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From University of Texas Medical Branch, Galveston, Texas; and University of New Mexico, Albuquerque, New Mexico.
Grant Support: By grants from the National Cancer Institute (R01-CA90626 and R01-CA871773) and the Sealy and Smith Foundation, Galveston, Texas.
Requests for Single Reprints: Xianglin L. Du, MD, PhD, Department of Internal Medicine, 3.134 Jennie Sealy Hospital, University of Texas Medical Branch, Galveston, TX 77555-0460; e-mail, firstname.lastname@example.com.
Current Author Addresses: Drs. Du, Osborne, and Goodwin: Department of Internal Medicine, School of Medicine, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555.
Dr. Key: New Mexico Tumor Registry, University of New Mexico Health Sciences Center, 2325 Camino de Salud NE, Albuquerque, NM 87131.
Mr. Mahnken: Sealy Center on Aging (Biostatistics), University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555.
Author Contributions: Conception and design: X.L. Du, C.R. Key, J.S. Goodwin.
Analysis and interpretation of the data: X.L. Du, J.D. Mahnken, J.S. Goodwin.
Drafting of the article: X.L. Du.
Critical revision of the article for important intellectual content: X.L. Du, C. Osborne, J.D. Mahnken, J.S. Goodwin.
Final approval of the article: X.L. Du, C.R. Key, C. Osborne, J.D. Mahnken, J.S. Goodwin.
Provision of study materials or patients: X.L. Du, C.R. Key.
Statistical expertise: X.L. Du, J.D. Mahnken.
Obtaining of funding: X.L. Du, C.R. Key, J.S. Goodwin.
Administrative, technical, or logistic support: X.L. Du, C.R. Key.
Collection and assembly of data: X.L. Du, C.R. Key.
National Institutes of Health consensus guidelines recommend adjuvant chemotherapy for premenopausal or postmenopausal women with node-positive tumors or node-negative breast tumors greater than 1 cm, regardless of hormone receptor status. The actual (and age-specific) use of chemotherapy in women with breast cancer is unknown.
Using data from the New Mexico Tumor Registry, these investigators show that chemotherapy is used much less frequently than recommended and that frequency decreases sharply with advancing age.
Since only a minority of postmenopausal women receive adequate treatment for breast cancer, many unnecessary deaths could probably be prevented by following the National Institutes of Health guidelines.
–The Editors
Although the efficacy of chemotherapy in prolonging survival for women with breast cancer has been well documented (1–12), limited population-based information is available on the actual use of chemotherapy. Some hospital-based surveys of breast cancer have examined the use of chemotherapy (13–15), but the completeness of information has been questioned because chemotherapy is frequently administered in outpatient settings.
The evolution of recommendations about the use of adjuvant chemotherapy in women with early breast cancer is illustrated by the National Institutes of Health (NIH) consensus development conferences (1, 3, 12). In 1985, the consensus conference recommended chemotherapy for premenopausal women with lymph node–positive cancer (1). By 1990, the consensus conference recommended chemotherapy for both premenopausal and postmenopausal women with lymph node–positive cancer and for women with cancer confined to the breast but with poor prognostic features, such as large size or negative hormone receptor status (3). The 2000 consensus conference extended the recommendation of chemotherapy to premenopausal and postmenopausal women with node-positive tumors or with node-negative tumors greater than 1 cm in size, regardless of hormone receptor status (12).
Because limited information is available from clinical trials of chemotherapy in women 70 years of age and older, none of the consensus conferences made specific recommendations for that age group, other than to invoke individual decisions based on clinical circumstances and patient preferences. We recently reported on chemotherapy use in women age 65 years and older by using the Surveillance, Epidemiology, and End Results (SEER) tumor registry data linked to Medicare data (16–17). As expected, chemotherapy use sharply decreased in women older than 70 years of age, and women with higher-stage, larger, or estrogen receptor–negative tumors were more likely to receive chemotherapy (16–17).
We review the use of chemotherapy in women residing in New Mexico who were 20 years of age or older and received a diagnosis of breast cancer between 1991 and 1997. We hypothesized that chemotherapy use would not vary by age in women younger than 65 years of age who have tumor characteristics for which chemotherapy is generally recommended. Furthermore, we hypothesized that use of chemotherapy would vary by age with highest use in younger women (<45 years of age) among women who had tumors with characteristics for which no clear consensus recommendations had been made.
The New Mexico Tumor Registry is a statewide, population-based tumor registry that was established in 1966; it is one of the seven original members of the SEER registry (18). New Mexico residents who are given a diagnosis and treated at facilities outside the state are identified through data exchange with surrounding state registries in Colorado, Arizona, Utah, and Texas; in addition, information is obtained from the New Mexico Bureau of Vital Records and Health Statistics and from pathology laboratories and hospitals that operate close to New Mexico borders (19).
We examined data on 5101 patients age 20 years or older with a diagnosis of stage I, stage II, or stage IIIA breast cancer (using the American Joint Committee on Cancer staging system) from 1991 through 1997 (19–20). We restricted our analyses to these stages because chemotherapy is considered the primary treatment for higher cancer stages rather than an adjuvant treatment. The Institutional Review Boards of the University of Texas Medical Branch and the University of New Mexico approved this study.
Information on chemotherapy was coded as follows (20): 0 = none (n = 4093); 1 = chemotherapy, not otherwise specified (n = 158); 2 = chemotherapy, single agent (n = 34); 3 = chemotherapy, multiple agents or combination regimen (n = 1504); 4 to 6 = not used for coding; 7 = patient or patient's guardian declined chemotherapy (n = 81); 8 = chemotherapy recommended but actual administration unknown (n = 77); and 9 = unknown (n = 0). For our analyses, we recoded 1, 2, 3, and 8 as having received chemotherapy; 0 and 7 were recoded as having not received chemotherapy. The pattern of the results did not change if we recoded category 8 as not receiving chemotherapy or if we excluded the 77 cases in category 8 from the analysis.
Information on hormone therapy was coded as follows (20): 0 = none (n = 3435); 1 = hormones, not otherwise specified, including antihormones (n = 1568); 2 = endocrine surgery or endocrine radiation (n = 5); 3 = combination of 1 and 2 (n = 0); 4 to 6 = not used for coding; 7 = patient or patient's guardian declined hormone therapy (n = 26); 8 = hormone therapy recommended but actual administration unknown (n = 65); and 9 = unknown (n = 2). For our analyses, we recoded 1, 2, 3, 8, and 9 as having received hormone therapy; 0 and 7 were recoded as not having received hormone therapy. The pattern of the results did not change if we recoded 8 and 9 as not having received hormone therapy or if we excluded the 67 cases in categories 8 and 9 from the analysis.
Our analytical strategy had three components. First, we examined the overall and age-specific rate (percentage) of chemotherapy use. The percentage of women receiving chemotherapy was a ratio of the number of women who received chemotherapy to the total number of women with a diagnosis of breast cancer. We used the Mantel–Haenszel chi-square test for trend to obtain the change in use of chemotherapy with age (21). Second, we used multivariable logistic regression analysis to generate the odds ratio of receiving chemotherapy in women with breast cancer and to determine the effect of age (Table 1) on chemotherapy use. In this model, we adjusted for race (white, black, or others), tumor stage (stage I, stage II, or stage IIIA), node status, hormone receptor status (Table 2), whether the patient had received surgery and radiation therapy (categorized as breast-conserving surgery without radiation, breast-conserving surgery with radiation, or mastectomy), and adjuvant hormone therapy use (yes or no).
In addition to odds ratios, we generated the probabilities of receiving chemotherapy from the parameters of the logistic regression for women with different ages by holding other factors constant. We used the method described by Hosmer and Lemeshow.
Finally, we performed sensitivity analyses to assess the potential effects of unmeasured confounders on the associations observed between age and chemotherapy use (23). The method developed by Greenland (23) for dichotomous exposure and confounding variable was expanded to accommodate the eight-level exposure variable for age groups. The prevalence of the unmeasured confounding variable was dichotomized at different age cut-points (ages younger than the cut-point had one prevalence rate and ages greater than or equal to the cut-point had another). Over the different prevalence levels, the odds ratio between the unmeasured confounder and chemotherapy ranged from 1.5 to 10.0. We then generated multivariable logistic regression models (which included this unmeasured confounding variable) to determine the effect of unmeasured factors on the result. All computer programming and analyses were done by using SAS software (SAS Institute, Inc., Cary, North Carolina) (21).
The National Cancer Institute of the National Institutes of Health and the Sealy and Smith Foundation funded this project but had no role in the collection, analysis, and interpretation of the data or in the decision to submit the paper for publication.
Among 5101 women with stage I, stage II, or stage IIIA breast cancer diagnosed from 1991 through 1997 in New Mexico, age at diagnosis ranged from 20 to 98 years; the mean age was 61 years. Table 1 presents the percentage of women receiving chemotherapy by tumor stage and patient age. Overall, 29% of women received chemotherapy, and the rate of chemotherapy use for stage I, stage II, and stage IIIA was 11%, 47%, and 68%, respectively. Across all tumor stages, the use of chemotherapy decreased substantially with increasing age (P < 0.001 for trend). Overall, 66% of women younger than 45 years of age received chemotherapy compared with 44% of women between 50 and 54 years of age, 31% of women between 55 and 59 years of age, and 18% of women between 60 and 64 years of age. Only 12% of women between 65 and 69 years of age and 3% of those older than 75 years of age received chemotherapy.
Table 2 presents the use of chemotherapy by patient age, lymph node status, and hormone receptor status in women with stage I, stage II, or stage IIIA breast cancer. As expected, chemotherapy was used more often in women with node-positive tumors and women with estrogen receptor–negative tumors. However, across all classes of tumor characteristics, use of chemotherapy decreased substantially with age (P < 0.001 for trend). For example, in women with node-positive and hormone receptor–positive tumors, the percentage of women who received chemotherapy decreased as follows: 87% for women younger than 45 years of age, 67% for women 55 to 59 years of age, and 22% for women 65 to 69 years of age. Chemotherapy use was relatively stable in women with node-positive and hormone receptor–negative tumors who were younger than 65 years of age; however, use decreased substantially after age 65 years. In additional analyses that were stratified by node status (positive versus negative) and by tumor size, chemotherapy use decreased with age (data not shown).
Table 3 presents chemotherapy use in relation to use of adjuvant hormone therapy (usually tamoxifen). The percentage of women who received chemotherapy plus hormone therapy or who received chemotherapy alone decreased with advancing age. The percentage of women receiving hormone therapy alone increased with age. However, the overall percentage of women with breast cancer who did not receive adjuvant therapy (neither chemotherapy nor hormone therapy) increased substantially with age.
The Figure presents the use of chemotherapy in women with breast cancer as a function of two variables: age and whether use of chemotherapy was clearly recommended in the 1990 NIH Consensus Conference [based on tumor characteristics]. We examined women younger than 70 years of age with 1) node-positive tumors, 2) node-negative, hormone receptor–negative tumors larger than 1.0 cm in size, or 3) node-negative tumors of any hormone receptor status that were greater than 3.0 cm in size. Any other tumors were categorized as having no clear consensus recommendation, based on the 1990 Consensus Conference. As hypothesized, the use of chemotherapy in women with tumors for which no clear chemotherapy guidelines existed decreased sharply with age, falling to less than 10% for women 55 years of age and older. However, we observed an almost parallel decrease in the use of chemotherapy with age in women with tumors for which chemotherapy was generally recommended. In these women, 77.4% of those who were younger than 45 years of age received chemotherapy. In contrast, chemotherapy was given to only 58.1% of those 55 to 59 years of age, only 37.7% of those 60 to 64 years of age, and only 25.0% of those 65 to 69 years of age.
Women with stage I, stage II, or stage IIIA breast cancer are categorized into two groups based on their tumor characteristics—characteristics for which the 1990 National Institute of Health (NIH) Consensus Conference generally recommended chemotherapy ( = 2486; ) and characteristics for which the consensus conference recommended decisions on an individual, discretionary basis ( = 2615; ). The 2000 NIH Consensus Conference recommended chemotherapy for all breast tumors 1.0 cm or larger in size; however, these recommendations were made after we conducted our study. For women 70 to 74 years of age and women 75 years of age and older, the NIH Consensus Conference made no specific consensus recommendations on treatment with chemotherapy.
Table 4 presents a multivariable analysis of the effect of age on the adjusted odds of receiving chemotherapy in women with breast cancer. We then converted the parameters used to generate odds ratios and their confidence intervals to probabilities (22). We obtained the probability of receiving chemotherapy for each age group, holding constant race, tumor stage, node status and hormone receptor status, surgery and radiation therapy status, and adjuvant hormone therapy use across age groups. We observed the same pattern seen in the bivariate analyses of declining chemotherapy use with age (Tables 1, 2, and 3 and Figure). Younger women with breast cancer had a greater chance of receiving adjuvant chemotherapy, and, as expected, women older than 70 years of age were least likely to be given chemotherapy.
