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European Board for Accreditation in Cardiology (EBAC) 2015 CME/CPD Survey Summary
Julie Simper1, Robert Schaefer2, Reinhard Griebenow3, Lampros Michalis4 and Heinz Weber5
1International CME/CPD Consulting, Amsterdam, The Netherlands; 2CEO EBAC, Cologne, Germany; 3Chairman, EBAC Advisory Committee, EBAC, Cologne, Germany; 4Vice-President Education, UEMS Cardiology Section, Brussels, Belgium; 5Chairman, Foundation Council, European Cardiology Section Foundation (ECSF), Cologne, Germany
In the spring of 2015, the European Board for Accreditation in Cardiology (EBAC) collaborated with International CME/CPD Consulting to design and administer a survey to approximately 1,171 professionals active in the field of European CME/CPD, with a focus on cardiology. With a nearly 5% response rate, the results herewith are non-representative, but do express current behaviours and attitudes of those active in European accredited CME/CPD.
Keywords: Survey, CME/CPD, provider, EBAC, accreditation, needs assessment, conflict of interest, evaluation, respondents
Citation: Journal of European CME 2016, 5: 29757 - http://dx.doi.org/10.3402/jecme.v5.29757
Copyright: © 2016 Julie Simper et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material for any purpose, even commercially, provided the original work is properly cited and states its license.
Received: 14 September 2015; Revised: 3 December 2015; Accepted: 3 December 2015; Published: 7 January 2016
Competing interests and funding: The survey was funded by the European Board for Accreditation in Cardiology (EBAC). Julie Simper (International CME/CPD Consulting) received compensation from EBAC for consulting services. Robert Schaefer (CEO, EBAC) is an employee of EBAC. Reinhard Griebenow (Chairman, EBAC Advisory Committee), Lampros Michalis (Vice-President of Education, UEMS Cardiology Section), and Heinz Weber (Chairman, European Cardiology Section Foundation Council) maintain administrative or supervisory roles with EBAC on a voluntary, uncompensated basis.
*Correspondence to: Julie Simper, International CME/CPD Consulting, Laurierstraat 38-3, NL-1016 PN Amsterdam, The Netherlands. E-mail: firstname.lastname@example.com
Commonly Used Acronyms
CME – Continuing Medical Education
CPD – Continuing Professional Development
EBAC – European Board for Accreditation in Cardiology
EFPIA – European Federation of Pharmaceutical Industries and Associations
UEMS – European Union of Medical Specialists
EACCME – European Accreditation Council for Continuing Medical Education
NA – Not Applicable
PCO – Professional Congress/Conference Organiser
RCP – Royal College of Physicians
The European Board for Accreditation in Cardiology (EBAC) is accountable for the accreditation of international CME activities in cardiology for the European medical community. Beyond accrediting CME activities, EBAC takes responsibility for the development, availability, and quality of international CME in European cardiology. Practically, this means that EBAC also:
- Advises and helps those who wish to establish accreditation procedures in cardiology
- Facilitates individual cardiologist's international CME credit acquisition
- Encourages the recognition of those credits by national authorities
- Produces guidelines for CME in cardiology
With this broader mission in mind, EBAC reached out to the European cardiology CME/CPD provider community in the spring of 2015 to survey those implementing the accreditation criteria and submitting applications. The goal was to validate certain observations made by EBAC reviewers and obtain some indications on trends and opinions in the quickly changing environment that is European CME/CPD. The insight gained would be used to help EBAC improve and facilitate its accreditation process. This report represents a summary of the survey process and overall results.
EBAC engaged the assistance of Julie Simper from International CME/CPD Consulting, an independent CME/CPD professional with over 13 years' experience internationally. Creation of the questionnaire was a collaborative effort between the two organisations, whereas the survey administration and presentations of results were solely managed by International CME/CPD Consulting. In this way, all responses remained anonymous, with only summarised and anonymised information provided to EBAC.
The survey questions originated from several initial considerations including EBAC accreditation applicant demographics and data on those accreditation requirements most commonly done incorrectly or posing the most difficulty for applicants. The questionnaire had a total of 29 questions structured into four categories.
- General (questions 1–9)
High-level questions to assess the respondent profile: organisation type, years in CME/CPD for both the organisation and individual, types of activities organised, geographic reach, and perceived value of accreditation.
- Implementing the Accreditation Criteria (questions 10–18)
Considering the various accreditation criteria and rules in general and how respondents integrate them into operations. For example, the role of physician leads versus the organisational team in activity planning (in theory and in practice), the ability to understand and apply the various criteria areas, topic selection, and evaluation practices.
- EBAC Accreditation and Support (questions 19–24)
Questions related specifically to respondents' experience with EBAC: number of applications annually, satisfaction with various elements of the EBAC accreditation process, suggestions to accreditors, desired changes to the accreditation process, and miscellaneous questions/comments.
- EBAC Provider and Sponsor Meeting (questions 25–29)
EBAC hosted an educational meeting for CME/CPD providers and sponsors in May 2015. The survey included several questions addressing intentions to attend and topics/questions respondents wished to see addressed. Responses to these questions are not included in this report, but can be downloaded with the full survey results.
The questionnaire was tested on several providers generously donating their time and constructive feedback, resulting in final adjustments to improve flow, comprehension, and limitation to approximately 15 min to complete. The survey was designed in Survey Monkey for online administration and co-branded by EBAC and International CME/CPD Consulting. It was open for 3 weeks: March 17–April 7, 2015. Three email invitations were sent from International CME/CPD Consulting to the complete EBAC database of those having interactions with EBAC to obtain European accreditation in cardiology. The database consisted initially of 1,449 contacts; however, 278 email addresses were undeliverable for a multitude of reasons. Therefore, 1,171 contacts were presumed to have received the survey invitation. Participation in the survey was on a voluntary basis; respondents were not incentivised or compensated for taking the survey, nor were responses linked to any EBAC applications.
Results and discussion
Fifty-five respondents completed the questionnaire, thus representing a nearly 5% response rate. Although not statistically significant, the results represent trends in practice that were further discussed during meetings with the Good CME Practice Group Spring Meeting (London, May 7, 2015) and the EBAC Meeting with Providers and Sponsors (Frankfurt, May 29, 2015). Below is an overview of each question, with all results being summarised at the conclusion.
General Q1 – Q9
Q1 Which best describes your organisation?
Q2 Which best describes your organisation's role in providing CME/CPD activities?
Multiple answers possible; Answered: 52; Skipped: 3
Twenty-nine respondents at 55% said they organise everything themselves, of which 10 indicated that in some circumstances they also collaborate. Therefore, 19 of the 52 respondents, or 36%, are full-service providers organising all elements without external support. At 64%, the majority of respondents collaborate with other organisations.
Q3 Approximately how many years has your organisation been involved in CME/CPD?
Q4 Approximately how many years have you personally been involved in CME/CPD?
