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Making It Work
From: NEW BEGINNINGS, Vol. 13 No. 2, March-April 1996, pp. 51-2
We provide articles from our publications from previous years for reference for our Leaders and members. Readers are cautioned to remember that research and medical information change over time.
"Making It Work" is a regular feature of the magazine NEW BEGINNINGS, published bimonthly by La Leche League International. In this column, suggestions are offered by readers of NEW BEGINNINGS to help mothers who wish to combine breastfeeding and working. Various points of view are presented. Not all of the information may be pertinent to your family's lifestyle. This information is general in nature, and not intended to be advice, medical or otherwise.
I am in a work situation that makes it especially inconvenient to use a pump. In addition, I prefer to avoid using "gadgets" of any kind whenever possible. I've heard that some mothers express their breast milk by hand. Can you tell me more about hand-expression?
I never liked using a pump, so I decided to try to express milk by hand. I started simply by standing over the sink and experimenting with various hand positions until I figured out how to do it. I highly recommend hand expression: it's inexpensive, and you don't have to sterilize a pump, cart it around with you, or find an electrical outlet. All you need is a collection of milk storage bags, a place to wash your hands, and a private space.
I usually expressed milk directly into plastic storage bags, holding the bag with one hand and using the other to express milk. To help the milk begin flowing, I imagined my son nursing at my breast.
To maintain my milk supply, I expressed milk this way twice a day, once at work at the time that my son would have nursed if I had been at home, and again after he went to sleep. I was usually able to obtain four to six ounces of milk each time. I did this from the time my son was four months old until he turned one, and it was never necessary to supplement with formula. Although my son weaned himself last month, two months shy of his second birthday, I will always feel good about our nursing relationship and my ability to provide lots of my milk for my baby while I was at work.
Kathy Roach
Chicago IL USA
I once got to see Chele Marmet demonstrate the Marmet Technique for hand-expressing breast milk. The nursing mother who volunteered didn't think she would be able to express much milk, because her baby had just "drained her dry." But the milk literally shot across the room. We were all quite impressed!
I think it's a good idea for every nursing mother to learn this technique. You'll always have your hands with you no matter where you go. It takes practice, but it's worth learning.
Mary DeCoste
Chapel Hill NC USA
During discussions about breastfeeding and employment, most people are surprised when I mention that hand-expression turned out to be the most effective way for me to empty my breasts at work. I found it to be faster (no pump parts to wash), cheaper (no pump to buy), and more convenient (no pump to carry) than using a pump. I imagine they wonder "How could such a primitive method be better than a late-20th-century gadget?" Perhaps my story will help you decide if hand-expression is right for you.
With little success, I tried to express my milk with a hand-held battery pump a few weeks after my first baby, Alena, was born. I had read about the Marmet Technique of hand-expression in THE WOMANLY ART OF BREASTFEEDING. I followed the steps involved, but my efforts were equally unsuccessful. At an LLL meeting a few months later, I asked the Leaders for help. They suggested, among other things, that I talk to a woman in the Group who had had success with hand-expression. She showed me the rolling motion of the thumb and fingers (Marmet's Step 3) to compress the lactiferous sinuses right through her blouse! Since I wasn't scheduled to return to work until Alena was nine months old, I had some time to practice.
Armed with the live demonstration, Marmet's Technique made more sense to me and with some practice, I felt confident that hand-expression would work for me. I learned to express both breasts at the same time (right hand to right breast, left hand to left breast), and I expressed the milk directly into two containers the size of an eight-ounce coffee mug or plastic yogurt cup. The whole session, including the time to store the milk and clean up, took about 20 minutes. I expressed twice during my eight-hour work day, and I would collect a total of eight to twelve ounces. This I brought to the sitter's home for use the following day.
Here's how it worked. Using two screens, I set up a little cubicle in the corner of the ladies' room at work. I placed the two containers on a small, hip-height table, which was covered with a cloth that could be easily laundered (my aim was not always so good!). Undressing from the waist up was helpful because clothing inhibited my hand motions. I found that my milk would begin to let down by bending at the waist, gently brushing the tips of my nipples with my shirt, and breathing out as I completely relaxed the top half of my body. I first initiated very quick finger-thumb compressions, much like the initial rapid suckling of a baby. During the strongest part of the let down, I would stop the compressions and just gently push straight back into the chest wall (see Marmet's Step 2) while holding the breasts in the "C" hold. (I found that the compressions actually slowed my flow of milk during the initial let down.)
When the flow went from a spray to a trickle, I would begin the rhythmic method of position, push, roll, and compress (Marmet's step 4); milk would then intermittently spray out of the breasts during the finger-thumb compressions. Periodically, I would massage from the outer areas of the breasts toward the nipples and then again proceed with step 4. (I never used Marmet's Step 5 because it was uncomfortable for me and did not allow me to more effectively empty my breasts.) When the flow during the compressions slowed down to where only a few drops were released, I was finished.
I did try the hand-held pump several times again after I had become proficient at hand-expression. I found that I could pump only about half of what I could obtain manually. In fact, after the flow slowed down to drops with the pump, I could still obtain quite a lot of milk if I removed the pump and hand-expressed. Pumps do work well for many women, but hand-expression worked best for me.
Dawn Bernard
Troy MI USA
The Marmet Technique of Manual Expression*
This technique has been developed by Chele Marmet, a La Leche League Leader and lactation consultant who is the Director of the Lactation Institute in West Los Angeles, USA. As with any manual skill, practice is important.
- Position the thumb and first two fingers about 1 " to 1 1/2" behind the nipple. Use this measurement, which is not necessarily the outer edge of the areola, as a guide. The areola varies in size from one woman to another. Place the thumb pad above the nipple and the finger pads below to form a "C." Avoid cupping the breast.
- Push straight into the chest wall. Avoid spreading the fingers apart. For large breasts, first lift and then push into the chest wall.
- Roll thumb and fingers forward as if making thumb and fingerprints at the same time. The rolling motion of the thumb and fingers compresses and empties the milk reservoirs without hurting sensitive breast tissue.
- Repeat rhythmically to drain the reservoirs. Position, push, roll; position, push, roll.
- Rotate the thumb and finger position to milk the other reservoirs. Use both hands on each breast.
*1978, 1979, 1981,1988 Chele Marmet. Used with permission.
Editor's Note: For more information about hand-expression, please refer to the chapter on "Common Concerns" in THE WOMANLY ART OF BREASTFEEDING [Available from the LLLI Online Store.]


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Torii rests one more day with matchups in play
ARLINGTON -- Torii Hunter was healthy and available to play in Tuesday's series opener against the Rangers. He was also 2-for-22 lifetime off Texas starter Colby Lewis.
So although Wednesday is expected to mark Hunter's return to the lineup and the start of Brad Ausmus' outfield rotation, Tuesday seemingly marked the first day of Ausmus playing his outfield by matchups. Ausmus gave Hunter one extra day of rest, but Hunter's struggles off Lewis surely made the decision to be patient easier.
"I don't want to make any predictions," Ausmus said on Tuesday afternoon. "I'm sure it'll be a little bit of both [matchups and rotations]."
Hunter spent Monday's off-day resting in his own bed at his home in nearby Prosper. He made it through all of his required workouts on Sunday without any issues, and he did some early work running on the field at Globe Life Park.
Ausmus said after Tuesday's 8-2 win that Hunter will be in the lineup on Wednesday night. So, too, he said, will J.D. Martinez, who has homered in five of his last eight games and has a 13-game hitting streak.
That means either left fielder Rajai Davis or center fielder Austin Jackson will get a day off.
Ausmus insists that finding time for four outfielders shouldn't be terribly complicated. He also doesn't expect to be resting Hunter much more often than usual.
"Even before J.D. [Martinez] heated up, there were times -- basically once a week -- that I would give Torii a day anyway," Ausmus said. "So I don't think that's going to be an issue. And when Torii's swinging the bat the way he normally does, this guy can still hit. So he's still going to get the bulk of the playing time in the outfield."
Jason Beck is a reporter for MLB.com. Read Beck's Blog and follow him on Twitter @beckjason. This story was not subject to the approval of Major League Baseball or its clubs.

subset: commoncrawl


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Gonzalez grateful to O's for Tigers opportunity
DETROIT -- Alex Gonzalez never played a regular-season game for the Orioles, but this weekend's series provides a chance to catch up with some friends.
Gonzalez signed a Minor League deal with Baltimore in late January with an invitation to Spring Training. Less than two months later, he was traded to the Tigers for Steve Lombardozzi, as Detroit needed a shortstop.
Gonzalez was thankful for the opportunity the Orioles gave him, saying he wouldn't be in Detroit or be at shortstop without it. A year ago, he was starting at first base for the Brewers.
"It's baseball. It can happen," he said of the trade Friday. "I feel good with the trade. It gave me more opportunity to play shortstop. Those guys gave me an opportunity to play shortstop, too, and I think that's one of the reasons I got traded. [The Tigers] saw me play shortstop. I think it was one of the reasons I came here."
Gonzalez hit a walk-off single on Monday in his Tigers debut.
He wasn't with the Orioles very long, but enjoyed the atmosphere in the clubhouse.
"It's a good group of guys," he said. "I had fun with them in Spring Training. They've got a great team and a great group of guys."
Chris Vannini is a contributor to MLB.com. Matt Slovin is an associate reporter for MLB.com. This story was not subject to the approval of Major League Baseball or its clubs.


