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The two ambulance services in Loudon County have reached a tentative agreement to better serve residents.
Loudon County commissioners, the county 911 attorney, Rural/Metro and Priority Ambulance met Thursday after two incidents when ambulances were slow to respond.
Rural/Metro has a contract with Loudon County to provide ambulance service in the county, but Priority Ambulance has the service contract with the City of Loudon and Lenoir City.
That left dispatchers not knowing which ambulance to send during an emergency.
'"That slows down response, plus just creates that extra chance that you could have a mistake and we don't want the mistakes. In this business mistakes are tragic, purely and simply," said Wayne Henry, Loudon County 911 attorney.
They will all meet again next Wednesday to come up with a formal protocol.
Back in May, Rural/Metro sued Lenoir City claiming the city's contract with Priority Ambulance violated its contract with Loudon County.
Rural/Metro says that lawsuit still stands.


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Support » Plugins » Looking for form plugin that logs cookies or IP
6 years, 9 months ago
I'm looking for a form plugin that can be restricted to one submission a day for every cookie or IP.
I've installed wp-polls, which can log cookies or IP. The only problem with this is that the user can only answer through checkboxes or radio buttons. They cannot submit answers in a textarea. If someone knows a workaround for this or knows of a better-suited plugin, please let me know. Thanks!

subset: commoncrawl


text: Over forty percent of the water pumps in Malawi are not working. The maintenance requires specialised knowledge, tools and spare parts, which are often not available within rural communities. We were founded in response to this lack of sustainability and have worked with the University of Edinburgh and local Malawian artisans to develop two simple, innovative and sustainable hand pump technologies - the Abakus and the Alinafe pumps. They can be built and maintained by rural communities, using locally available and low cost materials. For more information please click on the photographs.


text: Im interested in forming an assault static, i'm in dire need of ranking up and i need many of the items involved with it. I am currently Private First Class and I have Cor, Blm and Thf at 75. Many more jobs at various levels. If anyone is my rank or lower and is willing to do 4 assaults a week with me please let me know, I am very interested in joining or forming a static.


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UNH Procurement Services
Purchasing has developed this web page to assist you in your contacts with our office. It is in our mutual interest to strive to improve our business relations. If you have any questions, please do not hesitate to contact us.
Quick Access:
|Contact Purchasing
|Commodity Groups
|Terms & Conditions
|Site map
|Staff Directory
|Storm Info
General Information
As a public institution, we follow regulations established by the University System of New Hampshire Board of Trustees. Purchases at the University of New Hampshire are made to support academic and research programs as well as activities such as physical plant, housing, and food service. Common purchases include, but are not limited to, scientific equipment, office furniture, chemicals, construction, machinery, office supplies, and services.
USNH requires competitive bids to keep costs at a minimum and to give interested suppliers an equal opportunity to supply goods and services to the University System. If you're interested in providing goods/service to USNH, check our web site often for a current listing of available bids/proposals. Also, check the USNH Contracts List for information regarding existing contracts.
Purchasing Objectives
Purchasing professionals must have a highly developed sense of professional ethics to protect their own and their institution's reputation for fair dealing. To strengthen ethical awareness, Purchasing follows the NAEP code of ethics. Whenever possible we attempt to consolidate our requirements whether they be paper, copiers, or cleaning supplies. Whenever possible, we use volume purchasing and annual contracts to cover these requirements. We solicit your recommendations for products to include in our consolidated purchasing programs.
USNH has a Purchasing Card (PCARD) program. The USNH Pcard is actually a MasterCard Commercial Card which we use for high volume, low dollar purchases. Each BSC/department has the authority to identify, initiate and purchase certain goods using the card (within USNH procedures) for high volume, low dollar purchases.
BSC/Department Responsibilities
To provide for smooth and efficient processing of all requests, both the BSC/department and purchasing need to work together. Below is an outline of responsibilities of both parties. When each participant complies with these expectations, the purchasing process advances easily.
It is the University's policy to declare curtailed operations when the most severe weather conditions are expected or experienced. You may call the UNH Storm Hotline at 603/862-0000 to learn if the University is open or if curtailed operations are in effect. Any events scheduled for a day when curtailed operations have been declared will be postponed until the next business day at the same time as originally scheduled.
Back to Purchasing Home Page


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Rutger Hauer Autographed 'The 10th Kingdom' Beautiful Photo!
Here we have a very special photo from 'The Tenth Kingdom', the TV mini-series directed by David Carson and Herbert Wise, with Kimberly Williams, John Laroquette, Scott Cohen, Diane Wiest, etc !
Rutger played in an unforgettable way the 'Queen's Huntsman' character!
This glossy color close-up measures 12" x 8" (30 cms x 21 cms) and is printed on photographic paper.
Rutger has autographed it in light blue permanent ink.
A one-of-a-kind item!
Thank you for your support to Rutger's Starfish!
The Rutger Hauer Starfish Association is the real source for Rutger's autographed items. Fans and autograph collectors can find here the widest choice of original autographed materials, all coming directly from Rutger's own archives:


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Here you'll find the most recent content from around TU — blog posts, photos, videos and more from TU staff and members like you. Use the filters above to turn content on and off. For more information watch a video here.
The summer pattern has started where striped bass and bluefish are scattered throughout the Middle and Upper sections of the Chesapeake Bay.
Good tides during week, flat by the weekend. Back bay water temperature in the high70s so fish the front of the bay. Be sure to work the flies...
This week will start off very cool and wet with daytime highs barely hitting sixty degrees.
Trout fishing is currently excellent for larger trout. The fish are red hot. Daily flows are variable with improving consistency. Best current...
fish hoppers in afternoons and evenings
Steamers in deep water with fast retrieve
Work edge of flats early on in coming tide. Water is crystal clear and warnind up. reds and trout will really start to feed.
We had a warm spell last week, but rain and cooler temps should make for nice morning conditions this week.
Cooling water and shorter days see the fish feeding around mid day early afternoon.
The river is skinny but in great shape
Starting to be summertime in the Whites with some afternoon thunderstorms coming in the afternoon.
Find friends and other anglers
Join groups of like-minded anglers
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While Carl will deal with the latest shocking twist in his own way, Rick and the other survivors are gearing up for something big as Randall escapes the barn.
After arguing over whether they will kill Randall, the survivors have to bury a man on "The Walking Dead". In a shocking twist, it's not the prisoner who was dead in the latest episode, but it's the man who had been fighting for Randall's life, [SPOILER ALERT!] Dale.
Dale was attacked by a zombie whom Carl baited out of the mud, before Daryl mercifully ended the old man's life. As he realized that he indirectly caused Dale's death, Rick's son will somehow be affected by this tragedy, but his reaction may be different to a child living in a normal world would be.
"How he deals with that is going to be very different than how someone would deal with that if they had not grown up in this world," creator Robert Kirkman explains what's to be seen from Carl. "We're going to see him grow and change over time and twist and turn into something that may not be recognizable as what we perceive a child to be, which is really kind of cool."
Losing the man, who had been fighting for their humanity, will send the group in a bad place as Kirkman teased, "Now, we don't know how they're going to deal with Randall and we don't know what they're going to do as Rick and Shane continue to butt heads."
He went on dishing, "They've lost a very important piece of their ensemble, and so they're not going to be able to make the same decisions they would have made and that's really going to affect the group as a whole. They are kind of in a bad place and we're going to have to deal with that."
In the next episode of "Walking Dead", the survivors will move forward to stay alive post-Dale's death. In some sneak peeks from the upcoming outing, Rick is seen preparing the group for something big as Randall escapes the barn and may endanger the whole survivors.
"Better Angels" will air Sunday, March 11 at 9/8c on AMC.
"The Walking Dead" 2.12 preview:
"The Walking Dead" 2.12 clip #1:
"The Walking Dead" 2.12 clip #2:


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Latest question:
How do you think the new GigE standards will influence the machine vision industry?
Respond or ask your question now!
By Advanced Imaging Editorial Staff
UC San Diego Unveils World's Highest-Resolution Scientific Display System
As the size of complex scientific data sets grows exponentially, so does the need for scientists to explore the data visually and collaboratively in ultra-high-resolution environments. To that end, the California Institute for Telecommunications and Information Technology (Calit2) has unveiled the world's highest-resolution display system for scientific visualization at the University of California, San Diego.
The Highly Interactive Parallelized Display Space (HIPerSpace) features nearly 287 million pixels of screen resolution—more than one active pixel for every U.S. citizen, based on the 2000 census.
The HIPerSpace is more than 10 percent bigger (in terms of pixels) than the second-largest display in the world, constructed recently at the NASA Ames Research Center. That 256-million-pixel system, known as the hyperwall-2, was developed by the NASA Advanced Supercomputing Division at Ames, with support from Colfax International.
The expanded display at�Calit2 is 30 percent bigger than the first HIPerSpace wall at UCSD, built in 2006. That system was moved to a larger location in Atkinson Hall, the Calit2 building at UCSD, where it was expanded by 66 million pixels to take advantage of the new space. The system was used�officially for the first time on June 16 to demonstrate applications�for a delegation from the National Geographic Society.
"Amazingly it took our team less than a day to tear down the original wall, relocate and expand it," said Falko Kuester, principal investigator of the HIPerSpace system. "The higher-resolution display takes us more than halfway to our ultimate goal of building a half-billion-pixel tiled display system to give researchers an unprecedented ability to look broadly at large data sets while also zooming in to the tiniest details."


