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|November 8, 2006
Volume 8, Issue 23
|Midwifery Today E-News
"The Perineum"
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"Just one birth that is treated as sacred can influence the life experience of one being."
— Robyn Sheldon
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The Art of Midwifery
My mom, who has successfully nursed 12 babies, says that vinegar and baking soda are the best treatment for thrush. Before and after each feeding, swab the baby's mouth with a solution of baking soda in water—just enough to make a very thin paste—and dab vinegar on your nipples. This remedy takes three days of very consistent treatment.
— Anon.
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Passionate Midwifery Education
My Midwifery Education: Marion McLean
I have told you something of my own Midwifery education (see blog). One our biggest blessings was to have Marion teach us a for whole year in a program modeled after Frontier Nursing Services' CNM program. She condensed the program, teaching us just the parts that were relevant to our homebirth practices. The curriculum was not very medicalized because this was 25 years ago. I am sure most curricula now are very different.
Besides teaching our didactic lessons Marion joined us in our practices. We already had very full practices of 3–5 homebirths per month. She would work one-on-one with us during prenatal and postpartum visits. She also went to births with us. This gave us a rare opportunity to learn midwifery more deeply. Marion also sweetly acknowledged that she had learned from us! I was amazed by the learning experience.
Shadowing and teaching within the practice is a good idea for all mentors, although I am sure that midwifery can be taught in many other unique and functional ways. In the UK some programs require students to do caseload midwifery.
I would really appreciate you sharing various models with me through this column. I have no special gift for midwifery education other than a burning desire to welcome new midwives into this beautiful calling.
I believe that the full year of intensive help within our practices was a time of intense learning geared to exactly what was going on there. We were still quite young midwives, having done only about a hundred births, but with total care. After this great learning experience we were able to practice with Marion for a few years. When I started Midwifery Today Marion joined us as a regular columnist and our mentoring relationship continues. She has been an incredible gift to many midwives in our community. I hope and pray every one of you finds a Marion on your journey.
— love, Jan
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The Perineum
Ironically, one of the biggest contributors to perineal tearing is episiotomy, which has long been heralded as the great preventer of tearing. One recent study, which only assessed the effects of episiotomy on third- and fourth-degree tearing, found a definite correlation between episiotomy and tearing. The risk of severe lacerations was found to be nearly four times higher with episiotomy than without. Another study involving thousands of women found that the number-one risk factor for perineal tearing was episiotomy. It really should not be surprising that, like cloth, cut perineal tissue tears easier than intact tissue.
There are some other independent risk factors for tearing, such as maternal age (older women giving birth for the first time are more likely to tear), birth weight and assisted vaginal delivery (e.g., forceps). Given the choice between the lesser of two evils, a vacuum-assisted delivery is statistically less likely to make a woman tear than a forceps delivery, although it is standard practice to perform an episiotomy with assisted hospital deliveries. Take note: there have even been studies where women having forceps deliveries were not cut and did not tear.
Interestingly, the presence of stretch marks has also proven to be a fair predictor of tearing. They most likely are correlated with poor skin elasticity in general. A woman's basic physiology also affects her likelihood of tearing. Women with a short perineum, when the anus is close to the vagina, are more likely to tear during delivery.
The position a woman assumes when giving birth may be the single most important contributor to avoiding perineal damage. The top three positions for preventing tearing seem to be hands-and-knees, kneeling and squatting. The supported squat, when someone supports the woman under her armpits, letting her "hang," is also a useful position. Michel Odent, MD, author of Birth Reborn, says, "A fetus ejection reflex is usually associated with a bending-forward posture. When a woman is bending, the mechanism of the opening of the vulva is different from what it is in other positions. The risk of dangerous tears is eliminated." The kneeling and hands-and-knees positions incorporate the bending forward posture Odent recommends—the knees are shoulder-width apart and there is an optimal force of gravity at work. Again, the feet should be straight and not pointing in or out. The use of birthing stools and the squat position are beneficial during labor but may use too much gravity to totally prevent tearing.
If, for some reason, a woman cannot be upright, then lying on her side is a better alternative than on her back. Whoever holds her knees should make sure they are about shoulder-width apart during delivery—no wider. Knees should be pointing forward, as the more knees point outward, the more closed the pelvic bones are. In a side-lying position, there is no justification for having someone yank the woman's upper leg up to her ear. Such an assault is uncomfortable and can cause damage to the perineum.
Hospitals that encourage semipropped positions are all but guaranteeing every new mother will be wounded in the process. The same is true for the most infamous of positions, the lithotomy, or flat-on-the-back in stirrups. Sadly, many medical studies report that the mother's position during second stage has little influence on perineal trauma. That is because the two positions they compare—flat-on-the-back and semipropped—are equally horrible for giving birth intact. The researchers then wrongly conclude that position during delivery is unimportant. Although it is more difficult to assume an upright position with an epidural, it is possible.
Avoiding an epidural is also helpful for preventing perineal damage. In one study, women with no anesthesia had the highest rate of intact perinea (34.1%), while women with epidurals had the highest episiotomy rate (65.2%). Another study shows that women who had an epidural were more than three times as likely to suffer third- or fourth-degree tears. Why would this be? For one thing, women with epidurals often end up getting cut because they don't have enough sensation to push the baby out. The effects of epidurals are notoriously variable, and even the best anesthesiologist in the world can't predict when delivery will occur, or how different women may be affected by the same dosage of medication. Furthermore, an epidural prevents the mother from assuming optimal positions during delivery. She is also denied the natural sensations of an urge to push and must rely on external sources to tell her when it is appropriate, instead of listening to the wisdom of her body. Not surprisingly, oxytocin (or Pitocin) also increases a woman's chances of serious tearing: 47% with Pitocin versus 29% of those without Pitocin tore deeply.
One Australian hospital recently rediscovered an age-old method of delivering babies. "As the birth commences, support the perineum, keep the fetal head flexed, have the mother push gently or pant, gently push the anterior vagina over the back of the baby's head, wait until the mother pushes the anterior shoulder into view and deliver the shoulders one at a time." Using this technique, which really is the optimal way to deliver babies, the hospital was able to reduce its episiotomy rate from 78% to 7%, a rate comparable to that at many birth centers.
Michel Odent believes in a woman's innate ability to give birth. He is an expert on what he calls the "fetus ejection reflex," or pushing phase of labor. According to Odent, pushing is triggered by the release of oxytocin, which is in turn affected by the woman's state of mind. He strongly advocates for a woman's privacy and support during labor and delivery. His famous clinic in Pithiviers, France, featured dim lighting, pillows instead of a bed and warm water for the laboring woman's comfort. The importance of waiting for the mother's urge to push cannot be overemphasized. "During the powerful and irresistible contractions of an automatic ejection reflex there is no room for voluntary movements." He further warns, "It does not occur if there is a birth attendant who behaves like a 'coach,' observer, helper, guide, or 'support person.'" In other words, just having someone there "with" the laboring woman is all that is desirable. Quietly allowing the mother to discover her own pushing instinct is ideal.
— Elizabeth Bruce, excerpted from "Everything You Need to Know to Prevent Perineal Tearing," Midwifery Today Issue 65
When it comes to the birth itself, it is important that women remain well-hydrated during labour to promote tissue elasticity. During second stage, women should be encouraged to push instinctively, rather than to hold their breath and actively push. Instinctive pushing allows for a gentler second stage and more time for the pelvic floor to stretch. Of course, it is then important not to implement arbitrary time limits on second stage. As for maternal position, I generally find that if women are given the space, they will instinctively find appropriate positions in which to give birth. Standing and squatting positions are useful for bringing the head down onto the perineum, but once the head is visible I like women to be "lower," on hands and knees, for example. This reduces the strain on the pelvic floor and encourages the head to be born slowly. In my experience, most women will do this anyway.
I use a hot compress on the perineum, as it seems that most women find this very soothing and it helps to give them the courage to birth their babies. I know that some midwives don't like to use hot compresses because they argue that the pain of stretching at this point is important in that it naturally helps slow the birth. I know of a few Swiss midwives who report great success with using compresses made with strong coffee. They say it helps the perineum become stretchier.
— Sue Brailey, excerpted from "Making Room for Babies," Midwifery Today Issue 65
Want the whole story? Midwifery Today
Issue 65 includes numerous articles about tear prevention:
Issue 65
Research to Remember
A study to determine if overweight women and obese women experience prolonged labor enrolled 612 nulliparous women with term pregnancies. The study adjusted for maternal height, labor induction, rupture of membranes, oxytocin use, epidural, maternal weight gain and fetal size. To assess labor progression, researchers determined a median duration of labor by each centimeter dilation for normal weight, overweight and obese women. The study revealed that duration of labor from 4 cm to 10 cm dilation for overweight women was 7.5 hours, with the slowest progress at 4 to 6 cm; for obese women, duration was 7.9 hours, with slowest progress before 7 cm; and for normal weight women, duration was 6.2 hours.
— Obstet Gynecol 104: 943–51.
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Has anyone ever tried liquid bandage as a tissue adhesive for perineal repair?
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Question of the Week
Q: I injured my coccyx during vaginal delivery. The delivery was fine, but I noticed the pain continued after the rest of me was healed. I had an x-ray done one month postpartum and there was no fracture. The pain still comes and goes, and the constant pain in my tailbone even limited my breastfeeding to one month because of the pain. That was a huge letdown for me, and it still hurts emotionally to think I could never get comfortable enough to bond with my baby.
This pain is a constant reminder of how hard my recovery was. Is there anything I can take other than anti-inflammatory medications for the rest of my life? Also are there any exercises and stretches I can do?
— Pam
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Question of the Week Responses
Q: How do you, a birth practitioner, act during a woman's third stage—the delivery of the placenta? What is your approach to/attitude about third stage?
— Midwifery Today E-News Editor
A: I think it is important for the midwife to take the lead from the mother, so my behaviour will depend on each situation. If for example, she wishes to have a physiological expulsion of the placenta, things are very easy for the midwife as you just have to sit and wait for nature to take its course. However, even if she has requested an oxytocic the midwife can still afford not to be too hasty about getting that placenta out and wait for signs of separation before using cord traction. Of course whatever option the woman chooses, she should be having skin-to-skin contact with her baby. The key thing to remember is to not be in too much of a rush—being too hasty with any aspect of birth can cause problems.
— Alison Andrews
A: Long before I even thought of becoming a midwife, when I was getting my formal doula training at Seattle Midwifery School, Suzy Myers (a great midwife!) gave an amazing lecture on third stage. She said that in many traditional cultures, when the baby is born, s/he is virtually ignored at first. All the cheering and excitement happen when the placenta is delivered and hemostasis is achieved, so it is clear that the mother will probably live. I have lived through the experience of having a 23-year-old with her first baby lose her uterus to save her life five days post-cesarean. And early in my midwifery training, I had a preceptor who had spent years at The Farm who had had it with postpartum hemorrhages after lovely births; she practiced active management of third stage (routine Pitocin with delivery of the anterior shoulder). I really understand how she feels, though I don't routinely do the active management myself.
Most clients have no concept of the potential dangers of third stage, and I don't see the point of scaring them during the prenatal period. But I have never forgotten Suzy's lecture, and have a huge sense of responsibility during third stage. I don't really relax until it is over, though I hope I appear to be happy, etc., to those who are present at the birth. I try to unobtrusively do my third stage job as quickly as Mother Nature allows so that I, too, can focus completely on the beautiful baby!
— Cynthia B. Flynn
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Think about It
Assuming their basic needs are met, givers who love to please others, without expecting anything in return, are generally happier than getters. And what's more, psychologists have found that they're also likely to live longer. When the giving is good, everyone is strengthened—the giver, the birthing woman and society. Giving all that we [midwives] can give, of our very selves, is rewarding, and more rewarding than earning tons of money. The most rewarding form of giving is when you can see that someone really needs your gift, when you see that you can make a huge difference to other people's lives, when you know that they can't do without you, when they feel fortunate that you are there for them and when you can feel their deep gratitude for your efforts. Because midwives love to give and are so good at giving, they aren't especially good at taking home good money. That's why discussing the business of midwifery is so important.
— Michele Klein, excerpted from "Profits and Rewards—Why Don't Midwives Earn High Salaries?" Midwifery Today Issue 79
Want the whole story? MIDWIFERY TODAY Back Issues are available online. Get Issue 79.
Thanks to Rayner Garner for his interesting observations about the role of fear in labor, and his technique for discharging adrenaline [Issue 8:17]. We know that high levels of adrenaline can slow labour by inhibiting oxytocin release. There are many reasons for anxiety in labor but one of the biggest, I believe, is that the labouring woman does not feel private, safe and unobserved in her labour. (Note "feel" is important; we don't all have to go and give birth in a cave).
These are the core requirements for birth in all mammals and make perfect sense if we remember that our "hard wiring" for birth comes from our hunter-gatherer foremothers giving birth in the wild. The presence of danger, or the merest suggestion of danger, would activate the laboring woman's fight-or-flight reflex, switch off her labour and divert blood away from her baby and to her major muscle groups for flight or fight. This reflex continues to be activated in modern women—e.g., moving from home to hospital. Human research has also linked high levels of adrenaline with adverse fetal heart rate (FHR) patterns, indicating a lack of blood and oxygen, and of course animal breeders know how important it is for the laboring female to feel private and safe in labor for a safe and easy birth (see my book Gentle Birth, Gentle Mothering for more about this).
So I certainly agree that discharging adrenaline would be a good idea in labor, but I would wonder if this would give an ongoing benefit if conditions for the mother were still not private, and if she felt unsafe at a primal level. It is also true that, late in a natural labor, the woman is usually less influenced by her environment, perhaps because of high levels of beta-endorphin putting her into "labor land." Perhaps this technique will get the laboring woman into that later stage. I would be very interested, as Rayner suggests, in hearing the experiences of midwives and women who have tried this in labor.
— Sarah J. Buckley, MD
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Midwifery Today: Each One Teach One!