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ACParadise Network: American Cosplay Paradise American Cosplay Experience American Cosplay Snapshots
I'm currently a third-year medical student considering specializing in either pediatrics or family medicine. I became a member of Sailor Jamboree in 2005 and remained its final member until its last performance in 2006 (at Oni-Con in Houston, TX). I took a nice big break from cosplay when I moved to Nor Cal and started medical school in 2007, and am now hoping to revive my hobby... whenever I have time off of the wards, that is :)
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Dundonald International Ice Bowl hosts the World Police and Fire Games 27th July - 9th August 2013
16 January 2013 - 09 August 2013
Dundonald International Ice Bowl hosts the World Police and Fire Games from 27th July 9th August.
We welcome you to come along and join in the sporting spirit as you cheer on your favourite ice hockey team or bowler!
Ice Hockey
Matches run from 29th July - 5th August. Download a fixture list to find out more details on dates and times of games.
Public Skating Sessions will run at varying times throughout the games. Download the Public Skating Session details.
Competitions run on the 7th, 8th and 9th August. Download a competitions schedule.
All events are open to the public and entry is free. Access will be on a first come first serve basis.


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Internships at WGBY
WGBY, a public TV station, is now accepting applications for non-paid internships in several departments.
Education & Outreach Internship
Programming Internship: Connecting Point
Programming Internship: Together in Song
Production Internship: Connecting Point
Web & Digital Media Internship
Production & Programming internships are offered during the Fall semester (September-December) and the Spring semester (January-June).
Questions about internships? Please direct them to firstname.lastname@example.com, or call WGBY at 413-781-2801.


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American Express Engages Employee Diversity Networks to Drive Growth
April 24, 2013
Dante N. Mastri, global strategy and capabilities, global merchant services at American Express, discussed Shop Small Provincetown, a pilot initiative created by its PRIDE employee network to reach diversity market segments.
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Oversized White Floral Decal
No longer available
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Give yourself a garden view anywhere you look with this larger-than-life wall decal.
- 52" wide x 50" high
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- Clean the surface using a soft sponge and lukewarm water with mild soap or detergent.
- Avoid exposing the back side of the decal to dirt or water.
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This item will arrive in 3-5 business days. Please proceed to the Payment & Review page of Checkout for a precise delivery estimate.
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Retailers are busy with the holiday shopping season, but that doesn't mean they don't have time to contest a settlement they find unfair.
Earlier this month, U.S. District Judge John Gleeson granted preliminary approval to what could be the largest antitrust settlement in U.S. history. The $7.2 billion deal between a class of retailers, Visa Inc., MasterCard Inc. and several banks would resolve seven years of litigation concerning allegations that the credit card companies and banks conspired to fix credit and debit card use fees—also known as swipe fees. Stores are charged fees every time a customer makes a purchase using a card, resulting in more than $30 billion in swipe fees a year. Under the terms of the settlement, which would cover nearly 8 million merchants, the defendants would pay $6 billion to the class and reduce the swipe fees for eight months, which would result in $1.2 billion in savings.
Gleeson approved the deal despite objections from retailers such as Wal-Mart Stores Inc. and Target Corp., as well as the National Association of Convenience Stores. Now, some of the retailers and trade groups that are part of the settlement are officially challenging Gleeson's order. Yesterday, 10 stores and trade groups filed notice that they're appealing Gleeson's order to the 2nd Circuit. The plaintiffs say the settlement violates their rights by preventing them from opting out. They are challenging a portion of Gleeson's order that would release Visa and MasterCard from new legal claims over related issues.
Read Bloomberg Businessweek and Thomson Reuters for more about the appeal.
For more InsideCounsel coverage of the Visa/MasterCard settlement, read:
$7.2 billion Visa/MasterCard credit card fee settlement gets preliminary approval
More than 1,000 retailers oppose $7.2 billion Visa/MasterCard credit card fee settlement
Visa/MasterCard credit card fee settlement on expedited schedule for approval
Visa/MasterCard credit card fee settlement with retailers moves forward
Wal-Mart disapproves of $7.25 billion credit card fee settlement
Visa, MasterCard and banks agree to $7.25 billion settlement over credit card price fixing allegations
Merchants say card companies' liable for more than $10 billion in damages


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UEFA Champions League debutants AEL Limassol FC, Hapoel Kiryat Shmona FC, Málaga CF and VfL Borussia Mönchengladbach spoke of their excitement following the play-off draw in Nyon.
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Heather Nyberg-Schlotzhauer
Beacon Correspondent
Fortuna, "The Friendly City" -- that's what the sign says entering this small town, but in recent years many are wondering.
On Sunday, Oct. 28, Norman G. Ambrosini Elementary School was burglarized by three young suspects. "As of now we have nothing more," said Fortuna Police Department Sgt. Scott Hillman. "The school surveillance video does show three youths, but not clearly identifiable. We are still seeking information from the public."
It is reported that entry was forced into a classroom that was doing a rock study and those rocks were then used to destroy three other classroom windows to gain entry.
In all four classrooms the suspects then rummaged through items and stole a laptop from each room. It is estimated the value of the computers stolen is at several thousand dollars, depriving the classrooms of teaching tools.
Due to amount of glass debris scattered across the carpets, desks, and furniture, the classrooms are not habitable at this time and students have been displaced to other areas.
The school has a video surveillance system and has worked with the local law enforcement to identify the suspects. Fingerprints and DNA evidence have been collected from the school and the community has been notified of this crime for help identifying the suspects.
"It is appalling that someone would break into a school and steal equipment that is used to educate our children," Fortuna Police Sgt. Charles Ellebrecht said in a press release. "Schools across the state already have to deal with tight budgets and then when education equipment is stolen, our children are the real victims left to suffer."
As the damage is reviewed by insurance and assessed for a plan to reopen the classrooms it becomes clear how deeply the school will be affected. As there are shards of glass throughout the classrooms there is no guarantee that even professional cleaners will be able to contain all of it. Therefore, the classrooms with carpet will have to be replaced at an even greater expense to the school district.
"We know three young men between the ages of 10 to 12 years old visited the school early in the day on Saturday and then returned on Saturday night Oct. 27 at around 8:25 p.m. and burglarized our school," said Fortuna Elementary School District Superintendent Dr. Patti Hafner.
"We have started the glass clean up ... with New Life Services, but believe the students will be displaced for three weeks," Hafner said Wednesday. "It is clear we have to replace carpet and windows but now it is possible due to glass in the books we will have to replace some textbooks."
The damage to date is estimated to be at over $30,000. "This is very unfortunate that we are spending time, energy, and money on this and not on the kids' academics," Hafner said.
Many Ambrosini students came to school the Monday following the weekend incident and immediately asked if their teacher was OK. They were not concerned for their personal items in their desks, but rather the well-being and safety of their school family.
The school district and Fortuna police are asking that anyone with information contact the department's WeTip Hotline at 1-800-78-CRIME. There have been posters with this information distributed all over the community in hopes that someone will come forward with any information they have.
Callers to the WeTip Hotline will remain Anonymous and may be eligible for a cash reward of up to $1,000 if their information leads to an arrest and conviction.
photo caption:
Photos by Heather Nyberg-Schlotzhauer/Beacon
1. Three suspects used rocks from another classroom to shatter a large window in the newest building of Ambrosini School during a break-in that caused severe carpet, text book, and electronics damage/theft.


