text:
ADAM'S ALE, who carries the colours made famous by the brilliant Soba in the mid-1970s, promises to be the toast at Ripon this evening if he can manage to lift the featured sprint handicap.
Trained at Westow by Paul Midgley, the five-year-old has had two outings this season and looked to be coming to hand when third on this course three weeks ago.
Shirley Teasdale, pictured, rides in the silks of owner Muriel Hills on a horse she has got to know in the past. A bold bid is anticipated from a favourable draw near the stands rail in the Theakstons of Masham Paradise Ale Handicap.
Soul Brother, a brother of high-class sprinting stablemate Body And Soul, is napped to open his winning account in the SIS Delivering Content For Digital Platforms Maiden Stakes.
Tim Easterby's three-year-old has finished runner-up in both his outings this term and was only narrowly denied by the highly-regarded G Force at Newcastle on his latest start. He can make it third time lucky.
Stanghow, who made an eye-catching debut at Thirsk last Saturday, should not be overlooked as he makes a quick return to action in the SIS Bringing Betting To Life Maiden Stakes.
Mel Brittain's juvenile, a son of Monsieur Bond, lost an awful lot of ground at the start at Thirsk, where he was poorly drawn in any case, but he stayed on strongly late in the race to finish fifth to the useful-looking Captain Colby. He can do better here provided this race does not come too soon for him.
Lady Cecil sends a couple of runners to the meeting and both horses have leading claims if doing themselves justice on their first outings of the season.
Flow lines up in the most valuable contest on the card, the £12,000 SIS Top (Class Data Delivery Handicap.
Confined to just three outings last season, Flow rounded off with a narrow defeat by Running Deer at York in October. He is capable of winning races this year.
Cecil can also strike with Perfect Summer in the SIS At The Heart Of Racing Handicap. Runner-up at Haydock and Redcar on her last two outings last year, she remains a little unexposed.
At Chester, Hillstar gets the vote in the Boodles Diamond Ormonde Stakes.
Sir Michael Stoute's smart colt was out of his depth in the Dubai World Cup at Meydan in March, but he is more than capable of proving his worth in this Group 3 contest on the strength of his solid efforts last season in the King George VI Diamond Stakes and the Juddmonte International Stakes.
Mark Johnston saddles Somewhat in the Betfair Dee Stakes.
Last season as a juvenile, Somewhat built up a useful profile, winning at Listed level and being placed in Group 2 races. Although he was slightly disappointing on his reappearance in the Feilden Stakes at Newmarket last month, Somewhat deserves another chance to fulfil the potential he showed last year. Joe Fanning rides.
Gabrial's Star may be the answer to the concluding LDF Apprentice Handicap. Trained by Richard Fahey for Dr Marwan Koukash, Gabrial's Star shaped well to finish fourth at Catterick on his latest start. He may not have to improve much to win.
Racing selections
Chester today
1.45 Abseil, 2.15 Somewhat, 2.45 Hillstar, 3.15 See The Sun, 3.50 Related, 4.25 Tohaveandtohold, 5.00 Gabrial's Star.
Ripon today
5.55 Stanghow, 6.25 Elusive Band, 7.00 Adam's Ale, 7.35 Flow, 8.10 Soul Brother (NAP), 8.40 Perfect Summer.
Today's other meetings: Ascot, Lingfield, Market Rasen and Nottingham.
Tomorrow's meetings: Ascot, Haydock, Hexham, Lingfield, Nottingham, Thirsk and Warwick.


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|May 12, 2010
Volume 12, Issue 10
|Midwifery Today E-News
"Choice in Childbirth"
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Attend this two-day pre-conference class and discover a wide variety of techniques that will help you in your practice. On the first day, you'll learn new things about basic midwifery skills, become aware of how you can improve hands-on techniques to determine fetal position and explore ways to prevent complications with prenatal care. You'll also learn about comfort measures for labor support. During the second day, Elizabeth Davis will discuss the holistic complete exam as well as give a suturing overview. Other topics include Labor and Birth Complications, Helping the Slow-starting Baby and Trusting Birth.
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In This Week's Issue:
Quote of the Week
"It is my aspiration that health finally will be seen not as a blessing to be wished for, but as a human right to be fought for."
— United Nations Secretary-General Kofi Annan
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Jan's Corner
Mary Cooper is a fabulous midwife and conference speaker. She has done a couple thousand births and is "birth-sharp," with insights and outside-the-box thinking. She did a birth last week of a baby who weighed more than 10 pounds and the momma tore on an old episiotomy scar. Mary called me to ask about using Super Glue on the tear. I told her to not get her glove caught in it accidentally! She took a different approach though, so I've asked her to write about it for you. I also wanted to ask all of you if you have had experience with using either Super Glue or seaweed in place of suturing a tear, or if you have other techniques to share with us. ~ Jan Tritten
A Different Approach to Tear Repair
I had the wonderful privilege of helping Lynn and Danielle have their second baby at home. To give a little history, Lynn and Danielle had their first baby in the hospital, 2-1/2 years ago, a little girl who was 7 lb. Danielle was induced—she was a week late and her doctor was going out of town.
From the start, the Pitocin drip caused the contractions to be very painful. Seven hours later, Danielle was pushing. She liked pushing a lot and said she felt she could "finally do something" during her labor. She pushed hard and had a long, big tear. She tore to her rectum, and has, even now, had problems with re-occurring rectal pain, bleeding and swelling.
Danielle initially went to another midwife (who has years of experience), while I prayed about attending and helping at the birth. I started doing the prenatal check-ups at 26 weeks. She had an unremarkable prenatal course. Two times, the fundal height was 1/2 to 1 cm higher, which can be normal.
Danielle also wanted to have a waterbirth and had her birth tub set up and filled in the warm kitchen. Danielle had lots of contractions and started her labor already at 4 cm, 100% effaced. The labor was totally opposite of her daughter's birth, in that the contractions were 5–7 minutes apart and were effective but not as intense. Danielle was in the birth tub several times, but each time the contractions would stop, so she decided to get out and take a shower. Along with the upright position, she felt the shower helped the labor.
Danielle was 9-1/2 cm with a cervical lip. The lip did not go back, as her baby's head was +1, and fitting in her pelvis. I had her squat and walk, but the lip was still there. She then wanted me to push the lip, during a contraction. It took two contractions for the lip to pass back over the baby's head.
Danielle then started pushing and did not feel the progress she had with her daughter. I then said, "Come here, I want to 'hang you.'"
And, with that, I got behind her and put my arms around her and held onto her wrists. When the contraction started I held her against my body and she squatted and even sometimes lifted her feet off the ground—literally "hanging," thus the name I gave the position.
After several contractions, the baby moved and then started to emerge and to start to crown. We did warm arnica compresses and gentle massage to stretch the perineum. Danielle was on her knees, her arms on a chair. She gently breathed the baby out and her perineum was intact until she got to the baby's ears. The baby "sat" on the perineum for a while until the contraction came, and then the shoulders were born and then the rest of this alert and aware baby boy came into his father's hands. Lynn and I had seen the perineum blanch and start to tear, as the baby's ears birthed, and I felt the tear had gotten deeper and longer with his shoulders.
In assessing the tear, most of the perineum tore down the old episiotomy line. Danielle also had a labial tear, like a stretch mark or a skin split. With Danielle lying down, and the bottom of the perineum being at a six o'clock position, she had a partial "letter c" tear at 7 o'clock, then the tear came over to 6 o'clock and then went down the old scar line, ending before the pucker of the rectum.
It was a mutual decision to not stitch this tear and to use old methods that had worked for me in my busy practice, when the choice was made to not stitch a tear. I froze gauze pads with arnica oil on them for the swelling, and used sterile strips on the perineum, on either side of the tear. The blood flow would help the strips to not stick to the tender area, but the perineum would still be held in place. I then used a 2-1/2 foot strip of 1/2-inch adhesive tape on the side of Danielle's buttocks, bringing the tape through the middle of her healing perineum, then placing the tape on the side of her other buttock. Because her buttocks "stood out" more than her perineum, the healing perineum was never taped or sore from tape, but her taped buttocks held the perineum tightly together. I also used a piece of thin rope to tie Danielle knees together, as a reminder for her to keep her buttocks together. Danielle had help, so she could lie down for two weeks, nurse her baby boy and just bond and heal. The first day the sterile strips fell off with the pad changes, and the 1/2-inch adhesive tape had to be replaced, but by day three the blood flow was down a lot and the changes could be done without the tape coming off. The stinging from the urine was almost gone and the bruising was going away. The perineum was staying together and the swelling was almost gone and her odor had a good, clean smell. The labial tear also was almost gone. These types of tears are painful in the beginning, with urination, but heal well and that "droopy, hang-dog" look goes away with healing. The labium pulls back up into its rightful position as it heals. There usually is not even a mark or scar.
Now, in the state of Ohio, if a parent wants a birth certificate, they must take the baby in to see a doctor so the baby is "verified" and the mom must be there, so the doctor can also be a witness to the mother. So Danielle had to make a trip in to see the doctor to be seen in this process of getting a birth certificate. I suggested to her to keep the little rope around her knees and to take little steps and to put her bottom into the car first and let her husband swing her legs into the car and she lifted the top portion of her body, while he put her legs into the car, then reverse the maneuver to get out of the car.
On the seventh evening after the birth, Danielle took a bath, as she had a deep tub to soak her breast that had clogged milk ducts. She had figured out a way to step into the tub and to step out and still keep her bottom together. I was visiting in the beginning every day and bringing good meals, then I came every other day and then, on the 11th day postpartum, the final day, I checked her bottom and we used a hand mirror to look together at the healing taking place and at the index fingernail-sized place that was still healing where the skin had torn. We had to spread her bottom a little bit to even see it. From the external view of Danielle's vagina and perineum, that tear could not be seen. It was internal. The tear resembled a thin piece of tissue, as if it had been shaved with a cheese shaver. This thin piece of skin had rolled together and resembled a hymeneal tag on the bottom side of the perineum. Danielle had said she wanted to look at her bottom and was delighted with the healing and felt the time was well spent in staying on her couch for those 11 days. She has decided to stay for the remainder of the two weeks and give her bottom three more days of downtime to heal, before her life gets busy again.
Danielle's other midwife was going to be in the area, four days postpartum, so she stopped by with an herbal remedy to help the healing process and also checked her bottom and said it was healing so nicely that Danielle did not need the herbal healing powder, which would have been sprinkled on her pad, to promote healing—yet! Thanks Frieda, for your help and encouragement. Danielle never had problems with having a bowel movement, or rectal pain, as she had in her first birth. She had been expecting some of the same problems and pain, but they never happened.
I have written this to encourage you and to teach you there are other ways to healing, for different people. I learned this method, when another of my mother's chose to not have a third degree tear sutured. Her doctor had stitched her so tight that relations with her husband had been painful and too tight. When she had the next baby, she had wanted to heal naturally to "get back" some of her normal tone and elastically. This was the mother who taught me another way—a way off the beaten path, but still a path, for her, to heal and as she had said to "right herself back into herself."
— Mary Cooper
Editor's Note: To read more about alternatives to suturing, read Midwifery Today E-News 12:7.
Jan Tritten, mother of Midwifery Today, is the founder, editor-in-chief and mother of Midwifery Today magazine. She became a midwife in 1977 after the amazing homebirth of her second daughter. Her mission is to make loving midwifery care the norm for birthing women and their babies throughout the world. Meet Jan at our conferences around the world, or join her online, as she works to transform birth practices around the world.
Jan's blog: community.midwiferytoday.com/blogs/jan/default.aspx
Dramatic Decrease in Global Maternal Mortality Rate
The British journal Lancet has published a study of maternal mortality rates (MMR) in 181 countries from 1980–2008 that shows the rate of women dying during pregnancy and childbirth have dropped dramatically over the past two decades.
The analysis shows countries around the globe are making progress toward the Millennium Development Goal 5, which calls for a 75% reduction in the world's MMR from 1990–2015.
The study found the global MMR has dropped from 422 deaths per 100,000 live births in 1980 to 320 in 1990 and 251 in 2008. More than half of all maternal deaths occurred in six nations—Afghanistan, the Democratic Republic of the Congo, Ethiopia, India, Nigeria and Pakistan.
Although the research shows only 23 countries are "on track to achieve a 75% decrease in MMR by 2015," some countries are progressing faster than others, including Bolivia, China, Ecuador and Egypt.
— Hogan, Margaret C., et al. 2010. Maternal mortality for 181 countries, 1980–2008: a systematic analysis of progress towards Millennium Development Goal 5. Lancet. 12 April, early online publication doi:10.1016/SO140-6736(10)60518-1. Accessed 22 Apr 2010.
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Preserving Women's Choices in Birth
Every woman deserves to have a choice about where she wants to birth. Kitty Ernst, the Mary Breckenridge Chair of Frontier School of Midwifery and Family Nursing, said that "it is really sad in this country that you can die anywhere, but only birth in a few places."
That is what midwives are about, and that is what we must work to preserve, that women can birth where and how they want to. Sadly, there are women who do not know that they have a choice. Many women buy into the medical community's script of fear.
I lead the charge in our hospital in the '70s to have my husband in the delivery room when my youngest child was born. I had already worked as a nurse in that labor room for years. We had to convince dear Dr. Carver that there would not be more time spent attending the father than her. I was lucky, I knew what I wanted, more than what I didn't want. Fetal monitors had been invented, but we did not have any on the unit for three more years. I had no interventions other than a horrible enema, which I could not convince my friend not to give me. Mothers were not allowed to hold their babies until they were bathed. So, Dr. Carver was shocked when I grabbed my beautiful baby girl from her hands to my chest.
What happened to our "natural childbirth" world? Where did this fear of birth come from? Where did what is best for the baby disappear? It all disappeared about the time anesthesiologist decided that no one should have any pain, and they could make lots of money preventing any feeling. We know it is not possible to have no pain in life, and that pain is part of growth.
— Elaine Wakeland
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Question of the Week Responses
Q: What was the longest second stage you've experienced, and how well did mother and baby pull through?
— Midwifery Today staff
A: Marcie, 40 years old, had finally carried her first of eight pregnancies to term and I was her doula. Her caregiver was probably the best perinatologist in Northwest Florida. She had had a previous surgery for cervical cancer with significant scarring, and desperately wanted a normal vaginal birth. First stage passed relatively quickly—about six hours. The doctor came in on his day off to sit in the rocking chair in her room and just observe. She pushed for two hours and begged to be allowed to continue. His calm response was, "As long as you're okay and the baby's okay, it's your call—you can continue as long as you want to." Her husband and I worked as a team. I kept warm compresses on her perineum and he kept the warm compresses coming. Marcie pushed for another four hours, for a total of six hours, and achieved the vaginal birth she so wanted! Her baby boy weighed 7 lb 9 oz, was 19.5 inches long, with APGARS of 8 and 9. This was one gloriously happy mother! My thank you note to the perinatologist expressed my feeling that I had spent the day with a midwife.
— Helen Moore, CD (DONA), CIMI
Responses to any Question of the Week may be sent to E-News at any time. Write to firstname.lastname@example.com. Please indicate the topic of discussion *and the E-News issue number* in the subject line or in the message.
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Entry Deadline is August 10, 2010, so get your creative gears spinning! Go here for more information and instructions.
Think about It
FDA Reviews Triclosan, a Common Ingredient in Body Care Products
The U.S. Food and Drug Administration (FDA) has updated its Web site, www.fda.gov, with information about triclosan, an antibacterial chemical that has become ubiquitous in antibacterial soaps, detergents and personal body products.
In January, Rep. Edward J. Markey, chairman of the House Energy and Commerce Subcommittee on Energy and the Environment, sent a letter to the FDA requesting information about the status of FDA's ongoing review of triclosan in consumer product.
The FDA is reviewing triclosan in light of animal studies that have raised questions about the drug's safety. The chemical has been linked to liver and inhalation toxicity and even low levels may disrupt thyroid function. For a list of products containing triclosan, go here.
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Midwifery Today: Each One Teach One!

