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Southern Pacific LEGACY Scale 4-8-4 GS-6 (Black) #4460
6-11421 | Price: $1,299.99
GS Series Steam Locomotives
Introduced in 1937, the Southern Pacific's Daylight trains became some of the most heavily traveled routes in the country. Cars and locomotives received a brilliant livery of orange, red and silver. Streamlined, state of the art 4-8-4 locomotives dubbed the GS -2 class became the very first preferred power for these prestigious runs.
A near copy of the GS -2 was produced again in 1943 for both the Southern Pacific and Western Pacific. These 4-8-4s were unstreamlined due to wartime material shortages. Whether classed GS-6 on the SP or GS-64 on the WP, the locomotives performed admirably in freight and passenger service.
- LEGACY Control System equipped – able to run in LEGACY Control mode, in TrainMaster Command Control mode, or in Conventional mode with a standard transformer
- Odyssey II Speed Control with On/Off switch
- LEGACY RailSounds sound system featuring:
-CrewTalk dialog and TowerCom announcements, each with different scenarios depending on whether the locomotive is in motion or stopped
-Six official railroad speeds with CrewTalk dialog
-Eight diesel RPM levels
-LEGACY "Real-Time Quilling Horn" control with instant response for realistic signature "quilling" and correctly timed warning signals
-Single hit or continuous mechanical bell sounds
-Sequence Control plays the sound effects of an entire trip, including warning sounds and announcements, based on the movement and speed of the locomotive
-Current speed and fuel dialog, refueling sound effects
- Powerful maintenance-free motor with momentum flywheel
- Wireless Tether connection between locomotive and tender
- ElectroCoupler on rear of tender
- Directional lighting including operating headlight and back-up light on rear of tender
- Illuminated classification lights on the front of locomotive
- Traction tires
- Fan-driven smoke unit
- Adjustable smoke output
- Interior illumination in cab
- Die-cast metal locomotive body, pilot, and frame
- Die-cast metal tender body and trucks
- High level of separately applied metal details
- Separately applied builder's plates
- Authentically detailed cab interior
- Flickering firebox in cab
- Cab glass windows
- Engineer and fireman figures
Road Number: 4460
Gauge: Standard O Scale
Dimensions: Length: 28"
RailLine: Southern Pacific
Minimum Curve: O-54
Lionel 2012 Volume 2
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Georges St-Pierre Retains Welterweight Title at UFC 158 | MMAWeekly.com
Georges St-Pierre (24-2) has retained the UFC welterweight title for the eighth time with a commanding unanimous decision win over Nick Diaz (26-9, 1 NC) at UFC 158 on Saturday night at the Bell Centre in Montreal.
All three judges awarded the fight to St-Pierre 50-45.
In the opening two rounds, St-Pierre was able to completely dominate the fight, landing takedowns at will and was able to outwork Diaz from the top position with ground strikes.
He began to slow down in round three and Diaz was able to repeatedly stuff his takedown attempts and keep the fight standing, engaging in strikes. But the 31-year-old Canadian was still able to out-strike Diaz on his feet and never looked in doubt.
Coming into the final round, St-Pierre clinched, looking for the takedown, but Diaz broke free before falling to the mat where the eight-time world champion was able to land ground strikes from side control, maintaining top position, to the roars of his home crowd to the final bell."I didn't want to fight in a boxing range with him because he's the best boxer in mixed martial arts," St-Pierre said. "He has a very unusual scrambling style and I don't have a training partner like that, it's almost impossible to get ready for that."
Although there was animosity between the pair leading into the fight, it all seemed forgotten after the final bell, with both fighters full of praise for their counterpart.
"Nick, you made a great job promoting the fight. He's a good guy," St-Pierre told the crowd. "I never took it personal. Nick is a veteran. He was in the UFC before me. I'm actually a big fan of Nick Diaz and that's one of the reasons I wanted to fight him."
UFC champ Georges St-Pierre likely headed to Las Vegas for next title defense
For the first time in more than three years, UFC welterweight champion Georges St-Pierre's next title defense is unlikely to come in his home country.
The Canadian headlined Saturday's UFC 158 event at Montreal's Bell Centre and easily handled challenger Nick Diaz in the pay-per-view headliner.
However, in his next outing, which will come against co-main-event winner and surging contender Johny Hendricks (15-1 MMA, 10-1 UFC), expect St-Pierre (24-2 MMA, 18-2 UFC) to return to Las Vegas for the first time since UFC 100 in 2009.
"I was just telling Lorenzo (Fertitta) we've got to bring him back to Vegas," UFC President White told MMAjunkie.com (www.mmajunkie.com) following UFC 158. "He hasn't been out of Canada in a while."
After defeating Thiago Alves at UFC 100, St-Pierre headed to Newark, N.J., for a victory over Dan Hardy at UFC 111. However, since that March 2010 fight, he's fought exclusively north of the border. Montreal has hosted three of his fights, and Toronto got one.
So why fix what's not broken with the PPV juggernaut? White believes Montreal can draw big crowds – like the 20,145 people who produced a reported gate of $3.7 million at UFC 158 – even without St-Pierre. Specifically, he points to a UFC 113 event headlined by Lyoto Machida and Mauricio "Shogun" Rua that did similar figures.
"We had two Brazilians headline up here and it was fantastic," White said. "Montreal's a destination. It's a fun city to come to. I don't think anybody comes here and doesn't have a good time, even in the winter. It's cold as hell, but it's still a great place. Great restaurants, great hotels."
Nick Diaz says Georges St-Pierre 'hits like a woman,' wants a title rematch

subset: commoncrawl


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Credit : Laura Farr/Getty ImagesEarn Points
The Voice
Which Pop Diva Wore This Cleavage-Happy Ensemble to the Grammys? (PHOTO)
At last night's (Feb. 10) Grammy Awards, CBS asked the stars to cover up for primetime viewers. This request was a result of years of jaw-dropping looks like this one worn by one of our favorite pop divas in 2001.
This dirty girl hit the red carpet in a revealing dress with a V-neck cut that went down to her navel. Though she cleaned up her act a few years later, this pop princess has never been afraid to show off some skin.
Also noteworthy is her crazy, braided hairstyle. It certainly wasn't her only wacky 'do. In the past, this lady's sported cornrows, an afro, and dozens of hair colors.
Can you guess the star? Click on to find out!


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When West Virginia House Minority Leader Tim Armstead, R-Kanawha, spoke at the West Virginia Press Association's annual legislative breakfast last week he said West Virginia's Freedom of Information Act law needed to be more open to allow citizens and journalists even more access to documents from public bodies.
Being true to his word, Armstead introduced a bill meant to make internal letters and memos from government bodies available to members of the public, unless the documents fall under another exemption of the state's Freedom of Information Act law.
Great news, right? More transparency with public records is always a good idea.
Then, on Tuesday, House Bill 2911 was introduced. It's sponsored by 11 House Delegates (Folk, Householder, Frich, Kump, Faircloth, Lynch, Williams, Butler, Cooper, Cadle and Shott) and has been referred to the House Judiciary Committee.
Here is a link to the bill: http://www.legis.state.wv.us/Bill_Status/bills_text.cfm?billdoc=hb2911%20intr.htm&yr=2013&sesstype=RS&i=2911
It seeks an exemption to the Freedom of Information Act for all records pertaining to the issuance, renewal, expiration, suspension or revocation of a license to carry a concealed weapon. It carries the following note: "The purpose of this bill is to exempt records of concealed weapon license applications and issuance from disclosure under the West Virginia Freedom of Information Act."
Civitas Media and the West Virginia Press Association oppose such exemptions and have informed our state Legislators of our position.
Hiding public records is never a good idea. Hiding any public information of this nature goes against the very reason the Freedom of Information Act law was enacted in the first place.
We are urging members of the public contact your local House of Delegates members and let them know you oppose hiding more public records of any kind.
We believe the effective functioning of our constitutional democracy depends upon the participation in public life of a citizenry that is well informed. For nearly four decades, the Freedom of Information Act (FOIA) has provided an important means through which the public can obtain information regarding the activities of public agencies.
For more information about the Freedom of Information Act or to find out how to make a FOIA request, visit www.foia.gov online.
For more information on Sunshine Week, visit www.sunshineweek.org online, and follow @SunshineWeek on Twitter.