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Sensitivity and Specificity of QuantiFeron -TB Gold Test (QFT-G)in Patients With Psoriasis
The recruitment status of this study is unknown. The completion date has passed and the status has not been verified in more than two years.
Verified October 2010 by Tel-Aviv Sourasky Medical Center.
Recruitment status was: Not yet recruiting
Recruitment status was: Not yet recruiting
Tel-Aviv Sourasky Medical Center
Information provided by:
Tel-Aviv Sourasky Medical Center
ClinicalTrials.gov Identifier:
First received: October 18, 2010
Last updated: NA
Last verified: October 2010
History: No changes posted
- Full Text View
- Tabular View
- No Study Results Posted
- Disclaimer
- How to Read a Study Record
The purpose of this study is to determine the level of agreement between QuantiFeron -TB Gold test (QFT-G)and Tubeculin skin test (TST)for screening of latent tuberculosis in patients suffering from psoriasis.
|Tuberculosis Psoriasis
|Other: Tuberculin skin test and Quantiferon -TB Gold test
|Phase 4
|Study Type:
|Study Design:
|Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Diagnostic
|Official Title:
|Sensitivity and Specificity of QuantiFeron -TB Gold Test (QFT-G)in Comparison With Tuberculin Skin Test in Patients With Psoriasis and Psoriatic Arthritis
Resource links provided by NLM:
Genetics Home Reference related topics: psoriatic arthritis
MedlinePlus related topics: Psoriasis Tuberculosis
Drug Information available for: Tuberculin Purified Protein DerivativeU.S. FDA Resources
Further study details as provided by Tel-Aviv Sourasky Medical Center:
Primary Outcome Measures:
- The level of agreement between TST and QTF in patients with psoriasis in comparison with controls [ Time Frame: 3 days ]
Secondary Outcome Measures:
- Levels of TST in patients with psoriasis in comparison with healthy controls [ Time Frame: 3 days ]
|Estimated Enrollment:
|Study Start Date:
|November 2010
|Estimated Study Completion Date:
|August 2011
|Estimated Primary Completion Date:
|June 2011 (Final data collection date for primary outcome measure)
Intervention Details:Show Detailed Description
Other: Tuberculin skin test and Quantiferon -TB Gold test
TST A 2-TU dose of PPD will bevadministered by a certified technician using the Mantoux method and induration measured after 72 h.
QFT-G test The second-generation QuantiFeron® (QIFN) whole-blood IFN assay (Cellestis) will be performed and interpreted according to the manufacturer's instructions.
|Ages Eligible for Study:
|18 Years to 90 Years (Adult, Senior)
|Sexes Eligible for Study:
|Accepts Healthy Volunteers:
Inclusion Criteria:
- Patients with psoriasis and psoriatic arthritis
- Aged 18-90
Exclusion Criteria:
- History of TB
- Known allergy to TST
- Current or past treatment with anti-TNF alpha
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: NCT01223976
Please refer to this study by its ClinicalTrials.gov identifier: NCT01223976
|Contact: Ori Elkayam, MD
|Contact: Ayelet Brill
|Tel Aviv Medical Center
|Not yet recruiting
|Tel Aviv, Israel, 64239
|Contact: Ori Elkayam, M.D 97236973668 email@example.com
|Principal Investigator: Ori Elkayam
|Sub-Investigator: Hagit Mats
Sponsors and Collaborators
Tel-Aviv Sourasky Medical Center
More Information
Keywords provided by Tel-Aviv Sourasky Medical Center:
Additional relevant MeSH terms:
ClinicalTrials.gov processed this record on September 21, 2017
Chiang YZ, Panting K, Dever B, Parslew RA. Clinical applicability of T-cell interferon-a release assay for tumour necrosis factor-a inhibitor therapy in severe psoriasis. Clin Exp Dermatol. 2011 Jan;36(1):39-41. doi: 10.1111/j.1365-2230.2010.03850.x.
Laffitte E, Janssens JP, Roux-Lombard P, Thielen AM, Barde C, Marazza G, Panizzon RG, Saurat JH. Tuberculosis screening in patients with psoriasis before antitumour necrosis factor therapy: comparison of an interferon-gamma release assay vs. tuberculin skin test. Br J Dermatol. 2009 Oct;161(4):797-800. doi: 10.1111/j.1365-2133.2009.09331.x. Epub 2009 Jun 5.
|Responsible Party:
|Prof. Ori Elkayam, Tel Aviv Medical Center
|ClinicalTrials.gov Identifier:
|NCT01223976 History of Changes
|Other Study ID Numbers:
|Study First Received:
|October 18, 2010
|Last Updated:
|October 18, 2010
Keywords provided by Tel-Aviv Sourasky Medical Center:
latent tuberculosis psoriasis arthritis TST QTF
Screening of latent tuberculosis in psoriasis
Additional relevant MeSH terms:
Skin Diseases, Papulosquamous
Skin Diseases
Mycobacterium Infections
Actinomycetales Infections
Gram-Positive Bacterial Infections
Bacterial Infections
ClinicalTrials.gov processed this record on September 21, 2017


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Marketing Information
Our replacement cartridges re-use plastic hulks that still have productive life left-that is better for the environment and for your wallet. Although over 90% of cartridge parts are re-used, crucial xerographic components are replaced to ensure top quality. We know how to give you the most value for your money, while reclaiming a cartridge that still has usable life. It's only right.
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|Toner Cartridge
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|Xerox Corporation
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|Toner Cartridge
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|11000 Page
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This product is shipped only within Canada and Warranty valid for Canada only.
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Architect: Daniel Russoniello, Archer & Buchanan Architecture, LTD.
The LenFest Management and Preserve Center is a 10,000 square-foot facility designed to promote the preservation and maintenance of natural resources with public outreach, and education. The newly built center is nestled in a hillside of the preserve with views in all directions, and created in a traditional and agrarian aesthetic. The environment inspired the design aesthetics while the building's purpose was driven by the organization's mission. The architectural design, material selection, colors, scale, texture and character all draw on the region's agrarian heritage. Overall beauty, sustainability, and long-term quality were the primary concerns of the build. Marvin windows met the architect's requirements for extensive daylight, beautiful views and sightlines and profiles contributing to the traditional and agrarian design aesthetic.
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THE next round of Crown Paints and Darwen Town Council Community Awards will close on Tuesday July 1.
The annual award scheme is open to local groups and organisations within the Darwen area whose purpose is to serve the community.
Past recipients of the awards have been football teams, cricket clubs, Brownies, Guides and fishing clubs.
The £30,000 scheme, which the town council invests £20,000 and Crown £10,000 into annually, sees grants of up to £2,000 handed out to groups within the BB3 postcode.
In the last cash handout, £4,000 was given to groups including AFC Darwen Juniors, Darwen Girl Guides and Darwen Rangers JFC.
Once all the applications are in, a panel of three town councillors and three representatives from Crown, in Hollins Road, will decide which ones are successful.
To find out more, visit the Darwen Town Council website at www.darwentowncouncil.org.uk/CommunityAwards


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>Running 101>Half Marathon goal
Jumping right ahead to my question: I am setting a goal of running 13 miles once a week or so, what should my daily mileage eventually be if I plan to run 5 days a week?
I have read some training plans online but they are a bit more race-oriented and don't quite fit what I have in mind. Here're some info that hopefully help clarify my question a little.
- I run for general health/fitness. I don't really have running races or hitting certain speed/pace in mind.
- I'm not asking for how to get there. I'm wondering what "there" looks like? (not sure if I'm making any sense?)
- I like running easy pace now (thanks to the advises I'd gotten here before). "There" means I can run the HM distance at an easy pace once a week.
- I don't have a schedule to get there. It can take me weeks or months, it's not a concern right now.
- Currently I can do easy runs for around 7 miles a couple times a week without keeling over, and runs about 20 mpw. I have tried 13 miles once (took me almost 2.5 hours and I got dead legs for several days afterward), so I know it's a not an unrealistic goal to shoot for...
Ooh..a story problem.
I'd say your long run should be no more than 40% of weekly mileage. So roughly your total miles should brobably be at least 32 miles (40 would probably be better). Taking out your 13 mile run, that leaves 20 miles minimum for the remaining 4 days. I'd vary the distances from 4-8 daily over the remaining 4 days.
Maybe your weekly runs will be rest-4-8-rest-6-2-13, or whatever.
That's probably the very minimum of your total mileage. Others have a lot more expertise than I.
But the plan above is similar to what I am getting back to. I am working towards 40-50 mpw average, and longer long runs. I am probably guilty of putting too high a percentage of my miles into my long runs.
My guess is it doesn't matter. Training plans assume you're trying to make the most of a week's worth of training--you're just trying to run 13 miles once a week. There are probably plenty of folks who could do that without any running on the other days.
Just keep doing what you're doing the other days of the week and gradually extend your long run.
Runners run.
Thanks for the suggestions. Looking forward to getting my mpw up!
- I'm not asking for how to get there. I'm wondering what "there" looks like.
- I'm not asking for how to get there. I'm wondering what "there" looks like.
"There" isn't a vista; it's a perspective. The more you run, the surer your vision.
And, what Mikey said.
And also join this RA group for additional support and motivation with that exact goal.


