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|December 9, 2009
Volume 11, Issue 25
|Midwifery Today E-News
"International Issue"
Print Page
Welcome to Midwifery Today E-News !
Happy holidays from everyone at Midwifery Today!
Look for your next issue of Midwifery Today E-News on January 6, 2010.
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Midwifery Today Conferences
Plan now to attend our conference in Philadelphia, April 2010
You'll find classes for seasoned midwives, childbirth educators, doulas and activists, and for those aspiring or just beginning in the birth field. Come to the conference to expand your knowledge and your network and to renew and rejuvenate your heart. Planned teachers include Ina May Gaskin, Marsden Wagner, Michel Odent and Elizabeth Davis.
Learn more about the Philly 2010 conference and get a complete program.
Ina May Gaskin ~ Elizabeth Davis ~ Michel Odent
Learn about birth from these great teachers when you attend our conference in Strasbourg, France, September 29 - October 3, 2010. Planned classes include Prolonged Pregnancy, Prolonged Labor, Managing Hemorrhage, Posterior Position and Preventing and Managing Birth Complications at Home.
Learn more about the Strasbourg conference.
To receive a printed program by mail when it becomes available, please e-mail email@example.com with your name and postal address.
In This Week's Issue:
Quote of the Week
"You are a midwife. You are assisting at someone else's birth. Do good without show or fuss. Facilitate what is happening rather than what you think ought to be happening. If you must, take the lead. Lead so that the mother is helped, yet still free and in charge. When the babe is born the mother will rightly say, 'We did it ourselves.'"
— Lao Tzu, in Tao Te Ching
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The Art of Midwifery
This technique is called a "Piskacheck," after the Russian obstetrician who started using it. An important thing to note is that classical midwifery classifies labor into more steps than modern midwifery does. Classical midwifery divides second stage into two steps: descent and expulsion. Midwives in Russia understand that once a woman is 10 cm dilated that doesn't mean that she has to start pushing; they wait until the head is on the pelvic floor before encouraging women to push. This means that mother and baby don't get exhausted, and pushing only lasts for an average of 10 minutes.
The Piskacheck technique is an assessment tool to tell where the fetal presenting part is, in order to know in which part of second stage the labor is. The midwife usually uses a piece of cloth or drape and, holding it in her dominant hand, she presses it with her index and middle finger on the outer side of the labia majora. If something firm is felt through the labia, then the presenting part is low! If nothing is felt, then the patient is encouraged to rest and breathe until the baby is lower in the vagina.
— Sharon Craig, Kabul, Afghanistan
ALL BIRTH PRACTITIONERS: The techniques you've perfected over months and years of practice are valuable lessons for others to learn! Share them with E-News readers by sending them to email@example.com.
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Keep in touch with the international birth community!
Scientists at the University of Werzburg in Germany have discovered that parents' language patterns are evident in a baby's cries at even just a few days of age. Researchers analyzed the cries of 60 newborns (30 born to German-speaking parents and 30 to French-speaking parents), recorded when the babies were three to five days old. They found that the "melodies" of the babies' cries distinctly followed the patterns of each child's mother tongue, suggesting that babies begin picking up language patterns while in the womb (far earlier than previously thought).
The full report of this study was published in the November 5 issue of Current Biology.
— http://www.msnbc.msn.com/id/33656622/ns/health-kids_and_parenting/, Accessed 20 Nov 2009.
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Thesis Project: Administrating International Volunteer Programs
In my journey to become a midwife I had the privilege of working on a project that would increase the satisfaction of birth center administrators and volunteers at the Yayasan Bumi Sehat clinic in Bali, Indonesia. This was a rewarding experience for me but, more importantly, the program is now reporting much higher volunteer and paid staff satisfaction.
Like many students, I needed to fulfill the rest of my "primary under supervisions" in order to complete my schooling. In January of 2007, I traveled to Bali, Indonesia, to serve at the Yayasan Bumi Sehat clinic at the feet of Robin Lim. I learned so much about sisterhood and midwifery but also a great deal about myself during my time at the clinic. While there, I was a fairly typical volunteer: cocky, intense, serious, open; wanting to learn anything I could.
I did fulfill my education requirements during my time at the clinic. My time there was a great success. I returned home with a strong desire to help the clinic in any way that I could. As a student seeking a master's degree at the Midwives College of Utah, I also needed to do a thesis project or paper. I decided to blend my two desires and work on the volunteer program. The clinic functioned well before I went and would continue to do so without the project that I was to undertake. However, the volunteer program, or the portion of it that trained midwives, was suffering. Not the training, to be clear, that was fantastic and thorough. It was the logistical and organizational portion of the program that was lacking a level of administrative systems. I certainly got what I needed out of my time at the clinic, but I could see that there were great challenges for the staff and volunteers related to the functional aspects of the program. With the help of a few key participants I created, designed and implemented procedures of application and orientation, and instituted a set fee for services provided to student volunteers working at the clinic. Some of the areas that I addressed were cultural sensitivity, expectations of volunteers, procedures for arrival at the clinic and clear expectations of volunteers and staff. This program has benefited administrative staff, clinic staff and volunteers by including a clear application procedure, scheduling of volunteer shifts, clear expectations, etc.
While these procedures and forms were created initially to help the Yayasan Bumi Sehat clinic, I have made them available to birth centers worldwide for their use and implementation. They are available for download on my Web site at www.earthmothermidwife.com under the Thesis Project Forms tab. Please feel free to view and copy them for your use. In return I ask that you e-mail me at email@example.com with notification of your intent to use them, as well as the short- and long-term outcome of the implementation of the procedures or use of the forms at your clinic.
— Erin Kaspar-Frett, CPM, LM, MSM, CD
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Question of the Week
Q: I just read the article, "Questions about Prenatal Ultrasound and the Alarming Increase in Autism," by Caroline Rodgers, in Midwifery Today, Issue 80, Winter 2006. I have long felt that ultrasound is not as safe as the medical industry believes or states it to be. I am desperately looking for more current studies, information on changes in ultrasound practices or technology, and statistics on autism and other possible birth defects which may be caused by overuse of ultrasound.
I recently had a miscarriage and I think I may be pregnant again. Unfortunately, I had no menstrual period between the miscarriage and the new pregnancy, so it may be more difficult to determine a due date. Because of this and complications experienced in my last pregnancy, I am afraid that my doctor will be adamant about having ultrasounds, and I feel that I need the most current information available to hold to my determination to not endanger my baby.
Please let me know if there is any other well-documented information.
— Tami C.
Editor's Note: See the Midwifery Today article, "Ultrasound: Weighing the Propaganda Against the Facts," by Beverly Lawrence Beech.
SEND YOUR RESPONSE to email@example.com with "Question of the Week" in the subject line. Please indicate the topic of discussion *and the E-News issue number* in the message.
Question of the Week Responses
Q: How do you prevent postpartum hemorrhage?
— Midwifery Today E-News Staff
— Marlene, CPM
Q: (From E-News Issue 11:10) My 21-year-old daughter has been advised to have a LEEP (loop electrosurgical excision procedure) for moderate dysplasia due to HPV. I know this may leave scarring on the cervix or possibly pose a small risk of preterm labor when she becomes pregnant. My midwife said she would be put on a preterm labor protocol. What experiences have midwives had with this situation?
Have you seen cervical scarring or preterm labor after a LEEP? Does scarring lead to slower dilation or "stalls" in dilation? Does she have any alternatives for treatment other than the LEEP? What is your advice regarding pregnancy? Would this preclude her from using a midwife?
— Michelle
A: I've worked with lots of women who have had a LEEP and average birth experiences. When I was in a group practice, anytime any of us had ladies with LEEP we simply noted it on the "to know" list.
— Makeda Kamara, CNM, DEM
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.
Think about It
A clinic in the rural Santillana district, in the Ayacucho region of Peru, has attracted more women to using its birth facilities by taking the novel step of asking the community about traditional birth practices and for feedback on the clinic's performance. Very few local women were coming to the clinic for their births (despite high rates of childbirth-related deaths, due at least in part to birth helpers not having the means to treat complications such as hemorrhage or infection), and workers wanted to know why. Among the responses: workers did not speak the local language; husbands and relatives were not allowed in delivery rooms; women were forced to wear hospital gowns and to give birth lying down rather than squatting; workers threw away the women's placentas instead of giving them to the families to bury.
In response, members of the nongovernmental organization Health Unlimited worked with the local community to make changes in the way the clinic was run. Delivery rooms were set up to allow women to give birth in a squatting position, husbands and relatives were allowed to be present during labor and birth, and workers made sure that the local language was spoken.
The results? In 2007, 83 percent of births took place in the clinic (where women have access to life-saving medical supplies, along with workers trained in their use)—up from only six percent in 1999.
A full report on this project was published in the September 2009 issue of the Bulletin of the World Health Organization; the report can be viewed online at: www.who.int/bulletin/volumes/87/9/08-057794/en/index.html
— New York Times, 8 Sep 2009
Thanks for the flu issue [Midwifery Today E-News 11:22]. As a midwife whose phone is ringing off the hook to the pregnant daughter I am caring for, [receiving] good, clear, logical information is refreshing!
— Patricia Edmonds
Editors Note: The Midwifery Today E-News issue Patricia refers to contains excerpts from an article on the H1N1 virus and pregnancy. The full article can be found here: http://www.midwiferytoday.com/articles/preg_H1N1fluvirus.asp
Be sure to look for our brand new article on the same subject, with more information to share with clients, which will be up on our Web site within the next few days here: http://www.midwiferytoday.com/articles/preg_H1N1primer.asp
The Shanti Uganda Society improves the physical, emotional and spiritual well-being of communities impacted by poverty, HIV/AIDS and war in Uganda. Our programs include organic farming initiatives, income-generating initiatives for HIV-positive women, teen girls' groups, a birthkit project and the creation of safe and empowering birth spaces.
In December 2009, we begin building the Shanti Uganda Birth House and Learning Centre. In partnership with a natural building organization, the birth house is being built with and for the local community using local materials and is designed to honour the needs of women in the community. It will be a safe and empowering place for women to birth, supported by midwives, that is similar to a home environment. Design includes an outdoor garden compound and plans for an herb garden. We hope to be complete by Spring 2010.
How to Get Involved
If you are a midwife, doula, prenatal educator, homeopathic practitioner, herbalist or have other skills that you feel may benefit the work we do in Uganda, please contact us. Currently our volunteer midwives work in the labour ward at the local clinic we support. There are roughly 50 births a month at the clinic and it is staffed by local midwives and doctors, and has a room for c-sections. While the Shanti Uganda Birth House is being built, we will also be looking for volunteer midwives to help in the planning and training of local midwives and traditional birth attendants in the area. Once built, volunteers can work both at the clinic, which will be our transfer location, as well as at our eco-birth house.
Ways to Give
Sponsor A Midwife: Either for one month (http://www.shantiuganda.org/products/sponsor-a-midwife), or by joining together with the midwives and other birth practitioners you know to support a midwife for one year (http://www.shantiuganda.org/pages/workplace-giving).
Improve Maternal and Infant Health: Make a contribution towards reducing maternal and infant mortality rates in Luwero District, Uganda. Provide much-needed supplies at the Shanti Uganda Birth House, help educate midwives and traditional birth attendants and support prenatal education (http://www.shantiuganda.org/products/gifts-of-action).
Birthkits: The Shanti Uganda birthkits decrease the risk of infection and bleeding for both mother and baby. They are filled with the basic supplies a woman needs to have her baby with safety and health in mind and include a reusable fabric menstrual pad for the birthing mother to take home (http://www.shantiuganda.org/products/birth-kit).
Donate birth and midwifery supplies, prenatal education tools, receiving blankets, onesies, reusable menstrual pads: Mail to: 1900 Bowman Ave., Coquitlam, BC, V3J 6E3, Canada.
— Natalie Angell
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Midwifery Today: Each One Teach One!


