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Women's healthcare in the Netherlands
Birth control, abortion, check-ups and pregnancy — we provide insight on female healthcare in the Netherlands.
For many foreign women, one of the first medical questions they ask upon resettling abroad is, "Where can I find a gynaecologist?" They soon discover that the gynaecological (GYN) care provided by the Dutch health system can vary from the norms of their home country. In this feature you will find information on common GYN practices in the Netherlands.
Do private GYNs exist? In essence the answer is no. Doctors here do not generally set up private practices for patients to choose whom they wish to be attended by. Whether one has private or state health insurance, all patients must register with a general practitioner (GP) and are treated equally.
The GP must be consulted prior to visiting a specialist. With his/her consent a patient is then forwarded to a gynaecologist, for example. It is up to your GP to find a GYN for you if it is seen as necessary. But be warned, as one Dutch woman who has lived in various countries advised, "You need to ask your GP for a specialist right up front. Don't wait for them to decide for you."
A female GYN in her early thirties who works at a university hospital in the Randstad said, "Of course if you visit a GYN and do not like that person, provided you have private health insurance, you can switch to another GYN at another hospital or ask the reception to make an appointment with another doctor at the same hospital." However there is no guarantee you will see the same GYN each time you make an appointment, even when you are pregnant, unless you specifically request that person and can be available on the day he/she has polyclinic duties (sees patients and does routine check-ups).
Do Dutch women get routine check-ups? A second female GYN based north of Amsterdam laughed when asked this question. "Check-ups aren't done. We don't believe in it if there isn't a problem. If there are no complaints, don't fix it. We wait to see if something develops and then call a GYN only after some time passes." The first gynaecologist added, "Unlike in the States, women here do not get annual pap smears or checks for cervical cancer. What if we checked for every little thing a patient wanted and found a benign cyst? The patient would then wonder what to do. She'd ask herself, do I get an operation, do I need more investigations, do I take antibiotics… It is not our job to induce worry. We solve problems when there is a problem."
What about routine check-ups during pregnancy? "No pap smears during pregnancy for cervical cancer because hormones aren't at normal levels then, also during breastfeeding. Plus it takes 15 years to develop cervical cancer, not nine months." Although annual check-ups are not the norm, Dutch women do get routine pap smears every five years and women over 35 get a mammography by their GP or a specialist every two years. Foreigners' experience Two of three foreign women interviewed (French, US and Canadian), who wished not to be named, complained of less than professional care in the Netherlands. The French woman said, "When I had visited my GP with a bacterial problem he didn't send the smear to any lab. He looked at it in his microscope and told me to use yoghurt. I was mollified."
The American, who has been a resident of Holland for over five years, explained, "I had a bladder infection for two weeks and saw my GP who told me to come back if it became worse. How much worse could it become? Normally I'd visit my GYN and get some antibiotics or at least cranberry tablets. When I couldn't walk anymore my GP sent me to the local university hospital to see a GYN." Finally, the Canadian woman explained that she had a successful abortion here. Her insurance company covered it. "Abortion is legal in the Netherlands and there are dedicated licensed clinics that perform the operation besides some regulated hospitals".
A GP will usually refer a woman to an abortion clinic or to a hospital that performs the operation. All insurance companies in the Netherlands cover abortion, however, the woman may have to answer some routine questions, such as why she wants to have the operation, as per insurance company protocol. (For more information about abortion in the Netherlands, including a list of clinics, visit the Dutch Abortion Clinics Foundation). A positive aspect for foreign women is a large percentage of Dutch medical workers speak English and often also speak French, German and maybe one other language. Birth control The GYN working in the Randstad pointed out that "approximately 40 percent of Dutch women aged 15-30 use the pill. A third generation birth control pill (newest) is on the market and insurance covers it although privately insured patients have a harder time getting insured for pills."
Between 5–10 percent of patients use IUDs. But Dutch women do not use diaphragms. When asked why she stated plainly,"It's a pain in the ass. Dutch women don't want to think about it or touch it, yuck." During pregnancy Some foreign women will have a fine experience and receive regular checkups throughout pregnancy and have their baby delivered by the same GYN. There is no guarantee however that your GYN (if you found one and one only) will deliver your baby. That always depends on availability, holiday schedules, prior operations and appointments. Where foreign women may clamour for their GYNs at delivery time, Dutch GYNs do not see delivering a baby as particularly important. The opinion of the GYN working outside Amsterdam was blunt: "It doesn't really matter who delivers the baby since the woman has to do all the work, not the GYN."
Adjusting to the Dutch medical system may at first seem daunting, however hundreds of thousands of women are not going sterile. They are not passing on communicable diseases in any significant numbers nor are large numbers suffering from venereal diseases. While some advice may appear strange in its utter simplicity, the best advice is to follow your own gut feeling. If you are unsure and have private health insurance then by all means, get a second opinion.
Need advice? Post your question on Expatica's free Ask the Expert service to see if we can help.
Whether you've lived here for days, months or years, you won't regret attending the Expat Fair for Internationals. Sunday 8 October 2017, Amsterdam.
Get your FREE tickets and discover more about expat life in the Netherlands.
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2 Comments To This Article
MTurci posted:
The article quotes - a foreign woman complained of less than professional care in the Netherlands. Foreign women be warned OBGYN care in the Netherlands is only there to exploit the female patient by using co-assistants and residences to practice on, and diminish the woman being treated.
What the Dutch OBYN is not prepared to tell you. If, you should ever have to have a surgery, the attending DR will be specifically vague in outlining your rights. Should you be asked if a co-assistant or resident be an allowed in the surgery this means the student(s) and resident will be performing nonconsensual pelvic exams on you while failing to ask you for explicit consent. During the initial conversation the co assistant will introduce themselves however, by ommision, fail to explain what their role and responsibliites will be.
Second; the attending DR who is noted on your appointment might not be the person seeing you again, vague language and coercion is used to maximize the co-assistant and residents face time with the patient. Patients are often not informed that the person they are in front of is not the attending DR until you have disrobed and are in the stirrups.
Your rights:
Under the European Patient Care Act, Dutch OBGYNs are hiding behind vague language that exploits the patient, consent must always be explicit versus implicit.
Always check Zorgkaart Nederland which is an external mechanism to check patient ratings on Dutch Doctors.
Should you feel your rights have been violated, then Tucht College is an oversight committee of Drs that independently investigate patient complaints against the DR or the hospital. Patients may file their own complaint without the use of a lawyer.
Lastly, you can also write to the Medical Inspector General
Mw. dr. J.A.A.M. (Ronnie) van Diemen-Steenvoorde
sims posted:
What is the name of the author of this?


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Watch Smallville Season 10 Episode 1
September 25, 2010 by Post Team
Watch Smallville Season 10 Episode 1, Smallville season 10 episode of a so-called "Lazarus", which was directed by Kevin Fair directed by Holly Henderson & Don Whitehead issued this afternoon in the CW television network.
Smallville returns tonight for its 10th season and last season. For fans, this marks a bittersweet moment, during which their beloved show starts at the beginning of the end, leaving many fans excited to see how the series will end. Many fans have made the Internet to find out what is going on tonight on "Smallville."
The first episode, titled "Lazaurs" took place right in the heart of events since the end of last season. Clark is still in very poor condition, but will be able to recover relatively quickly.
Now Lois knows Clark's secret and begins to have a little fun with it. Despite his secret is not completely out, however, she manages to find some ways to make fun of Clark. Unfortunately, happiness does not last long, and Lois finished tied on the cross, like the image that became famous in a season for Clark.
Lex Luthor has an appearance in the episode, and Tess returned at the premiere with his face completely recovered from his accident. Oliver is in trouble with Chloe, with little hope of being saved, and Pa Kent will also make an appearance, reminding viewers of the early seasons of Smallville. It will be interesting to see where to take this final season of Smallville.
Please feel free to send if you have any questions regarding this post , you can contact on
Disclaimer: The views expressed on this site are that of the authors and not necessarily that of U.S.S.POST.