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Rules on mandamus and similar orders vary by jurisdiction. In the federal courts, these orders most frequently appear when a party to a suit wants to appeal a judge's decision but is blocked by rules against interlocutory appeals. Instead of appealing directly, the party simply sues the judge, seeking a mandamus compelling the judge to correct his earlier mistake. Generally, this type of indirect appeal is only available if the party has no alternative means of seeking review.
See Civil Procedure


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Safety Study of Bevacizumab to Treat Women With a History of Breast Cancer and Suffering From Upper Extremity Lymphedema
Recruitment status was: Not yet recruiting
- Full Text View
- Tabular View
- No Study Results Posted
- Disclaimer
- How to Read a Study Record
|Drug: Bevacizumab
|Phase 1
|Study Type:
|Study Design:
|Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
|Official Title:
|Phase I Study Evaluating the Safety of Bevacizumab in Women With a History of Breast Cancer Suffering From Moderate to Severe Upper Extremity Lymphedema
|Estimated Enrollment:
Lymphedema occurs with varying frequency in patients with cancer but approximately 10-15% of all breast cancer patients will develop lymphedema following breast cancer treatment. Lymphedema in breast cancer patients following axillary lymph node dissection is caused by the interruption of the axillary lymphatic system by surgery or radiation therapy, which causes an accumulation of fluid in the subcutaneous tissue of the arm, with decreased distensibility of tissue around the joints and increased weight of the extremity. The primary current therapy employed involves complete decongestive therapy (CDT) which encompasses the use of manual lymphatic drainage (MLD) and compression bandaging (CB) to the affected limb.
The specific contribution of the vascular system to the development of lymphedema is unclear. Vascular permeability is a complex process which is primarily controlled by the interaction of the ligand vascular endothelial growth factor (VEGF). As a result of the understanding of the biology of VEGF and the anecdotal appreciation of women with lymphedema who have noted improvement in their lymphedema while on VEGF inhibitor therapy, it is hypothesized that the reduction in vascular permeability resulting from the use of a VEGF inhibitor either alone or in conjunction with standard decongestive lymphedema therapy may significantly improve the outcome for patients with this post-operative complication.
Bevacizumab is a recombinant humanized monoclonal antibody directed against VEGF. Bevacizumab blocks the development of new blood vessels in cancer and it is approved by the FDA for the treatment of colon cancer in combination with chemotherapy. While bevacizumab has been administered to thousands of patients with cancer, there is only limited information about the use of bevacizumab in subjects without active cancer.
This study will evaluate the safety profile of escalating doses of bevacizumab administered intravenously alone for 4 weeks followed by 4 weeks of therapy in combination with manual lymph drainage (MLD) and compression bandaging (CB) to patients with moderate to severe unilateral upper extremity lymphedema due to prior breast cancer therapy.
|Ages Eligible for Study:
|Child, Adult, Senior
|Sexes Eligible for Study:
|Accepts Healthy Volunteers:
Inclusion Criteria:
- Women with a history of breast cancer status post (s/p) prior surgical resection (i.e., either lumpectomy and radiation, modified radical mastectomy or radical mastectomy) with lymphedema defined as a difference in limb volume of at least 500 ml by perometric assessment
- Lymphedema may be newly diagnosed or previously treated as long as it is Stage I (pitting) or II (fibrosis) at the time of study entry.
- No known evidence of recurrent or active metastatic breast cancer
- No prior chemotherapy within 6 months of study entry and has recovered to grade 1 or less from the toxicity of all prior chemotherapy or radiation therapy (with the exception of alopecia); ongoing anti-estrogen therapy for post-menopausal survivors is permissible.
- Normal end organ function defined as: serum creatinine < 1.5 mg/dl or a calculated creatinine clearance > 50 ml/min; SGOT and SGPT < 2.5 X upper limit of normal (ULN); total bilirubin < 1.5 X ULN; absolute neutrophil count (ANC) > 1,500 cells/µl; hemoglobin > 10 g/dl (without transfusions); platelet count > 100,000/µl; serum albumin within normal limits (WNL).
Exclusion Criteria:
- Stage III (lymphostatic elephantiasis) lymphedema
- Clinical evidence of bilateral lymphedema. Those patients who have undergone bilateral breast cancer surgery or prophylactic mastectomy on the non-cancerous breast will be excluded.
- Any prior history of deep venous thrombosis (DVT) or pulmonary embolus (with the exception of prior line-related thrombotic events) or myocardial infarction (MI), cerebrovascular accident (CVA) or any other arterial thromboembolic event (i.e., transient ischemic attack [TIA], reversible ischemic neurologic deficit [RIND], history of angina pectoris, clinically significant peripheral vascular disease with claudication, etc.)
- Patients with problems with wound healing (e.g., diabetic ulcers), gastrointestinal fistula
- Patients receiving therapeutic anti-coagulation including full dose aspirin or non-steroidal anti-inflammatory agents known to inhibit platelet function (low dose coumadin for port prophylaxis and low dose aspirin are allowed)
- Untreated hypertension with a baseline systolic blood pressure (SBP) of > 150 mmHg or a diastolic blood pressure (DBP) >100 mmHg will be excluded (stable treated hypertension with values less than those noted will be eligible).
- A history of infectious complications of the involved arm or those with any contraindication to MLD + CB [e.g., congestive heart failure (CHF), DVT, acute or chronic renal failure] will be excluded.
- Women with a history of CHF [New York Heart Association (NYHA) Class II or greater] will be excluded.
- Pregnant or breast-feeding
- Unwilling to use an appropriate form of barrier contraception for the duration of the study and for three months following the last dose of bevacizumab
- Those patients who are actively undergoing MLD and/or CB at the time of study entry and for up to 4 weeks prior to entry
- Unable to provide written informed consent or to comply with study procedures
- Baseline urine protein : creatinine ratio > 1.0
- Known evidence of a bleeding diathesis or coagulopathy
Please refer to this study by its ClinicalTrials.gov identifier: NCT00318513
|Contact: Michael S Gordon, MD
|United States, Arizona
|Premiere Oncology of Arizona
|Not yet recruiting
|Scottsdale, Arizona, United States, 85260
|Principal Investigator: Michael S Gordon, MD
|Principal Investigator:
|Michael S Gordon, MD
|Premiere Oncology of Arizona
|ClinicalTrials.gov Identifier:
|NCT00318513 History of Changes
|Other Study ID Numbers:
|Study First Received:
|April 24, 2006
|Last Updated:
|May 9, 2006
Keywords provided by Premiere Oncology of Arizona:
breast cancer
Additional relevant MeSH terms:
Breast Neoplasms
Neoplasms by Site
Breast Diseases
Skin Diseases
Lymphatic Diseases
Angiogenesis Inhibitors
Angiogenesis Modulating Agents
Growth Substances
Physiological Effects of Drugs
Growth Inhibitors
Antineoplastic Agents
ClinicalTrials.gov processed this record on September 21, 2017


