this Picture: Hot girl holding a gun in fatigues
Let me see your papers.
What Is The Doll For… What Is The Doll For…
Ran out of wrapping paper for their birthday.
Ran out of wrapping paper for their birthday.
She's like a real life doll.
You can keep your sex doll.
I'm not sure if this teaches anything.
Why is that lip paint worn away?
Haunted Doll
Troll Doll
Kind of cool, but a little gross.
In This Picture: Photo of girl sticking tongue out
So sex dolls off a bridge, huh? That's a political statement.


text:
Crazy Substitute Teachers
Enjoy, NG4.03 / 5.00 1,121 Views
Vacuum Salesman
This dude and his Megazord vacuum cleaner3.97 / 5.00 2,315 Views
Markiplier Animated | Mark Of The Survey Corps
This took far too long to make...3.93 / 5.00 2,889 Views
what? yay...Minecraft....I'm too busy playing ZombieCraft, ****ING SHEEP
I can't help it.....
Anyways awesome!!
Really clever, and the animation was awesome.
This was really amazing. Gave me goosebumps at some points. Great job. The animations were spot on, you clearly put a lot of effort into it. Voice was fantastic, audio was very clear not out of sync or anything.
This is the most epic thing in my live! No offense best roller coster of the world.


text:
Deepthroat group sex brunetteAfter a rapid prayer, this mormon plumbs his three wifes.
Facials interracial threesomesATTACKED BY 3 MONSTER BBC
Smoking120 smoking wife
Mom mother wifeRocks
Extreme teen humiliateBrutal humiliation
Wife shared friendWife shared with friend
Arab black and ebony interracialSexy Arab girl enjoying BBC
Homemade first timeNervous first time amateurs
Bbc (big black cock) blowjob ebonyHuge Black Dick Squirts All Over Ebony's Face
Hardcore interracialTaking bbc 2
Black horsecock cumBbc breeding white bottom
Bbc (big black cock) blonde interracialBig Boobs White Girl Ready To Fuck With Two Guys
Amateur brunettesMan nextdoor fuckin my wife
Amateur cuckold interracialHusband Shares Redhead Wife with BBC
Facials interracialCollege Student Impaled on BBC
Homemade orgasm bigWife jerking out a big load from big cock
Pornstar ebony ridingBig ass plowed by bbc
Interracial mature ridingOlder Housewife Gets Her First Ever Young Bbc
CreampieBlonde bbc gb
Big cock homemadeWife gives into bbc lover. pathetic husband films.
InterracialFucking whit BBC
Anal deepthroat stockingsWife Pays Husbands Card Bet Geting Double Pounded
House wife milfHot horney house wife milf fucks herself with a dildo close up
Adult pump toysStream vid - vacuum pumping
Cuckold interracial wifeHusband films petite wife on bbc
Anal chinese hairyBbc and sweet chinese prostitute
CuckoldHusband watches classy wife with guys
Interracial latinVictoria Sweet BBC Penitrated.
Amateur babes blowjobBabe with tight body gets licled and screwed on amateur vid
Asshole babes big black cockVoluptuous blonde girl gets pussy and asshole crushed up by BBC
Creampie mom motherSlut wife fucks bbc for her husband
Homemade first timeWife first bbc in both holes french
BisexualsHusband helps his wife with BBC
Amateur cuckold homemadeHusband sharing his hot wife with BBC
Big blow blowjobsWifes sucking bbc
Blondes cuckold interracialYoung Blonde Wife gets BBC & Hubby Smiles!
Sharing share sharedSharing his petite wife with a black stranger as husband films t
Amateur black and ebony interracialTeen wants BBC
Monster cock hugeBig black cock on white milfs compilation bbc cuckold party
Amateur homemadeCuckold Husband Films His Wife With BBC
Amateur homemadeHe Watch His Wife With A Black Bull
Amateur chubby homemadeWhite BBW Wife Fucking BBC
Amateur cuckold interracialSlutty White Wife fucked by big black cock
Wife share sharedWife and husband and friend
Black and ebony cream pie cuckoldHot wife with big black cock cuckold
Amateur interracialHotel hottie and bbc
Amateur cheating cougarReal life amateur wifes nude sexy pictures!