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Perry Surrenders, is Booked
In an event that looked more like a campaign rally than a booking (the governor's office called it a 'processing'), Gov. Rick Perry surrendered to be fingerprinted and booked this afternoon on two felony charges of misuse of his office," Newsradio 1200 WOAI reports.
"I'm here today because I believe in the rule of law," Perry declared to the overwhelmingly supportive crowd, many of him carrying signs reading 'Rick is Right.'
"I am here today because I did the right thing. I will enter this courthouse with my head held high, knowing that the actions that I took were not only lawful and legal, but right."
During his twenty minute booking, Perry and two of his lawyers could be seen inside the glassed in Sheriff's office laughing and patting each other on the back.
Perry, 64, is charged with abusing his authority by threatening to veto $7.5 million in state funding for the Public Integrity Unit of the Travis County District Attorney's office, after D.A. Rosemary Lehmberg had been arrested in an embarassing DWI case.
Perry told supporters that he is facing charges because Democrats 'are trying to do in the courthouse what they failed to do at the ballot box.'
His arraignment, where he will enter a not guilty plea, is set for Friday.
Perry promised that he will continue doing the people's work, despite the 'distraction' of the criminal charges.
"If I had to do so, I would veto funding for the Public Integrity Unit again," Perry declared to cheers from his supporters.
Republicans have already begun making the case about Lehmberg and not about Perry. T-shirts seen at today's event showed a picture of Leghberg in restraints and sticking her tongue out at a Sheriff's booking camera, with the caption "THE NEW FACE OF THE DEMOCRATIC PARTY.'


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By Spencer Israel, USA TODAY
During the top of the second inning in yesterday's spring training game between the Diamondbacks and Giants, Arizona centerfielder Chris Young broke into a hard sprint--but he wasn't running to or from a base.
Young was instead running toward left field, away from a giant swarm of bees that had suddenly appeared in the form of a dark cloud over right field.
"I didn't see them at first, I just heard them." Young said afterward. "I'm not afraid of one or two of them. I wouldn't flinch at that. When you start talking about 500, 600 of them yea, I am afraid of that."
The swarm eventually moved down the right field line and toward the Giants dugout behind first base, delaying the game for 41 minutes. Two nearby sections of fans were evacuated, as many of the bees settled in a camera well next to the dugout.
To get rid of the swarm, the Diamondbacks' grounds crew concocted sugary distraction that could keep anybody up for days.
By smearing two utility carts with a combination of concession-stand lemonade and cotton candy, the crew was able to lure most of the bees away from the players, fans and field. Some bees however remained on a television camera.
During the delay, some players hung out on the field or signed autographs for fans. But Giants centerfielder Angel Pagan was prepared for the worst.
"I was right next to the bathroom in case I had to lock myself in," he said.
The game eventually resumed, with only a Salt River Field employee reported being stung.
Sunday couldn't have been a worse time, if there is a good one, for a swarm of bees to overtake Scottsdale's Salt River Field. A field record 12,568 fans attended the game.
This was the second time in as many days the Giants have been plagued by an unusual incident. Saturday, the team had to evacuate their facility at Scottsdale Stadium because of a gas leak.
San Francisco manager Bruce Bochy wondered aloud what Monday would behold for the 2010 World Series Champs.
"Let's see, yesterday gas, today bees. What's next? Tomorrow night is a night game, so bats?"
Monday the Giants play host to the Brewers at 6:35 local time. Stay tuned.
The Associated Press contributed to this report.
Daily Pitch is a baseball fan's destination for breaking news, emerging trends and enlightening banter. With a veteran group of reporters positioned in three time zones, we provide a balanced, comprehensive glimpse at our national pastime, with a nod to both the passion and complexities that make the sport irresistible to many. More about our reporters


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Our finance recruiters are specialists in the markets that they serve; local knowledge combined with the international resources of PageGroup means the capability to handle any hiring brief.
Who we are
PageGroup is recognised worldwide for our finance recruitment track record. This reputation, built over nearly four decades, has led the way for our global diversification; specialist finance teams are often established first in each new market we enter.
Many of our consultants are qualified accountants and ex-finance professionals, meaning their recruitment expertise is underpinned by first-hand knowledge of what it's like to be an employer or candidate in this market.
What we do
We recruit the full range of finance roles, from part qualified accountants to group FDs through all of our brands, including Michael Page, Page Personnel and Page Executive. We recruit candidates on a permanent, temporary, contract and interim basis for employers of all sizes, in most industry sectors. We've also established dedicated teams in the specialist fields of actuarial, audit, tax, treasury and more.
Roles we recruit
Audit and Consulting
Discover more about PageGroup
About Us
Established in the UK in 1976, PageGroup has grown to become one of the world's best-known and most respected recruitment consultancies.
Find out more
Our Locations
With operations in 36 countries, PageGroup provides recruitment services and career opportunities on a local, regional and global level.
Our Brands
PageGroup operates three key brands: Page Executive, Michael Page and Page Personnel, supported by additional brands across our business.
Find out more
Our focus is on specialist areas of the market, including industry sectors and job functions, replicated across our international network.
Our strategy is to increase the diversification of PageGroup by organically growing teams, offices and disciplines.
Contact PageGroup
Work for Us
(PageGroup plc)
Page House, 1 Dashwood Lang Road, The Bourne Business Park, Addlestone, Weybridge, Surrey KT15 2QW. Registered number: 3310225.
Tel: 44 (0) 207 831 2000
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Few things in life are recession-proof, and that includes the smart fortwo. Although sales of the little microcar are reportedly still strong, an increasing number of customers are canceling their orders.
Doing so creates "orphans," a cute way to describe cars left on dealer lots. Those familiar with traditional dealerships may not perceive this as a problem, but it's in stark contrast to Smart USA's typical distribution process. Aside from demonstration cars, dealers can't order cars to their dealership unless the car is ordered for a specific customer.
Although exact orphans figures aren't available through Smart, Automotive News quotes a dealer in Maryland as having nearly 48 orphans sitting on the lot. Another reported having 15 examples on the lot, nearly 2-3 times the number of orphans the store handled in 2008.
Why are customers dropping their orders? Some say it's simply a matter of today's weakened economy. Many customers were buying Fortwos as a second or third car – or, in some cases, "toys." Such a move may not seem smart, if even possible, in today's market.
Still, those orphans aren't wasted. Smart USA launched its "Smart Express" program in January to help match customers with unsold cars. Dave Schembri, president of Smart USA, still feels the brand is on track to sell 25,000 cars in 2009.
Source: Automotive News


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You are a fan of enterbrain nursing ? Come to discover the best forums enterbrain nursing on the internet and share your experience with a community fan of enterbrain nursing . You can also build a forum enterbrain nursing and create your online discussion.
free forum : a community of Pinay/Pinoy who will underatake the Competency Assessment Program in New Zealand and Nurses already working in New Zealand.
#nursing, zealand, philippines, competency, program, nurse2nz
Family planning, burial/cremation plans, stop elder abuse, nursing home abuse, abuse by a care giver, time management guilt, assisted living comparison shopping
extended, family, care, planning, burial/cremation, plans, elder, abuse, #nursing, giver, time, management, guilt, assisted, living, comparison, shopping
We will be using this forum to communicate with each other.
#nursing, clinical-, roland, park, place, communicate
Hello All! This forum is where we will be communicating throughout your experience here. I may throw out some questions and each of you are welcome to jump in!
lijmc, 2017, #nursing, externs, all!, communicating, experience, throw, questions, welco


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Astronomers have spotted a planet they call a "super-Earth" about 42 light years away that could have liquid water and an atmosphere stable enough to support life as we know it.
The new super-Earth planet sits in the habitable zone of a nearby star known as HD 40307, and is part of a six-planet system that was previously thought to contain three planets in orbits too close to the star to support liquid water. A new developed software package that is able to process the signals more thoroughly reveal the presence of the three additional planets. The astronomy team, including Carnegie co-author Paul Butler, Mikko Tuomi of the University of Hertfordshire and Guillem Anglada-Escudé of the University of Göttingen , reanalyzed spectra taken with the HARPS spectrograph through the European Southern Observatory public archive.
Tuomi said: "We pioneered new data analysis techniques including the use of the wavelength as a filter to reduce the influence of activity on the signal from this star. This significantly increased our sensitivity and enabled us to reveal three new super-Earth planets around the star known as HD 40307, making it into a six-planet system."
MORE: Greatest hits: When space and music collide
The planet outermost orbit from the star has raised the astronomers' interest the most. It has a mass at least seven times of the Earth. Its orbit around the host star is at a similar distance to Earth's orbit around our Sun, so it receives a similar amount of energy from the star as the Earth receives from the Sun - increasing the probability of it being habitable. "This is where the presence of liquid water and stable atmospheres to support life is possible and, more importantly, the planet is likely to be rotating on its own axis as it orbits around the star creating a daytime and night-time effect on the planet which would be better at creating an Earth-like environment," he astronomers said.
The star HD 40307 is a perfectly quiet old dwarf star, so there is no reason why such a planet could not sustain an Earth-like climate," said Anglada-Escudé.
The team noted that NASA's Kepler spacecraft found a planet with a similar orbit earlier this year but said that planet, known as Kepler 22d is 600 light years from Earth.
Check out these other hot stories:
US Navy outfits destroyers with potential $30 million worth of Gigabit Ethernet
DARPA seeks smart camera would blend visible, infrared images into a single shot
NASA shifts vital computer tasks onboard long-running Mars Odyssey satellite
FTC escalates anti-robocall campaign - takes out 5 mass callers
NASA teams to build gyroscopes 1,000 times more sensitive than current systems
First 20-ton mega-mirror finished-off for massive Magellan telescope
Gartner: How big trends in security, mobile, big data and cloud computing will change IT