text:
|Sport, 2 pitches, 170'
|YDS: 5.9 French: 5c Ewbanks: 17 UIAA: VI ZA: 17 British: HVS 5a [details]
|Ron Olsen and Bruno Haché, 7/9/07
|New Route:
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|Submitted By:
|Orphaned on Jul 5, 2007
|Comments on Buried Treasure
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Comments displayed oldest to newest — Skip Ahead to the Most Recent Dated Oct 30, 2014
By Mike McMahon
From: Little Cottonwood Canyon, Utah
Jul 17, 2007
|Climbed the "Buried Alive" (p1 & p2 Buried Treasure, p3 Staying Alive) variation last night. Great link-up. The undercling traverse into the V-slot on the final pitch was really fun. Thanks for all of the work you've done on this area Ron!
By Jake Wyatt
From: Longmont, CO
Jul 20, 2007
|With the Buried Alive finish, this climb packs a nice variety of climbing into the three pitches.
By Tony B
From: Around Boulder, CO
Sep 22, 2007
rating: 5.8 5b 16 VI- 15 HVS 4c
One of the better lines in this part of the wall, sadly, it deserves no more than 2 bolts. Lead ground-up on gear while cleaning it, the only bolts that tempted me were those leading out right to gain the arete 2/3 up, but I found myself on 5.8 jugs anyway... Both bolts there are OK, but only one was really needed to protect the moves.
If those had been the only bolts this would read differently, but that is not the case.
I cleaned a lot of cracks out with my nut tool and sewed the climb up as I liked, save for that one place. It's a shame it was not done in mixed or trad style, in my opinion. This is a good candidate for the FA party to reconsider the bolts on. In my opinion, the route would be improved.
By percious
From: Bear Creek, CO
May 26, 2008
rating: 5.9 5c 17 VI 17 HVS 5a
I led this yesterday with a set of cams and stoppers. I feel it is rather well protected. As Tony has stated above, I think this route should be considered for retro-unbolting with the first ascentionist's permission. I think the bolts left of the crack on P2 of Staying Alive are an atrocity. This part of the climb in particular is well protected and does not warrant permanent fixtures. I encourage other 5.9 leaders to lead the route traditionally and weigh in on the issue.
For those looking to lead this marvelous climb, a set of stoppers (every other size will probably do) and cams to 2 1/2 inches will be suitable, perhaps with doubles in the 1/2->1 inch sizes.
By Mark Cushman
From: Cumming, GA
Jun 2, 2008
Dear Buried Treasure,
We first met at the suggestion of a friend, he told me I'd like you and that you were fun. Boy, he was right! We had some good times, didn't we? Sure, I may have gotten a little off-track with you here or there, but I always came back! I'm sorry it had to end - it's not you, it's me! I like you just the way you are. Don't you ever change!
P.S. I'll come visit again soon.
By kevinnlong
From: Boulder, CO
Aug 8, 2008
rating: 5.8 5b 16 VI- 15 HVS 4c
If put to a vote, I would support chopping all but two bolts on this route. Leave the anchors; that is fine, but the bolts next to the cracks should be removed.
With that said, this is an excellent route. I really enjoyed my experiences today at the tower. Thank you FA folk.
By Wayne DENSMORE
From: Superior, CO
Sep 19, 2008
As a new climber, doing mostly top ropes, just learning to lead some sport routes but having no experience placing gear yet, this route was a blast! Went with a better climber and actually led the middle pitch.
Thanks for putting this up!
By Tom Woods
Sep 21, 2008
|I would like to express my sincere thanks and appreciation to Ron Olsen, Bruno Hache, Bob D'Antonio, Ken Cangi and others who contributed their considerable time, effort, expense and expertise to create the climbing routes that are now to be found on Tonnere Tower. Please keep up your excellent work. I climbed at this area for the first time today and had a truly outstanding day of climbing. I will be back for more.
By E Johnson
From: Boulder, CO
Oct 3, 2008
Guess what, there are climbers who don't climb trad. And never will. While trad climbers can choose not to use the bolts and put their gear in the cracks (the bolts aren't in their way in the cracks), but if you lead sport, what? you are sorry out of luck because a bunch of purists get to decide when rock gets bolted?? I was up at Exit 38 in WA appreciating the rare opportunity to have lots of moderate sport routes to gain lead experience on and then thought about Boulder Canyon, or Boulder in general and how there are all these people who think "if it's protectable, nearby bolts are an abomination and should be chopped". As much as I love where I live and the granite of the canyon and the close proximity of a lot climbing, it was a drag thinking about the attitudes I would be returning to.
It's just rock climbing, people, and there are different styles. Why should trad preclude sport climbing? Sport climbers aren't stopping trad climbers from doing their thing. As soon as you step off a trail you've changed nature. As soon as you apply sticky shoe rubber to the rock, you are aiding. Live and let live.
By Kyle Turner
From: Brighton, CO
Oct 30, 2008
rating: 5.9- 5c 17 VI 16 HVS 4c
Bolts or gear, the buried alive link is a blast. Nice work guys! Look forward to going back for more on Tonnere.
By kyle breuning
Aug 29, 2009
Concering a loose anchor,
The nut is loose on the left anchor. I still rapped down from both but would not recommend this to anyone! The anchors are mentioned above in the beta. The anchors atop the second pitch, 15 feet to left (I believe these are the anchors to one of the routes on the right of Sport Land) of the typical second pitch anchors.
By Jeff Welch
From: Denver, CO
Sep 3, 2009
rating: 5.8+ 5b 16 VI- 15 HVS 4c
Traddies have been driving past this crag and route for at least 50 years to get to Castle Rock, yet never bothered to do it. It was hardly cutting edge difficulty, even 50 years ago, so you can't use "too hard" as an excuse.
If it hadn't been bolted, it would probably remain undone, or at best, obscure. As it is, it's a fun, easy, well-protected multipitch climb that seems to get regular traffic. I doubt that would be the case if the bolts were removed.
I bet not a single person would have carried a rack up here if not for the "see how many bolts you can skip" challenge posed by the FA.
By tooTALLtim
From: Boulder, CO
Sep 16, 2009
rating: 5.8- 5b 16 VI- 14 VS 4c
|Buried Treasure was intentionally created as a sport route, to provide an easy multi-pitch clip-up for newer climbers (this is how we rationalize bolting cracks). In almost all places, it can also be protected with trad gear. If you prefer to place gear, bring your trad rack (nuts and cams up to 1") and see how many bolts you can skip. If you prefer to clip bolts, bring your quickdraws, no nuts needed.
By tooTALLtim
From: Boulder, CO
Sep 16, 2009
rating: 5.8- 5b 16 VI- 14 VS 4c
E Johnson: Birds get to fly because they have wings, fish get to live underwater because they have gills, and trad climbers get to climb cracks because they use equipment available since the late '70s that protect cracks without leaving a mark. If you want to climb cracks, learn to place gear in them. No one is making you climb cracks, go nuts on bolted slabs! Just skip the bolts, I mean cracks!
Just because the rock can be bolted doesn't mean it should be. Placing a nut in a crack and removing it when you're done should preclude drilling a hole in the rock and pounding some metal into it.
Jeff Welch: I carried a light trad rack up the 5 minute approach because I heard they over-bolted the place and wanted to skip the bolts, yes.
By Jason Wells
Oct 21, 2009
Yo admins, why were my comments about this climb removed?! The Cascade Creek discussion prompted me to look back at some of the prior comments I made after doing most of the Tonnere Tower climbs, but they are all gone! I simply don't understand, are only glowing reviews of this climb acceptable?
FWIW, I climbed this specific route and found that the overwhelming number of bolts, especially those on the third pitch next to the crack in the corner, to greatly detract from the climb and the overall experience of the wall. It could have been a great route.
By CJ Coccia
From: Denver, CO
May 21, 2010
|Did the Buried Alive extension and continued on the third pitch...seems like it would be good to carry some longer runners as I experienced a lot of rope friction leading up.
By Michael Kopinsky
Aug 27, 2010
With the Buried Alive linkup, this was awesome.
As a new leader who has yet to place a single trad piece, I appreciate that this is bolted. Thanks to the FAs.
By Phil Lauffen
From: The Bubble
Aug 29, 2010
rating: 5.8 5b 16 VI- 15 HVS 4c
I can see where you'd place gear.... But I think some of the bolts are "necessary" near the top of the first pitch. The bolts are there, it would be stupid to remove them, live and let live. This place saw no attention before Ron O, Bob D and crew so they should develop it how they saw fit. What used to be an overgrown, mossy POS crag now sees 20+ climbers on a sunday afternoon.
Overall, it is pretty overrated. 5.9?!?
By topher
Jul 5, 2011
|Climbed "Buried Alive" variation and while this link up could go on gear it was a great line and sometimes clippin' bolts is fun.
By Bill Olszewski
From: Colorado Springs, CO
Oct 8, 2011
rating: 5.8 5b 16 VI- 15 HVS 4c
|Fun route! I felt it was no harder than 5.8, and no more than 5.9 on the direct variations.
By Rob Davies UK
From: Cheshire, UK
Oct 14, 2011
rating: 5.8+ 5b 16 VI- 15 HVS 4c
|Good climbing, nice positions, but would be better had it been done as a trad climb
By L G
From: Boulder, CO
Oct 27, 2011
|Great route with some interesting variety and expansive views. The bolts near the bottom felt a little widely spaced for my tastes. I was glad the route didn't require dragging up trad gear, giving it a more modern feel than some of the "mixed" routes in the Canyon. This area would be relegated to an obscure footnote in an aging guidebook without the bolting effort. Instead, parties were lined up waiting to play on clearly popular routes -- good work!
By dseltzer
From: Boulder, CO
Nov 1, 2011
rating: 5.9 5c 17 VI 17 HVS 5a
|Good route. First pitch is a solid 5.9 with the second quite a bit easier. A great first multi-pitch, or just a fun climb for the more experienced. I for one am glad that it's bolted. I took a less experienced friend on his first multi pitch, and was glad to be able to just climb a moderate sport route with him his first time. It's nice to have a few of these longer sport routes in the canyon to teach or just have fun on. Leave the bolts up!
By Rich F.
From: Colorado Springs, CO
Apr 21, 2012
rating: 5.8+ 5b 16 VI- 15 HVS 4c
|Fantastic climb -- especially when the 3rd pitch is added in the "Buried Alive" variation. This climb is worth doing again!
By Zack Wentz
From: Bishop, CA
Apr 23, 2012
Just climbed "Buried Treasure" this afternoon, and I must say this has got to be one of my all-time favorite climbs. It's been so hard finding quality, bolted, multi-pitch routes in the canyon. It really is "Buried Treasure," as finding a route this well-bolted with this much vertical climbing in such a bomber spot is really discovering something new.
That said, please don't retro-bolt or remove bolts from this route. I'm new to climbing, and I'm hoping to eventually become a trad leader doing multi-pitch climbing. The standard progression for a climber learning to lead trad is to lead sport routes before attempting to lead trad. We need routes like these still available for amateurs like myself to practice the belay transition, hauling, and top-belay systems that are crucial to know when doing a multi-pitch and/or big wall climb. The bolts aren't affecting where you place your trad gear, so please cut us a break and leave the route as it is. I'll promise to approach it in a year with my trad gear.
By JJR
From: Boulder, CO
Jun 12, 2012
Did the "Buried Alive" variation this afternoon. So awesome, highly recommended! The first pitch is a fun 5.8 with some cool moves (I'm a newer leader so if you're really experienced maybe not as fun). The second pitch is pretty short but has some neat exposure. The real fun is doing the last pitch of "Stayin' Alive", 5.10a. Just awesome... like I said I'm a newer leader, so this felt pretty exhilarating for me. Regardless, I think this route is well worth doing. Great views of Boulder Falls (had lots of tourists staring/pointing/taking pictures of us while climbing lol...) and great climbing. One complaint: if you don't have runners or slings, there is definitely some serious drag on that third pitch.
As to all the trad vs. bolts debate... sure this route could definitely be done on gear, but some people don't have a rack (myself included); someday I hope to lead trad and have a full rack and maybe I will come back and do this all on gear, but let's face it, this is Boulder Canyon... it's bolted out the wazoo... you wouldn't be preserving anything by taking the bolts off this unless you somehow took the bolts off the other 700 some odd sport routes in the canyon. (In other words... have pity on those of us not fortunate enough to have a full rack.)
By Andrew Locke
From: Louisville, CO
Jun 30, 2013
rating: 5.9- 5c 17 VI 16 HVS 4c
I lead this today, with the Buried Alive linkup, and enjoyed it quite a bit. I would definitely put the third pitch at 5.10a, and I think the first route goes at 8+, if only for the sequence right by the tree. There's a nice two/three finger pocket that makes it much easier, but without it, I can't see the pitch going lower than 8+.
To anyone doing the three pitch linkup, I would recommend anchoring on the two bolts at the top of Stayin' Alive's first pitch, rather than the bolts on Buried Treasure. There might be some drag up the second pitch, but this anchor is visible to the bottom belayer (the normal anchor is not), and the zig-zag out left to the first bolt only to move back right to the second bolt made for a pretty nasty fall when I took the wrong approach.
All that said, I really enjoyed the route. The crux on p3 (the finger crack dihedral section IMO) was fantastic!
By Elijah Flenner
Sep 21, 2014
|I combined the last pitch of Buried Treasure with the last pitch of Staying Alive, which resulted in much rope drag. However, this does make for a long and enjoyable pitch, just make sure you have several long runners and consider back cleaning or skipping some bolts.
By Ken Cangi
From: Eldorado Springs, CO
Oct 30, 2014
Buried Alive feels like the most natural line of pitches. Very fun three-pitch 5.9. Great intro for aspiring 5.9 leaders. Carry your approach shoes, as the walk-off is much easier and faster than rapping.
Pitch 1: (Buried Treasure) 5.8-
Pitch 2: (Buried Treasure) 5.6
Pitch 3: (Staying Alive crux) 5.9.