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It is being said on the IS site that WRTV said JO COULD be out for the rest of the year....and then this article appears.
Though Jermaine O'Neal is eliglble to return from the injured list in two more games, there appears little possibility he'll be back that soon, which means the Pacers will have to continue the small-ball style that has produced two victories in the last three games, both on the road.
"We've had kind of like five different sets of players," said Coach Rick Carlisle. "We've had to make a lot of major adjustments in a short period of time on a lot of occasions but we're getting used to it. Our team has become very adaptable. Reggie (Miller) and Jack (Stephen Jackson) are going to be important guys for us as are all of our guys. It's a tough time because of our personnel situation but we've still got to find a way to win games."
O'Neal spent Wednesday and Thursday in Los Angeles having his sprained right shoulder examined further. Carlisle said he "may be out for awhile."
"There's no official word yet but I'm starting to be afraid that this is more serious than we had hoped," Carlisle said. "It's something that's got to come from the doctors. Hopefully we'll find out more tomorrow."
Jamaal Tinsley likewise is not much closer to a return. The point guard who missed all but three games in February has yet to play this month. He has participated in limited on-court work in practice.
"At some point, I do believe he'll be back this year but I don't think it's fair to him or right for me to guess on when that could be," Carlisle said. "I can tell you he's been making steady, gradual improvement and he has done some things on the floor, but he's not ready yet."
With their primary ball-handler and lone low-post scoring threat sidelined, the Pacers have once again been forced to alter their offensive system. The presence of Dale Davis, who has averaged 29.7 minutes and 9.0 rebounds in three starts at power forward since signing with the team last Friday, allows the defensive scheme to be largely unaltered.
In the last three games since O'Neal's injury, Jackson and Miller have combined to average 47.4 points per game. The starting point guards (Anthony Johnson in Utah, Fred Jones the previous two) have averaged 18.0 points. The old inside-out philosophy has been turned, well, inside-out.
"The thing that's making it easy to drift over to this new style is this is the way everybody grew up playing," Jackson said. ."Everybody grew up playing this pickup-type of small basketball because growing up playing you don't always have a big man; sometimes you'll have a 6-5 guy playing center. Everybody has played this style of ball and everybody's used to it so if we play together this style of ball can work."


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- Film by Mr Aaron Christian, Video Style Editor, MR PORTER
When photographer Mr Adam Brown founded Orlebar Brown in 2007, he introduced a whole new approach to men's swimwear with his carefully tailored trunks - or, as he calls them, "shorts that you can swim in, not just swim shorts".
Eschewing the drawstrings, elastic waistbands and baggy cuts which had all too often been associated with swimwear, Orlebar Brown shorts are flattering, simple and stylish. And what's more, thanks to their tailored construction, they're smart enough to wear to lunch or to the pool bar with a shirt or T-shirt on top.
These days high-profile fans of the label include Messrs Ryan Reynolds, Hugh Jackman and Jay-Z, and although the range has expanded to include clothing and beach accessories (the towelling polo shirts are great to throw on after a swim), it's the shorts that stay at the core of what the brand does.
Whether you opt for the mid-length Bulldog fit or the shorter, retro-inspired Springer and Setter shapes, a pair of Orlebar Browns are a MR PORTER holiday essential. Watch the video, above, to find out more about the brand.