subset: commoncrawl


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Good Morning and Happy Monday!
"You have power over your mind - not outside events. Realize this, and you will find strength."
~ Marcus Aurelius,
May this new week provide you strength and peaceful thoughts followed by happiness and success. Make it a beautiful day and Smile....... it's contagious :-)
Hugs and High Fives
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Thanks Laura! Hope y ours has been wonderful so far! :-)
I LOVE these quotes you post, Jamie. They make my mornings better. A happy Monday to you too!
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W Debate: Where will Howard end up?
Question: Will Dwight Howard stay with the Lakers or go somewhere else in free agency?
Kate Fagan: Dwight is gone -- he's going elsewhere. But more importantly, once he signs this contract -- my money is on Houston -- we'll finally be done talking about Dwight Howard for at least three years. You would think he would be sick of being a constant part of the news cycle, yet here we are, going on Summer No. 3 tracking Dwight's every move.
Anyway, I think he's going to Houston because the Rockets have the best upside: Dwight would be playing with James Harden and Jeremy Lin.
Dwight becomes a Rocket and ends the Dwight-saga or the Dwight-mare, or whatever else we're calling it these days.
Sarah Spain: I disagree, but not because your prediction doesn't make sense. If Howard went to the Rockets, he would be paired with a top-notch complementary player in Harden, have a great chance to win and be a hero to a Houston fan base that's waited nearly 20 years for another championship. He could help the Rockets win while avoiding some of the scrutiny that comes with playing in a market like L.A. and while getting out of the shadow of Kobe Bryant, who still feels he has a few things left to prove. It makes sense. But when predicting the next move of one Dwight Howard, common sense needn't be applied. This is a man who announced he wanted to leave Orlando, then announced he wanted to stay, then left. He wanted to go somewhere he could win. No, he wanted to play in a big market. No, he wanted to play where he'd be the star.
In the end, he went to a big market where he wasn't the star, and he didn't win. One outta three ain't bad.
Now, after a year with the struggling Lakers (and a significant drop in his Q-score), Howard seems to have realized that winning -- and only winning -- is the way to get people on your side. So will he go somewhere that gives him the best chance at a championship? Your guess is as good as mine. A move to Houston means giving up a lot of money -- the Rockets can give him a four-year deal worth about $88 million, while the Lakers can give him a five-year, $117.9 million contract. A move to Houston means putting his faith in an up-and-coming team that says it's about winning but hasn't won it all in nearly two decades. The Lakers had a rough year, and they'll need to make some moves if they want to be contenders, but if there's a team that is defined by success, it's the Lakers. Both teams make sense for different reasons. Who knows which one makes "sense" in Howard's world.
Do the other teams in the running, such as the Hawks, Mavs and Warriors, even have a chance?
KF: I think Golden State is the dark horse in this race, because the Warriors have an awesome young core and Dwight could help them win while also escaping the blinding glare if he (more likely) doesn't help them win. Still, I think he's going to Houston. Atlanta is too obvious because it's his hometown, and the Hawks really aren't that good. The Mavericks would just be too over-the-top: Can you picture Dwight grinning on the big HD screen inside that arena? I can, but I really don't want to.
As for the Lakers, I just feel like that would be too easy, too commonsense of a move for Dwight. Stay with the team that traded for him and can offer him Bird rights money? Nah ...
Have you seen this graphic going around Twitter? Dwight in the Houston Rockets jersey looks the most right to me.
SS: I don't know, that Warriors jersey sure looks nice, too.
And you know what, Kate? At this point in the Dwight-mare/Howard-coaster, hearing that the big man picked a team based on its jersey wouldn't even be all that surprising. His talent cannot be underestimated, but his mental weaknesses have proved to be his Achilles' heel. Howard would have been better served playing in a different era, when demanding trades and switching teams wasn't so easy to do. Back in the old days Howard would have been forced to grow up and learn how to take a team from dark times into winning days. Instead, he's made a name for himself as a man who can't step up and put the weight of a franchise on his back, a man who wants to demand the best but rarely gives his best. People have grown tired of his act, as evidenced by the more subdued, less frenzied coverage of his free agency this summer when compared to last. He may someday find what he's looking for (A championship? Love from his fans? The respect of his peers?), but I predict he'll be remembered as much for his failures off the court as any successes he may have on it.


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UK: Bentley might introduce entry-level crossover - reports
Bentley might launch an entry-level crossover in future, Rolf French, board member for engineering, has said.
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2 May 2007,
Price realised EUR 3,600
An assorted lot of blue and white miniature teapots and vases
Mainly Kangxi
Comprising two globular teapots and covers, 5.5 and 8 cm. high; one ribbed teapot and cover, 8 cm. high; a globular mustard-pot, applied with a C-scroll handle, matched cover, 9.5 cm. high; a pair of small rouleau vases decorated with 'precious objects', 8.7 cm. high; a pair of miniature sprinklers painted with blossom, 8.5 cm. high; an oviform jarlet and cover painted with the 'hundred boys' pattern, 8.2 cm. high; a cylindrical vase decorated with panels of ladies and flower-sprays, 11.5 cm. high; and a small jar and cover similarly decorated, 9.3. cm. high, chips (11)
New York +1 212 636 2000
London +44 (0)20 7839 9060
Hong Kong +852 2760 1766
Shanghai +86 21 6355 1766
Special Notice
Christie's charges a premium to the buyer on the Hammer Price of each lot sold at the following rates: 29.75% of the Hammer Price of each lot up to and including €5,000, plus 23.8% of the Hammer Price between €5,001 and €400,000, plus 14.28% of any amount in excess of €400,001. Buyer's premium is calculated on the basis of each lot individually.
The tiny and exquisitely beautiful curiosities that once housed tobacco are highly prized. Specialist Margi Gristina advises on how to start a collection
How to get clued up on everything from reign marks to firing flaws, palettes, glazes and the different kilns
In the late 19th century Emile Gallé's vibrant glassware helped to transform ideas of what art could be. Specialist Carina Villinger shares her insights
Know your Gutai from your Mono-ha, and discover the artists who threw away their paintbrushes and scrubbed the streets of Tokyo
Untitled from 1996, offered at Christie's on 13 September, marks 'the apogee' of the great Indian artist's career
Leiko Coyle explains why this Nepalese sculpture is her 'dream piece'