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TWELVE wickets fell on day one at New Road as Worcestershire were dismissed cheaply in their LV= County Championship Division Two home opener against Kent.
The County began their season with a useful rain-affected draw at Hampshire but were bowled out for 224 by Kent with Alexei Kervezee the only batsman to get past 50.
However, Worcestershire dismissed openers Sam Northeast and Rob Key after tea to leave the visitors on 39-2 in reply at the close of play.
Jack Shantry trapped Key lbw for 11 in the 11th over and then Shaaiq Choudhry rapped Northeast on the pads to leave Kent on 35-2.
They added four more runs but the momentum was with Worcestershire despite a difficult first innings when Daryl Mitchell (47) and Moeen Ali (41) were the only other batsmen to really contribute.
They won the toss and elected to bat but lost Matthew Pardoe for a duck as he was bowled lbw by former County overseas player Doug Bollinger.
Moeen rattled off 41 runs in just 37 balls, including a six off England team-mate James Tredwell that led to a replacement ball being needed.
He was then bowled by Darren Stevens and teenager Tom Kohler-Cadmore followed just two balls later lbw for a duck.
Kervezee put on 92 for the fourth wicket with Mitchell before he was caught by Tredwell off the bowling of Robbie Joseph and Mitchell also departed soon after.
The skipper nicked to wicketkeeper Sam Billings off Joseph to exit for 47 in a continuation of the good form that saw him register 172 not out in Hampshire last week.
Ben Cox was next to go for a four-ball duck and Ross Whiteley (12) followed, bowled by Bollinger, but not before he had hit Tredwell for a second six. This time, the ball was found.
Choudhry (15), Gareth Andrew (14) and Shantry (13 not out) all made useful contributions but the County will have wanted to score more on a glorious day.


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The State Department, facing an accelerated timeline imposed by Congress, has announced that it will deny the permit needed to build the Keystone XL tar sands pipeline.
Larry Schweiger, president and CEO of the National Wildlife Federation, said today in response to these media reports:
"Most politicians today buckle to the kind of threats made recently by oil lobbyists, but President Obama is doing the right thing by standing up for the families who are fighting to protect their clean water from the Keystone export pipeline.
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Building the Keystone XL tar sands pipeline would threaten America's clean water supplies, raise Midwest gas prices and result in a net loss to American jobs. TransCanada has already issued eminent domain threats against American landowners.
Oil and Gas Methane Pollution Report


text:
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While drivers of gasoline-powered cars are cringing every time they fill up, owners of Honda's Civic GX, a natural gas powered vehicle, are paying 35% - 50% less at the pump. With gas hitting $3 a gallon across California, natural gas, currently priced between $1.80 to $2.00 per gas gallon equivalent, is a clean-burning alternative fuel that is available at re-fueling stations throughout the state. Additionally, the availability of a new home refueling appliance, named Phill, now gives GX owners the opportunity to say goodbye forever to gas stations while further increasing their savings.
Honda is the only automaker currently retailing an all natural gas-powered passenger car in the U.S. market. Though Honda has marketed the Civic GX to fleet operators with their own fueling stations, the company believes there is a growing public demand for lower-cost, ultra-clean and convenient alternatives to gasoline-powered transportation. Honda has begun offering GX to its customers at select dealers.
California, home to 50% of all natural gas vehicles (NGVs) nationwide, has a substantial natural gas refueling infrastructure, with over 135 public fueling stations in its major metropolitan areas. This infrastructure continues to expand with new stations being planned and built. NGV owners can check on line to find stations, for instance, on a support site offering an interactive map of the state.
Although the MSRP for GX is higher than a similar gasoline-powered Civic, the Federal government currently offers a $2,000 tax deduction on the purchase of a new alternative fuel vehicle, and more incentives are planned. Another key incentive is that Honda's GX qualifies for California's High-Occupancy Vehicle (HOV) lane access for solo commuters. Local incentives and rebates may also be available to some consumers.
Recent concerns about America's energy independence have focused attention on the abundant supplies of domestically produced natural gas. Most Californians already have natural gas supplied to their residences. GX owners have the option of using their home natural gas supply line to fuel their cars overnight using Phill, a pay-phone sized that can be mounted on a garage wall or outdoors. Phill can be leased or purchased, and is installed by technicians from FuelMaker, the appliance's manufacturer. It offers simple "start" and "stop" buttons and will automatically turn itself off when the tank is full. Civic GX buyers can lease Phill through Honda dealers for approximately $34 to $79 per month (plus installation) depending on regional incentive programs.
The Civic GX sedan seats four passengers and has a driving range of between 200 and 220 miles. It shares the same platform with the Civic LX sedan and offers a similar array of safety and convenience features. The Civic Sedan has earned a 5-star frontal impact crash rating from the National Highway Transportation Safety Administration.
The U.S. Environmental Protection Agency has labeled the U.S.-made Honda Civic GX as "the cleanest internal combustion engine-powered vehicle ever tested." The American Council for an Energy-Efficient Economy (ACEEE) recently named the Civic GX as the "Greenest Vehicle of the Year" in overall environmental performance, ahead of even hybrid vehicles.
Natural gas powered vehicles are part of Honda's strategy to offer the best available technology for the reduction of air pollution, greenhouse gas emissions and petroleum dependence.
Natural gas, an abundant North American resource, is among the best alternatives for displacing petroleum on a near-term basis. Longer-term, the Civic GX and Phill can help to bridge the gap between gasoline and even cleaner, more efficient energy alternatives such as hydrogen-powered fuel cells.
Honda's extensive history of environmental leadership includes recognition as the "Greenest Automaker" by the Union of Concerned Scientists (UCS) in its 2005 ranking of corporate environmental performance with the lowest average emission levels and highest average fuel economy.
For more information or downloadable high-resolution images of the Civic GX and other Honda vehicles, please visit www.hondanews.com. Consumer information is available at www.hondacars.com. Additional resources for items mentioned in this release include www.cngvc.org, www.fuelmaker.com, www.epa.gov and www.aceee.org.