Answered: 52; Skipped: 3
Organisations (Q3): 50% of the organisations responding to the survey were well established with over 10 years of experience, whereas 32% had less than 5 years history in CME/CPD. Individuals (Q4): indicating a similar but not identical trend as Q3, 37% of the individuals had over 10 years of experience, with 42% having under 5 years in CME/CPD.
Q5 What types of CME/CPD activities do you organise?
Multiple answers possible; Answered: 52; Skipped: 3
The vast majority of respondents, or 85%, organise live events for 0–500 participants. In addition to live events, 37% provide e-learning, 13% provide print/journal, and 4% CD-ROMs. One respondent said they also provide exams and another said they provide workshops and seminars.
Q6 In which geographic locations do you offer CME/CPD activities?
Multiple answers possible; Answered: 51; Skipped: 4
The most prominent response had 51% of respondents indicating they offer CME/CPD internationally in Europe. Most of those respondents marked multiple answers. Single responses to Q6 were:
- 7 (14%) organise only regionally in their local area
- 8 (16%) checked only nationally in their country
- 8 (16%) checked only internationally in Europe
- 6 (12%) checked only internationally globally
Q7 From which organisations have you received CME/CPD credit in the past 5 years?
Multiple answers possible; Answered: 51; Skipped: 4
Naturally, given the target audience, EBAC had the most responses. However, surprisingly, 14 of the 51 respondents had not received CME/CPD credit from EBAC over the previous 5 years. About half of the respondents checked more than one answer, of which the event planning companies and companies specialising in CME/CPD checked the most multiples.
Q8 Please indicate to what extent you agree or disagree with the following
Q8 by respondent group: CME/CPD accreditation adds no value
Seventy-four percent (30 respondents) disagreed with the statement, thus expressing that there was strong agreement that accreditation does provide added value. However, the 26% (13 respondents) who were neutral or agree was not negligible and indicated a quarter of those actively involved in CME were not necessarily convinced of its value.
Q8 by respondent group: The resources necessary to obtain credit outweigh the benefits of offering credits
Overall, the responses were closely split with 37% agreeing (19 respondents) and 45% (23 respondents) disagreeing. A breakdown by provider type illustrates that medical institutions and physicians tend to find that the resources necessary do indeed outweigh the benefits. While organisations who specialise in organising the logistical or CME/CPD elements disagreed and found the resources required worth the benefits of offering credits.
Q8 by respondent group: CME/CPD accreditation is an indicator of high-quality education
Seventy-six percent (38 respondents) agreed with the statement while the remaining 24% (12 respondents) were split evenly between neutral/unsure and disagreement. The event planning companies and companies specialising in CME/CPD tended to agree while the most varied answers were from the medical institution group.
Q8 by respondent group: CME/CPD is an important reason for participants to attend
Overall, 67% (33 respondents) agreed with the statement, with 72% (13 respondents) of medical institutions and 84% (5 respondents) of event planning companies agreeing most strongly.
Q8 by respondent group: CME/CPD accreditation ensures independent content free from industry influence and bias
The role of accreditation in ensuring independence from bias was validated overall with 70% (36 respondents) agreeing and only 10% (5 respondents) disagreeing. However, a significant 20% (10 respondents) was unsure. Thirty-three percent of physicians (1 respondent) outright disagreed and 67% (2 respondents) were neutral or unsure.
Q8 by respondent group: We have considered organising medical education that does NOT offer CME/CPD credits
Overall 48% (24 respondents) agreed with the statement while 28% (14 respondents) disagreed, with those answers of disagreement coming primarily from medical institutions at 58% (4 respondents) and medical societies/associations at 22% (4 respondents).
Q9 Overall, in your personal opinion, do you think the importance of CME/CPD accreditation will: increase, decrease, stay the same, you're not sure
Answered: 53; Skipped: 2
Sixty-two percent believed the importance of CME/CPD accreditation would increase, while 25% thought it would stay the same, 8% thought it would decrease, with 6% unsure. Most of the decrease answers came from physicians and medical institutions.
Implementing the Accreditation Criteria Q10 – Q18
Q10 Ideally, in your opinion, who should be responsible for the following?
Q11 In reality, when actually planning a CME/CPD activity, who is most often responsible for the following?
Q10 and Q11 Comparison: Ideally versus Reality
Comparing responses for the following areas illustrates a parallel in what respondents feel should ideally be the task distribution and what is actually reportedly as happening.
Similarly, when comparing the responses, the following areas reflected the most striking variances: educational format selection, creation of educational materials, collection/management of all conflicts of interest declarations/disclosures, and management of industry funding and sponsorships. For these areas, medical institutions perceived the physician course directors to be contributing most actively, while CME/CPD and event companies indicated willingness to play a more active role, indicating in almost every area "organisational team" for both ideal and reality. As such, the following may be areas for improving communication between parties and clearer distribution of roles and responsibilities.
Q12 Rank the following in terms of your ability to understand and apply to your CME/CPD activities
Answered: 46; Skipped: 9
Highest activities judged easy to extremely easy:
- Identifying a physician course director/chair (70%)
- Separating industry promotional activities (63%)
- Tracking attendance/credits and issuing certificates (58%)
- Creating educational objectives (57%)
- Understanding where advertisements can/cannot be located (57%)
Highest activities judged difficult to extremely difficult:
- Collecting all conflicts of interest disclosure forms from committees/faculty (30%)
- Performing an evaluation to assess educational outcomes (30%)
- Identifying professionals with CME/CPD expertise to assist (28%)
- Resolving any conflicts of interest (29%)
- Implementing interactive educational formats (26%)
Of note with high neutral/unsure responses:
- Resolving any conflicts of interest (29%)
- Performing a needs assessment (35%)
- Understanding where industry sponsors can/cannot be involved (35%)
Q13 How do you choose the content/topics for your CME/CPD activities?
Multiple answers possible; Answered: 47; Skipped: 8
Most of the respondents use multiple methods with the top three answers being:
- 79% selected by physician course director or scientific committee
- 51% needs assessment done by participants of similar events
- 40% topics recommended by national authorities
Q14 Do you evaluate your CME/CPD activities?
Answered: 47; Skipped: 8
Q15 Why don't you evaluate your CME/CPD activities?
No responses.
(Of those responding "yes" to Q14)
Q16 Please indicate the evaluation method you use most often
Answered: 33; Skipped: 22
Fifty-eight percent do onsite evaluations, 18% do online evaluations, and 24% do both. Sixty percent use customised forms and 40% standardised forms. Medical institutions and societies lean on standardised forms more than companies specialising in CME/CPD and event planners.
(Of those responding "yes" to Q14)
Q17 For which purposes do you use the evaluation results?
Multiple answers possible; Answered: 35; Skipped: 20
The top three answers were: measure educational quality, selection of topics for future events, and feedback to presenters. Only 34% indicated they use evaluations to measure independence from commercial interests. Of which, respondents were mostly from companies specialising in CME/CPD.