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We...have reached...the 20's! Two parts in one day (this, for me, means on a roll). I feel like doing a happy dance! Part 20! So. You're here to read it, I s'pose...well, seems how I've written it and seems how you wanted it...READ IT!
James stared up at the building before him, memories of Mary and her angel-smooth voice slowly filling his mind, along with treasured thoughts of what the hotel used to be. What used to be a haven for him and Mary had now been decorated by moss, blood, rust, and rot. He let out a sigh at that horrid realization. "Come on guys, let's go in."
Little Walter noticed a small music box by one of the filthy fountains that stood before the hotel in the dying gardens. He picked it up and started gnawing on it while following after James.
Creaking open the door, James reached his flashlight in and slowly swerved it around. "This is all so familiar..." He whispered, squinting at the intricate paintings on the wall. "Me and Mary used to sit on that staircase all the time, just talking to each other." He pointed at a broad staircase, lush red carpet draping over each and every step.
"What kind of stuff would you talk about?" Heather asked, examining the paintings.
James ran his fingers through his hair. "She always told me how beautiful this town was, and how she wanted to come back someday. I promised we would...but then she got the disease and..." His voice died down and he sighed, walking over to another door.
Everyone looked over at each other and shrugged, continuing to follow their leader. The next room was much brighter, save for the mist that had gathered on the windows and was blocking out all (if any) sunlight. James turned off his flashlight. It was a properly and beautifully decorated dining hall, the tables set up in a perfect formation and white cloth blanketing them.
"Oh, cool! A piano!" Henry laughed, running over to the enormous piano that stood in the corner of the room. Suddenly, a loud, ominous chord was played. "EEP!" Henry grew extremely pale and fainted, hitting the floor with a solid whumpf. A wet spot appeared on his pants.
"EW!" All of the girls yelled.
Little Laura came out from behind the piano, giving a ghastly smile and whispering, "Ha! Did I scare you?"
James whipped out his shotgun and aimed at Laura's head. "AHA! EAT LEAD, YOU SNOTTY LITTLE-" Heather let out a cry and snatched his shotgun from him.
"James, you can't just kill someone cause they locked you in a room full of bloodthirsty monsters!" She grumbled.
"Try me." He took out his handgun and Heather grabbed that from him, too. "GRRR..." He took out his chainsaw and Heather kicked him in the groin. He gladly decided not to attack Laura.
Laura seemed to have no clue that James had tried to kick her
bratty little butt. "So, did you find Mary? Huh? Did you? Huh?"
"No..." James barely was able to make his groans of pain into a word as he slowly stood. "Sorry, you little son of a..." Heather stomped on his foot. "I MEAN LITTLE ANGEL."
"Oh. That's too bad. I got a letter from her and all that good stuff if you wanna read it." Laura giggled as she took out a letter. James tried reaching for it, but Henry ended up grabbing it.
"Blah blah blah, hey Laura, how you doin, blah blah, don't be a punk to James-" He read, but James interrupted.
"Don't be a punk to me? Little late for that one..." He grumbled.
"Blah blah, he may be a little surly sometimes-"
"Blah blah, but he's still a nice guy, blah blah. Hope to adopt you, blah blah, happy 31st...I mean 8th birthday."
James snatched the letter from the smug Henry and read it over again just to make sure he wasn't lying. "Hmmm...Laura, when'd you turn 8?" James asked, sitting down on a table.
"Just last week," She replied while she drew a picture of a mentally-retarded looking cat.
Everyone looked at each other again. Maybe Mary really was alive after all. James leaned over to Heather. "Can I have my weapons back so I can slaughter this demon?!"
"What demon?!" Heather hissed.
James pointed at Laura. "THAT demon." Heather stomped on his foot again.
Laura walked over to Eileen and pointed to her back. "What's with that weird tattoo? 20121..."
"WHY YOU LITTLE..." Eileen swung her fist at Laura, who ducked and shreiked and ran behind Heather.
Little Walter kept staring at Laura with puppy-dog eyes. He leaned over to her and whispered, "Hiii...y...you wanna hang out s...s...ometime?" He tried giving his best imitation of a lady's man pose, which wasn't much since he was only a toddler and toddlers couldn't be some supermodel.
"Ew! You're creepy." Laura scowled while she skipped away from him.
Little Walter looked up at Heather, then at Henry, and then at everyone else. He was preparing his ultimate weapon. He felt his lips quiver, his body shake, his eyes filling up with tears, and out of nowhere, his mouth gaped open. "AAAAAAAAAAH! WAAAAAAAAAH!" He burst into tears and screamed so loud the windows could shatter.
"SHUT HIM UP!" Everyone yelled, covering their ears. Henry took out a bottle of chocolate milk and handed it to him.
Little Walter examined the carton, still wildly screeching. He took a gulp and suddenly he looked like he had tasted something surprisingly good. "Ooooh man. That was AWESOME."
Laura tried grabbing the carton. It became a rapid tug-a-war.
"Gimme it!" She growled.
"No!" Little Walter gave it another sharp tug.
Laura tugged harder, and little Walter fell flat on his butt. "Darn it..." He grumbled. "One day, if I become a physchotic serial killer and end up killing 21 people, YOU'LL BE...what comes after 21? Um...22!"
"Like that's gonna happen." Laura teased, chugging the chocolate milk down and sticking her tongue out at him once she was finished.
Henry kneeled down to Laura. "...You don't know how right he is..."
Laura looked up at Henry with a puzzled expression. "Uh..." She looked over at little Walter, then back at Henry. "You're stupid." And then she skipped away, leaving everyone in the room to wonder what the heck just happened.
Part 20 has been completed! But the series isn't over yet. 21, anyone?


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Petra Nemcová
Life Path Number 2
Petra Nemcová is a Model.
She was born on Sunday June 24th 1979, in Karvina, Czech Republic.
The key word in Petra's nature is peacemaker. Petra Nemcová has the soul of an artist. She is extremely sensitive, perceptive, and a bit shy. These qualities are both her strengths and weaknesses, for while Němcová possesses enormous sensitivity to her feelings and those of others, that same sensitivity can cause her to hold back and repress her considerable talents. Sensitivity and perceptiveness are among her many fine qualities.
Because Petra Nemcová intuitively knows what people want, or feel, she can be extremely diplomatic and tactful. She is also patient and cooperative. Petra works well with groups and somehow finds a way of creating harmony among diverse opinions.
Němcová enjoys music and poetry and requires a harmonious environment. She has an eye for beauty and a fine sense of balance and rhythm. Petra has also healing capabilities, especially in such fields as massage, acupuncture, physical therapy, and counseling.
However, Němcová's sensitivity can also be her downfall. Her extremely delicate ego bruises easily and can make too much of someone else's thoughtless remarks or criticisms. Because Petra Nemcová gets hurt easily, she may tend to withhold her own thoughts and contributions to the matter at hand. This can cause Petra considerable resentment and anger, but too often - Petra Nemcová runs from confrontation to avoid a battle.
When she employs her considerable inner strength, Němcová will discover her enormous power and abilities to direct difficult situations toward her own goals. It is the awareness of her inner strength that will give Petra Nemcová the courage to use her own personal power when it is needed. Petra is a sensitive and passionate lover; her perceptiveness makes her aware of her partner's needs and desires, which Petra is able to fulfill with almost magical delicacy.
However, when Petra Nemcová feels she has been mistreated or jilted, she can react with devastating power, sometimes using personal criticisms vindictively. Her awareness, diplomatic skills, and organizational talents give her the ability to bring off difficult tasks. Němcová willingly steps out of the limelight to facilitate the success of her endeavor. In truth, Petra Nemcová is often the power behind the throne.
However, Petra does not always receive the credit she deserves for the fine work she has done, or her role is underestimated and her accomplishments overlooked. Rather than brood over her losses, Němcová needs to confront those who would make less of her contributions and stand up for her accomplishments.
Petra Nemcová needs security and comfort, quiet settings, and the company of loved ones. She is a perfectionist when it comes to her home and work environment. She has excellent taste which is obvious in her private surroundings. Petra is a fine companion and possesses a good sense of humor. Friends seek Němcová out for her calming and peaceful company. Petra is a safe haven to other sensitive people, who recognize her compassion and understanding. When Petra Nemcová has found her niche in life, she has all the talents and intelligence for great success. Petra must seek out work that allows her sensitive nature to flourish so she can be the glue that binds others together.
You and Petra
About Petra's Life Path number
If ever there was a single moment of total transformation, it was actually the moment of Petra Nemcová's birth. In that instant, Petra stepped through a door in time into a new reality - the reality of human life. The most critical number in Němcová's numerology chart is based on the date of her birth - the moment when the curtain went up in Petra Nemcová's life.
Read more about our numerological interpretation of Petra Nemcová's


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The Savvy Ones
Roll with IT
The Connected Student
1-9-90 Rule
- 1% of students are actively creating information
- 9% knows how to curate information - synthesis, systems of learning
- 90% of students are simply consuming
What do you make of this? Comment in the section below.
Your Goals
Next year is OFFICIALLY your year to start integrating technology into your curriculum. Yes, I know you've already been "cheating on" phase 1 this year (you can't help it!), but instead of focusing on the technology itself, you will focus on your curriculum first. As you update your ITP, what will you add, change, revise, or delete to shift your focus?
Evaluating Tech Tools
Let's create a rubric. What are the criteria? How will you rate each tool?
Dust off your blog, or head to your favorite social media site. Complete this 3-2-1, and share it with the world:
- 3 things you have learned with your TILT group this year
- 2 questions you still have, or 2 things you still want to learn
- 1 thing you are most excited about as you move forward


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Israel is located in the mist of this Nations, and they have vowed that they will make sure Israel knows no peace, but look at them and look at Israel. The difference is clear.
This a warning to those who have vowed that they will never eat or drink until they destroy you, their lives will end up like one of these nations.