subset: commoncrawl


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One of the most ancient forms of outdoor winter transportation is making a strong comeback these days. In the last couple of years, the number of people partaking in snowshoeing—a low-impact, cardio-beneficial form of snow recreation—has increased drastically. Snowshoeing is, after all, far cheaper than downhill skiing, snowboarding or cross-country skiing (rentals average $10-$20; $100-$300 to purchase your own).
The activity is gentle on the body, yet burns between 400 and 600 calories per hour. And, oh! The places you can go! When the snow covers the abundant desert and mountain terrain surrounding us, the snowshoe explorations and destinations become nearly limitless; snowshoes allow their wearers to journey into depths of wildernesses for which boots and skis may not be adequate. And opportunities to view winter wildlife abound.
Paradoxically, this desert of ours provides us with some of the most beautiful areas for days spent walking on top of powdery white water. Below are three of the best snowshoe destinations in and around Santa Fe.
Enchanted Forest Cross Country Ski and Snowshoe Area
Located just off of Highway 38—a two-hour drive from Santa Fe—is the Enchanted Forest. The area is geared specifically toward cross-country skiing and snowshoeing and, on certain trails, dogs are allowed to tag along.
Enchanted Forest is a good place for a first-time snowshoe experience, as snowshoes are available for rent, and there are nine miles of trails allotted solely to snowshoeing. Yet, while there are trails especially for snowshoes, shoers are able to amble along the cross-country paths as well—provided they do not trample the ski tracks.
More than 20 pristine backwoods trails wind among pine and fir, and glorious views abound in the snowy solitudes of the Enchanted Forest. If one day isn't enough, or if you're pining after some winter camping, yurts are available for rent ($65-$125) so that you can warm yourself by the woodstove and enjoy the silence of a snowy night.
Valles Caldera National Preserve
Across the valley from Santa Fe, in the beautiful Jemez Mountains, is one of the Earth's six ancient super-volcanoes. The volcano's open-meadow top makes for wonderful wanderings through the snow on these cold northern New Mexico days. Valles Caldera offers snowshoe rentals ($10-$15), groomed trails and, on certain winter days, nighttime hours for those who enjoy hiking in the solitude of cold night, under the light of the moon and stars. Though a day-use permit is required for most trails, the Coyote Call Trail and the area surrounding it is free.
Most trails are maintained especially for snowshoers and cross-country skiers, but the adventurous are free to wander off the trails and into un-trod territory. Many visitors, both on and off the beaten path, have been graced with eagle, deer, coyote and elk sightings. What could be a more glorious way to spend a winter's day than walking on top of the cold white snow on what once was a hot and active volcano?
Santa Fe National Forest
And then, of course, there's the simple pleasure of not having to travel far for your outdoor adventure. Wouldn't it be nice to snowshoe to your snowshoe destination? On days when the snow covers the ground even in town, strap on the snowshoes and wander into the Dale Ball trail network. If you're feeling energetic, you may find yourself hiking up and eastward into the National Forest. Or, park along Hyde Park Road and snowshoe the Aspen Vista loop, a 10-mile hike of some of the most breathtaking views of the wilderness and valley below. The Winsor Loop ambles along the Big Tesuque Creek, and the Chamisa Trail takes you through beautiful snow-covered meadows and pine forests. These trails are free to use, but you must supply your own winter gear.