(Of those responding "sometimes" to Q14)
Q18 Why do you only sometimes evaluate your CME/CPD activities?
Multiple answers possible; Answered: 10; Skipped: 45
EBAC Accreditation and Support Q19 – Q24
Q19 For how many activities do you seek EBAC accreditation annually?
Answered: 45; Skipped: 10
Q20 Please indicate your satisfaction with the following aspects of EBAC accreditation
Answered: 45; Skipped: 10
The highest satisfaction scores (satisfied and very satisfied):
- Overall EBAC experience (71%)
- Clarity of the process, rules, and responsibilities (64%)
- Clarity of whom the official CME provider/applicant must be (64%)
- Requirement to have a Letter of Endorsement (61%)
The highest unsatisfied scores (unsatisfied and very unsatisfied):
- Requirement that each event must be submitted separately, even if a recurring/repeating (16%)
- Clarity of whom the official CME provider/applicant must be (13%)
- Requirement to have a Letter of Endorsement (14%)
- 8 week minimum application deadline (11%)
For all the categories, the majority of respondents were satisfied (and more satisfied than very satisfied). Each category also had a strong showing of neutral/unsure answers ranging from 22% to 38%.
Q21 What would you recommend to CME/CPD accreditors like EBAC?
Multiple answers possible; Answered: 41; Skipped: 14
Q22 If you could instantly change one thing about the process for obtaining CME/CPD credits, what would it be and why?
Answered: 18; Skipped: 37
Responses are as written by respondents. Most answers focused on the process of obtaining credits: applications, timelines, expenses ("price is too high for added value"), and bureaucracy ("make it easier to apply").
- One application for recurring events with single annual fee.
- Simplify reaccreditation of an already conducted activity.
- Make sure that one application is submitted which will also be able to include sessions supported by grants.
- Grant it online to those who attend.
- More tight relation with the faculty/lecturers in order to facilitate and speed up the review process of lecturers and content/presentations.
- Lately the decision from EBAC is taking a longer time, it could be due the increased number of applications received, ideally 5 weeks would be great, it would facilitate the planning process, there are many other deadlines to meet while organising a CME event, so that would be ideal.
- The time to obtain the credits: more transparency and compliance with deadlines as to launch a CME programme. The process should be easier because we are in a very fast-moving sector, and we should be able to have a CME activity in max. 1 month, but it is not possible because we first have to get everything ready as if we launched the programme, then send to have the credits and wait a lot to obtain them. There should be other ways to credit the CME providers and have a self-code of conduct with controls, but this would allow the CME provider to be more effective and the doctors to have CME faster.
- It would be great if the process could be split up in two steps. Step 1: As soon as destination is announced, we can apply for CME credits with no programme; we just get a positive or negative reply from CME provider (no specific number of credits), but we still get to use their logo and say that the event will be EBAC accredited (EBAC can have an option to pull out at step 2). Step 2: As soon as advance programme is available, we make the full application and EBAC give us the number of credits.
- Most independent reviewers we have worked with (anonymously through RCP and EACCME) have demonstrated a clear lack of understanding about e-learning formats yet insist on making most comments about the delivery of the education, whereas ACCME-accredited providers who collaborate with CME providers tend to focus on ensuring the criteria are followed (conflicts of interest, needs assessments, learning objectives, outcomes) and allow the CME providers to identify the ideal delivery and coordinate the faculty and content development.
- To have a better control on attendance, so not everyone can get CME/CPD credits! We/you should create a system (electronic maybe) to know how many hours the attendees were present at the seminars."
- Instantly forbid any medical communications agency from being involved in CME and clarify a grant process that is EFPIA compliant. Everyone wants clarity that industry is not involved in CME, and these two things would give it instantaneously.
Q23 Do you have other questions or comments? Don't be shy, let us know
Answered: 13; Skipped: 42
- Assessment should be based on knowledge and courses attendance.
CME credits overall just meet an administrative need and do not reflect knowledge/experience gained.
If the CME credits requirements are waived, the folks may attend meetings with the idea of getting knowledge and not just to get credits. I do think it is important to stay up to date with science but not sure CME collected in the current format is the correct way to track the activity. Not sure what will be the right process do so.
- This survey is not exactly relevant for us as accreditors.
- CME should be from practical points and good illustrated.
- CME/CPD means so many different things around the world that it is difficult to justify online CME/CPD for a global audience.
- Currently the number of credits corresponds to the number of hours a delegate could attend whatever the subject or way of learning; why would someone that watches a webinar online for 1 hour get the same points as someone that attends a 1-hour "how to" training session in person with a world-renowned expert.
- Let industries get EBAC credit for events organised by industries.
- Nice survey Julie. I hope that the results will be published in JECME.
- No.
- Overcome double accreditation with EBAC and national/international societies.
- Thanks!
- The latest EBAC evaluation form is extremely long with too many questions. Doing big international congresses, participants attending a 1-hour session have no time to complete this, they have to run to next session, so it is really unfortunate that we are not able to collect many of those forms, evaluating a session is extremely useful for all of us.
- The need for independent education for physicians with accreditation and CME will increase even for small events and the borders between sponsors and professions must be transparent – this implicates development of methods and the process for accreditation.
Q24 Would you be willing to provide additional input during a short telephone call?
11 respondents submitted their email address.
The survey respondents represented a relatively broad range of provider types with only journal going unrepresented and medical institutions most prominent at 19 (Q1). The majority of providers collaborate with other organisations for various aspects of the activities, although 36% are "full-service" providers managing all elements directly (Q2). Overall, the group was a relatively knowledgeable one with many years' experience in CME/CPD both organisationally and individually (Q3, Q4). Live events are the primary offering across all groups (Q5), with such events being offered regionally, nationally, and internationally (Q6). As such, respondents are obtaining credits from a range of accrediting bodies (Q7).
Though results of this survey cannot be considered as representative in any of the subgroups, they nevertheless provide recent data from the field and demonstrate opinions often encountered by EBAC in current discussions on CME/CPD accreditation. Further, although the majority of respondents recognised the value of CME/CPD accreditation, they also expressed that they have considered offering activities without credits at all (Q8). Moreover, the accreditation procedure itself has been embarrassingly considered as at least potentially:
- a purely bureaucratic exercise with investment of resources outweighing the benefit (62.7%)
- not ensuring educational quality (24%) or
- independence of information (29.4%), and thus
- adding no value (26%) (Q8).
However, 87% agreed that the importance of CME/CPD accreditation will at least remain the same, with the likelihood that it will actually increase (Q9).