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Hurricane Maria will approach the Mid-Atlantic coast early this week then finally shove eastward into the open Atlantic. Maria will likely not make landfall but will come close to portions of North Carolina midweek and could bring tropical storm force winds, locally heavy rain, storm surge, and very rough surf. Maria will create hazardous surf and rip currents for much of the East Coast this week. Read More >
Last Map Update: Tue, Sep. 26, 2017 at 4:52:24 pm CDT


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BLACKBURN-based street furniture designer Woodscape has secured a £950,000 finance facility to support its continued expansion.
The firm has won several key contracts, including with supermarket giant Tesco and the Queen Elizabeth Olympic Park, and the finance package with HSBC would allow it to 'generate working capital from its order book to facilitate continued growth'.
Managing director Richard Nelson said: "We have experienced strong growth and forecast more of the same this year, so we needed a finance package that meant that growth wouldn't put too much strain on our working capital."
HSBC Lancashire area commercial director Jason Gledhill added: "I'm pleased to welcome Woodscape as an HSBC customer.
"The company has won some major contracts over the past 18 months, so is clearly impressing people with its ability to make interesting and appealing street furniture.
"We have been impressed by the management team and its strategy, and are delighted to support its growth."


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NEW YORK ( TheStreet) -- U.S. stock futures were suggesting a flat open for Wall Street on Thursday as U.S. lawmakers trying to reach an agreement on how to avert the so-called fiscal cliff appeared at an impasse. European shares were lower while Asian stocks ended Thursday's session mixed. Japan's Nikkei 225 index fell 1.2% to close at 10,039.33. The White House on Wednesday threatened to veto House Speaker John Boehner's alternative tax plan as the Jan. 1 fiscal-cliff deadline nears. Boehner has said Republicans in the House may vote Thursday on his "Plan B" bill.
The economic calendar in the U.S. Thursday includes the third and final estimate gross domestic product estimate from the Commerce Department at 8.30 a.m. EST, and the Labor Department's weekly jobless claims report, also at 8:30 a.m.
U.S. stocks on Wednesday fell for the first time this week as politicians wrangled over the "fiscal cliff" deal in Washington. The Dow Jones Industrial Average declined 99 points, or 0.74%, to 13,252 on Wednesday.
NYSE Euronext ( NYX), the operator of the New York Stock Exchange, is in talks to sell itself to rival IntercontinentalExchange ( ICE), according to reports. People close to the discussions told The Wall Street Journal an announcement could come as early as Thursday. Under a deal, ICE would value NYSE at $33 a share, a 37% premium to its closing price on Wednesday, according to a report from CNBC.
Research In Motion ( RIMM), the BlackBerry maker, is expected by analysts on Thursday to post a fiscal third-quarter loss of 35 cents a share. RIM, which has steadily been losing market share in the U.S., is banking on reversing its fortunes with BlackBerry 10, the new operating system that will be unveiled at the end of next month.
Earnings are also being reported Thursday from the likes of ConAgra Foods ( CAG), Nike ( NKE) and Discover Financial Services ( DFS).
An experimental therapy from Amicus Therapeutics ( FOLD) and GlaxoSmithKline ( GSK) failed to improve kidney response in Fabry disease patients compared to placebo in a late-stage study, the companies disclosed late Wednesday.
Bed Bath & Beyond ( BBBY) on Wednesday issued forecasts for the fourth quarter and fiscal year that were below analysts' views.
Stephen Gillett, president of Best Buy's ( BBY) digital business, is joining Symantec ( SYMC) as chief operating officer. -- Written by Joseph Woelfel >To contact the writer of this article, click here: Joseph Woelfel >To submit a news tip, send an email to: email@example.com.
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I have a question for you blake. Since I found your disc review page and read all your articles its been obvious you not only know flight mechanics very well, but also the mechanics of the throw.
My question is simple, if I or anyone else looking for help, a critical critique or just your opinion; would you watch videos of us throwing and let us know what you think?
Im asking because most the more experienced guys I play with dont have anything to say about my form when I ask. Most these guys are older and it seems that all they see is my disc goes further than theirs and they dont have much to say, and for the guys who do throw further dont have much to say either.


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Alexandra House will host the 10th annual Hope Gala Saturday, March 2, 6 p.m., at the Tournament Players Club in Blaine.
Tickets are priced at $125 per person and are available online at www.alexandrahouse.org. Proceeds from the gala support Alexandra House's comprehensive services for survivors of domestic and sexual violence.
The evening's program will focus on Alexandra House's youth services. Each year, Alexandra House reaches hundreds of local middle and high school students through classroom presentations, "Choose Respect" programming, support groups, one-on-one advocacy and more.
The event will feature a keynote address from a former Alexandra House client, focused on the importance of youth services and violence prevention.
During the evening, guests will be entertained by the music of the Steve Blons Trio, and will enjoy a three-course meal with wine.
Before dinner, those in attendance can try their luck at the cork toss to win bottles of wine or sip a drink from the martini luge.
The gala's annual highlights include the live and silent auctions, featuring a lineup of luxury items, services and experiences.
The live auction will include a Napa vacation package with private wine tastings, Minnesota Vikings tickets and autographed memorabilia, a wild game dinner hosted by the Tournament Players Club and more.
For those unable to attend, an online auction will also take place in conjunction with the gala from Feb. 25 through March 5. More information is available at www.alexandrahouse.org.
New this year, Alexandra House will be raffling off a Mediterranean cruise for two (or $5,000 trip of the winner's choice). Raffle tickets are available to the public now and the winner need not be present at the gala to win.
Sponsors of the 2013 Hope Gala include Anchor Bank Family Foundation; Erck, Inc.; Nystrom & Associates; Connexus Energy; Bromley Printing; Corazzo Bookkeeping; Corrective Care Chiropractic; Minneapolis Regional Labor Federation; Minnesota School of Business; Northgate Liquors; Rasmussen College; Klein Bank; Dr. Randall and Janet Warren; and Ken and Jane Daniels.
An updated list of sponsors and auction donors can be viewed at www.alexandrahouse.org.
Alexandra House provides domestic violence and sexual violence services in Anoka County. Its free services include 24-hour emergency shelter, support services and advocacy to victims of domestic and sexual violence. The agency is located in the cities of Blaine and Anoka, but serves victims of domestic and sexual violence across the state of Minnesota.