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Boesch joins mix as Hamilton and Co. seek spark
ANAHEIM -- The 2014 season was in its embryonic stage, and Josh Hamilton could do little wrong. He was getting hits half the time, taking pitches when he needed to, putting together quality at-bats against opposing lefties and driving the ball the way he always has. He looked very much like the slugger of his Texas days and very little like the one who struggled through his first season in Southern California last year.
It was during that time when Hamilton got a text message from Angels hitting coach Don Baylor, who at that point was recovering from a fractured femur, that read: "You're about ready to carry this team."
Not long after that, the Angels' cleanup hitter broke his left thumb on a headfirst slide into first base, an ailment that would put him on the disabled list for 10 weeks. And now, four months removed from that blistering start, Baylor looks up and wonders what happened to the Hamilton who scorched through the season's first couple of weeks.
"I haven't been disappointed," Baylor said, "it's just taken a lot longer for him to find that stroke again."
For a while, the Angels' high-powered offense marched on despite lacking that prototypical production from the cleanup spot. But not lately. They entered Tuesday's game against the Phillies ranked 28th in the Majors in OPS and tied for 28th in runs per game since the All-Star break, averaging 3.17 each contest after averaging more than five in the first half.
In hopes of a spark, they called up left-handed-hitting outfielder Brennan Boesch, who sported a .326/.380/.625 slash line with 22 homers and 75 RBIs for Triple-A Salt Lake, and batted him seventh as the designated hitter on Tuesday night against righty Jerome Williams in the club's Interleague series opener against the Phillies.
Boesch, who reached base in 11 consecutive plate appearances for the Bees until Monday's fourth inning, will be in the mix with Collin Cowgill and Efren Navarro for at-bats.
"My attitude is I'm here to contribute," said Boesch, who was added to the roster when reliever Caleb Clay was sent back to Triple-A. "Obviously the talent here speaks for itself. If there's been a struggle -- I haven't followed the team too much -- it probably won't last long. There are too many good players in this locker room."
With the exception of Boesch, and Chris Iannetta behind the plate in what has long been a platoon at catcher, Angels manager Mike Scioscia didn't make any drastic changes coming out of Monday's off-day. Kole Calhoun, Mike Trout, Albert Pujols, Hamilton, Erick Aybar and Howie Kendrick made up the first six spots of the lineup, respectively, just like it's been for most of the season.
Scioscia isn't opposed to temporarily moving someone in the order to get him going, but doesn't think "a long-range lineup change makes any sense."
That includes Hamilton, who's sporting a .265/.334/.417 slash line, has homered eight times in 68 games and snapped an 0-for-23 skid on Saturday night.
"This isn't about one guy getting moved to all of a sudden make our offense go," Scioscia said. "There's a solid nine guys from top to bottom who have had trouble getting into their game after the All-Star break. It's in there; we just need to exercise some patience."
Baylor doesn't believe Hamilton's struggles have anything to do with lineup positioning or even hitting mechanics.
"It's more confidence than his swing at this point," Baylor said, while admitting that the state of his numbers is probably affecting Hamilton mentally.
"They talk about seeing all these breaking balls, changeups. But he's been a hitter all his life. I remember Gene Mauch used to say "hitters will hit." It might take him a little longer, but hitters will hit. I believe that."
Alden Gonzalez is a reporter for MLB.com. Read his blog, Gonzo and "The Show", and follow him on Twitter @Alden_Gonzalez. This story was not subject to the approval of Major League Baseball or its clubs.


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A Review Of The "Cinco de Mayo" Event.
Thanks to everyone who participated to our end of the semester, the "Cinco de Mayo" Event. Much Mahalo to Rebecca Meeder M.Ed. for providing us with a fun virtual field trip! I would also like to say Mahalo to DJ Becca Imako for her great music taste and fun dancing experience! Thank you, Becca for contributing your time and effort with the various events throughout the semester!
University of Hawaii Virtual Education Group has been offering various events for over a year. This was our first event we tried something different, which was the virtual field trip. It was a great opportunity for people to realize that there are uncountable places in SL besides UH Island where you can learn, experience, and explore. We would like to ask those of you who participated in the virtual field trip to give us a feedback about your experience.
We are always welcoming new avatars and would love to help get them familiar with the virtual world and some of the basic skills that help you to explore in Second Life. If you have any questions about the UH Island and UH SL Virtual Education Group over the summer, please feel free to contact Yoko Yamamoto (firstname.lastname@example.com) or IM Elle Mexicola in SL.
I would like to say thank you to all of you who participated in our events this semester. I had met many new people and was able to share my experience and in exchange, I was able to listen to what kind of experiences they are experiencing in SL. I would like to say a special thanks to Dr. Diane Nahl for all of her guidance and support and Rebecca Meeder M.Ed. for her supportive guidance and showing me a step by step on how to organize events. Again, Much mahalo to everyone who helped me to be more aware and alert to the virtual world experience. I personally have learned a lot throughout the semester and I am looking forward to the continuation of improving my skills in Second Life. Have a great summer to all of you and see you next semester!
Please take a look at the pictures below:


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Which coach will be first to lose his job?
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Which coach will be first to lose his job?
In 49 states it's just basketball, but this is Indiana!
Jack Del Rio.
I'm torn between Jack Del Rio or Tony Sparano as far as being fired first.
I might lean towards Del Rio. The Dolphins don't seem to care about the remainder of the season and know they suck and know they need a new coach so they'll wait until the offseason to fire Sparano.
For the Eagles, I think firing long time head coach is a bit of a risk and he doesn't seem willing to leave so I think he'll stay at least the rest of the season.
In 49 states it's just basketball, but this is Indiana!
I feel like if the Dolphins were to fire Sparano, it would have been before their bye week.
Didn't Sparano just get a "vote of confidence" from ownership? Yeah yeah, that's like JO guaranteeing to come out and dominate every year, but still.
I hope Brian Billick gets a head coaching job somewhere.
I always felt he was a very good head coach.
He'd do well in Miami.
In 49 states it's just basketball, but this is Indiana!
Spagnuolo(Rams coach)
The Dolphins are in the running for Luck at least with Sparano they have a shot they'll dump him at the end of the season.
Del Rio? They're surprisingly still in the division hunt
Eagles? Same thing
If they do fire Steve Spags we should get him as a D coordinator.
Andy Reid please. He should have been fired a few seasons ago, then Michael Vick saved his ***. The team can't play a complete game, seem unprepared, lack discipline on the field... The entire culture seems wrong and that starts at the top. And for a guy who used to be an o-lineman, its embarrassing to see how terrible our o-line is. His constant ignoring of the linebacker core has reached an all time worst as well.
Oh and making a guy who was an o-line coach the new defensive coordinator, even though he hadn't coached defense since his high school coaching days, was a pretty dumb move too.
There is no reason this team should be 1-4. Even with the o-line and LB problems, they always seem to have a turnover or penalty at the worst time. And the redzone offense and defense have gotten worse. Oh and he still doesn't run the ball enough even though the o-line is actually good at run blocking and McCoy is a very good RB.
Last year Andy was able to get everyone look the other way as we all expected a down year and then Vick exploded.
This team could easily be 5-0, but instead we sit at 1-4 and its embarrassing. But he won't be fired during the season just because of his past with the team.
Del Rio should have been fired years ago. He's the only coach dumb enough to get his own 15yard penalty for unsportsman-like conduct sandwiched inbetween two other 15yd penalties in a game that's up in the air.
He's been down right awful for years.
Hopefully they don't fire him, but they should.
After game 9, hello Jim Tressel, head coach of the Indianapolis Colts.
You know how hippos are made out to be sweet and silly, like big cows, but are actually extremely dangerous and can kill you with stunning brutality? The Pacers are the NBA's hippos....Matt Moore CBS Sports....
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It would be absurd to fire him now at the end of the season yes he should go.
But this division is still winnable considering the NFC East isn't great to begin with.
Ride this out then fire Reid and get a decent draft pick.


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Comparison Between Rituximab Treatment and General Corticotherapy Treatment in Patients With Pemphigus (Rituximab 3)
- Full Text View
- Tabular View
- No Study Results Posted
- Disclaimer
- How to Read a Study Record
Pemphigus is a severe and sometimes life-threatening disease with a mortality rate between 5 and 10 percent depending on the severity of disease and age of patients.
The standard of care is high doses of corticosteroids (CS) (usually, prednisone, 1 to 1.5. mg/kg/day, which are often associated with immunosuppressive drugs i.e., azathioprine, mycophenolate mofetil, cyclophosphamide, cyclosporine, although only one randomised study has demonstrated the superiority of the combination of corticosteroids and immunosuppressive drugs as compared to corticosteroids alone (9). Because of the low frequency of the disease, control trials are difficult to conduct. Evaluation of the different treatment regimens proposed, i;e; corticosteroids alone, CS and immunosuppressive drugs, IV immunoglobulins or new therapeutic regimens such as rituximab (an anti-CD20 monoclonal antibody directed against B- lymphocytes) or immunoadsorbtion.
|Pemphigus Disease
|Drug: General Corticotherapy Drug: Rituximab
|Phase 3
|Study Type:
|Study Design:
|Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
|Official Title:
|Comparison Between Monoclonal Antibody CD20 Treatment (Rituximab (mabthéra))and General Corticotherapy Treatment in Patients With Pemphigus
- Number of patients with pemphigus controlled 24 months after the start of Rituximab treatment [ Time Frame: 2 years ]
- Number of patients with pemphigus with both cutaneous and mucosal lesions healing after 6 months of rituximab treatment [ Time Frame: 6 months ]
|Estimated Enrollment:
|Study Start Date:
|July 2009
|Study Completion Date:
|December 2016
|Primary Completion Date:
|December 2013 (Final data collection date for primary outcome measure)
|Assigned Interventions
|Experimental: Rituximab
Drug: Rituximab
for patients with severe pemphigus : rituximab Arm : 1mg/kg/d for 1 month, then 0.75 mg/kg/d for 1 month, then 0.5 mg/kg/d for 1 month, then 0.3 mg/kg/d for 1 month, then 0.2 mg/kg/d for 1 month, then 0.1 mg/kg/d for 1 month for patients with moderated pemphigus : rituximab Arm : 0.5mg/kg/d for 1 month, then 0.30 mg/kg/d for 1 month, then 0.2 mg/kg/d for 1 month,
Active Comparator: Corticotherapy
General Corticotherapy
Drug: General Corticotherapy
for patients with severe pemphigus : general corticotherapy Arm : 1.5mg/kg/d for 1 month, then 1.25mg/kg/d for 1 month, then 1mg/kg/d for 1 month, then 0.75 mg/kg/d for 1 month, then 0.5 mg/kg/d for 3 months, then 0.3 mg/kg/d for 3 months, then 0.2 mg/kg/d for 4 months, then 0.1 mg/kg/d for 4 months, for patients with moderated pemphigus : general corticotherapy Arm : 1mg/kg/d for 1 month, then 0.75mg/kg/d for 1 month, then 0.5mg/kg/d for 2 months, then 0.3 mg/kg/d for 2 months, then 0.2 mg/kg/d for 3 months, then 0.1 mg/kg/d for 3 months,
|Ages Eligible for Study:
|18 Years to 80 Years (Adult, Senior)
|Sexes Eligible for Study:
|Accepts Healthy Volunteers:
Inclusion Criteria:
- age >=18 and <= 80years
- consent obtained from patient
- effective female contraceptive method for women in procreate age
- new case of pemphigus vulgaris (PV) or pemphigus foliaceus (PF)
Exclusion Criteria:
- pemphigus vulgaris (PV) or pemphigus foliaceus (PF) treated
- pregnant woman or nursing mother
- woman able to have a baby and without contraception during the clinical trial period
- age < 18 or > 80
- karnovsky < 50%
- serious antecedents of allergy or anaphylactic reaction with human monoclonal antibody
- patient with depletion lymphocytic treatment in the next month
- unstable angina or ischemic heart disease
- cardiac insufficiency
- cardiac rhythm trouble uncontrolled
- positive HIV serology
- positive hepatitis B and / or C serology
- no consent
Please refer to this study by its ClinicalTrials.gov identifier: NCT00784589
|CHU de Rouen - Hôpitaux de Rouen
|Rouen, Seine Maritime, France, 76031
|Principal Investigator:
|Pascal JOLY, Professor
|Clinique Dermatologique - Hôpitaux de Rouen
|Responsible Party:
|University Hospital, Rouen
|ClinicalTrials.gov Identifier:
|NCT00784589 History of Changes
|Other Study ID Numbers:
|Study First Received:
|November 3, 2008
|Last Updated:
|June 13, 2017
Keywords provided by University Hospital, Rouen:
therapeutic efficacity
therapeutic tolerance
Additional relevant MeSH terms:
Skin Diseases, Vesiculobullous
Skin Diseases
Autoimmune Diseases
Immune System Diseases
Antineoplastic Agents
Immunologic Factors
Physiological Effects of Drugs
Antirheumatic Agents
ClinicalTrials.gov processed this record on September 21, 2017