Responses also demonstrated clearly that planning and delivery of CME/CPD is decidedly a team effort, with physician course directors and committees no longer directly managing all aspects (Q10, Q11). There were no surprises in the distribution of roles and responsibilities amongst these physician groups and supporting organisational teams. There was, however, some discrepancy between responsibilities in theory and in reality in regard to educational formats, educational materials, conflict of interest management, and management of industry funding, with the physician leads playing a more active role than what is considered ideal (comparison of Q10 and Q11). Correspondingly, respondents expressed a level of difficulty with these same areas while also indicating some difficulty with implementing an evaluation and appropriate outcomes measurement (Q12). Based on the results of the survey, the physician course directors, chairs, and committees are still the primary group responsible for selecting topics (79%), although most respondents indicated they use multiple methods for creating the programme content (Q13). This means that evaluation results are used for providing feedback to presenters, but also drive the design and content of future events (Q17).
These answers, in conjunction with the finding that 30% of respondents do not (or only occasionally) evaluate their CPD activities (Q14) and that a surprisingly high percentage of respondents do not see the medical professionals in a leading role when it comes to managing industry funding and conflicts of interest (Q10/11), may lead to the conclusion that concept and practice of CME/CPD accreditation need further promotion and dissemination in order to be understood by all stakeholders. This is even more important since the bulk of respondents only submit 0–5 applications annually to EBAC (76%) (Q19) and many providers expressed that CME/CPD represents only a portion of their job responsibilities. As such, most comments focused on ways to facilitate the integration of the accreditation requirements into operations, which are typically more dynamic than the accreditation process allows for (Q21–23). This includes transparency around the accreditation process itself and its ensuing credit decisions, as well as bridging the gap between the accreditation criteria in theory, the "what" to do, and the practical implementation of these standards into business realities, the "how" to do it. This manifests itself by being accessible for questions, providing education on key concepts, and offering concrete support in the form of tools, templates, and best practices.
In this regard, EBAC is satisfied with feedback regarding the accreditation process itself (Q19–21). For all the categories, the majority of respondents were satisfied with EBAC. Interestingly, and worth further exploring, each category also had a strong showing of neutral/unsure answers ranging from 22% to 38%. There are areas for improvement that were identified, namely around the applications process and timelines (Q20). This was also reflected in the recommendations that would be made to accreditors in general, which included less bureaucracy (44%) and facilitation of provider accreditation (37%) (Q21).
Though fully recognising the non-representative nature of the results, they nevertheless are consistent with the observations that EBAC reviewers have regularly made in the process of CME/CPD accreditation, as reflected in their comments on individual applications.
Thus, EBAC considers this survey as part of a continuing quality improvement process aiming to help providers and health-care professionals see CME/CPD accreditation as more than a tedious bureaucratic duty, but rather to regard it as an important contributor towards the delivery of highest possible standard of patient care.
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Liqueur thief to be sentenced
A man who faced 20 shoplifting charges after taking Drambuie from a bottle store has been remanded for sentence.
Peter William Carney, 61, of Clyde, appeared before Judge Michael Turner in the Invercargill District Court last week for driving while disqualified on April 29, wilful trespass on August 11, threatening to kill and 20 shoplifting charges between July and August.
Carney was remanded to September 17 for sentence.
Mark Raymond Fisher, 27, was sentenced to a total of four months and two weeks' home detention for assaulting two females and intentionally damaging a door on February 23, breaching a protection order on November 29 and breaching community work on December 5 and 28 and January 16. The sentence also included resentencing for assault on September 6 and threatening behaviour.
Melissa Phebe Hughes, 23, was remanded to October 15 for sentence for assaulting police on July 14.
Darryn Lyall Bower, 23, was sentenced to three months' community detention, and 150 hours' community work for assult with intent to injure on May 9.
The court was told he headbutted his partner and grabbed her throat.
Allan Rawiri MacLean, 21, shearer, of Gore, was sentenced to 14 months' jail, disqualified from driving indefinitely and ordered to pay $150 reparation for assault, assault with intent to injure, intentionally damaging a cellphone, driving with a breath alcohol level of 612mcg and driving while disqualified on March 16.
Daniel Grace, of Napier, was fined $250 for breaching community work on June 30, 2006.
Mitchell Thomas McGregor Carston, 17, was fined $400 for possessing an airgun (under 18 years) without a licence on August 23.
Indecent act
An Invercargill man was given interim name suppression and remanded to September 10 for sentence for doing an indecent act, driving while suspended and failing to stop for police on August 26.
Intentional damage
Nicki Christina Townsend, 19, was ordered to come up for sentence if called upon within nine months and ordered to pay $1401 reparation for intentionally damaging a wall and door on August 12.
Without reasonable excuse
Logan Joseph Baker-Saunders, 17, was ordered to come up for sentence if called upon within 12 months for being in a building in Esk St without reasonable excuse on August 29.
Margaret Evelyn Boyle, 76, was disqualified from driving for six months and ordered to pay $500 emotional harm reparation for careless driving causing injury on June 14.
David John Roberts, 29, mill hand, of Riverton, was remanded to October 18 for sentence for dangerous driving and driving while forbidden on August 11.
Angelina Simeon Heita, 19, was sentenced to three months' community detention, nine months' supervision and disqualified for nine months for driving with a breath alcohol level of 350mcg (under 20 years) and driving while disqualified on July 18.
Siobhan Evans-Rautahi, 19,was sentenced to 150 hours' community work and disqualified for eight months for driving with a breath alcohol level of 711mcg and careless driving on August 11.
Todd Duncan McGregor, 32, labourer, was remanded to November 5 for sentence for driving with a breath alcohol level of 468mcg on July 26.
Genevieve-Rose O'Donoghue, 20, of Bluff, 705mcg on August 4. Fined $700 and disqualified for six months.
Roseanne Hetaraka, 54, of Nightcaps, 750mcg on May 13. Sentenced to four months' home detention, ordered to undergo drug and alcohol assessment and treatment and disqualified for one year and one month.
Caleb Ricky Thomson, 17, sawmiller, of Riverton, 400mcg (under 20 years) on August 23. Fined $400 and disqualified for four months.
Carl Peter Tomlinson, 54, 894mcg on December 13, 2012. Sentenced to three months' home detention, fined $1000 and disqualified for one year and one month.
Fearghal Patrick Cronin, 29, of Australia, 573mcg on August 30. Fined $570 and disqualified for six months.
Susan Elizabeth Smaill, 53, of Wanaka, was fined $1100 and disqualified for eight months for driving with a blood alcohol level of 216mg on August 3.
The Southland Times


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Reusable for wrap free lunches and snacks.
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|78 reviews in total
I was much moved by Charlie St. Cloud and by Zac Efron in the title
role. It looks like the young man is going out way beyond being a Walt
Disney bubblegum poster boy for pubescent young ladies.
When we first meet Efron in the title role he looks to be a young man with a bright future. A scholarship to Stanford is his as he graduates high school from his New England coastal town where he enjoys sailing and the companionship of his younger brother Charles Tatan. The two are rabid Red Sox fans as all New England kids are brought up to be. Efron's boat is named the Splendid Splinter which everyone in New England knows is the nickname of Ted Williams. Being much older than Zac or his character, I actually remember seeing Ted play.