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What better way to entertain your guests then with a crudite platter over flowing with a rainbow of crisp veggies? Watch then, try our monochromatic display or our portable tumblers, and impress your guests with your food styling know-how.
|Creative Crudite Ideas
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text: KB Home (NYSE: KBH), one of the nation's largest and most recognized homebuilders, has been honored by the U.S. Environmental Protection Agency (EPA) as a WaterSense® Partner of the Year for the second time in as many years. The Built to Order™ builder was the first to partner with the WaterSense program in 2009 to include WaterSense labeled fixtures as standard features in its new homes, and is the only homebuilder to be recognized as a WaterSense Partner of the Year. KB Home has constructed the most WaterSense labeled new homes in the country, including net-zero energy homes that also met the WaterSense program certification requirements. Additionally, all KB homes built today include WaterSense labeled faucets, showerheads and toilets. "We are pleased that our extensive water conservation initiatives have again been recognized by the highest government authority," said Dan Bridleman, senior vice president of sustainability, technology and strategic sourcing for KB Home, who was presented the award at last week's WaterSmart Innovations Conference held in Las Vegas, Nevada. "KB Home remains committed to water efficiency and our other sustainability-related initiatives that increase the value of the homes we build. We intend to continue to lead the way in this area as we believe it is the right thing to do as a homebuilder for our customers and the planet." The EPA's WaterSense program offers a national label for water-efficient new homes that helps Americans identify homes that save water, energy and money on utility bills. According to the EPA, WaterSense labeled homes use 20 percent less water when compared to typical new homes. For a family of four, that translates to a savings of 50,000 gallons of water per year, and about $600 in annual utility bills. "WaterSense is proud to partner with these champions of water efficiency who share our mission to protect the future of our nation's water supply," said Nancy Stoner, EPA's Acting Assistant Administrator for Water. "The 2012 WaterSense Partners of the Year were exceptional in their efforts to support innovative approaches to help people and companies save water and money on utility bills nationwide."


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Jonathan Groff to Host AIDS Walk New York Kick-Off Event, 4/8
More big news for Jonathan Groff today!
AIDS Walk New York just announced on Twitter that the Tony-nominated star of HBO's series LOOKING and upcoming movie THE NORMAL HEART, as well as Disney's FROZEN, is set to host this year's kick-off event on April 8.
Groff has appeared on Broadway in Spring Awakening, for which he was nominated for a Tony Award, and In My Life. His off-Broadway credits include The Submission, The Singing Forest, Prayer for My Enemy, Hair and more. He has also starred on the West End in Deathtrap.
The actor's other TV credits include Boss, GLEE and The Good Wife.
AIDS Walk New York will take place on Sunday, May 18, 2014 in Central Park. Register at http://aidswalk.net/newyork or call (212) 807-WALK (9255).
Since 1986, AIDS Walk New York has raised more than $105 million for HIV programs and services in the tri-state area, and has grown into the largest AIDS fundraising event in the world.
Photo Credit: MediaPunch Inc/REX USA


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PIA takes 7 passengers standing to Saudi.
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Jet Airways does it again, Berlin scrambles fighte
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J&K govt uses caller tune to combat skewed sex rat
Category: INFRASTRUCTURE
Perks of being a corporate 'pasha'.
Category: BUSINESS, INDUSTRY & TRADE,ECONOMY & FINANCE,INFRASTRUCTURE
2 reasons behind new Metro policy.


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It was a Saturday. I woke up to find myself in my girlfriend's room. I don't know what happened the night before or how I got here. I looked at the clock... 1:00 a.m. My parents were gonna kill me when I got home. So I figured, why not wait until morning. I roll over to put my arm around my girlfriend, only to discover that she's not there. I wondered where she could have gone. Then I thought to myself, "Maybe she went to the bathroom. Yeah, that's it." And I rolled over and went to sleep.
The next morning, I wake up around 9:00 a.m. to learn that my girlfriend still wasn't in bed. I got up and went to the living room to face her parents and ask where their daughter was, only to find that they were gone too... Where the hell could everyone be? Pondering the thought in my mind, I headed on home to face my parents. I get home, and my parents look at me with tears in their eyes.
"Where the hell have you been, Matt?! We've been worried sick!" My mother said as she embraced me with a hug.
I replied, "I was at my girlfriend's house. I know I should've told you but..." My sentence was cut short.
"Your girlfriend? Son, she moved out yesterday!" My dad said.
Could what he have said been true? Could my girlfriend really have moved out, and I can't remember a thing? All I know is, whatever happened last night, has got me confused...


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Salwar Kameez Trends in Islamic Clothing
Elegant, comfortable and easy to wear, salwar kameez is a classic outfit for women, which can be in a single color, or can have a combination of two or more colors. It sometimes features beautiful designs and embroidery patterns. Nowadays, the colors and designs of salwar kameez are based on the latest trends.
This outfit has also become a significant part of Islamic clothing. Suitable for formal, casual, as well as traditional look, salwar kameez is one of the most commonly worn Islamic attires.
Facts About Salwar Kameez:
Wearing salwar kameez has become an impressive fashion statement for Muslim women. It looks trendy and at the same time helps to maintain modesty in dressing. There are some basic facts underlying the trend of salwar kameez suits.
- Choice of fabric is one of the biggest advantages with salwar kameez. Cotton, Georgette, wool and chiffon are some of the common fabrics used for designing salwar kameez. While wool is a winter fabric, cotton is apt for summers.
- Kameez is a long tunic or shirt. The name " kameez" has been derived from the Latin word "camisia" that means "shirt" or "tunic". An Indian kameez is straight and cut flat. It fits loosely on the wearer. The neck and sleeves feature decorative designs. Islamic kameez is a little different when compared to former. It is wider at the chest, waist and bottom, with the sleeves being loose. The length of Islamic kameez goes below the knee and the neckline is higher at the back for religious reasons.....
...See More at - http://eastessence.tumblr.com/post/118356520904/salwar-kameez-trends-in-islamic-clothing


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Rapper CDQ has unveiled the official cover artwork for his debut album "Quality".
Alongside dropping the artwork the rapper expressed on his Instagram page gratitude to his fans.
"A dude from the ghetto, slum, floor, project resting on the shoulder of success all because you gave me chance and believe in me…I can't thank you all enough my fans and well wishers God bless you #Woss #QUALITY #ALBUMCOVER #GRL"#7DaysTo Go."
The rapper on Monday, August 15, 2016 held a media press conference to announce the official release date for the album slated for August 22, 2016.
Formerly signed to management company, 323 Entertainmentowned by Tiwa Savage's estranged husband Teebillz.
The rapper's well known for singles 'Salaro' and 'Oobi' with his unique indigenous style, featured in a Reminisce cypher session that had rapper Vector on it.
The rapper has been nominated for Best Rap Act at theNigerian Entertainment Awards 2016.
Acts associated with CDQ include Reminisce, Vector, Olamide amongst others.
CDQ signed to Masterkraft's General Records in 2013, and is set to drop his major project.


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I don't know if heels or flats would go better? Or what kind specifically. link
Most Helpful Guy
How about, with the black dress, low rise heels, with gold glitter on them?00|00|0
I don't know if heels or flats would go better? Or what kind specifically. link
How about, with the black dress, low rise heels, with gold glitter on them?
Have an opinion?
As you see the dress curves from underneath the breast, so you would need a slight heel on this, but nothing to high, say nothing over one and a half inches. A white shoe that exposes most of your foot would go well, the heel cam be minimum or a main feature of the shoe, this dress would compliment either, try not to go to heavy at the front, have your toes exposed at least.x
Yeah 5 inch heels wouln't go with that dress. Flats are much better choice or you can go with smaller heels.
From a guys perspective, flats. That's more of a casual dress.
a classy pair of heels. seeing as it's a black dress just about color heels would do.
these would go great with it link
You could wear toms but, it's a dress...you don't want to make it all the sudden, casual, do you?
Well, I do want it to be casual. I don't want it to be super super dressy. I'm just going to my little brothers elementary ceremony into middle school.
It's a dress, wear heels
id go with a pair of closed heels, like no toes. black dress can go with any color heel, if your planning on going sexy go with a color, like red or if your going more classy, go for a white or gold
hope that helps:)
I wouldn't use it with toms. Heels would look better with it maybe some slingbacks or black leather wedge heels with the heel being wood.
heels, and toms wouldn't work with it
most definitely pumps. If you don't want to wear heels. Black flats or black/gold flats should do.
Ballet flats black or sliver
heels or really nice flats
not toms lol
Go with flats
You cannot undo this action. The opinion owner is going to be notified and earn 7 XPER points.