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A 14 year-old boy has been arrested over an incident in Angle yesterday (Tuesday) which has left a 50 year-old woman with serious injuries after she fell 10ft onto rocks.
Dyfed-Powys Police is investigating the allegation of assault, which is said to have happened at about 6pm.
Police said the woman was walking a dog at a location known as 'Hall walk' when she was approached by a youth, who also had two dogs.
The incident resulted in the woman falling about 10ft to rocks below.
Police officers and ambulance crews were called to the scene, and the victim was airlifted to Withybush hospital with serious injuries, which are not believed to be life threatening.
A 14 year old boy has been arrested and is in custody.
Anyone who witnessed the incident or has any information which could assist is asked to contact Police in Haverfordwest on 101, or Crimestoppers anonymously on 0800 555111.
* A 14 year old boy has been charged with Section 18 assault and is due to appear before Llanelli Margistrates Court today (Thursday).

subset: commoncrawl


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When Brad Keselowski won his first Sprint Cup title, one of the most memorable moments was when Keselowski got a phone call from NFL star Ray Lewis.
Keselowski had talked about how Lewis, although controversial, had inspired him with his speech on the Madden '13 video game.
MORE: NASCAR-NFL connnections | Danica commercials | 2013 rivalries | Most Beautiful
So Keselowski will be rooting for Lewis' Baltimore Ravens on Sunday when the Ravens take on San Francisco in Super Bowl XLVII. But he's not sure the Ravens will pull it off.
"My heart is with the Ravens," Keselowski told the Detroit Free Press a day before he left for New Orleans to enjoy the weekend festivities. "But I think San Francisco is going to win."
The Super Bowl certainly has piqued the interest of many in the NASCAR world.
Kevin Harvick hopes Keselowski is right. A native of Bakersfield, Calif., Harvick is rooting for the 49ers and will be there thanks to sponsor Budweiser.
"I've been a lifelong 49ers fan — it hasn't always been pretty over the last several years but to be able to see them play now will make the day go a lot more exciting," Harvick said. "I'll have some 49ers gear on for sure."
Harvick tweeted a photo of a 49ers jersey he bought for avid Seahawks fan Kasey Kahne, whose team lost to San Francisco in the playoffs.
"I bought my friend Kasey Kahne a nice, new personalized 49ers jersey that he can wear, too," Harvick said.
The 49ers are a four-point favorite, and NASCAR star Denny Hamlin believes they will win. He tweeted to Micah Roberts of Sporting News' Linemakers:
"27- 24 San Fran. In a backdoor cover on the over. … San Fran leads early with a 27 17 lead and Balt scores late to turn everyone's world upside down."
Hamlin might know how to pick them but he can't be considered an expert next to his racing boss, team owner and NFL Hall of Fame coach Joe Gibbs.
"If I had to guess, to me, I think it's hard to stop San Francisco right now," Gibbs said. "That's a pretty awesome deal they've got going. But I wouldn't have guessed right (with the championship games) — I wouldn't have thought we'd wind up with these two teams in the Super Bowl."
Dale Earnhardt Jr. believes Baltimore might just have an edge.
"The Ravens seem to be on a course of destiny for some reason," Earnhardt said. "There are a lot of veterans on the team and they know what it takes.
"So going into that game, I think they'll be the best-prepared team but the 49ers have been able to overcome adversity early in games. I expect it to be pretty close."
So which team is Earnhardt rooting for?
"I'm excited about the two (Harbaugh) brothers coaching against each other — that's going to be a lot of fun seeing that drama play out," Earnhardt, an avid football fan, said. "The Ravens have come a long way. The 49ers are exciting. It's just hard to say.
"As the game plays itself out, I'll sort of gravitate to one team and it will be because of the way they play and the character of the team and their performance on the field. It's hard for me as a diehard Redskins fan to pull for anybody."
The fact that the Harbaugh brothers are facing each other is something that many NASCAR drivers are used to as they often have raced against family.
"The first thing that you would have to do is put it out of your mind that it is your brother and you're trying to outsmart him in a sense," said Kurt Busch, who has battled brother Kyle for several years on the Cup circuit.
"There is going to be one moment in the Super Bowl where the one brother is ahead of the other brother because he was able to put some of the emotions aside."