A cruel trick of fate puts the two of them in the path of an oncoming drunk driver. Both die, but a determined paramedic played by Ray Liotta brings Efron back.
As per an agreement they made minutes before the crash, Efron and Tatan still meet in the woods every day to play catch and work on Tatan's baseball skills. It's all Efron lives for. By some trick of fate he can communicate and see Tatan, in fact he sees all kinds of dead folks including a young man he graduated with from high school who was killed in Iraq. Efron's forgotten Stanford and he now works at the local graveyard, the better to be near the ones he identifies with.
I won't go into the rest except that Efron does learn to let the dead bury the dead. Meeting up with Amanda Crew, another sailing enthusiast does help. And Liotta now dying of cancer tells Zac that he was saved for some special purpose.
Two great lessons of life are to be learned in Charlie St. Cloud. First that we all have some kind of destiny, the trick is to find it and recognize it. The second is that some people die young and maybe are meant to so that the rest of us recognize how precious life is and not to waste it. Having lost any number of people including a sister at a young age, it's something that is always uppermost in my mind.
Charlie St. Cloud is beautifully filmed with some breathtaking sailing sequences. The performers are flawless, especially Zac Efron. One thing I will agree with other reviewers about is that I wish that the role of the mother of the St. Cloud brothers played by Kim Basinger was more fully developed. After the death of her younger son, she moves out of town and you never really learn why.
Despite that minor criticism, Charlie St. Cloud is a moving film that should be seen by all generations for the life lessons imparted.
I like movies that are exactly as they claim to be. "Charlie St. Cloud"
is just that, a romantic drama, nothing more and nothing less.
There is nothing profound, although with a few thoughtful dynamics, it's just the story of a young man (Zac Efron) unable to overcome the tragic death of his younger brother until he meets a beautiful girl who shares his same passion for sailing.
The problems are plentiful, with cringe-worthy dialogue, supporting actors who haven't yet learned how to act, no affecting drama producing few tears, and there just isn't enough to completely hold your attention. But yet, because it's a simple love story that doesn't pretend to be grandiose and doesn't force out-of-place tears, I liked "Charlie St. Cloud". I found it to be sweet, subdued and modest.
It was also the perfect choice for Zac Efron as he matures in his acting career. Sure, there are probably a few too many shots of Efron standing in his jeans and t-shirts staring into the sunset with his longing, blue eyes, but that is, of course, partly why we would watch it in the first place.
Ben Sherwood's Novel THE DEATH AND LIFE OF CHARLIE ST. CLOUD pretty
much describes this Hallmarky love and spiritualism showcase for teen
idol Zac Efron. Craig Pearce and Lewis Colick adapted the book for the
screen and director Burr Sherwood (known for his other films that are
of this genre) stirs the whipped cream. It is a pretty story with
pretty people filmed in a pretty location (British Columbia) and the
results are pretty predictable, yet when compared to the types of
stories on film that flood the theaters at least this film has gentle
heart and a lack of terror and horror and for that we should be
Charlie St. Cloud (Zac Efron, who holds in own in this rather implausible role) is a highly regarded young sailor who is wins a sailing scholarship to Stanford upon graduation from high school. He is devoted to his younger brother Sam (Charlie Tahan) and his single mother nurse Claire (Kim Basinger - don't blink or you'll miss her very brief appearance in the film). One night while Claire is on extra shift at the hospital Charlie and Sam are in an auto accident: Sam dies, but Charlie is resuscitated by paramedic Florio Ferrente (Ray Liotta, in another very brief cameo). Charlie is devastated over Sam's death and gives up his chances for a life by taking a custodian job in the town cemetery so he can be near a certain spot where he 'sees' and communicates with Sam every sunset - a life long promise to never leave his little brother. Five years pass and Charlie's friend Alistair (Augustus Prew) - his only other friend Sully (Dave Franco, brother of actor James Franco) has gone into the military - tries to encourage Charlie to date, but Charlie's eyes fall on Tess (Amanda Crew), a fellow sailor from the past, and love begins. Tess decides to take a long solo voyage in her boat and disappears. Charlie meets the now cancer-ridden and dying Florio who gives him his St Jude medal and encourages Charlie to embrace life. Charlie strikes out on a mission to find the missing Tess and the rest is pretty obvious.
Though the story is heavy on the saccharine edge and strains credibility, the team of actors is very fine - especially Zac Efron, whose presence is on the screen in practically every frame - so the film ends up being endearing. The cinematography by Enrique Chediak is gorgeous and the musical score by Rolfe Kent leans heavily on sad love songs. It is not a profound film though it does dip gently into the ideas of 'the beyond', but there is something about the honesty of it all that makes it s a satisfying evening of entertainment.
Grady Harp
*** This review may contain spoilers ***
After reading the book, I could hardly wait for this film to open and
believe me it doesn't disappoint.
Zac Efron does a great acting job as Charlie St. Cloud, a boy who has just received a sailing scholarship from Stamford. His future is all but sewn up until he and his brother Sam (played wonderfully by Charlie Tahan)get into a car accident. Sam and Charlie both die, but a caring paramedic by the name of Florio Ferrente (another great performance by Ray Liotta) performs a miracle and is able to bring Charlie back. Before he returns to the land of the living, Charlie promises Sam that he will always be there for him, no matter what. And so every day, Charlie comes back to play catch with Sam. Five years later he has chucked his scholarship and is now a caretaker at Waterside Cemetery, so that he can be close to his brother. Everything is going along well, until he spies a young woman by the name of Tess Carroll (another great acting job by Amanda Crew) who is getting ready to sail around the world. He meets her at the cemetery while she is cleaning out her father's grave and the two form a strong bond, although neither of them knows it yet.
One day, Florio spots Charlie in the street and tells him that he was saved for a reason and was given a second chance at life and that Charlie is just throwing his life away.
After a few days, he spots Tess again at her father's grave and their bond becomes deeper until the two fall passionately in love. Now Charlie must choose between the living and the dead and find his second chance at life.
By the way, Charlie can see the dead because of the promise he made to his brother before he was brought back to life by Florio. When he breaks the bond with Sam, he loses the ability to see the dead.
The movie did follow the book closely with slight differences, but all in all it is a film worth checking out just to marvel at the great acting job by all. And I am going to recommend reading the beautiful book The Death and Life of Charlie St. Cloud by Ben Sherwood. You will need a hankie for both.
for geniuskentyk...my advice is to read the book..it will explain away a lot of the things that are missing for you...
As I watched this movie I felt like I was viewing my own life story...
In 1991 I lost my little brother to a tragic accident as well. The emotions and inability to continue "living" life felt by Charlie are the same I had struggled with for many years. I found this movie to be extremely emotional, heart felt and true to the subject at hand. The acting of ALL the actors was outstanding, as well as the camera work, editing, directing, and most of all the writing.