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Tom Cruise becomes a film magazine 'legend'
Tom Cruise is a 'legend of our lifetime', according to the Empire film awards.
He was just one of a handful of Hollywood A-listers who made it to the movie magazine's annual bash.
Les Miserables star Hugh Jackman was handed an 'icon' prize, Emma Thompson was named best actress and Arnold Schwarzenegger received the 'action hero of a lifetime' award.
31 Mar 2014
- From the section Entertainment & Arts


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Scholarships made it possible for Mindy Le '12 to earn her degree in biology and prepare for a career in medicine.
Scholarships make dreams come true for Class of 2012
- June 14, 2012 5:46am
For thousands of students graduating this weekend, donning their caps and gowns wouldn't be possible without the generosity of alumni and friends of the University, and the funding they provide for scholarships and programs that keep the dream of a college education in reach.
More than 60 percent of CSUEB students depend on some kind of financial aid. ThanhPhuong (Mindy) Le, who graduates Friday with a B.S. in biology, is one of them. She's part of the first generation in her family to go to college in the U.S., and the first of her siblings to earn a bachelor's degree. Entering CSUEB as a transfer student, she had to work hard to manage her demanding schoolwork and her family responsibilities, making the 60-mile round trip to Hayward every day from San Pablo to attend classes — and every year as tuition fees went up, so did gas prices.
Even with graduation in sight, it wasn't easy to find the money to pay the bills and support her family. But thanks to programs like the "S.O.S." fund and the College of Science fund, Mindy was able to finish her coursework (with an honors-level GPA) and graduate, ready to focus on her next goal — applying to medical school.
We shared Mindy's story with donors and friends this spring to encourage them to support the University's Annual Fund, which provides funding for colleges, special programs, and scholarships that ensure students like Mindy have the support they need — academically, financially, and personally — to stay enrolled and graduate.
Raising money to support student success is one of the University's top priorities. Every year, these gifts provide:
- scholarships for students who need to balance school, work, and family responsibilities while maintaining their academic success;
- research- and project-based learning opportunities with faculty that give students invaluable experience conducting and presenting research;
- equipment and materials needed to provide state-of-the-art teaching.
Mindy may be graduating, but every year more students with stories just like hers enter CSUEB ready to work to achieve their dreams. And with state support declining and tuition fees rising, they need help to get there.
Scholarships are an integral part of the University's mission and our commitment to the East Bay region. We thank all of the generous donors who made it possible for the Class of 2012 to reach their goals!
- © Copyright California State University, East Bay.
California State University, East Bay is the San Francisco East Bay Area's high-access public university of choice. CSUEB serves the region with campuses in Hayward and Concord, a professional development center in Oakland, and an innovative online campus. With an enrollment of more than 14,000, the University offers a nationally recognized freshman year experience, award-winning curriculum, personalized instruction, and expert faculty. Students choose from among more than 100 professionally focused fields of study for which the University confers bachelor's and master's degrees, as well as an Ed.D. in education. Named a "Best in the West" college, as well as a Best Business School, by the influential Princeton Review, Cal State East Bay is among the region's foremost producers of teachers, business professionals and entrepreneurs, public administrators, health professionals, literary and performing artists, and science and math graduates.