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Mets to stick with Laffey in Marcum's absence
NEW YORK -- Right-hander Shaun Marcum has resumed his throwing program in Port St. Lucie, Fla., according to Mets manager Terry Collins, but "he's not anywhere close to getting in a game."
Until Marcum does, left-hander Aaron Laffey will continue making rotation turns for the Mets. Laffey gave up 10 hits over 4 1/3 innings against the Marlins on Sunday, many of them on hard-hit balls. But Collins chalked that up mostly to the fact that Laffey had not pitched in nearly two weeks.
Lacking other options, the Mets plan to stick with Laffey for the foreseeable future.
"That's tough to answer," Collins said when asked how much rope Laffey would receive in the rotation. "He's going to be the guy until we figure out when Shaun's going to be back -- or if he's going to be back -- or where we stand. There's no number in mind of how many starts. It could be three, it could be seven. I don't know."
Laffey logged most of his big league innings last season as a starter with the Blue Jays, posting a 4.81 ERA in 16 opportunities (vs. a 3.07 mark in six appearances as a reliever). Among pitchers with at least 100 innings, his strikeout rate was fourth lowest in baseball.
One obvious alternative would be right-hander Collin McHugh, who struck out seven over 5 1/3 innings of one-hit ball last week in his Triple-A Las Vegas debut. But unless Laffey proves clearly unworthy of a rotation spot, the lefty will continue pitching out of the No. 5 spot.
Anthony DiComo is a reporter for MLB.com. Follow him on Twitter @AnthonyDicomo. This story was not subject to the approval of Major League Baseball or its clubs.


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Follow us on Facebook
This site has been created to introduce you to Greentree Naturals certified organic farm and offer some perspectives of ways we feel have helped us become more successful as a small acreage farming enterprise.
We have added a few updates. Check out our Summer 2017 Newsletter, On Farm Research page, About Organic Certification page, the new Planning the Garden CD, new CSA newsletters and the What's Happening on the Farm page for events. We've also added new information about Visiting the Farm at the bottom of this page.
Please visit us on our Greentree Naturals Facebook page for frequent updates.
On this page, we also have added a link to the video that PBS did on us last summer.
We are receiving frequent information requests that are asking us how to do what we do. While, on the one hand, we do not want to give away the hard earned knowledge that we have learned about being successful small acreage growers, we feel it is very important that more people are exploring the possibilities of becoming small acreage farmers. We believe that our experience has value. We are proud of what we do. We hold a passion for this land and the whole process of nurturing our gardens. This is the stewardship of the land that we hope to encourage others to accept.
The large farms across the country are slowly being lost to over-production and high land taxes. It is the small acreage organic farm that will be the wave of the future. Populations all over the world rely on local farms for fresh produce. In this country, most of the food we eat comes from many miles away and the connection between the farmer and the consumer has been lost. We hope to educate our communities of the importance of supporting the local small acreage farmers and market gardeners and encourage others to do the same.
It is our mission at Greentree Naturals is to provide fresh, nutritious, high-quality certified organic produce to our local community. We provide a place for organic gardening workshops; hands-on learning through agricultural related activities, and on-farm research. We are committed to forging partnerships with other farmers and educators, working together to create a more sustainable future for our community.
Our goal is to empower the next generation of small acreage farmers and eventually establish a 'demonstration farm'; a place where farmers and students of sustainable agriculture can meet and learn about organic gardening techniques and discuss technical and management issues. Our garden serves as a hands-on classroom during our workshops. We are committed to providing opportunities for all ages of people to get involved with organic food production. We hope to empower conscious eaters by connecting visitors with their local food system, while demonstrating how food gets from the field to your plate.
If you believe in what we are doing and would like to make a donation or become a sponsor for any of our projects, we welcome your charitable contributions. Your sponsorship and contributions help maintain the farm, gardens and animals, as well as support our school field trips, apprenticeship and mentorship programs, adult educational workshops, and more. Please support our work by making a donation.
Diane Green and husband, Thom Sadoski, operate Greentree Naturals, a small certified organic farm nestled between the Cabinet and Selkirk mountain ranges in rural northern Idaho. Diane and Thom produce a wide assortment of specialty produce, herbs, fresh & dried flowers, gourmet garlic, hops, and berries. Expanding from a farmer's market to supplying upscale restaurants, Greentree Naturals has also become a center for summer farm tours, workshops, on-farm research, a fresh flower subscription service as well as a small CSA (Community Supported Agriculture). Diane teaches on- farm workshops related to all aspects of sustainable organic production and market gardening and offer a consulting service of the same. (This page has a list of Seminars and Recent Projects.) They also have an active apprenticeship program for aspiring farmers. Diane has developed an accredited on-farm curriculum for students wanting to earn college credits and a successful farmer mentor training program for the Cultivating Success Program through University of Idaho.
This is a short video (approximately 8 minutes long) about Greentree Naturals, produced by KSPS Public Television, Northwest Profiles program out of Spokane, Washington 2012.
Marketing is a large part of the Greentree business. "We believe that diversity in our farming practices is every bit as important as diversity in our approach to marketing our crops." Diane and Thom have carved out a valuable niche by growing a wide range of unusual and hard-to-find produce and herbs. They grow 37 different kinds of salad greens, 60 culinary herbs, 15 varieties of squash, 8 kinds of peppers, 7 varieties of eggplant, and much more. Greentree carrots come in four different colors: orange, yellow, red and purple! They get top dollar for these unique crops that chefs can't get through the normal produce suppliers.
Cooperation has been another key to making their business work. During the season, we often purchase berries, fruit and other produce items that we do not grow to make them available for our customer base. Rather than try to grow everything, we support other local organic farms this way and are able to provide more variety for our CSA members.
From 1998 - 2006, Diane managed a local Growers' Collective, marketing several farmers' combined produce through the CSA, farmers' market and restaurants. "By ourselves, we couldn't meet the demands of the market, but by working together, we all are able to improve our sales," she says. "There's also safety in numbers. If one of the growers has a crop failure, we can count on one of the other farms to meet the order, so we don't lose a customer." Each farm in the Collective was at a different elevation, enabling them to extend the availability of crops through a longer growing season. The Collective worked together to provide the ability to fill larger orders. Though the growers market their products collectively, they don't do so anonymously. "We always let the buyers know that "these summer squash come from Wattcliff Farm, these onions come from Almost Eden Farm, and so on." Anytime we bring in produce from other farms, we make sure that our CSA members know where their food came from. This is an excellent model to work with and I am certain that we will do it again. For more details, visit the Growers Collective link.
Greentree Naturals is a working farm, which means quite simply, we are working. Please call ahead to find a mutually convenient time for your visit. We are willing to make an appointment for you to come out for a visit and encourage you to call or email to set a time and date that works around our farming schedule. We really love sharing the beauty of our place, it's just that every time we stop to show what we are doing, we are no longer moving forward with what has to be accomplished to generate income to survive.
Visitors are welcome, but on the understanding that they use the area at their own risk and they assume responsibility for injury, damage or loss to any individual or their property. We ask you, for everyone's safety and peace of mind, to respect and follow our procedures outlined below.
If you want to put on your grubby clothes and come out and help us work, we might be willing to let you have that experience (make an appointment). We might even consider hosting a private party on the farm for a fee and are willing to work with our local chef to make this personal affair an event everyone will remember forever! Otherwise, you might have a better chance of seeing the farm by attending one of the events listed on the What's Happening on the Farm page.
Your farm visit can be a wonderful opportunity for you to model the learning process with your children. Make sure your children are respectful of the farms rules. Be curious. Wonder aloud. Ask questions and listen carefully. Take in this new knowledge and go home more connected to the land.
Greentree Naturals
2003 Rapid Lightning Road Sandpoint Idaho 83864
General Information: firstname.lastname@example.com


