text:
Down syndrome
Down syndrome | |
Classification and external resources | |
Boy with Down syndrome assembling a bookcase
DiseasesDB | 3898 |
MedlinePlus | 000997 |
eMedicine | ped/615 |
MeSH | D004314 |
Down syndrome (DS) or Down's syndrome, also known as trisomy 21, is a genetic disorder caused by the presence of all or part of a third copy of chromosome 21.[1] Down syndrome is the most common chromosome abnormality in humans.[2] The CDC estimates that about one of every 691 babies born in the United States each year is born with Down syndrome.[3] It is typically associated with physical growth delays, a particular set of facial characteristics and a severe degree of intellectual disability.[1] The average full-scale IQ of young adults with Down syndrome is around 50 (70 and below is defined as the cut-off for intellectual disability), whereas young adult controls have an average IQ of 100.[1][4]
Many children with Down syndrome are educated in regular school classes while others require specialised educational facilities. Some children graduate from high school,[5] and, in the US, there are increasing opportunities for participating in post-secondary education.[6] Education and proper care has been shown to improve quality of life significantly.[7] Many adults with Down syndrome are able to work at paid employment in the community, while others require a more sheltered work environment.[5]
Down syndrome is named after John Langdon Down, the British physician who described the syndrome in 1866.[8] The condition was clinically described earlier by Jean-Étienne Dominique Esquirol in 1838 and Édouard Séguin in 1844.[9] Down syndrome was identified as a chromosome 21 trisomy by Dr. Jérôme Lejeune in 1959. Down syndrome can be identified in a newborn by direct observation or in a fetus by prenatal screening.[1][10] Pregnancies with this diagnosis are often terminated.[11]
Signs and symptoms
The signs and symptoms of Down syndrome are characterized by the neotenization of the brain and body.[12] Down syndrome is characterized by decelerated maturation (neoteny), incomplete morphogenesis (vestigia) and atavisms.[13] Individuals with Down syndrome may have some or all of the following physical characteristics: microgenia (abnormally small chin),[14] oblique eye fissures on the inner corner of the eyes,[15][16] muscle hypotonia (poor muscle tone), a flat nasal bridge, a single palmar fold, a protruding tongue (due to small oral cavity, and an enlarged tongue near the tonsils) or macroglossia,[15][16] "face is flat and broad",[17] a short neck, white spots on the iris known as Brushfield spots,[18] excessive joint laxity including atlanto-axial instability, excessive space between large toe and second toe, a single flexion furrow of the fifth finger, a higher number of ulnar loop dermatoglyphs and short fingers.[16]
Growth parameters such as height, weight, and head circumference are smaller in children with DS than with typical individuals of the same age. Adults with DS tend to have short stature and bowed legs[16]—the average height for men is 5 feet 1 inch (154 cm) and for women is 4 feet 9 inches (144 cm).[19] Individuals with DS are also at increased risk for obesity as they age.[20]
Characteristics | Percentage[21] | Characteristics | Percentage[21] |
Stunted growth | 100% | Flattened nose | 60% |
Mental retardation | 99.8% | Small teeth | 60% |
Atypical fingerprints | 90% | Clinodactyly | 52% |
Separation of the abdominal muscles | 80% | Umbilical hernia | 51% |
Flexible ligaments | 80% | Short neck | 50% |
Hypotonia | 80% | Shortened hands | 50% |
Brachycephaly | 75% | Congenital heart disease | 45% |
Smaller genitalia | 75% | Single transverse palmar crease | 45% |
Eyelid crease | 75% | Macroglossia (larger tongue) | 43% |
Shortened extremities | 70% | Epicanthic fold | 42% |
Oval palate | 69% | Strabismus | 40% |
Low-set and rounded ear | 60% | Brushfield spots (iris) | 35% |
Individuals with Down syndrome have a higher risk for many conditions. The medical consequences of the extra genetic material in Down syndrome are highly variable, may affect the function of any organ system or bodily process, and can contribute to a shorter life expectancy for people with Down syndrome. Following improvements to medical care, particularly with heart problems, the life expectancy among persons with Down syndrome has increased from 12 years in 1912, to 60 years.[22] The causes of death have also changed, with chronic neurodegenerative diseases becoming more common as the population ages. Most people with Down syndrome who live into their 40s and 50s begin to suffer from dementia like Alzheimer's disease.[23]
The American Academy of Pediatrics, among other health organizations, has issued a series of recommendations for screening individuals with Down syndrome for particular diseases.[24]
Neurological effects
Most individuals with Down syndrome have intellectual disability in the mild (IQ 50–70) to moderate (IQ 35–50) range,[25] with individuals having Mosaic Down syndrome typically 10–30 points higher.[26] The methodology of the IQ tests has been criticised for not taking into account accompanying physical disabilities, such as hearing and vision impairment, that would slow performance.[27]
Language skills show a difference between understanding speech and expressing speech, and commonly individuals with Down syndrome have a speech delay.[28] Fine motor skills are delayed[29] and often lag behind gross motor skills and can interfere with cognitive development. Effects of the condition on the development of gross motor skills are quite variable. Some children will begin walking at around 2 years of age, while others will not walk until age four. Physical therapy, and/or participation in a program of adapted physical education (APE), may promote enhanced development of gross motor skills in Down syndrome children.[30]
Children and adults with DS are at increased risk for developing epilepsy and also Alzheimer's disease.[31]
Congenital heart disease
The incidence of congenital heart disease in newborn babies with Down syndrome is up to 50%.[32] An atrioventricular septal defect also known as endocardial cushion defect is the most common form with up to 40% of patients affected. This is closely followed by ventricular septal defect that affects approximately 35% of patients.[32]
Although the general incidence of cancer amongst individuals with Down syndrome is the same as in the general population,[33] there are greatly reduced incidences of many common malignancies except leukemia and testicular cancer.[34] People with Down syndrome also have a much lower risk of hardening of the arteries and diabetic retinopathy.[35]
Hematologic malignancies such as leukemia are more common in children with DS.[36] In particular, acute lymphoblastic leukemia is at least 10 times more common in DS and the megakaryoblastic form of acute myelogenous leukemia is at least 50 times more common in DS. Transient leukemia is a form of leukemia that is rare in individuals without DS but affects up to 20 percent of newborns with DS.[37] This form of leukemia is typically benign and resolves on its own over several months, though it can lead to other serious illnesses.[38] In contrast to hematologic malignancies, solid tumor malignancies are less common in DS, possibly due to increased numbers of tumor suppressor genes contained in the extra genetic material.[39]
Thyroid disorders
Individuals with DS are at increased risk for dysfunction of the thyroid gland, an organ that helps control metabolism. Low thyroid (hypothyroidism) is most common, occurring in almost a third of those with DS. This can be due to absence of the thyroid at birth (congenital hypothyroidism) or due to attack on the thyroid by the immune system.[40]
Down syndrome increases the risk of Hirschsprung's disease, in which the nerve cells that control the function of parts of the colon are not present.[41] This results in severe constipation. Other congenital anomalies occurring more frequently in DS include duodenal atresia, annular pancreas, and imperforate anus. Gastroesophageal reflux disease and celiac disease are also more common among people with DS.[42]
Males with Down syndrome usually cannot father children, while females demonstrate significantly lower rates of conception relative to unaffected individuals.[43] Women with DS are less fertile and often have difficulties with miscarriage, premature birth, and difficult labor. Without preimplantation genetic diagnosis, approximately half of the offspring of someone with Down syndrome also have the syndrome themselves.[43] Men with DS are almost uniformly infertile, exhibiting defects in spermatogenesis.[44] There have been only three recorded instances of males with Down syndrome fathering children.[45][46]
Eye disorders
Eye disorders are more common in people with DS. Almost half have strabismus, in which the two eyes do not move in tandem. Refractive errors requiring glasses or contacts are also common. Cataracts (opacity of the lens), keratoconus (thin, cone-shaped corneas), and glaucoma (increased eye pressures) are also more common in DS.[47] Brushfield spots (small white or grayish/brown spots on the periphery of the iris) may be present.