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Online Health Chat with Matthew D. Barber, MD, MHS
September 9, 2013
Pelvic organ prolapse is a downward descent of female pelvic organs, including the bladder, uterus and the small or large bowel. This drop results in the protrusion (sticking out) of the vagina, uterus, or both. Prolapse development can be caused by several factors, including vaginal child birth, advancing age, and obesity. It occurs when weakened muscles cause one of the pelvic organs, most commonly the bladder, to drop.
Nearly 50 percent of women who have had children are affected by pelvic organ prolapse. Many women are embarrassed to talk about this problem—even to their doctors. It is important to discuss your concerns with your doctor as there are many different treatment options available—both surgical and non-surgical methods.
About the Speaker
Matthew D. Barber, MD, MHS, is Professor of Surgery at the Cleveland Clinic Lerner College of Medicine at Case Western Reserve University and Vice-Chair of Clinical Research in the Ob/Gyn and Women's Health Institute. He is a board-certified staff physician in the Section of Urogynecology and Pelvic Reconstructive Surgery in the Department of Ob/Gyn and the Glickman Urological Institute at Cleveland Clinic.
Dr. Barber's specialty interests include pelvic organ prolapse, urinary incontinence, fecal incontinence, vesicovaginal, rectovaginal fistulas and management of pelvic mesh complications.
Dr. Barber completed his fellowship in female pelvic medicine and reconstruction and his Masters of Health Sciences degree in clinical research at Duke University Medical Center, in Durham, NC. Dr. Barber also completed his residency in obstetrics and gynecology at Duke University Medical Center. He received his medical degree from Thomas Jefferson Medical College, in Philadelphia.
Let's Chat About What to Do About Dropped Bladder
Matthew_D._Barber,_MD,_MHS: Good afternoon and welcome to this webchat on pelvic organ prolapse and urogynecology. Thank you for joining us today. It is a very common problem that many women have, but are too embarrassed to talk about. I look forward to your questions, and I hope to be able to provide some direction in regards to your concerns.
Some degree of relaxation or dropping of the bladder and vagina is common in women who have had vaginal childbirth. In fact, over one third of women who have had vaginal childbirth have stage 2 pelvic organ prolapse. Stage 2 is when the uterus or vagina protrudes to within 1 cm of the vaginal opening when they strain hard. Most women have no symptoms and do not require treatment. In essence, stage 2 could be considered normal in many women. We typically recommend treatment when a woman complains that they can feel or see a bulge coming through the vagina. Other related symptoms might be urine leakage or difficulty emptying the bladder or bowels. If you do not have these symptoms, then it is likely that you do not need treatment. If you are having these symptoms and they bother you, then your options for treatment are insertion of a pessary or surgery. Typically, we recommend surgery to women who have Stage 3 or 4 prolapse (i.e., prolapse that protrudes more than 1 cm beyond the vaginal opening with straining) or women with stage 2 prolapse who have bothersome symptoms. I would not recommend surgery to someone with stage 2 prolapse who did not have bothersome symptoms.
Causes of Pelvic Organ Prolapse
Redsnake: I was told that I have a prolapsed uterus by two different doctors. One said that I needed surgery right away, and the second said I am only at stage 2. When should I take action? I am very confused by these different opinions.
Matthew_D._Barber,_MD,_MHS: Vaginal childbirth commonly results in some degree of relaxation or dropping of the bladder. Although over one-third of women who have vaginal childbirth will experience stage 2 pelvic organ prolapse, most women have no symptoms and require no treatment.
LucyintheSkies: I have never had children. Does this give me a better chance of not having a dropped bladder or uterus? Or are there other factors besides vaginal birth that can lead to pelvic organ prolapse?
Matthew_D._Barber,_MD,_MHS: Yes, women who have not had vaginal childbirth have a lower risk of developing pelvic organ prolapse than those who do. Other clear risk factors are increasing age and being overweight. Some studies suggest that having a hysterectomy, smoking and having a job that includes heaving lifting also increase your risk. There is certainly a genetic risk as well.
shoeluvr: Can numerous fibroids and an enlarged uterus cause bladder prolapse? Why does my gynecologist think my bladder bulging into my vaginal canal is a fibroid even after I was sent to a urologist for stress incontinence issues?
Matthew_D._Barber,_MD,_MHS: Typically, uterine fibroids would not cause bladder prolapse. However, they can certainly make the symptoms and/or the degree of prolapse worse, depending upon the size and location of the fibroid. It is also possible that a fibroid in the right location could actually cause the front wall of the vagina—where the bladder is—to protrude. An ob/gyn can often figure this out with a pelvic examination, but sometimes an ultrasound or MRI is needed.
Association of Prolapsed Bladder and Rectocele
laura628: Can a prolapsed bladder contribute to a rectocele?
Matthew_D._Barber,_MD,_MHS: The often occur together, but it is unlikely that one caused the other.
Prolapsed Bladder and UTIs
gogetter: I have frequent urinary tract infections (UTIs) and I have prolapse of the bladder. I shower twice a day and drink lots of water and do everything I can to prevent UTIs. Is there any surgery to hold the bladder up away from the urethra?
Matthew_D._Barber,_MD,_MHS: In addition to drinking lots of water, other options for recurrent UTIs include using a vaginal estrogen cream (if you are postmenopausal) and/or taking a protective ('prophylactic') antibiotic every day. Sometimes when the UTIs appear to be related to sexual intercourse, you can take a low dose of antibiotics right before or right after intercourse to prevent them as well. In someone with prolapse, having surgery to correct the prolapse may also help.
Asymptomatic Bacteriuria vs. UTI
dcmna3: In the elderly, bladder infections seem to occur so frequently to the point my mother's doctor has told me he doesn't treat them. Then she developed a severe infection with blood loss that landed her in the hospital. Any suggestions on additional preventive medicine? Any special considerations for the elderly patient?
Matthew_D._Barber,_MD,_MHS: Many elderly patients have what doctors call 'asymptomatic bacteriuria' where the bladder becomes permanently colonized with bacteria, much like our mouths have bacteria that live in them. It is important to distinguish between a real UTI and asymptomatic bacteriuria in older patients. Asymptomatic bacteriuria should generally not be treated while a true UTI, which would often be associated with burning with urination and urinary frequency and urgency, should be treated. I would suggest your mother see a urologist, urogynecologist or infectious disease specialist if she has not already.
Staging Pelvic Organ Prolapse
grahama2: I have heard that there are stages of prolapse. How are these stages determined, and does the stage then indicate a specific treatment pathway?
Matthew_D._Barber,_MD,_MHS: Yes, urogynecologists stage prolapse by determining how far different portions of the vagina or uterus descend when a women strains during a pelvic exam.
- Stage 0 is perfect support of the uterus and vagina
- Stage 1 is mild descent of the vagina or uterus but no descent beyond 1 centimeter above the vaginal opening
- Stage 2 is descent to within 1 cm above or beyond the vaginal opening
- Stage 3 is prolapse more than 1 cm beyond the vaginal opening
- Stage 4 is complete prolapse of the vagina and/or uterus
Most women who have stage 0 or 1 and many who have stage 2 can be considered normal. Almost a third of women who have had children have stage 2 prolapse and many don't have symptoms and may never develop them. We offer treatment to women with Stage 3 or 4 prolapse and women who have stage 2 who have bothersome symptoms.
Kegel Exercises
bbo: What exercises will help?
Matthew_D._Barber,_MD,_MHS: Pelvic muscle exercises, often called Kegel exercises, can be effective in improving vaginal support and slowing down prolapse. The pelvic floor muscles are the muscles around the vagina and bladder that you squeeze when you 'hold' your urine. We typically recommend 15 pelvic muscle contractions performed three times per day. It is also important to contract your pelvic floor muscles when you are lifting heaving objects and doing other activities that put pressure on your pelvis.
misslottie: What can you do if it is just beginning to drop? Is there anything besides surgery?
Matthew_D._Barber,_MD,_MHS: Pelvic muscle exercises, often called Kegel exercises, can be effective in improving vaginal support and slowing down prolapse. The pelvic floor muscles are the muscles around the vagina and bladder that you squeeze when you 'hold' your urine. We typically recommend 15 pelvic muscle contractions performed 3 times per day. It is also important to contract your pelvic floor muscles when you are lifting heaving objects and doing other activities that put pressure on your pelvis.
Magic: I am 72 years old and been diagnosed with mild to moderate bladder prolapse. Will Kegel exercises help me enough to avoid surgery in the future?
Matthew_D._Barber,_MD,_MHS: They might. Kegel exercises can be helpful in improving mild to moderate prolapse and urinary leakage. If you begin to notice bulging from the vagina, then you can consider a pessary or surgery. If urine leakage is your biggest issue, then sometimes surgery is appropriate, but often behavioral treatments and/or medications can be helpful depending upon the cause of the urine leakage.
Congor: Will doing Kegel exercises while wearing a pessary cause erosion of the vagina walls?
Matthew_D._Barber,_MD,_MHS: No, I would think not. Erosions are caused by a pessary that is too large or in the wrong place that constantly compresses the vaginal wall. They can typically be prevented by making sure you have the appropriate fit for your pessary, using estrogen cream in the vagina if you are past menopause, and undergoing regular examinations by your physician.
Pessary Treatment
eileena: What are the advantages and disadvantages of using a pessary? Can it permanently damage the vagina?
Matthew_D._Barber,_MD,_MHS: Pessaries, which are like diaphragms inserted into the vagina to correct pelvic organ prolapse, are really the only non-surgical treatment for prolapse. They are very safe as long as you are seen and examined by your ob/gyn (obstetrician-gynecologist) or urogynecologist every few months. Some of my patients love them and have used pessaries for decades without any issues. Other patients of mine don't like how they feel and don't use them for very long. The only way to know for sure is to be fitted for one and try it for a while. About 50 percent of women who try a diaphragm, and can be successfully fitted will be happy, and still using them a year later. The major side effects of a pessary are an increase in vaginal discharge and, in some cases, an odor. Also, sometimes it can cause erosions or abrasions of the vagina that will require either treatment with an estrogen cream or temporary or permanent removal of the pessary. That is why it is important that anyone who uses a pessary have regular pelvic examinations by her physician.
Congor: I have been wearing a pessary successfully for five years for cystocele with uterine prolapse that was diagnosed when I was 77 years old. My gynecologist said that 90 percent of what was outside my body was my bladder. The rest was the tip of the uterus. He also said that my vaginal walls are thin and weak and that the pessary will help support the walls. I do have occasional urge incontinence, which I assume is related to the cystocele. When my gynecologist retired I went to another one who put hormone cream on the pessary after cleaning it and before reinserting it. He prescribed Estrace® (estradiol) vaginal cream and advised me to use a full plunger of the cream once a week.
Does Estrace® strengthen the walls of the vagina, and if so, do the risks of Estrace® outweigh the benefits for an 82-year-old woman? Another doctor advised me to use the gel of a vitamin E capsule and apply it to about an inch inside the vagina instead of Estrace®. Would that have a beneficial effect?
Matthew_D._Barber,_MD,_MHS: Estrogen creams, like Estrace®, are often recommended in women who are using pessaries in order to decrease the risk of developing an erosion or abrasion of the vaginal wall that can result from the pessary. Estrogen does appear to strengthen the vaginal wall and decrease the risk of these erosions. It also decreases the vaginal discharge and odor that some women get with pessary use. At the dose and frequency you describe, estrogen cream is safe. In fact, estrogen cream placed into the vagina typically does not affect organs outside of the genital tract so you don't have to worry about the same side effects that you might when you take estrogen by pill.
Delaying Treatment for Pelvic Organ Prolapse
eileena: If you decide to live with pelvic organ prolapse and not correct it through surgery or other means, is there a health danger? Are there consequences to just leaving the prolapse alone?
Matthew_D._Barber,_MD,_MHS: We offer treatment to women for pelvic organ prolapse when they develop bothersome symptoms such as seeing or feeling a vaginal bulge through the vaginal opening, urinary incontinence, or difficulty emptying the bowels or bladder. In women without these symptoms, particularly if they are not bothersome, treatment is rarely needed. Even in women with symptomatic prolapse, it is perfectly safe for many to just 'live with it' as long as they are seen regularly by their ob/gyn or urogynecologist and do not have vaginal bleeding or difficulty emptying their bladder. It is important to remember that pelvic organ prolapse is not life threatening. While pelvic organ prolapse can often cause distressing symptoms and significantly affect a women's quality of life, sometimes it does not. In cases where the symptoms are minimal, regular observation by a physician without other treatment is just fine. The most common consequence of leaving prolapse untreated is that it will eventually get worse and symptoms develop. However, in many women with mild prolapse it may never get worse. I have some patients with severe prolapse who have chosen no treatment and done just fine, some for many years. If these patients ever proceed to where they develop difficulty emptying their bladder, erosions of the vagina that did not go away or if they developed symptoms that bothered them enough to request surgery, then I would suggest treatment.
dcmna3: Is it inevitable that a prolapsed uterus and collapsed bladder will require surgery? If the patient isn't experiencing any discomfort, are there any disadvantages in waiting for the corrective surgery?
Matthew_D._Barber,_MD,_MHS: No, it is not inevitable. Many women have mild prolapse that does not require treatment and may not ever progress to the point where treatment is required. If you are not experiencing any discomfort or other related symptoms, then waiting is exactly the right course.
Treatment for Urinary Incontinence and Pelvic Organ Prolapse
dcmna3: Who do I trust to repair a prolapsed bladder and uterus? Should I see my ob/gyn (obstetrician-gynecologist) or do I seek a different type of surgeon?
Matthew_D._Barber,_MD,_MHS: Anytime you have surgery, it is important to make sure that your surgeon has a lot of experience performing the proposed surgery. Some general ob/gyns are quite experienced with prolapse surgery and would be good choices to do this type of surgery. However, many general ob/gyns do not regularly perform prolapse surgery or only do a few operations per year, so it is important to ask. Urogynecologists are ob/gyn or urology specialists who have had additional training in advanced techniques of prolapse surgery and other pelvic reconstructive techniques. They typically perform many prolapse surgeries every month or even every week. The official name of the urogynecology' specialty is female pelvic medicine and reconstructive surgery.
HoosierBuckeye: I have been diagnosed has having a prolapsed bladder and was instructed to do 'floor' exercises, as well as Kegel exercises to strengthen the muscles. Other than that, the only other options are to wear protective liners—or if the situation warrants, 'diapers.' I have been advised that the surgery to fix the situation only has a lifetime of approximately 10 years and cannot be re-done. Thus, I should wait until I am at least 70 years old to consider this route. Is this true? I don't have a serious issue at the moment, but I'm sure that the force of gravity will have a profound effect on this as time marches on!
Matthew_D._Barber,_MD,_MHS: From your description, it sounds like your main issue is urine leakage. Is this correct? Urine leakage (i.e., urinary incontinence) is often related to pelvic organ prolapse, but not necessarily. The treatments for urinary incontinence depend upon the type of urine leakage that you have. If you have leaking related to coughing, sneezing and physical activity, which doctors call 'stress urinary incontinence,' then the primary treatments are Kegel exercises and surgery. The most commonly performed surgery is a sling procedure. This surgery has a high success rate with approximately 85 percent of women becoming either dry or significantly improved. These procedures are intended to be permanent, and current data suggests that this surgery remains effective for at least 15 years. They likely last longer, but we just haven't been able to study them that long yet.
lightning#: I've been told that my pelvic floor is relaxed because of Ehlers-Danlos syndrome. Can Kegel exercises take care of this or is surgery necessary? I suppose it has to do with the severity of symptoms. The incontinence is annoying. I have seen a physical therapist who gave me exercises that caused spasms in my back.
Matthew_D._Barber,_MD,_MHS: Kegel exercises can be helpful in improving mild to moderate prolapse and urinary leakage. If you begin to notice bulging from the vagina, then you can consider a pessary or surgery. If urine leakage is your biggest issue, then sometimes surgery is appropriate, but often behavioral treatments and/or medications can be helpful depending upon the cause of the urine leakage.
Sling Procedure
janiceasad: Is the sling procedure safe? Will the tissue cause problems later in life? How are the outcomes of this procedure so far?
Matthew_D._Barber,_MD,_MHS: Sling procedures are the most commonly performed surgery for stress urinary incontinence (i.e., leaking when you cough, sneeze or do physical activity). They are generally quite safe and effective. In fact, it can be argued that they are the best studied surgery in all of gynecology. After a sling procedure, approximately 85 percent of women can expect to be dry or significantly improved. The surgery is usually performed as an outpatient (i.e., same day surgery). Sling procedures have risks that are much the same as any similar procedure, including a small risk of bleeding, infection, risk of anesthesia, etc. The best studied and most commonly used sling procedures use a synthetic mesh called polypropylene. Permanent mesh is used with the intent of making the surgeries last a long time—hopefully, the entire lifetime. The use of this mesh does add an additional risk of erosion of the mesh into the vagina or surrounding tissues, which occurs in less than one to two percent of women who have the procedure.
Mesh Repair of Pelvic Organ Prolapse
mflower: In 1999 my doctor used a mesh to repair my pelvic organ prolapse. My bladder did not fully empty after the surgery and even today the bladder leaks. My question is should I have a CT Scan to see if everything is ok? Was there any problem with the mesh that was used in 1999?
Matthew_D._Barber,_MD,_MHS: Do you know what kind of mesh? Was it a sling for urinary incontinence or a prolapse mesh to suspend your vagina and bladder? A CT scan will typically not reveal anything with most implanted meshes even if there is something wrong. I would suggest you see your gynecologist or urogynecologist for an pelvic examination. They may also want to do a test called urodynamics to further evaluate your bladder symptoms.
Repeat Surgery for Bladder Prolapse
sylvester: I have had bladder surgery and a sling inserted, several years ago. Is it possible for the bladder to prolapse again? I'm having symptoms like the first time, including the need to urinate twice, some burning or irritation, and the need to urinate urgently sometimes. I take diuretics, but also medications for the urgency.
Matthew_D._Barber,_MD,_MHS: Yes, it is possible for bladder prolapse to recur. Fortunately, this is not common, but five to 10 percent of women will require a second operation at some point in their life. If you are having symptoms again, I would suggest you make an appointment to be examined by a gynecologist or urogynecologist.
Recurrent UTIs After Pelvic Floor Reconstruction
eileena: If you had a previous pelvic floor reconstruction over 10 years ago and now suffer from chronic bladder and urinary tract infections (UTIs), could the bladder have shifted closer to the rectum so bacteria is crossing over through the tissues? If so, is there a repair possible to correct this? Or are there other suggestions to prevent UTIs?
Matthew_D._Barber,_MD,_MHS: Doctors define recurrent urinary tract infections as more than three infections over a 12-month period. There are a number of causes of recurrent UTIs, including vaginal atrophy (inflammation and thinning of the vagina in women who have gone through menopause) and changes in the anatomy of the urethra, bladder and/or vagina. In someone who has had previous pelvic reconstruction, it would be important to make sure that there is not obstruction or blockage of the urethra from the previous surgery. Another concern would be the possibility of a stitch or mesh from the previous surgery in the urethra or bladder. This is uncommon, but could certainly cause recurrent UTIs. I would recommend that you see a urogynecologist or urologist for further evaluation. After this doctor takes your medical history and examines you, it is likely that he or she may want to do further testing such as a cystoscopy or urodynamic evaluation to rule out these issues. Common treatments for recurrent UTIs include use of vaginal estrogen cream in postmenopausal women and use of preventative or prophylactic antibiotics on a daily basis.
Urinary Retention After Gall Bladder Surgery
Delayne: What is the most likely cause of urinary retention after gall bladder surgery?
Matthew_D._Barber,_MD,_MHS: How long ago was your surgery? Have you started any new medications?
Prior Rectocele Repair and Rectal Bleeding
liesel: I am a 74-year-old female. I am dealing with a lot of lower abdominal pain, mainly on my lower left side. I also have rectal bleeding issues about three or four times per week when I go to the bathroom. I did have a sigmoidoscopy in 2008 and a colonoscopy in September 2011. The gastroenterologist said nothing was wrong, but there was possibly a fistula that I would have to live with. I had a rectocele repair in 2001. A pelvic examination by my gynecologist two weeks ago did not reveal any problems. Should I worry about the constant rectal bleeding and the lower abdominal pain? What should my next step be since I already had the colonoscopy?
Matthew_D._Barber,_MD,_MHS: Rectal bleeding should always be taken seriously. The symptoms that you describe, chronic left sided lower abdominal pain and rectal bleeding, may indicate that you have a condition called diverticulosis or diverticulitis—or even something more serious. Even though your colonoscopy was normal in 2011, the fact that your symptoms have continued suggest that you have an ongoing problem that should be evaluated. I would suggest you return to the gastroenterologist and let them know you are still having the symptoms. Alternatively, you could seek a second opinion from another gastroenterologist. I do not think the rectocele repair you had in 2001 is in any way related to your current complaints.
Activity Restrictions with Prolapsed Bladder
HoosierBuckeye: Knowing that I do have prolapsed bladder, do I have to refrain from any heavy lifting? If so, would it aggravate the situation if I do not refrain? Also, what is the recommended minimum weight we should lift, if this is a risk?
Matthew_D._Barber,_MD,_MHS: You do not necessarily need to refrain. You should only refrain if doing heavy lifting causes the prolapse to protrude or causes you discomfort.
Moderator: I'm sorry to say that our time is now over. Thank you, Dr. Barber, for taking the time to answer our questions today pelvic organ prolapse.
Matthew_D._Barber,_MD,_MHS: Thank you again for joining me today to discuss pelvic organ prolapse and urogynecology. I have enjoyed our time today and all of your questions were great!
For Appointments
To make an appointment with a urogynecologists in Cleveland Clinic's Women's Health Institute, please call 216.444.6601, toll-free at 800.223.2273 (extension 46601) or visit us at clevelandclinic.org/obgyn for more information. You can also download our treatment guide at clevelandclinic.org/prolapseguide.
For More Information
On Cleveland Clinic
In the Section of Urogynecology and Reconstructive Pelvic Surgery in Ob/Gyn & Women's Health Institute and the Glickman Urological Institute at Cleveland Clinic, our physicians have been performing a number of innovative urogynecology techniques for the diagnosis and pelvic floor disorders and treatment of urinary and fecal incontinence.
Both basic and advanced urodynamic testing, including video urodynamic testing, is available to evaluate women with urinary symptoms, disorders, and pelvic floor disorders. There are many different urogynecology treatments available for pelvic organ prolapse, urogynecologic disorders and incontinence. For other types of pelvic floor disorders and incontinence, outpatient or inpatient surgical procedures can be performed, including reconstructive pelvic surgery. To treat pelvic organ prolapse, 'short-stay' procedures include laparoscopic and robotic-assisted sacral colpopexy and vaginal reconstruction with and without mesh implantation. For urinary incontinence different types of outpatient procedures include tension free vaginal tape (TVT) procedure, transobturator tapes, mini-slings and sacral neuromodulation.
Cleveland Clinic gynecology care is ranked third in the nation by U.S. News & World Report, and has top ranking in Ohio. We offer care at convenient locations throughout Northeast Ohio.
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This information is provided by Cleveland Clinic as a convenience service only and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. Please remember that this information, in the absence of a visit with a health care professional, must be considered as an educational service only and is not designed to replace a physician's independent judgment about the appropriateness or risks of a procedure for a given patient. The views and opinions expressed by an individual in this forum are not necessarily the views of the Cleveland Clinic institution or other Cleveland Clinic physicians. ©Copyright 1995-2013. The Cleveland Clinic Foundation. All rights reserved.Reviewed: 09/13