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A group of local residents committed to bumping up Eureka's minimum wage handed in about 2,700 signatures to the city Thursday to have their cause approved by the City Council or put on the next election ballot.
The proposed Eureka Fair Wage Act, also known as the Minimum Wage Ordinance, would require employers within Eureka city limits to pay their employees at least $12 an hour. The initiative would exempt small businesses with 24 employees or fewer.
The city clerk accepted the signatures, and will have 30 working days to verify the signatures before the measure will go before the City Council for approval.
Eureka resident James Decker said he is one of the "Fair Wage Folks" working to circulate the petition since last summer, when the initiative was first filed with the city. Decker said it's important that all citizens are able to make a fair wage, especially in a city like Eureka, he said, where poverty levels are higher than the state average.
"In much of the volunteer work that I do, I am working with the disabled or the working poor," he said. "Often, they don't have a home because they can't afford the fair rent markets here. Because they are constantly broke, they often have bad credit. I am encountering these problems on an almost daily basis. It's a very difficult struggle for the poor."
In 2008, California minimum wage rose to $8 an hour, but many say that is still far from a living wage. A 2010 report by the California Budget Project said to provide a "modest standard of living" for a family of four in Humboldt County without the help of public services, both parents would have to earn just under $17 an hour. A modest standard of living, as explained in the report, accounts for basic expenses such as the cost of food, child care and other essentials needs to support a family. The report notes that this does not include extras like college savings, vacations or emergencies.
That same report said a single adult would need to earn $13.32 an hour to meet the same modest standard of living. The report assumes 40 hours worked per week and 52 weeks per year of work.
Humboldt County Economic Development Coordinator Jacqueline Debets said the minimum wage in California was intended to be a living wage when it was established, but hasn't kept pace with inflation and increased costs of living.
While Debets said she thinks the idea of raising minimum wage is a valuable conversation to have, and is one city officials should talk about, she said there would likely need to be some sort of economic analysis conducted before such a measure could be implemented.
"There is considerable debate as to what the economic impact of these kinds of measures actually is," she said.
Humboldt State University economics professor Steve Hackett agreed.
Hackett said the debate over the impacts of raising minimum wage is an unsettled area in economics literature.
"Progressives will argue that raising minimum wage will have minimal impacts on employment because the labor demand curve is steep," he said. "On the other hand, more conservative folks will say the labor demand curve is flatter, meaning a minimum wage increase could have considerable negative impacts."
The only real way to resolve the question, Hackett said, is with data. It can also be helpful, Hackett said, to look at how raising minimum wage impacts other cities, like San Francisco, which has the highest minimum wage in the nation after voters approved an ordinance tying minimum wage to the regional inflation rate. Since 2003, when the ordinance was passed, San Francisco's minimum wage has increased from $8.50 per hour up to $10.55 in 2013.
According to a Dec. 31, 2012 article published in the San Francisco Examiner, a University of Kentucky study showed "minimum wage laws like San Francisco's contribute to a lack of jobs for young workers."
The study detailed in the article concluded that "for each $1 increase in floor compensation, the unemployment rate among younger workers increases by 4.5 percent."
Eureka City Councilman Mike Newman said those are the types of findings that make him wary about increasing minimum wage in the city.
"Money doesn't grow on trees," Newman said. "Increasing minimum wage puts an unfair burden on our employers as well as raises prices for everything. While I appreciate that the economy is hard right now, this is something that has to be an across-the-board thing at either a state or local level. Otherwise it will just make it less desirable to do business in Eureka."
Eureka City Councilwoman Linda Atkins said she is split on the issue. Like Newman, she worries about being the only city with a minimum wage increase.
"It seems like not such a good idea," she said. "But I do also know raising the minimum wage can be a good thing for people who are working and for the economy of the area. It's tricky."
Atkins said she would prefer if the increase was countywide.
"Singling Eureka out, I'm just not sure about that," she said. "But I guess the people will decide for themselves if they want to vote for it."
Kaci Poor can be reached at 441-0504 or firstname.lastname@example.com


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Cascade Plaid Sheet Set
No longer available
- Overview
A relaxed plaid adds classic color and snooze-worthy comfort to your sleep-in space.
- 100% cotton.
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- Set includes flat sheet, fitted sheet and two standard pillowcases (one with twin XL).
- Twin XL sheeting has a longer fitted sheet to fit both standard twin and twin XL dorm mattresses.
- Extra pillowcases are available in sets of 2.
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- Shipping Info
This item will arrive in 3-5 business days. Please proceed to the Payment & Review page of Checkout for a precise delivery estimate.


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Texas-based radio host Alex Jones, of The Alex Jones Show, knows America's real problem isn't with more gays on television, but more gays in real life. Who's to blame? The government, of course: Jones says he's seen the documents proving the feds are engaged in a "chemical warfare operation … so that people don't have children." And how are they feeding distributing these nefarious nelly chemicals? By putting MSG in juice boxes! It makes dudes want to wear skirts and put on lipstick! Mr. Jones also happens to operate the websites Infowars.com and PrisonPlanet.com, which alternate between attacking Lady Gaga fans and pumping up gold prices. (Update: Appears this clip has been circulating for a few months.)
[via Gawker]
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Tagged: alex jones, conspiracy theories


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Founded in 2001 by PM Tenore, RVCA (pronounced roo-kuh) has emerged as a popular streetwear brand producing tees, pants, sweaters, outerwear, accessories, and more. RVCA is a design-driven lifestyle brand that draws influence from a variety of sources, such as action sports culture, music, and art. RVCA products are distinct for their versatility, and are an ideal choice for a night out or a day at the skate park. RVCA's designs are supplied by the RVCA Artist Network Program (ANP), which includes a diverse group of artists with the skills to inspire. RVCA prides itself for its ethical practices, and its supply chain follows the standards set by Social Accountability International in order to make sure its workforce is always treated fairly.
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NetWellness is a global, community service providing quality, unbiased health information from our partner university faculty. NetWellness is commercial-free and does not accept advertising.
Monday, September 25, 2017
Addiction and Substance Abuse
Hi this question is actually regarding my older brother. He is 25 [will be 26 in 2 months]. Well I know he`s had an alcohol problem for about 5 [maybe more] years now. He usually get`s these episodes where he gets the shakes and is afraid to drive. He also gets very ill, when he`s going through this someone always has to be with him, and he is afraid to be alone. I`ve read up on this and I also know this could be withdrawal symptoms from him just trying to quit `cold turkey`. He went to his primary care phsysician and she said that it could be `anxiety`. She also said the condition he has typically leads to alcoholism even suicide thoughts. He`s also been out of work on 2 different occasions. Last year was for 6 months, and since December, he`s been home. Honestly I dont think he has an `anxiety` problem, I just think its all of the alcohol he`s consumed, that and he`s lazy. He had problems with his liver and kidney, blood tests show that they`re both doing better [now that he`s been off of the alcohol]. But recently I suspect he`s starting to drink again, and when I suspected it, he was begging me to stay home from work because he didnt feel well. Could this genuinely be an anxiety problem leading to alcoholism, or can this really honestly all be related to the alcohol intake. Me and my mom used to go sneak in his room and clean under his bed on a weekly basis, usually finding about 80 liquor bottles, all hard liquor/no soda.
Your brother could have alcoholism alone or alcoholism with an anxiety disorder as well. To treat alcoholism, it is recommended that he do more than just stop drinking. Most treatment centers recommend that alcoholics go to AA and change their way of thinking and dealing with life. Just putting alcohol or drugs down does not change an alcoholic. In fact, they can become what is known as a dry drunk.
To decide if there is a separate anxiety disorder, I would recommend that he stay sober a few weeks and go to AA and then if problems persist or worsen, I would recommend that he see an addiction psychiatrist to sort it through. He could have both problems. Certainly withdrawal can lead to severe anxiety, but it should resolve within a few weeks to months after he quits drinking. There is a new medication called Campral that could help him also. He would need to talk to a physician to get it prescribed. Also, outpatient treatment for alcoholism would be a good choice as well.
For you there is Al-Anon to help you deal with how his alcoholism has affected you. You can find a local meeting by looking on the first page of your phonebook for the number for their office. AA is there also. Good luck. Thanks for the good question.
Edna M Jones, MD, MRO
Emeritus Clinical Assistant Professor of Family Medicine
College of Medicine
The Ohio State University