If you like movies with true heart and emotion I highly recommend this movie as you can tell by my rating of 10. Honestly, I would rate it even higher than that if I could.
Although my love of this movie is very much inspired by my personal attachment to the subject, I think anyone would find this movie to be very touching...
I have to admit, that I never gave much thought of the phenomenon that
was surrounding Zac Efron. The ladies seemed to love him and no one
could have blamed him, if he just kept making the simple romantic
movies, that would please his fan base.
He seems to have other things on his mind though. He is trying to act. And I have to admit, that I was surprised at how engaging and how truthful he seemed in this one. I do think he is better than the High School Musical tag he has stamped on him (which would mean, he is a bad actor, which frankly I don't think could be said of him).
His character does get a lot of attention from the female characters on display here, which seems natural. On the other hand, you do have the female lead in here, that does not seem to get any attention whatsoever, which makes you wonder if the male "population" in the movie is blind or into other things. Whatever it is, this is one of the things that do not feel right. The other being the mixture between the elements on display here. Let me just tell you, that this isn't neither your simple romantic movie, nor just pure drama. There is other aspects to it. I can see though that this might ruin the movie for quite a few people. Especially if they expected something more straight-forward.
This film is about a young man who loses his younger brother to a
traffic accident. He remains locked in a state of grief until he
rekindles with his friend from high school.
"Charlie St. Cloud" is beautifully filmed, with great artistic scenes and amazing sceneries. Cinematography is great, and many scenes are so beautiful that they could become postcards. However, the story is not as good, it is not very engaging. I find the plot unconvincing and the story telling is rather poor. The romance Charlie and the girl develops is unconvincing and contrived, and the emotional burden and guilt of Charlie could have been explored further.
Charlie St Cloud is the type of movie many people will love to hate.
The plot is simply contrived and the script is somewhat identical to
Shyamalan's film "The Sixth Sense" yet I was very much moved by the
story of Charlie St. Cloud and by Zac Efron in the title role. It looks
like Zac is going out of his way to shred that teenage 'High School
Musical' image that he is now known for.
When we first meet Efron in the title role he looks to be a young man with a bright future. A scholarship to Stanford awaits as he graduates high school from his New England coastal town where he enjoys sailing with his younger brother Charlie Tahan. The two share some heart warming chemistry as brothers, those who have younger siblings will understand the brotherly love between the two.
However, a cruel trick of fate puts the two of them in the path of an oncoming drunk driver. Both die, but a determined, spiritual paramedic played by Ray Liotta manages to bring Efron back.
As per an agreement they made minutes before the crash, Zac and Charlie still meet in the woods every day to play catch and work on Charlie's baseball skills. It's all Efron lives for. By some trick of fate he can communicate and see his deceased brother. Efron's forgotten Stanford and he now works at the local graveyard, to be close Charlie so that He can fulfil the promise he made.
I won't go into it too much except that the climax is something that we have seen before yet it is still touching and shows that we must learn that the true value of life is to live and let live.
I came out of the cinema feeling good and that is what the film is all about- loving life. My only criticism is that Liotta and Kim Basinger(as the mother) don't have enough screen time, although i must say that Liotta still manages to impress even with this small supporting role. Zac Efron and Charlie Tahan deliver strong performances as the two brothers and Amanda Crew is pretty decent. The film is beautifully shot and the scenery is quite breathtaking at times.
We've seen quite a few romantic dramas this year(Dear John, The Last Song)- but this has to be one of the most touching(not the most original i must say) but still, it'll make you feel good inside. So my advice is go watch the movie or rent it when it comes out on DVD and don't believe those critics who's job it is to tell us how bad the movie must be just because it didn't earn $100 million at the box office.
I really enjoyed this movie. It didn't disappoint me at all because I
didn't expect much more than a beautiful love story, pretty scenery,
very good acting, and thought-provoking ideas. I got exactly what I
came for and maybe even a little more. The script is pretty dull, but
the way the movie was filmed and acted made it absolutely amazing the
way I saw it. Absolutely gorgeous scenery and cinematography, original
ideas and scenes (I loved the graveyard scene when Tess and Charlie are
chasing each other around with candle lights and pretty music, there
was nothing at all about it that I'd seen before), very good acting,
and a very beautiful story is what made this movie so great in my eyes.
Despite how gorgeous Zac Efron is, it is clear he is capable of above-mediocre acting. He had nearly nothing to work with but made this movie captivating because of how carefully he played his words and showed his emotion. Nothing felt forced. The script is so dull but because of his ability to portray what was meant to be said, it made the movie ten times better. He is much more than good looks even though and I know his blue eyes are distracting, but he has a lot of talent. I think some people don't want to believe that someone can have both great looks and great talent because they get envious. He has made astounding career choices and has worked his way to the top, unlike Miley Cyrus, he has pure talent and heart at what he does, and hasn't gone all bare-skinned and photo scandal-ish to draw attention away from his lack of talent. He is grateful for his career and his talent is shining through. I believe he has a very promising career ahead of him despite all this silly hatred he is getting. He is a precious gem in my eyes; both gorgeous and very talented and able to show emotion in such a real way. The lead actress Amanda Crew did an okay job, she wasn't terrible, wasn't great. His graveyard friend provided comic relief and I thought he was funny.
All in all, I give this movie 10/10 because I went in theaters to see it twice, I am thoroughly impressed with Zac and the career choices he has made, I loved how uniquely it was filmed and how original the story was, and I'm just a sappy hopeless romantic so I love films like this.
*** This review may contain spoilers ***
Charlie St. Cloud is a remarkable story about life and love, death and
loss, letting go and moving on. But above all it's about the bond
between two brothers that not even death can break.