Hearing disorders
In general, hearing impairment and otological problems are found in 38-78% of children with Down syndrome compared to 2.5% of normal children.[48][49][50] However, attentive diagnosis and aggressive treatment of chronic ear disease (e.g. otitis media, also known as glue-ear) in children with Down syndrome can bring approximately 98% of the children up to normal hearing levels.[51]
The elevated occurrence of hearing loss in individuals with Down syndrome is not surprising. Every component in the auditory system is potentially adversely affected by Down syndrome.[50]
Otitis media with effusion is the most common cause of hearing loss in Down children;[49] the infections start at birth and continue throughout the children's lives.[52] The ear infections are mainly associated with Eustachian tube dysfunction due to alterations in the skull base. However, excessive accumulation of wax can also cause obstruction of the outer ear canal as it is often narrowed in children with Down syndrome.[53] Middle ear problems account for 83% of hearing loss in children with Down syndrome.[53] The degree of hearing loss varies but even a mild degree can have major consequences for speech perception, language acquisition, development and academic achievement[52] if not detected in time and corrected.[49]
Early intervention to treat the hearing loss and adapted education are useful to facilitate the development of children with Down syndrome, especially during the preschool period. For adults, social independence depends largely on the ability to complete tasks without assistance, the willingness to separate emotionally from parents and access to personal recreational activities.[48] Given this background it is always important to rule out hearing loss as a contributing factor in social and mental deterioration.[50]
Other complications
Instability of the atlanto-axial joint occurs in approximately 15% of people with DS, probably due to ligamental laxity. It may lead to the neurologic symptoms of spinal cord compression.[54]
Down syndrome disorders are based on having too many copies of the genes located on chromosome 21. In general, this leads to an overexpression of the genes.[55] Understanding the genes involved may help to target medical treatment to individuals with Down syndrome. It is estimated that chromosome 21 contains 200 to 250 genes.[56] Recent research has identified a region of the chromosome that contains the main genes responsible for the pathogenesis of Down syndrome.[57]
The extra chromosomal material can come about in several distinct ways. A typical human karyotype is designated as 46,XX or 46,XY, indicating 46 chromosomes with an XX arrangement typical of females and 46 chromosomes with an XY arrangement typical of males.[58] In 1–2% of the observed Down syndromes,[59] some of the cells in the body are normal and other cells have trisomy 21. This is called mosaic Down syndrome (46,XX/47,XX,+21).[60][61]
Trisomy 21
Trisomy 21 (47,XX,+21) is caused by a meiotic nondisjunction event. With nondisjunction, a gamete (i.e., a sperm or egg cell) is produced with an extra copy of chromosome 21; the gamete thus has 24 chromosomes. When combined with a normal gamete from the other parent, the embryo now has 47 chromosomes, with three copies of chromosome 21. Trisomy 21 is the cause of approximately 95% of observed Down syndromes, with 88% coming from nondisjunction in the maternal gamete and 8% coming from nondisjunction in the paternal gamete.[59] The actual Down syndrome "critical region" encompasses chromosome bands 21q22.1-q22.3.[62]
Robertsonian translocation
The extra chromosome 21 material that causes Down syndrome may be due to a Robertsonian translocation in the karyotype of one of the parents. In this case, the long arm of chromosome 21 is attached to another chromosome, often chromosome 14 [45,XX,der(14;21)(q10;q10)]. A person with such a translocation is phenotypically normal. During reproduction, normal disjunctions leading to gametes have a significant chance of creating a gamete with an extra chromosome 21, producing a child with Down syndrome. Translocation Down syndrome is often referred to as familial Down syndrome. It is the cause of 2–3% of observed cases of Down syndrome.[59] It does not show the maternal age effect, and is just as likely to have come from fathers as mothers.[citation needed]
Prenatal testing
Both ACOG and NICE guidelines recommend that screening for Down syndrome be offered to all pregnant women, regardless of age.[63][64]
A number of tests can be used to screen for Down syndrome, with varying levels of accuracy and invasiveness. They are usually used in combination to increase their detection rate, while maintaining a low false positive rate.
Screen | When performed (weeks gestation) | Detection rate | False positive rate | Description |
Combined test (Nuchal translucency/free beta-hCG/PAPP-A screen) | 10–13.5 | 85%[65] | 5% | Uses ultrasound to measure Nuchal Translucency in addition to the free beta-hCG and PAPP-A (pregnancy-associated plasma protein A). NIH has confirmed that this first trimester test is more accurate than second trimester screening methods.[66] |
Quad screen | 15–20 | 81%[35] | 5% | This test measures the maternal serum alpha-fetoprotein, unconjugated estriol, beta-hCG, and inhibin-Alpha (INHA).[67] |
Integrated test | 15-20 | 95%[68] | 5% | The integrated test uses measurements from both the 1st trimester combined test and the 2nd trimester quad test to yield a more accurate screening result. Because all of these tests are dependent on accurate calculation of the gestational age of the fetus, the real-world false-positive rate is >5% and may be closer to 7.5%.[citation needed] |
Ultrasound imaging can be used to screen for Down syndrome. Increased fetal nuchal translucency (NT) is an indicator of increased risk of Down syndrome. A 2003 systematic review of 30 studies of NT in Down syndrome found an average sensitivity of 75-80% with a false positive rate of 5.8-6% (95% confidence intervals).[69] Therefore, while the false positive rate is too high for NT to be used alone as a screening test, it is useful as part of a combined test. Ultrasound measurement of NT is usually performed between 11 and 14 weeks gestation.
Other ultrasound findings have been associated with Down syndrome. Absence of the fetal nasal bone has been associated with Down syndrome. A 2001 observational study suggested that there is an increased rate of absence of nasal bone in fetuses with Down syndrome.[70] However, it is unclear how useful this would be as a screening test as the reproducibility and consistency of the procedure has not been demonstrated.