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Stilson, Jenkins give Blue Jays a future preview
BRADENTON, Fla. -- Right-handers John Stilson and Chad Jenkins are among those who have caught the eye of Blue Jays general manager Alex Anthopoulos during the first few weeks of Spring Training.
Neither pitcher is considered a frontrunner to break camp with the team, but they likely will enter the mix at some point this season. Jenkins already has some experience at the big league level under his belt, while Stilson is considered one of the club's top prospects, but has yet to make his debut.
"Stilson, he's been on the radar. He's a third-round pick, he's one of our better relief prospects; we like him a lot," Anthopoulos said when asked if there have been any surprises early in camp. "I think he's had a good camp so far.
"Chad Jenkins actually has pitched great. His velocity is up. Chad actually definitely looks like he's a cut above where he was a year ago at this time."
The other player to really stand out in Anthopoulos' eyes this spring has been outfielder Melky Cabrera. Toronto's left fielder had a tumor removed from his back last fall, and it appears to have been the cause of his lack of mobility. Cabrera has been moving well this spring and appears to be a different player now that he is finally healthy.
"It's night and day, I think, from what we saw last year," Anthopoulos said. "It makes sense. The doctors told us they were pretty confident that we would see a changed guy just because they were surprised he was even playing with what he had going on.
"It made sense that his legs were weak and he had a hard time getting around. He's certainly moving the way we expect, I expect to see a lot more extra-base hits and I think we're going [to see] the player we expected to see last year."
Gregor Chisholm is a reporter for MLB.com. Read his blog, North of the Border, and follow him on Twitter @gregorMLB. This story was not subject to the approval of Major League Baseball or its clubs.


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My Summerslam predictions
by, 08-14-2010 at 12:42 PM (3266 Views)
Ok so with WWE's Summerslam right around the corner I thought I'd post my predictions here for all you guys to see, and feel free to share your thoughts and your own predictions.
WWE Championship
Sheamus(c) vs. Randy Orton
My Prediction - Sheamus wins via pinfall
My Thoughts - In my opinion it would destroy Sheamus' momentum for the WWE to take the title off him now, I mean he's only had one Title defence and he won that thanks to the help off Nexus. So I see Sheamus holding onto the title until Hell In A cell, where I think The Miz will cash in his MITB and become the New WWE Champion.
World Title
Kane(c) vs. Rey Mysterio
My Predictions - Kane wins via pinfall
My thoughts - Kane has to have the win here, I think Kane will win and then continue to beat down Rey after the match which will lead to the lights going out and Undertaker appearing and slamming Kane into a casket.
7 on 6 Elimination match
Team WWE vs The Nexus
My Prediction - The Nexus via pinfall
My Thoughts - Now I am starting to think that I could be wrong with one of those picks because this means that every main event has a heel winning. But no matter what I think this match has to have The Nexus winning as I said in my earlier blog.
Perhaps a returning Daniel Bryan or HHH (Yes I know he's injured still) will fill out the last spot on Team WWE. If it is HHH then I feel he will be the person to turn heel and betray Team WWE, if it is Daniel Bryan then I feel that it will be Cena turning heel.
IC Title Match
Dolph Ziggler(c) vs. Kofi Kingston
My Prediction - Dolph Ziggler via pinfall
My thoughts - It would be way too quick for the WWE to take the title off Ziggler, and I personally want him to have a long reign because he really does deserve it.
Divas Title Match
Alicia Fox(c) vs. Melina
My Prediction - Melina via pinfall
My Thoughts - Alicia really has come out of her shell as of late but with Melina beack I think that the only sensible thing to do would be to put the title on Melina.
Handicap Match
SES vs Big Show
My Prediction - Big Show via Pinfall
My Thoughts - I think we are witnessing the end of the SES IMO, so I see a loss here for them and for CM Punk to then proceed onto greatness by himself while Joey, Luke and Serena remain together without Punk. This leaves Punk free to challenge for the World title and for Luke and Joey to challenge for the tag titles.


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May 22, 2006
'Life's Better Outside' for Texas Young People, Families
AUSTIN, Texas — The Texas Parks and Wildlife Department wants to lure you and your kids away from TV, computers, gaming consoles, traffic, and the urban rat race and get you into soul-satisfying natural settings where you'll relax and have fun.
The agency has partnered with a top ad firm to launch a new public awareness effort called Life's Better Outside. The idea grew out of the Education and Outreach Advisory Committee appointed by TPW Commission Chairman Joseph Fitzsimons. There's a lot of research showing this would be good for you and your kids. But like all great truths, the idea is self-evident in its simplicity.
"State parks and the great outdoors are healthy, fun, educational—these things are all true," said Lydia Saldaña TPWD communications director. "But research has also shown that the natural world is ideally conducive to provide something important that is missing for most modern families— the opportunity for quality time spent together."
The new public awareness initiative owes its spark in large part to GSD&M, the Austin-based advertising firm that created "Don't Mess With Texas," the anti-litter public education campaign that set the gold standard for such efforts years ago. In this case, GSD&M donated its services pro bono, seeing a cause worth supporting.
"We served on the advisory committee looking at this problem, went back and worked on it and came up with the tagline "life's better outside," donating our creative time and talent," said David Rockwood, GSD&M community relations director. "We're a Texas-based company with Texas roots, so this stuff is part of our DNA, you might say. We're trying to evoke childhood memories and encourage people to get outdoors more."
The Life's Better Outside print materials show a video game controller hanging from a string before a tree-lined river in a state park. The headline reads "Do whatever it takes to get your kids outside." A smaller subhead reads "Keep score by counting time spent together." Print ads will run this summer in Texas Monthly and Texas Parks & Wildlife magazines.
Radio public service announcements titled "Home on the Couch" and "Click the Remote" impart a similar message with a different approach, making entertaining parodies of well-known children's songs. The PSAs shipped this month to more than 150 Texas radio stations that expressed interest in airing the spots. Donated billboards will also go up this month in many Texas cities, including major urban areas. The timing is intended to engage families as they plan summer vacation activities
Some careful thought went into Life's Better Outside.
GSD&M did phone interviews with families, visited an urban Austin youth center, and held a mini focus group session with parents of young children. They asked several urban families to visit state parks and keep journals about their experiences. They also reviewed secondary research already done by national organizations, including the Outdoor Industry Association of America, Roper RSW, and the University of Michigan.
A key finding was that free time is fading away, with unstructured leisure time for families declining, not just among parents but, incredibly, among our youngest Americans. Among 3-to-12 year olds, discretionary time is down 12 percent and play time down 16 percent in the past two decades, while participation in structured hobbies such as organized sports is up 150 percent.
Not surprisingly, they also found parents wish they had more opportunities for things like uninterrupted family time, sleeping and relaxing, and getting away from home for fun and vacations.
In spite of these dreams, GSD&M found that modern families are creatures of the indoors for the most part, spending 50-to-80 percent of their waking hours outside work or school doing indoor things like video games and computer surfing.
"We've become way too captivated by appliances" said Robert, a parent from Houston.
"Inside it gets easy to be in your own little world by yourself" said Norah of Austin.
Some parents told researchers that time in the outdoors can make memories that stick with the family forever, the kinds of experiences they felt could not be had elsewhere. Some could vividly recount childhood stories of fishing or going on camping trips in state parks with family.
So what's stopping them?
GSD&M found that unfamiliarity breeds uncertainty. Parents who were less familiar with the outdoors worried about things like "What do we wear?" and "Do we need to bring a lot of gear?" and "Will the kids get bored?" They also thought that the closest state parks were three to five hours away. (In fact, every major urban area in Texas has a state park within an hours drive.)
Life's Better Outside aims to make it easier and more inviting for families to find new adventures and break from the everyday routine, enabling them to discover a depth of family connections that can be difficult to make indoors.
The lifesbetteroutside.org Web site is one way to make it easy for families who are less experienced enjoying the outdoors. The site offers links to Texas state parks, fishing, paddling, and maps showing state parks within 60 miles of Austin, Dallas, Fort Worth, Houston and San Antonio.
Toyota has signed as a corporate sponsor of the Life's Better Outside initiative, providing funding for paid advertising to reach urban parents in Texas. The department is seeking additional sponsors. For more information, contact Darcy Bontempo at email@example.com or at (512) 389-4574.
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B.S., 1990, University of Wisconsin, Madison
Ph.D., 1997, Washington University, St. Louis, MO
Email: firstname.lastname@example.com
Office: 252A SSB
Phone: 218-726-7681
Research Focus
The research in my laboratory uses zebrafish to uncover mechanisms that control development of the vertebrate nervous system. One of our goals is to understand how the neural tube is formed during development. The neural tube starts as a flat layer of cells that then folds or rolls to form the neural tube, the precursor to the brain and spinal cord. We have identified a new signaling pathway that is essential for neural tube closure, which may ultimately give insights into the causes of neural tube closure defects, such as spina bifida, in humans. Other projects in the laboratory include uncovering the role of the Alzheimer's Disease-associated protein Amyloid Precursor Protein in patterning the embryo, and identifying mechanisms that control the onset of circadian rhythms during development.
Visit the Zebrafish in the Classroom website.
Courses Taught
- Biology 2202 (Genetics Laboratory)
- Biology 3301 (Patterning the Embryo)
- Biology 3987 (Biology Seminar)
- Biology 4361 (Developmental Biology)
Recent Publications
- Liang, J. O. et al.. 2010. Zebrafish in the Classroom. Direct Website Submission (http://www.zfic.org).
- P. Joshi*, J. O. Liang*, K. DeMonte, J. Sullivan, S. W. Pimplikar. 2009. Amyloid precursor protein is involved in convergence extension movements during development in Zebrafish. Dev. Biol. 335:1-11. *co-first authors
- Sussman, C. R., J. Zhao, C. Plata, J. Lu, C. Daly, N. Angle, J. DiPiero, Z. M. Josephs, I. Drummond, J. O. Liang, W. F. Boron, M. F. Romero, M.-H. Chang. 2009. Cloning, localization and functional expression of the electrogenic Na+ bicarbonate cotransporter (NBCe1) from zebrafish. Am J Physiol Cell Physiol. 297:C865-75.
- Liang, J. O. and L. D. Hutson. 2009. Making an impact: zebrafish in education. Zebrafish, 6:119-20.
- Barresi, M. J., S. A. Farber, L. D. Hutson, D. R. Hyde, J. O. Liang, and J. K. Morris. 2008. Zebrafish in the Classroom: A Meeting Report. Zebrafish, 5: 205-208.
- Pierce, L. X., R. R. Noche, O. Ponomareva, C. Chang, J. O. Liang. 2008. Novel functions for Period 3 and Exo-rhodopsin in rhythmic transcription and melatonin biosynthesis within the zebrafish pineal organ. Brain Res., 1223:11-24.
- Aquilina-Beck, A., Q. Liu, K. Ilagan, J. O. Liang. 2007. Nodal signaling is required for closure of the anterior neural tube in zebrafish. BMC Dev. Biol. 7: 126. Listed as a "highly accessed" article.
- Pierce, L. X., D. Harrison, J. O. Liang. 2007. The Time Reaper 5-channel automatic liquid dispenser: a new tool for the study of embryonic and larval zebrafish. Zebrafish 4: 179-186.
- Nakamura, Y., G. Weidinger, J. O. Liang, A. Aquilina-Beck, K. Tamai, and M. L. Warman. 2007. Wnt inducible signaling protein 3 (Wisp3) modulates Wnt signaling in zebrafish. J. Clin. Inv., 117: 3075-3086.
- Plata, C., C. R. Sussman, A. Sinoic, J. O. Liang, D. B. Mount, Z. M. Josephs, M.-H. Chang, M. F. Romero. 2007. A novel electroneutral sodium monocaboxylate transport (SMCTn) is present in zebrafish: A comparison to the electrogenic SMCT (SMCTe/Slc5a8). J. Biol. Chem., 282: 11996-12009.