Amateur swingers threesomesHomemade Wife Swap
Amateur cuckold interracialWhite Wife Carrie and BBC Cuckold Hubby
Homemade amateur amatuerHot wife emma has screaming orgasms
Amateur cuckold gangbangBlonde wife in Interracial Gangbang
Anal bbc (big black cock) interracialMature BBC's Anal Smashing
BisexualMarried man tears up A youthfull Boy While His wife gargles His hard-on
Amateur cuckold interracialThe husband is watching his nasty wife with BBC
Big cock monsterWife wants big black cock
Amateur homemadeCuckold hubby filming his wife with bbc
Interracial suck fuckA special gift to his wife
Homemade mother cougarJewish boston slut wife
Interracial amateur coupleWhite ex wife gets fucked by big black cock
Homemade amatuer realMature amateur wife sucks and fucks in a car with facial cumshot
Bdsm cuckold milfsWife Humiliate His Cuckold Husband
Asian fingering hidden camsYoung Wife Home Massage Part 2
Homemade teen teenagerAmateur teen wife gets shared with hubbys friends
Anal bbc (big black cock) interracialBrandi Lyons 1st ever BBC Anal.
Blondes group sex milfsWife Blind Folded Threesome
Homemade interracial amateurMan let his girl try a bbc
Homemade mom motherFuck with my wife in forest
Amateur interracialSlut wife orgy
Homemade amatuer realHusband and wife threesome
Amateur homemadeWife and BBC side view
Amateur homemadeMy first vid
CelebritiesKatie Price Scandal Vid
Matures squirtingHOTT VID
Amateur homemadeMilf fucks bbc


text:
Please select your home edition
Europe North
Europe South
New Zealand
United Kingdom
Cruising Northern
Cruising Southern
Marine Business
NZ Boating World
Show Menu
Audi Melges 20 Miami Series - Taylor, Lucas and Brown awarded honors
by Melges 20 on 9 Mar 2014
Taylor, Lucas and Brown awarded - 2014 Audi Melges 20 Miami Winter Series JOY /IM20CA©
For Audi Melges 20 Bacardi Miami Sailing Week 2014 (BMSW) champion John Taylor, aboard Ninkasi, congratulations are in order. Taylor sailed the event with tactician Bill Hardesty and crew Joey Mello.
'I feel a little bit bad for John (Kilroy) as he and his team sailed really, really well at the first part of the regatta.' commented Taylor. 'But we also sailed well on Thursday, working through some tough starts and shifty conditions. Sailing on Friday was a hoot! More people need to sail Melges 20s. It was really fast. Really fun!'
Additional congratulations go out to Russ Lucas on Shimmer as he rose to the top of the standings to become 2014 Audi Melges 20 Miami Winter Series Champion. Lucas beat 2013 winner Richard Davies on Section 16 by one point. Michael Kiss on Bacio, and John Kilroy on Samba Pa Ti completed the series in third and fourth respectively, tied with equal points. Cesar Gomez Neto from Brazil on Portobello rounded out the top five.
View The 2014 Miami Winter Series Ranking
John Brown on Blind Squirrel was also crowned 2014 Audi Melges 20 Corinthian Miami Winter Series Champion. It is only his second year in the class, and he and his team made up of Will and George Demand have worked very hard to acquire the title.
There was no racing on the last day of BMSW due to lack of breeze, therefore Friday's final results stand as is.
Top ten results
1.) John Taylor/Bill Hardesty, Ninkasi; 9-13-5-3-5 = 35
2.) Drew Friedes/Charlie Smythe, Pacific Yankee; 15-4-2-10-6 = 37
3.) Russ Lucas/Harry Melges, Shimmer; 4-15-3-6-13 = 41
4.) Cesar Gomez Neto/Paulo Ribiero, Portobello; 11-2-10-12-9 = 44
5.) Michael Kiss/Chris Rast, Bacio; 21-5-13-5-1 = 45
6.) Richard Davies/Charlie McKee, Section 16; 10-1-15-19-3 = 48
7.) John Kilroy/Paul Goodison, Samba Pa Ti; 3-3-4-1-42/DNF = 53
8.) Marc Hollerbach/Jonathan McKee, Fu; 8-7-7-10-16/ZFP = 57
9.) Wes Whitmyer/Max Fraser, Slingshot; 22-6-8-21-8 = 65
10.) Bruce Ayres/Mike Buckley, Monsoon; 6-8-16-23-17 = 70
View Official Bacardi Miami Sailing Week 2014 Website
View Yachtscoring Bacardi Miami Sailing Week 2014 website
For full entry list click
If you want to link to this article then please use this URL: www.sail-world.com/119966
Related Articles
SAP Extreme Sailing Team and Alinghi apply the pressure in Hamburg
Morgan Larson's dominant Omani team who go into the clubhouse in first place at the half way stage of the Act.