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What is JotForm?
JotForm is a free online form builder which helps you create online forms without writing a single line of code. No sign-up required.
At JotForm, we want to make sure that you're getting the online form builder help that you need. Our friendly customer support team is available 24/7.
We believe that if one user has a question, there could be more users who may have the same question. This is why many of our support forum threads are public and available to be searched and viewed. If you'd like help immediately, feel free to search for a similar question, or submit your question or concern.
Make the form more dense in height?Asked by hookey on June 10, 2014 at 04:55 AM
I am new to Jotform - a very good tool indeed! Thanks for providing it!
I would like to get my forms a bit more "dense", the distance in height between the entries are a bit to large for what I want to achive. I cannot fins ant option to fix this - is there a soloution?
Thanks in advance!
Are you referring to the space of your fields between the other fields? You can adjust the question spacing in Preferences > Field Styles > Question Spacing decrease the number to reduce space between other fields.
Before decreasing the number:
After decreasing the question space. Fields are now much closer to each other.
Hello, Yes this is correct! Great! But when you have shrunk it (as above) it seems even more dense than if I do it, even if I set the number to "0"?
That's the closest it can get is that setting the value to "1". You wanted it even more closer between other fields? You can reduce a few more spacing by adding this css.
.form-line {
padding-top: 0px !important;
padding-bottom: 0px !important;
hello again,
My mistake was to set the value to "0", not to "1". Setting it to "1" solved the problem for me! Thank you!
JotForm Support
Hello hookey,
On behalf of my colleague, you are welcome.
I am glad to know that your problem is solved.
Do get back to us if you have any questions.
Thank you!


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The Longhua Qipao is an elegant long-sleeved Chinese dress with a flower motif and corset waist with a ribbon sash. It is available for female characters in Character Creation for Soulcalibur IV.
Soulcalibur IV
This Upper Body equipment raises Defense by 25 and HP by 30. It can either be bought for 3,050 Gold after earning 15 Honors/Achievements, or it can be obtained on the 21st floor of the Tower of Lost Souls. To accomplish the latter, the player has to Ring Out themselves.


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5 Must-Have Educational Mobile Apps
by Katelyn Trieu
1) Evernote (iOS, Android)
This note-taking tool allows users to type in or upload video and picture notes! Create and save text, web-clips and PDF files. Audio notes may be recorded. Students my organize themselves by creating To-Do lists as well! Data is automatically synchronized between devices. Usable by all ages.
Students may use this app to take notes in class in an organized fashion. Pictures may be added to their text notes for detail and added clarity. Audio notes may come in handy if a teacher is reciting words on a spelling list, or if the students are learning to play a new song on an instrument in Music class.
2) Dropbox (iOS, Android)
Expand the classroom's sharing of files by creating folders for projects, papers, planning, group work--the sky's the limit! Photos, documents and videos can be uploaded and shared on nearly any device. The files have the option of syncing between devices and each account (requires basic information to sign up) receives 2 GB of memory space upon signing up.
Each student can save their individual work privately and contribute to group file sharing (may create groups of two, to sharing to the entire classroom)! Offline viewing is also convenient, if students are on the go and have extra time to look over readings and newly assigned projects or papers.
3) eClicker Polling System (iOS)
Get students to contribute to everyday lectures by voting on questions or taking surveys during lessons! Presentations can be made more effective by transforming iDevices into centres for making drawings, taking polls, and sharing results!
4) The Elements: A Visual Exploration
(iOS, Android)
A quick, resourceful tool which illustrates the periodic table with richly detailed photos and comprehensive information about each element! Going a step further from the basic periodic element, students will be able to view what form the element physically exists as, a Bohr model diagram of the element, its crystal structure, and other details such as atomic weight, density, and electronegativity! Images are rotatable to be viewed at any angle, and are able to be viewed in 3D, should a student wish to purchase special 3D glasses.
5) Study Blue (iOS, Android)
Teachers and students can create and share a plethora of mobile flashcards, study guides, and quizzes! If students run out of ideas, they have the ability to choose from an extensive collection of student-authored flashcards and flashcard decks. They have the option of making their work public, so their work would not be shared without permission. This app would be convenient by helping students study on-the-go! Accessible any place, any time on their mobile devices!


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Linking Cans, Cylinders,& Rational Equations
By Kyle Appelhans, Dillon Pholman, Cameron VanDerLinden
We solved for finding the formula to use to find the volume of a coffee can by multiplying the base, which would be the two circles, times the height of the cylinder. The cost of the top and bottom of the cylinder however will be more expensive so it will require a cost change than the height. The formula would look like: .06(2pir^2)*.04(2pirh)= cost
By plugging in the formula into a graph we will be able to find the lowest cost we can receive by representing r as x and the cost as y.
By doing this we received a cost of $6.71.
The can we choose for our project was a simple Pringles can. The can holds the dimensions of a 10.5 inches for height and 1.5 inches for radius. We were able to plug these variable to a modified version of the formula that we created in part 1, we altered the formula by reducing the cost of the materials from .06 to .03 and .04 to .02.
By plugging this information into the new formula we come to a total cost of $0.84.


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What is Byetta?
By: Ani Barsamian, JD
Byetta, also known as exenatide, is an injectable diabetes medicine manufactured by Amylin Pharmaceuticals (now Bristol Meyers-Squibb) that helps control blood sugar levels and is used to treat type 2 Diabetes. This prescription medication is intended to assist the pancreas produce insulin more efficiently.
Additional Byetta FAQs


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Yup! The almighty backpack! If you have back problems, if you lug around heavy things simply out of necessity, you NEED a backpack, son! You neeeeeed it!
These are neither as comfortable as most backpacks nor can they carry as much stuff. But, they're made to be convenient, to hold a fair amount of things and are extremely cute. When you have to pay for something and are in a hurry a backpack will make you look like a fool while you take it off, rumble around in there and find what you're looking for. A messenger bag is right there, probably hanging right by your hand. You swiftly open it and find what you need. When you're done you simply close it and swing it back onto your hip or butt. xD
Grocerie bag that's machine washable - as if that's not the most useful thing anyone who's taking care of themselves and their household could ever ask for. Instead of getting those paper bags that rip and make your produce hit the unbelievably filthy floor, the plastic ones that are not bio degradable and also are prone to breaking, you get these ones - cloth, easy to wash, reusable - porbably will last you foreveeeer. Unless something sharp cuts through them. xD


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Steve Burrows
United Kingdom
Dad, graphic designer, website designer, website developer (Drupal). Loves family time, branding, typography, CSS3, Open Source, Man Utd, and rush hour traffic.
Tweeter? http://twitter.com/#!/stevenburrows/
Press play to try again.
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why every time I'm in a relationship I feel like I'm not really into the relationship even tho I really like the person but I know myself and in my mind I don't wanna get hurt so I feel the need to not get attached and be realistic that the relationship won't last and so I feel like I'm cold towards my partners and I hate feeling like they really like me and care for me and once I get bored of them I hurt them and I don't mean to but its just how I am and I don't know what to do.
idk why I'm like this. is this normal? is it just a phase? I don't wanna keep hurting my lovers. its like I like them at first and then I just lose all feelings/interest and need to move on and I hate it when they seem so heart broken because I don't like hurting people and it makes me wonder will I also get hurt like that by someone?
i mean it always starts nice, I like the guy, he makes me happy, then I start being a bitch I get bored I break up with them and the cycle continues and every time I keep in my mind that this kind of relationships don't last and love is all fake and corny
I'm still young and will have more relationships but my ex's always seem to think we will last a long time but in my mind I'm always doubting it because I know I will get bored :/ is this bad?
Most Helpful Guy
If you're not leading them on, you can't control if your ex's thought it was forever. You're just not ready for a relationship, and you said it yourself, you're afraid of getting hurt. You just have to find the guy you're willing to hurt over. Part of the fun of dating is getting hurt. I mean that sincerely. Pining madly for something that won't work, thinking up ways to change yourself so they'll love you. It's a great lesson.
You have to care for the relationship to work, and if you care you risk getting hurt. Only the brave and reckless fall in love. If anything, keep dating, but keep it casual.11|00|0