We also conducted sensitivity analyses to estimate the potential effect of unknown confounders on the study results. These analyses demonstrated that the relationship between age and chemotherapy use in our large population-based setting was relatively insensitive to confounding by unmeasured factors. For example, let us examine the following scenario: The prevalence of an unmeasured confounding variable is 90% in women younger than 50 years of age and 50% in women 50 years of age or older. The odds ratio for receipt of chemotherapy associated with this unmeasured confounder is 2.0. Thus, the adjusted odds ratio of receiving chemotherapy for the women in the 55- to 59-year-old age group relative to women younger than 45 years of age would be 0.25 (95% CI, 0.19 to 0.34) instead of 0.21 (CI, 0.16 to 0.29), as shown in Table 4. However, under extreme conditions, the effect of age on chemotherapy use could be affected. If the prevalence of an unmeasured confounding variable were 90% in women younger than 50 years of age and 10% in women 50 years of age and older and if the odds ratio for receiving chemotherapy associated with this unmeasured confounder were 5.0, the adjusted odds ratio of receiving chemotherapy for the 50- to 54-year-old age group relative to the group younger than 45 years of age would become insignificant (0.79 [CI, 0.58 to 1.07]). Even under such extreme circumstances, the age groups 55 to 59 years of age and 60 to 64 years of age relative to the group younger than 45 years of age are still significantly associated with decreasing use of chemotherapy. However, the significance is reduced to 0.43 (CI, 0.31 to 0.59) for women 55 to 59 years of age and reduced to 0.19 (CI, 0.14 to 0.27) for women 60 to 64 years of age compared with women younger than 45 years of age. In addition, we used two different approaches for a small number of women with missing information on chemotherapy and hormone therapy use: We excluded these women from the total number of women or recorded them as not having received therapy. The results showed little difference in the relationship between age and chemotherapy use, although overall rate of chemotherapy use was slightly altered (data not shown).
Our study describes the patterns of adjuvant chemotherapy use in women 20 years of age or older with stage I, stage II, or stage IIIA breast cancer in New Mexico from 1991 through 1997. The rates of chemotherapy use for stage I, stage II, and stage IIIA were 11%, 47%, and 68%, respectively. Across all tumor stages, the use of chemotherapy decreased substantially with increasing age (P < 0.001 for trend). Overall, 66% of women younger than 45 years of age received chemotherapy compared with 44% of women 50 to 54 years of age, 31% of women 55 to 59 years of age, and 18% of women 60 to 64 years of age. In women age 65 to 69 years and those older than 75 years, only 12% and 3%, respectively, received chemotherapy. The decreasing pattern of chemotherapy use with age was maintained after adjustment for such prognostic factors as node status, hormone receptor status, and other treatments received.
Although numerous studies have shown that age older than 65 years is a risk factor for inadequate treatment of breast cancer (13–15, 24–35), few studies addressed chemotherapy (13–15). In the hospital-based reports, the rates of chemotherapy use did not vary much by age in women younger than 65 years of age. A striking finding of our population-based study is that, even in women younger than 65 years of age, the use of adjuvant chemotherapy dramatically decreased with age.
Several factors may explain the decreasing use of chemotherapy with age. First, the efficacy of adjuvant chemotherapy has been shown to decrease with age. A systematic overview of the 47 randomized trials of early-stage breast cancer by the Early Breast Cancer Trialists' Collaborative Group showed a proportional reduction in 10-year mortality with chemotherapy of 27% for women younger than 50 years of age, 14% for women 50 to 59 years of age, and 8% for women 60 to 69 years of age (6). The result is an absolute benefit in 10-year survival of 7% to 11% for women younger than 50 years of age and 2% to 3% for women 50 to 69 years of age (6). A similar pattern was seen for reduction in risk for recurrence by age groups (2, 4, 6). These meta-analyses found no benefit of chemotherapy in women age 70 years and older. On the other hand, the National Surgical Adjuvant Breast and Bowel Project (NSABP) showed efficacy of chemotherapy in older women, including those age 70 years and older (5, 10, 36); however, the effect size was smaller in older women than in younger women.
Second, physicians and older patients who are considering chemotherapy may be concerned about the possibility of toxicity increasing with age. However, several studies have shown that women of different ages whose general health is otherwise satisfactory experience similar toxicity profiles when treated with commonly used chemotherapy regimens (37–41).
Regardless of the reasons for decreased chemotherapy use with age, the result is that only a small number of postmenopausal women are receiving chemotherapy in compliance with consensus recommendations. The decrease in efficacy of chemotherapy with age is not reflected in the consensus recommendations, which do not vary greatly by age for women younger than 70 years of age (1, 3, 7–9, 11–12). The development and dissemination of clinical practice guidelines have been recognized as a major advance in improving quality and decreasing variations in medical practice (42–44). Nevertheless, concerns have been raised about the limitations of such guidelines, including how quickly they may become outdated (42, 45). Evidence-based guidelines rely on the results of clinical trials, but participants in clinical trials do not always represent a cross-section of patients in the community. This is especially true for trials of cancer therapies (34, 46). However, information comparing the effectiveness of chemotherapy in the community with efficacy in trials is very limited. It seems that community oncologists and their postmenopausal patients with breast cancer often conclude that the clinical guidelines should be ignored because of the risk–benefit profile for chemotherapy use.
Our study has several limitations. One concern is whether the information on chemotherapy from the SEER tumor registries is valid and complete. This information may be incomplete because SEER does not require all medical oncologists' offices to be checked for chemotherapy administration by the SEER data collectors (47). The SEER information may also be incomplete because patient follow-up may not have been long enough to obtain complete chemotherapy treatment information (20).
On the other hand, the validity of the registry data regarding chemotherapy was supported by several internal consistencies of the data. For example, patients who might be expected to use chemotherapy often include younger women with advanced tumor stage and women with hormone receptor–negative tumors. The registry data confirmed this expectation. Another example of the internal consistency of the registry data is that 96% of women younger than 45 years of age with stage IIIA breast cancer were recorded as having received chemotherapy (Table 1). More than 71% of women 65 to 69 years of age with node-positive and hormone receptor–negative tumors received chemotherapy; only 4% of women categorized into these same age groups who had node-negative and hormone receptor–positive tumors received chemotherapy (Table 2). Such internal consistency supports the validity of the information on chemotherapy use in the New Mexico Tumor Registry. In addition, even if the tumor registry information on chemotherapy were incomplete, it is difficult to envision how this limitation would produce a marked decrease in chemotherapy use with age.
Another limitation of our study is that we did not investigate whether older women with breast cancer who received chemotherapy fared any better than those who did not. In addition, we did not have information on comorbidity. However, although comorbidity becomes an important issue in the choice of therapy for women older than 65 years of age, it is unlikely that the increase in comorbidity associated with age in women younger than 65 years of age is sufficient to explain the decrease in chemotherapy use. Furthermore, we did not have information on patient preferences and physician attitudes and preferences toward chemotherapy use in women of different ages. We also do not have data on variation in the choice of chemotherapy for breast cancer at the level of the provider. A sensitivity analysis suggested that the relationship between age and chemotherapy use in our large population-based setting was relatively insensitive to changes in these unmeasured factors.
In conclusion, chemotherapy administration was substantially influenced by patient age and tumor stage. Chemotherapy use declined substantially with age in women younger than 70 years of age who had tumors with characteristics for which chemotherapy was recommended by the NIH Consensus Conference. In other words, there is a clear divergence between consensus recommendations and clinical practice. Given the decrease in efficacy of chemotherapy with age in the clinical trials, one could argue that our findings represent appropriate responses of oncologists and their patients to the less favorable benefit–risk profile in older women with breast cancer. The question of whether the recommendations are overly aggressive or whether practicing oncologists are too conservative in chemotherapy use should be addressed in population-based outcome studies and in studies that examine how oncologists and their postmenopausal patients with breast cancer deal with the benefits and risks of chemotherapy.
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Chemotherapy in Women with Breast Cancer
The summary below is from the full report titled "Discrepancy between Consensus Recommendations and Actual Community Use of Adjuvant Chemotherapy in Women with Breast Cancer." It is in the 21 January 2003 issue of Annals of Internal Medicine (volume 138, pages 90-97). The authors are XL Du, CR Key, C Osborne, JD Mahnken, and JS Goodwin.
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Q: My cockatiel wants to find his reflection or shadow all the time. He sees himself in my patent leather boots, and he flies at the glass doors in the bottom of the TV cabinet. He goes to the kitchen sink or to waxed floors to find his reflection. I put him in his cage when he goes to these places, but he keeps finding more and more new places to find his friend. Help!
A: Your problem is often seen in wild birds that attack or are attracted to their reflection in shiny hubcaps or in car mirrors.
Because your cockatiel looks for his "friend," consider putting a mirror in his cage. Or one on a playgym or top of the cage for him to use when he's out of the cage. A mirror can be a companion for your bird, which is a flock animal.
Another reason your cockatiel might insist on tracking down the mysterious other bird in its life is that it perceives it as a rival. Your male sees another male, and wants to defend its territory.
Your cockatiel might also be looking for a mate, and may be finding it in the cockatiel in the mirror.
Breeding Behavior
We can't neuter our pet birds, so they can go through periods of breeding behavior. We can control this to some extent by not providing our companion birds with stimuli to breed. Some of the first signs of hormonal birds include: increase in vocalization; clingy behavior; calling to you (the owner, or the other perceived mate); chewing everything in sight; choosing an object to brood; and defending territory aggressively. Male cockatiels scout out a nesting site, then invite their mate to come look it over. They have intimate conversations about the choice and usually it's acceptable, with a little chewing on the edges to decorate.
Never fear, your cockatiel will become its docile and friendly self again after this period, which is usually a couple of weeks in the spring and fall. If this is a particularly pronounced spate of breeding behavior, follow the guidelines in the sidebar to reduce breeding stimuli. Cut your bird's daylight hours back to about 10 hours for a good couple of weeks. The change is not instantaneous, but in about two weeks you should see results.
Female Cockatiel Breeding BehaviorsA hormonal female cockatiel might start laying eggs. If she does, allow her to keep them and, if she's inclined, to sit on them for about 10 days. Then take them away. Cockatiels instinctively want to complete a clutch of eggs. It takes a cockatiel about seven days to lay a clutch. Leave a female's eggs with her so that she knows she has laid a clutch. If you take eggs away from her as soon as they're laid, she will keep trying to lay a clutch of four to five eggs and never completes that. Your environmental manipulation will mean she won't be inclined to continue laying, or to lay a second clutch this season, which is normal for breeding cockatiels.
Good luck with your bird! I think you can turn his reflection into a friend and not a foe with some simple changes.
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Archive – March 2011
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I live in the Seattle area and one of my members recommended (thank you, Mark L) Pok Pok in Portland Oregon. That's right, a three hour drive just for a meal? ABSOLUTELY!
Pok Pok has also been featured on several TV food shows and in the press. Rightfully so as owner/chef Andy Ricker was the 2011 James Beard Award winner for Best Chef, Northwest.
When I arrived at Pok Pok I almost felt like to I was on a pacific island. This Thai restaurant is a shack and on this sunny Sunday afternoon it was PERFECT for dining out on their patio. No worries, there is also indoor seating as well.
Prior to ordering, we were given several napkins and wet naps. At this joint, eating with your hands is a must. Wash up, roll up your sleeves, dig in, and be prepared to enjoy!
We sat on picnic tables and examined the menu a bit. What we ate:
Ike's Vietnamese Fish Sauce Wings – one of their specialty dishes and probably their claim to fame. Excellent flavors that give "wings" a whole new meaning. Sweet, spicy, salty, garlicky – all in a single bite. The sauce is so good, it's finger licking good.
Neua Naam Tok – a delicious flank steak salad. Very good with the salty from the fish sauce, the tart from lime, and heat from the chili powder. Round off with flavors of cilantro and lemon grass and texture from the rice powder this was a pleasantly unique salad.
Kai Krapao Khai Dao – a ground chicken stir fry with small pieces of green beans and basil topped with a fried egg. There was a bitterness to it, probably from the basil. A dry dish and probably my least favorite of the meal.
Kuaytiaw Reua "Boat Noodles" – a large bowl of soup. Very hearty and probably a meal in itself. This soup has delicious flavors and finishes with a little sweetness. This was really filling, especially with the chunks of beef and meatballs.
Naam Manao – Thai inspired limeade which included salt. I liked it, but didn't love it. The salt threw me off.
Cucumber Relish – I ordered for the acidity to compliment the rest of the meal, but it came with a lot of heat. It was really spicy.
There is a separate lunch and dinner menu. If you're thirsty there is an extensive drink menu. Despite have a sweet tooth, I didn't have room for dessert.
What a wonderful meal. Yes, worth the drive. Pok Pok lives up to the hype – but would you expect anything less from a James Beard winner? Andy Ricker knows his way around a kitchen.
We arrived shortly after opening and by the time we were finished the place was packed. A testament of how popular and how delicious the food is at Pok Pok.