A sunny day on the River Elbe coupled with a lively breeze saw SAP Extreme Sailing Team and Alinghi challenge Oman Air for honours on the second day of the Extreme Sailing Series™ in Hamburg, but it's Morgan Larson's dominant Omani team who go into the clubhouse in first place at the half way stage of the Act.
Posted today at 2:55 am
Comanche sets new trans-Atlantic Record - Video of the Finish
High definition video of Comanche crossing the virtual finish line off the Lizard to set a new monohull trans-Atlantic r
High definition video of Jim Clark and Kristy Hinze-Clark's supermaxi, Comanche setting a new, provisional world record for crossing the Atlantic for a monohull, in a manually powered sailing vessel of 5 days, 14 hours, 21 minutes 25 seconds. The video was recorded on and off the boat as she crossed the virtual finish line off the Lizard, southern England.
Posted today at 1:06 am
Close fight around Wight on Day 6 of Brewin Dolphin Commodores' Cup
20-25 knot winds and glorious sunshine made for one of the most memorable races around the Isle of Wight on record
With a win for Eric de Turkheim's A13, Teasing Machine (despite destroying a kite), and a second for Daniel Andrieu's Sun Fast 3200, Cifraline 4, France Blue have leapt ahead in the overall results, now holding a 35.5 lead margin over the second placed Flanders North Sea Team.
Posted on 29 Jul
52 Super Series – Puerto Portals Week – Azzurra concludes with a win
Azzurra closes PPSW, the third event in the series with a win that feels like a wish for good luck in the events to come
Azzurra closes the PPSW in Mallorca, the third event in the series, with a win that feels like a wish for good luck in the events to come. Quantum is the Series' current leader, followed by Azzurra.
Posted on 29 Jul
52 Super Series – Puerto Portals Week – Quantum Racing takes the prize
Quantum Racing wrapped up their third regatta title of the season with a race to spare on the Bay of Palma
Quantum Racing wrapped up their third regatta title of the season with a race to spare on the Bay of Palma, winning 2016 Puerto Portals Sailing Week, Vladimir Liubomirov's Bronenosec completed a notable comeback after a disappointing ninth at the Audi Settimana delle Bocche
Posted on 29 Jul
Oman Air faces some infamous challenges at Extreme Sailing Series
All teams made it onto the podium at some stage during the seven race programme, reflecting the degree of difficulty
All seven teams made it onto the podium at some stage during the seven race programme, reflecting the degree of difficulty in achieving any sort of consistency in a very shifty and unstable breeze that topped out at a bracing 14 knots when all the GC32s catamarans took off on their foils and flew around the race course.
Posted on 29 Jul
Gstaad Yacht Club Centenary Trophy – 2 months to go to the 6th edition
The regatta is reserved to boats that are one hundred or more years old and in 2016 will celebrate its sixth edition.
The regatta, unique in its genre, is reserved to boats that are one hundred or more years old and in 2016 will celebrate its sixth edition anniversary. Over the years, the Centenary trophy has gathered some of the most gorgeous and best performing classic yachts from the past century.
Posted on 29 Jul
Vendée Globe – Sébastien Destremau – Simplicity as a credo + Video
A native of Toulon in the south of France, Sébastien Destremau can lay claim to one of the smallest budgets of the fleet
A native of Toulon in the south of France, Sébastien Destremau can lay claim to one of the smallest budgets of the fleet. His credo is to keep it simple, inexpensive and effective. Interview with the skipper of faceOcean, winner of the Calero Solo Transat back in the spring.
Posted on 29 Jul
The Vendée Globe – 100 days and counting
With some 100 days until the start, the first thing to note is that the fleet of participants is stronger than ever
With some 100 days until the start, the first thing to note is that the fleet of participants is stronger than ever, since there are some twenty-eight skippers, registered and qualified, whilst 'just' twenty sailors took the start in 2012. As a result, we're set to be close to or equal to the 2008 record (thirty skippers at the start)!
Posted on 29 Jul
Clipper Race – Constant trimming and little sleep in the North Sea
There is little opportunity for tactical moves and the timings of tacks are crucial if teams want to make vital gains.
After a downwind start with spinnakers trimmed in light airs against the tide off Den Helder on the Dutch coast yesterday, the fleet has been match racing across the North Sea towards the Thames Estuary.
Posted on 29 Jul
This site and its contents are Copyright © 2016 Sail-World USA and/or the original author, photographer etc. All Rights Reserved. Photographs are copyright by law. If you wish to use or buy a photograph contact the photographer directly.