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The result was "My Brother the Soldier," which Brenner wrote as a poem and asked childhood friend Amy Snyder to put to music.
Now the women hope a major country music artist will record the song and agree to donate sale proceeds to the Wounded Warrior Project, which assists wounded U.S. military veterans after they come home.
"I see it as a tribute to people who lay their life down for their country," Snyder said of the song.
"Today I heard my momma cry,
I didn't need to ask her why,
Today we got the news,
That my brother, a soldier, had died."
— "My Brother the Soldier"
Brenner's son started basic training last February and graduated in May, she said by phone from Kingman, Ariz., where she now lives. A private in the Army's 101st Airborne Division, he is at Fort Polk in Louisiana preparing for deployment to Afghanistan.
When she started to write "My Brother the Soldier," all Brenner could think of were the words, "Today I heard my momma cry." She went with it.
"It was about my son, and I was the mom crying, so the singer had to be my daughter, Chelsea," Brenner said.
The song came together in about 15 minutes, she said. She did some minor tweaking of the wording later after Snyder put it to music.
Brenner and Snyder had been childhood friends while growing up in Decatur. They drifted into other interests as they moved into high school, Brenner said.
But when Brenner heard Snyder was coming back to Decatur last May to play a patriotic Memorial Day concert, she contacted her to ask for help with music for "My Brother the Soldier."
Snyder, who now lives in Taylor, S.C., near Greenville, has taught piano for more than 30 years and also does composing and arranging. She has written about 75 songs and has recorded four CDs of her music.
After her concert in Decatur, Snyder and Brenner sat down to talk about the lyrics Brenner had written for her son's song and for a few other songs.
"My Brother the Soldier" jumped out at her, Snyder said.
"At this time we are living in, I thought this would be relevant to a lot of people," she said, adding, "I have a soft spot for patriotic things."
"Taking heavy fire during the end,
Taking charge and running in,
Saving his friends from the attack,
Only to take a fire in the back."
Snyder started working on the music in June and had it ready for Brenner about a week later. To help get the song out to the public, they had it recorded.
Snyder recruited one of her piano students, Reece Diaz-Verry, 15, who also takes voice lessons, to sing the song. A friend of Snyder's husband recorded the performance at his studio near Greenville. The studio owner also filled in on bass guitar, and his son played drums.
Brenner said it really became a song for her in early December when Chelsea's husband, Josh, blended the song with photos of U.S. soldiers at war, wounded and being buried to create a music video he posted to YouTube (at www.youtube.com, search for My Brother the Soldier Josh Taylor)
"Every time I watch it, tears come to my eyes," Brenner said.
Even before the video posting, Brenner had been busy trying to get the song noticed.
She took a pre-mix of the song to radio station WZBD, 92.7-FM, which serves Berne and Decatur, where it received some air play before Thanksgiving.
Brenner also has sent out CDs of the song to family and friends. She also took CDs to Nashville, Tenn., where she dropped them off at Capitol Records and a recording studio in hopes the song would get noticed by a top country music singer.
Along the way, Brenner said she also thought that, in addition to dedicating the song to her son and daughter, they also should dedicate it to two fallen Adams County heroes: Staff Sgt. Phillip Jenkins of Decatur was killed in 2010 while serving in Iraq. Spc. Nicholas Taylor of Berne died in July in Afghanistan.
That led Brenner and Snyder to the idea that money raised by sale of the song should be donated to the Wounded Warrior Project.
"Sitting there as they folded up the flag,
With such precision and guide,
They gave it to my mother and I,
With ever so much pride,
Even though a hero was he,
That day a little of my mother and I died."
Snyder also hopes the song encourages people, just like so many in the U.S. military, to think of others rather than of themselves.
"There is so much me, me, me now," she said. "There's a lot of people who see beyond that and think about others first. If that involves sacrificing themselves, they'll do it."
Brenner wrote another song for her son, "Just One More Battle," a positive one about a soldier getting through the last night before he comes home after completing his tour of duty.
"He is finally realizing that the time to be deployed is getting nearer and nearer, and reality is setting in," Brenner said of her son in an email. "I hope this one will psych him up and be determined to want to make it back. He needs moral support to get through this."
"Today I heard my momma cry,
I didn't need to ask her why,
Today we got the news,
My brother, a hero, had died,
Today we got the news,
My brother, a hero, had died ... ."
(Copyright Forever Jules LLC)


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A memoire was recently published this fall by a local resident, telling her story about reuniting with her long lost daughter and coming to terms with her brother's murder by Ted Kaczynski, the "Unabomber."
Barbara M. Murray, R.N.'s book is called "A Sister's Memoir: Surviving the Unabomber's Last Blast."
It includes a story about her brother, Gilbert P. Murray, who was the third and final murder Kaczynski did, she said. He was the president of the California Tree Association when he was killed on Apr. 24, 1995.
Kaczynski was known for bombing individuals who were using modern technology in monumental ways.
"They were using a computer for reforestation and that is why the California Tree Association was on his list," Murray said. Kaczynski often bombed individuals by mailing bombs to them.
"The package had the previous president's name on it, because Kaczynski didn't do his homework," Murray commented.
Murray said that while writing her book there was ups and downs that she went through to get her story written.
"My book is about the therapy I got in order to get over my brother," she said. "The hard part was going back reliving the worst part."
She said that the constant "slaps in the face," reminding her constantly of her brother's death was what made her decide she needed to move past the pain. This came in hard when she learned that the Kaczynski's items would be auctioned off online.
"Everything was triggered by the auction that happened 2 years ago," she said. "I thought that was ridiculous. Who would want to buy the unabomber's stuff?"
Murray then looked into a newer therapy called EMDR Therapy, which is based on moving memories from one side of the brain to the other, like in REM sleep, she explained. The therapy has been tested on individuals suffering with PTSD and been proven effective.
"I followed that therapy up with memoir writing," she added.
The easiest part of her memoir to write was her maternity story, and explaining how she got reunited with her daughter, 42-year-old Carla Giesen.
"I ran away from home when I was 18 and 6 months pregnant to downtown Hollywood," Murray explained.
She put her daughter up for adoption, and did not see her again until 40 years later. She decided to search for Giesen after after an encounter she had while volunteering for Cinderella's Closet in Paradise.
"A woman called me as a fairy god mother," Murray said. "On the fridge was a Mother's Day card. She had just found her daughter after 46 years."
The woman had told Murray that she had hired Lori Ewert to find her daughter for her, so Murray decided to hire Ewert too.
"I sent her an email and 3 hours later she had a Facebook page and an amended name," Murray said. "There she was with a husband and two children -- two teenagers. She looked just like me."
From there, Murray contacted her daughter, who was 40 at the time, and set up a meeting.
"I found her and I met her," she said. "That is where I end my book is finding her."
She will be writing a sequel to her book with plans to be published a year from now, she commented. The sequel will continue the story of what happened after she met her daughter.
"When she turned 41, we went to Disneyland," she said. "When she turned 42, I gave her the book. It was in her hands by her birthday."
"A Sister's Memoir: Surviving the Unabomber's Last Blast" is available at Smashword as an ebook for $9.99 or print for $19.99. It is also available on Amazon in print. Smashword has the ebook formatted for all eReaders, including Kindle, Nook and iTunes.
"A Sister's Memoir: Surviving the Unabomber's Last Blast" is can be downloaded for free from Smashword using the coupon code: KM35G.
Her newly published cookbook is called "Crock It." It is composed of recipes to some of her favorite dishes mentioned in her memoir. It is available for free download on Smashword using the coupon code: LM28C.
Nicole can be reached at email@example.com


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Therapeutic books inspire fun toys...
San Diego Comic-Con coverage brought to you by Tonner, Collectibles Insurance, and Big Bad Toy Store.
Returning to the Art Toys section of the San Diego Comic-Con exhibit hall this year was the Evergrow booth featuring their Emotes line. Based on a series of books by psychotherapist Matt Casper, the Emotes are creatures that live in the internet; each embodies one core emotion like Boom (angry), Ick (disgusted), Abash (embarassed), and Drain (exhausted).
Emotes products include cute plush toys, 3 inch collectible figures labeled "Defenders of the Web" (and also collected in multi-packs), t-shirts, special custom figures, plush keychains, and much more! No matter what emotion you were feeling, Emotes had the figure for you.
Check out photos of the Emotes booth in our gallery HERE!
- Scott Rubin


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Celebrity Relationship Status Updates Summer 2013
Kristen and Fabrizio's Split, Halle Marries, and More Relationship Status Updates
If you can't keep up with all the recent events in Hollywood's most talked-about relationships, then you are not alone, which is why we've rounded up the latest updates, from weddings and pregnancies to breakups and makeups. Kristen Wiig and Fabrizio Moretti have ended their romance after a year and a half, and George Clooney and Stacy Keibler called it quits, with Stacy reportedly breaking things off after a discussion about her future plans for starting a family. On a happier note, Jimmy Kimmel, Halle Berry, and Happy Endings star Elisha Cuthbert have all tied the knot recently, and Jesse Eisenberg is dating his The Double costar Mia Wasikowska.
Plenty more stars have been making advancements in their relationships this Summer, including Katy Perry and John Mayer, Adam Levine and Behati Prinsloo, and Glee star Matthew Morrison and his bride-to-be, Renee Puente. Click through now to get the latest on your favorite A-list romances.