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Hi! My name is Mittens
I am Domestic Shorthair from canton, NY
Nicknames: mitt mitt, corndog
Age: 4 years old
Gender: M
Coat: short haired
Education: bravery toward our dog
My favorite tricks and treats are: climbs into the bath with the wife and swims in the warm bubbly water and rice crispies with rice milk
Where I hang out: on the bed
My favorite grubs: limburger cheese
My pet peeves: mittens dont like onions
What I love about my owners: spoils me rotten
My cat hobbies: play with his toys
Pet motto: if it looks like a toy, it must be a toy - mittens
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my white manx which i had for 4 years from a kitten got poisened, and ill, and mittens was given to me at 3 months old
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WASHINGTON (AP) - A half-year after the United States began taking terror suspects to the Guantanamo Bay prison, the total has reached 564 from some 36 countries, and the Bush administration has made little apparent headway in deciding what to do with them.
The Russians want to take home their three citizens and prosecute them. The Swedes wonder whether their young countryman is really a hardened terrorist or just a misguided follower of Islam.
"It appears they have just put them down there and thrown away the key," said David Henderson, a spokesman for lawyers representing 11 of 12 Kuwaiti prisoners.
"The only thing we know for sure is they have five" French nationals, said Remi Marechaux of France's embassy in Washington. "We are waiting to see what the United States does with them."
Secretary of Defense Donald H. Rumsfeld said in February that authorities were interrogating prisoners to build legal cases as well as gather intelligence.
But three months after announcing rules for military tribunals, there's no sign officials will try anyone.
And the Justice Department has announced no plans for civil trials of inmates at the Guantanamo Bay Naval Base in Cuba.
Officials at the departments of Justice, Defense and State involved with the operation all refused requests for interviews.
But others who have been briefed about Guantanamo paint a picture of an operation still inx crisis mode - with officials worried primarily about finding more terrorists and preventing attacks.
That means painstakingly collecting and crossmatching information, including from prisoners, other countries and the mountains of documents, computer discs and other items found in al-Qaida hide-outs in Afghanistan and elsewhere.
Prosecution is not the priority. At least a dozen governments say they'd like to prosecute their own citizens.
Several say they're unsure how that would be done because American authorities haven't shared information about possible charges or evidence.
"We have requested since early on that we want them to be turned over to us," said Saudi Arabia's embassy spokesman Nail al-Jubeir of the estimated 100 Saudi detainees. "We are still waiting."
Sixteen foreign delegations have visited Guantanamo to identify citizens, check on their welfare and question them. Britons went three times to visit the six British nationals held. Kuwait and Saudi Arabia haven't been given access yet. But most countries aren't pressing to repatriate prisoners. Not privy to evidence or possible charges, some foreign officials say they're unsure prisoners can be tried under their laws. Some countries also fear that trials at home could cause trouble.
Cato Institute constitutional expert Robert A. Levy wonders whether there will be any prosecutions from Guantanamo. Most men there aren't top al-Qaida or Taliban and the real purpose of incarcerating them in the first place was to gather intelligence, he said.
The few high-level figures in Osama bin Laden's terror network who've been captured aren't at Guantanamo.
, but at undisclosed locations. It's unclear what will be done with them, either, after officials finish interrogations.
Asked whether America might soon release prisoners not of intelligence value, Rumsfeld said he tended to think not.
On one hand, the Guantanamo prison is nearing capacity - 564 prisoners in permanent cells built for 600. But on the other hand, prisoners who don't seem of value now could turn out to be useful later, Rumsfeld said last week, adding that many have lied and changed their stories repeatedly but may eventually decide to cooperate.
Prisoner stonewalling has left interrogators uncertain of the identities and even nationalities of dozens, officials said.
The Swedes have said their citizen appears more a misguided young Islam follower than hardened terrorist.
"I don't doubt that a lot of these guys should be taken out and shot," Levy said, but others might be victims of a tragic mistake, perhaps scooped up for being in the wrong place at the wrong time.
The administration is in no hurry to let anyone go, having defined the men - many captured from battlefields - as combatants who can be held until war's end.
Saudi Arabia's al-Jubeir said his government is willing to let Americans go through that process, particularly if they share intelligence gathered by interrogators.
"After they're done with them, we want to try them in Saudi Arabia," he said. "Saudi justice is swift."
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The FBI says it is looking for the woman who robbed a bank in Raytown Tuesday afternoon.
Spokeswoman Bridget Patton said the Bank of America branch at 10017 E. 63rd St. was robbed about 12:20 p.m.
Investigators said a woman in her 40s came into the bank, handed the teller a demand note and left after getting some cash. The woman did not show a weapon and no injuries were reported.
Investigators said the woman is white, about 5 feet 8 inches tall, 150 pounds with a medium build and a pale complexion. She was wearing a purple beanie-style hat that covered her hair, a long gray or black jacket, sunglasses, black gloves, a purple scarf and carried a black bag.