text:
Sally Mortlock
Sally Mortlock | PhD Student
Sydney School of Veterinary Science
Rm 505, RMC Gunn Building B19
The University of Sydney NSW 2006
E: email@example.com
Bachelor of Animal and Veterinary Bioscience (Hons1)
Research Interests
Canine Cancer
Research Project
Lymphoma in Australian Bullmastiffs
Project Supervisor
Associate Professor Peter Williamson
Associate Supervisors
Professor Rosanne Taylor
Dr Peter Bennett
Dr Mehar Khatkar
About the project
Lymphoma is one of the most common cancers in dogs. Studies conducted overseas investigating incidences of lymphoma in dogs have identified an association between disease occurrence and breed, with some breeds exhibiting an extremely high rate of disease [1]. Bullmastiffs are one such breed that has been identified in some countries as having a high incidence of lymphoma [2, 3]. The high rate of disease in Bullmastiffs suggests a genetic predisposition to the disease and thus provides a unique opportunity to investigate the genetic mechanisms behind lymphoma susceptibility. After reports of a high incidence of lymphoma in families of Australian Bullmastiffs and thanks to the generous Maple Simmons Research in Lymphoma bequest, donated to the faculty by Katherine Howard and David Simmons in memory of their beloved Bullmastiff Maple, we were able to set up this project to investigate lymphoma predisposition in this breed.
The aims of this project are:
- To identify the current health status, longevity and genetic diversity of the Australian Bullmastiff population.
- To investigate lymphoma in Australian Bullmastiffs and investigate the genetic mechanisms behind lymphoma predisposition.
Identification of genes predisposing Bullmastiffs and other breeds to lymphoma will allow for prevention of the disease through breeding strategies. Screening of the parents for the presence of predisposing genes will prevent potential suffering of the progeny while avoiding potential treatment costs and loss of life. Understanding the nature of any genetic changes associated with the development of lymphoma may lead to new treatment options in the future.
We are currently seeking blood samples from Australian Bullmastiffs as a source of genetic material that will help us identify any genetic aberrations that increase the probability of lymphoma development in dogs. We are especially interested in samples from dogs with lymphoma and dogs over the age of 8 that have not had lymphoma. We are also seeking information on lymphoma cases past and present in the breed including age at diagnosis, pedigree information, type of lymphoma if known and any other known relatives with the disease. Information on any dogs that have reached 8 years and over without having had lymphoma is also valuable to the study. If you are a Bullmastiff owner and interested in contributing to our study by submitting a blood sample from your dog or providing information on your dog please email Sally (details above).
If you are interested in submitting a blood sample from your dog please download the forms below.
- Information Statement (pdf)
- Consent Form (pdf)
- Modiano, J.F., et al., Distinct B-cell and T-cell lymphoproliferative disease prevalence among dog breeds indicates heritable risk. Cancer Research, 2005. 65(13): p. 5654-5661.
- Villamil, J.A., et al., Hormonal and sex impact on the epidemiology of canine lymphoma. Journal of cancer epidemiology, 2009. 2009: p. 591753
- Edwards, D.S., et al., Breed incidence of lymphoma in a UK population of insured dogs. Veterinary and comparative oncology, 2003. 1(4): p. 200-6.