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Get a new post-production tip every Wednesday, on topics such as compositing, color correction, audio, and media management.
Find out how to use keywords, markers, and other metadata to keep Final Cut Pro assets organized during every stage of the editing process: from import to export.
A complete overview of Final Cut Pro X's multicam editing workflow, including creating multicam clips for interview and music video-style projects.
Introduces the concepts behind color correction and color grading, and guides editors through the process of correcting contrast, color balance, and hue/saturation in individual shots and entire films.
Learn how to color correct and color grade video in Final Cut Pro X.
Learn how to organize and edit video and how to enhance the look and sound of your projects with Final Cut Pro X 10.2.
Create your own great looking movies to share with family and friends in iMovie.
A comprehensive method for developing compelling storylines in Final Cut Pro X 10.1.x.
Learn how to build a polished documentary using Final Cut Pro X 10.1.x and a few essential editing techniques.
Create a polished, effects-driven commercial in Final Cut Pro X 10.1.x.
Learn how to migrate your workflow and projects from Final Cut Pro 7 to Premiere Pro.
Demonstrates how to transfer audio from Final Cut Pro X v10.1.x to Pro Tools with X2 Pro Audio Convert.
Shows filmmakers and film editors how to present their vision dynamically with Final Cut Pro X 10.1.x.
Learn how to create a polished, professional movie with iMovie for iOS, the easy-to-use video editing software for iPhones and iPads.
Discover how to compress video and get it ready for publishing in Compressor, and learn about key compression concepts, from transcoding to codec types.
Covers the most common questions videographers encounter when shooting and editing with DSLR cameras, from choosing a frame size and frame rate to understanding moiré.
Get the most out of one of the best camera phones in the world, the iPhone 5s.
Learn how to build and refine your story with the redesigned editing toolset in Final Cut Pro X.
Guides you through the process of script writing for informational videos, commercials, and public service announcements.
Get on-location tips and post-production techniques to speed up time and create compelling visual effects with time-lapse photography.
Learn to manipulate emotion, mood, time of day, and location in a variety of shots, from interior spaces to outside landscapes, with color grading.
Create a polished, effects-driven commercial in Final Cut Pro X.
Explore a powerful round-trip workflow between Logic Pro and Final Cut Pro that enables sound editors to quickly mix dialogue, sound effects, and music for film.
Learn how to build and refine your story with the redesigned editing toolset in Final Cut Pro X.
Shows filmmakers and film editors how to dynamically present their vision with Final Cut Pro.
Capture footage of everyday objects and combine it with effects in popular postproduction tools like After Effects and Premiere Pro, resulting in rich, abstract backdrops for your project.
Find out how to build a polished documentary using Final Cut Pro X and essential documentary editing techniques.
Demonstrates how to transfer audio from Final Cut Pro to Pro Tools with X2 Pro Audio Convert.
Create a fast-paced sports video, for the home team or the pros, with the friendly tools in iMovie '11.
Shows beginning videographers how to approach capturing, editing, and sharing a family vacation video using iMovie and their own videos and photographs.
Lays out the nuts and bolts of budgeting for video projects and shows how to create estimates, quotes, and invoices.
Explores the world of hypersyndication—showing how to distribute content across all media platforms quickly and more efficiently.
A comprehensive method for developing compelling storylines in Final Cut Pro X.
Details the principles of color grading, while explaining how to enhance and style footage in Final Cut Pro X.
Streamline the compressing and encoding media processes with Compressor, the companion compression software for Final Cut Pro.
Shows how to create stunning motion graphics and animations for video production in Motion 5.
Covers the key differences video editors need to know to master Media Composer and make the switch from Final Cut Pro.
A comprehensive tour of the new tools and the interface makeover for Apple's premier video editing software, explaining the differences from Final Cut Pro 7 and paving the way for a painless upgrade experience.
Create a polished video with the iOS version of iMovie.
Shares the core concepts and techniques used to create compelling animations and transitions in Apple Motion.
Shows how to organize, edit, and share videos using iMovie 11.
Shows how to set up, administer, and integrate Final Cut Server into a production workflow.
Unleash the potential of Final Cut Studio with the help of other applications in Apple's video and audio editing suite.
Shows the complete workflow and new features of this important Final Cut Studio application, including batch templates and auto-detection.
Explains the principles of color grading, including a detailed discussion of the color wheel and using the Color interface.
Shows how to set up an effective Soundtrack Pro system and establish a fundamental workflow, from simple audio processing to final mixdown and exporting.
Shows how to start building outstanding motion graphics and animations for video production.
Covers the entire iMovie editing process for beginners and experienced users alike, from adding audio files to integrating text.
Teaches how to use this updated application, highlighting the enhanced elements and new features of Color 1.5.
Teaches the core features and tools that will take a hodgepodge of video clips and turn them into a finished project.
"I am a 56-year-old film editor. FCP 7 was the first really intimidating system I encountered. I tried books and a video course but was still confused. Then my son came home with a free trial for lynda.com. I get it! I am editing again! No more feelings of defeat and feeling "too old for this"! THANK YOU!" —Colin L.
more from our members »


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Since we released version 0.9.9, you have been creating some fantastic extensions to improve your productivity.
We published the first few extensions in August to give you a taster for what could be done with extensions. Powerpack users have since created over 100 extensions so we've added a whole new section to our new support site to show off the best extensions.
The new support site
In preparation for version 1.0 and Alfred being all grown up, we've created a new support site. On it you will find:
- Numerous Tutorials on the many features of Alfred
- A growing Knowledge base with answers to questions you have been asking
- The much awaited Extensions repository
- New forms to report a bug or suggest a feature
- And finally, for new users and to convince your friends to use Alfred, a tour of Alfred and a comparison of features between Spotlight, Alfred's free version and the Powerpack.
Huge thanks go out to Wikidot for the platform itself and to Bryce from Roaring Apps for suggesting it early on. Also, Zaharenia, who has done a great job wrestling Wikidot into the design you're seeing today.
Submitting your own extensions
As so many great extensions are being sent our way, I wrote a little guide to submitting an extension. By following 3 simple steps, you'll help us make the most of the Extensions section of the site and we'll be able to give you credit for your creation.
Note: If you're one of the early birds who created a script we've already listed, please help us by adding the information in the guide above to your extension's page.
Finally, we can't say it enough – thank you so much for your energy and support. We love seeing the extensions, custom themes, custom searches and everyday uses you've found for Alfred, so keep tweeting us and telling your friends about Alfred. You make every day of work much more fun! :)


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Double V-Neck Bodysuit - ONLINE EXCLUSIVE
Style # 212350
AVAILABILITY: Unavailable for immediate shipment.
Enter spring's sexiest and highly versatile top. This bebe bodysuit features a wide V-neck design and ultra-soft and lightweight fit. Try yours with anything from a bold print to denim shorts.
- 92% nylon, 8% spandex
- Center back to hem: 20" (51 cm)
- Machine wash according to care label
- Made in USA with imported materials
- Model is 5'9" and is wearing a US size S
Rated 0 out of 5
0-0 of 0