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The newest Harry Potter movie, "Harry Potter and the Deathly Hallows Part 2," is getting rave reviews and has been hailed as the movie to see this summer. The eighth and final film of the series, it is based on the last Harry Potter novel by British author J.K. Rowling, who wrote the books from 1997 through 2007.
The books and movies played a part in the lives of these six summer camp counselors from St. Louis King of France's Camp Crusaders:
Dominique Wilthew – "My mom read the first two books to me when I was 8 years old, and then I read and listened to the audio tapes of the rest of novels. The last book was my favorite as it brought all of the characters back together in this book."
Brooke Ponder – "I was in third grade at St. Louis King of France School when we read the first of Rowling's novel as a class project. It was also exciting for me when we had a school field trip to see the movie after we read the book. I continued to read the books, and I have loved every movie that was made."
Dillon Hoffmann – "I remember reading the first book in the third grade at St. Louis King of France, but I didn't read any of the others. However, I loved all eight of the movies because of the special effects. This latest movie was awesome, and to me there is not another movie that could be better for special effects than the Harry Potter movies."
Sara Blakemore – "From reading the first book to the last one, I felt like I grew up with the characters in the novel. I think the author wrote her books with the idea of our generation growing up with the characters of Harry, Ron and Hermoine. And I am going to miss not having another book or movie to watch about Harry Potter."
Jennifer Baer – "I never read the books, but I saw all the movies and loved each one. I was always fascinated with how all the movies presented witchcraft in such a unique way."
Liz Pax – "The Harry Potter novels and movies were a big part of my childhood and adolescent years. I read each of the books four times to make sure that I did not miss anything that was written. J.K. Rowling's style of writing was unique and fascinated me. I also attended the midnight premieres of three of the movies. The final Harry Potter novel and this last movie made me realize that my childhood was over. And I hope that when I have my own children, I will be able to share my Harry Potter adventures with them."
I was in Scotland last summer and stopped to have coffee at the Elephant House Tea and Gourmet Coffee Shop in Edinburgh. As I walked over to a window to view the Edinburgh Castle on the hill, a waitress asked me if I was aware of the table that was by the window. Not knowing the importance of the table, I was elated when she told me that this was the table where J.K. Rowling wrote some of her first Harry Potter novel.
Top sellers named
The Boy Scouts of America's Southeast Louisiana Council has announced its top popcorn sellers for the year.
The overall top salesman was Cameron Black, who sold more than $6,000 worth of popcorn.
Other top sellers were:
Cypress District – Christopher Meyer and Nathan Chesire.
Bayou District – Floyd Milford IV, Zachary Rodrigue and Barry Williams.
Cataouatche District – Daniel Fernandez, Jacob Le Breton and Ethan Prunty.
Fleur Des Lis District – Luke Wills, Race Skrmetta and Gabriel Watts.
Pelican District – Nicholas Hagstette, Austin Faucheux and Ethan Bairnsfather.
Congratulations to everyone.
Email Hope Mazzeno at firstname.lastname@example.com