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News and notes from Latin baseball
November, 6, 2009
While baseball fans, players and officials debated the merits of the increased presence of instant replay during Major League postseason games, replay played a significant role in a recent game between Sancti Spiritus and Havana of the National Series in Cuba. In the 16th inning, Sancti Spiritus infielder Yulieski Gourriel, generally considered one of the best players in Cuba, hit a line drive that appeared to hit the pitching mound and then was caught by Havana infielder Dayan Garcia, which resulted in a single. After the play, Havana manager Esteban Lombillo argued that the line drive had struck his pitcher's foot and then was caught by Garcia, which would have resulted in an out. The umpires convened and could not come up with a consensus, so they decided to check the replay. After watching several replays, the umpires concluded that the ball had struck Havana's pitcher, so they ruled Gourriel out. Sancti subsequently played the game under protest. (Article: Spanish | English -- Google translation)


text:
A Justice Site
Mirror Sites: CSUDH - Habermas - UWP
Lectures - Notes - Post to Learning Records
Post to Discussion Group, transform-dom
California State University, Dominguez Hills
University of Wisconsin, Parkside
Created: September 12, 2005
Latest Update: September 12, 2005
This morning I received a forwarded e-mail from Susan. ( I was gonna say "got," but this is an English Professor after us, so, no slang." By the way, you shouldn't even use "so" as I did here, according to the NY Times on Language by Safire, I think it was.) I was trying to put up learning records for transparent grading, but this stopped poor Susan cold, and me with her. Thus, I've taken time out from your learning records to create this lecture for Week 4 when I will have been absent this Thursday. This will give you some fun while I'm gone.
Here's the forwarded e-mail:
"Date: Mon, 12 Sep 2005 12:49:02 -0500 (Central Daylight Time)
From: Susan Takata
To: Curran Jeanne
Subject: Forwarded mail....
fyi... one of UWP's english professors put this out to all faculty (the governance email). geez.
. . . . . .
Gee, susan. I guess it doesn't matter that we define and put up on our site all those words as concepts and link them to both our courses and our lectures, so that students will understand "transparency" when it's all the fashion in discussions of Enron and "no-bid contracts" in New Orleans and Iraq. I guess only Enron and Halliburton get to use those big words, the better to subordinate those without power. jeanne---------- Forwarded message ----------
Date: Mon, 12 Sep 2005 10:28:04 -0500
From: Robert H Canary
To: firstname.lastname@example.com
The Emperor Has Transparent Clothes
Prompted by one of our rate-busting award-winning colleagues, the Institute for Institutional Prose has declared September "Transparency Month," in an effort to promote the new uses of "transparent" and "transparency" in institutional prose. The multi-syllabic Latinity of "transparent" makes it preferable to such out-of-date words as "clear" or "open"Łe.g., "clear grading standards" might be nice but a "transparent grading process" is much more impressive. Its use has the additional advantages of warning the alert reader that something is being concealed and of lending itself to double entendre.
A quick search of the UWP archives suggests that too many of us are behind the curve and out of the loop on this. We do, however, have a splendid model taken from an actual Parkside site, showing how "transparency" can be strung together with other jargon to make splendidly opaque sentences, rich in sexual symbolism. We cut and paste it without (we swear) any alteration: "Because we are going to conceptually relate this back all our midterm discussions and exhibition projects to theory on illocutionary discourse and answerability, transparency, responsibility, structural violence, and accountability, we'll have to review this concepts. This is where we have need of our naked space to bring in all our fractal patterns of experience and share them with each other in reacting to the new work we create together."
Now that you see how it is done, we hope that you will all go out and use this concepts as you conceptually relate your fractal patterns in whatever naked space you can share.
[Previous, equally useful bulletins of the Institute for Institutional Prose can be found at http://it.uwp.edu/iip ]
Well, although I have already defined most of these these technical terms we have drawn from texts like Jonathan Lear's Love and It's Place in Nature, Jürgen Habermas' Between Facts and Norms, Maria Pia Lara's Moral Textures, Gordon Fellman's Rambo and the Dalai Lama. etc. I had forgotten the "fractal patterns," drawn from T.R. Young's Red Feather Site in Critical Theory. For students at UWP, who may be using different texts, you'll find our definitions in the Lectures, Indexed on the Current Issue of Dear Habermas.
- fractal pattern - a non-linear pattern approximating nature in which multiple images are repeated, branching out, as happens in real social interaction that cannot be predicted on a linear a to b to c to z pattern. Fractal patterns are used by sociologists trying to discover a closer approximation to the ways in which humans actually interact both with each other and with their perspective of their context. But neither Susan nor I are teaching that this semester. And I guess we should stay away from such "big words and ideas."
- Freesearch definition of "fractal" Don't forget that dictionaries are a part of our learning.
- Boot Camp 2003 - Educating in Fractal Patterns Exercises in Introspective Reflection by Edward B. Nuhfer. Volume 12 Number 5, the national Teaching and Learning Forum. Some good material on reflecting on why you want to teach and what you want to accomplish. Suggest some of those who would like to have careers in teaching or training read this. jeanne
- Chaos Theory and Non-Linear Dynamics in Social Agency" Visited on Monday, September 12, 2005. This is the area of sociology where you would find terms like "fractal patterns." Because we're not using chaos theory models this semester, I didn't bother to go back to this older issue from a time when we were using some critical criminology theory.
- Naked Space - The name of our semester end Gallery Showing of visual sociology, photographs, sculpture, and painting. The title came from a protest by the Dear Habermas group against the Political Science Club's use of the naked lady mud flap as it's newsletter icon, which was posted around school. We resolved that controversy by sharing the Gallery Show in which both genders were displayed with all the perspectives of nakedness and its social and political meanings. For those who would like to see the Gallery Show you will find the interactive show at Table of Contents for Freeing the Feminine Other and Freeing the Feminine Other: A Collaborative Hypertext Poem Encompassing the Naked Space Exhibit of Spring 2004 and the The Invitation to the Gallery Show.
The definition of naked space came about from negotiated discussions between Dear Habermas and the Political Science Club as we discovered that what both of us wanted was to stimulate discussion of real world social and political issues in which people felt it was socially accepted in expressing their thoughts, not in passively accepting what they were told. We discovered that both groups tended to situate themselves in circles and keep the center space free, as a symbol of our acceptance of answerability (Bakhtin) or the expression of our own voices (Women's Ways of Knowing) and validity claims (Habermas). And so we called the Gallery Show the Naked Space Exhibition. (I know, I shouldn't use so thus.)
- answerability - the gift that every human possesses of a unique reaction and response to every experience. Remember that the reaction, response may be in archaic rather than conceptual langue (Lear, Love and Its Place in Nature)
See our extensive definition at Answerability: Definition to which you will also find a link in the Site Index.
Discussion Questions
Relating to Sociology 220: Analytical Statistics
- Glance through some of the material on fractal patterns. What does it tell you about statistics, as you are learning it?
Consider that fractal patterns relates to mathematical theories about non-linear relationships. Not only do we not have equal intervals along an x or y axis, we don't even have an axis. We have multiple images repeating in ever smaller sizes with the need to find patterns in the chaos. Figure T.R. Young might be considering fractal patterns as we wonder about how to cope with the chaos that is now New Orleans. No, we won't have time to cover chaos theory this semester. But be aware of it. It's called "thinking out of the box" in some circles.
Relating to Sociology 370: Moot Court
- Set up an imaginary dialog for Susan and Jeanne and Professor Canary.
Consider Susan and jeanne's insistence that you recognize professional jargon to guard against subordination by those in power who wish to deny your answerability.
Relating to Sociology 386: Sociology of the Helping Professions
- Both Susan and I were taken aback by this quasi-public denunciation of our work. What does this suggest in terms of how faculty support faculty in their efforts at teaching? How does this management of intrafaculty support affect students?
Consider the chilling effect of being publicly ridiculed if you try something that is different from the main stream. Never mind that jeanne has a Ph.D. from USC in the Sociology of Education, with a specialty in learning theory. If your teachers feel a chilling effect, consider the possibility of that suggesting to them a less lovable world for their own context.
Relating to Sociology 395: Love 1A
- Was this a confrontation that suggested a loving orientation to the world?
Consider the phrases:
- "Prompted by one of our rate-busting award-winning colleagues" My take on that phrase is that it is pejorative labelling. Do you agree? Why or why not? How does that set the tone for the message?
- "declared September "Transparency Month," - actually despite its sarcasm, I'd welcome a "Transparency Month," on our campus. And personally, I think the phrase, The Emperor Has Transparent Clothes, is a fine description of Dubya. Those clothes got a little more transparent with the federal government's response time to Katrina. But now I'm responding in kind. If I have a loving orientation to the world, I ought to recognize that Professor Canary (Is that his real name or a pseudonym, Susan?) is not party to how many of us are from New Orleans and had relatives in New Orleans. I shouldn't really take his words out of context, anymore than he should take ours out of context. See how easy it is to abandon a loving orientation?
Consider that Susan and I do our best to explain these concepts in plain English, but that vocabulary, particularly the vocabulary of those in power, is a status symbol. UCLA Law first years begin to include "disingenuous" and "egregious" in their casual conversations during their first semester there.