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I would love to meet other LA moms, since I am a Los Angeles mommy blogger. If you live in Los Angeles and would like to network, please join the club and introduce yourself!
Location: Los Angeles
Members: 26
Latest Activity: Mar 1, 2014
Started by Tisha Berg Nov 18, 2012. 0 Replies 0 Likes
Hey ladies, I have 10 tickets to the DirecTV ESPN COLLEGE BASKETBALL TOURNAMENT in Anaheim for next weekend. Since I'm not into sports, I'm giving them away on my blog. Want 'em? Win them here:…Continue
Started by Tisha Berg Sep 20, 2012. 0 Replies 0 Likes
Win Two Free Movie Tickets to a Theater of Your Choice! (9/30)Each month on the Biz Mommy Facebook page we'll select a winner for TWO free movie tickets to any Regal Cinemas, Edwards, United Artists,…Continue
Started by Tisha Berg Sep 20, 2012. 0 Replies 0 Likes
One lucky winner will join Gold Medal Olympians Mike and Bob Bryan (who happen to be pro tennis' all time winning doubles team with 80 pro titles and 11 Grand Slam titles) and other Top Tennis Pros…Continue
Started by Alexia Aug 19, 2012. 0 Replies 0 Likes
Has anyone heard of Wingsplay, make money with Facebook, Twitter, and your blog! http://www.wingsplay.com/?ref=b1c120The fun way to monetize your…Continue
Sarah Jessica Parker's collection is out! See and shop it here: http://www.losangelesmammablog.com/?p=729
Please VOTE for Los Angeles Mamma Blog for Top 25 SoCal Moms - 2013 http://www.circleofmoms.com/blogger/los-angeles-mamma-blog
If you are a mommy blogger, who loves to review products the Mamma Reviewers Community, housed on Yuku - wants YOU! (http://mammareviewers.yuku.com/). How it works: I seek review opportunities and then post them on the forum for members (you) to view and apply for. I think this can be a wonderful resource for you, whether you are an established blogger, or just starting out. There are 3 review opportunities available presently, with more to come. Help me spread the word. Do you know a mommy blogger who would like to receive more review opportunities? Please recommend the Mamma Reviewers Community by forwarding this email to a mommy blogger friend today! This program in currently available to mommy bloggers in the USA and Canada only.
JOIN: https://www.paypal.com/us/cgi-bin/webscr?cmd=_flow&SESSION=liUf...
Blog tour host needed for The Persecution of Mildred Dunlap by Paulette Mahurin. NOTE: If you have already received this book from the author and have not posted your review yet; you can still be a part of the tour.
Here's what's new with Los Angeles Mamma Blog!
Check out a couple of my posts on Lucky Magazine's Community! Woot (Feel free to vote for them, too!)
Has anyone heard of Wingsplay, make money with Facebook, Twitter, and your blog! http://www.wingsplay.com/?ref=b1c120
The fun way to monetize your influence Wingsplay is the platform that connects influential social media users with the best viral video advertisers. Share the best viral videos on Facebook, Twitter or your blog, watch them spread and make money!
$5 to JOIN Mamma Reviewers (for a yearly membership) http://www.losangelesmammablog.com/new-mamma-reviewers
TODAY ONLY. Happy Earth Day!
If you like reviewing beauty products you'll love Julep Maven. Use code LOSANGELESMAMA to get your sneek peak box for $5 (worth over $40) http://www.julep.com/?r=18983867
Sign up for "Mamma Reviewers" on Los Angeles Mamma Blog!
The goal of this page is to help other mommy bloggers get review opportunities, and be seen by PR looking for reviewers. The cost to join is $.99/month, or $6.99/year. You can join by clicking on the link above, or feel free to email me with questions.
What various business owners are saying about Mamma Reviewers:
Thanks for the head's up on your new section. That is great, and we will absolutely be in contact with the bloggers listed. I look forward to seeing a huge list grow!
Stay Playful,
Karen Duggan Founder 805.540.8851 www.playfulplanet.com
Thank you so much! Will definitely look into them.
Omid - Spaphile
Thanks for this info! I'll bookmark it. Very neat idea - and easy to find on your site. Have a great weekend! Karen
Karen Welby Marketing Director EatSmart Products
That's great. Thank you! May we add Mamma Reviewers to our blogger list to receive review copy offers?
Laura Rivas
Assistant Director of Marketing, Publicity, and Events
Candlewick Press
This is really brilliant, I am desperate to find more mummy bloggers in the US and start a US blogger database So thank you! Lx Louise Harris Rock and Roll Baby World 07980 996318 www.rockandrollbabyworld.co.uk
Thanks for sharing this info! This is a great resource. I'll be sure to let any mom blogger I contact know that I found them there, and will refer people there as appropriate. Thanks again, and have a great weekend! Vicki
Vicki Lesage


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Kids' Yoga Wildlife Girls
Model: SGS2920T
Color Selected:
Available Sizes: Size Chart
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See what the buzz is all about! These are the bee's knees!
Sizes 8/9 & 10/11 have a back strap
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Additional Information
- Animal print canvas strap with soft webbing toe post and soft jersey lining
- Footbed made from real yoga mat
- Happy U sponge rubber outsole
- Sizes 8/9 & 10/11 have a back strap
- Vegan and Vegetarian
Product Reviews
Reviewed by 1 customer
- Comfortable
- Cushions Impact
- I Like The Backstrap
Best Uses
- Casual Wear
- Travel
Comments about Yoga Wildlife Girls:
I wanted these flip flops because I wanted these to be good for her little feet and provide good cushioning and also for the backstrap to keep them on her feet easily.
- Sizing:
- Feels true to size
- Width:
- Feels true to width
Do you have questions about this product?
Get answers from our staff experts by clicking "Ask a Question" or click here to send an email to our customer service team.


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Quick Links
Shop All Jewelry
RGZ10873 In Stock
This 11 Stone Bezel Set CZ bubbles Ring is very unique and rare. It can be worn with any outfit and is hard to miss with it's Diamond shape. Sparkling CZ's outline the diamond shape on this 11 Stone Bezel Set Cz Bubbles Ring adding to its "weaved" like appearance. This 11 Stone Bezel Set CZ Bubbles Ring comes in size 6 through 9. Pair it with any item in our bubbles collection!
Eve's Addiction.com wants you to be a happy customer. We want you to be completely satisfied with the sterling silver jewelry that you receive from us, as we only sell high quality silver and cubic zirconia cz jewelry. We do understand that you may not like your purchase for some reason.
You may return or exchange your jewelry within 60 days of purchase if you are not satisfied with it. The jewelry must be returned in its original condition for a refund or exchange. Engraved, personalized, photo, monogram, name and initial, chocolate and clearance items are not returnable or exchangeable.


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Browse and search white papers and mission & technology studies received by the Planetary Science Decadal Survey. Click here for basic user instructions.
Title: Lunar Science with ARTEMIS: A Journey from the Moon's Exosphere to its Core [version 2]
Primary Author: Krishan Khurana
Secondary Author(s): V. Angelopoulos, Charles W. Carlson, Gregory T. Delory, William M. Farrell, Robert E. Grimm, Ian Garrick-Bethell, Jasper S. Halekas, L. L. Hood, M. Horanyi, Robert J.Lillis, Robert P. Lin, Clive R. Neal, M. E. Purucker, Chris T. Russell, Gerry Schubert, D. G. Sibeck, Pavel Travnicek
Institution: IGPP/UCLA
Summary: This white paper describes the planetary science objectives to be achieved by ARTEMIS, a two-spacecraft constellation en route to the Moon, and presents recommendations pertaining to future lunar science. [version 2]
Panel Selection: Inner Planets: Mercury, Venus, and the Moon.
Download File
Return to Index
These documents have been prepared in coordination with the National Academies of Science in support of the National Academies Planetary Science Decadal Survey. These documents are being made available for information purposes only, and any views and opinions expressed herein do not necessarily state or reflect those of NASA, JPL, or the California Institute of Technology.