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On Tap Today: The Sanford legacy
The news that Sanford, one of Wisconsin's most-renowned fine-dining restaurants, had been sold made headlines this week. In Friday's Weekend Cue, Dining Critic Carol Deptolla looks back on Chef Sandy D'Amato's long career in Milwaukee.
Other local restaurants and pubs are making news by glamming up for the holidays. Writer Kathy Flanigan tells us where the tinsel is. »Read Full Blog Post


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Hi! My name is In luving memory of Moonlight
I am a Persian from Danville, IN
Nicknames: We would call her "Moon" or "Light" for short.
Age: 17 years old
Gender: F
Coat: long haired
My favorite tricks and treats are: If drooling when you pet her counts...
Where I hang out: The front steps.
My favorite grubs: Anything
My pet peeves: Being alone & when people stop petting me.
What I love about my owners: She pets me, plays with me, & gives me lots of attention.
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I had always liked Moonlight, & then her owners moved. And for some reason they just left her. So we took her in. She was our first & only out door cat. We fed her, pet her, played with her, & groomed her. Even though she was outside she was still spoiled.
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How Tubing and Luer Misconnections Occur
Tubing and Luer misconnections occur when one medical device is mistakenly attached to another medical device that performs a different function. Because these connectors are easy to use and compatible between different medical device delivery systems, clinicians can mistakenly connect unrelated systems to one another, causing medication or other substances to be delivered through the wrong tubing. These errors are sometimes called tubing misconnections, wrong route errors, catheter misconnections or Luer misconnections and can result in patient injury or death.
The FDA has received many reports of serious and even fatal misconnections. For example, an infant died when a feeding tube was misconnected to an IV. For more examples, visit the Examples of Tubing Misconnections page.


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NFL owners pass 2 rules changes
PHOENIX -- NFL owners approved two rule changes Tuesday to enhance player safety. They might not vote on a proposal to ban offensive players from using the crown of their helmets against defenders.
The owners outlawed peel-back blocks anywhere on the field; previously, they were illegal only inside the tackle box. A player makes a peel-back block when he is moving toward his goal line, approaches an opponent from behind or the side, and makes contact below the waist.
The penalty will be 15 yards.
Also banned is overloading a formation while attempting to block a field goal or extra point. Defensive teams can now have only six or less players on each side of the snapper at the line of scrimmage. Players not on the line can't push teammates on the line into blockers, either.
The alignment violation is a 5-yard penalty. The pushing penalty is 15 yards for unnecessary roughness.
But the potential change that has drawn the most attention -- yes, even more than eliminating the infamous tuck rule, which seems to be a foregone conclusion -- is prohibiting ball carriers outside the tackle box from lowering their helmets and making contact with defenders with the crown.
New York Giants owner John Mara, a member of the competition committee that has recommended the change, expressed doubt Tuesday that the proposal would be voted on before today, when the owners meetings conclude. He also said there was "a chance" it could be tabled until the May meetings in Boston.
- The Indianapolis Colts jumped at the chance to get a veteran backup for Andrew Luck.
On Tuesday, the Colts signed former Tennessee quarterback Matt Hasselbeck to a contract. Terms were not immediately released.
- With leading receiver Victor Cruz still unsigned, the New York Giants have added Louis Murphy. The Giants on Tuesday confirmed the signing of the speedy receiver who played last season with Carolina.
- A Florida family claims in a lawsuit that they feared for their lives when Cleveland Browns defensive lineman Desmond Bryant allegedly showed up drunk and shirtless at their home, repeatedly banged on the front door and ripped off a door handle.
The lawsuit, filed Monday in Miami-Dade County Circuit Court, seeks unspecified damages on behalf of Isaac and Iris Bakar and their three children, ages 10, 7 and 4. The family claims they thought someone was trying to rob them when the 6-foot-6, 311-pound Bryant came to their house at 5:30 a.m. Feb. 24 after drinking at South Beach nightspots.
- A federal magistrate has found that Titans wide receiver Kenny Britt is not guilty of driving under the influence after trying to pass through a security gate at Fort Campbell Army post on the Tennessee-Kentucky state line.
After a five-hour trial on the post Tuesday, U.S. magistrate Lanny King also found Britt was not guilty of violating the implied consent law for refusing to take a Breathalyzer test.
- The Dallas Cowboys and Miami Dolphins will meet in the Hall of Fame Game on Aug. 4 to open the NFL's preseason at Fawcett Stadium in Canton, Ohio.
-- from wire reports