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- 1 of 2 Photos | View More Photos
The driver of this semi tractor-trailer, above, lost control on snow Thursday morning on Interstate 70 just west of the Fairview exit and it overturned. Emergency crews from a number of area departments responded to the scene. Another semi jack-knifed at the scene and the driver of a car also lost control and ended up in the median. At right, Ethan Vincent, top, and his brother, Jacob, ventured outside during the snow Thursday to do some shoveling on the front walk and steps of their North Side Cambridge home. Ethan said he doesn't mind the cold and wears shorts throughout the winter season.
Photos by
Michael Neilson
The Daily Jeffersonian


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Mr. HIGGINS. Madam Speaker, this week, conferees met to reach an agreement on the National Defense Authorization Act. As we consider a final agreement, I rise in support of language in the conference report which prevents the movement and retirement of C-130 aircraft.
Madam Speaker, western New York is home to the Niagara Falls Air Reserve Station, which hosts a robust fleet of C-130 aircraft. These aircraft were among the planes used to deliver supplies to the regions of New York and New Jersey in the aftermath of hurricane devastation. Additionally, these western New York aircraft flew over 1,500 missions in Iraq and Afghanistan.
Representatives Kathleen Hochul, Louise Slaughter, and I wrote to the conferees on this important issue, and we are pleased that the committee agreed to keep in language in the House-passed bill to maintain the C-130 fleet. I encourage the House to support the conference report language that will maintain the C-130 fleet.
Source: http://thomas.loc.gov


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Let's TalkZapaday, Verrijn Stuartlaan 7, Rijswijk, Netherlands.
Email: firstname.lastname@example.com
2013 Peace Prize is awarded to Svetlana Alexievich, a Ukrainian-born Belarusian author.
According to the German Publishers and Booksellers Association, Alexievich "has consistently and effectively traced the lives and experiences of her fellow citizens in Belarus, Russia and the Ukraine by articulating their passions and sorrows in a humble and generous manner."
The Peace Prize of the German Book Trade consists of a sum of €25,000 and has been awarded since 1950 to outstanding humanist intellectuals.
Visit the Official Website


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Michelle Bernstein Brings Crumb on Parchment to Miami Beach
Sandwiches, scones, and salads. On South Beach.
Alexandra Rincon
Michelle Bernstein is finally making a move over the causeway with her Crumb on Parchment outpost at The Webster hotel on South Beach.
Opening Wednesday, August 29, Crumb at The Webster will feature the same fast casual soups, salads, sandwiches,and baked goods that Bernstein's Design District eatery draws consistent lunchtime lines for. Located in the hotel's first-floor lounge, the intimate space will seat about 30 guests, with room for an additional 12 on the outside patio. Plus, there's the beach (with unlimited ocean-view seating) a mere block away.
Crumb at The Webster will initially serve lunch from 11 a.m. to 4 p.m. Wednesday through Sunday, with fresh-brewed coffee, pastries, and cocktails offered until 8 p.m. -- just in time for a little après-beach pick-me-up.
What prompted Bernstein to finally make a move to the beach? The
opportunity to work with the team behind The Webster,
Laure Heriard Dubreuil and Milan Vukmirovic, who Bernstein says, "mirror how David and I approach cooking and hospitality." Bernstein was referring, of course, to husband and business partner David Martinez.
of Bernstein on the mainland will be pleased to note that she and
husband Martinez will continue to own and operate the original Crumb on
Parchment, as well as the flagship Michy's, with "additional
restaurant concepts in the works." Stay tuned.
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|Home > Opinion > Article
|Saturday April 6, 2002
It involves the combination of sperm and ova (eggs) outside the woman's body to allow fertilisation. That is, in a laboratory. After fertilisation, the developing embryo - two to three days' old - is placed into the mother's uterus.
For each such pregnancy a number of embryos must be created. They are a by-product of this IVF treatment and - if not used in research - are either stored or thrown away.
This is not abortion. This is not cloning. This is using for research cells that will otherwise be destroyed.
People who choose to oppose something this benign have a problem. Some of the things they say strike me as attitudinising. It is almost time, I think, to recollect what happened to other great scientists pushing the boundaries of research, such as Galileo. History shows we must honour scientific inquiry over unbased fears.
Certainly, "embryo" is an emotive word. It makes us think of a small human-like form, a potential foetus. Stem cells are extracted for research when the embryo is no more than 14 days old. They are derived from an absolutely minute body of cells. As a cluster, smaller than a full stop.
On their own, as one researcher told me, smaller than one hundredth of a pin head. Far from being what we imagine by the word "embryo" they cannot be seen except under a microscope.
Yet uniquely, these cells have the capacity to develop into every cell type in the human body. Once crafted or modified in a laboratory, stem cells could be transplanted to a damaged organ to give it strength; into the pancreas to encourage it to start producing insulin or into a damaged spine to heal injury.
Imagine the kidney patient who no longer has to spend 20 hours a week hooked up to a dialysis machine. Or the patient with a weak heart, who can only walk a few metres a day, now being able to go to the park with grandchildren. This is the world of wonder the researchers are probing.
Two weeks ago I visited the Prince of Wales Hospital to see the work of Professor Bernie Tuch and his team. They are working towards a cure for type 1 diabetes (or juvenile diabetes), a disorder that afflicts about 40,000 people in NSW.
It is a serious disease: heart problems are two to four times more common in people with diabetes; it is a leading cause of adult blindness and Australia's seventh most common cause of death.
These researchers are working towards the successful manipulation of human embryonic stem cells. They want to render them insulin-producing cells. Transplanted into an affected person, they may therefore reverse diabetes.
Under the proposal discussed at federal cabinet late last month, I am advised that the Minister for Aging, Kevin Andrews, was seeking to ban certain types of embryonic stem cell research. This could be done either through new legislation or changes to National Health and Medical Research Council guidelines.
If this happened researchers such as Professor Tuch would probably have to continue their work in places such as Singapore and Britain.
Some argue that there is no need for research into embryonic stem cells. It is true that adult stem cells also appear to have great potential. These cells do not come from embryos but various parts of the body, such as bone marrow or blood from the umbilical cord.
Most scientists, however, believe that adult stem cells could only be developed into a limited number of cells and are not capable of making the specific cell types required for certain treatments.
That is why continuing embryonic stem cell research is essential.
Two bodies have extensively considered the issue of adult stem cell research versus embryonic stem cell research.
They are the US National Institutes of Health and Britain's House of Lords Select Committee on Stem Cell Research. Both organisations concluded that to ensure maximum medical benefit it is necessary to keep both routes to therapy open.
And there is another argument. Before we achieve breakthroughs in the use of adult stem cells we may require more research on embryonic stem cells. The House of Lords committee concluded that the full therapeutic potential of adult stem cells can only be realised if research on embryonic stem cells is continued.
Years ago I used to wonder whether my lifetime would see the end of Marxist dictatorships in Russia and Europe. Now I hope I live long enough to see the day when some of the people living bravely with quadriplegia will be able to walk. Embryonic stem cell research is about expediting such cures, helping our fellow humans sooner rather than later.
We cannot turn our back on the daughter watching her mother disappear into the quiet world of a demented mind. Or on the quadriplegic. Or the eight-year-olds I met at Royal North Shore Hospital last week who need insulin injections every day lest they go blind.
Subtle shadings of theology developed in the 19th century should not censor or filter or slow down what happens in medical research.
Whatever John Howard and Mr Andrews decree from Canberra, as long as I am Premier this research will continue in NSW.
Let researchers do their jobs. Let science yield its miracles. We cannot lose a day.
Bob Carr is the Premier of NSW.
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In this section
Stop the presses - it's all a bit rich for Jodee
Faye Lo Po' stands between Carr and certainty
Sorry, John, but classroom cops are no solution
A Kokoda kind of confidence
Supple changes
Pope's failure to confront sexual secrecy is destroying his flock
Media's back is going to the wall
Good buildings begin at school
Fresh minds bring sanity to drug policy
When defence comes to the party, expect a hangover
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George D. Redding, Sr. 85, of Georgetown, Florida passed away on Sunday, April 3, 2011 at Haven Hospice Roberts Care Center in Palatka, Florida. George was born on Thursday, October 29, 1925 in Eau Gallie, Florida to the late George W. And Eunice C. (Stokes) Redding. He is also preceded in death by his loving wife Georgia Redding, son, Todd Redding, brother, Dick Redding and sister Floydean Redding. Mr Redding faithfully served his country proudly in the U.S. Marine Corps during WWII. During his service he received the following medals: World II Victory, Asiatic Pacific Campaign, USMC Rifle (marksman badge), Insignias Star and many others. He was a member of the Beulah Baptist Church and enjoyed fishing, shrimping, and gardening. Memories and condolences may be sent to the family by signing George's guest book online at WWW.WattsFuneralHomes.com. Mr. Redding is survived by his wife June Redding of Georgetown, Florida; sons: George D. Redding, Jr. And wife Margaret of Belleview, Nebraska; John D. Redding and wife Treva of Melbourne, Florida and Robert Bramlitt of Lake Como, Florida; daughters: CeCe Simpson and husband Dennis of Palm Coast, Florida, Ina Slater and Barbara Hamel both of Jacksonville, Florida; brothers: Frank Redding and wife Debbie of Geneva, Florida, Edmond Redding of Orlando, Florida, Douglas Redding and wife Sharon of Newville, Alabama and Donald Redding of Palm Bay, Florida; sisters: Joyce Faircloth of Geneva, Florida and, Yvonne Boykin of Orlando, Florida; eleven grandchildren; ten great grandchildren; Many other releatives and friends who will miss him dearly. A Tribute to Life service will be 11 AM, Saturday, April 9, 2011 at Beulah Baptist Church in Fruitland, Florida with Pastor Robby Paxton and Rev. Dennis Simpson, officiating. Military honors will be bestowed by the U.S. Marine Corps. Simplicity Cremation arrangements have been entrusted to the care of Watts Funeral Home and Cremation Center, Inc., San Mateo, Florida.Print Obituary & Condolences
George D. Redding, Sr.
1:53 pm 2 Condolences
Messages of Condolence
im sooo sorry to the family and friends of there loss is wife is like my grandma and he was like my grandpa he will be missed by soo many he was a great preson..he is loved by so many yall r in my prays
To the Redding Family,
Sorry to read about your lose. I've lost contact with your family over the past 40 some odd years, but our prayers and thoughts are with you in Rome, Georgia.
Jack Floyd
Please share your thoughts ...