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Eau Cendree Cologne
By Jacomo for Men
Eau Cendree Cologne by Jacomo, A modern scent for men, eau cendree is ideal for those who enjoy being in nature . Introduced by the design house of jacomo in 1974, this masculine scent is perfect for the mature men. It combines the classic notes of bergamot, lavender, lemon, coriander and petigrain, and its lingering aroma will command attention and leave a lasting impression. The fragrance is ideal for everyday use, so spray it on in the mornings before heading to work or important business ... Read More ... Read More events. All products are original, authentic name brands. We do not sell knockoffs or imitations.
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Dr. Ian P. Hamilton
Professor, Chemistry and Biochemistry
Chair, Chemistry and Biochemistry
Contact InformationEmail: email@example.com
Phone: 519.884.0710 ext. 2669 | lab ext. 2347
Fax: 519.746.0677
Office Location: N3013B | Lab Location: SR422
Languages Spoken
Academic BackgroundBSc, PhD University of Toronto
BiographyMy academic career has been very rewarding. Following a PhD in theoretical/computational chemistry at the University of Toronto I was a Research Associate at the University of Chicago and a University Research Fellow at the University of Ottawa before joining the Chemistry Department at Wilfrid Laurier University where I am now Professor of Chemistry. I am also Adjunct Professor of Chemistry at the University of Waterloo. I have been a visiting scientist/professor at the Fields Institute in Toronto, the Agency for Industrial Science and Technology in Japan (where I was a STA fellow), the Centre of Theoretical Chemistry and Physics in New Zealand (with support from the Massey University International Visitor Research Fund), and the University of Toronto.
My research program is focused on several inter-related areas of theoretical and computational chemistry.


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Because of some truth and some exaggeration, the seed corn supply for 2013 planting has made the news. Reports have worried some farmers that there won't be enough quality seed for farmers to plant as many acres as they want.
In an article earlier in the week posted in this website news section, farmers were warned to make sure they had placed their seed orders for the best race horse hybrids and were taking early delivery of their seed so there aren't any supply situations at the last minute.
But seed availability naturally varies from company to company based on where the company had seed corn fields planted in 2012 and if Southern Hemisphere seed farms were used to grow additional seed.
A prime example of a company taking exception with quality corn seed being unavailable is Beck's Hybrids. "Even with an increase of more than 15 percent in corn orders (from farmers), Beck's Hybrids has an excellent supply of high performing corn and soybean products still available for Midwest farmers to purchase," the company responded.
"Last spring we planted twice the amount of seed we sold the previous year, across a wider geography and across a nine-week period, giving us an advantage in our overall seed supply," said Sonny Beck, president of Beck's Hybrids. "With this increase in production acres, the use of winter production, and seed in cold storage, we're able to have many of the best performing products available for Midwest farmers."
From 101 to 115 day, Beck's Hybrids has a wide range of high performing corn products available, including its number one selling product, which is a 112-day, refuge-in-the-bag product," the company further noted.
Beck's Hybrids is an independent family run seed company based out of Atlanta, Ind.