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Focus Area:Prevention
- HIV Prevention Knowledge Base
- See All Topics
- Topics by Alphabetical Order
- See All Topics
- Combination Approaches
- Biomedical Interventions
- Antiretroviral Therapy as an HIV Prevention Strategy
- Blood Safety and Availability
- Contraception to Prevent Unplanned Pregnancies among Women with HIV
- Diagnosis and Treatment of Sexually Transmitted Infections
- HIV Testing and Counseling as Prevention
- Infant Feeding for Mothers Living with HIV
- Injection Safety
- Microbicides
- Post-exposure Prophylaxis (PEP)
- Pre-exposure Prophylaxis (PrEP) for HIV Prevention
- Prevention of Mother-to-Child Transmission of HIV
- Voluntary Medical Male Circumcision
- Behavioral Interventions
- Structural Interventions
- Multimedia Resources
- Podcast: Reaching Transgender and MSM Populations through Social Media
- Video on Voluntary Medical Male Circumcision (VMMC)
- Prevention Update
- HIV Prevention Update: Latest Must-Read Literature
- Subscribe to the Prevention Update
- Resources
- Case Studies
- Promising Practices (G3Ps)
- Reports
- Spotlight on Prevention
- Structural Approaches to HIV Prevention Position Paper Series & Resource Tool
- Technical Briefs
- Technical Consultation Materials
- National Guidance
- National HIV/AIDS Strategic Plans
Subscribe to AIDSTAR-One!
Sign up to receive current HIV technical resources delivered to your inbox. Customize your updates based on your areas of interest.
What can AIDSTAR-One do for you?
From short-term technical assistance to long-term program implementation support and more, AIDSTAR-One provides rapid, evidence-based services to PEPFAR country teams in generalized, mixed and concentrated HIV epidemic settings.
Biomedical Interventions: Diagnosis and Treatment of Sexually Transmitted Infections
I. Definition of the Prevention Area
Sexually transmitted infections (STIs) likely facilitate HIV transmission and acquisition. STI treatment efforts have been used as an HIV prevention approach with mixed outcomes. This prevention strategy may be most effective in settings with a high burden of STIs and when targeted to most-at-risk populations and their sexual partners. However, randomized trials have found STI treatment to have little to no effect on HIV incidence.
II. Epidemiological Justification for the Prevention Area
The role of STIs in the transmission dynamics of HIV epidemics is paradoxical and complex. Population-based studies have found that both the prevalence and incidence of HIV were substantially higher in people with STIs. Both curable STIs and chronic infections such as herpes simplex virus type-2 (genital herpes) can increase vulnerability to HIV infection by disrupting skin and mucosal barriers and/or by causing inflammation that brings HIV-susceptible immune cells to the genital tract. STIs are biological markers for risky sexual behaviors, which are also risk factors for HIV acquisition.
In addition, a number of studies in HIV serodiscordant couples report that HIV-positive individuals with herpes or genital ulcer disease are significantly more likely to transmit HIV to their partners. Some STIs appear to increase the risk of HIV transmission by boosting viral shedding in the genital secretions of both men and women who are HIV-positive. Other studies of HIV-positive individuals on antiretroviral therapy suggest that STIs may increase the infectiousness of HIV, even when an individual has an undetectable viral load.
Despite these data, numerous clinical trials have not been able to demonstrate a decline in HIV incidence as a result of STI treatment. Some hypothesize that treated STIs may still cause inflammation and other changes in the genital mucosa even after the initial symptoms have disappeared. The ongoing inflammation and changes in the genital mucosa may be why STI treatment does not have an effect on HIV incidence. Epidemic stage, prevalence of viral versus bacterial STIs, and type of treatment may also be reasons that STI treatment does not lower HIV incidence.
III. Core Programmatic Components
While STI treatment does not seem to have a significant impact on HIV incidence, effective management of STIs is an essential public health activity and is particularly important for improved maternal and child health outcomes. Data linking the prevalence of STIs with increased risk of HIV transmission and acquisition underscore the importance of STI prevention, which can best be achieved through a comprehensive STI control program.
The U.S. President's Emergency Plan for AIDS Relief (PEPFAR) supports STI control for HIV prevention depending on epidemic type and population. In concentrated epidemics, the population focus should be on most-at-risk populations, individuals with symptomatic STIs, HIV-positive persons with high-risk behaviors, and other groups that may be at high risk for STI acquisition. In generalized epidemics, PEPFAR supports STI control programs for high-risk subpopulations, including most-at-risk populations, individuals with symptomatic STIs, HIV-positive persons, and sexually active adolescents. PEPFAR also supports HIV testing and counseling services for STI patients.
A 2009 review of STI control and HIV prevention in the Bulletin of the World Health Organization concluded that the core elements of a comprehensive STI control program should include:
- Reaching out to populations at greatest risk, particularly those who change partners frequently, potentially propelling transmission within the population
- Promoting safer sex through the provision of condoms and other prevention activities
- Offering effective clinical interventions (including STI screening, treatment, and case management)
- Initiating structural interventions to ensure an environment that supports safer sex behavior and care- and treatment-seeking behaviors
- Collecting reliable data to monitor disease trends and the effectiveness of interventions.
IV. Current Status of Implementation Experience
Research is ongoing to better understand how STIs modify HIV transmission. The development of improved screening strategies to detect some asymptomatic STIs in resource-limited settings remains a research priority. Currently, STI treatment as a stand-alone HIV prevention intervention in generalized epidemics is not supported by scientific data.
STI control for HIV prevention depends on the type of HIV epidemic and the populations at highest risk. A number of resource-limited countries, including Cambodia, Kenya, Senegal, Sri Lanka, and Thailand, have demonstrated that it is feasible for programs to expand STI control services. Several countries that have successfully controlled STIs have also reported stabilization or reversal of their HIV epidemics. For instance, in India, the Avahan Initiative reported a reduction in STI and HIV incidence after it included the improved delivery of STI management to most-at-risk groups as part of its comprehensive prevention interventions. Thailand's 100% Condom Program appears to have contributed to both STI reduction and HIV prevention by requiring condom use in brothels. STI screening, management, and treatment are key components of the PEPFAR comprehensive package of services for most-at-risk populations.
Prevalence of Sexually Transmitted Co-infection in People Living with HIV/AIDS: Systematic Review with Implications for Using HIV Treatments for Prevention
Kalichman, S., Pellowski, J., & Turner, C. Sexually Transmitted Infections (2011), Vol. 87, pp. 183-190.
The review examines the role that sexually transmitted infections (STIs) play in people living with HIV and how the co-infections of STIs and HIV play on the prevention potential of antiretroviral therapy (ART) in limiting HIV transmission rates. The search includes studies that report on STIs in people living with HIV and were published from 2000 to 2010. It also only includes STIs that demonstrate HIV shedding in the genital tract such as syphilis, chancroid, and gonorrhea. Thirty-seven studies are presented in the review, and it was found that the overall mean point prevalence of STI co-infection was 16.3 percent. The most common STIs co-infections were syphilis, gonorrhea, chlamydia, and trichomoniasis. The highest prevalence of STI/HIV co-infections were in people newly diagnosed with HIV, but STI co-infections take place throughout the course of HIV infection and not only when first diagnosed. For example, the average STI/HIV co-infections was 14 percent. People taking ART also were diagnosed with STI co-infections to a high degree, and there was not a significant difference of co-infections between HIV-positive individuals who were or were not on ART. The review points to limitations to forecast data on the overall effect of ART for prevention programs on reducing transmission rates in HIV epidemics. They often do not include the effect of STI co-infections in the models, which would reduce the successfulness of those results. STI co-infections should be included in future models and forecast when considering ART as a prevention strategy.
Treatment of Sexually Transmitted Infections for HIV Prevention: End of the Road or New Beginning?
Hayes, R., Watson-Jones, D., Celum, C., et al. AIDS (2010), Vol. 24 Supp 4, pp. S15-S26.
Treatment of curable sexually transmitted infections (STIs), a relatively inexpensive, simple, and effective intervention, should be promoted as an essential component of HIV control programs in communities with a high incidence of STIs. The authors derived this from reviewing the observational studies and nine randomized controlled trials (RCTs) evaluating the impact of STI treatment interventions on HIV incidence. Although only one of nine RCTs has demonstrated an effect on HIV incidence, the authors conclude that issues in trial design and conduct—including HIV epidemic phase, STI prevalence, and intervention in comparison groups—affected several of the trials. The RCTs examined three different management approaches to a broad spectrum of curable and incurable STIs in varying populations, with different levels of risk behaviors and STI prevalence, in both concentrated and generalized HIV epidemic settings. Four of the trials focused on population-level effects of STI treatments, with only one focusing on populations with high STI prevalence. Three trials, focusing on herpes suppressive therapy, found that antivirals for herpes simplex virus suppression were insufficient to control the cofactor effect of herpes simplex virus type-2 on HIV transmission. The authors advocate for future research examining the biological mechanisms responsible for the STI-HIV interactions, testing new STI control strategies that target these interactions, and developing point-of-care STI diagnostics and evaluation of alternative partners service approaches (e.g., patient-delivered partner therapy).
Acyclovir and Transmission of HIV-1 from Persons Infected with HIV-1 and HSV-2
Celum, C., Wald, A., Lingappa, J. R., et al. New England Journal of Medicine (2010), Vol. 362 No. 5, pp. 427-439.
This randomized, placebo-controlled clinical trial of acyclovir set out to determine whether or not the drug could reduce the transmission of HIV from partners co-infected with HIV and herpes simplex virus type-2 (HSV-2) to their serodiscordant partners. The study was conducted among over 3,400 serodiscordant couples in 14 sites in Southern and Eastern Africa. Although daily therapy with acyclovir reduced mean plasma concentrations of HIV and the occurrence of genital ulcers due to HSV-2, it did not cut the risk of HIV transmission, the study found. However, it proved the feasibility of conducting trials among HIV serodiscordant couples.
Sexually Transmitted Infections and Infectiousness Beliefs Among People Living With HIV/AIDS: Implications for HIV Treatment as Prevention
Kalichman, S. C., Eaton, L., & Cherry, C. HIV Medicine (2010), Vol. 11 No. 8, pp. 502-509.
This study used confidential computerized interviews to ask people living with HIV about recent history of sexually transmitted infections (STIs) as well as their sexual behaviors and infectiousness beliefs. It found that one in seven respondents had been diagnosed with an STI over a six-month period, most commonly herpes simplex virus and syphilis. There was a strong association between belief that viral load was undetectable and diagnosis with an STI. The authors advocate integration of STI diagnosis and treatment into routine clinical HIV care. It is also crucial to correct false beliefs about infectiousness and provide education about STI symptom recognition and the importance of early detection and aggressive treatment, they write.
Selecting HIV Infection Prevention Interventions in the Mature HIV Epidemic in Malawi Using the Mode of Transmission Model
Maleta, K., Bowie, C. BMC Health Services Research (2010), Vol. 10, p. 243.
The Joint United Nations Programme on HIV/AIDS Mode of Transmission Model spreadsheet was used to assess the impact of various HIV prevention interventions based on data available from Malawi, taking into account the country's high prevalence of partner concurrency and serodiscordancy. Interventions in the model include increased condom use, more circumcisions, and converting all multiple concurrent partnerships into monogamous partnerships. The model showed that most new cases were among low-risk heterosexual groups (i.e., those who were part of serodiscordant couples or those who had casual sex and their partners). Condom use by discordant couples, a monogamy policy such as Uganda's Zero Grazing campaign, and abstinence were the most effective prevention measures; improved treatment of sexually transmitted infections had only a limited effect.
Disentangling Contributions of Reproductive Tract Infections to HIV Acquisition in African Women
van de Wijgert, J. H. H. M., Morrison, C. S., Brown, J., et al. Sexually Transmitted Diseases (2009), Vol. 36 No. 6, pp. 357-364.
The prevalence and incidence of reproductive tract infections (RTIs) and HIV over a five-year period and the relationship between RTIs and HIV infection were examined in this study of more than 4,400 women attending family planning clinics in Zimbabwe and Uganda. Even though the women received regular counseling on risk reduction, screening, and treatment for RTIs, the incidence of HIV and RTIs did not diminish during the study period and almost all types of RTI were associated with increased risk of HIV infection. The authors still conclude that aggressive efforts to control RTIs may contribute significantly to HIV prevention and recommend continued efforts to find more effective treatments and interventions.
Persistence of HIV-1 Receptor–Positive Cells After HSV-2 Reactivation is a Potential Mechanism for Increased HIV-1 Acquisition
Zhu, J., Hladik, F., Woodward, A., et al. Nature Medicine (2009), Vol. 15 No. 8, pp. 886-892.
This small study offers an explanation for why treating herpes simplex virus type-2 (HSV-2) does not lead to a reduction in HIV acquisition even though infection with HSV-2 is associated with increased risk of HIV infection. Examining biopsies from eight subjects infected with HSV-2, the authors found that below healed herpes lesions, there is profound localized inflammation that persists even after prolonged antiviral therapy. Future interventions to break the association between HSV-2 and HIV should strive to reduce this inflammation or lead to the development of a HSV-2 vaccine, the authors conclude.
Effect of Acyclovir on HIV-1 Acquisition in Herpes Simplex Virus 2 Seropositive Women and Men Who Have Sex With Men: A Randomized, Double-Blind, Placebo-Controlled Trial
Celum, C., Wald, A., Hughes, J., et al. The Lancet (2008), Vol. 371 No. 9630, pp. 2109-2119.
This randomized, double-blind, placebo-controlled trial enrolled HIV-negative, herpes simplex virus type 2 (HSV-2) seropositive women in Africa and men who have sex with men in Peru and the United States. Participants were given either acyclovir or placebo for 12 to 18 months. The primary endpoint was HIV acquisition, and the study showed that suppression of HSV-2 infection did not lead to a reduction in incidence of HIV. This is disappointing, the authors comment, given that infection with HSV-2 is associated with significantly higher risk of HIV acquisition. They recommend further studies re-examine this assumption derived from observational studies and whether higher doses of acyclovir or other antiviral drugs would yield better results.
Reassessing the Hypothesis on STI Control for HIV Prevention
Gray, R., & Wawer, M. The Lancet (2008), Vol. 371 No. 9630, pp. 2064-2065.
The commentary is in response to two randomized controlled trials that tested the effect of STI treatment on HIV acquisition, both published in volume 371 of the Lancet in 2008. The first was conducted in Tanzania and the other was multicenter (HIV Prevention Trials Network 039). Both found no effect of herpes simplex virus type 2 suppression on HIV acquisition, a surprising result based on observational data. The authors provide plausible reasons on why this may have been found. Diagnosis and treatment of STIs is a public health responsibility; however, they conclude that HIV prevention strategies may need to be revised based on these new findings. Resources should be directed to strategies that are proven efficacious.
Control of Sexually Transmitted Infections for HIV Prevention
White, R., Celum, C., Wasserheit, J., et al. The Lancet (2008), Vol. 372 No. 9646, p. 1297.
The commentary is in response to the view expressed by Gray and Wawer (in "Reassessing the Hypothesis on STI Control for HIV Prevention," Lancet 2008) that HIV prevention strategies should be adjusted based on the results from two randomized controlled trials showing no effect of STI control on HIV acquisition. The authors disagree with this view and support sexually transmitted infection control in HIV prevention founded on the results of modeling studies. Reducing funds to sexually transmitted infection diagnosis, treatment, and control could have adverse and unexpected effects on the HIV epidemic and should not be relaxed.
Treating Curable Sexually Transmitted Infections to Prevent HIV in Africa. Still an Effective Control Strategy?
White, R. G., Orroth, K. K., Glynn, J. R., et al. Journal of Acquired Immune Deficiency Syndromes (2008), Vol. 47 No. 3, pp. 346-353.
This study used a mathematical model to examine whether or not interventions to treat sexually transmitted infections (STIs) are cost-saving in populations with generalized HIV epidemics. The model was applied to the population characteristics of four cities in West Africa and East Africa, two with high HIV prevalence and two where prevalence was relatively low. It found that in settings where there is a generalized HIV epidemic, even though the proportion of HIV infections attributable to curable STIs is likely to fall, interventions targeting these diseases are still highly cost-effective and potentially cost-saving, assuming STIs have not been controlled by changes in risk behavior.
Syndromic Management of Sexually Transmitted Infections and Behavior Change Interventions on Transmission of HIV-1 in Rural Uganda: A Community Randomised Trial
Kamali, A., Quigley, M., Nakiyingi, J., et al. The Lancet (2003), Vol. 361 No. 9358, pp. 645-652.
This study compared the impact of three scenarios—behavioral interventions with or without syndromic management of sexually transmitted infections and routine medical care—on incidence of HIV in rural Ugandan communities. Awareness of herpes simplex virus type-2 (HSV-2) symptoms improved in the behavioral intervention group and HSV-2 incidence decreased in the group that also received syndromic sexually transmitted infection management. The study took reported condom use with the last casual partner as a proxy for high-risk sexual encounters and found that the behavioral interventions were associated with increased condom use. However, there was no measurable reduction in the incidence of HIV in any of the groups.