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Sodium Bicarbonate in Cardiopulmonary Resuscitation (SB CAT)
Recruitment status was: Not yet recruiting
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Out-of-hospital cardiac arrests (OHCA) account for over 60% of deaths from coronary artery disease. The annual incidence of OHCA treated by Emergency Medical Systems (EMS) is 41-89 per 100,000 population. Outcome of OHCA and cardiopulmonary resuscitation (CPR) is very poor: Less than 1/3 of the victims regain spontaneous circulation (ROSC), 40-60% of those achieving ROSC suffer significant neurological disability due to brain hypoxia and only 1.7-6.4% are discharged from the hospital. In order to minimize hypoxia time, the primary goal of CPR is to achieve return of spontaneous circulation (ROSC) as fast as possible. Metabolic (lactic) acidosis develops rapidly during CA and is considered detrimental to CPR outcome. Sodium bicarbonate (SB), a generic, commonly used acid buffer, was subjected only to a single, small, prospective controlled trial that found a trend towards improved outcome in prolonged OHCA and CPR. Another study indicated that EMS's that used SB early and often during CPR had significantly higher ROSC rates and better long-term outcome compared with EMS's that used SB more seldom and administered it late in the course of CPR.
Aim of the Study:
To determine whether early administration of SB during OHCA and CPR improves short-term CPR outcome.
|Sudden Cardiac Arrest
|Drug: sodium bicarbonate
|Phase 4
|Study Type:
|Study Design:
|Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
|Official Title:
|Does the Early Use of Sodium Bicarbonate Improve Results of Cardiopulmonary Resuscitation Following Out-of-Hospital Cardiac Arrest - a Prospective, Controlled Clinical Trial
- Short-term survival [ Time Frame: at completion of CPR ]proportion of patients who achieve return of spontaneous circulation (ROSC) and proportion of patients admitted alive (not requiring CPR) to the hospital's emergency room
|Estimated Enrollment:
|Study Start Date:
|December 2011
|Estimated Study Completion Date:
|March 2014
|Estimated Primary Completion Date:
|December 2013 (Final data collection date for primary outcome measure)
|Assigned Interventions
Active Comparator: Sodium bicarbonate
1 mEq/kg sodium bicarbonate administered intravenously immediately following the administration of the first epinephrine dose during advanced CPR.
Drug: sodium bicarbonate
1 mEq/kg sodium bicarbonate administered intravenously immediately following the administration of the first epinephrine dose during advanced CPR. Dose may be repeated every 5-10 minutes up to 3 doses.
Note: The Placebo Arm receives 1 ml/Kg of 0.9% NaCl (in a blinded fashion).
Placebo Comparator: 0.9% NaCl
1 ml/kg of 0.9% NaCl (Blinded label)
Drug: sodium bicarbonate
1 mEq/kg sodium bicarbonate administered intravenously immediately following the administration of the first epinephrine dose during advanced CPR. Dose may be repeated every 5-10 minutes up to 3 doses.
Note: The Placebo Arm receives 1 ml/Kg of 0.9% NaCl (in a blinded fashion).
Detailed Description:
General: Prospective, randomized, double blinded, placebo-controlled clinical trial. Exception from Informed Consent, under the regulations for the conduction of research in emergency situations, has been approved by the Helsinki Committee of the Rambam Medical Center and by the Supreme Helsinki Committee of the Israeli Ministry of Health. Included will be adult patients who suffer an OHCA, who do not respond to basic CPR and to early defibrillation and in whom advanced CPR is initiated. 1st dose (1 mEq/Kg) of SB/placebo will be administered by Israeli Magen David Adom (MDA) advanced life support (ALS) teams immediately following the first IV epinephrine. SB/placebo vials or syringes will be masked and coded. Calculated sample size is 2130 patients. Study endpoints include only short-term outcome variables - rates of ROSC and of admission to the emergency room.
Expected results: Based on previous analysis we expect a 20% improved short-term outcome in the SB treated group. Sample size was calculated accordingly.
Importance: Around 2.2 million OHCA's are treated by EMS worldwide annually. Current ROSC rate is ca. 30%. A 20% better short-term outcome will result in over 130,000 additional patients regaining spontaneous circulation annually.
Probable implications to Medicine: The use of SB in CPR is controversial. Current International Guidelines for CPR present very reserved recommendations regarding SB use. Results of this study may have a direct impact on the Guidelines and on the conduction of CPR world-wide. Based on the results of this trial, a Phase II trial, researching the effects of early SB administration on long-term outcome (hospital discharge and final neurological outcome) may be warranted and conducted.
|Ages Eligible for Study:
|18 Years and older (Adult, Senior)
|Sexes Eligible for Study:
|Accepts Healthy Volunteers:
Inclusion Criteria:
- patients who suffer Out of hospital, non-traumatic cardiac arrest
- patients who do not respond to the initial resuscitation efforts (including basic CPR, defibrillation (when indicated) and other appropriate ACLS measures)
- patients in whom a vascular access (either an IV line or an intraosseous needle) has been obtained
- patients who have reached the "drugs" step in the ACLS algorithm.
Exclusion Criteria:
- Patients with known terminal illness
- Patients with a Do Not Resuscitate (or similar) order
- Cardiac arrest due to trauma, drug overdose or known intracranial disease
- Age less than 18 years
- Known pregnancy
- Patients in whom 30 minutes or more have passed from collapse to initiation of CPR
- If collapse time is unknown - patients with obvious death marks
- Patients with no vascular access (either an IV line or an intraosseous needle)
Please refer to this study by its ClinicalTrials.gov identifier: NCT01377337
|Contact: Gad Bar-Joseph, Prof.
|Contact: Rachel Gil, RN
|Rambam Medical Center
|Not yet recruiting
|Haifa, Israel, 31096
|Contact: Gad Bar-Joseph, Prof. firstname.lastname@example.com
|Magen David Adom
|Not yet recruiting
|Tel Aviv, Israel
|Contact: Zvi Figenberg, MD email@example.com
|Principal Investigator:
|Gad Bar-Joseph
|Rambam Health Care Campus
|Responsible Party:
|Rambam Health Care Campus
|ClinicalTrials.gov Identifier:
|NCT01377337 History of Changes
|Other Study ID Numbers:
|Study First Received:
|June 16, 2011
|Last Updated:
|November 6, 2011
Keywords provided by Rambam Health Care Campus:
cardiac arrest
cardiopulmonary resuscitation
(sodium) bicarbonate
return of spontaneous circulation
Additional relevant MeSH terms:
Heart Arrest
Out-of-Hospital Cardiac Arrest
Death, Sudden, Cardiac
Heart Diseases
Cardiovascular Diseases
Death, Sudden
Pathologic Processes
ClinicalTrials.gov processed this record on September 21, 2017


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'Top Chef: Just Desserts' Chris Hanmer to Open Pastry Shop in Sioux Falls
SIOUX FALLS – A pastry chef who gained national fame as a winner of the Bravo network's "Top Chef: Just Desserts" TV show plans to open a shop in South Dakota's largest city.
Chris Hanmer won the second season of the TV competition. His wife, Caryn, is from Sioux Falls. Hanmer tells the Argus Leader that they wanted to bring big-city sweets to the relatively small downtown this spring.
The shop will be called CH Patisserie, named for the initials Hanmer and his wife share with their 20-month-old daughter, Carys. The business will be on South Phillips Avenue.
Hanmer confirmed the store plans in an email to The Associated Press. The shop will sell desserts such as French macaroons, bonbons and cookies. It will also offer pastry classes.
Copyright 2013 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.


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Do you still have that nice little amphitheater by the river there?
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Do you still have that nice little amphitheater by the river there?
The best exercise of the human heart is reaching down and picking someone else up.
Pacers blowing a lead? Never!!
Looks to me like they still have a lead.
Tinsley went out and our lead is only 1 and it only took dallas 3:25 to accomplish that. Tinsleys play lately makes me not think we need a point guard but a backup point guard to come in and hold the lead while Tinsley can get some rest.
Now, to start the 4th, only up one, how do they handle this. This goes a long way to tell if this team can be any good this year, not just this game, but its been terrible so far.
I really hope its not Tinsley going one on 5. I don't care if her creates, but dribbling out the shot clock and jacking up bad shots isn't what we want.
Crossing my fingers.
knicks????????? fking screw the them! i dont pick teams because of where i live i pick them because of the players and who i liked when i was younger and i always liked the pacers since i was 8.. knicks are pathetic
Don't get down here fellas. Dallas is one of the best teams in the league and they made their run. The Pacers could very well make one of their own here.
Marquis with the goofy move.
Oh they have been ahead by one point all game? Could of sworn I saw them up by double digits earlier.
Its alright Smooth, sorry if I hurt your feelings.
Come on Danny take control, in a controlled way.
Danny with the layup!
I just don't trust this team. That is all.
Nowzitski and Murphy going at it. Dirk needs a T
OH MY, I don't thik Dirk wants any of that....
Super Bowl XLI Champions
2000 Eastern Conference Champions
Your right he should have got a T. Oh wait, they both got one. Dude Murph will give a hard foul too.
Are you mocking Lordhelmet?
Quinn...that is not a flagrant......check yourself before you speak lol.
Super Bowl XLI Champions
2000 Eastern Conference Champions
They are a mess right now.
Wowow - Avery got ejected!!
No Linking to your own site if it sells something.
Excellent!! WOOHOO!!!
That's what Quinn was wowing about then, it went to commercial.
Super Bowl XLI Champions
2000 Eastern Conference Champions