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Touching Base: A Message from the ChiefMarch 10, 2013
Dear Community Members and Department Personnel:
For your Information:
Free Gun Disposal Offered by the Pasadena Police Department: I would like to remind community members that they may dispose of unwanted firearms through the Pasadena Police Department. All types of firearms are accepted; pistols, rifles, shotguns, antiques or replicas, regardless of their condition. There are no costs associated with surrendering your firearm.
Community members can request a police officer to respond to their home or business in Pasadena, where they can surrender the weapon. Individuals may also transport the unloaded weapon to the Pasadena Police Department at 207 North Garfield Avenue, Pasadena. If you intend to transport the firearm into the police station, please contact the Pasadena Police Department beforehand at (626) 744-4241. The police operator will provide instruction on the safe and legal means for transportation. Gun registration or related paperwork is helpful, although not necessary to voluntarily surrender the firearm.
The police department also accepts unwanted ammunition; however, military ordinance requires special handling and will be evaluated for safe disposal by law enforcement personnel on a case by case basis. Removing unwanted firearms by turning them into law enforcement is an important step community members can take to ensure guns never end up in unintended hands and possibly used in a violent crime.
Save the Date:
On March 14, between 5:00 and 9:00 p.m., Pasadena Police employees will trade in their duty belts for aprons in support of the 9th Annual "Tip-A-Cop" to benefit Special Olympics. The event will take place at Hamburger Hamlet Restaurant, 214 South Lake Avenue. We encourage you to dine with us on March 14 and tip your favorite police officer. All tips will be donated to the Special Olympics; a global non-profit organization serving 20 million people with intellectual disabilities. For more information regarding this event, or to make a donation on behalf of Special Olympics Tip-A-Cop, please contact the Pasadena Police Department at (626) 744-7874 or (626) 744-3871.
The 7th Annual Norooz Celebration in Pasadena will occur on March 14, Scottish Rite Cathedral, 150 North Madison Avenue. The reception (6:15 to 7:00 p.m.) is followed by the program from 7:00 to 8:00 p.m. Special guests will include Mayor Bogaard and the keynote speaker, Professor Ali Nayeri. Traditional Persian Tea House will serve sweets and authentic appetizers. Although the event is free and open to the public, reservations are recommended. Please RSVP at firstname.lastname@example.com or (626) 583-9116 (Source: Dr. Nazee Rofagha).
On March 16, Harambee Ministries is celebrating 31 years of serving Northwest Pasadena. Their Annual Benefit will be held at the Church of Our Savior, 533 West Rose Road, San Gabriel. The theme for this year's event is "Shaping Hearts and Developing Minds." For more information, please contact Harambee Ministries at (626) 798-7431 or www.harambeeministries.org.
On March 30, El Centro de Accion Social is hosting its Annual Cesar Chavez Commemoration and Peace Walk. The peace walk will start at Villa-Parke Community Center (363 East Villa Street) inside the Auditorium at 10:00 a.m. Following a rally for peace, participants will march from Villa-Parke to Robinson Park, where a few community leaders will speak on reducing violence and creating peace. For more information, please contact El Centro de Accion Social Executive Director Randy Ertll, at (626) 792-3148, or firstname.lastname@example.com. For more information on El Centro de Accion Social, please visit www.elcentropasadena.org.
On April 13, 2013, Delta Sigma Theta Sorority, Inc., Pasadena Alumnae Chapter is hosting the 2013 Young African American Women's Conference at Pasadena City College, 1570 East Colorado Boulevard. The conference is from 8:00 a.m. to 3:00 p.m., and features diverse workshops, engaging presentations on educational choices, career options, embracing youth's uniqueness, as well as personal development. Dr. Rema Reynolds, Assistant Professor from Azusa Pacific University, will be the keynote speaker addressing students, parents, and others attending the conference. If you have questions, email firstname.lastname@example.com. To register, please visit online at http://yaawc2013.evenbrite.com.
On May 11, 2013, the Pasadena Youth Center (PYC) is sponsoring the 19th Annual Adelante Mujer Latina (AML) Conference at Pasadena City College from 9 a.m. to 3 p.m. The AML conference is an exciting and inspirational day-long career and educational conference attended by more than 1,500 young Latinas, ages 12 to 21, their mentors, and moms. The purpose of the AML Conference is to provide middle and high school Latinas with tools for personal and professional growth, challenge them to raise their expectations, promote leadership, encourage them to pursue post-high school education, achieve their goals, and have a positive impact on their lives and the lives of others. If you are interested in being a workshop presenter and sharing your personal success, please visit www.adelantemujerlatina.org. To learn more or sign up as a workshop presenter by March 9, 2013, visit http://pasadenayouthcenter.org/aml_conference/aml_presenters . Special thanks to PYC's Executive Director, Stella Murga, for her continued and dedicated service to Pasadena's youth.
Our Community:
On February 27, Commander John Perez and I met with the Pasadena Latino Coalition. We discussed several public safety issues including crime, education, and related topics. The meeting was well attended and the group asked some great follow-up questions.
On February 27, Pasadena Police Specialist Kathleen Johnson attended the first ever LVAA (Linda Vista/Allendale Association) Neighborhood Watch meeting. Approximately 20 neighbors attended the meeting, which was facilitated by Kathleen. Several topics were discussed including community safety and property crime. Diane Vallete coordinated the meeting and was pleased with the outcome. Kathleen is currently assigned to the department's Community Services Section.
On March 1, several Pasadena Police officers and employees participated in "Read Across America" in our local schools. The program is an annual reading motivation and awareness program sponsored by the National Education Association. It recognizes the books of Dr. Seuss and he ability of his books to inspire young readers. Many school invited adults in their communities to join and help read stories aloud to young students. In some school districts, including PUSD, the special program lasted all week. The Pasadena Police Department is a proud participant in "Read Across America" each year. This year readers included: PS Jennifer Godzsak, PS Hilda Jurado, Sergeant Bobby Lomeli, Officer Shannon Reese, Corporal Glenn Thompson, PS Sarah Presley, Officer Christian Allen, PS Karla Kauhola, Sergeant Marcia Taglioretti, Corporal Monica Cuellar, Commander John Perez, Lieutenant Diego Torres, Officer Van Kim, Officer Lynda Mercado, Officer Domino Scott, LSW Guillermo Vasquez, Officer Louie Luevano, Officer Richard Vindiola, Deputy Chief Darryl Qualls, and me. PS Hilda Jurado organized the department's participation.
On March 1, Police Lieutenant Jason Clawson, Officers Ralph Ordonez and Cristian Allen attended the Northwest Commission meeting. One of the commissioners presented the "Know Your Rights" video. Jason, Ralph, and Cristian participated in the discussion following the presentation.
On March 3, several community leaders, friends and family attended a community celebration honoring Walter Jackson for his 40 years of community service. The event was held at Robin's Wood Fire BBQ and was very well attended. Mayor Bill Bogaard, Fire Chief Calvin Wells, Robin Salzer, Betty McWilliams, and I had the opportunity to offer a few brief remarks about Walt and his community service. The event was organized by Former Police Lieutenant Phlunte Riddle and Former Commander Rick Law, Lieutenant Rodney Wallace (ret), and Lieutenant Jason Clawson attended as well.
On March 4, I had the opportunity to meet with community member Schoene Mathmood about Restorative Justice Strategies. Currently, Schoene collaborates with the Western Justice Center (WJC) in the effort to increase awareness about restorative justice with the long-term goal of expanding the program throughout Pasadena. The Pasadena Police Department's Youth Accountability Board (YAB) is a progressive program built on restorative justice philosophies diverting young offenders away from the criminal judicial system. The program is supported by the Pasadena Police Foundation and continues to be a valuable tool in the effort to engage community youth and prepare them for the future. For more information on the Youth Accountability Board, please visit www.pasadenapolicefoundation.org/youthaccountability and cityofpasadena.net/Police.
On March 5, Retired Santa Monica Fire Chief Jim Hone and I had the opportunity to lecture to a group of Long Beach Police and Fire personnel about the 2003 Santa Monica Farmer's Market Incident. The lecture was focused on "Mass Casualty Response," based on our personal experience at the farmer's market incident. The lecture was well received and all topics related to the event were discussed.
On March 9, several Pasadena Police officers, employees, and community members attended the "Thank you Joe Brown" celebration, which was held at the Rose Bowl. Mayor Bill Bogaard and other elected officials joined city staff and community leaders to honor Joe for his years of service as the Pasadena Branch NAACP President and community advocate. The event was well attended and every one celebrated Joe's great work in Pasadena. Pasadena Weekly Deputy Editor Andre Coleman was the emcee and Ms. Allisonne Crawford sang America (by Ray Charles).
VIPs included Mayor Bill Bogaard, City Manager Michael Beck, Councilwoman Jacque Robinson, NAACP Pasadena Branch President Gary Moody, Pastor John McCall, Fantasy Tours CEO Tom McMullins, Pastor Ed Bacon, Assembly member Chris Holden, Monrovia Mayor Mary Ann Lutz, Congressman Adam Schiff's Field Representative, Teresa Lamb-Simpson, Duarte Deputy City Mayor Karen Herrera, Del Yarbrough, Pastor Skinner, and ACLU Representatives. Robin Salzer, Larry Wilson, Mayor Bogaard and I "sang" a tribute to Joe.
On March 9, students from Pasadena Child Development Association, Inc. visited the Pasadena Police Department. About sixty young people toured the police building as they asked questions and interacted with staff. The tour was facilitated by Pasadena Police Officer Kim Baecker and PS Karla Kauhola. Sergeant Bobby Lomeli organized the tour. Kim serves as the department's Police Volunteer Coordinator and Karla is currently assigned to Community Services.
On March 8, Pasadena Police Lieutenants Cheryl Moody and Jason Clawson, Officer Domino Scott and Police Dispatcher Robin Evans attended the Pasadena Alliance of African American School Educators (PAAASE) Scholarship Fundraiser. The event was well attended and many of the participants were distinguished educators and community leaders. VIPs included PUSD Board President Renatta Cooper, NAACP Pasadena Branch President Gary Moody, and Human Services & Recreation Supervisor Jarvis Emerson. The funds raised will go toward the $1,000 scholarships awarded to six African American graduating seniors from PUSD.
Pasadena's Finest:
On March 7, several Pasadena Police officers, employees, volunteers, community members, and Pasadena Police retirees attended the Retirement Dinner and Celebration for Pasadena Police Lieutenant Rodney D. Wallace. Rodney served this great department and community for more than 34 years. The event was held at the Pasadena Convention Center and John Muir High School Alumni and Hall of Fame Recipient Cameron Turner served as the Master of Ceremonies. Ms. Allisonne Crawford thrilled the audience with her rendition of America the Beautiful.
For those readers who did not attend Rodney's retirement celebration or you did not have the opportunity to meet him, I thought you might like to read his biography:
Rodney D. Wallace was born in Montgomery, Alabama, the second oldest of six children born to Carl and Ernestine Wallace. The family moved and settled in the Los Angeles area in the late 1950s. Shortly after the riots of the mid 1960s, the family moved to the Altadena/Pasadena area where Rodney attended Eliot Junior High, John Muir High, Pasadena City College, and the American Academy of Dramatic Arts. While at PCC, Rodney and several others identified a pattern of institutional bias in the casting of several theatrical productions. This led them to create "The Black Dramatist," which performed throughout the City of Pasadena from 1973 to 1974.
Rodney was hired by the Pasadena Unified School District as a Counselor Aide at Madison Elementary School in 1974. He was instrumental in providing youth with alternatives to "anti-social behavior." It was during this time, he realized his calling to mentor and teach youth but he also began to feel the tug of Law Enforcement.
Rodney eventually yielded to that call and was hired by the Pasadena Police Department on October 5, 1978. He worked a variety of assignments but also played an integral role in creating and implementing programs that even today, strengthen police and community relationships; Drug Abuse Resistance Education (DARE), Summer Youth Leadership Conference, Junior Public Safety Academy, Police Activities League (PAL), and the Police Explorer Post, to name a few. He served as Vice President on the Board of Pasadena Police Officers Association (PPOA); is a founding member of the Pasadena Black Municipal Employees Association (PBMEA); sings in the Men's Choir at First AME Church in Pasadena; is a founding member of the Men of First AME (MOFAME); Past President of the San Gabriel Valley Chapter of the National Organization of Black Law Enforcement Executives (NOBLE); and Past Vice President of NOBLE – Region VI.
Rodney received several honors but is most proud of the Alpha Phi Alpha "African American Father of the Year" (1993). He was also recognized by the Pasadena Journal (1999) "Community Legends"; San Gabriel Valley Council (2000) "Explorer Post Advisor of the Year"; NAACP Pasadena (2007) "Community Involvement"; Learning for Life (2009) "Badge of Courage."
Critical Incidents:
On March 1, Special Enforcement Officers Jordan Ling and Edgar Sanchez were on routine patrol in the 2900 block of North Fair Oaks Avenue when they observed a group of known Hispanic gang members acting suspiciously. The officers developed sufficient probable cause and detained two subjects. As a result, one of the subjects was arrested for narcotics violations and booked at the Pasadena Jail.
On March 1 at about 4:30 p.m., officers assigned to the Special Enforcement Section, Special Investigation Unit, and the West San Gabriel Valley-Anti Crime Taskforce, executed a narcotics search warrant in the 2900 block of North Fair Oaks Avenue. The suspect, a known gang member, was not located at the location; however, the officers recovered narcotics evidence and a large sum of US currency. Our investigation is ongoing.
On March 2 at about 2:30 a.m., the Pasadena Police Department received several calls of "shots fired" in the 1800 block of North Marengo Avenue. While checking the area of the incident, officers observed a vehicle traveling on Tremont Street seemly unrelated to the shots fired call. All of a sudden, a Male Black adult emerged from a garage (the residence is located on North Marengo Avenue) and for unknown reasons, began firing several rounds at the passing car. The Pasadena officers saw the shooting and witnessed the suspect run back into the garage. Additional officers responded and contained the location. Officers and supervisors formulated a tactical plan and the suspect was later taken into custody without further incident. The suspect's rounds struck a vacant dwelling across the street. Fortunately, no one was hit by gunfire. The Pasadena Police officers involved in this incident used extraordinary restraint given the nature of the call and the totality of circumstances. Even though the suspect was engaged in firing his handgun, the officers were able to avoid a lethal confrontation. All are commended for their maturity, courage, and creativeness in the effort to resolve this incident.
On March 2, at about 6:30 p.m., Sergeant Javier Aguilar and Officer Jordan Ling were on routine patrol in the area of Mar Vista Avenue and Villa Street. While on patrol, they observed a known gang member who was wanted for a recent Christmas day homicide in Pasadena. Javier and Jordan contacted the suspect and arrested him without incident. The suspect was booked at Pasadena jail for murder. Both Javier and Jordan are assigned to the Special Enforcement Section (SES).
On March 5 at about 7:35 p.m., Pasadena Police officers responded to Central Park regarding an altercation. On arrival, the officers learned the female adult suspect traveled to Pasadena from Glendale in a taxicab. She was dropped off at Central Park and walked directly over to the victim, who was sitting at a park table. Without any warning, the female suspect began stabbing the male victim several times. Minutes later, patrol officers arrested the suspect without incident. The victim was transported to a local hospital for medical evaluation and the suspect was booked at the Pasadena jail for attempted murder.
On March 9 at about 9:30 a.m., Pasadena Police officers were dispatched to a non-responsive person in Central Park. On arrival, the officers located the victim, a male adult, 58. Pasadena Fire Paramedics responded and pronounced the victim deceased. The victim was a local transient and there were no signs of foul play. The coroner's investigator responded to the park and believes the victim died from natural causes. Lieutenant Ed Calatayud was the incident commander.
Phillip L. SanchezChief of PolicePasadena Police Department207 N. Garfield AvenuePasadena, CA 91101(626) 744-4545Mission First, People Always