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Continued Utility of Civil Service for the Chief's Position
By Alice E. Perry, Assistant District Attorney, Northwestern District Attorney's Office, Northampton, Massachusetts, and Doctoral Candidate at Northeastern University
This article is based on a survey of police chiefs in Massachusetts, and the focus is on the respondents' attitudes about the continued utility of civil service for the chief's position and the concomitant issue as to when leadership training should begin.
ivil service, whether it is state or local, provides a measure of job security against political changes. Critics of the system have pointed to the bureaucratic rigidity of civil service and the lack of flexibility and discretion in decisions. The civil service systems came about in the late 1800s and early 1900s to solve the problems of political patronage and corruption in government agencies, and, in some states, they still strongly influence government personnel decisions. Over the years, not much has changed in the civil service system.
Unlike the civil service system, the policing strategy in the United States has undergone tremendous shifts. Currently, policing is in the problem-solving era. One author contends that "strong leadership is integral to the success of preventive policing."1 The issue of leadership is of paramount importance for a variety of reasons; chief among those reasons is the global world with its varied cultures and diverse attitudes about law enforcement. Second is the intense media scrutiny of all things law enforcement, with its attendant local, national, and global publicity, which places a heightened stress on police leaders. Third, current economic woes facing the United States demand that fiscal resources spent on police agencies reap the most benefit for the communities they serve.
The Setting
The Commonwealth of Massachusetts has most of its population of 6.6 million living in the Boston metropolitan area. The eastern half of the state is made up of urban and suburban with a mix of rural areas, while western Massachusetts is mostly rural. Massachusetts is the most populous and wealthiest (by gross domestic product per capita) of the six New England states.
Massachusetts has been significant throughout U.S. history. Plymouth, Massachusetts, was the second permanent English settlement in the United States. Colonists from England founded many Massachusetts towns in the 1620s and 1630s, and many residents today can trace their roots back to these founding families. Then during the eighteenth century, Boston became known as the "cradle of liberty" for the agitation there that led to the American Revolution and the independence of the United States from Great Britain. It was also a center of the temperance movement and abolitionist activity. In 2004, Massachusetts became the first U.S. state to legally recognize same-sex marriage. Today, the state's economy is based on higher education, health care, technology, and financial services.
Massachusetts policing is steeped in tradition. During the political entrenchment era in policing from 1840 to 1900, police departments were decentralized into precincts. The neighborhoods were significantly influenced by local politicians that created an inextricable link between the politicians and the police. This was a time when cities were controlled by political machines. The politicians decided who would be hired as police officers and who would be rejected. These close ties with politicians inevitably led to patronage and corruption.2
Civil Service System
The reform and the professionalization of Massachusetts police departments began in the 1920s. Standards for eligibility, recruitment, and training were instituted. Centralization of decision making was implemented to remove political control from the precincts. A chain of command with an attendant rank-and-file system was established, which included top-down management with one-way authority over decision making.
During the reform era, Massachusetts police departments and the police chief's position were made part of the civil service system.3 It was assumed that if a prospective employee had to take an exam and score high enough to be hired, hiring practices would be removed from the politicians' grasps. In other parts of the United States, police leaders such as Orlando Winfield Wilson opposed the civil service system because of the belief that the civil service tests encroached upon the police chief's ability to select the most qualified personnel for leadership positions.4
Massachusetts is currently in the problem-solving era of policing. Problem-oriented policing seeks to integrate the police into the social fabric of the community.5 Problem-solving policing must deemphasize control and discipline and focus on leadership.6
Study Methodology
The Massachusetts Chief of Police Questionnaire was disseminated to the 350 police chiefs in Massachusetts; 100 police chiefs returned useable responses for a 28 percent response rate. A written survey was chosen as the research vehicle to solicit the wisdom of the Massachusetts chiefs on matters currently being debated by public policy makers nationally, as well as in Massachusetts.
Survey Analysis
Demographics: The respondent police chiefs ranged in age from 31 years old to 65 years old. Ninety-eight were white, one was black, and one respondent did not indicate race. Ninety-four of the respondents were male, and six were female.
In answering the questions about the highest education attained, sixty-five respondents had graduate degrees, nineteen had bachelor's degrees, nine had associate's degrees, and three had high school diplomas. Four respondents did not answer the education question.
The sizes of the police departments were also ascertained. Sixty-six respondents indicated their departments employed fewer than fifty employees, twenty-nine respondents reported their departments employed between fifty and five hundred employees, and five respondents did not answer the question.
Preferred education level: 84 percent of the responding Massachusetts chiefs possess a bachelor's degree, and, of particular note, approximately 68 percent possess a graduate degree. However, when queried about the level of education a police recruit should possess, the chiefs were almost evenly split in their preference for either an associate's degree or a bachelor's degree (see figure 1).
Eighty percent of my officers now have, at a minimum, a bachelor's degree; unfortunately, they all majored in criminal justice. I wish we could . . . attract candidates who might have a degree in philosophy, economics, history, or something other than criminal justice. I think it would make for a more well-rounded department. If you are intelligent, motivated, and sincerely committed to making a difference, we can teach you all the "cop stuff." It has always bothered me that we will pay an educational stipend to someone pursuing an associate's degree in criminal justice from Bunker Hill Community College, but will not offer the same to someone pursuing a bachelor's degree in sociology from Columbia.
The author has heard the chief's sentiments expressed many times over the course of this study. In short, the chiefs are saying that the law enforcement field would be well served with a diversely educated workforce, for example the addition of forensic accountants for white-collar investigations or mechanical engineers for accident reconstruction. In order to better serve communities and move in time with technological advances, the police forces should reflect this reality with diversification in educational backgrounds of recruits.
Attitude toward the civil service system: The civil service system was created by the desire to thwart political patronage and to remove government departments from political influence. The civil service system in Massachusetts was established in 1884.8 To hire police officers in Massachusetts cities and towns that use the civil service system, the appointing authority must use the "rule of three." The rule of three requires that the appointing authority select the candidate from the top three scores on the civil service examination. If a decision is made to bypass a name on the list, the appointing authority must justify the decision.
The Worcester, Massachusetts, Research Bureau reports that in cities with populations surpassing populations of 40,000, approximately 60 percent of police chief positions come under the civil service system.9 Adherence to the rule of three limits the discretion of the hiring body in the selection process for a new police chief. Candidates who are bypassed for promotion may grieve the bypass to the appointing authority and then to the Civil Service Commission.10
The litigant can appeal the Civil Service Commission's decision to the Superior Court and onward to the Massachusetts Supreme Judicial Court. Both of these courts review the Civil Service Commission's decision on promotion to determine if it violates any of the standards set forth in the administrative procedure statute governing judicial review and cases construing those standards.11 If the litigation is protracted, it can divide a department. There have been incidents when a passed-over captain spends years litigating the decision while still working with the successful candidate for police chief. This can create a divided workforce among employees supporting the passed-over captain versus the current chief.
According to Jonathan Walters, senior correspondent for Governing magazine, "[T]ime hasn't been kind to the Massachusetts merit system. Title IV, Chapter 31, of the Massachusetts General Code, entitled 'Civil Service,' a ponderous 233-page set of rules and precedents, is no longer up to the big job of helping government in Massachusetts recruit and hire the most talented personnel possible. Over the course of the century, Massachusetts has fallen well behind the leaders in public sector personnel administration practice."12
Walters points out that, nationally, other state public administration officials have been examining ways to improve the hiring, the recruitment, and the evaluation of state employees. Every state, with the exception of Georgia and Texas, has civil service systems.13
Of the police chief respondents in this survey, 63 percent did not hold a civil service position; 34 percent did have a civil service position. When queried as to whether the chief's position should remain in the civil service or should be removed from civil service, 41 percent believed the chief's position should be removed from civil service; 33 percent disagreed (see figure 2).
I have changed my position over the years. I used to think that the chiefs needed civil service protection, but now I see that the cities and towns need protection from bad chiefs they cannot get rid of. Civil service should be abandoned so as to ensure employees are hired and retained on their own merit, and not where they appear on a list. That's a difficult question. There are pros and cons to both, but I guess in the long run, the community is best served by a non–civil service chief.
The civil service issue is quite important. In order to maintain the high standards by police departments, it may be time to rethink the constraints placed on departments by adherence to the civil service system, starting with the chief's position.
Leadership development: The real issue is whether the civil service system provides the best leaders for the position. Today's role of the police chief is changing and extremely demanding. The erosion between state and federal boundaries has broadened the police chief's focus beyond local issues. Technology has changed the way in which police departments are directed and managed. Technology has also changed the way chiefs and police departments communicate with the community. The increased media attention to law enforcement and the use of social media outlets to show local policing activities and crime have added to the pressures of the chiefs' job.
In addition, the chief needs new management and leadership skills. Police chiefs must possess the talent to lead, motivate, and train the officers moving up the ranks. This officer training and education must be completed with increasingly smaller budgets and with the knowledge that lawsuits against municipalities and police departments continue to rise and show no signs of abating. Police chiefs require the intellectual acuity in this increasingly global world to respond with alacrity when presented with a crisis.
A critical element of this survey was to determine when leadership training should begin. Fifty-one percent of the responding chiefs replied that leadership training should begin at the police academy. That response did not change when cross-tabulated with the size of the department or with the respondent's educational background (see figure 3).
What the Chiefs Said
This survey set out to see how Massachusetts police chiefs felt about three important items, and they have responded accordingly. The critical messages follow:
Based on the outcomes of this study, it behooves public-policy makers to examine the current bureaucratic systems to see if they are still relevant. Policy makers would do well to listen to the sagacity of the present chiefs when deciding policy for future police leaders.■
Notes:1David A. Harris, Good Cops: The Case for Preventive Policing (New York: The New Press, 2005), 131.2Larry K. Gaines and Victor E. Kappeler, Policing in America (Cincinnati, Ohio: Anderson Publishing, 2003).3Ibid.4Edward A. Thibault et al., Proactive Police Management, 4th ed. (Upper Saddle River, N.J.: Prentice Hall, 1998).5Herman Goldstein, Problem Oriented Policing (New York: McGraw-Hill, 1990).6EmmaJean "E.J." Williams, "Structuring in Community Policing: Institutionalizing Innovative Change," Police Practice and Research 4, no. 2 (2003): 119–129.7The Likert scale is an ordered, onedimensional scale from which respondents choose one option that best aligns with their view. A common form is an assertion, with which the person may agree or disagree to varying degrees. In scoring, numbers are usually assigned to each option (such as 1 to 5). 8Jonathan Walters, "Toward a High-Performance Workplace: Fixing Civil Service in Massachusetts" (white paper, Pioneer Institute for Public Policy Research, Boston, Mass., 2000), 1, http://www.pioneerinstitute.org/pdf/wp13.pdf (accessed March 19, 2006).9Worcester Regional Research Bureau, "Reorganizing Public Safety Functions: Considerations For and Against," Report No. 05-05 (December 15, 2005), 1–15.10Mass. Assoc. of Minority Law Enforcement Officers v. Abban, 434 Mass. 256, 748 N.E.2d 455 (2001).11Id.12Jonathan Walters, "Toward a High-Performance Workplace," 1.13Ibid.
Please cite as:
Alice E. Perry, "Continued Utility of Civil Service for the Chief's Position," The Police Chief 77 (August 2010): 106-110, http://www.nxtbook.com/nxtbooks/naylor/CPIM0810/index.php#/106-110 (insert access date).
From The Police Chief, vol. LXXVII, no. 8, August 2010. Copyright held by the International Association of Chiefs of Police, 515 North Washington Street, Alexandria, VA 22314 USA.