Randomized Trial of Presumptive Sexually Transmitted Disease Therapy During Pregnancy in Rakai, Uganda
Gray, R. H., Wabwire-Mangen, F., Kogozi, G., et al. American Journal of Obstetrics and Gynecology (2001), Vol. 185 No. 5, pp. 1209-1217.
This study looked at the impact of presumptive treatment of sexually transmitted infections on both HIV transmission and pregnancy outcome. The study randomized over 4,000 pregnant women to either one presumptive treatment for sexually transmitted infections during pregnancy or vitamin and mineral supplements, with confidential notification and treatment referral for those diagnosed with syphilis during the study. The intervention resulted in less cervical and vaginal infections and fewer cases of infant ophthalmia, as well as significantly lower rates of low birth weight and neonatal mortality. However, there was no change in maternal HIV acquisition or in mother-to-child HIV transmission.
A Systematic Review of the Epidemiologic Interactions Between Classic Sexually Transmitted Diseases and HIV: How Much Really is Known?
Rottingen, J., Cameron, D. W., & Garnett, G. P. Sexually Transmitted Diseases (2001), Vol. 28 No. 10, pp. 579-597.
This 2001 meta-analysis combined the best available evidence to date to examine the effect of sexually transmitted infections (STIs) on HIV susceptibility. It found that many studies had been done in this area, but that a quantitative understanding of the interaction between the two was still lacking. Although randomized controlled trials are the gold standard for proving causation, most studies on HIV and STIs were observational. The authors recommend that future studies should strive to quantify the extent to which treating STIs has an impact on HIV prevention.
Control of Sexually Transmitted Diseases for AIDS Prevention in Uganda: A Randomised Community Trial
Wawer, M. J., Sewankambo, N. K., Serwadda, D., et al. The Lancet (1999), Vol. 353 No. 9152, pp. 525-535.
This study sought to test the hypothesis that controlling sexually transmitted infections (STIs) at the population level would reduce the incidence of HIV, as had been found in the first clinical trial conducted in rural Tanzania. The study was conducted in clusters of villages that encompassed social, and therefore sexual, networks in a rural district in southwestern Uganda with high rates of both HIV and STIs. The intervention group participants were given mass treatment with antibiotics while the control group participants were given vitamins and treatment for parasitic worms. Although the prevalence and incidence of some STIs significantly reduced in the intervention group versus the control group, there was no difference in HIV incidence.
Impact of Improved Treatment of Sexually Transmitted Diseases on HIV Infection in Rural Tanzania: Randomised Controlled Trial
Grosskurth, H., Mosha, F., Todd, J., et al. The Lancet (1995), Vol. 346 No. 8974, pp. 530-536.
This was the first randomized controlled clinical trial to test the hypothesis that treating sexually transmitted infections (STIs) would reduce HIV infection. The STI intervention program was conducted in 12 large communities and included setting up a reference clinic and laboratory, diagnosis and treatment training for existing staff, supplying drugs, and visits to villages served by each health facility to encourage people to seek prompt treatment for STIs. The study found that in the intervention group, HIV incidence fell by more than two-fifths over two years, with the greatest impact among women aged 15 to 24 and men aged 25 to 34. Subsequent clinical trials have not been able to replicate these results.
Quality Assurance and Quality Improvement Using Supportive Supervision in a Large-Scale STI Intervention with Sex Workers, Men Who Have Sex with Men/Transgenders and Injecting-Drug Users in India
Mogasale, V., Wi, T. C., Das, A., et al. Sexually Transmitted Infections (2010), Vol. 86 Suppl. 1, pp. i83-i88.
This evaluation monitored the performance of Avahan, the India AIDS Initiative, using a supportive supervision tool to analyze outcomes from three perspectives: clinical, community, and management. The tool assessed the accessibility, acceptability, and contact coverage of sexually transmitted infection clinical services. It looked at barriers to access and monitored the quality of individual service components, including correct treatment, infection control, confidentiality, and counseling. Monitoring demonstrated that Avahan improved and sustained quality in terms of coverage, quality, technical support, community involvement, and networks of referrals. The monitoring tool provides timely and useful feedback but can be time-consuming and resource-intensive to implement.
Changes in Risk Behaviours and Prevalence of Sexually Transmitted Infections Following HIV Preventive Interventions Among Female Sex Workers in Five Districts in Karnataka State, South India
Ramesh, B. M., Beattie, T. S. H., Shajy, I., et al. Sexually Transmitted Infections (2010), Vol. 86 No. Suppl. 1, pp. i17-i24.
This study used biological and behavioral surveys to assess the impact of HIV prevention programs targeted at female sex workers, such as peer outreach and behavior change communication and provision of sexual health clinic services including syndromic and presumptive management of sexually transmitted infections (STIs). By follow-up, almost all participants had been visited by a peer educator, at least three-quarters had visited a drop-in center or sexual health clinic, and two-thirds had received presumptive treatment for chlamydia and gonorrhea. Rates of condom use with clients improved but were static with regular partners. The prevalence of HIV reduced significantly across the board, but for curable STIs, only street-based female sex workers had a reduced prevalence at follow-up. Rates of curable STIs did not decrease for brothel- and home-based female sex workers.
Prioritising Prevention Strategies for Patients in Antiretroviral Treatment Programmes in Resource-Limited Settings
Spaar, A., Graber, C., Dabis, F., et al. AIDS Care (2010) Vol. 22 No. 6, pp. 775-783
Twenty-seven antiretroviral therapy programs in Africa, Asia, and South America were surveyed to determine the extent of preventive services they offered. The survey showed that prevention efforts in most programs focused on health education to change behavior, supply of male condoms, and prevention of mother-to-child transmission. Other interventions (e.g., protocols for partner notification and interventions for high-risk groups such as serodiscordant couples and adolescents) were less common. Few sites offered regular sexually transmitted infection screening. Survey respondents cited stigma, lack of financial resources, and high patient load as the main obstacles to implementing preventive services within antiretroviral therapy programs.
Control of Sexually Transmitted Infections and Prevention of HIV Transmission: Mending a Fractured Paradigm
Steen, R., Wi, T. E., Kamali, A., et al. Bulletin of the World Health Organization (2009), Vol. 87, pp. 858-865.
This paper argues that the "fractured paradigm" of HIV prevention separate from programs to tackle sexually transmitted infections (STIs) is counterproductive for both, given that weak control of STIs may undermine HIV prevention efforts. The paper reviews the components, benefits, and feasibility of STI control and offers an alternative, unified paradigm to tackle HIV together with other STIs. A useful table lays out the epidemiological parameters for integrating HIV prevention and STI control, detailing which target groups and diseases should get priority in which settings and when STI interventions are most effective in preventing HIV transmission.
Linking Sexual and Reproductive Health and HIV/AIDS, Gateways to Integration: A Case Study From Haiti
World Health Organization, United Nations Population Fund, Joint United Nations Programme on HIV/AIDS, & International Planned Parenthood Federation. (2008).
In Haiti, voluntary HIV counseling and testing became a gateway to providing comprehensive sexual and reproductive health services including condom use promotion, family planning, maternal child health services, and services specifically for young people and survivors of sexual violence. Integration made sense because most HIV infections in Haiti are transmitted sexually, mother-to-child transmission is common, and people living with HIV face stigma and discrimination in accessing health services. Services evolved as needs were identified. Although such integration requires great efforts to overcome the stigma associated with HIV, providing access to a range of health services greatly improves uptake of HIV counseling and testing.
Monthly Antibiotic Chemoprophylaxis and Incidence of Sexually Transmitted Infections and HIV-1 infection in Kenyan Sex Workers
Kaul, R., Kimani, J., Nagelkerke, N., et al. Journal of the American Medical Association (2004), Vol. 291 No. 21, pp. 2555-2562.
The randomized double-blinded and placebo-controlled trial enrolled Kenyan female sex workers to test whether the use of antibiotic prophylaxis to treat common sexually transmitted infections (STIs) would also reduce the rate of HIV acquisition. Four hundred and sixty-six seronegative sex workers were enrolled in the study. All women were provided with risk-reduction counseling, condoms, treatment of symptomatic STIs, and biannual screening and treatment for asymptomatic STIs. Oral azithromycin was given to half of the participants and the other half was given a placebo. There was no statistically significant difference between the treatment and placebo groups on HIV-1 incidence. Out of 35 seroconversion cases, 19 were in the treatment group and 16 were in the placebo group. There was a strong association between prior STI and incident HIV-1 infection, and a significant positive effect of azithromycin on the reduction of incidence and prevalence of bacterial STIs. A reduction in risky sexual behaviors in both groups was found. Condom use with all clients increased from less to 20 percent to more than 50 percent within one month. The number of clients per week decreased from more than 16 to less than 6 within six months. There was a correlation between HIV-1 infection and risky sexual behaviors within the year of seroconversion. The authors provide plausible reasons for the lack of effectiveness in reducing HIV-1 acquisition with azithromycin treatment in this population.
Changing Patterns in Sexually Transmitted Disease Syndromes in Kenya After the Introduction of a Syndromic Management Program
Cheluget, B., Joesoef, M. R., Marum, L., et al. Sexually Transmitted Diseases (2004), Vol. 31 No. 9, pp. 522-525.
This study of Kenya's syndromic management program for sexually transmitted infections (STIs) used HIV sentinel surveillance data in patients with STIs to identify changes in the proportion of patients with three syndromes associated with increased HIV acquisition: genital ulcer disease, urethral discharge, and vaginal discharge. Incidence declined after the introduction of the program in 1995 and then increased again when free STI medication was no longer offered in 2001. As this was an ecological study, it was vulnerable to possible selection bias, and the authors recommend further studies such as randomized clinical trials to better understand the impact of complex interventions like STI syndromic management programs.
How Effective is Syndromic Management of STDs? A Review of Current Studies
Pettifor, A., Walsh, J., Wilkins, V., et al. Sexually Transmitted Diseases (2000), Vol. 27 No. 7, pp. 371-385.
This review of programs implementing syndromic management of sexually transmitted infections (STIs) found that the processes for diagnosis and treatment of urethral discharge and genital ulcer disease in men were highly sensitive or had good cure rates, but those for women were less sensitive, particularly for those without symptoms. Algorithms for vaginal discharge do not effectively detect gonorrhea or chlamydia in women. Once the qualitative aspects of STI syndromic management are taken into account, the algorithms are likely to be even less sensitive than the literature suggests, and the authors urgently call for the development of affordable and effective rapid STI testing for use in resource-poor settings.
Guidance for the Prevention of Sexually Transmitted HIV Infections
U.S. President's Emergency Plan for AIDS Relief. (2011).
The Office of the Global AIDS Coordinator guidance is aimed at U.S. President's Emergency Plan for AIDS Relief (PEPFAR) country teams to provide them with the latest scientific data on prevention programs to increase the impact of their country portfolios. Prevention programs should be tailored to the epidemiological and social context of the country as well as optimizing on current programs implemented by other partners to help fill gaps. The guidance highlights the importance of knowing the country's epidemic, context, response, and costs, as well as ensuring that HIV prevention is part of the overall country continuum for the response. It also outlines current evidence and program activities that PEPFAR funds will support in relation to the diagnosis and treatment of sexually transmitted infections.
A Strategic Approach to Strengthening Control of Reproductive Tract and Sexually Transmitted Infections: Use of the Programme Guidance Tool
World Health Organization. (2009).
National- and regional-level decision makers can use this Programme Guidance Tool to set goals and priorities for interventions to address reproductive tract infections. The tool has 10 steps, 7 of which are for strategic situation analysis, followed by development of recommendations, implementation of new measures, and expansion of those found to be successful. It gives detailed guidance about what items should be covered at each stage. There is a section on how to conduct rapid assessment, including details on who should be interviewed and what interview tools can be used. There is also a suggested funding proposal outline for financing the first stage of the tool.
Training Modules for the Syndromic Management of Sexually Transmitted Infections
World Health Organization. (2007).
This sexually transmitted infection (STI) management training program can be used for in-service training of health care workers in health centers, district hospitals, STI clinics, or other first-level health facilities. Seven modules cover STI prevention and control, syndromic case management, history-taking and examination, diagnosis and treatment, patient counseling and education, partner management, and recording and development. There is a trainer's guide and a CD-ROM that can be used for self-learning or in conjunction with conventional training. The program is also available in French and Spanish.
Sexually Transmitted Diseases Treatment Guidelines 2006
Centers for Disease Control and Prevention. (2006).
These guidelines present sexually transmitted infections grouped by presenting symptom, with a section each for infections characterized by vaginal discharge, urethritis and cervicitis, and genital ulcers. Each section gives the range of recommended treatment regimens. The guidelines also cover partner management and special issues such as sexually transmitted infections during pregnancy; infections in babies, children, and adolescents; and, where applicable, treatment of drug-resistant disease strains. These guidelines are based on laboratory diagnosis rather than the syndromic management method that is used in resource-constrained settings.
National Guidelines for the Management of Sexually Transmitted Infections
Eqyptian Ministry of Health and Population, Family Health International, & U.S. Agency for International Development. (2006).
These guidelines are part of a set of training materials that also includes a training manual, wall chart, and Arabic language promotional materials. The guidelines cover the syndromic management of sexually transmitted infections and have a diagnostic flow chart and treatment table for each common syndrome. They also highlight the importance of education and counseling as a component of both treatment and prevention of sexually transmitted infections. The training manual provides a sample workshop agenda and slides for each session. The wall chart, with a summary of symptom and treatment information, is ideal for use in clinics.
Integrating STI/RTI Care for Reproductive Health. Sexually Transmitted and Other Reproductive Tract Infections: A Guide to Essential Practice
World Health Organization. (2005).
This guide is a reference manual for use in reproductive health care settings such as family planning and maternal and child health care clinics. It focuses on women, as they are the typical users of such clinics and are less likely to use sexually transmitted infection (STI) clinics. There are sections giving basic information on STIs and other reproductive tract infections (RTIs), improving prevention and treatment services, and the clinical management of RTIs. HIV is mentioned in the guide but is not covered extensively because it is not a disease of the reproductive tract.
Periodic Presumptive Treatment for Sexually Transmitted Infections: Experience from the Field and Recommendations for Research
World Health Organization. (2008).
This report describes experiences from the field in periodic and one-time presumptive treatment for sexually transmitted infections (STIs) among sex workers and their clients. The report followed on from a technical consultation on global experiences of presumptive STI treatment programs among high-risk populations. The consultation identified the conditions needed for effective STI control using presumptive treatment and produced recommendations for research. Both topics are covered in this report, as is the effect of presumptive treatment on specific STIs. The report presents case studies and offers brief guidance on operating such programs.
View Report (PDF, 1.96 MB)
The Global Strategy for the Prevention and Control of Sexually Transmitted Infections 2006–2015: Breaking the Chain of Transmission
World Health Organization. (2007).
This document makes the case for a global strategy to tackle sexually transmitted infections (STIs), describing the public health burden and the opportunities for an accelerated response such as the emergence of new and cost-effective technologies. The strategy aims to provide a framework for this response and is targeted at managers of national HIV prevention and STI control programs as well as other health sector stakeholders including health care providers, health ministers, and donors. It details both the technical strategy for STI prevention and control and an advocacy strategy for mobilizing resources and political and social leadership.
View Report (PDF, 3.1 MB)
Guidelines for the Management of Sexually Transmitted Infections
World Health Organization. (2003).
These guidelines lay out the standardized treatment recommendations for syndromes associated with sexually transmitted infections (STIs) using at-a-glance flowcharts and tables. There are also treatment recommendations for each specific STI. The guidelines detail the main considerations in choosing a treatment, such as cost, efficacy, treatment compliance, and availability. There is a chapter covering practical considerations in case management of STIs and another on treatment of STIs in children and adolescents.
View Report (PDF, 2.75 MB)