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Moggalana wrote:Has anyone here also done a retreat with the people at IMC? It is also in the tradition of U Ba Khin, so it is probably not too different from Goenka's retreats, or is it?
I have attended a retreat at IMC's centre in Witshire UK. I think anyone familiar with the Goenka system will find IMC compatible.


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Roster spot in hand, Harvey works on refining pitches
Collins says young Mets pitcher going about spring starts the right way
PORT ST. LUCIE, Fla. -- In his second Grapefruit League start, Mets right-hander Matt Harvey continued working toward the regular season Saturday afternoon against the Marlins at Tradition Field.
The 23-year-old struck out four batters and walked another in 2 2/3 innings. He threw 49 pitches.
His lone blemish came on the third pitch of the game, which Marlins top hitting prospect Christian Yelich sent over the right-field wall for a home run.
"I thought Matt threw good," Mets manager Terry Collins said. "Hung a slider first inning, and as you saw in different counts, he was working on some things. He threw some changeups behind in the count, which he needs to do. Now that he knows that he's got this club made, I think he's going about it the right way, which is, 'Hey, I've got to refine my stuff and get my stuff ready.'"
Unlike last season when the rookie didn't use his curveball that often over his 10 starts, Harvey utilized it and all his other pitches on Saturday. Though he was happy with his curveball, Harvey admitted his fastball location still wasn't where he wants it to be.
"It was a little cold and a little tough getting a grip on the ball, but I've got to get used to it and figure it out," said Harvey, who faced a game-time temperature of 59 degrees. "I did a lot of good things and I did a lot of bad things. Obviously I've still got work to do, but other than that, everything feels good."


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Topic: Intro from 28 year old in Greater New York area
Hi All,
I have been following this blog for a few months and wanted to take this opportunity to properly introduce myself.
I'm a 28 year old from the CT/ NYC area who has been diagnosed with intrahepatic CC this past June. More information about my diagnosis can be found on my blog at http://connectwithjoe.blogspot.com. As you can see from the blog, I have an incredible support network, especially my mom, sister Lis, and Sarah who have been instrumental in navigating through these unchartered waters.
I have a CT scan scheduled with my Connecticut oncology team later this week to check progress after my six chemo sessions. My doctors plan on keeping me on this same treatment plan for the foreseeable future.
I feel extremely comfortable with my team of doctors (oncologists, surgeons, radiologist, etc.) at both Memorial Sloan Kettering Cancer Center, (MSKCC) and St. Vincent's Hospital/Swim Cancer Center.
I wanted to reach out and have some open communication in case anyone had any questions or insight. It certainly is a small world of intrahepatic CC patients, especially in my age group!
Good wishes to everyone battling cancer out there!
Joe Garassino


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Use this calculator to help you determine your paycheck for hourly wages. First, enter your current payroll information and deductions. Then enter the hours you expect to work, and how much you are paid. You can enter regular, overtime and one additional hourly rate.
Information and interactive calculators are made available to you as self-help tools for your independent use and are not intended to provide investment advice. We cannot and do not guarantee their applicability or accuracy in regards to your individual circumstances. All examples are hypothetical and are for illustrative purposes. We encourage you to seek personalized advice from qualified professionals regarding all personal finance issues.


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And even so, I'm doing a straight-up sudo, and PERL5LIB carries over.
Are you sure? I believe that by default sudo will clear PERL5LIB because of a security issue [debian.org].
So, you can either edit
I didn't mean inside Perl, I meant in your shell, like the local::lib examples give:
eval `perl -Mlocal::lib=/opt/perl`
This will cover all the bases -- Module::Install, Module::Build, your arch-specific dirs, etc.


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2011 Social Media Resolutions
A shiny brand new year is upon us once again. Time to make plans, set goals, resolve to be better than we were the year before. Right? Who wouldn't want to be a slimmer, fitter, vice-free self?
Who am I kidding, put down the hand weights, grab a Twinkie, and let's talk about spending more time staring at the computer screen this next year. Or at least making the most of the time we spend when we do have to sit here.
Actually, I'm excited to take the time to set some professional goals for myself. Last year was completely amazing, so I can't wait to take off for new heights in 2011. So, I had to ask myself, what could I focus my attention on that would make my Social Media life even better? I came up with a handful of things that will not only help me, but I think will help you, too.
Learn more.
I won't ask you to admit it out loud, but how many of you are guilty of taking the little you do know and running on instinct for the rest? In such a fast paced industry as Social Media Marketing, and Internet Marketing in general for that matter, we almost have to go with our gut sometimes. We are surrounded by creative, innovative people who look as though they are flying by the seat of their pants.
It should come as no big surprise that there are tons of opportunities to LEARN in this industry. What is amazing is the willingness of all the people I've met to share what they know and seek out the ideas and perspectives of others. Learning opportunities abound, and I personally plan to take advantage of as many opportunities as I can.
Already, I'm reading more. I picked up several books over the Christmas season that I am devouring. Some of them are very easy reads, others are going to take me a while to dig through and digest. But, doubt not that I am stuffing my brain with all kinds of goodness.
The bloggers within this field are amazing, too. I am constantly asking others who they like to read. My goal for this year is to set aside designated time every day to keep up with all that's out there in cyberspace.
Let's not forget for a moment all the great conferences. There's nothing like sitting in a room and absorbing the wealth of knowledge. I will be doing everything in my power to get to 3 or 4 more this year.
With all the great resources out there, there's no excuse not to add something new to what you already know.
Share what I'm learning.
I don't know about you, but I need time to process all of the good stuff I learn. One of the best ways I've found to really assimilate all the new data is to write it down. That, my friends, is all the excuse I will ever need to up my level of contribution to the conversation. When I share what I'm learning, as I'm learning it, it sticks with me better. And if I'm sharing, I will usually get great comments and fresh perspective on the topics I choose to discuss.
So, I will be dedicating more time this new year to keeping my own blog up to date with the latest and greatest. I will also take advantage of the opportunities to write for other blogs.
How about you? How will you share what you've learned with the world around you in 2011?
Be a more active blogger.
Obviously, writing more blog posts will contribute to this goal. But I want to be a more active member of the blogging community. I plan to make it a point not only to read and write more, but to actively comment and engage with other bloggers. I'm not writing for TV, magazines, or newspapers. Blogging is social. It's a conversation, and I want to be an active part and not just skulk around in the shadows.
Maybe you aren't as comfortable writing blog articles, yet, but you could take the extra moment to comment on the posts that really sparked some ideas for you. Make the effort to click a Facebook or twitter button and share the blog posts that you're enjoying with your network of friends and colleges.
Try a few more networks.
I've become so enamored of the networks that I really connect on that I've lost sight of all the Social goodness still to experience out there. This is the year to try some new things, build a few more profiles, and make some new friends. Who knows, I might discover just the right solution to someone's unique Social Media needs.
Are you really comfortable with Linked-In and Facebook, but still not so sure about Twitter? This might just be the year to jump into the stream and see what everyone else has been chirping about.
Reach out to others.
If I'm going to learn and share and grow, I want to be sure that I'm taking others along on the journey. I want to connect and learn from all of the super-smart people around me, so I'm not going to hesitate to reach out to them with my questions. I also want to help others. I'm going to make a greater effort to reach out to people who need tips, hints, and answers about how Social Media can benefit them.
Hopefully my handful of resolutions have triggered some ideas for you. Let's make 2011 a spectacular year together!