Blood tests
Several blood markers can be measured that can be used as part of combined tests to predict the risk of Down syndrome. These include α-fetoprotein, β-hCG, inhibin-A, PAPP-A and unconjugated estriol.
During the first trimester, a combination of β-hCG and PAPP-A levels can give a 60% detection rate at a 5% false positive rate.[71]
In the second trimester, various markers including β-hCG, inhibin-A, α-fetoprotein and unconjugated estriol can be used to give detection rates between 60 and 70%.[72]
Several non-invasive prenatal tests which employ DNA sequencing of fragments of fetal DNA in the mother's blood have been developed. The main method is to obtain maternal blood through venipuncture for analysis of cell-free fetal DNA (cffDNA). It can be performed at 10 weeks of gestational age.[73] Methods to analyze cffDNA are mainly either massively parallel sequencing (MPSS) or directed DNA analysis, wherein the former analyzes a random subset of cffDNA fragments.[73] MPSS is estimated to have a sensitivity of between 96 and 100%, and a specificity between 94 and 100% for detecting Down syndrome.[74] The International Society for Prenatal Diagnosis finds that this is an advanced screening test which may be of use, in conjunction with genetic counseling, in high-risk cases based upon existing screening strategies. While effective in the diagnosis of Down syndrome, it cannot assess other conditions which can be detected by invasive testing; (for pregnant women who are screen-positive using current screening protocols, Down syndrome represents about half of the fetal chromosomal abnormalities identified through amniocentesis and CVS).[75]
Amniocentesis and CVS
Where screening tests predict a high risk of the fetus having Down syndrome, more invasive diagnostic tests such as amniocentesis and chorionic villus sampling may be performed. These tests have a much lower false positive rate than the screening tests, therefore they are more reliable in establishing the diagnosis of Down syndrome. However, they are invasive, and carry a slightly increased risk of miscarriage.
Abortion rates
A 2002 literature review of elective abortion rates found that 91–93% of pregnancies in the United Kingdom and Europe with a diagnosis of Down syndrome were terminated.[11] Data from the National Down Syndrome Cytogenetic Register in the United Kingdom indicates that from 1989 to 2006 the proportion of women choosing to terminate a pregnancy following prenatal diagnosis of Down syndrome has remained constant at around 92%.[76][77]
In the United States a number of studies have examined the abortion rate of fetuses with Down syndrome. Three studies estimated the termination rates at 95%, 98%, and 87%.[11]
Postnatal diagnosis
In cases where prenatal tests have been negative or have not been performed, midwifery staff usually express the initial concern that a newborn has Down syndrome, such as by distinctive signs or by general appearance.[78] Clinical examination by a pediatrician can often confirm or refute this suspicion with confidence.[78] Systems of diagnostic criteria for such an examination include Fried's diagnostic index, which includes the following 8 signs: flat face, ear dysplasia, tongue protrusion, corners of mouth turned down, hypotonia, neck skin excess, epicanthic fold, and a gap between 1st and 2nd toes.[78] With 0 to 2 of these characteristics the newborn can likely be said to not have Down syndrome (with less than one in 100 false negatives), with 3 to 5 of these characteristics the situation is unclear (and genetic testing is recommended) and with 6 to 8 characteristics the newborn can confidently be said to have Down syndrome (with less than one in 100.000 false positives).[78] In cases where there are no clinical grounds for making the diagnosis, it has been suggested that parents can reasonably be kept unaware of the initial suspicion.[78] When the diagnosis remains possible, it is recommended to perform karyotype testing and inform the parents.[78]
Test | Age |
Hearing test | 6 months, 12 months, then 1/year |
T4 and TSH | 6 months, then 1/year |
Ophthalmic evaluation | 6 months, then 1/year |
Dental examination | 2 years, then every 6 months. |
Coeliac disease screening | Between 2 and 3 years of age, or earlier if symptoms occur. |
Baseline polysomnography | 3 to 4 years, or earlier if symptoms of obstructive sleep apnea occur. |
Cervical neck X-rays | Between 3 and 5 years of age |
Many children with Down syndrome graduate from high school and can do paid work,[5] or participate in university education.[6] Management strategies such as Early childhood intervention, screening for common problems, medical treatment where indicated, a conducive family environment, and vocational training can improve the overall development of children with Down syndrome. Education and proper care will improve quality of life significantly.[7]
Plastic surgery
Plastic surgery has sometimes been advocated and performed on children with Down syndrome, based on the assumption that surgery can reduce the facial features associated with Down syndrome, therefore decreasing social stigma, and leading to a better quality of life.[80] Plastic surgery on children with Down syndrome is uncommon,[81] and continues to be controversial. Researchers have found that for facial reconstruction, "... although most patients reported improvements in their child's speech and appearance, independent raters could not readily discern improvement ..."[82] For partial glossectomy (tongue reduction), one researcher found that 1 out of 3 patients "achieved oral competence," with 2 out of 3 showing speech improvement.[83] Len Leshin, physician and author of the ds-health website, has stated, "Despite being in use for over twenty years, there is still not a lot of solid evidence in favor of the use of plastic surgery in children with Down syndrome."[84] The U.S. National Down Syndrome Society has issued a "Position Statement on Cosmetic Surgery for Children with Down Syndrome",[85] which states "The goal of inclusion and acceptance is mutual respect based on who we are as individuals, not how we look."
Cognitive development
Individuals with Down syndrome differ considerably in their language and communication skills. It is routine to screen for middle ear problems and hearing loss; low gain hearing aids or other amplification devices can be useful for language learning. Early communication intervention fosters linguistic skills. Language assessments can help profile strengths and weaknesses; for example, it is common for receptive language skills to exceed expressive skills. Individualized speech therapy can target specific speech errors, increase speech intelligibility, and in some cases encourage advanced language and literacy. Augmentative and alternative communication (AAC) methods, such as pointing, body language, objects, or graphics are often used to aid communication. Relatively little research has focused on the effectiveness of communications intervention strategies.[86]
Children with Down syndrome may not age emotionally/socially and intellectually at the same rates as children without Down syndrome, so over time the intellectual and emotional gap between children with and without Down syndrome may widen. Complex thinking as required in sciences but also in history, the arts, and other subjects can often be beyond the abilities of some, or achieved much later than in other children. Children with Down syndrome may benefit from mainstreaming (whereby students of differing abilities are placed in classes with their chronological peers) provided that some adjustments are made to the curriculum.[87]
Speech delay may require speech therapy to improve expressive language.[28]
Globally, as of 2010, Down syndrome results in about 17,000 deaths.[88] About 1 out of every 691 babies born in the United States each year is born with Down syndrome.[3] Each year about 6,000 babies in the United States are born with this condition. Approximately 95% of these are trisomy 21.