If you have any questions about advertising or editorial then please
contact our team
. If you encounter any technical issues then please email
Terms & Conditions
Privacy Policy


text:
I am looking to create a Web Performance test that can be bound to a CSV file with usernames and passwords so that I can run concurrent tests with different users. How do I modify a recorded WebTest in order to accomplish this?
Announcing Stack Overflow Documentation
We started with Q&A. Technical documentation is next, and we need your help.
Whether you're a beginner or an experienced developer, you can contribute.
Have you checked out Walkthrough: Adding Data Binding to a Web Performance Test (CSV File)?
Once you have added the csv file as a datasource to the webtest,


text:
Enter your mobile number below and we'll send you a link to download the free Kindle App. Then you can start reading Kindle books on your smartphone, tablet, or computer - no Kindle device required.
Getting the download link through email is temporarily not available. Please check back later.
To get the free app, enter your mobile phone number.
|Print List Price:
|Kindle Price:
Save £7.35 (100%)
Saved By His Submissive (The WILD Boys of Special Forces Book 1) Kindle Edition
Amazon Price
|New from
|Used from
Audio Download, Unabridged
"Please retry"
|Free with your Audible trial
|Length: 252 pages
|Word Wise: Enabled
|Enhanced Typesetting: Enabled
|Page Flip: Enabled
- Book 1 of 8 in The Wild Boys of Special Forces (8 Book Series)
Customers Who Bought This Item Also Bought
Product Description
Product details
Would you like to give feedback on images or tell us about a lower price?
What Other Items Do Customers Buy After Viewing This Item?
Customer Reviews
Top Customer Reviews
OHHHHHHHHHHHHHHHHHHHHH! this was, to say the least, a little different in the military dude/BDSM theme, in that SHE wanted and HE was fighting it! We get to hear from Garrett AND Sage, and thats a good thing. Cos both these characters are messed up, what with Sage being kidnapped and sold on, and Garrett still trying to keep Sage in his head and his heart, even after he was told she was dead. Sage is strong, and determined and will get her man, and Garrett is alos strong and determined to protect her...from him. I LOVED Uncle Wyatt and his words of wisdom to Garrett, that made him see sense, and i LOVE LOVE LOVE that stories have been laid down for the next couple of books. They will appear on my wish list, just as soon as.
I really liked that, although there is sexual tension, and some serious making out up against a tree, Sage and Garrett only come together in a scene, just once or twice!
It does deal with kidnapping, torture, mutilation, and is quite violent, well dealing with human traffickers aint gonna be a walk in the park, so its on the over 18 shelf.
Garrett is the ultimate warrior. He fights hard and loves even harder so losing the love of his life was a constant nightmare but things got even worse when he found her.
Sage was fighter herself having been kidnapped, held prisoner and humiliated but she held out hope and it paid off.
When Garrett and Sage got together things had changed and the emotions where so high that I really thought these two had lost that loving feeling. Garrett wanted a bdsm lifestyle and he didn't think Sage would want the same but she did. Her problem was trying to convince Garrett that she wanted to be his sub.
This wasn't constant bdsm scenes but when they did happen they were quite hot. This had a lot to do with the constant threat of being kidnapped for sex slavery and how the elite forces protected what was theirs.
Handcuffed By Her Hero (The WILD Boys Of Special Forces Book 2)
Sage and her best friend Rayna were captured over a year ago in the jungles of Africa. They managed to free themselves and struggled just to survive for quite some time but as luck would have it, their freedom didn't last. Now they await the indignity of another sale and a life of no hope as the nameless play toys of some rich pervert in a foreign country. The only thing that has helped Sage maintain her sanity has been all of her happy memories of her fiance, Garrett. Now the harshness of reality threatens to strip even that from her. That is until the blaze of gunfire and mayhem brings the sweetest of sounds to her ears… Garrett. Her Garrett. And rescue. Because as strong as she's had to be in order to survive there are limits to what a woman can take.
But the man that rescues Sage and the gentle lover of a year ago aren't the same. He's changed. Then again so has she. There is a hard edge to her man that wasn't there before. There is an air of dominance more pronounced than ever before… an edge that excites her… that is until he storms out on her.Read more ›
Most Recent Customer Reviews
I really liked this book it had a very good story to it, and good strong characters too I would definitely recommend this bookPublished 4 days ago by sally
Totally hot . Couldn't put it down. Well written, well woven story! The first in the series ... what a way to start!Published 12 months ago by Maggie McKenzie
Hot and sexy . Not the usual type of BDSM story but still deep and thrilling while keeping up thehot factor.Published on 21 Jan. 2014 by jd66
This is the first I have read of Angels books and it was brilliant. I absolutely loved it. I would highly recommend reading this. Read morePublished on 12 Jan. 2014 by Sharlene
Look for similar items by category


text:
Mandriva: Linux Market Should Make Room
Is there room for three in the Linux corporate market?