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Snowboarding Forum - Snowboard Enthusiast Forums (http://www.snowboardingforum.com/forum.php)
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- - [HELP ME] Flow Era vs Stepchild Kam-Knife (http://www.snowboardingforum.com/boards/138569-help-me-flow-era-vs-stepchild.html)
[HELP ME] Flow Era vs Stepchild Kam-Knife
Im going to buy one of them, ill buy it online and get shipped to my house (international shipping, i have only this two options because shipping to my country is expensive) so i really need to be secure about what to buy...
i want a park board to improve my spins and rails, but not a full park with flex 1, i want to ride at full speed on the mountain too and just have fun with natural obstacles, jibbing a little and doing some stuff...
Stepchild Kam-Knife: Stepchild Snowboards Kamknife Snowboard | Backcountry.com
Flow Era:Flow Flow Era Snowboard - Freestyle Snowboards | Backcountry.com
i think flow era is a good option (i dont know if flow is overrated), but the stepchild has something that makes me want to buy it, so help me please!
The ERA has a sintered base, the KAMKNIFE has a Snag Free base...
What the hell is a snag free base? or is that just another way of saying an extruded base, made cheaply...??? I have never heard of that before, if extruded, then i understand, and i would not buy it, easy maintenance maybe, but just not a fan...
Love the ERA though, was considering getting that anyway myself from the sales... Hehe
That is cheap, but can get so much cheaper from the USA, and my neighbour will fly at least 4 times before the new season, and he is picking a new board up as well, hard case available and free baggage when he flies business as well, so may well end up with it... Hehe
I'm trying to justify hitting the "legg til" button, there's fuck all with snow up here in Gautefall, I feel a core shot coming up once the rain stops ;) time to properly lay this Operator to rest.
You start your easter yet?
To the OP, sorry to thread jack; the Era got a good review from BA, both Nivek & BA have nothing but good things to say about Flow decks. ERA got some fancy hybrid camber with a concave center that looks prime for pressing if your looking at some flat ground tricks. I'm personally going for the Shifty as I'm digging flat between the feet for an all round ride and that little camber section at the tips seems to me like a win win.
I'm also sorry for hijacking the thread, buit i would choose the ERA... Haha
I am dubious about anything that isn;t explained in simple terms, and that base is not one or the other in terms of what is normal on the shifty, and that leads me to believe it is probably a fancy name for extruded, which is not something i want another of...
yes we have started our Easter, my son is over until Sunday morning, we have hit up Kongsberg last monday, Oslo Winter Park tues & wed, went shopping in Sweden today, now got Friday and Saturday in Kongsberg before he flies home Sunday morning, i will head straight up to Kongsberg for the last day of the season there, and then just the Slush day left on the 1st May with Sneaky and his snowboarding school... So 4 days of snow left for me... Hehe
God i'm bored just thinking about having nothing to do already...!
The Kam Knife is a good board! Good choice on that. Snag free bases are hardened in the press, it cooks the base harder as it sandwhiches the board, just makes the bases a bit more durable and easier to maintain. All our boards come with this.
Hope that helps.
... What do you think about this? Flow era or Kam Knife?
I'm still not sure of it, in there TECH description, it says the bases are hardened in the press by a temperature controlled system that cooks the base harder, this process is applied to every base material we use...
Now the simple fact is, that the structure of a base is very simple, extruded and sintered.
They are both made with polyethylene pellets, Extruded are done under heat, and Sintered is by pressure...
So by the simple fact that they say they do it under heat, then surely it can't be a sintered base...
That is not to say an extruded base does not work, but an extruded base is cheaper due to time in manufacturing and how they are made, they are also easier to look after in terms of it makes little difference if you forget to wax, and they don't absorb wax as well as a sintered base, so asa whole they may be easier, but they certainly aren't better... When waxed properly and regularly a sintered is faster but they are harder to repair...
Snowboard Bases: Extruded Vs. Sintered
I would go with the ERA personally... ;) But again, others will have a different opinion...
I was struggling between the Flow ERA and the BUCKWILD from Ride
The ERA is winning right now... ;)
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$95.00$0.48 / ml
Offers & Perks
$95.00$0.48 / ml
A cult classic, Rodial Body Sculpture is an intensive gel formulated to help moisturise skin in problem areas and reduce the look of cellulite.
The fast acting formula is promoted when massaged onto the body used in upward movements, focusing on problem areas - thighs, bottom and upper arms.
|Aqua (Water), Alcohol Denat., Propylene Glycol Diethylhexanoate, Propylene Glycol, Cyclopentasiloxane, Polyacrylamide, Butylene Glycol, Cyclohexasiloxane, Phenoxyethanol, C13-14 Isoparaffin, Punica Granatum (Pomegranate) Extract, Gelidium Cartilagineum Extract, Siloxanetriol Alginate, Triticum Vulgare (Wheat) Protein, Caffeine, Lavandula Angustifolia (Lavender) Oil, Citrus Tangerina (Tangerine) Peel Oil, Parfum (Fragrance), Limonene, Lilial, Linalool, Alpha Isomethyl Ionone, Benzyl Benzoate, Lyral, Menthyl PCA, Laureth-7, Ethylhexylglycerin, Triethanolamine, Sorbic Acid, CI 17200 (FD&C Red No.33), CI 42090 (FD&C Blue No.1)
Massage onto problem areas – thighs, bottom, upper arms using upward strokes.


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text: Canon PowerShot ELPH 520 HS Digital ELPH Camera, Black Also available in Silver, Red, & Blue Flag this deal What's the matter? Choose a reason Dead deal Duplicate Bad link Spam Inaccurate No value Alive again Edit deal ancagavs Nov 28, 2012 that's a great price drop. our camera broke a few months back. Reply nimase85 Nov 27, 2012 This is a pretty nice Camera I so hope I get a new Camera this year so I might have to share this deal with a few people ;) Reply YellowYY Nov 27, 2012 Thanks for sharing. Reply ishoplive Nov 27, 2012 Free shipping with this camera. It's time for to buy a camera to travel. Reply 1 like seanvcxz Nov 27, 2012 That's a killer price for a camera with those specs. Perfect for a first timer. Reply Dexterous Nov 27, 2012 Good price for this cannon shot camera Reply tanush6 Nov 27, 2012 i still like these point and shoot cameras for their ease of use and price. thanks for the deal Reply tanush6 Nov 27, 2012 The prices have dropped considerably since the onset of digital SLR cameras Reply Load More Comments


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After films like The Prestige and Memento (remade here as Ghajini), and not to forget The Dark Knight, Chrisopher Nolan is the master of the mind-bending thriller. His ideas are audacious, his writing intricate and his filmmaking truly genre-breaking. Where, you wonder, does he come up with ideas like that!
At one level Inception has all the elements of a thriller, espionage, chases, shoot-outs, intrigue. But it all happens in a dreamscape that Nolan creates in the minds of his characters. And since the human mind cannot be completely controlled, no matter how much science advances, emotions can come in the way of best laid plans.
Inception is what is now called a high concept film—it works round the idea that if it is possible to remove ideas from a human brain, it is possible to do the reverse-plant an idea. And this can be used to destroy as well as to create.
Dom Cobb (Leonardo DiCaprio) can enter the dreams of his 'subject' and alter his waking reality. He is assigned by a Japanese businessman (Ken Watanabe) to destroy the empire of his rival Robert Fischer (Cillian Murphy) by having him break away from his father.
Cobb and his cohorts (Arthur (Joseph Gordon-Levitt), Eames (Tom Hardy), Yusuf (Dileep Rao), and a newly Adriane (Ellen Page) enter Fischer's mind, but Cobb's dead wife, Mal (Marion Cotillard), haunts his dreams and pops up at the wrong moments. This can endanger the mission.
They enter deeper levels of subconscious, and that allows for extravagant set pieces, but after a point, it all seems just a bit tedious. It is perhaps hard to grasp it all in one viewing, but the film, dazzling though it is, may not induce second-viewing pangs in most viewers.
Inception is the kind of film that evokes admiration and awe, but perhaps not universal adoration. And when you think about it, the meticulously crafted framework of sci-fi logic may not really hold up. There is a technique of lace-making that involves making tiny knots in the thread, but one wrong knot and the whole thing has to be discarded. Inception is something like that.