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Each month, Rated People connects over 50,000 homeowners with quality tradesmen - simply enter your job details in the form above to get started.
We'll match your job to the relevant tradesmen in your area - those interested will pay to see your contact details and call you to quote.
As each tradesman expresses interest in quoting on your job, we'll send you their profile and ratings to help you choose the right one for you.
After the work is complete, return to the site and rate your tradesman based on their quality of work, reliability and value for money.
Driveway Services
Added 29/03/2017
blockpaving driveway need it dun soon as
Driveway Services
Added 07/10/2016
to supply and fit block paving on my drive
Driveway Services
Added 02/01/2015
block pave off road parking, pathway & step approx. 10 - 15 m2, immediate start for right...
Driveway Services
Added 18/06/2014
Unsold lead, updated details: current area is half concrete/half dirt Original: approx 19.5sq...
Driveway Services
Added 17/11/2013
I want a small block paved driveway.
Really great friendly team. Left the place neat and tidy - nothing was too much trouble. We had to wait a while for them to fit us in but then again I would be worried if the turned up the next day! Value for money yes - not the cheapest but by no means most expensive. Would be happy to have them back again.
Did a great job, on time, easy communication, good value. Will use Flamur again.
Managing your job is easier with the Rated People Homes App, download it today.


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Hello all!!! My second day, learned my mistake about posting a trolpasta yesterday! Wont happen again!!! :3 I uploaded my first creepypasta poem, so thats a plus!!!! Anyone recommend any creepypastas, i dont mind what kind!!! So I guess thats my blog post for the day! Glad to be a part of the wiki!!! Posting another creepypasta tomorrow! Maybe another blog post too!!! Bye all!
- 3 -Cinnamon!


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How to make Coloured smoke from Wax Crayons. Smoke bomb/ grenade for paintball, airsoft.. etc MP3
This is for Educational Purposes only! DO NOT try to recreate the items in the video unless you have experience in Pyrotechnics. It is your responsibility to ...
How to make colored smoke bombs [DIY] MP3
Here is how to make the best colored smoke mix with very rich and bright color. In this video I show you how to make purple ones using rhodamine B. You can ...
How to Make the Best Giant Smoke Bomb MP3
Hi guys today we make an epic purple smoke bomb using some of the most simple ingredients. Now there are lots of other smoke bomb tutorials out there that ...
Ultimate Color Smoke Bomb ! How to Make It MP3
Actually this video is not mine. I downloaded it from metacafe and just wanted to share it with you guys.
Colored smoke bomb. Violet dye. MP3
smoke bomb colored with rhodamine B! This smoke bomb is made of kclo3 rhodamine baking soda and dextrin. It's a rly nice color and a lot of smoke but it lasts ...
Colored Smoke Bubbles MP3
Experimenting with coloured smoke bubbles, using Green/Red/Blue/White smoke pellets. www.highlandjoker.com Please notice: This is not an instructional ...
Supra Colored Smoke Burnout Baby Gender Reveal MP3
With our second child on the way we fitted our single turbo Toyota Supra that my wife Cori drives with colored smoke tires that we had shipped to us from our ...
How To Make Colored Smoke Grenade MP3
The recipe * All CREDITS and COPY RIGHTS go to the owner of this material. It was copied for educational purposes only. * additive.
Colored Smoke MP3
Just a little experiment - recorded incense in front of a projector at VoxelCon 2013. Music: Carbon Based Lifeforms 01 - ABIOGENESIS 02 - VORTEX.
GRWM Shoot - Colored Smoke MP3
Heyy! Voici une nouvelle vidéo d'un Shoot avec Charles de Vilmorin et des fumigènes d'air soft! N'hésitez pas à me faire partager vos commentaires et à aimez ...
Smoke Bomb Smoke Screen MP3
This video exemplifies my randomness, resourcefulness, craziness, and belief that you should take advantage of everything as much as possible. This video has ...
Cbr600rr burnout (colored smoke tire) MP3
Breaking in my new colored smoke tire. It's really not worth the money. But it does look pretty cool.
Colored Smoke Grenade by Line Thrower MP3
Colored Smoke Grenade by Line Thrower.
How to make great colored smoke mix! MP3
This is how you can make great colored smoke mix. A lot of you have been asking me. I hopes this helps you out. As there are many mixes. I know in the video I ...
Basic Multi-Colored Smoke in Blender MP3
You can find a tutorial, including a downloadable BLEND file here: http://youtu.be/jnzzUrYg_Ng.
How to make a colored smoke bomb. MP3
Tutorial by www.colored-smoke.eu (supplier of smoke bomb chemicals) Composition: 25g of 40-36-24 Dye-KClO3-Lactose Ignition mix: less than 0,5g ...
Colored Smoke Volvo 242 Burnout MP3
Kumho tires burnout, swedish style!
MUSTANG IN THE BURNOUT COMPETITION @ THE NMRA FORD NATIONALS 2012 Please subscribe and "Like" us at facebook.com/dirthicksproductions.
Как сделать цветную дымовую шашку (русская озвучка) / How to make colored smoke bomb MP3
Легендарная дымовуха своими руками.
6g Colored Smoke Bomb (Homemade) MP3
6 gram Red/Pink Smoke Bomb potassium chlorate/sugar/dye all ingredients are powdered! Easy to make and easy to get the materials needed.
Colored Smoke Compilation - Blender 2.57 - with picture tutorial - Zeitfreund MP3
After I discovered how easy two-colored smoke can be created, I got to work. :D After 2 weeks and quite some experiments, it's ready. :) Picture Tutorial JPGs: ...
Fumaça colorida narguile [ Colored Smoke Narghile] MP3
Aqui um video de aneis de fumaça colorido . Se gostar da um joinha.
Colored Smoke Tyres JAN017 Mercedes Benz CLK200 Kompressor MP3
Дымные шарики | Дымовые шарики | Dymne Kule Maxsem MA0508 | Colored Smoke Bols MP3
Дымные шарики | Дымовые шарики | Dymne Kule Maxsem MA0508 | Colored Smoke Bols. Купить дымные шарики в Киеве с доставкой по Украин...
☠☠☠☢☢☢☢ Как сделать цветную дымовую шашку / How to make colored smoke MP3
Сегодня покажу вам как сделать цветной дымовой взрывпакет своими руками. Основой которого лежит смесь...
Photoshop: Colored Smoke MP3
Battlefield 3: Noob Servers, Colored Smoke & Rush Exploit? - Sunday Mailbox #11 MP3
Hey guys. Today's Sunday Mailbox, I discuss the potential of separating new players from experienced ones, colored smoke grenades and Rush tactics. Let me ...
Colored Smoke Grenades MP3
Demonstration of CTS Red Colored Smoke Grenade.
Giant Colored Smoke Ball 2 inches in diameter MP3
A review of the Giant 2 inch smoke ball/bomb made by Big Thunder.