Red Hat and Novell have become de facto standards in the commercial world. Yet one longtime Linux distributor is betting that corporate customers won't settle for a two-horse race.
Paris-based Mandriva, formerly known as Mandrakesoft, last week unveiled global partnerships with Intel and Hewlett-Packard and plans for a major corporate push based on its Mandriva 2006 product line, complete with corporate server and a new SMB bundle.
Mandriva CEO Francois Bancilhon last week said his company tanked after the dot-com bubble burst but is staging a comeback based on its new product line and acquisitions of Linux distributor Conectiva in Brazil and assets from U.S. Linux desktop publisher Lycoris. "We're back in black," he said.
- Login or register to post comments
- Printer-friendly version
- PDF version
More in Tux Machines
- Highlights
- Front Page
- Latest Headlines
- Archive
- Recent comments
- All-Time Popular Stories
- Hot Topics
- New Members
Chakra GNU/Linux Users Get KDE Plasma 5.7.2, Qt 5.7 and KDE Applications 16.04.3
Chakra GNU/Linux developer Neofytos Kolokotronis today, July 25, 2016, announced the release of the latest KDE and Qt technologies, along with new software versions in the main repositories of the Linux kernel-based operating system.
In a Quiet Market for PCs, Chromebooks are Marching Steadily Forward
It's no secret that Chrome OS has not been the same striking success for Google that the Android OS has been. And yet, Chromebooks--portable computers running the platform--have not only found their niche, but they are also introducing a new generation to cloud computing. Chromebooks are firmly entrenched in the education market, where many young users have become used to the convention of storing apps and data in the cloud. Now, according to new research from Gartner, Chromebooks are ready to hit new milestones. Analysts there report that Chromebook shipment growth will be in the double digits this year. At the same time, though, Chromebooks have not become fixtures in the enterprise, replacing Windows PCs.
Server Administration
Kernel Space/Linux


text:
|By Elizabeth White
Article Rating:
|April 22, 2014 10:30 AM EDT
Cloud Expo® New York Early Bird Savings here!
Next-Gen Cloud. Whatever you call it, there's a higher calling for cloud computing that requires providers to change their spots and move from a commodity mindset to a premium one. Businesses can no longer maintain the status quo that today's service providers offer. Yes, the continuity, speed, mobility, data access and connectivity are staples of the cloud and always will be. But cloud providers that plan to not only exist tomorrow - but to lead - know that security must be the top priority for the cloud and are delivering it now.
In his session at 14th Cloud Expo, Kurt Hagerman, Chief Information Security Officer at FireHost, will detail why and how you can have both infrastructure performance and enterprise-grade security - and what tomorrow's cloud provider will look like.
Attendees of this session:
- Will examine how and why today's cloud providers are missing the security mark
- What tomorrow's provider must do in order to stay relevant and stay in the game
- Gain insight into achieving security and performance and better understand that there does not have to be a tradeoff of one to get the other
Explore Cloud Expo® Sponsorship & Exhibit Opportunities !
Speaker Bio:
As chief information security officer (CISO) for FireHost, Kurt Hagerman is responsible for all aspects of security and compliance for both corporate and customer facing products. He is responsible for leading FireHost in attaining ISO, PCI, HIPAA and other certifications, which allows FireHost customers to more easily achieve their own compliance requirements.
Hagerman was most recently the managing director of the southwest region and PCI practice director for Coalfire Systems, Inc., a leading IT Security GRC company and QSA. During his twenty plus years in the field of information technology he has held a wide number of positions encompassing many IT and security disciplines including: network engineering, systems engineering, security engineering, and IT auditing and compliance. Hagerman regularly speaks and writes on information security topics in the payments and health care spaces, as well as on cloud security. He holds CISA and CISSP certifications and is an active participant on the Cloud Security Alliance SME council as well as on the Public Policy Committee of the Internet Infrastructure Coalition. Hagerman holds a BS in Industrial Management from Purdue University.
A Rock Star Faculty, Top Keynotes, Sessions, and Top Delegates!