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I will not be returning as a commish or owner in the ABA.
It would be nice if someone stepped up and kept the league going but its more than I can do right now.
If you were in the ABA in the past you should be aware that we have a couple keeper leagues. Its possible that we could have some openings for the coming season. If you're interested in picking up a team, let me know.


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I know it may be hard to believe, but in just a little more than four months, runners will be toeing the line at the start of the 2013 Kiwanis Kingston Classic 10k.
Officially, the race will be held on April 14 with its traditional 1 p.m. start time.
Behind the scenes, race organizers, specifically the Kiwanis Club of Kingston, has been meeting and planning the details of the race for the past few months.
If all worked out as planned, early online registration could be available as you read this column.
Race director Greg Riley said the registration and timing company, Albany Running Exchange, were working on setting up the link through Active.com on the race web site, www.kiwaniskingstonclassic.com.
This would be the earliest that registration has been available in years as the Kiwanis Club makes improvements each year to make the race an event not to miss.
Along with the availability of registration is also an opportunity to save money as early entrants can pay just $15 until Feb. 15 for the 10k race.
After Feb. 15, the price increases to $20 until April 1 and after that, it's up to $25.
Students 18 and under who want to cover the 10k distance get an even better discount, paying just $15 through April 1 and $20 thereafter.
Anyone wishing to compete in the 2.1-mile fun run pay only $10 until April 1, then $15 after that time.
Riley said paper applications should also be available at a number of locations, including many of the race sponsors, local fitness clubs and more.
He said organizers will have a greater presence on social media networks, hoping to take advantage of the exposure available through Twitter and Facebook.
The Classic is joining forces once again with the YMCA Kids Classic, which is scheduled one day earlier, April 13.
Also on April 13 is the pre-race pasta dinner at 5 p.m. at Dietz Stadium where you pick up your race packet, enjoy a great meal, and listen to musical entertainment provided by the Ponytails.
Organizers will announce the inductees into the Classic Hall of Fame as well that evening.
Fan Zones, planned spots along the race route where organizations can vie for prize money, are back, along with the team competition resulting with the presentation of the Mayor's Cup.
As for the course, there are no changes planned, so runners can expect to cover the route that begins on North Front St., rolls through uptown Kingston, out onto Hurley Ave. and back to the finish line inside Dietz.
This time of year, the race calendar gets a little bare, but there are still two more local races before 2012 ends.
First up is the Holiday Classic 5k at 10 a.m. on Dec. 22 at Columbia-Greene Community College in Greenport.
The festive run is hosted by Phil Carducci, who incidentally just finished up directing the Run That Turkey Off 5k in Altamont two days after Thanksgiving.
The Holiday Classic travels on roads near the college and costs just $15 to enter.
The first 100 registrants receive a great pair of running gloves for their timely entry.
Carducci asks all to bring an unexpired dry good item that will be donated to a local food pantry.
You can get more info about the race by emailing Carducci at email@example.com or calling him at (518) 861-6350.
One week later, Dec. 29, also at 10 a.m., is the annual Viking Run 10k in Rosendale.
This hilly and challenging course that starts and ends at the Rosendale Recreation Center is a favorite among hardy runners and features hot soup afterwards with a modest $5 entry fee.
More details can be obtained by contacting Rachel Schabot at (845) 331-4346.
Please send all race results and information to 79 Hurley Ave., Kingston, N.Y., 12401; fax to (845) 331-3557; or email to email@example.com. Follow him on Twitter at http://twitter.com/runerichrun


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Great value
By Rick
from High Falls, NY
About Me Commuter
Comments about Sram Pg-730 7 Speed Cassette:
Very solid, great value
Bottom Line Yes, I would recommend this to a friend
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(1 of 1 customers found this review helpful)
Nice cassette ant a great price!
By Joe Dirt
from Clermont,Florida
About Me Avid Cyclist
See all my reviews
Bought a gt palomar mountain bike and upgraded the wheels with the nashbar viuelta zero-lites ,the originals had a freewheel. Please note that when installing on a 8,9,10 cassette body that you will need a spacer or two , I always use old cogs off old cassettes or you can buy a spacer I think it's a 4.5 mm? I think that's what the gentleman in the other review was having a problem with , nice cheap cassette if you want to stick with 7 speed stuff.
(4 of 10 customers found this review helpful)
Not shimano compatable
By B.L.
from Bethany, Ct.
About Me Casual/ Recreational
Bought to use on shimano 7 speed but could not figure out how to make it work. The inside of the lock ring is smaller than the freewheel removal tool for the shimano and different than the original. Others have a complete cassette/freewheel available for this application at reasonable cost.
Bottom Line No, I would not recommend this to a friend
Merchant response: The tool to remove a shimano freewheel and the tool to remove a shimano/sram are different. As you stated the splines are shallow with a deep inset for the axle on the freewheel tool compared to a deeper spline and a shallow axle inset on the cassette tool.
Totally Stoked
By DR
from Orange CA
This was the only 7 speed cassette I could find. It is very inexpensive and seems to work just fine. Installation was easy. My 15 year old cromoly mountain bike is running again. A slight adjustment at the tumbler right on the shifter and it works perfect. I made that adjustment while I was riding. I'm not sure how long it will last, but for [$] I expect to get my money's worth.
Best Upgrade on this Bike
By stevencj
from Fallbrook, CA
Wow. My early 90's 14 speed vintage Trek rides like a new bike. Really notice the increased range on the hills; two lower gears and one higher gear without expensive or complicated upgrades. Best bang for the buck.
A great value
By rkmc
Very happy with this cassette. My prior cassette was of much lower quality.
(5 of 5 customers found this review helpful)
Great Upgrade
By Don
from Stratford,CT
Great upgrade from original 12-28 Shimano. Adds 26& 32 tooth takes away 24 & 28. More usable ratios & overall better gear changes.
(16 of 16 customers found this review helpful)
excellent upgrade
By Tim
from Philadelphia, PA
An excellent upgrade from an old worn Shimano 105. Durable, smooth shifting, and smooth running. I've used these with both road an MTB drivetrains with great results. A much better value than the Nashbar part, which I also have.
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Dec 11, 2009 7:51 AM EST
Granger Already Thinking About Rushing Back From Injury
Pacers forward Danny Granger is doing his best to remain positive despite suffering a torn right plantar fascia.
He'll miss at least a month with the injury.
"It's not so much frustration, just kind of disappointed, obviously with the way the season's going and the situation with my heel," Granger said. "But it happens and I'll get through it."
Granger was averaging 24.4 points and 6.1 rebounds prior to the injury.
"I'm not going to lie to you," he said of rushing back. "It will be very difficult, especially since I don't know where we'll be standings-wise in the East when it's time for me to come back. I'm going to try and get back as soon as possible and hopefully we'll still be in playoff contention."
Heading into Friday night's action the Pacers were 6-13, 2 1/2 games behind the Bobcats for the Eastern Conference's eighth seed.
Via Indianapolis Star


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Burton Hyperlink 13in Laptop Case
Mandatory protection for your machine and accessories with stashes for cables, cords, and documents, plus carry handles and a removable shoulder strap.
Click here to see a horse and its owner doing something you never… Oh wait, you're actually reading this? If so, you better protect that precious web-surfing machine with the Burton Hyperlink 13" Laptop Sleeve.
- Padded Protection
- External Zippered Storage Pocket
- External Velcro® Pocket
- Internal Document Pockets
- Carrying Handles
- Removable Shoulder Strap
- Lifetime Warranty