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Spending Time with my Children.> I love spending time with my children. I have three daughters. Mackenzie who is seven, Laney who is five, and Kloe who is three. They are so full of life and positive energy all the time. I have three online classes the first half of summer semester. The second half of summer semester, I have one online class and Chemistry 1210. I would like to have the time to take them to the park. They love going there.
Photography>I love photography! This semester I plan to take many photographs of Mackenzie, Laney and Kloe. I plan to take them to the park and get many photos there. I will also take them out to the country where I grew up. There are many beautiful places. The country gives the perfect opportunity for photography.
Spending time with my husband.> I will try to spend more time with my husband. We have been married for four years and it has been wonderful. However, we both have jobs, children, and are attending college. Life is busy to say the least. Through all of this craziness, I would love to find some time for us.


text: http://news.bbc.co.uk/2/hi/science/nature/3416751.stm Housing vital to chicken welfare By Paul Rincon BBC News Online science staff The chickens are very sensitive to their environment Chickens that are commercially farmed for their meat will suffer more through bad housing conditions than through overcrowding, experts have discovered. The European Union (EU) is planning a limit on stocking densities, but the latest study suggests other measures could improve the birds' welfare. The moisture of the birds' litter and ventilation levels were found to be the most important factors for well-being. Details of the research are published in the scientific journal Nature. "If you give the birds a reasonable environment, you can mitigate some of the effects of stocking density that you might find in less good housing," Dr Marian Stamp Dawkins, a zoologist at the University of Oxford, UK, told BBC News Online. About 70% of the UK broiler chicken industry was involved in the study, Dr Dawkins added. Ten companies in total took part, making it the biggest study of its kind. Biggest study As part of their participation in the study, the firms were asked to keep chickens at different stocking densities - the measure of how crowded a chicken house is - so the scientists could measure the effect of this factor on chicken welfare. Those correlations point to further research, rather than being definite conclusions in themselves Dr Marian Dawkins, University of Oxford The level of moisture in the birds' litter and the concentration of ammonia had a significant effect on chicken health. These factors are both related to an increased incidence of problems with the chickens' feet and legs - an important measure of their health. Temperature fluctuations and overall humidity can also have a strong influence on the animals' welfare. Unexpectedly, ammonia was associated with lower bird mortality, but it was also correlated with higher levels of stress hormone in the birds. However, the research does not assess the relative importance of these environmental factors. "Those correlations point to further research, rather than being definite conclusions in themselves," explained Dr Dawkins. New standards "If you do the ventilation and air circulation right then you're not compromising their well-being. To the human eye it looks very crowded, but in terms of animal well-being I don't think they're being compromised," commented Professor John Feddes, an expert in animal housing, from the University of Alberta, Canada. But the RSPCA dismissed the conclusions of the report. "Given that at slaughter a broiler weighs two to three kilograms, we are looking at around 23 birds crammed into a square metre in some of these sheds by the end of their lives," said RSPCA senior scientific officer Caroline Le Sueur. "That provides less space than for battery hens." Dr Dawkins emphasised that stocking density is still an important factor in chicken welfare. The report found that when chickens were housed at high densities, they jostled more and also grew more slowly than animals with more space. But more obvious measures of bird welfare - such as the number of birds that die, are culled as unfit and show leg defects - were not affected by stocking density. Dr Dawkins describes the findings as surprising, because stocking density was always thought to be the major welfare factor for chickens. "[The EU] had been open to the idea that stocking density might not be the only thing to look at and that you might be able to specify certain environmental factors which were also important," she told BBC News Online. "And I'm just hoping that they're going to take that on board." _________________________________________________________________ Scope out the new MSN Plus Internet Software optimizes dial-up to the max! http://join.msn.com/?pgmarket=en-us&page=byoa/plus&ST=1


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Thank you... This rash is on my 84 year old Father. It started on his calf as a baseball sized skin discoloration (looks rather like a bruise) that area is very itch and very sore. He has small bumps on his arms legs and hand. If he starts to scratch it accelerates the itching. He has seen several Dr.'s with no help.READ MORE
Dark patch of discolored skin Itchy sore/Itchy bumps on arms legs and hand
Hi Donna
What do the doctors say this could be? Do they give your father any treatment for this?
Even if I was a doctor (which I am not) you can't diagnose someone over the internet so the best I can give you are resources and information.
Has your father seen a dermatologist for this?
If not I am going to give you the American Academy of Dermatology link to find a dermatologist in your area.
Sorry I can't be of more help. Thank you for your question.
FROM OUR COMMUNITYYou should know Answers to your question are meant to provide general health information but should not replace medical advice you receive from a doctor. No answers should be viewed as a diagnosis or recommended treatment for a condition. Content posted by community members does not necessarily reflect the views of Remedy Health Media, which also reserves the right to remove material deemed inappropriate.DISPLAY TEXTLINK URL


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he ate my dinner
Discussion in 'The Lounge' started by 84gmcjimmy, Aug 28, 2005.


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Hal Leonard Boston - Guitar Play-Along DVD Volume 31
Sku #H76333000000000
Hal Leonard
Guitar Instruction DVDs
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A straightforward way to learn 8 Boston smash hits.
Boston, Volume 31 of Hal Leonard's Guitar Play-Along DVD series, lets you hear and see how to play songs from the famous rock icons of the '70s and '80s from the city of the same name. It's so simple. You just watch, listen and learn! Each song starts with a lesson from a professional guitar teacher. Then, the teacher performs the complete song along with professionally recorded backing tracks. You can choose to turn the guitar off if you want to play along or leave the guitar in the mix to hear how it really should sound. You can also choose from multiple viewing options; fret hand with tab, wide view with tab, pick & fret hand close-up, and others.
The songlist includes:
"Don't Look Back"
"Let Me Take You Home Tonight"
Long Time"
"More Than A Feeling"
"Peace Of Mind
"Rock & Roll Band"
- Width: 5.25"
- Length: 7.5"
Get more than a feeling for how to Boston's biggest radio rockers. Order this DVD today!