text:
sundara wrote:What does investigation of the Dhamma mean in the 2nd enlightenment factor?
[2] Any time one examines, investigates, & scrutinizes internal qualities with discernment, that is analysis of qualities as a factor for Awakening. And any time one examines, investigates, & scrutinizes external qualities with discernment, that too is analysis of qualities as a factor for Awakening. Thus this forms the definition of 'analysis of qualities as a factor for Awakening,' and it is in this manner that it is two.
sundara wrote:Is contemplating impermanence really obligatory, or can I just contemplate suffering?
sundara wrote:It's all very well but how is that going to resolve my predicament as a human being.
sundara wrote:What are the fruits of contemplating impermanence?
rowyourboat wrote:A Buddha is not required to say that everything is impermanent. Ask any man on the street. However a buddha is required to find a path through and beyond impermanence. This is where the meditative practices of vipassana/insight comes in.
sundara wrote:In the book "7 Contemplations of insight" it says a story about Venerable Channa when he was doing contemplation of impermanence he felt his self was going into a abyss, he became frightened, because he didn't discern conditions. He thought he was going to be annihilated. I don't know how to discern conditions.
sundara wrote:Apart from seeing the flowers decay, what other things in the 5 aggregates are beneficial to contemplate impermanence that can lead to calm?
Return to "General Theravāda Meditation"
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Hey there, time traveller!
This article was published 26/8/2013 (1491 days ago), so information in it may no longer be current.
The Rim fire is one of the largest blazes on record in California, a state known for frequent summer wildfires. Emergency crews continue to battle the Rim fire from dawn until dusk — and often beyond.


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BP Comment Quick Links
|Strength of Schedule Report
July 25, 2011
On the Beat
Cardinal Complications
The problems started early for the Cardinals, and they've never really ended. Right-hander Adam Wainwright, ace of the pitching staff, blew out his elbow during the early days of spring training and underwent season-ending Tommy John reconstruction surgery. Closer Ryan Franklin turned into a pumpkin on Opening Day, never regained his form and was eventually released in June, leading to a bullpen that is still somewhat in disarray.
Third baseman David Freese missed 53 games after undergoing surgery for a broken hand, left fielder Matt Holliday sat out 23 games because of an appendectomy and then a strained quadriceps, and first baseman Albert Pujols again showed he is not mortal by missing just 15 days after a suffering a broken wrist, an injury that normally causes someone to miss six weeks.
Yet the Cardinals are tied with the Pirates for first place in the National League Central, one percentage point ahead of the Brewers and three games in front of the Reds.
How have they done it? Second baseman Skip Schumaker gives much of the credit to manager Tony La Russa.
"We have a manager who has been through a lot in his career," Schumaker said. "He's kept positive through the whole thing. A lot of guys have stepped up, and a lot of young guys have come through. A lot of that comes back to the manager, because he is putting those guys in situations where they can succeed and gain confidence."
La Russa certainly has Hall of Fame credentials, as he ranks third all-time with 2,692 wins, 71 away from John McGraw, who is in second place. La Russa always seems to enjoy the challenge of managing the most when the odds seemed potentially stacked against him. Yet he believes the key has been the mental makeup of his players.
"It's a special group of guys, who, character-wise, are as good as it gets," La Russa said. "It's not just the injuries that we've had to overcome, but more than that. We'll lose a tough game and these guys will come back the next day and you can't even tell what had happened the day before. We've been in situations where we've lost a few games and could have fallen into a rut, but they are always the same, and they are always ready to play."
The Cardinals have had some young players step into voids, particularly rookie Fernando Salas at closer, who has a 3.21 FIP in 48 innings. Outfielders Allen Craig and Jon Jay have also played well, first when Holliday was injured and again now that center fielder Colby Rasmus has fallen out of favor. Craig, who has been out since June 8 with a broken kneecap, has a .337 True Average in 122 plate appearances and should come off the DL later this week. Jay has a .278 TAv in 275 PA.
Holliday is having a fine season with a .330 TAv, and left-hander Jaime Garcia (2.92 FIP) and right-handers Chris Carpenter (3.25) and Kyle Lohse (3.75) have all combined to cover for the absence of Wainwright.
Yet the biggest contributor has been right fielder Lance Berkman, who has a .356 TAv and 27 home runs. It was seen as a gamble when the Cardinals signed Berkman to a one-year, $7 million contract as a free agent last winter. He was not only coming off the worst season of his 13-year career—the 35-year-old had a combined 1.3 WARP for the Astros and Yankees—but he was being asked to play regularly in the outfield for the first time since 2004.
"You've got to give our general manager (John Mozeliak) a lot of credit because he did a good job of indentifying some of our weaknesses and addressing them, especially in the case of Lance," Schumaker said. "In my opinion, he has been the MVP of the National League Central."
"What he has done is make our lineup deep enough to where we can lose a guy here or there and still be competitive," La Russa said. "He's been great. He's been a real constant. He's driven in a lot of runs and played well defensively."
Berkman's surprising success has compensated for a down season—relatively speaking—by Pujols. The three-time NL MVP has a .304 TAv, 38 points below his career mark. However, Berkman has also been a presence off the field, something Mozeliak was banking on by signing him and shortstop Ryan Theriot to change a clubhouse mix that had gone stale.
"He's been one of our leaders, the guy who gets everyone together for dinners on the road and does the things that veterans should do," Schumaker said. "He speaks up when it's needed, but he really keeps things loose. He's a funny guy, but even more importantly, he's just a good guy, a really likeable guy."
Of course, Berkman would be even better-liked if he could help deliver a division title, though it looks like the Cardinals will have to beat three teams to win it.
"It could happen where somebody gets hot and can't do anything wrong and breaks it open, but I think it's going to be a tight division down to the end," La Russa said.
"People said the National League Central was going to be like this at the beginning of spring training, and so far that is how it's been," Schumaker said. "Milwaukee is not going away. Cincinnati is not going away, because it is the defending division champ. Pittsburgh is at the top for a reason. And I know we're not going away. We haven't let anything stop us so far this season, and we're going to keep on playing hard until the end and hopefully we're on top."