Charlie St. Cloud the movie was not exactly like the book but it did not disappoint me as a whole,because while it is based on the book, you also have to appeal to the movie goers and I think they did that well.For me, having read the book there were a couple things (scenes and script) that I missed. Iwill point out what I missed but I feel I first have to comment on the beautiful portrayal of the main character Charlie St. Cloud by ZacEfron. Even if I had not known who was going to be playing Charlie in the movie Zac Efron would have been my choice, he just fits the part.He brought everything that was needed in that character to the big screen. You really felt the bond between him and his younger brother Sam who was portrayed by Charlie Tahan (wonderful performance). AfterSam dies but is caught in the in between, he and Charlie are still connected, and you need that bond to be strong but also believable throughout and they did just that. Zac Efron is one of the best actors out there today in my opinion. Yes he is incredibly handsome but he is also incredibly talented and in my opinion as the years go on I think he is just going to become more of a talented actor and may be even become one of the best actors of all time if he continues on. I think people should not type cast him in the musical roles, because while he is great in all of those, he is also amazing in more serious roles that don't involve singing and dancing (like Me and Orson Welles and 17 Again... he may do a tiny bit of both in each of those but you get what I mean, I'm talking the full on musicals) and I hope he continues to do more of the serious/mature roles like this one was. I've heard that some critics out there don't feel that Zac got the emotions across that Charlie goes through; I feel that all those critics are wrong, I think he got all the emotions across the way that the book intended them to be and the way that in real life sometimes you feel in those kind of situations. Zac to me always gets his emotions across through his beautiful blue eyes, and too me that's important, because you can tell a lot of what someone is feeling from their eyes (at least in my opinion). I felt every emotion that he felt, and to be honest I think every time he cried I cried because it was a moment when you would and the same goes for his happy moments and so on, so don't tell me that he didn't get his emotions across because I felt them all through his acting. All of the actors and actress's portrayed their characters well, however there were a few characters from the book that were missing in the movie and in some ways I felt they were needed, but what can you do. This movie had some incredible scenery and the way it was captured on film was beautiful. The soundtrack, which is always important to me, was amazing. I especially loved the song While We Were Dreaming by Pink Mountaintops. The things I missed from the book in this film, well there's a scene where Tess meets and can see Sam and I think it is a pivotal moment in the book and would have brought more sense to those who watched the movie and had not read the book. I think they should have taken us on Tess's journey in her boat when things go wrong, I guess for the movie goers they thought maybe it would give away too much, I suppose in some ways it might have. Ray Liotta's character Florio Ferrente to me did not get enough of a part, he is a key character in the book and I think it would have given the movie just that much more if he had narrated a bit at the beginning and end like he seems to do in the book. Some of the most beautiful words come from his character and I don't think they did him justice in the movie and that's too bad, I really admired his character in the book. All in all I think both the book and the movie are a must read and watch. Until next time! "Qualcuno ti ama."
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Bradley Hills Animal Hospital
7210 Bradley Blvd
Bethesda, MD 20817
(301) 365-5448
Mon - Wed: 7:00AM - 6:00PM
Thu: 7:00AM - 7:00PM
Fri: 7:00AM - 6:00PM
Sat: 7:00AM - 12:00PM
Sun: Closed
We believe that quality animal medicine involves fusing state-of-the-art technology and equipment with skilled and caring veterinary professionals. At Bradley Hills Animal Hospital, we offer the latest advances in veterinary services for dogs, cats, ferrets and other small mammals including guinea pigs, rabbits, rats, mice, hamsters, and gerbils.
As pet owners ourselves, we appreciate the special bond between animals and their families. Everything about our facility is designed with your pet?s health, comfort and safety in mind; from our friendly, calm environment to our dedicated staff. We strive to make you feel like a part of our family from the moment you and your pet enter our doors.
We invite you to tour our website and discover the exceptional veterinary care we can provide for your very special animal companion.
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Charlie Weiss
MD - Maryland
Certifications & Memberships
5 stars Pamela B Featured review
We have been extremely pleased with Dr. Weiss and his staff, during our five year stay in MD. Their care of our ailing 14-year old cattle dog during her final days was nothing short of extraordinary and the way they eased our family through the grieving process when we lost her went above and beyond. We will be forever grateful to Dr. Weiss for his compassion, easy rapport, and professional expertise!
5 stars Carol S Customer since 2017
What can I say? I knew at the very moment I walked through the door for the first time that I had found the very best and right place to bring my 2 kitties!! Crystal and Amber welcomed us so warmly, we both felt like we were home. Dr. Weiss is truly an Animal Whisperer with a gentle touch that puts the most nervous of cats at ease. I would recommend to anyone and everyone. So happy I found them!!
5 stars John M Customer since 2013
We are pleased with Dr. Muller and Dr. Weis
5 stars Anonymous Verified customer
We've really enjoyed our experience with Bradley Hills thus far. My only reservation is the pricing. They quoted us 200% area market average for a spay procedure (OUCH!) and their on-hand heartworm and flea/tick monthly chewables are priced about 4x the prices online or Amazon. Great service, super clean environment, extremely friendly staff. However, if you are on any sort of budget, this may not be the veterinarian for you.
5 stars Sue W Customer since 2013
my elderly cat has received excellent care
5 stars Rainey F Customer since 2009
The. Best - as always!!
5 stars Anonymous Verified customer
The doctors and staff are always friendly, caring and helpful! :)
5 stars Karen & Tom K Customer since 2010
Dr. Weiss has to be o e the best veterinarian around if not the best. He has taken great care of our pets for over 7 years, he is very knowledgeable, courteous, and very professional.
They are very gentle and you can tell they care about your pets.
I highly recommend Dr. Wiess.
5 stars Mary L Customer since 2016
The best vet in the Montgomery County area.
5 stars Marcey Z Customer since 2013
Great as always but was surprised to hear Dr. Mueller was gone.
3 stars Anonymous Verified customer
I was disappointed with the lack of time the doctor spent with me and my dog. He didn't even examine him except his teeth in my presence. I would appreciate having him check his heart and lungs with me there and even having the shots and blood work done in my presence.
His demeanor is fine and it's great he sits on the floor to get the dog to relax but he didn't ask many questions either.
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Program Waivers – Ah yes… the paperwork!
We'll definitely need your program waivers. Don't forget to fill out and submit the appropriate waiver! We require these before you get in the water!
- Click here to download the waiver for snorkeling.
- Click here to download the waiver for scuba diving.
If you have any questions, please call 303-789-2450.
Please note: Rescheduling and cancellations less than 48 hours in advance are subject to transfer and cancellation fees.
Downtown Aquarium
Denver's Downtown Aquarium, where all our programs are held, features a public aquarium boasting more than one million gallons of underwater exhibits highlighting fascinating ecosystems from around the world and over 500 species of animals. Aquarium website
Scuba Diving Vacations
Once you've explored the Downtown Aquarium dives, you'll be ready for more action! A-1 Scuba and Travel Center's full-service travel agency offers great deals for independent travelers as well as exciting group expeditions.
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Selecting The Best Wooden Bunk Beds From The Most Popular Bunk Beds
A bed is one of the items that you will never fail to recognize from the moment you step into any bedroom. People sleep on their beds when they are tired due to tiresome activities during the day. A well-curved bed can offer services such as being used as a chair, dining table or as a study desk. Beds are decorators of your home if they are well curved and designed. There are various types of beds in the market that you can choose from. Due to the various types of beds, their prices are also different according to the design. People have varied tastes and preferences and this will make them choose a bed according to their likeness.
Wooden bed bunks are a famous kind of bunk beds, and they have many advantages over the metal bunk beds. Ideally, these wooden bunk beds are usually safer since there is no need to worry about weld cracking. In most instances, wooden bunk beds are stylish than metal beds because of the additional components such as shelves and drawers. The presence of wooden bunk beds in a room make it look good, and aside from sleeping on it, posters and stickers can be put on it also. Wooden bed bunks use minimum amount of space, and they are suitable for a small home. The use of wooden beds delights children mostly, and they are suitable for any home.