text:
GDOT District Three designer Jason Mobley and project manager Adam Smith presented their concept for a replacement of the bridge over the Norfolk Southern Railroad at the May 21 meeting.
Smith said he and Mobley wanted to include the county commissioners in the plan. He said the GDOT is looking at the possibility of accommodating bicycle and pedestrian traffic.
"We are in the concept phase, and it is early in the design. The money just got released; the next step is the preliminary design. We have the survey already," he said.
Mobley said the purpose of the project is to replace the existing bridge. He said they are looking toward the eventual widening of Highway 49 in that area to a four lane. He said the plan is to move the replacement bridge and later the road to the side of the current bridge.
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Police arrested three men, two of them under the legal drinking age of 21, at the Macclenny Park late on June 6 for disorderly intoxication and loitering after they were spotted drinking in a shelter near the volleyball courts on North 8th.
Deputy Chad Montean said one of the men, William Foster, 18, of Macclenny, fled on foot as he approached the area about 11:30 pm. He was caught minutes later by Deputy Robert Simpkins on Blair St. east of the park. Mr. Foster had an open bottle of vodka in his pocket.
The other two were identified as Kristopher Legg, 21, of Macclenny and Matthew Russell, 20, of Glen St. Mary.
Deputy Montean noted that a water spigot at the shelter was turned on and had flooded the floor, and a nearby garbage can had been overturned. Also, an empty vodka bottle was lying nearby on a picnic table.