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|Publication number
|Publication type
|Application number
|Publication date
|Sep 12, 1989
|Filing date
|Apr 20, 1988
|Priority date
|May 4, 1987
|Fee status
|Publication number
|Ho C. Tu
|Original Assignee
|Tu Ho C
|Export Citation
|BiBTeX, EndNote, RefMan
|Patent Citations (6), Referenced by (98), Classifications (9), Legal Events (3)
|External Links: USPTO, USPTO Assignment, Espacenet
This application is a continuation-in-part of prior U.S. patent application Ser. No. 46,589, filed May 4, 1987, entitled Combination Blood Sampling and Intravenous Infusion Apparatus and Method, by Ho Chung Tu, and now abandoned.
1. Field of the Invention
This invention pertains in general to the field of sterilized medical apparatus and in particular to the field of combination intravenous infusion and blood sampling or medication injection apparatus which provides a completely sterile environment for obtaining blood samples from a patient or injecting medication into a patient who is connected to intravenous infusion apparatus.
2. Description of the Prior Art
In recent years in the medical field a great amount of emphasis has been placed upon new and different sterilized procedures whereby the advent of contamination of a patient is either minimized or completely eliminated. The success of such efforts are in a large measure attributable to the ability to mass produce various components made from inexpensive plastic materials. By using such materials, the apparatus in question is completely sterilized and then placed within the sealed sterile container. After use, the apparatus is simply discarded. This overcomes the prior art reusable apparatus which after use must necessarily be resterilized and set aside for later use. During such storage periods the equipment must be maintained within a sterile environment in order to preserve such sterility. Unfortunately, the ability to sterilize and maintain such apparatus in a completely sterile condition prior to re-use is not readily obtainable and contamination of such equipment has caused serious infections in patients. Accordingly, the move to prepackage sterilized and disposable apparatus is extremely beneficial.
One example of still problematic procedures involves a baby patient where blood gas specimens are being drawn in order to monitor oxygen therapy. In this example specimens may be required as often as twenty times a day and for as much as two weeks. In the prior art this routine procedure involved a setup where the arterial umbilical line of the baby is continuously connected to an intravenous solution supply through a three-way valve. The valve allows for disconnection and reconnection of up to three different syringes which are necessary for the blood gas sampling procedure. These disconnections and reconnections involve many steps, each of which increases the risk of contamination of the baby's arterial line. The arterial line opens the entire body of the baby to a possibly contaminated environment. Once bacteria get into the blood stream via the arterial umbilical line, the bacteria travel and multiply in any organ of the body. And, since the bacteria from a hospital environment are usually resistant to antibiotics, the end result could be that the baby dies of infection.
In another example the patient may be receiving intravenous medication through a vein in the patient's arm and it is desirous to obtain a number of blood samples over an extended period of time. In this example similar apparatus is used where a syringe is connectable to a port of a three-way valve. Again, in this routine procedure it is required to disconnect and reconnect a number of syringes to the syringe port in order to draw a blood sample. And, again, there is the distinct possibility of contamination entering the patient's body from the contaminated syringe port of the valve. The contamination can occur from a previously sterile syringe being placed on the patient's bed during the syringe changing operations which is then reconnected to the syringe port. It is because of the relatively large number of steps involved during the procedure that hospital personnel sometimes forget to cover the tips of the disconnected syringes and place them on the patient's bed causing the contamination. Of course, it is possible in the second example to avoid contamination by using one arm for blood sampling and the other arm for injecting the medicinal solution. But, in this event the patient experiences numerous punctures which are obviously undesirable.
Accordingly, it is an object of the present invention to provide medical apparatus whereby a procedure which allows for intravenous infusion of medicinal fluids into a patient and periodic blood sampling from the patient utilizing apparatus which is continuously sterile in a closed system and thereby prevent injury to the patient from contaminated equipment.
Another object of the present invention is to provide medical apparatus whereby the patient may be intravenously infused with a medicinal fluid and where periodic blood samples are obtained from a catheter inserted in an artery.
Another object of the present invention is to provide medical apparatus whereby procedure may be utilized wherein both intravenous infusion and blood sampling of the patient may occur utilizing medical apparatus which is disposable.
The above-stated objects as well as other objects which although not specifically stated, but are intended to be included within the scope of the present invention, are accomplished by the present invention and will become apparent from the hereinafter set forth Detailed Description of the Invention, Drawings, and the claims appended herewith.
The above objects as well as other objects are accomplished by the present invention which comprises medical apparatus of a disposable type which allows a completely sterilized procedure for either intravenous infusion or blood sampling of a patient in a generally non-sterile environment.
A three-way valve is provided having one port which is connected to a port of a sealed blood sampling apparatus, the outlet of which is connected to a catheter which may be used to be attached to a patient's vein or artery. Another port of the three-way valve is connected to intravenous infusion tubing which may be connected to a source of intravenous medicinal fluid. The remaining port of the three-way valve is connected to a flushing syringe. By manipulation of the three-way valve, the two ports connecting the intravenous fluid with the catheter in the patient's vein or artery may be effectuated and thereby provide for intravenous infusion to the patient. By manipulating the valve to open the catheter and flushing syringe ports, the intravenous infusion is stopped and the fluid within the catheter tubing may be flushed by using the flushing syringe. Thereafter, after all of the intravenous fluid has been flushed from the catheter tubing, and when blood from the patient reaches the flushing syringe the needle of a blood sampling syringe may be applied to the sealed sampling apparatus and an appropriate blood sample may be taken. Following the blood sampling, the three-way valve may be again manipulated to connect the intravenous fluid to the catheter tubing and thus allow a continuation of the intravenous infusion procedure. Any number of blood samples may thereafter be taken at periodic times by utilizing the same procedure as aforedescribed with the combination blood sampling and intravenous solution infusion apparatus being left in place. Upon completion of the combination intravenous infusion/blood sampling procedure which can be as long as two weeks or more, the three-way valve, the sealed blood sampling apparatus, the catheter tubing, the flushing syringe and the intravenous tubing may be removed from the patient and completely discarded. By using such a procedure as above-described, there is no need to disconnect and reconnect the various syringes which in the prior art opened the system to a contaminated environment. Thus, there is no chance of the patient being injured by the normal contamination which is ever present about the bed location of the patient. By making the apparatus of inexpensive plastic or silicon material, the medical apparatus provided by this invention is disposable without the need for subsequent re-use and sterilization. And, because the number of steps involved in the procedure is decreased, the procedure is much more simple and, therefore, less prone to error.
Various other objects, advantages and features of the invention will become apparent to those skilled in the art from the following discussion taken in conjunction with the following drawings, in which:
FIG. 1 schematically illustrates the inventive apparatus as applied to a patient's vein or artery or a baby's umbilical line which allows a sterile procedure involving periodic blood sampling in combination with intravenous infusion of a medicinal fluid;
FIG. 2 is an isometric rendering of a combination three-way valve and blood sampling device which may be used with the present invention; and,
FIG. 3 is a partial cross-sectional view of the apparatus of FIG. 2 showing the details of the injection or sampling port.
As required, detailed embodiments of the present invention are disclosed herein; however, it is to be understood that the disclosed embodiments are merely exemplary of the invention which may be embodied in various forms. Therefore, specific structural and functional details disclosed herein are not to be interpreted as limiting, but merely as a basis for the claims and as a representative basis for teaching one skilled in the art to variously employ the present invention in virtually any appropriately detailed structure.
Reference is now made to the drawings wherein like characteristics and features of the present invention shown in the various figures are designated by the same reference numerals.