Maternal age influences the chances of conceiving a baby with Down syndrome. At maternal age 20 to 24, the probability is one in 1562; at age 35 to 39 the probability is one in 214, and above age 45 the probability is one in 19.[89] Although the probability increases with maternal age, 80% of children with Down syndrome are born to women under the age of 35,[90] reflecting the overall fertility of that age group. Recent data also suggest that paternal age, especially beyond 42,[91] also increases the risk of Down syndrome manifesting.[92]
English physician John Langdon Down first characterized Down syndrome as a distinct form of mental disability in 1862, and in a more widely published report in 1866.[93] Due to his perception that children with Down syndrome shared physical facial similarities (epicanthic folds) with those of Blumenbach's Mongolian race, Down used the term mongoloid, derived from prevailing ethnic theory.[17] While the term "mongoloid" (also "mongol" or "mongoloid idiot") continued to be used until the early 1970s, it is now considered pejorative and inaccurate and is no longer in common use.[94]
By the 20th century, Down syndrome had become the most recognizable form of mental disability. Most individuals with Down syndrome were institutionalized, few of the associated medical problems were treated, and most died in infancy or early adult life. With the rise of the eugenics movement, 33 of the (then) 48 U.S. states and several countries began programs of forced sterilization of individuals with Down syndrome and comparable degrees of disability. "Action T4" in Nazi Germany made public policy of a program of systematic involuntary euthanization.[95]
Until the middle of the 20th century, the cause of Down syndrome remained unknown. However, the presence in all races, the association with older maternal age, and the rarity of recurrence had been noticed. Standard medical texts assumed it was caused by a combination of inheritable factors that had not been identified. Other theories focused on injuries sustained during birth.[96]
With the discovery of karyotype techniques in the 1950s, it became possible to identify abnormalities of chromosomal number or shape. In 1958, Jérôme Lejeune discovered that Down syndrome resulted from an extra chromosome.[97] and, as a result, the condition became known as trisomy 21.[95]
In 1961, 18 geneticists wrote to the editor of The Lancet suggesting that Mongolian idiocy had "misleading connotations," had become "an embarrassing term," and should be changed.[98] The Lancet supported Down's Syndrome. The World Health Organization (WHO) officially dropped references to mongolism in 1965 after a request by the Mongolian delegate.[94] Advocacy groups adapted and parents groups welcomed the elimination of the Mongoloid label that had been a burden to their children. The first parents group in the United States, the Mongoloid Development Council, changed its name to the National Association for Down Syndrome in 1972.[99]
In 1975, the United States National Institutes of Health convened a conference to standardize the nomenclature of malformations. They recommended eliminating the possessive form: "The possessive use of an eponym should be discontinued, since the author neither had nor owned the condition."[100] Although both the possessive and non-possessive forms are used in the general population, Down syndrome is the accepted term among professionals in the U.S., Canada and other countries; Down's syndrome is still used in the UK and other areas.[101]
Society and culture
In most developed countries, since the early 20th century many people with Down syndrome were housed in institutions or colonies and excluded from society. However, since the early 1960s parents and their organizations, educators and other professionals have generally advocated a policy of inclusion,[102] bringing people with mental and/or physical disabilities into general society as much as possible. Organizations advocating for the inclusion of people with Down Syndrome include MENCAP advocating for all people with mental disabilities, which was founded in the UK in 1946 by Judy Fryd;[103] the National Association for Down Syndrome, the first known organization advocating for Down syndrome individuals in the United States, which was founded by Kathryn McGee in 1960;[104] the National Down Syndrome Congress, the first truly national organization in the U.S. advocating for Down syndrome families, founded in 1973 by Kathryn McGee and others,[105] and the National Down Syndrome Society, founded in 1979 in the U.S.[106]
In May 2008, the [U.S.] Congressional Down Syndrome Caucus (CDSC) was formed under the leadership of congresswoman Cathy McMorris Rodgers, to educate members of congress and their staff about Down syndrome and work with the National Down Syndrome Society to support legislative activities to improve Down syndrome research, education, and treatment, and promote public policies that would enhance the quality of life for those with Down syndrome.[107]
In September 2011, the National Institutes of Health (NIH) established an NIH Down Syndrome Consortium. The purpose of the Consortium is to foster the exchange of information on biomedical and biobehavioral research on Down syndrome being conducted by NIH institutes and centers working on Down syndrome-related topics and the national Down syndrome community.[107]
Ethical issues
Medical ethicist Ronald Green argues that parents have an obligation to avoid 'genetic harm' to their offspring,[108] and Claire Rayner, then a patron of the Down's Syndrome Association, defended testing and abortion saying
"The hard facts are that it is costly in terms of human effort, compassion, energy, and finite resources such as money, to care for individuals with handicaps ... People who are not yet parents should ask themselves if they have the right to inflict such burdens on others, however willing they are themselves to take their share of the burden in the beginning."[109]
Some physicians and ethicists are concerned about the ethical ramifications of the high abortion rate for this condition.[110] Conservative commentator and father of a son with Down syndrome George Will called it "eugenics by abortion".[111][112] British peer Lord Rix stated that "alas, the birth of a child with Down's syndrome is still considered by many to be an utter tragedy" and that the "ghost of the biologist Sir Francis Galton, who founded the eugenics movement in 1885, still stalks the corridors of many a teaching hospital".[113] Doctor David Mortimer has argued in Ethics & Medicine that "Down's syndrome infants have long been disparaged by some doctors and government bean counters."[114] Some members of the disability rights movement "believe that public support for prenatal diagnosis and abortion based on disability contravenes the movement's basic philosophy and goals."[115] Peter Singer argued that
"neither haemophilia nor Down's syndrome is so crippling as to make life not worth living from the inner perspective of the person with the condition. To abort a fetus with one of these disabilities, intending to have another child who will not be disabled, is to treat fetuses as interchangeable or replaceable. If the mother has previously decided to have a certain number of children, say two, then what she is doing, in effect, is rejecting one potential child in favour of another. She could, in defence of her actions, say: the loss of life of the aborted fetus is outweighed by the gain of a better life for the normal child who will be conceived only if the disabled one dies."[116]
World Down Syndrome Day
The first World Down Syndrome Day (WDSD) was held on 21 March 2006. The day and month were chosen to correspond with 21 and trisomy respectively. It was proclaimed by European Down Syndrome Association during their European congress in Palma de Mallorca (February 2005). In the United States, the National Down Syndrome Society observes Down Syndrome Month every October as "a forum for dispelling stereotypes, providing accurate information, and raising awareness of the potential of individuals with Down syndrome."[117] In South Africa, Down Syndrome Awareness Day is held every October 20.[118]
Notable individuals
- Jamie Brewer, is an American actress, best known for her role Adelaide "Addie" Langdon in the horror TV series American Horror Story: Murder House and Nan in American Horror Story: Coven.[119]
- Chris Burke is an American actor, folk singer, and motivational speaker. He is best known for his character Charles "Corky" Thacher on the television series Life Goes On.[citation needed]
- Andrea Friedman: actress who portrayed Corky's girlfriend Amanda in Life Goes On and Ellen in the Family Guy episode "Extra Large Medium".[120]
- Dr. Karen Gaffney became the first living person with Down syndrome to receive a Doctor of Humane Letters degree, presented by the University of Portland in 2013, for her long-standing humanitarian work in raising awareness about the capabilities of people who have Down syndrome through her roles as an accomplished sports figure, public speaker, and advocate.[121]
- Stephane Ginnsz, actor — In 1996 was the first actor with Down syndrome in the lead part of a motion picture, Duo.[122]
- Sandra Jensen was denied a heart-lung transplant by the Stanford University School of Medicine in California because she had Down syndrome. After pressure from disability rights activists, Stanford University School of Medicine administrators reversed their decision. In 1996, Jensen became the first person with Down syndrome to receive a heart-lung transplant.[123]
- Tommy Jessop, British actor who starred with Nicholas Hoult in the BAFTA-nominated BBC drama Coming Down the Mountain.[124] In 2012 he became the first actor with Down Syndrome to play Hamlet professionally, in a production by Blue Apple Theatre.[125]
- Rene Moreno, subject of "Up Syndrome"—a documentary film about life with Down syndrome.[126][127]
- Joey Moss, Edmonton Oilers locker room attendant.[128]
- Pablo Pineda, Spanish actor who starred in the semi-autobiographical film Yo También and first student with Down syndrome in Europe to obtain a university degree.[129]
- Lauren Potter, American actress, best known for her role as Becky Jackson on the television show Glee.