text:
The eggs were obscenely fresh — this was my first clue that something had changed at Shoreline Coffee Shop. In late 2011, after nearly 50 years slinging "freezer to fryer" meals, owner Santiago Ojeda handed the keys to Ged Robertson of Mill Valley's Small Shed Flatbreads. Robertson, known for his commitment to the Marin holy trinity (sustainable-local-organic) brought in Luis Lagos as a chef and partner and set about the business of changing everything so that nothing is different.
Come again? First, it looks exactly as it did. Same narrow counter at the front, well-worn linoleum on the floor and colorful, wavy-backed booths. Thirty-two years in, Bonnie is still waiting tables on the weekends and her cohort, Alice — at 87, the "young one'" with a mere 15 years at Shoreline — works the weekday shifts. The ladies, the decor and the food keep the regulars coming so Lagos, formerly executive chef at the renowned Haramara Retreat in Sayulita, Mexico, and Robertson make small, steady changes to the tight Mexican-American menu. There's a list of daily specials on butcher paper taped to the side of a huge refrigerator.
It can sometimes mean a bit of juggling. Two eggs any style ($7) is still served with hash browns and toast, just as it was in 1962 when the doors first opened. Today, the eggs are from Woolly Egg Ranch, a hop and a skip down Tennessee Valley Road and the bread is from Green Gulch Farm, but the hash browns are pressed, spaghetti-swirly mid-20th century freezer-to-fryer hash browns. Regulars howled with protest when they were removed so they are back and not going anywhere.
Open-face meatloaf ($9), made with Marin Sun Farms pork (25 percent) and beef (75 percent) gets its gluten-free body from brown rice and corn tortillas; it was exceptionally light textured. The snappy tartar sauce, flecked with capers and parsley, added vivid, punchy flavor to this normally sedate dish. Yucatan cochinita pork sandwich ($7.50), deeply red, slow-roasted pork shoulder seasoned with achiote and orange juice, was warmly spicy and subtly sweet. Layered with a Cake Box bakery bun, avocado and pickled red onions, it pleasingly hit every sensory part of my palate.
The daily special soup ($4 cup), broccoli-leek that day, creamy and thick without added cream, was a deft balance of bitter and sweet with a punch of chili on the finish.
Fish tacos ($10.5) were less successful. Served open-faced, the zesty cabbage-cilantro-toasted pepita slaw and peppery Serrano chili sauce masked overcooked, chewy red snapper. Stick with the coffee shop burger ($5.50 single). Made with 100 percent Marin Sun Farms plate-pressed beef with just a bit of salt and pepper, it was cooked to an ideal, juicy, medium-rare. The 1962 set-up of raw white onion, tomato, iceberg lettuce and cornichons is so old it's new again.
From the granola and yogurt to the chorizo and guava syrup (for the French toast), Lagos makes just about everything on location and dots the menu with fresh Mexican flavors. The pickled cauliflower, brined with coriander, mustard and jalapeño and served alongside the cochinita pork, is not to be missed, nor is the tres leches cake ($6). Foraged mushroom tacos ($11) are served on toast (costra) in the style of Mexico City.
And the coffee? It's Four Barrel drip ($2.50); Robertson says he has a new set of regulars who stop in just for the premium brew.
Lagos and Robertson are making headway on some planned changes, too. A beer and wine menu, patio seating for about six tables and espresso drinks are on tap for late spring. Maybe by then, the workmen in coveralls, CHP officers, day hikers and bikers, and Marin families who fill the tables will ask for "hash browns à la Lagos." Then again, maybe not.
Christina Mueller writes about food — restaurants, chefs, products and trends — for local and national publications as well as other industry clients. Send her an email at firstname.lastname@example.com.
Address: 221 Shoreline Highway, Tam Junction, Mill Valley
Phone: 388-9085
Website: N/A
Cuisine: Mexican-American diner
Service: Casual tableside
Noise level: Low
Recommended items: Two eggs, any style, Yucatan cochinita pork, coffee shop burger, open face meatloaf, broccoli leek soup.
Liquor selection: N/A
Corkage: N/A
Heart-healthy and vegetarian selections: Yes
Dog friendly: Yes
Wheelchair access: Yes
Parking: Lot
Hours: 6 a.m. to 3:30 p.m. weekdays; 7 a.m. to 3:30 p.m. weekends.
Credit cards: MasterCard and Visa
Prices: $10 and less
Summary: This long-standing diner tucked away behind a Walgreens in Tam Junction, mixes Mexican-American diner classics with the fresh flavors of Marin and Mexico. Look for locally sourced everything and classic diner favorites such asuna salad, bacon and eggs, pancakes and chilaquiles, alongside newer dishes — costra tacos, amaranth granola — all made on location.


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Efavirenz-based Versus Nevirapine-based Antiretroviral Therapy Among HIV-infected Patients Receiving Rifampin (N2R)
This study has been completed.
Bamrasnaradura Infectious Diseases Institute
Mahidol University
Chulalongkorn University
Information provided by:
Bamrasnaradura Infectious Diseases Institute
ClinicalTrials.gov Identifier:
First received: June 5, 2007
Last updated: November 21, 2011
Last verified: June 2009
- Full Text View
- Tabular View
- No Study Results Posted
- Disclaimer
- How to Read a Study Record
The randomized controlled trial is conducted among antiretroviral naive co-infected HIV and tuberculosis patients who receiving rifampicin-based antituberculous regimen fro at least 4 weeks butt not exceed 16 weeks before enrolment. All patients receive the same backbone regimen of stavudine (30 mg/40 mg twice daily)+ lamivudie 150 mg twice daily. They are randomized to receive nevirapine 400 mg/day twice daily vs efavirenz 600 mg/day at bed time. All patients are followed through 144 weeks after initiation of antiviral therapy. The primary objective are to compare the proportion of patient who achieve undetectable plasma HIV-1RNA<50 copies/ml at week 48. The previous reports demonstrated that the standard doses of both nevirapine and efavirenz coulde be used among co-infected HIV and tuberculosis patients who receiving rifampicin even though plasma levels are somewhat reduced by rifampicin. However, there have been not been a randomized control trial to compare these two regimens. Thus, this trial will provide the efficacy data between these two regimens.
|HIV Infections Tuberculosis
|Drug: efavirenz Drug: nevirapine
|Phase 3
|Study Type:
|Study Design:
|Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
|Official Title:
|Efavirenz-based Versus Nevirapine-based Antiretroviral Therapy Among HIV-infected Patients Receiving Rifampin
Resource links provided by NLM:
MedlinePlus related topics: HIV/AIDS Tuberculosis
Drug Information available for: Rifampin Nevirapine EfavirenzU.S. FDA Resources
Further study details as provided by Bamrasnaradura Infectious Diseases Institute:
Primary Outcome Measures:
- To compare proportion of patients who achieved undetectable plasma HIV-1RNA< 50 copies/mL at 48 weeks after initiation of antiretroviral treatment between the 2 groups [ Time Frame: 48 weeks ]
Secondary Outcome Measures:
- to compare CD4 response at 48, 96 and 144 weeks after initiation of antiretroviral treatment, to compare adverse drugs reaction between the 2 groups [ Time Frame: 144 weeks ]
|Study Start Date:
|January 2007
|Study Completion Date:
|December 2010
|Primary Completion Date:
|December 2008 (Final data collection date for primary outcome measure)
|Assigned Interventions
Experimental: Efavirenz
Efavirenz 600 mg/day + stavudine +lamivudine
Drug: efavirenz
efavirenz 600 mg/day + stavudine + lamivudine
Experimental: Nevirapine
Nevirapine 400 mg/day + stavudine +lamivudine
Drug: nevirapine
nevirapine 400 mg/day + stavudine +lamivudine
|Ages Eligible for Study:
|18 Years to 60 Years (Adult)
|Sexes Eligible for Study:
|Accepts Healthy Volunteers:
Inclusion Criteria:
- Age 18-60 years
- Positive Serology for HIV-1
- Naïve to antiretroviral therapy
- Baseline CD4 cell counts <250 cells/mm3
- Diagnosed active tuberculosis by clinical features and/or positive acid fast stain and/or positive culture
- Received rifampicin at least 4 weeks but not exceed 16 weeks prior to enrollment
- Willing to participate and sign inform consent
Exclusion Criteria:
- Aspartate transferase enzymes (AST) or alanine transminase enzyme (ALT) >5 times of upper limit
- total bilirubin >3 times of upper limit
- serum creatinine) >2 times of upper limit
- pregnancy or lactation
- receiving immunosuppressive drugs
- receiving any drugs that may have drug-drug interaction with nevirapine and rifampicin
- chronic alcoholic drunken and intravenous drug users
- Previously received single dose of nevirapine to prevent mother to child transmission
- positive for serum cryptococcal antigen
Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.
Please refer to this study by its ClinicalTrials.gov identifier: NCT00483054
Please refer to this study by its ClinicalTrials.gov identifier: NCT00483054
|Bamrasnaradura Infectious Diseases Institute
|Nonthaburi, Thailand, 11000
Sponsors and Collaborators
Bamrasnaradura Infectious Diseases Institute
Mahidol University
Chulalongkorn University
|Principal Investigator:
|Weerawat Manosuthi, MD
|Bamrasnaradura Infectious Diseases Institute
More Information
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Keywords provided by Bamrasnaradura Infectious Diseases Institute:
Additional relevant MeSH terms:
ClinicalTrials.gov processed this record on September 21, 2017
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Manosuthi W, Sungkanuparph S, Tantanathip P, Lueangniyomkul A, Mankatitham W, Prasithsirskul W, Burapatarawong S, Thongyen S, Likanonsakul S, Thawornwa U, Prommool V, Ruxrungtham K; N2R Study Team. A randomized trial comparing plasma drug concentrations and efficacies between 2 nonnucleoside reverse-transcriptase inhibitor-based regimens in HIV-infected patients receiving rifampicin: the N2R Study. Clin Infect Dis. 2009 Jun 15;48(12):1752-9. doi: 10.1086/599114.
|Responsible Party:
|Department of Disease Control, Ministry of Public Health
|ClinicalTrials.gov Identifier:
|NCT00483054 History of Changes
|Other Study ID Numbers:
|Study First Received:
|June 5, 2007
|Last Updated:
|November 21, 2011
Keywords provided by Bamrasnaradura Infectious Diseases Institute:
co-infected HIV and tuberculosis patients
Additional relevant MeSH terms:
HIV Infections
Lentivirus Infections
Retroviridae Infections
RNA Virus Infections
Virus Diseases
Sexually Transmitted Diseases, Viral
Sexually Transmitted Diseases
Immunologic Deficiency Syndromes
Immune System Diseases
Mycobacterium Infections
Actinomycetales Infections
Gram-Positive Bacterial Infections
Bacterial Infections
Reverse Transcriptase Inhibitors
Nucleic Acid Synthesis Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Anti-Retroviral Agents
Antiviral Agents
Anti-Infective Agents
Anti-HIV Agents
Cytochrome P-450 CYP2C9 Inhibitors
Cytochrome P-450 Enzyme Inhibitors
Cytochrome P-450 CYP2C19 Inhibitors
ClinicalTrials.gov processed this record on September 21, 2017