Reference is now made to FIG. 1 of the drawings, which schematically depicts an exemplary embodiment of the present invention. A patient is shown who may comprise an adult or a child having his blood oxygen level continuously being monitored and/or having his blood being sampled on a periodic basis while being administered an intravenous fluid. A catheter 11 is inserted in a vein within his arm or canalized in an umbilical artery at the umbilical tube. The inlet end 12 of the catheter 11 is connected to the outlet port 21 of a sealed blood sampling device 13. Blood sampling device 13 comprises a main body portion having inlet and outlet ports 20 and 21, respectively, connected thereto in addition to a third port 22 which is sealed by a diaphragm 32 made from rubber or other appropriate material. The inlet port 20 of blood sampling device 13 may be directly connected to outlet port 24 or, in the alternative may be connected to an outlet port 24 of a three-way valve 14 by a short length of tubing. The connection of ports 20 and 21 of blood sampling device 13 to tubing 12 and to outlet port 24 or three-way valve 14 is accomplished in a sterile environment at final assembly of the inventive apparatus. It is to be noted that the connections to ports 20 and 21 are not intended to be disconnected at any time after final assembly of the inventive apparatus. Thus, no contamination can enter the inventive apparatus through the connections of these ports. Similarly, the rubber diaphragm 32 across port 22 is of a permanent nature such that no contamination may enter at this location. In the alternative embodiment shown in FIG. 2, the blood sampling device 13 is integrally connected to the three-way valve 14, hence no port connections between items 13 and 14 are required and, therefore, there is no possibility of contamination.
Three-way valve 14 includes three ports: namely, an intravenous infusion port 26, a flushing syringe inlet port 27, and the aforementioned outlet port 24. A valve handle 28 is connected to a rotatable cylinder within three-way valve 14 which allows the connection of either ports 26 and 24 or ports 27 and 24. A flushing syringe 15 is connected to flushing inlet port 27 of three-way valve 14 and may be left in place throughout the procedure when the inventive apparatus is used. In this manner no contamination may enter by way of the connection of flushing syringe 15 to inlet port 27. Flushing syringe 15 may be used as hereinafter described to flush the intravenous infusion fluid from the location of three-way valve 14 to the connection of catheter 11 when it is desired to cease the intravenous fusion and obtain a blood sample.
The intravenous infusion inlet port 26 of three-way valve 14 is connected to intravenous fusion tubing 16 at one end thereof. The other end of intravenous fusion tubing 16 is appropriately connected to a container 17 of appropriate intravenous infusion solution. The container 17 of intravenous infusion solution is appropriately connected to a stand 18 such as is commonly used in an intravenous infusion procedure. All of these connections are made in a normal manner which assures that no contamination occurs.
The apparatus as provided by this invention comprising the intravenous infusion tubing 16, the three-way valve 14, the catheter tubing 12, and the catheter 11, as well as the flushing syringe 15 may all be made from disposable plastic materials which have been sterilized prior to and during the various connections of these components and packaged in the sealed sterile container for use when needed. The sealed container is indicated by the dashed line in FIG. 1 around items 16, 15, 14, 13, 12 and 11. When it is desired to use the inventive apparatus, the sealed container is opened at the location of the patient and appropriately attached to the patient and a container of intravenous infusion fluid. The length of catheter tubing 12 is such that the blood sampling device 13, the three-way valve 14, and the flushing syringe 15 may be placed an appropriate distance away from the patient such that movement of the patient does not interfere with said apparatus.
When it is desired to obtain a blood sample from the patient, the lever 28 of three-way valve 14 is manipulated to connect ports 27 and 24 and thereby close port 26. Then, the flushing syringe 15 is operated to draw all of the intravenous solution in catheter tubing 12 and the entrance to syringe 15 with blood from the patient. This procedure will also cause the internal passages of blood sampling device 13 to fill with the patient's blood. A blood sampling syringe 19 is then applied to the diaphragm 32 of the blood sampling device 13 thereby piercing the diaphragm 32 by the needle of syringe 19 and connecting the blood sampling syringe 19 thereto. Then, a blood sample may be taken from the patient by activating the plunger of blood sampling syringe 19. When a desired amount of blood has been withdrawn from the patient, blood sampling syringe 19 may be removed from the diaphragm 32 of the blood sampling device 13. Because of the nature of diaphragm 32, the sealed opening across port 22 is reestablished when the needle of blood sampling syringe 19 is removed from diaphragm 32. After removal of syringe 19, the plunger of syringe 15 is pushed down thereby pushing the blood within syringe 15 and catheter tubing 12 back into the patient. Flushing syringe 15 is then in a position for re-use when another blood sample is to be taken. Lever 28 of valve 14 is then moved to reconnect ports 24 and 26 and close port 27. This procedure reconnects the container 17 of infusion fluid to the patient to allow continuation of the intravenous infusion. At any time thereafter and for as many times as desired, the aforestated procedure may be repeated in order to obtain additional blood samples from the patient. When the combination intravenous infusion and blood sampling procedure is completed, the catheter 11 may be removed from the patient and the intravenous infusion tubing 16 may be removed from the intravenous infusion container 17 and discarded in an appropriate manner.
It is to be noted that all of the operations performed during the alternative intravenous infusion and blood sampling procedures are accomplished in a completely sterilized manner.
The inventive, apparatus may also be used to inject medication into the patient. For this procedure flushing syringe 15 may be filled with a solution of normal saline which is then used to flush the catheter tubing 12 with the saline solution. Then, a syringe 19, filled with a predetermined medication, is applied to diaphragm 32. Activation of the plunger of syringe 19 pushes the medication through catheter 11 and into the patient. Syringe 14 may then be removed from device 13 and flushing syringe 15 is further used to push the medication in catheter tubing 12 into the patient. Valve 14 is then set between ports 24 and 26 whereupon the intravenous solution infusion is reestablished into the patient. Again, a completely sterile procedure is effectuated.
Reference is now made to FIG. 3, of the drawings wherein another preferred embodiment of the invention is shown. In this embodiment, a single unit comprising a three-way valve and an injection/sampling site is utilized. There is no breakable connection between the injection/sampling side and the outlet port 24 of the three-way valve 14. A straight length of non-flexible or rigid tubing 30 connects outlet port 24 of valve 14 to injection/sampling site 23. The use of non-flexible or rigid tubing 30 provides a degree of rigidity to the inventive apparatus generally designed by the number 10.
The rigidity of the inventive apparatus 9 allows the attending physician or the person drawing the blood sample from the patent to easily manipulate the various syringes 15 and 19 and the handle 28 of three-way valve 14. A flexible connection between injection/sampling site 13 and the outlet port 24 of valve 14 may result in a degree of difficulty in manipulating valve 14 and syringes 15 and 19.
Injection/sampling site 23, in the embodiment of FIG. 3 substantially eliminates any air between the rubber stopper or diaphragm 32 and the internal diameter 31 of the inventive device 10. Thus, when a flushing syringe 15 is used to flush the lines between the flushing syringe and the patent, no air is drawn into flushing syringe 15. Consequently, when the fluid within flushing syringe 15 is re-injected back into the patient, no air is allowed to be injected contemporaneously along with the fluid in syringe 15. In order to accomplish this important objective, the overall height H1 of injection/sampling site 23 is made very short and substantially equal to the height of H2 of the rubber diaphragm 32. More importantly, the bottom or lower surface 30 of rubber diaphragm 32 is made substantially flush with the internal diametrical surface 31 of the inventive apparatus 10. In other words, the inventive apparatus 10 eliminates an air pocket between the injection/sampling site 23 and the fluid within the apparatus 10 which connects lines 12 and 16.
In the use of the inventive apparatus for injecting a medicine, the flushing syringe is filled with a saline fluid.
While the invention has been described, disclosed, illustrated and shown in certain terms or certain embodiments or modifications which is has assumed in practice, the scope of the invention is not intended to be nor should it be deemed to be limited thereby and such other modifications or embodiments as may be suggested by the teachings herein are particularly reserved especially as they fall within the breadth and scope of the claims here appended.
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|International Classification
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|Apr 14, 1993
|Maintenance fee reminder mailed
|Sep 12, 1993
|Lapse for failure to pay maintenance fees
|Nov 30, 1993
|Expired due to failure to pay maintenance fee
Effective date: 19930912


text:
Jun 8, 2010
Project Report on Ebanking
Project report on Ebanking for engineering as well as management students. This report is a good to make project or seminar as e-banking is a hot topic for project. Electronic banking, also known as electronic funds transfer (EFT), is simply the use of electronic means to transfer funds directly from one account to another, rather than by cheque or cash. It is the most used way now to transfer the money from abroad or India, now everyone is using Net banking for their transactions. You can also Subscribe to FINAL YEAR PROJECT'S by Email for more such Projects and Seminar. Use this for reference and study.
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12:37:18 am
Rohit Chavda, A 26-year Old Advertising Executive Now Has A Wardrobe That He Says He Loves To Show Off.
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