- Isabella Pujols, adopted daughter of Los Angeles Angels first baseman Albert Pujols and inspiration for the Pujols Family Foundation.[130]
- Paula Sage, Scottish film actress and Special Olympics netball athlete.[131] Her role in the 2003 film AfterLife brought her a BAFTA Scotland award for best first time performance and Best Actress in the Bratislava International Film Festival, 2004.[132]
- Judith Scott (May 1, 1943 – March 15, 2005) was a highly regarded American outsider sculptor and fiber artist, whose work features in a number of galleries.[133]
- Giusi Spagnolo was the first woman with Down Syndrome to graduate from university in Europe (she graduated from the University of Palermo in Italy in 2011).[134][135]
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External links
Wikimedia Commons has media related to Down syndrome. |
- Facts about Down Syndrome from the National Institutes of Health
- Tying Your Own Shoes An animated documentary that provides insight into the lives of four adult artists with Down Syndrome, by National Film Board of Canada


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UPDATE: 4/18 at 4:35 p.m.
The Shawano County Sheriff's Office has identified a 32-year-old Junction City man, and a 23-year-old Wisconsin Rapids woman as persons of interest in the January burglary of a home belong to a deceased couple.
It happened at the home of Eldore and Malinda Mielke on Mielke Rd. near Marion.
According to WLUK-TV, sheriff's officials say evidence was collected at the scene and the department worked with other law enforcement agencies throughout the state.
ORIGINAL STORY: 1/12 at 5:28 p.m.
A grieving Shawano County family is coping with three difficult losses in three days.
A WLUK-TV report says a 90-year-old husband and wife died separately within about a day of each other. Then their home was burglarized.
The couple's children say it was tough enough losing their parents, but it was especially shocking to hear of the burglary.
Eldore and Malinda Mielke were married for 68 years. They both came down with the flu last week. Eldore died Monday and Malinda died Tuesday.
Their daughter, Sue Anderson, says her parents' Marion home was burglarized Wednesday. She says the thieves took her parents' wills and deeds, along with cash and coins.
She says she's still in shock that there are people out there who could stoop so low.

subset: commoncrawl


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FRESNO, Calif. (KFSN) -- More fruits and veggies grown here in the Valley may soon be served at McDonald's restaurants across the country.
McDonald's says it's working on adding additional fruits and vegetables items on its menus. The restaurant is also putting calorie counts on food items listed on its drive-through and in-store menu boards.
McDonalds is already buying 100-million cups of apples a year to sell at restaurants.
(Copyright ©2013 KFSN-TV/DT. All Rights Reserved.)
ag report, apple, ag watch
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- Royal Purple Las Vegas Bowl: Chance for 'Dogs to break bowl...
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LPN Medication Care ManagerAlexandria, VAJob Snapshot
Job DescriptionJob: Resident Care Organization: Sunrise at Mount Vernon Do you enjoy providing hands-on care to seniors? If you would like to provide care in a first class home like environment, we would like to hear from you! At Sunrise Senior Living, you will be part of a dynamic and talented team of professionals dedicated to the highest standards of excellence and quality of care. As a part of this organization, you will find opportunities that provide more than just a job. Personal and professional growth is an integral part of your career experience.Responsibilities The LPN Medication Care Manager is responsible for providing the highest degree of quality care and services by administering medication and treatments in a safe organized manner. A summary of responsibilities include but not limited to administration of medications, documentation of medication administration, conducting SHU's, and providing resident care while demonstrating the Mission for Sunrise Senior Living, 'to champion the quality of life for all seniors' in accordance with federal, state and local standards and regulations and Sunrise Senior Living policies to promote the highest degree of quality care and services to our residents. Job Requirements
Join the journey and hear the stories of the residents and team members in this important and rewarding role. |


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Prints, Drawings, and Photographs Alla Mora Players near a Small Lime-Kiln Made in Haarlem, Netherlands, EuropeMid- 17th century Cornelis de Visscher, Dutch, 1628/29 - 1658. After Pieter Jacobsz. van Laer, Dutch, 1592 - 1642. Etching and engraving Currently not on view 1985-52-38463 |
The Muriel and Philip Berman Gift, acquired from the John S. Phillips bequest of 1876 to the Pennsylvania Academy of the Fine Arts, with funds contributed by Muriel and Philip Berman, gifts (by exchange) of Lisa Norris Elkins, Bryant W. Langston, Samuel S. White 3rd and Vera White, with additional funds contributed by John Howard McFadden, Jr., Thomas Skelton Harrison, and the Philip H. and A.S.W. Rosenbach Foundation, 1985 |


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WebMD Physician Directory
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Dr. Firas Beitinjaneh, MD
Neurology Specialists
6161 Kempsville Cir Ste 315
Norfolk, VA 23502
(757) 461-5400
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Gender: Male
Years in Practice:18 Years
Languages Spoken:English, Spanish
Education & Training
Medical School:University of Damascus - Faculty of Medicine, Damascus, Syria
Graduation Date:1995
Specialties & Hospital Affiliations
Hospital Affiliations:Bon Secours Depaul Medical Ctr
Office Information
*This physician has multiple office locations. See Appointments for details.