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De Coster, Dungey, Musquin, Roczen. Supercross 2013 interview
The Red Bull KTM USA team is ready for Supercross 2013. Ryan Dungey will be in 450 SX. Marvin Musquin in the 250 Lites East Region. Ken Roczen in 250 Lites West Region. Managed by Roger De Coster.
Here, Roger, Ryan, Marvin and Ken talk about Supercross 2013!
You can follow the team & each rider, on Twitter, Facebook, and Instagram here
Marvin, Ryan, and Kenny


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Instructions: This information will be used only to provide feedback to the instructor to help improve the quality of teaching. Please indicate your own feelings about the statements listed below. Try to consider each statement separately, rather than letting your overall feelings about the course and instructor determine your answer.
On the accompanying Opscan sheet, mark:
A if you Disagree Strongly with the statement
B if you Disagree Moderately with the statement
C if you neither agree or disagree with the statement
D if you Agree Moderately with the statement
E if you Agree Strongly with the statement
1. The instructor explained the material very carefully.
2. The instructor put the material across in an interesting way.
3. The instructor was well prepared for class sessions.
4. The instructor was enthusiastic about teaching psychology.
5. The material was presented in a well-organized fashion.
6. The instructor summarized the major points.
7. The instructor used enough examples or illustrations to explain the material.
8. Lectures were too repetitive of what was in the text.
9. The instructor's speech was effective.
10. The instructor spoke too fast.
11. The instructor used activities and materials to get students actively involved in the class.
12. The instructor managed classroom discussions well.
13. The instructor answered students' questions thoroughly.
14. The instructor was excellent.
15. The instructor knew if the class was understanding what he/she was saying.
16. The instructor made me feel free to ask questions and express my ideas.
17. The instructor was helpful when I had difficulties.
18. The instructor was sensitive to students' feelings and problems.
19. The instructor seemed concerned that the students learn the material.
20. The course material was too difficult.
21. The exams were too difficult.
22. The grading system was too harsh.
23. I would recommend this course to a friend.
24. My interest in psychology has been increased by this course.
Revised 5/2002


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DeLorme illustrated 2 new PN-line-up GPS receivers, the Earthmate PN-60w and the Earthmate PN-60, at the Outdoor Retailer Summer Market operate illustrate. These 2 devices share many of the aspects apart from the PN-60w appears with SPOT Satellite Communicator, creating it the fist handheld GPS with Type and Send outbound text satellite messaging.
Both devices contain GPX file support for suppleness in running and saving waypoint, geocache and track files; an altitude profile tool that pinpoints consumer location; new power management and 3.5GB in-built memory for storing maps and mid-air imagery. The PN-60w and PN-60 are prepared with 32-channel GPS navigation chipset, a color display, dual-core processor and are pre-loaded with DeLorme Topo North America GPS maps.


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TNT (Mon., March 5, 8 P.M. ET)
Part psychodrama, part fable, this portrait of the early years of British author Fleming is most interesting for a notable casting quirk. The man who created the dashing James Bond is played by Jason Connery, the son of the man who played 007 so memorably in seven films. Amid Fleming's Secret Service derring-do and effortless conquests of beautiful women, we meet the people on whom he purportedly based Q, M, Miss Moneypenny, Blofeld and other characters in his popular spy novels. David Warner, Kristin Scott Thomas and Joss Ackland co-star in this silly tall tale that just may tickle Bond buffs.
Picks and Pans Review: The Secret Life of Ian Fleming
updated 03/05/1990 AT 01:00 AM EST
•originally published 03/05/1990 AT 01:00 AM EST


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HONOLULU, Hawaii – The New Orleans Privateers men's basketball team fell to the University of Hawaii on Thursday morning, 91-58, at the Stan Sheriff Center.
The Privateers (1-3) were led by Isaac Mack with 14 points as he was the lone Privateer to score in double digits. Mack had an assist and a rebound in the game, while also making 2-of-3 3-pointers. Sophomore Kevin Hill led the team in rebounding with six.
Hawaii (4-2) had four players in double figures, as Brandon Spearman led the way with 16 points. Christian Standhardinger had a double-double with 13 points and 14 rebounds.
As a team, Hawaii was hot, shooting 45 percent (31 of 69) for the game while New Orleans was limited to 28 percent (16 of 58) from field goal range. Hawaii also sank 10 3-point baskets in the game to the Privateers' four.
New Orleans hung with the high-scoring Hawaii offense in the first half and tussled to take a two-point lead – 17-15 – in the first with 8:05 on the game clock. Hawaii mounted a rally of its own and took a seven-point advantage – 39-26 – into halftime. After the intermission, the Warriors went on a roll, scoring 52 second half points en route to the victory.
The Privateers will remain idle before traveling to Minnesota on Saturday, December 7. Tip-off is set for 2 p.m. ESPN3 will carry the contest.


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Jags Coach Gus Bradley Says He Still Trusts Justin Blackmon
Picking up a four-game suspension for a substance abuse violation less than four months after a new head coach has taken over isn?t the best way to make a first impression.
According to Ryan O?Halloran of the Florida Times-Union, Bradley still trusts the second-year wide out. He said he?s had ?six or seven conversations? with Blackmon already since the suspension was levied earlier this week.
?I told Justin I do trust him,? Bradley said. ?We both have to earn each other?s trust and I don?t want trust to be mistaken for being na?ve.?
Bradley intends on using the issue with Blackmon as a barometer to set the discipline for the team going forward. With a four-game suspension, Blackmon is now just one more offense away from a full season suspension. The Jaguars will need to hope Bradley?s trust in Blackmon will be rewarded or they could be playing without their former first-round pick for an extensive amount time.
For more on this story visit: Curtis Crabtree, NBC Sports Pro Football Talk


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Preview and discuss The Powerbroker by Bonnie Boswell.
During the 1950s and 60s, civil rights leader Whitney Young navigated a divided society. He challenged America's white business and political leaders directly, but his efforts to open the doors for equal opportunity were often attacked by Black Americans who felt his methods were in contrast with the Black Power Movement of the time.
For more information about the film, visit http://www.whitneyyoungfilm.com/the_powerbroker.html.
Community Cinema is a presented locally as a partnership between VPT, Catamount Arts, the Flynn Center for the Performing Arts, Lane Series at UVM, Osher Lifelong Learning Institute (OLLI) at UVM and the Rutland Free Library.


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Serving Size:
3/4 cup (31g)
Calories - Total Calorie count at this serving size: 118 Calories. The calorie chart below shows the breakdown for Fat, Carbs, and Protein. In this case, Calories from Fat = 8, Calories from Protein = 6, and Calories from Carbohydrate = 107.
Fat - One serving of this size contains 0.9 grams of total Fat. There can be several types of Fat in each food. In this case 0.62 grams are from Saturated Fat, Trans Fat is unknown, and there are 0.28 grams left over.
Cholesterol - A serving of this size contains no Cholesterol. This is good news if cholesterol is part of your healthy eating plan.
Carbohydrates - Total Carb count for one serving: 26.68 grams. Sugar: 10.53 grams, Fiber: 0.59 grams, and Net Carbs: 26.1 grams (helpful to know if you're counting carbs).
Protein - There are 1.62 grams of Protein in each serving of this food.
Minerals - There are 6.88 mg of Iron and 5.27 mg of Calcium in each serving of this food. In addition, there are 196.85 mg of Sodium and 61.07 mg of Potassium in this food.
Vitamins - This food provides both Vitamin A (508.4 International Units) and Vitamin C (15 mg).
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Apple Cinnamon Squares Mini-Wheats Cereal
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Cinnamon Marshmallow Scooby-Doo! Cereal
Corn Pops Cereal
Cracklin' Oat Bran Cereal
Crispix Cereal
Kellogg's Cinnamon Mini Swirlz Cereal
Kellogg's Complete Oat Bran Flakes Cereal
Kellogg's Complete Wheat Bran Flakes Cereal
Kellogg's Cran-Vanilla Crunch Cereal
Kellogg's Crispix Cinnamon Crunch Cereal
Kellogg's Cruncheroos Cereal
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Your Benefits
YOUR BENEFITS RESOURCESEmployees must enroll for benefits within 31 days of first becoming eligible, within 31 days of a qualified (IRS) change in family status, or at the next scheduled enrollment period. Detailed information on health plans, including dental and vision, life insurance plans and health and dependent care spending accounts is available online at www.ybr.com/gannett or by phone from the Your Benefits Resources Customer Care Center (1-866-343-2333).
Your Benefit Resources (YBR) Benefits and 401K for enrollment and information.
For operator, say "Representative" when asked for a password.
Employees enroll for benefits online at www.ybr.com/gannett, or by calling the Customer Care Center (1-866-343-2333). Eligibility and benefit determinations are made in accordance with prevailing plan documents. Additional information and plan brochures are available from Human Resources.
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