Cloud Expo® 2014 New York, June 10-12, at the Javits Center in New York City, New York, will feature technical sessions from a rock star conference faculty and the leading Cloud industry players in the world.
The growth and success of Cloud Computing will be on display at the upcoming Cloud Expo® conference and exhibition in New York City, New York, June 10-12, 2014.
All main layers of the Cloud ecosystem will be represented at the 14th International Cloud Expo® - the infrastructure players, the platform providers, and those offering applications, and they'll all be here to speak, sponsor, exhibit and network.
Sponsorship Opportunities
for Cloud Expo® 2014 New York
Cloud Expo® 2014 New York "show prospectus" has shipped. Sponsorship, exhibit, and keynote opportunities can be obtained from Carmen Gonzalez by email at events (at) sys-con.com, or by phone 201 802-3021.
Early Bird Registration Options
for Cloud Expo® 2014 New York
Cloud Expo® delegates can pre-register for Cloud Expo® New York with Early Bird Savings here.
About SYS-CON Media & Events
SYS-CON Media (www.sys-con.com) has since 1994 been connecting technology companies and customers through a comprehensive content stream at www.sys-con.com - featuring over forty focused subject areas, from Cloud Computing to Web Security - interwoven with market-leading full-scale conferences produced by SYS-CON Events. The company's internationally recognized brands include among others Cloud Expo® (www.CloudComputingExpo.com), Big Data Expo (http://BigDataExpo.net), Virtualization Conference & Expo (www.VirtualizationConference.com), DevOps Summit (http://DevOpsSummit.sys-con.com), Internet of @ThingsExpo (http://www.ThingsExpo.com), SDDC Expo (http://SDDCExpo.sys-con.com), WebRTC Summit (http://WebRTCSummit.net), Government IT Conference & Expo (www.GovITExpo.com), Cloud Computing Bootcamp (www.CloudComputingBootcamp.com), and UlitzerLive! New Media Conference & Expo (http://events.sys-con.com).
Cloud Expo® is a registered trademark of Cloud Expo, Inc.
UpGuard has become a member of the Center for Internet Security (CIS), and will continue to help businesses expand visibility into their cyber risk by providing hardening benchmarks to all customers. By incorporating these benchmarks, UpGuard's CSTAR solution builds on its lead in providing the most complete assessment of both internal and external cyber risk. CIS benchmarks are a widely accepted set of hardening guidelines that have been publicly available for years. Numerous solutions exist t...
Jul. 30, 2016 07:45 AM EDT Reads: 850
Amazon has gradually rolled out parts of its IoT offerings in the last year, but these are just the tip of the iceberg. In addition to optimizing their back-end AWS offerings, Amazon is laying the ground work to be a major force in IoT – especially in the connected home and office. Amazon is extending its reach by building on its dominant Cloud IoT platform, its Dash Button strategy, recently announced Replenishment Services, the Echo/Alexa voice recognition control platform, the 6-7 strategic...
Jul. 30, 2016 07:45 AM EDT Reads: 703
In addition to all the benefits, IoT is also bringing new kind of customer experience challenges - cars that unlock themselves, thermostats turning houses into saunas and baby video monitors broadcasting over the internet. This list can only increase because while IoT services should be intuitive and simple to use, the delivery ecosystem is a myriad of potential problems as IoT explodes complexity. So finding a performance issue is like finding the proverbial needle in the haystack.
Jul. 30, 2016 07:45 AM EDT Reads: 2,390
There will be new vendors providing applications, middleware, and connected devices to support the thriving IoT ecosystem. This essentially means that electronic device manufacturers will also be in the software business. Many will be new to building embedded software or robust software. This creates an increased importance on software quality, particularly within the Industrial Internet of Things where business-critical applications are becoming dependent on products controlled by software. Qua...
Jul. 30, 2016 07:30 AM EDT Reads: 1,665
Big Data, cloud, analytics, contextual information, wearable tech, sensors, mobility, and WebRTC: together, these advances have created a perfect storm of technologies that are disrupting and transforming classic communications models and ecosystems. In his session at @ThingsExpo, Erik Perotti, Senior Manager of New Ventures on Plantronics' Innovation team, provided an overview of this technological shift, including associated business and consumer communications impacts, and opportunities it ...
Jul. 30, 2016 07:30 AM EDT Reads: 424
In his session at Cloud Expo, Robert Cohen, an economist and senior fellow at the Economic Strategy Institute, will provide economic scenarios that describe how the rapid adoption of software-defined everything including cloud services, SDDC and open networking will change GDP, industry growth, productivity and jobs. This session will also include a drill down for several industries such as finance, social media, cloud service providers and pharmaceuticals.