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New York -- Target Corp. will soon join the ranks of retailers who are no longer reporting monthly same-store sales. The discounter on Thursday said it will no longer report comparable sales, beginning in fiscal 2013.
"This decision is based on discussions with many of our investors and is consistent with the practice of the vast majority of our retail peers," said John Mulligan, CFO, Target. "We believe aligning our sales guidance and reporting with disclosure of our quarterly financial results will create a longer-term focus and provide greater understanding of our sales results in the context of our overall financial performance."


text:
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At GlimmerGlass Alpacas, our goals are simple: improve each generation of alpacas born on our farm; utilize and promote North American alpaca fiber and alpaca fiber products; provide our alpacas with the best health services and nutrition available; provide our clients with ongoing support for as long as necessary.
Located in beautiful upstate New York, GlimmerGlass Alpacas is ...
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Sunshine's Double Trouble


text:
And, of course, the fine print:
Get free shipping on your next order when you spend over $100. The discount will be automatically applied to your purchase; no promo code required. The subtotal of your purchase must be $100.01 or greater after any promotional discounts have been applied. Additional fees such as tax or shipping and handling do not apply toward your minimum subtotal requirement of $100.01. Offer applies to standard shipping only. Certain items that require additional shipping and handling are excluded from this promotion and do not apply towards your $100.01 subtotal minimum. Offer subject to change.
Store logs efficiently with this handcrafted, industrial firewood holder. It's fashioned from industrial steel and black walnut for exceptional log-holding capabilities –– no frills, no fuss.
- Industrial steel
- Oregon black walnut
- Brass hardware
- Measures 24" x 11.5" x 9.5"
This product ships from the maker within 14 days, via USPS
** This item may have additional shipping charges applied at checkout.
If you're not happy with this item for any reason, you may return it for a full refund within 14 days.


text: Anybody interested in a group exchange of lith prints? Set up would be similar to the other exchanges with groups of 4 or 5 so that each person won't have to mail a bunch of prints. I think lith print should include straight lith and bleach and redevelop in lith. Imput is more than welcome so that those of us who are interested can set up and exchange that we all enjoy. Date of exchange would be set up after seeing how much interest there is.


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Veterans who own small businesses in Arizona can save up to $3,000 by tapping into a new loan program called VetLoan Advantage.
The program, offered by CDC Small Business Finance, features rebates and fee waivers associated with SBA-504 loans (for commercial real estate purchases) and Community Advantage loans for working capital, equipment purchases and other needs.
According to the U.S. Small Business Administration, veterans are at least 45 percent more likely than those with no military experience to be entrepreneurs, and often times face challenges in raising capital or getting a conventional loan.
"Veteran-owned small businesses employ nearly 5.8 million people nationwide, making the need for loan assistance vital to our recovering economy, said Chris Bane, loan officer with CDC Small Business Finance. "These programs are our way of saying thanks to vets for their honorable service."
The VetLoan Advantage programs in Arizona by CDC include:
SBA-504 – for purchasing commercial/industrial buildings or large equipment. CDC will issue a cash rebate up to $3,000 for any funded loan to help veteran owners offset loan expenses. The SBA-504 loan offers a low-down payment (typically 10%) and long-term fixed rates (now under 5%).
Community Advantage – provides up to $250,000 for working capital, equipment, inventory, tenant improvements and business acquisition. CDC will waive the packaging fee for veterans, a savings of up to $2,500.
For more information visit: http://cdcloans.com/small-business/vetloan-advantage/
CDC Small Business Finance is the nation's leader in SBA-504 loans as well as a leader in helping start-up and emerging small businesses via a variety of other SBA loan programs.


text:
Don't Go There!Situation puzzles (sometimes called lateral thinking puzzles) are ones where you need to ask lots of yes or no questions to figure out what happened in the situation. These are good puzzles for groups where one person knows the puzzle and answers the questions.
A healthy young man is approaching an empty field. He knows that when he reaches the field he will die. He is terrified and wants to turn back - but he can't.
HintRead the clue carefully and don't make assumptions.
AnswerHis parachute has failed.
What Next?
See another brain teaser just like this one...
Or, just get a random brain teaser
If you become a registered user you can vote on this brain teaser, keep track of
which ones you have seen, and even make your own.
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text:
Brian Hartline is staying with the Miami Dolphins.
Hartline, a wide receiver, has agreed to a five-year, $30.775 million contract with $12.5 million in guaranteed money, according to multiple reports.
"So happy and blessed to be here in Miami," Hartline said in a text message to The Miami Herald late Thursday. "Now let's go win some championships."
PHOTOS: Top 50 NFL free agents
Agent Drew Rosenhaus confirmed the numbers to The Associated Press.
Hartline, 26, led the Dolphins with 74 receptions and 1,083 yards last season. Both were career highs for the Ohio State product. He had one TD reception.
He has 183 career receptions and six scores.
Hartline would have become an unrestricted free agent Tuesday but wanted to remain with the team that drafted him in 2009.
Even with Hartline re-signed, the Dolphins likely will look to add a top free-agent wide receiver, according to the South Florida Sun Sentinel. Mike Wallace and Greg Jennings are two possible targets, according to the paper.
Dolphins wideout accounted for three touchdown catches last season.


text:
Mary Bullwinkel
Beacon Correspondent
The Fortuna Garden Project now has a washing station for vegetables thanks to the Eagle Scout project of a young man from Fortuna. Andrew Rulofson wanted to contribute to the community and in a three-week time period, built the washing station using donated lumber and hardware.
"Wyckoff's and Pierson's donated the materials" Rulofson said, "and the sink came from Cottonwood." Rulofson is a member of Boy Scout Troop 17 in Fields Landing, and this is his final Scouting project.
There is a plaque on the washing station which says: Donated by Andrew Rulofson, September 2012. The plaque also recognizes the washing station as Rulofson's Eagle Scout project.
Rulofson received a certificate of appreciation from Fortuna Community Services for his contribution to the garden. The 1.5 acre garden, located just off Newburg Road, provides fresh vegetables for the Fortuna Community Services Food Bank and the St. Joseph Pantry Shelf. This year alone, the garden project will distribute almost 1,000 pounds of fresh vegetables.
Photo Caption:
Photo by Mary Bullwinkel/Beacon
Fortuna Community Services Executive Director Rhonda Lewis presents Andrew Rulofson a certificate of appreciation for his contribution of a washing station to the Fortuna Garden Project.


text:
Bunk Bed Mattress
No longer available
- Overview
Save 10% on a Serta mattress when you purchase a PBteen bed at the same time. Excludes Heavenly Mattress. Enter Mattress10 at checkout.
Developed exclusively for us by Serta®, this mattress has a low profile that fits below bunk bed guardrails for safe sleeping.
- Full: 54" wide x 75" long x 7" high
- VertiCoil Premier™ innersprings contour to the body for balanced support; coils are made from 95% recycled steel.
- Convoluted surface is zoned into three areas for optimum weight distribution and air circulation.
- Patented StabL-Base® design is more than twice as strong as traditional wood frames.
- Patented Fire-Shield Insulator® system is among the safest fire retardants available, and contains no harmful chemicals.
- Nano-Pel™ offers superior moisture and stain resistance; water and oil roll off of cover fabric.
- Dimensions + Care
Twin Bunk
- 39" wide x 75" long x 7" high
- Bonnell Coil Count: 216
Full Bunk
- 54" wide x 75" long x 7" high
- Bonnell Coil Count: 312
- Zoned convoluted top is constructed with 1-3/8" thick foam.
- Constructed with 13-gauge coils with five turns for superior comfort.
- Perimeter is reinforced with a 9-gauge clipped rod to retain its shape for years of use.
- Antimicrobial treatment ensures freshness.
- Developed exclusively for PBteen by Serta®.
- We recommend the use of a mattress pad.
- Spot clean with mild soap and water.
- Rotate mattress regularly to redistribute the comfort layers and maximize wear.
- Do not flip this mattress.
- Shipping Info
This item is delivered by our Premium In-Home Delivery Service. With In-Home delivery, the item is brought into your home, unpacked, and assembled (except for some headboards and Style-It Desk components, which are not unpacked or assembled. Our service also does not mount hutches and shelves to customer's walls.) Delivery is by appointment. Monday-Friday, in all areas; Saturday delivery in some areas. Our delivery service will contact you to arrange a day. This service is available in the contiguous 48 states only. Please allow approximately 2-3 weeks for delivery. Returns of mattresses are subject to a $40 return shipping fee.


text:
Juan Pablo Montoya thinks he can still salvage the 2013 season.
To do it, he probably has to win this weekend at Watkins Glen.
MORE: Tony Stewart's injury in photo | Drivers behaving badly
Montoya, 23rd in the Sprint Cup standings and 31 points out of 20th, would need a win this weekend and likely another over the final five races before the Chase for the Sprint Cup field is set in order to make his second Chase appearance.
That might be more possible than it sounds. His two career Cup wins have come on road courses, including the August 2010 race at Watkins Glen, and he led 67 laps in May on his way to a fourth-place finish at Richmond—the site of the NASCAR regular-season finale.
"There is a lot of really good races coming that we've been very close to winning this year that, going there, we know we have a chance," Montoya said.
"We know we're throwing a lot of points away. We ran out of gas with one lap to go at Sonoma, for example, running second, and we converted a second-place finish into (34th). We can't do that."
Montoya has had speed at times but mistakes by him and the Earnhardt Ganassi Racing team have plagued them. From gearbox issues to pit-road penalties, Montoya feels his team has not lived up to its potential.
"We've thrown them away," Montoya said. "We've found ways to screw them up. But to tell you the truth, as a team we keep our head up and we keep fighting, and believe me, we believe we have a chance.
"We really, really believe that we have a good chance."
So how does the team avoid mistakes? Montoya said at The Glen, it will be a strategy where he doesn't have to punish the car throughout the event, even though he has the car control to do so.
"We're going to the Glen to win, not second place," Montoya said. "The truth is, in Sonoma we had a bit of the same approach, but in the end, we noticed that we were giving it our all to win, but because the end result of the strategy was so poor, we used up the car before the end of the race.
"We didn't have tires left or anything. So we won't try to force it so much."
He shouldn't. The former Formula One and IndyCar driver has the ability that should give him an advantage at Watkins Glen.
"For guys that run in ovals every week, that (Glen course) is very difficult," Montoya said. "And for me, my background is road-racing, going over curves and hustling the car, that's what it's all about.
"And something that has been really cool this year is, with the new Gen‑6 car, it's so much more agile on road courses, and that makes it so much more fun."