text:
Professional Usability in Open Source Projects:
GNOME, OpenOffice.org, NetBeans
Short paper for CHI 2004, HCI Overviews by Calum Benson, Matthias Müller-Prove, Jiri Mzourek
© ACM, 2004. This is the author's version of the work. It is posted here by permission of ACM for your personal use. Not for redistribution. The definitive version was published in CHI 2004, Extended Abstracts doi.acm.org/10.1145/985921.985991
- hc10-benson 2 pages, 56 KB
- Slides
- hc10-benson-slides.sxi 12 slides, 1.1 MB
- hc10-benson-slides.pdf 12 slides, 900 KB
- hc10-benson-slides.pdf 12 slides, 900 KB
Working as a usability professional in the open source arena is a challenging task. The decentralized and engineering-driven approach of open source projects can be at odds with corporate processes and usability engineering methodologies. Nonetheless, there is great potential for large corporations to contribute to open source projects. Providing usability know-how that leads to usable and useful products is a win-win situation for developers, the corporations, and – most importantly – the users.
Author Keywords open source software development, usability, multinational corporate environment
ACM Classification Keywords H.5.2 User Interfaces
There is some truth in the common notion that open source systems have poor user interfaces. Often they are created by engineers for engineers. The feedback cycle with real users does not exist because there are few usability experts participating in open source development processes. This problem is well-known and has been discussed in previous papers and conferences [1].
Sun Microsystems, Inc. is a large, multinational corporation with engineering teams around the world, and a long tradition in building systems on open standards. Sun's involvement in the usability of open source projects is a natural continuation of this strategy.
This field represents new challenges for HCI professionals. They have to meet corporate needs like consistency, documentation, support, and conformance to development processes [2]. On the other hand HCI professionals need to interact with engineers worldwide and evangelize usability to an unseasoned community.
This paper examines our current experience from the NetBeans, GNOME, and OpenOffice.org projects.
NetBeans is an integrated development environment that provides the foundations for Sun's Java development tools. It was one of the first open source projects started at Sun in June 2000.
Sun is the main contributor to NetBeans, and the only HCI contributor. The biggest accomplishment of the NetBeans HCI group has been establishing a user interface specification document as part of the development process [3]. Such documents now describe the detailed interaction and visual design of the majority of new features.
Sun's HCI group performs regular usability studies of NetBeans, and publicizes the results. Usability issues are given equal importance to functionality bugs, and are tracked in the same database. Graphics such as splash screens, icons, and other artwork form a large part of the project, and are contributed exclusively by Sun's designers under an open source license. Sun's user experience contribution also includes accessibility, localization into Japanese and Simplified Chinese, as well as documentation.
What are the biggest challenges?
- Communication: Discussion is fragmented between the mailing list and bug reports. These channels need a clearer charter and decision-making system.
- User profiles: Are mailing list participants really our target audience? If not, who should we optimize for?
- Responsibility: Who owns the functionality? The developer, who writes and owns the code, or the designer, who writes the specification? A clearer notion of shared ownership is required.
Sun has contributed usability resources to GNOME, a free, cross-platform desktop environment, since August 2000.
Sun's first major input was a usability study of GNOME 1.2 [4]. This offered the first feedback that many developers had received from real users, and the impact was profound. Consequently, the community formed the GNOME Usability Project (GUP), a cross-community group of HCI practitioners and students. Four of Sun's usability staff have served in this group, one role of which is to publish the GNOME Human Interface Guidelines [5]. Developers have been quick to adopt these guidelines, partly due to the GNOME Release Team's decision not to ship applications with too many open usability bugs.
As with NetBeans and OpenOffice.org, accessibility is an increasingly important aspect of GNOME usability. Sun designed the GNOME accessibility framework on which several innovative assisitive technologies are now being built [6].
Finally, Sun has written or improved much of the GNOME user documentation, translated it into several languages, and returned the results to the community. So what challenges remain for GNOME and the usability professionals who wish to contribute?
- Communication: Dedicated usability mailing lists and irc channels do exist but they host few useful discussions and, along with the complex bug database, can be intimidating to non-technical contributors.
- Early input: The GUP acts less as a usability "consultancy" for developers and more as a group of individuals who comment on usability bugs. Although the open source philosophy of contributing code early and often should lend itself well to rapid iterative prototyping, usability assistance is usually only sought after interfaces have been "designed".
- User profiles: There is no shared or documented vision of GNOME's target audience.
- Process: No obvious usability methodology is employed. Many developers contribute in their spare time for fun, so are understandably reluctant to follow heavyweight processes.
- Attitude: Some developers feel that "Sun will fix that, so we don't need to bother".
Sun is the main contributor to OpenOffice.org, the leading office application on Linux and the main competitor to Microsoft Office. The project was open-sourced by Sun in October 2000. The differences between OpenOffice.org and Sun's StarOffice are unimportant in this context – StarOffice features are ordinarily incorporated into OpenOffice.org, and vice versa.
The StarOffice User Experience Team includes professionals from all fields of HCI, including GUI and interaction design, usability engineering, linguistic expertise, accessibility, and globalization. The latter is especially important, as OpenOffice.org is localized into more than 30 languages.
The requirements for a release of OpenOffice.org come from several sources. Sun's marketing team gathers the product requirements from business customers, while the open source community files requests for enhancements in the bug tracking system. In general, the development process follows Sun's product life cycle: the Product Requirements Document is succeeded by the Product Concept Document (PCD). The PCD is discussed heavily in community newsgroups because the PCD represents the agreement of the features that will be addressed in the next release. The annual OpenOffice.org conference also offers many opportunities for vivid discussions between Sun and members of the open source community [7].
The StarOffice User Experience team also plays a major role in the next design phase: writing specifications. These describe in detail the new features and design changes for the user interface. As with source code, these documents are contributed back to the community [8]. The design process is supported by internal Sun usability studies, and external studies conducted by, for example, HCI students [1].
Although usability is still a relatively new concept for open source projects, it is starting to exert some influence, for example, in the form of studies and guidelines. A number of challenges remain to be met, however, many of which are common to all open source projects.
We believe that defining and integrating a suitable usability methodology into open source processes should be the first priority. It is also vital for each project to agree on its target audience, and to specify a clear and preferably centralized decision-making process.
Ultimately, it is in the open source movement's fundamental interest that its systems are widely-used. The contributions of HCI professionals are essential to gain market share and to find the way to the user.
- Frishberg, N., Dirks, A. M., Benson, C., Nickell, S., Smith, S.: Getting to Know You: Open Source Development Meets Usability. In: CHI 2002, Minneapolis, MI. ACM Press, 2002.
- Karels, M. J.: Commericializing Open Source Software. In: Queue 1(5), ACM Press, 2003, 46-55
- NetBeans.org: The User Interface Developer's Corner.
- Smith, S., Engen, D., Mankoski, A., Frishberg, N., Pedersen, N., and Benson, C.: GNOME Usability Study Report. Sun Microsystems, Inc., 2001.
- Benson, C., Elman, A., Nickell, S., and Robertson, C. Z.: GNOME Human Interface Guidelines, 2002.
- Chucri, L.: Breaking Down Barriers with GNOME 2.0, 2001.
- OpenOffice.org Conference 2003, Hamburg.
- OpenOffice.org Specification Project.
à propos
- User Experience Panel at OpenOffice.org Conference 2003
- Meeting the challenge of open source software usability by Calum Benson in Interfaces 60 32 pages, 1 MB, Autumn 2004, British HCI Group
- User Experience for OpenOffice.org by Matthias Müller-Prove in Interfaces 71, Summer 2007, British HCI Group
- Community Experience at OpenOffice.org by Matthias Müller-Prove in <interactions> 6, 2007
Incoming Links
- surfmind.com/musings/ by Andy Edmonds
- del.icio.us / androse / HCI by Ned Baldessin
- Accretions by Morgan Ames:
"The last morning of CHI I went to a talk on professional usability in open source projects, which was a pretty good, though simplistic, summary of the various papers and blog rants I've read on the topic over the years."