Jul. 30, 2016 07:15 AM EDT Reads: 437
DevOps at Cloud Expo – being held November 1-3, 2016, at the Santa Clara Convention Center in Santa Clara, CA – announces that its Call for Papers is open. Born out of proven success in agile development, cloud computing, and process automation, DevOps is a macro trend you cannot afford to miss. From showcase success stories from early adopters and web-scale businesses, DevOps is expanding to organizations of all sizes, including the world's largest enterprises – and delivering real results. Am...
Jul. 30, 2016 05:45 AM EDT Reads: 2,387
"We host and fully manage cloud data services, whether we store, the data, move the data, or run analytics on the data," stated Kamal Shannak, Senior Development Manager, Cloud Data Services, IBM, in this SYS-CON.tv interview at 18th Cloud Expo, held June 7-9, 2016, at the Javits Center in New York City, NY.
Jul. 30, 2016 05:15 AM EDT Reads: 1,468
The 19th International Cloud Expo has announced that its Call for Papers is open. Cloud Expo, to be held November 1-3, 2016, at the Santa Clara Convention Center in Santa Clara, CA, brings together Cloud Computing, Big Data, Internet of Things, DevOps, Digital Transformation, Microservices and WebRTC to one location. With cloud computing driving a higher percentage of enterprise IT budgets every year, it becomes increasingly important to plant your flag in this fast-expanding business opportuni...
Jul. 30, 2016 05:15 AM EDT Reads: 2,709
With the proliferation of both SQL and NoSQL databases, organizations can now target specific fit-for-purpose database tools for their different application needs regarding scalability, ease of use, ACID support, etc. Platform as a Service offerings make this even easier now, enabling developers to roll out their own database infrastructure in minutes with minimal management overhead. However, this same amount of flexibility also comes with the challenges of picking the right tool, on the right ...
Jul. 30, 2016 04:45 AM EDT Reads: 1,469
IoT is rapidly changing the way enterprises are using data to improve business decision-making. In order to derive business value, organizations must unlock insights from the data gathered and then act on these. In their session at @ThingsExpo, Eric Hoffman, Vice President at EastBanc Technologies, and Peter Shashkin, Head of Development Department at EastBanc Technologies, discussed how one organization leveraged IoT, cloud technology and data analysis to improve customer experiences and effi...
Jul. 30, 2016 04:00 AM EDT Reads: 2,129
The Internet of Things will challenge the status quo of how IT and development organizations operate. Or will it? Certainly the fog layer of IoT requires special insights about data ontology, security and transactional integrity. But the developmental challenges are the same: People, Process and Platform. In his session at @ThingsExpo, Craig Sproule, CEO of Metavine, demonstrated how to move beyond today's coding paradigm and shared the must-have mindsets for removing complexity from the develo...
Jul. 30, 2016 03:00 AM EDT Reads: 1,650
SYS-CON Events announced today that MangoApps will exhibit at the 19th International Cloud Expo, which will take place on November 1–3, 2016, at the Santa Clara Convention Center in Santa Clara, CA. MangoApps provides modern company intranets and team collaboration software, allowing workers to stay connected and productive from anywhere in the world and from any device.
Jul. 30, 2016 02:45 AM EDT Reads: 1,492
The IETF draft standard for M2M certificates is a security solution specifically designed for the demanding needs of IoT/M2M applications. In his session at @ThingsExpo, Brian Romansky, VP of Strategic Technology at TrustPoint Innovation, explained how M2M certificates can efficiently enable confidentiality, integrity, and authenticity on highly constrained devices.
Jul. 30, 2016 02:15 AM EDT Reads: 1,191
"delaPlex Software provides software outsourcing services. We have a hybrid model where we have onshore developers and project managers that we can place anywhere in the U.S. or in Europe," explained Manish Sachdeva, CEO at delaPlex Software, in this SYS-CON.tv interview at @ThingsExpo, held June 7-9, 2016, at the Javits Center in New York City, NY.
Jul. 30, 2016 02:00 AM EDT Reads: 1,690


text:
I have 3 red and white Persian Kittens for sale from 3 different litters, a male red and white van born 4-1-16, a female high red tuxedo born 5-28-16, and a female red and white van born 6-22-16. The male has a flat face and the females are dollfaced. The male is very ready to go to his new home and has had both kitten shots. The females are younger. The tuxedo (high red) is ready to go, ...