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Otley's community pub-supporting organisation, Otley Pub Club, has written to the new CEO of Enterprise Inns, Simon Townsend, urging him to ensure that the Black Horse Hotel, which is on the route of the Tour de France, is open for the once-in-a-lifetime event.
The Black Horse, currently closed, has had a chequered history in recent years, closing and opening several times.
Otley Pub Club is calling on Enterprise to publicly commit to having the Black Horse open – and available for people to book – for the Tour and for the annual Otley Cycle Races, which take place just before the Grand Depart.
Otley Pub Club is suggesting that Enterprise should either commit to doing this by reopening the hotel with a temporary manager or that they sell the hotel to an operator who would ensure that it is open and trading in July. The public letter to Enterprise has been copied to Otley Town Council, Otley's MP, Welcome to Yorkshire and the organisers of the annual Otley Cycle Races. Andy FitzGerald, chairman of Otley Pub Club, said: "It is a sad indictment of how Enterprise manages its properties that there is the very real risk of the Black Horse being empty on the day the world's greatest cycle race passes by the front door.
"We would welcome the opening of the Black Horse in time for it to participate in this historic event and demonstrate just what a successful hotel it could be."
Greg Mulholland MP, president of Otley Pub Club and Otley's MP, said: "Millions of people around the world will be watching the Tour de France as it passes through Otley and it would reflect badly on the town and on Enterprise Inns if this historic hotel remained closed. "The first week in July, with the Tour de France and the annual Otley Cycle Races, will be an unprecedented week-long celebration of cycling in the town and we need to have the only hotel in the town centre open and trading.
"Enterprise Inns must either publicly commit to having the Black Horse Hotel open soon and to remain open in July or should sell it to a proper hotel operator who could run it and make it a success.
"The chequered history of the Black Horse means that Enterprise are unlikely to get another tenant, nor will it work on that basis, so selling it to an appropriate hotel company remains the most likely way for the Black Horse to succeed.
"Either way, it cannot sit gathering dust much longer, so it really is time for Enterprise to make a sensible decision and ensure that Otley's town centre hotel is open for Le Tour Yorkshire."


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mikenz66 wrote:Is a bit (or a lot) of reading sufficient to really understand?
At an absolute minimum one would have to hear Dhamma (either via eye, or via ear) and relate what is heard to one's experience for verification. There were arahants for whom that was sufficient.
But we digress...


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SHIRVENHAM will be using revenge as motivation for their Hellenic Premier season ending game with Binfield tomorrow.
Earlier in the month tomorrow's visitors scored very late to steal three points away from Collier and his side. It was a rare blip in their recent run of form which has seen Shrivvy pick up five wins in their last eight, culminating in their dramatic win over local rivals Highworth last Monday.
It has been quite some turnaround for Shrivenham and Collier after he took over in such trying circumstances following the sudden and sad death of Dave Turner.
It took almost two months for Collier to get his first win but since then his team's form has improved to the point where he does not want the season to end.
"The lads have stuck together and we've been a good side, the league table lies in that we've been picking up points and have got a good bunch of lads who should be higher up," said Collier. "We feel we owe Binfield after the game a couple of weeks ago, that hurt us, we deserved at least a point, we will be going for revenge.
"We know how they play, this will be my fourth game against them, I've had two for Bassett and one for Shrivenham.
"We almost don't want the season to end now, we're playing well and picking up points regularly.
"We're all happy, considering what's gone on for the lads, Monday was a good day for club, winning the local derby was big. After what had happened, it was a tough start, we've not been battered by anybody, it took a while to get going but I've only signed one new player who's been playing regularly, we've just clicked recently.
"We go into every game wanting to win, we've won five of last eight, and we want to finish as high as possibly can."


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Hard to believe, but NBA free agency is just one week old today. Already, there have been convulsions and upheavals all over the league, but probably no place more than in the Western Conference, which was tough last year—five teams won 56 games—but will be even tougher this time around. Here's how things shake out after a couple of moves reshaped the league:
MORE: Houston wins Howard | What's next for Howard losers? | Clippers 3-team trade
Going up
Changes: The Rockets won the Dwight Howard sweepstakes and are now investigating ways—most important, a trade of Omer Asik—of revamping their roster around him.
Outlook: Exactly how high the Rockets can climb in the West depends on what they do with the rest of the team and how Howard responds to his new locale. Coach Kevin McHale intends to mold Howard into a better interior post player, and the Rockets have the perimeter shooters to create room for him. No matter how that development goes, with a core of James Harden on the perimeter and Howard inside, the Rockets have a shot at being the conference's best team.
Golden State
Changes: The Warriors made a big score, landing what could be considered the third-best player in the free-agent class, small forward Andre Iguodala. To get him, though, the Warriors lost key bench contributors Jarrett Jack and Carl Landry.
Outlook: The hope is that the Warriors can find a cheap replacement for Jack, and that Andre Iguodala's ability to handle the ball and play point-forward will lessen the need for a backup of Jack's quality. The addition of Iguodala means Harrison Barnes will likely come off the bench, giving coach Mark Jackson the option of using small lineups with Barnes as the power forward. That will mitigate the loss of Landry, though another big man figures to be added. (UPDATE: Golden State reportedly has agreed to a multiyear contract with free-agent big man Marreese Speights.) If the Warriors can stay healthy—a big if when you have Andrew Bogut in the middle—they should be a Top 4 team in the West.
LA Clippers
Changes: The Clippers re-signed Chris Paul and kept Matt Barnes, also adding wings J.J. Redick and Jared Dudley, giving a big boost to their perimeter shooting. They lost Eric Bledsoe, but point guard Darren Collison gives the Clippers a reliable backup for Paul. Remember, Collison played his best basketball while under Paul's tutelage in New Orleans. The biggest change, though, is at the bottom of the roster, where Doc Rivers takes over as head coach.
Outlook: With Rivers at the helm and an improved rotation, the Clippers are gunning for the top spot in the West. Whether their leap can go that far could depend on Rivers' ability to reach DeAndre Jordan, who was considered trade fodder as Rivers was moving from the Celtics to the Clippers. But with Redick and Dudley on the perimeter, Paul is primed for an MVP-type year.
Holding steady
San Antonio
Changes: After some speculation about splashy moves, the Spurs have pretty much stood pat, re-signing Tiago Splitter and Manu Ginobili while adding reserve Marco Belinelli.
Outlook: Though they might slide a bit in the regular season, as coach Gregg Popovich gives priority to resting his veterans, there's little reason to think the Spurs can't make a return trip to the Finals, even if they finish fourth or fifth in the conference. As long as Tim Duncan holds up well, Tony Parker is his usual self and Manu Ginobili bounces back from a subpar postseason, the Spurs will be fine. Keep an eye on Kawhi Leonard, who figures to make a huge third-year leap.
Changes: The Grizzlies' big change thus far has been dumping head coach Lionel Hollins and promoting assistant Dave Joerger. It's likely that Joerger will run the same offense and defense that Hollins had in place, but Hollins was popular among his players.
Outlook: The Grizzlies advanced to the conference finals last year, where they were swept by the Spurs. They've probably been passed in the conference by the likes of Golden State and Houston, so look for a sixth-place finish in the West here.
Oklahoma City
Changes: So long, Kevin Martin. The Thunder lost Martin early in free agency, then failed to lure Dorrell Wright in free agency. It looks like they will have to hope that one remaining vestige from the James Harden era—Jeremy Lamb—is ready to play.
Outlook: The Thunder still have Russell Westbrook and Kevin Durant, and as long as you've got that, you're going to contend in the West. There will be a step backward, no doubt, but the Thunder should still land in the mix of the West's Top 5.
LA Lakers
Changes: Dwight Howard is gone, and that's about all there is to know.
Outlook: With Howard gone and Kobe Bryant coming off of an Achilles tendon injury, the Lakers will get off to a middling start at best, and from there, scramble to try to earn a playoff spot. Which is exactly how last year went.
Changes: They lost Iguodala, traded away center Kosta Koufos, entirely altered their front office and got rid of coach George Karl, replacing him with first-timer Brian Shaw. That's a lot of upheaval.
Outlook: Shaw is an unknown as head coach, and he will be dealing with a team in flux. The Nuggets won 57 games last year, and were 38-3 at home. That won't happen again, though Denver still will have a crack at a No. 6 or 7 seed in the conference.
Changes: The T-Wolves kept Chase Budinger and added shooting guard Kevin Martin, also bringing in rookie Shabazz Muhammad. They will, though, lose Andrei Kirilenko and have to figure out what happens with restricted free agent center Nikola Pekovic. The biggest difference, though, could be a healthy Kevin Love.
Outlook: The loss of Kirilenko will be a blow to the team's defense, but Martin's shooting gives the Wolves a weapon at the off-guard spot that they've long been lacking. They have not made the playoffs since 2004, but this could be the year that changes.
Changes: The Blazers were threatening for a playoff spot last year, but fell apart down the stretch because they lacked depth, with arguably the worst bench in the league. That has changed with the addition of Dorrell Wright and Earl Watson, and bringing in Robin Lopez to start at center will boost the team's defense.
Outlook: Portland's brass felt all that was keeping the team from a playoff spot was interior defense and depth. They've addressed both, and as long as LaMarcus Aldridge—rumored to be seeking a trade—is pacified, the Blazers will be contenders for the No. 8 seed.
New Orleans
Changes: The Pelicans added guard Tyreke Evans, selling him on a Manu Ginobili-style role in a new-look backcourt that has Jrue Holiday at the point. Banking on Anthony Davis to improve and the addition of a center to replace Robin Lopez, the Pelicans will be an improved outfit.
Outlook: It's probably too much to ask New Orleans to leap all the way into the postseason picture. There are a lot of variables that need to work out just right—Gordon must stay healthy, Evans must embrace his role, Holiday must continue to get better as a playmaker. But the Pelicans have, at least, an outside shot at the playoffs.