Rumors and Rumblings: The Brewers' trading might not end with Francisco Rodriguez, as they are also interested in Rays right-hander James Shields, who would join off-season acquisitions Zack Greinke and Shaun Marcum and Yovani Gallardo and veteran left-hander Randy Wolf in a potentially devastating rotation. The Rangers, Reds, and Tigers are also suitors for Shields… The Tigers also have interest in Dodgers right-hander Hiroki Kuroda, as do the Red Sox, Indians, Brewers, and Rangers… The Rays have put center fielder B.J. Upton on the trading block after calling up top prospect Desmond Jennings last Friday and will also listen to offers for designated hitter Johnny Damon, even though he wants to finish his career in Tampa Bay… The Padres are willing to move third baseman Chase Headley in the right deal… The Twins are trying to trade right-hander Kevin Slowey after activating him from the disabled list and optioning him to Triple-A Rochester… The Braves are looking for right-handed relief help… Owner Jeffrey Loria wants an experienced manager to lead his Marlins into their new ballpark next spring and hasn't ruled out bringing back 81-year-old interim skipper Jack McKeon… Angels coach Dino Ebel clocked rookie outfielder Mike Trout at 3.82 seconds from home to first recently, which is just about breaking the sound barrier for a right-handed batter.
Scouts' views:
Astros second baseman Jose Altuve: "I know it looks like the Astros rushed him to the big leagues, but I think he can hit major-league pitching right now. The biggest adjustment for him is going be on defense. He's going to need to adjust to the speed of the game."
Cubs shortstop Starlin Castro: "Mike Quade is harder on Castro than the rest of his players, but I think that's a good thing in this case. The kid has phenomenal talent, but he gets a little lazy and careless at times. If Quade can teach him to stay focused, it will at least be one of the few good things to come out of this season for the Cubs."
Royals right fielder Jeff Francoeur: "I think he would make a great pickup for any contender looking for a right-handed-hitting outfielder. He mashes lefties, he's holding his own against righties this year, and he's got a gun for an arm, so you can't run on him."
Orioles right-hander Alfredo Simon: "I'll give him credit for being able to block out distractions. Who knows what is going to happen with his court case in the Dominican [where Simon was accused of but not charged with shooting a distant cousin to death during a New Year's Eve celebration.] Yet he's been throwing the ball very well, and I see better mound presence from him than in the past."
Athletics catcher Kurt Suzuki: "He's the type of guy you love to have on your team. He's energetic and takes charge of that pitching staff. You can tell he loves to play. What worries me, though, is he is going to burn out early in his career. He hates to take days off, and all the wear and tear he's already put on his body is going to catch up with him as he gets older."
John Perrotto is an author of Baseball Prospectus.
10 comments have been left for this article.
BP Comment Quick Links
There's no way that the Brewers have enough farm system left to get Shields. None. The Rays aren't going to take a pittance for him, and the Crew still owes two minor leaguers to the Mets for K-Rod.
Jul 25, 2011 08:38 AM
I don't understand what the Rays are doing. Upton is only arb-eligible and Shields will only cost them $5M more than the buy-out in 2012. Maybe the 2011 wildcard is out of reach (6 games back), but they have as good a chance as amyone in 2012 with only $20M in 2012 payroll commitments (all $ from Cot's).
Jul 25, 2011 10:03 AM
I agree. No need to blow it all up unless they think they can get a ton of value for Shields right now. If you're a contender that needs SP you pony up big time prospects for that guy. The Reds would be a great match in terms of farm systems.
Jul 25, 2011 10:52 AM
My guess? The surprise of Cobb, the successful return of Niemann, the emergence of Moore --- it's given 'em an opportunity to see if someone wants to overpay for Shields. I doubt he goes anywhere and I doubt the Rays have ever been looking for mere fair-value for him.
Jul 25, 2011 10:52 AM
"The Braves are looking for right-handed relief help"
Jul 25, 2011 10:46 AM
As a Mets fan, don't worry about those two minor leaguers, they can be bottom of the barrell prospects and we're all good!
Jul 25, 2011 12:22 PM
Berkman has been a great surprise for everyone. I hope he gets some Comeback Player of the Year consideration as well as MVP votes.
Jul 25, 2011 12:32 PM
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Focus on planting tips, emergence issues and scouting for early season pests.
Planting Tips
A successful planting season means focusing on the details, including evaluating soil temperature, proper seed spacing and seed depth.
Instead of looking at temperatures at the start of planting, look at the weather forecast for 10 days following planting as this period can have the most impact. A cold rain following planting can be bad. Water temperature during initial contact with the seed is crucial. Hydration at or below 50 F likely will damage emergence and reduce stand. A cold spell after emergence is less likely to hurt stands. In addition, the growing point of corn will stay below ground for two to three weeks after emergence with normal planting temperatures.
In terms of proper seed spacing, research has shown that even plant spacing can increase yields. Poorly spaced and missing plants were found to decrease yields by 7 to 19 bushels per acre. Non-uniformity in corn stands places your sizable investment in a planter, seed and other inputs at risk of lower returns. Another way to improve in-row plant spacing is simply by slowing down the planter speed.
For seed depth, experts recommend planting corn at a depth of 1½ to 2 inches for optimal nodal root development, with 2 inches best under normal conditions and 1½ inches possibly more favorable when planting early into cool soils. Growers should never plant shallower than 1½ inches. Symptoms of irregular planting depth can include uneven emergence, non-uniform mesocotyl length and varying plant height.
Emergence Issues
Weather can have a huge impact on corn development and stand establishment.
A cold rain immediately after planting can be damaging to the crop. When the first water imbibed by a seed is too cold, imbibitional chilling injury can result. This is because cell membranes inside the seed lack elasticity, causing membranes to rupture and allow leakage of cell contents, providing a food source for invading pathogens. Large swings in soil temperature can have a similar effect on seedlings.
A spring frost also can decrease corn plant populations or force replant. Freezing temperatures can kill the growing point even if it is under the soil surface. While it can be difficult to wait after a frost, it is best to wait at least three days before attempting to assess the survival and health of the corn's growing point. Evaluating corn stands before three days can be very difficult, if not impossible.
As temperatures increase, the process needed for germination to proceed occurs at a faster rate, leading to more rapid emergence. Under ideal conditions, corn will emerge in 10 days or less. That said, these conditions can be influenced and slowed down by factors such as cooler soil conditions and heavy residue, which also can create cooler soils.
Scouting Your Fields
Once plants emerge in the field, it's never too soon for growers to start scouting their fields for pests. Following is a corn scouting calendar that provides an overview of the typical time periods specific pests emerge. Please note, this calendar may vary by region as well as by when planting occurred, especially with this year's early spring conditions in many areas.