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To all those going to the game... im envious.
Fieldhouse is gonna be rocking.
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To all those going to the game... im envious.
Fieldhouse is gonna be rocking.
It will be a very tough game, just getting home from a brutal WC road trip. I just hope we're rested.
Probably not the best game to come into. I would bring him back Friday (home vs Charlotte)
Wow those Heat fans are cocky and are talking alot of cash ****** on that Heat Red Zone message board. Can't stand them
Larry Bird and Ryan Grigson- wasting the talents of Paul George and Andrew Luck
Everyone around me is terrified of us and thinks its our year. I love it lol I just play it off like I'm not that confident about it deep down, but I am :P
Just like the OKC game....I suspect that this will be another "I'm sick and tired of hearing about PG24 and the Pacers being the best Team in the League" type of Statement game for LeDecision as it was for KD. I'm also guessing that this is one of the ulterior motives of sitting Wade for for the last game and overall...the couple of days...they want Wade as healthy and rested as possible so that they can take on the Pacers.
I know we are playing at home....but I hope that the Pacers come out rested enough. This game might as well be a Road Game against an Elite Team like the Heat....especially being the 12th game in 21 days.
Ash from Army of Darkness: Good...Bad...I'm the guy with the gun.
This would be a glorious win. I'm not convinced we'll get it, though.
They need to win this one, or at least make it so competitive, because it is one of the most anticipated matchups this season. This game will be one big step of gaining some more casual fans as the hype in this game and also the upcoming games against the Heat is so huge.
teams traditionally struggle after a WC trip in the first game upon return. why that is I don't know.
with that said I still think were gonna kick the leheats a**.
this probably has to be the biggest regular season Pacers game that I can remember since when... maybe the return of Jordan and the NBC televised game???
Yep my Heat fan buddy says the same thing
Last edited by rabid; 12-09-2013 at 10:21 PM.
Yeah, the fact that this is only 2 days after a long WC trip has me dreading an ugly game. I wish we played them on Friday and Charlotte tomorrow.
I have a feeling we'll win.
what I truly love about our Indiana Pacers is that they play the game the way it should be played. many of us on here grew up watching those Pacers of Millers era, and seeing battles fought with the knicks, pistons, bulls.. and others were physical tough playoff basketball.
that's what this team is truly all about. we play playoff type basketball in the regular season. we play fundamental basketball, bang it in low kick back out, to me some many traits of what I believe Indiana basketaball is about.... unselfishness, defense, TEAM
and its what this team represents. I love Coach Vogel smashmouth basketball. in the playoffs is when games become a grind. exactly why teams like the clippers will never win a championship.
This team represents Indiana Basketball and love this Pacers team.
thank you LEGEND.
** bottom line, the Pacers are not going anywhere for the next decade Basketball Gods willing. MIAs window closes if LeBron leaves. and if stays this will be the rivalry of the decade,,, but we gotta beat em.
Last edited by PacersPride; 12-09-2013 at 10:59 PM.
First game since the home vs. Chicago game that I am anticipating anxiously. A nice showing would be great after such a brutal road trip, and I do love the undefeated at home mark.
I don't expect any kind of let down from us tomorrow. Jet lag, tired legs, it really doesn't matter. Every team brings their best shot for the Miami Heat. We will have 18,165 wild fans to push us over the edge. Also, I'm predicting a big game from Lance tomorrow. He is due for one after that road trip.
God I hope we win....but my money is on a loss for all the reasons list here (1st game back from West Coast, Heat wanting to prove they still own us, etc). If Lance and GHill don't come up big, it will be an ugly embarrassing night.
House Name: Pacers
House Sigil:
House Words: "We Kneel To No King"
^^ I hope his head doesn't get in the way of Wade's elbow again.
It's hard to explain how excited I am for tonight's game.
Turner and Young are THE FUTURE!
No hype about this game ..........
NBA TV is showing all 7 playoff games from last year. Game 2 is on now.
Nah - no hype at all ..............
Perhaps the Embarrassment against OKC was actually resting our legs for this game....
You can't get champagne from a garden hose.
Dwayne Wade (knee) expected to return tonight for Heat at Pacers.— Brian Windhorst (@WindhorstESPN) December 10, 2013


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Liam Payne of One Direction + Danielle Peazer Spotted Holding Hands
There was a reunion of sorts with One Direction member Liam Payne over the weekend, and no, he wasn't joining fellow bandmate Harry Styles and his new girl Taylor Swift at the zoo.
Payne and his ex-girlfriend Danielle Peazer met up in New York City's Time Square after she flew there today (Dec. 3) ahead of 1D's sold-out concert at Madison Square Garden. The on-again couple were even spotted holding hands during there time together, and managed to stop by the H. Stern Jewelry store that same day. No word on whether there was a purchase or not, though!
Back in September, the couple of two years mutually decided to call it quits after One Direction's popularity continued to rise to insane heights, and his crazy tour schedule kept them apart.
"Liam and Danielle were both very upset when the relationship ended," said a source to The Sun (via Celebuzz). "Most of the trouble was down to not being able to spend enough time together. They really miss each other."
But it looks like the pretty couple are on track to getting their relationship started up again; it's not everyday that a non-girlfriend flies thousands of miles to be with someone!
Watch the One Direction 'Little Things' Video
Subscribe to PopCrush on