Other Physicians in Practice
- Mary A. Bowles, MD, Neurology
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- Joseph P. Hogan, MD, Neurology
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Debby Boone
Debby Boone
Reflections of Rosemary
Original Release Date: April 26, 2005
Track Listing
1. Blue Skies
2. I'll Be Home
3. The Best Is Yet to Come
4. I'm So Lonesome I Could Cry
5. Mood Indigo
6. It Might As Well Be Spring
7. Van Heusen Medley: But Beautiful/Moonlight Becomes You/Like Someone in
8. You're Gonna Hear from Me
9. It Never Entered My Mind/In the Wee Small Hours of the Morning
10. I've Grown Accustomed to His Face
11. Time After Time
12. The Music That Makes Me Dance
13. You Are There
14. [Untitled Hidden Track]
Debby Boone: Vocals, Liner Notes
Rosemary Clooney: Vocals
Matt Catingub: Music Consultant
Gary Foster: Clarinet, Sax (Alto), Sax (Tenor)
Scott Hamilton: Sax (Tenor)
Chuck Berghofer: Bass
Jim Fox: Guitar
Daniel Greco: Percussion
Dan Higgins: Flute (Alto), Sax (Tenor)
Leslie Ann Jones: Engineer, Audio Engineer
Armen Ksadjikian: Cello
Warren Luening: Trumpet, Flugelhorn
John Oddo: Piano, Arranger, Musical Direction
Charles Paakkari: Assistant Engineer
John Pizzarelli: Guitar
Joe Soldo: Music Contractor
Gregg Field: Drums
Allen Sviridoff: Producer, Audio Production
Randee Saint Nicholas: Photography
Abbey Anna: Art Direction
Michael McCoy: Engineer
Neil Tucker: Engineer
Seth Presant: Engineer, Mastering, Mixing, Audio Engineer
Bob Carey: Photography
Earl Singers Brown: Vocal Arrangement
Rohan Onraet: Assistant Engineer
Danielle Brancazio: Package Design
Ryan Simms: Assistant Engineer
Laury Browning: Vocals (Background)
Cherry O'Neill: Vocals (Background)
Lindy Michaelis: Vocals (Background)


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First Presbyterian Day School fourth-grade students represented famous Mississippians in their annual Mississippi Parade. Shown are (from left) Blake Haskins as James D. Hardy, Joshua Thomas as Elvis Presley, David Crews as Jimmy Buffet, and Grant Vanlandingham as Mussacunna.


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20 min ago | The Globe and Mail
TSX set to play catch up to U.S. markets in 2014
The Toronto stock market lived up to its predicted modest gains for 2013, closing up about six per cent, but there's optimism in the air for Canada's main stock market for the year ahead.
Do you support affirmative action?
Should government buildings be allowed to display religious symbols?
4 hrs ago | Ledger-Enquirer.com
Stocks are mixed after a three-day downturn
In this Thursday, Dec. 12, 2013, photo, trader Richard DeViccaro works on the floor of the New York Stock Exchange.
6 hrs ago | WAPT-TV Jackson
Stocks up ... but not by a whole lot
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9 hrs ago | Canada.com
TSX closes slightly lower as retail data, U.S. budget deal add to Fed tapering concerns
The Toronto stock market closed slightly lower Thursday as a U.S. budget deal and a solid retail sales report fuelled expectations that the U.S. Federal Reserve could start cutting back on its monetary stimulus program as early as next week.
13 hrs ago | The New Zealand Herald
Asian stocks tentative amid Fed stimulus cut fears
Asian stock markets mostly posted tentative gains Friday as investors prepared for the U.S. Federal Reserve's decision next week on whether to reduce its monetary stimulus.
Global Markets-Dollar gains, world shares slip on wary view of Fed
The dollar rose and global equity markets slipped to a one-month low on Thursday after stronger-than-expected U.S. retail sales data added to jitters about when the Federal Reserve will start trimming its stimulus.
Investors are moving into stocks and away from some bonds, flipping years of behavior
After years of sticking with plain-vanilla bond funds, investors are starting to turn their backs on them and opt for stocks instead.
Merrill paying $131.8M to settle SEC charges
Merrill Lynch has agreed to pay $131.8 million to settle U.S. civil charges that it misled investors about risky mortgage bonds it sold ahead of the 2008 financial crisis.
US stocks lower, setting up 3rd day of declines
Trader Andrew Silverman, center, works on the floor of the New York Stock Exchange, Thursday, Dec. 12, 2013.
No, Virginia. There is no Santa Claus rally
Stocks fell Thursday as investors watched some high profile initial public offerings and looked for clues as to when the Federal Reserve will wind down its bond buying program.
Asian shares slide to 2-1/2 month low
Asian shares stumbled to a 2-1/2 month low on Thursday on heightened expectations the Federal Reserve may act sooner than later to unwind its stimulus after a provisional budget deal in Washington eased some of the fiscal drag on the US economy.
Insight: Philips restores profit by rediscovering relevance
Every year Singaporeans and Malaysians choke on smoke when farmers and plantation firms in neighboring Indonesia clear the land with fires during the dry season.
Markets sluggish despite seeming US budget deal
Financial markets were sluggish Wednesday as an apparent budget deal in the U.S. Congress failed to divert attention from investors' primary focus - whether the Federal Reserve will reduce its stimulus next week.
Sustainable strategies win over skeptical emerging stock investors
Cajoled by developed world governments and shocked by disasters such as the Bangladesh factory collapse, investors in emerging market companies are looking more closely at environmental, social or governance issues before they buy.
Stocks slide despite U.S. budget deal
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Stocks edge lower in morning trading
Stocks edged lower in morning trading Wednesday as investors weighed a budget deal out of Washington and the outlook for economic stimulus from the Federal Reserve.
Gold stocks push Toronto stock market modestly higher amid Fed concerns
The S&P/TSX composite index gained 27.97 points to 13,340.75 as commodity prices rose amid positive Chinese economic data.
Twitter shares climb to roughly double its IPO price
Twitter shares hit a new high Tuesday, leading the way on a day of big gains for Internet stocks, as the microblogging service climbed to roughly twice the price the company set for its initial public offering last month.
News Summary: After record, stocks edge lower
TAKING A BREAK: Stocks fell modestly Tuesday as investors stepped back a day after the market notched its latest record high close.
Financial regulators approve long-awaited Volcker Rule
Banking regulators on Tuesday unveiled a central element of the sweeping 2010 reform law Congress passed in response to the financial crisis.


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Slightly sweet basil adds bold flavor to salads, pastas, sauces, and desserts.
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NAPLES-CT-B-K - Outdoor Greatroom Naples Coffee Table w/ Balsam Wicker Base
Freight Shipping
Outdoor Greatroom Naples Coffee Table w/ Balsam Wicker Base
Enjoy your time in the great outdoors when you sit around the Outdoor Greatroom Naples Coffee Table w/ Balsam Wicker Base (NAPLES-CT-B-K). This elegant looking coffee table features a wicker resin base and an aluminum frame for added durability, while the black glass table top ensures that your guests will love your new furniture. On the top of the table, a built-in fire pit allows you to start a warm, roaring fire in just seconds, and the easy-to-use, push-button fire will give your outdoor living area a bright centerpiece for everyone to see.