There are many designs available in the market because wood can be made into any design that you want for your children. Attractive designs can be incorporated into these wooden bunks, and these designs are meant to please the girls. These kinds of beds will not only look warm but will be inviting as well. Wooden beds are also much harmless as they are not hard compared to materials they are made from. For proper usage, caution your children from jumping on the bed, play in it, and this may increase the durability of the bed. When carefully maintained, wooden bunk beds are very durable because of the nature of wood used.
Getting Creative With Reviews Advice
As you buy any item for your home, it has to reflect or give you value for your money, and this means that you should be knowledgeable. Space should be a major consideration when deciding which kind of furniture to get. Wooden bunks beds make use of little space, and they are suitable for any home. The bed that you have always been yearning to have is here because they are suitable for everyone. It is false to state that wooden bunk beds are not appropriate for use by children and so you should select the right one for use.Doing Sales The Right Way


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Yeah, it's over. I don't believe I even mentioned that I was going on vacation, but I noticed a pretty large amount of views over the past 5 days and I'm guessing some were wondering why there were no new posts... and the answer is vacation.
So, we'll post again now. :)
Well Said: I gave you a brain and you never used it.
20 hours ago


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It was as if the Yankees were cursed like the Boston Red Sox, for one evening. When the first of Chili Davis's two line drives turned into a triple play last night, that was extraordinary bad luck. When his second line drive became a double play, that was plain weird.
Roger Clemens -- formerly of the doomed Red Sox -- pitched his best game for the Yankees, striking out 13, and yet he was the losing pitcher because of a 25-foot swinging bunt. The Yankees fell to the Texas Rangers, 4-2, before 30,157 at Yankee Stadium, and everybody in the clubhouse was talking about fate.
''That was one of those games we weren't meant to win,'' Joe Torre said before contrasting the tides of this game with the charmed 1998 season.
Davis added, ''Bad biorythms today.''
The Yankees smashed rockets all over the Stadium and almost all of them turned out to be duds. Davis came to bat in the second inning with Tino Martinez on second base and Paul O'Neill at first, Davis battled the Rangers' Aaron Sele to a full count.
Attempting to avoid a double play, Martinez and O'Neill began running as Sele delivered his next pitch. Davis hammered a liner to second baseman Mark McLemore, who caught the ball for the first out and threw to the shortstop Royce Clayton, who stepped on second to double off Martinez.Continue reading the main story
O'Neill already was about 20 feet from second base, and Clayton fired to first baseman Lee Stevens for an easy completion of the triple play, the first against the Yankees since Steve Balboni lined into a triple play against Baltimore on June 15, 1989, and only the second in the Rangers' history.
''He should've taken me out of the ball game right there,'' Davis said. ''I was bad luck.''
No, all the Yankees were hexed. If a team cannot win when Clemens pitched as he did last night, they lack karma, harmony or whatever. All night, the Texas hitters would return to the dugout, looking disconsolate, and report observations to teammates: he has an explosive fastball; his slider is nasty; his splitter, well, they were all missing that pitch.
Clemens kept firing strikes, hard strikes, fastballs clocked at 96 miles an hour, one after another, like a relentless machine. He would pound fastballs to reach a two-strike count and follow with split-fingered fastballs that neared the plate and then burrowed into the dirt, and the Rangers would swing and miss.
Pitching against the Florida Marlins last weekend, Clemens reached two-strike counts 11 times in the first five innings, and 7 of those 11 batters reached base with a hit or walk. Clemens had no problem finishing off hitters last night: he reached two-strike counts 14 times in the first six innings and got 14 outs, most of them strikeouts.
Posada said, ''That was the best he's thrown all year.''
Three Rangers whiffed in the first inning, three more in the second, another in the third. Fans began murmuring with each strike, clapping with two strikes, and they roared for strikeouts. Clemens struck out three in the fourth, for a total of 10. The game was not half over and Clemens was halfway to 20 strikeouts, the record he first established in 1986, tied in 1996, the record that Kerry Wood tied last year.
The Rangers tied the score in the fifth, the Yankees went ahead in their half of the inning, Martinez dumping a broken-bat single to center to drive home a run. But Juan Gonzalez, who had unsuccessfully chased Clemens's fastball all over the strike zone in his two at-bats, finally caught one. The slugger whacked the first pitch thrown by Clemens in the sixth inning far and high over the left field wall, tying the score.
Rain had begun falling in the first inning and continued throughout most of the game, in varying degrees, heavy enough that hitters wiped their bats and light enough that many fans chose to remain in their uncovered seats without umbrellas, or even hats. The wet grounds weren't a factor, for six innings.
Clemens had thrown 99 pitches in the first six innings, his strikeout count had slowed -- he had 12 as the seventh inning began. Gregg Zaun singled and when Clayton bunted and Clemens rushed in to field the ball, Posada called for Clemens to throw the ball to first, even when it appeared as if Clemens had a good chance to get Zaun at second; there was always possibility Clemens would slip and fall.
''You want to be aggressive, but you also want an out,'' Posada said.
Zaun took third on a groundout. Two outs. Clemens, his cheeks and chin sprouting hewn, day-old whiskers, was still in control. Martinez, the Yankees' first baseman, went to the mound to remind Clemens that the home plate umpire, Eric Cooper, seemed to have an expanded strike zone, a couple of inches off the outside corner. With a 1-2 count on Roberto Kelly, Clemens fired a fastball at that very spot: Ball 2.
''It just happens that way sometimes,'' the right-hander said.
Clemens then jammed Roberto Kelly with a fastball, the ball rolling barely 25 feet from the plate, on the third base side. An instant passed before Posada spotted the ball, before he hustled to grab it. Zaun sprinted homeward, too far away from the ball to be tagged out. Posada's only play was at first.
As he whirled to throw, his feet slid out from under him, like a skater flubbing a half-axle. Posada held the ball, Zaun charged across home with the go-ahead run.
There was hope. O'Neill singled with one out and Davis glided forward to blister a line drive -- speared by the pitcher Mike Munoz, in self-defense, and Munoz threw to first to nab O'Neill off first base. Davis stood and stared ahead disbelievingly.
JORGE POSADA knew what he would be told when he had his eyes checked yesterday. His eyesight is perfect and can't be blamed for his low batting average and 10 passed balls.Continue reading the main story


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Organic Nacho Style Dippers Gluten Free, ingredients: ds*, linseed gold*, yeast extract* (not raw), pink Himalayan salt, sunflower oil*, lemon juice*, paprika powder* *certified organic ingredients
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Nacho Style Dippers should be made illegal because they taste soooo goood you just can't stop eating them. There's no way you can open a pack of these little beauties without eating the whole lot. Never mind dipping them into anything, I just eat them as they are.


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Zomblaster The zombie apocalypse has ended, but a few zombies are still hanging around. In Zomblaster our hero, who is a part time firefighter and a part time cleaner, has to fight them off.
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