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RAD001 in Pheochromocytoma or Nonfunctioning Carcinoid (PheoCarcRAD001)
- Full Text View
- Tabular View
- No Study Results Posted
- Disclaimer
- How to Read a Study Record
- According to Martin F et al, AKT is highly phosphorylated in phenochromocytoma but not in benign adrenocortical tumors.
- In nonfunctioning carcinoid, the PI3K/AKT/mTOR pathway is activated.
- Although mTOR is clearly an attractive therapeutic target in tumor, no clinical study on mTOR inhibition by RAD001 have been conducted in pheochromocytoma or extra-adrenal paraganglioma or non-functioning carcinoid.
- So we design this phase II study of RAD001 in pheochromocytoma or extra-adrenal paraganglioma or non-functioning carcinoid to evaluate the efficacy of RAD001 in this orphan disease.
|Pheochromocytoma Extra-adrenal Paraganglioma Non-functioning Carcinoid
|Drug: RAD001
|Phase 2
|Study Type:
|Study Design:
|Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
|Official Title:
|Phase II Study of RAD001monotherapy in Patients With Unresectable Pheochromocytoma or Extra-adrenal Paraganglioma or Non-functioning Carcinoid
- progression-free survival rate at 4 months [ Time Frame: 10 months ]proportion of patients who are alive and progression-free at the time of 4 months of treatment among all patients
- time to progression (TTP) [ Time Frame: 10 months ]
- overall survival (OS) [ Time Frame: 2 years ]
- response rate (RR) [ Time Frame: 6 months ]
- metabolic response rate by PET-CT [ Time Frame: 2 months ]
|Study Start Date:
|July 2008
|Study Completion Date:
|December 2011
|Primary Completion Date:
|May 2011 (Final data collection date for primary outcome measure)
|Assigned Interventions
Experimental: RAD001
RAD001 10 mg daily po medication
Drug: RAD001
RAD001 10 mg daily po medication.
Treatments will be continued until any of the following events occur
Detailed Description:
Although several therapeutic options exist for patients with metastatic pheochromocytoma, all options are limited and there is no cure. Reduction of tumor size palliates symptoms, but a survival advantage of debulking is unproven. A reduced tumor burden can facilitate subsequent radiotherapy or chemotherapy. External-beam irradiation of bone metastases and radio frequency ablation of lesions are treatment alternatives. Chemotherapy with a combination of cyclophosphamide, vincristin, and dacarbazine can provide tumor regression and symptom relief in up to 50% of patients, but the responses are usually short-lived. To date, 131I-labeled MIBG therapy is the single most valuable adjunct to surgical treatment of malignant pheochromocytomas. As a single agent, 131I-labeled MIBG has a limited efficacy of cure, and there is no consensus on what doses to use for treating either bone or organ metastases. Multicenter studies are required to reach a consensus on the efficacy of high-dose versus fractionated medium doses of 131I-labeled MIBG and monotherapy versus combination therapy with other radio nuclides or modes of chemotherapy.
The PI3-K/Akt/mTOR pathway is dysregulated in many cancers and is activated by several upstream proteins, such as ras, TCL1, and bcr-abl, and membrane receptor tyrosine kinases, including vascular endothelial growth factor receptor, platelet-derived growth factor receptor, c-kit, and Flt3. Increased expression and constitutive activation of the catalytic subunit of PI3-K and Akt and/or decreased or absent PTEN protein expression have been reported in many types of cancer. Activating mutation in PIK3CA, the gene for the catalytic subunit of PI3-K have been reported in 25% of gastric cancer.
Upstream in the growth-promoting pathways that converge on mTOR are critical molecules that are often deregulated in cancer. These deregulated molecules precede inappropriate signals that activate the mTOR switch, driving the growth and proliferation of the cancer cell. Because the number of potential defects that can cause inappropriate activation of mTOR is large and one or another is common to most cancer cells, blocking their effect at the point of convergence is a rational approach.
According to Martin F et al, AKT is highly phosphorylated in phenochromocytoma but not in benign adrenocortical tumors.
Although mTOR is clearly an attractive therapeutic target in tumor, no clinical study on mTOR inhibition by RAD001 have been conducted in pheochromocytoma or extra-adrenal paraganglioma.
So we conduct this phase II study of RAD001 in this disease And we also include the nonfunctioning carcinoid in this study.
|Ages Eligible for Study:
|18 Years and older (Adult, Senior)
|Sexes Eligible for Study:
|Accepts Healthy Volunteers:
Inclusion Criteria:
- 1. Histologically or cytologically confirmed pheochromocytoma or extra-adrenal paraganglioma or carcinoid
- 2. Local, locally-advanced or metastatic disease documented as having shown progression on a scan (CT, MRI, MIBI scan) taken 2 to 12 months prior to baseline compared to a previous scan taken at any time in the past. Progression must be documented according to RECIST criteria.
- 3. Disease that is not amenable to surgery, radiation or combined modality therapy with curative intent.
- 4. Presence of at least one measurable target lesion for further evaluation according to RECIST criteria
- 5. 18 years or older
- 6. ECOG performance status 0, 1
- 7. Previous treatment with chemotherapy, loco-regional therapy (e.g chemoembolization) are permitted providing that toxicity has resolved to ≤grade 1 at study entry and that last treatment was at least 4 weeks prior to baseline assessment.
- 8. Adequate organ function
- 9. A patient with the willingness to comply with the study protocol during the study period and capable of complying with it
- 10. A patient who signed the informed consent prior to the participation of the study and who understands that he/she has a right to withdrawal from participation in the study at any time without any disadvantages.
Exclusion Criteria:
- 1. A patient with no measurable disease
- 2. Prior chemotherapy, radiation therapy or surgery within 4 weeks prior to study entry except palliative radiotherapy to non-target lesions (within 2 weeks prior to study entry)
- 3. A patient with functioning carcinoid
- 4. A patient with previous active or passive immunotherapy
- 5. A patient with intestinal obstruction or impending obstruction, recent active upper GI bleeding
- 6. A pregnant or lactating patient
- 7. A patient of childbearing potential without being tested for pregnancy at baseline or with being tested for positive. (A postmenopausal woman with the amenorrhea period of at least 12 months or longer is considered to have non-childbearing potential)
- 8. A man or woman of childbearing potential who has no willingness to use a contraceptive measure during the study
- 9. A patient with history of another malignant disease within past 5 years, except curatively treated basal cell carcinoma of skin and cervical carcinoma in situ.
- 10. A patient with history of uncontrolled seizures, central nervous system disorder or psychiatric disorders that are considered clinically significant by the investigator that would prohibit the understanding of informed consent or that may be considered to interfere with the compliance of the administration of the study medications.
- 11. A patient with clinically significant heart disease (e.g. congestive heart failure, symptomatic coronary artery diseases, cardiac arrhythmia, etc) or myocardial infarction within past 12 months.
- 12. Ongoing cardiac arrhythmia of grade ≥2, atrial fibrillation of any grade, or QTc interval>450msec for males or >470msec for female.
- 13. A patient with interstitial pneumonia or diffuse symptomatic fibrosis of the lungs
- 14. A patient with peripheral neuropathy of grade 1 by NCI CTC, caused by other factors (e.g. alcohol, diabetes, etc). If the absence of deep tendon reflexes is the only neurologic disorder, this condition does not apply to the exclusion criteria.
- 15. A patient with organ transplantation requiring immunosuppressive therapy
Please refer to this study by its ClinicalTrials.gov identifier: NCT01152827
|Korea, Republic of
|Seoul National University Hospital
|Seoul, Korea, Republic of, 110-744
|Principal Investigator:
|Yung-Jue Bang, MD, PhD
|Seoul National University Hospital
|Study Director:
|Do-Youn Oh, MD, PhD
|Seoul National University Hospital
|Responsible Party:
|Seoul National University Hospital
|ClinicalTrials.gov Identifier:
|NCT01152827 History of Changes
|Other Study ID Numbers:
|Study First Received:
|May 31, 2010
|Last Updated:
|May 19, 2015
Keywords provided by Seoul National University Hospital:
extra-adrenal paraganglioma
non-functioning carcinoid
Additional relevant MeSH terms:
Carcinoid Tumor
Carotid Body Tumor
Paraganglioma, Extra-Adrenal
Neuroendocrine Tumors
Neuroectodermal Tumors
Neoplasms, Germ Cell and Embryonal
Neoplasms by Histologic Type
Neoplasms, Glandular and Epithelial
Neoplasms, Nerve Tissue
Antineoplastic Agents
Immunosuppressive Agents
Immunologic Factors
Physiological Effects of Drugs
Anti-Bacterial Agents
Anti-Infective Agents
Antibiotics, Antineoplastic
Antifungal Agents
ClinicalTrials.gov processed this record on September 21, 2017


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This booklet was designed to inform victims of their rights and services available to them, as well as promote awareness to help stop domestic violence.
If you are a victim of domestic violence, and the police responds to assist you, they are required by law to read certain portions of this "booklet" to you. An asterisk next to the heading marks this information. The other information is provided for your additional benefit.
You also have the right to file a petition in court requesting a protective order that may include any of the following provisions:
The forms you need to obtain a protective order are available from the police or nearest court. It is not necessary to have an attorney to obtain a protective order, but you may consult an attorney if you choose.
If you would like help in obtaining a protective order, you may call the victim advocacy program, law enforcement agency and/or prosecuting agency in your area. These may be indicated on the back of this booklet.
If the perpetrator has been charged, and you would like to follow the progress of the case, you may contact the nearest District Attorney's Office or Municipal Prosecutor's Office. They may also have a designated victim/witness coordinator who is available to assist you during the length of the case.
The State of Alaska has a Violent Crimes Compensation Board,
which can provide compensation to victims who have been physically or emotionally injured
in a violent crime.
Such compensation might include medical care for your injuries,
crime victim related-counseling, wages lost by you due to injuries, and more. You can find
out how to apply by contacting the Board at:
Violent Crimes Compensation Board
PO Box 110230
Juneau, AK 99811-0230
450 Whittier St
Phone: 465-3040
Fax: 465-2379
By phone at 1 (800) 764-3040 or by calling collect 1 (907)
Call the agency in your area that is identified in the back of this "booklet". (If the agency is not identified, you may call the nearest law enforcement agency for the name and phone number of the shelter or program in your area.) An advocate from the program may provide a number of the following:
Alaska has confidentiality laws protecting you, if you decide to seek services from a domestic violence or sexual assault program. These programs maintain strict principles of confidentiality. The laws in Alaska protect communications between victims of domestic violence and sexual assault and advocates, except in limited circumstances.
An advocate is one who listens and is non-judgmental. Advocates are neutral parties who do not conduct investigations, assist in investigations, make assessment of parties involved, or testify in court. Advocates offer support and can assist with the many different areas listed on the previous pages. The goal of an advocate is to maintain positive working relationships with members of law enforcement, prosecution, and the courts in an effort to ensure the system runs smoothly for the victim. An advocate encourages self-reliance and provides information that will assist the victim to do things for themselves. An advocate will only speak or act on behalf of the victims at the victim's request and direction.
When law enforcement officers become aware of an incident of domestic violence they are obligated to investigate. Officers/troopers are required to make an arrest if there is evidence violence occurred, and the perpetrator has been identified and can be located within 12 hours of the incident. After 12 hours, officers/troopers can arrest the perpetrator with or without a warrant. Evidence includes your statement, the statements of others, injuries, damages to property, etc. It is the responsibility of the state or municipal prosecuting agencies to "press charges". If there is probable cause a crime has been committed, only the police and the prosecutor, not the victim, have the decision to arrest.