Jul 24 -
Los Angeles :
Los Angeles - Cats & kittens
I have two cream and white van Persian kittens for sale, one male born 5-1-16 and one female born 6-22-16. The male is ready to go to his new home. The female is younger, so I can hold her with a deposit for a few weeks until she is ready to go. I am asking only $500 for each pet price without papers. The male has a flat face and the female is more of a dollface. They are healthy, loving ...
I have two rare Calico Persian Kittens for sale, one with a lot of color and one a van(high White),both with flat faces and female, of course. They were born 5-28-16, so are about ready for their forever homes. They will get their first kitten shot this week, are healthy and PKD negative genetically. They are eating solids and litter trained very well. Calicos are hard to find, but I am ...
I have two male black and white, flat-faced, tuxedo Persian kittens available. They are almost identical, perfectly marked. Their mom is a calico and their dad a black and white van. I am asking only $550 pet price, and you can reserve one of these handsome quality kittens for $200 if you would like first pick. They have been handled and loved since birth, on July 4, 2016, so will be ...
Jul 23 -
Los Angeles :
Los Angeles - Cats & kittens
I have a litter of two Persian Kittens for sale, one cream and white female and one red and white female, both high whites (vans) with a little color, and both dollface.
Their mother is a calico van and their father a CFA Champion black and white van. They were born 6-22-16, so will soon start eating solid food and be litter trained. They are healthy, PKD negative and will have their ...
Scottish Folds Cats For Adoption, Adult Females
CFA Reg; Tortoiseshell $350. & Dilute Calico $200.
Very Sweet & Loving, Call for Appointment
(714) 842-0771
Jul 18 -
Orange County :
Huntington Beach - Cats & kittens
These adorable kittens are from CFA registered Champion bloodline sire. Babies are 3 weeks old and will be available to go to loving homes by end of August.
Taking deposits for the most gorgeous colored Calico females and handsome Red & White Tabby males. Their eyes will change to blazing copper as they get older.
Spay/Neuter and shots will be current with record at time of pick up.
Calico ...
Jul 17 -
Los Angeles :
Valencia - Cats & kittens
Beautiful Calico Baby Girl,14 weeks old.
She is very sweet girl, very playful, well socialized , very nice around other cats.
ready to go to her forever home,,
Vet checked, Litter box trained.
Parents are CFA Register Champion Lines .
Only serious enquiries please.
For more info and pic visit our website
Jul 16 -
Los Angeles :
Beverly Hills - Cats & kittens
Absolutely gorgeous, adorable baby- Calico girl .12 weeks old.
Very playful, nice personality, very good around other cats.
Parents Are CFA Register, Campion Title. PKD Negative .Very Good Pedigree.
She is doing great, eating Royal Canin dry food. Ready to go.
Serious inquiries only please. No dogs, no small kids, no smokers, please.
Feel free to email me with any questions,
for more ...
Jul 9 -
Los Angeles :
Beverly Hills - Cats & kittens
Two cats need a good home.
Lulu - Tabby cat - very lovable about 2 years of age. She needs a lot of attention and someone to love her. She will sleep with you and lay with you on the couch. Does not scratch furniture. Loves to play. Indoor cat.
Penny - Calico/Mix 3 years of age. Before she came to us I believe she had it rough. It took a while for her to come around but is a very sweet cat. ...
Jun 28 -
Los Angeles :
Thousand Oaks - Cats & kittens
Petite Little Persian Babies****Males & Females*****Flat Or Doll Faces*****One Blue Eyed Chocolate Point Baby Boy*****All Kittens Have A One Year Written Health Guarantee And Are CFA Papered And Have Kitten Vaccines*****Also Two Beautiful Pure White Adult Persian Females, One Has Blue Eyes****CFA ****All Adults Have Current Vaccines**** 2-3 Years Old**** Indoor Pets Only ****Would Like to ...
Jun 21 -
Inland Empire :
Yucca Valley - Cats & kittens
Adorable Siamese Kittens two months old. Ready to go to a good loving home. $100 dollars for the Siamese kittens and $70 for the calico and $60 for the rest. Females and males. Any questions please call or text me at 909-200-0492.
Jun 15 -
Inland Empire :
Rancho Cucamonga - Cats & kittens
3 males & 2 females (8 weeks)
They're calico and tabby
Contact me if interested..
(Email & text only)
This ad was posted with the eBay Classifieds mobile app.
Jun 8 -
Los Angeles :
Long Beach - Cats & kittens
We'll be sending text message alerts for your subscription to