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|September 3, 2003
Volume 5, Issue 18
|Midwifery Today E-News
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ALL BIRTH PRACTITIONERS: The techniques you've perfected over months and years of practice are valuable lessons for others to learn! Share them with E-News readers by sending them to email@example.com.
In This Week's Issue:
Quote of the Week
"Obstetricians are educated way beyond their intelligence."
— Unknown
The Art of Midwifery
Postpartum suturing: If I am really uncertain about what goes where, applying an icepack to reduce the perineal swelling helps greatly. Other helpful tips:
— Maggie Ramsey, Midwifery Today Forums
Are you enjoying your free copy of the Midwifery Today E-News?
News Flashes
An 18-year cohort study of 48,390 deliveries included 23% of women testing negative for herpes simplex virus, 49% testing positive for only HSV-1 (cold sores) antibodies, 11% with HSV-2 (genital herpes) antibodies, and 17% with both. The group with the highest transmission risk were those women whose blood showed no HSV antibodies (1 in 1900 cases). Women who have acquired HSV in the last trimester are most likely to shed HSV, and their infants are at highest risk from HSV. Women with previous HSV-2 showed 2 in 5,761 risk of transmission, showing that infants with specific antibodies for the virus have a reduced vulnerability rate. The study also showed that HSV transmission rate is highly influenced by delivery management—recognition of lesions, using preventative measures against exposure, maintaining infant's skin integrity during labor (e.g., avoiding use of fetal scalp electrodes). Transmission occurred less frequently among women with genital lesions than among those who were shedding virus into the birth canal, probably because the former was an indication for cesarean section. (University of Washington, www.washington.edu/newsroom/news/2003archive/01-03archive/k010703b.html)
Surgical Training Aids
Because you have better things to do with your money than pay for expensive training:
Ultrasound in Pregnancy
Ultrasound: high-frequency sound waves that travel at 10 to 20 million cycles per second. The pattern of echo waves creates a picture of tissue and bone.
In 1987, UK radiologist H.D. Meire, who had been performing pregnancy scans for 20 years, commented, "The casual observer might be forgiven for wondering why the medical profession is now involved in the wholesale examination of pregnant patients with machines emanating vastly different powers of energy which is not proven to be harmless to obtain information which is not proven to be of any clinical value by operators who are not certified as competent to perform the operations" (1).
Routine prenatal ultrasound (RPU) actually detects only between 17 and 85 percent of the 1 in 50 babies who have major abnormalities at birth (2,3).
RPU can identify a low-lying placenta (placenta previa). However, 19 of 20 women who have placenta previa detected on an early scan will be needlessly worried: the placenta will effectively move up without causing problems at the birth. Furthermore, detection of placenta previa by RPU has not been found to be safer than detection in labor (4).
The American College of Obstetricians has concluded that "in a population of women with low-risk pregnancies, neither a reduction in perinatal morbidity and mortality nor a lower rate of unnecessary interventions can be expected from routine diagnostic ultrasound. Thus ultrasound should be performed for specific indications in low-risk pregnancy (5).
Effects of ultrasound include cavitation, a process wherein the small pockets of gas that exist within mammalian tissue vibrate and then collapse. In this situation "...temperatures of many thousands of degrees Celsius in the gas create a wide range of chemical products, some of which are potentially toxic. These violent processes may be produced by microsecond pulses of the kind which are used in medical diagnosis." (American Institute of Ultrasound Medicine Bioeffects Report 1988). The significance of cavitation in human tissue is unknown.
Studies have suggested that these effects are of real concern in living tissues:
— Excerpted from "Ultrasound Scans: Cause for Concern,"
Excerpt references:
For the article in its entirety, MIDWIFERY TODAY ISSUE 64 may be ordered from Midwifery Today's website. Click here to order.
Products for Birth Professionals
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Thinking about becoming a midwife?
Web Site Update
Please check out this extensive article newly posted to the Midwifery Today Web site: "Why Homebirth?" by Jill Cohen
Forum Talk
I am curious about the scope of practice or legal implications for a CNM performing circumcisions. I didn't realize this was an aspect of training for nurse midwives. I have understood it is a surgical procedure. What is your understanding? The CNM I occasionally work with does these a few days following birth in the office. I was quite surprised to discover this.
— Penny
Go to our forums to share your thoughts and experience.
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Question of the Week
Q: We have a client who in her first birth had a retained placenta. Retrieving was complicated by a vagal response. She ended up needing to be transported, and the placenta was removed while she was under anesthesia. We are trying to collect data about incidence of repeat retained placentas and any suggestions for reducing its incidence. We are aware of the possible role of vitamin E, and she is minimizing her intake in this pregnancy.
SEND YOUR RESPONSE to email@example.com with "Question of the Week" in the subject line. Please indicate the topic of discussion *and the E-News issue number* in the message.
Question of the Week Responses
Q: Is it safe to use Epsom salts in the bathwater during labour and to remain in the same bathwater during the actual delivery (can it harm the baby or placenta)? I know Epsom salts are fantastic for relieving muscular pain, so would they reduce the action of the uterine muscles and prolong labour?
I am currently 34 weeks pregnant and experienced a 76-hour labour with my daughter, so I am looking for ways to relax and to hopefully prevent the same thing happening again. I am using a birth centre with midwives only attending me. I intend to use herbal teas and tinctures, essential oils, and visualisation.
— Caron Kambi
A: I am not knowledgeable regarding epsom salts and bath water, but I highly recommend the book "The Birth Book" by William Sears. I had a long hard labor with my first child and read this book in preparation for birthing my second child. As a result I was well prepared mentally, emotionally, and physically. My one encouragement for labor is to change positions frequently and walk as much as possible. Think upright and work with gravity!
— Danielle
A: I've never done a waterbirth using Epsom salts so I cannot comment on it. Apparently, salt water was tried in the early days of waterbirths and plain water was found to be preferable. I should think that plain water would be the best approach.
I recommend to my clients that they consider an Epsom salts bath in early labour to slow down uterine contractility (assuming the amniotic sac is intact). This is based on the theory that Epsom salts relax the muscles and the uterus, being a muscle, could respond to the relaxing effects of the magnesium sulphate that is in Epsom salts. Assuming this theory is true, then it would be advisable to avoid an Epsom salts bath in active labour or second stage as you want progress to occur.
The two things I have found helpful for reducing the length of labour are fish oil and hypnosis. There is quite a lot of research that shows hypnotherapy significantly reduces the length of labour. Fish oil is necessary for the baby's brain and eye development prior to the birth. Anecdotally, women in southern Ontario who consume fish and evening primrose oils throughout the pregnancy (4,000 mg daily) have faster labours, fewer stretch marks, and perineal tears because these oils allow for stretchiness of the cell wall throughout the body. Their babies also receive the critically important DHA that their developing brains need.
— Shawn Gallagher, BA, RM, C.CHt, clinical hypnotherapist, registered midwife
Editor's Note: Responses to any Question of the Week may be sent to E-News at any time. Write to email@example.com. Please indicate the topic of discussion *and the E-News issue number* in the subject line or in the message.
Exclusively on the BirthLove site: Gloria Lemay, celebrated midwife and teacher, is offering advanced online doula education. She covers a vast amount of topics that today's doulas and student midwives need to know: herpes simplex II, medical terminology, pediatric exam of the newborn, prenatal diagnostic tests, business and professionalism, pregnancy-induced hypertension, gestational diabetes and so much more. The course is free for all BirthLove members. Check it out! www.birthlove.com/glo_doula.html
Question of the Quarter for Midwifery Today Print Magazine
Question of the Quarter: What does "instinctive birth" mean to you? How do you facilitate it?
Our favorite responses will be published in Midwifery Today magazine, December 2003. E-mail your response to: email@example.com. Responses are subject to editing for space and style. Try to keep the word count under 400.
Question of the Quarter is a feature of Midwifery Today magazine, E-News's parent publication. Click here to subscribe today!
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Attend "Birth, Brain and Bonding: The Psychology and Science of Attachment."
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Register by 9/15 for discount: www.birthpsychology.com/congress/congress03.html Work/Study discounts available. Contact email@example.com or 707-887-2838.
I just read your article on breastfeeding herbs [Issue 5:17], and I was pleased to see it. However, in a article on galactagogues, I was surprised to see no mention of fenugreek. Also, although it isn't an herb, I think oatmeal would be a good mention in this regard. Otherwise keep up the good work.
— Larry McMahan
Beechwood Midwifery, a homebirth practice in Rutland, VT, is offering preceptorships for students desiring a midwifery education through National College of Midwifery. See www.beechwoodmidwifery.com and www.midwiferycollege.org for more info and/or call 802-786-0740.
EASIER BIRTHING WITH MEHER CLINIC—Meher Clinic has helped many Australian women with birthing over the last 10 years. We individually assess and prescribe Homeopathic remedies for pregnant women to give help in the later stages of pregnancy. Many midwives recommend our Birthing kit. For details see our web page: www.meherclinic.com/
Oregon Coastal Conference, September 26-28. Accommodations (yurts and meals) included in price. Visit www.globalmidwives.org or call 541-488-8254 for details. See you on the beach!
THE POCKET MIDWIFE affirmations for pregnancy. Unique gift, practice promotion item. 70pp tabletop format, midwife author. Elegant, empowering. $15 plus S/H. Quantity discounts. FREE SAMPLE AFFIRMATION: e-mail us, mention "EMT-8." email@example.com www.pocketmidwife.com
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Midwifery Today: Each One Teach One!