Powered by a liquid propane tank or natural gas line, you can adjust the flame height to meet your heating needs, and the table can hook up to a standard 20 lb tank. A concealed door allows you to hide your gas tank so you won't have to worry about anyone messing with the flame, which is great for keeping your kids and guests safe from any accidents. Perfect for any outdoor living area, this wicker coffee table can keep you warm and entertained for hours on end.
Outdoor Construction:
Made of a wicker resin with a rust-proof aluminum base, this table is perfect for keeping outdoorsFlame Adjustment:
Able to be powered by a natural gas line or liquid propane tank, you can adjust the height and power of the flame for optimal temperature controlElegant Look:
This table displays the elegance of your outdoor furniture, with a wicker base and a black glass table top to accent it
Usually Ships in 5 - 7 Business Days
This item ships via Freight Line Carrier Delivery times related to this ship method are usually between 3 to 7 business days once the item leaves the warehouse. We will forward tracking information to you once the product leaves our warehouse. The shipping company will contact you to arrange a delivery appointment as a delivery signature is required. All deliveries will occur Monday through Friday. Order must be fully processed by 12pm CST to be eligible for "Guaranteed Same Day Shipping." Orders processed after that time may ship out the following business day.Freight Line items will be delivered to the first ground floor exterior door available provided there are no stairs to ascend or descend. If you require inside delivery you will need to select the premium shipping option in checkout. To determine if the item is eligible for premium shipping please add it to your shopping cart and view the shipping options drop down box. Please contact our customer service department with any questions related to shipping at (800) 297-6076, M-F, 8am to 5pm CST.
Model: GFC-CRUSH-B
Outdoor Greatroom Company Reflective Crushed Glass In Stock: Usually Ships in 5 - 7 Business Days |
$44.10 |
Model: GFC-CRUSH-C
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$44.10 |
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Outdoor Greatroom Company Arctic Ice Reflective Crushed Glass In Stock: Usually Ships in 3 - 4 Business Days |
$17.10 |


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The time may be very short before God's judgment falls on America as we are facing the most critical hour of my lifetime. No nation has ever been more blessed than the United States of America. We remember America's glory days ... days when our citizens honored God and acknowledged with grateful hearts the bountiful blessings he showered on us. God has allowed America to enjoy unprecedented wealth, freedom and influence.
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[9] http://www.northsidesun.com/category/byline/joyce-sanford


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Saturday, August 26, 2006
Second One in a Row!
What can I say, the painting a day bug bit me good! I have been wanting to paint a pair of peaches I bought last week but never gave my time to it. I was hopping to do one of my regular still lifes using the peach as an homage to Chardin. After my success with Vermilion I decided to do another small painting. This took me all night, started around 9:30 PM on Friday night and it is now 1:41 AM on Saturday morning. I didn't think I was going to pull this one off tonight, but here I am posting my peach. I'm hopping to put this up for sale on eBay later tonight if I'm able to figure out how to link it to the eBay page. Mick McGinty is helping me with this....Thanks Mick, you're the best. It has been a long night but I'm a happy painter and can now go to bed and have sweet dreams!
13 comments:
- Coco said...
wowow Luis,
I thought I left a message on the one below(vermillion), but it is no tup ! May be i miss-typed the verification word...
anyway, congrats to your daily painting project to come reality ! and good luck with e-bay. Earlier this week, my online daily art gallery shop went live, too.
C x - 5:38 AM
- ParisBreakfasts said...
Good 4 U - 8:29 AM
- Luis Colan said...
Thanks ladies, I'll try to keep this up, at least two of them a week. It takes a lot dicipline and right now I'm not sure if I have it. We'll see!
luis - 11:49 AM
- m collier said...
Love the peach -- the slight green banding on the plate adds a nice secondary detail -- Makes your eye move around the painting.
- Luis Colan said...
Thanks M, I'm very pleased with this painting. I'm very exhited to paint another one.
luis - 8:05 PM
- Run Around Paris said...
Incredible...I'm so impressed with those who have the ability to paint. Your work is consistantly beautiful.
Erin - 12:42 AM
- Darren Maurer said...
- This comment has been removed by a blog administrator.
- Darren Maurer said...
I'm happy to hear you have committed to two paintings a week. You will get a lot out of this. All I want to do now is paint after starting my painting a day blog back in March. Keep up the great work. I love the peach.
- Luis Colan said...
Thank you so much Erin for the praise!
Darren, I'm hopping to keep this up, not so much to make money but to learn more about our craft. Thank you for the support.
luis - 2:15 AM
- Darren Maurer said...
You are looking at it the right way. I paint my miniatures because I would be painting anyway, and if they sell they sell and if they don't thats fine too. If we start painting with only the end goal being the piece sells the creative process would suffer. I am constantly looking during the day for things that appeal to me as an artist.
- Todd said...
another great painting, hats off to you for doing these on a regular basis like that. I'm sure you will get the large payoff
- Luis Colan said...
I couldn't agree more! I'm looking around for things as well, sometimes it gets hard but then again something always sparks up your interest. Disinterestedness will always make a great artist.
luis - 2:35 PM
- Luis Colan said...
thanks Todd, just enjoying this new way of working, for now at least. The large payoff for me would be to just lay donw a single stroke of paint and getting it right that first time....someday, someday!
luis - 2:39 PM


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Expert-reviewed information about the Earth. For everyone.
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Hindu Kush alpine meadow
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Newton Steps out on a High
Chris Newton has announced he is retiring from professional racing on both road and track and will be joining the coaching staff at the Great Britain Cycling Team. Chris has won medals at the last three Olympic Games and the last two Commonwealth Games, as well as holding the World Champion title in the Team Pursuit and the Points Race.
Chris' cycling talents on the road have been prominent in the past three years riding for Rapha Condor Sharp. The man from Stockton-on-Tees has won the Premier Calendar title three times, including this season's series. He has held the road National Champion title and won three stages of the RAS in Ireland.
Chris said of the move: "I've reached the stage in my career where I'm ready to step back from full-time racing and focus my attention on coaching. I've achieved a lot during my cycling career and I'm very grateful for the support I've received from so many people in helping me reach my goals."
British Cycling's Performance Director Dave Brailsford said: "Chris has come to the end of a fantastic racing career and I think he has all the key ingredients that will make him a successful coach."
Rapha Condor Sharp team manager John Herety added: "It's been a stellar year for Chris on the road in the UK and he will continue to race for Rapha Condor Sharp until the end of the season, so fans will have plenty of opportunity to see him in action before the year is out. As we go forward Chris will still play a part in the development of Rapha Condor Sharp, putting his renowned eye for detail into effect as a technical consultant to the team."
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Watch the tiny teaser trailer for Batman: Arkham Origins
Batman: Arkham Origins, as the name suggests, is a prequel for the other two Arkham games, set a couple of years before Batman: Arkham Asylum.
Although Origins is being made by WB Montreal rather than Rocksteady, the original studio did advise Warner Bros.' in-house team on elements of the game engine and mechanics.