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Teams playing in Mountain View-Los Altos Girls Softball's summer travel program, Nova, recently capped a successful summer.
Four of the six Nova teams captured a championship this summer: the 8U and 12U B teams won their respective divisions at the ASA Bat Buster Tournament in Brentwood; the 10U C team claimed the NorCal Tournament championship in Sunnyvale; and the 10U B team took home top honors at the Incline Village Tournament in Lake Tahoe.
Nova squads placed in the top five at several tournaments: the 8U team took second at the Zebra Classic in San Jose; the 10U B team secured second at the ASA Bat Buster and third at NorCal; the 12U B team finished second at the Bagby Classic in San Jose and tied for fifth at NorCal; and the 14U C team took second at NorCal.
Due to their success at NorCal, the 10U C and 14U C teams qualified for the Western Regional Championships in San Diego, and the 10U B and the 12U B squads advanced to the ASA Western National Championships in Arizona. The 10U C team finished fifth out of 19 participants at the regional.
For more information on Nova, visit mvlags.org.


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3/21 Night
PD-1 was contacted by Glendora PD regarding assistance with
a parole search in the City of La Verne.
The suspect, who was on parole, had an outstanding warrant and was also
wanted for an earlier burglary from the Kohl's in Glendora. Glendora and La Verne ground units contained
the suspects residence prior to PD-1's arrival.
When PD-1 arrived on scene, ground units made announcements and cleared
the inside of the suspect's residence but no one was located. While ground units were checking the
residence PD-1 located a heat source with the FLIR, one property south of the
target location. The heat source was
coming from under a tree that was located on a sloped area between
properties. After PD-1 directed ground
units to the heat source, ground units detained and confirmed it was the
suspect that was wanted for an outstanding warrant and burglary.


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A DRUNKEN man challenged police officers to a fight before grabbing one around the throat and trying to pull him out of his car, it is alleged.
Police are appealing for witnesses to come forward to the alleged assault in Shipston shortly before midnight on Saturday, December 14, in which the officer who was attacked was forced to use CS spray to help subdue the man, who was arrested.
Two members of the Shipston Safer Neighbourhood Team were patrolling Shipston town centre when they turned into the Telegraph Street car park to speak to a group of youths.
Before they had chance to engage the youths, a man and a woman – who both appeared to have been drinking – approached the police car and the man became abusive and challenged one of the officers to fight him.
He is then alleged to have opened the passenger door and grabbed one of the officers around the throat and tried to pull him out of the car, while the officer was still strapped in.
A 22-year-old man was arrested on suspicion of assault was released on police bail. Police are now appealing for witnesses to the incident. Anyone who saw this incident or who has any information about it is asked to contact Warwickshire police by calling the non-emergency number 101 quoting incident 003 of 15 December 2013.
Alternatively information can be passed on anonymously through the independent charity Crimestoppers on 0800 555 111.
Warwickshire Police and West Mercia Police are also encouraging people to drink sensibly over the festive period through Operation Christmas Presence, in order to keep themselves safe and prevent alcohol-related violence.


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HMIS Data Quality Completeness Year-to-Date for FY2013
The Homeless Management Information System (HMIS) is a computer system with a collection of data with information about homelessness. It is the central repository for all in the Continuum of Care, including both programs and clients. The Fairfax-Falls Church Community Partnership to Prevent and End Homelessness partner agencies that provide services to homeless persons and others in need use the same computer system because it helps us do a better job of providing services to people in the community. Among many other uses, the information is used to plan and deliver services to clients, for statistical purposes and to meet federal reporting guidelines.
Report Card Grades for Providers
This chart displays the percentage of individual programs within HMIS who achieve a specific grade on their data quality in HMIS.
Year-to-Date Overall Quality
This chart displays the grade achieved across the entire Fairfax-Falls Church community continuum on the data quality in HMIS.
View Training Schedule and Latest Report Card.


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KATIE ROCHE Opens Tonight at the Mint Theater
Mint Theater (Jonathan Bank, Artistic Director) will extend the first-ever American Production of Katie Roche by Teresa Deevy until March 31st at their home (311 West 43rd Street). Opening Night is tonight, Monday, February 25th.
Katie Roche is the latest production of Mint's ambitious three-year project dedicated to the brilliant Teresa Deevy. Mint Theater Company has single-handedly put Deevy back onto the literary map with their acclaimed productions of Wife To James Whelan in 2010 and Temporal Powers in 2011. Katie Roche and the Deevy Project are supported in part by a $40,000 grant from the National Endowment for the Arts.
The title role is played by Wrenn Schmidt who currently appears as Julia Sagorsky opposite Jack Huston and Mark Borkowski in Season 3 of HBO's Emmy-nominated "Boardwalk Empire." Following Katie Roche, Wrenn will join Emmy Award-winner John Turturro in Henrik Ibsen's The Master Builder at Brooklyn Academy Of Music, directed by Andrei Belgrader.
Also featured in the cast of Katie Roche, directed by Mr. Bank, are Margaret Daly, Patrick Fitzgerald, Jon Fletcher, David Friedlander, Jamie Jackson, John O'Creagh, and Fiana Toibin.
"Masterpiece is a word to be used sparingly, but I have no hesitation in applying it to Miss Deevy's Katie Roche. Imagine a play in which the really eloquent and revealing things are the sentences The Players do not say; a play in which words become almost unimportant and situation everything; a play of fantastic irony, of vital convincing characters, of superb craftsmanship. That is Katie Roche." So said The Irish Independent in 1936.
Katie is a servant girl of uncertain parentage. She is wild with ambition and dreams of finding something great to do. Teresa Deevy's drama takes you on Katie's journey as she struggles to find herself and her destiny. Originally produced by Ireland's Abbey Theatre in 1936, Katie Roche was included in the Gollancz Anthology of "Famous Plays of 1936" ("even though it cannot yet be called famous," wrote the editor in a preface) along with Clifford Odets' Awake and Sing. The Abbey chose Katie Roche to kick off their US tour in 1937 and in 1938 it was produced in London.
Even those who praised the play most enthusiastically had difficulty describing it. The critic for the London Times acknowledged: "It is almost impossible to give an idea of the quality of this really fine play." The Independent critic had no hesitation in calling the play a "masterpiece," neither did he hesitate to "admit frankly that I do not appreciate it fully at the moment. It is a play to be read, to be studied, to be seen again and again."
Teresa Deevy was born in 1894 as the youngest of thirteen children in Waterford, Ireland. Though she intended to teach, Teresa contracted Meniere's disease while at University College Dublin and lost her hearing. She went to London to study lip-reading and the theater provided her an opportunity to practice-there she discovered her calling. Despite obvious obstacles and years of rejection, Teresa eventually became a celebrated playwright. She had six plays produced at Ireland's National Theater, the Abbey, between the years 1930 and 1936. It was Katie Roche that solidified her place as Ireland's most important female dramatist since Lady Gregory. A servant girl whose mercurial ambitions reach for the heavens, Deevy's remarkable heroine introduced a study of feminine power with unprecedented subtlety and depth.
"The Mint does for forgotten drama what the Encores! series does for musicals, on far more modest means" (The New York Times). The Mint was awarded an OBIE for "combining the excitement of discovery with the richness of tradition," and a special Drama Desk Award for "unearthing, presenting and preserving forgotten plays of merit." Ben Brantley, in The New York Times Arts & Leisure hailed the Mint as the "resurrectionist extraordinaire of forgotten plays." It was recently nominated for the prestigious Drama Desk Award for Outstanding Revival for A Little Journey.
Performances are Tuesday through Thursday at 7 PM, Friday at 8 PM, Saturday at 2 PM & 8 PM, and Sunday at 2 PM. Tickets are $55. Special added Matinee Wednesday March 20th at 2pm. There will be no performance on March 19th. All performances take place on the Third Floor of 311 West 43rd Street. Tickets are available by calling the Mint box office toll-free at 866-811-4111 or go to the Mint website, where you can also see video and more!