Warner Bros. has said that while the combat system hasn't been greatly altered, players can expect new enemies, requiring new tactics. This very brief teaser trailer introduces Deathstroke as at least one of the villains Batman will face during the game. … Read more


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Class Notes
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Showing class notes submitted in the last year by graduates in the 1990s
Debbie A. Klis '90 has been named to Maryland's Top 100 Women list by The Daily Record. The list recognizes the accomplishments of women who have achieved professional success and making a difference through their leadership, community service, and mentoring.
Ms. Klis, of counsel in Ballard Spahr's Bethesda office, concentrates on transactional matters in an array of business, securities, and tax issues. She is known for her work with investment management companies, including the formation and operation of EB-5 immigration investment funds, hedge funds, private equity funds, SPACs, real estate funds, oil and gas funds, and international master-feeder structures.
Sandy (Dallas) Herman '90 writes, "The Herman family (husband Mike and three sons: Jack, 11, Nicholas, 7, and Luke, 5) has embarked on a new adventure, recently moving to the Montreux Golf Community located atop Mt. Rose, about 20 minutes from Incline Village in Lake Tahoe. Mike is VP of Business Development at Ruvato (based out of Incline Village) and when I am not chasing our three kids around, I spend time doing human resources consulting."
Joseph Angelo Gulino M.S. '90 writes, "We moved from San Jose to Laramie, Wyo., in January 2008. I worked for an extension program at the University of Wyoming for almost five years. Both of our children attended the University of Wyoming and live in Wyoming. We now have two grandchildren and another due in February 2014. I started JAG Engineering, LLC in Laramie at the beginning of 2013."
Nicholas Murphy, eldest son of Brendan '91 and Nina '91, graduated from Thomas Aquinas College in Santa Paula, Calif. in May 2013. His brother Matthew completed his freshman year at the same school.
Oscar Zavaleta '92 started Montez Group Inc., an engineering consulting firm specializing in Quality Control/Quality Assurance.
Xavier Romano M.A. '92 writes, "After taking on a consultancy in Saudi Arabia during the 'Arab Spring' near the Yemen boarder, and witnessing one Tahrir Square protest in Cairo, I found myself back in California in April 2012 taking on the role as Fresno campus director of Alliant International University. After more than a year in Fresno I have a newfound respect for Silicon Valley, the Bay Area, and a dozen years in the 'wilderness' of Illinois while at Knox College! Good to be back in California—and my time in the Middle East prepped me well for the heat of Central California. ;-)"
Xavier E. Romano Director, Fresno Campus Alliant International University Fresno CA 93727
Paul Lindblad '88, MBA '92 writes, "At the start of the year we relocated to Shanghai where I have taken over responsiblity for Wacker Chemical's business in China. My wife Monica '90 and my two daugters are settling back into Asia, though they are missing friends in Germany. They still get to summer and see family at Christmas at our place in Incline Village, but China is a far cry from Germany!"
Nick Fedeli '92 and Lisa (Kellers) Fedeli '92 welcome Cormac Frank Fedeli, born April 11, 2013. Big brother, Aengus, could not be more elated! The family lives in Reno, Nev. where Nick is the Controller for Campus Dining/Chartwells at the University of Nevada, Reno, and Lisa stays-at-home with the two boys and two basset hounds.
Lani L. Biafore '92 is serving as In-House Staff Attorney for Delta Gamma Executive Offices in Upper Arlington, Ohio. While at Santa Clara, she was a member of Delta Gamma Fraternity. She, daughter Lia, and husband, Dr. Michael S. O'Mara, moved to the Columbus, Ohio area in 2012.
Helen K. Yi '93 and James S. Choi welcomed their second son on April 16, 2013. Aaron David Choi was born on April 16, 2013 at 12:40 pm at Sequoia Hospital in Redwood City and joins proud big brother Andrew. Helen continues to serve as General Counsel for The Matteson Companies, a peninsula based property management, development and investment company.
Patricia L. Sullivan '93 is an assistant professor of international relations in the Department of Public Policy at the University of North Carolina at Chapel Hill. Her book, Who Wins? Predicting Strategic Success and Failure in Armed Conflict, was published by Oxford University Press in July 2012.
Kevin Smith '93 is the vice president of software development for Ellucian, a leading provider of software and services for Higher Education institutions. Kevin currently resides near Washington D.C. with his wife Kate, and their 3 boys - Jackson, Sean, and Daniel.
Paul M. Nuti '93 and business partner Alborz Wozniak opened a new environmental engineering consulting firm called Veritas Environmental Consulting, Inc. in June 2013. The new firm is located in Pleasant Hill, California, and consults nationally to variety of private and public clients. Paul and wife Elizabeth (Goebel) Nuti '93 live in Pleasant Hill with their two children, Julia and Emma.
Patricia (Aquino) Magolske '93 and husband John Magolske—a daughter, Stella Rose, on Jan. 5, 2013. The family resides in San Francisco.
Keith Jordan '89, J.D. '93 writes, "I work for an amazing company that is a disruptive game-changer for the betterment of business and employees. I partner with other companies and look for ways to bring value to their business with a measurable ROI. I determine how I can improve a company's 'PIERS': Productivity, Image, Expenses, Revenue, Safety, Security, Stability."
Melanie Gangle '93 and husband James Dewey are overjoyed to announce the adoption of their daughter, Maria Hypatia, on June 15, 2012.
Lisa DeMattei '93 and Koray Ergur are thrilled to announce the birth of their daughter, Zeynep Sophia Ergur, on June 8, 2013. The family lives in San Francisco, Calif.
Lara E. Zientek Colvert '93 writes that she is pursuing psychology in the form of massage therapy. Over the years, her bodywork studies have taken her to Oakland and Hawaii, where she spent a very relaxing four weeks learning Lomi Lomi massage. She currently works as an on-call therapist in Campbell, stays involved with her two beautiful children, Tia and Stephen, sings with Ladyesong Vocal Ensemble, as well as another small group, and occasionally gets to perform with her husband, Bill Colvert, who is the trained "real" singer in the family. She also loves to spend time with her amazingly supportive friends, hiking, biking, singing, and taking her children to Santa Clara University every now and then to see all of the changes.


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What other people are saying...
Katwoman1 - April 29, 2011 at 10:34 AM
Thank the gods it's over & we could maybe watch some REAL news?????
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Royal photos of a very royal wedding
After nearly a decade of highly scrutinized courtship, Prince William and Catherine Middleton finally tied the royal knot in Westminster Abbey on April 29, 2011 in a lavish ceremony watched around the world.
Check out all the photos of British royalty, British onlookers—and all those wacky British hats.


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December 12, 2013
Merrill junior Renee Sladek has been to the state track meet, and just recently led the Blue Jays volleyball team to state as well.
Now she has her sights set on the same thing on the hardwood.
Renee goes under the spotlight in this week's edition of "Hello, My Name is..."