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Roadie the Roadrunner is going to run in the Great Roadrunner Race. He'll need your help to finish in first place!
Watch Diego only on Nick Jr.
Roadie the Roadrunner is going to need your help to win the Great Roadrunner Race. Move the mouse to the right to make him run faster and left to make him slow down. Make sure to pick up some prickly pairs along the way. They make great energy snacks and help Roadie go super fast! Watch out for walls, rocks, bushes and other obstacles--they'll slow Roadie down. You can run around these or click the left mouse button to jump over them. Have a great race!
Parent Tip: Remember to press the spacebar if you get caught in a sandstorm!
Up, up, and away--to save the baby dinosaurs!
Answer animal distress calls, drive Diego's rescue rover & save fierce animals
The mission: A risky river crossing! Al rescate!
Help Diego rescue the world's baby animals and bring them home
Kids enter Diego's world of shapes, colors, & animals in this arctic adventure
Kids use colors and patterns to paint new shells for the hermit crabs!
Get ready for an exciting animal rescue!
It's the age of the Maiasaura. Help Diego rescue baby dinosaurs
Kids help Diego get the baby sea turtles back home to the ocean
Listen to the drum and help Diego break the spell on the animals in Africa.
All Aboard the Animal Rescue train!
Kids snowboard though the Arctic and save animals with Diego
Help Diego break the spell to release the African animals
Puzzling, isn't it? How will Diego get to the party?
This party can't start until Diego gets Baby Jaguar's growl back!
Go mudboarding on the muddy mudslide and save the animals with Diego!
Kids join Diego on an adventure of prehistoric proportions
Tuga is hungry! Help her gobble jelly fish--and avoid snacking on trash!
Diego's Field Journal is filled with fascinating facts about animals.
To deliver the animal science book, Diego must avoid slipping on banana peels.
Five games in one dino-adventure!
Save the lost little wolf pup!
Help Dora kick, run and block her way to the Big Cup soccer game!
Ruby does figure eights in her skates, but she needs to watch out for Max!
Roll with Dora and Boots on their adventure to open Skate Park!
She shoots, she scores! Kids will get a kick out of this sporty game
Help Dora balance-beam walk, trampoline jump, & swing her way to the big show!
Take off with the team! Speed by obstacles & robots in a race to the finish line
Who needs the beach? Muno and Plex are playing volleyball on another planet!
Kids snowboard though the Arctic and save animals with Diego
Look out, Tiger Woods! Dora has taken up golf!
Go mudboarding on the muddy mudslide and save the animals with Diego!
Up the creek without a paddle? Don't worry. Dora has a raft!


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WAVERLY — Cora Avanelle Adams, 71 of Waverly, the wife of Carl Adams, passed away Tuesday, Jan. 29, 2013, at the Riverside Methodist Hospital, in Columbus. Funeral services will 1 p.m. Tuesday, Feb. 5, 2013, at Botkin Funeral Home in Waverly. Interment will follow in the Givens Chapel Cemetery. Visitation is Monday from 5 to 8 p.m. and Tuesday from noon to 1 p.m. at the funeral home.
PORTSMOUTH — Maxine Womack, 87, of Portsmouth passed away Wednesday, Jan. 2, 2013, at Southern Ohio Medical Center in Portsmouth. Arrangements are pending at the Ralph F. Scott Funeral Home in Portsmouth.
PORTSMOUTH — Judy Nichols, 69, of Portsmouth, formerly of McDermott, the wife of David Nichols, passed away Thursday, Jan. 31, 2013, at Hempstead Manor Nursing Home in Portsmouth. Arrangements are pending at McKinley Funeral Home in Lucasville.
WEST UNION — Harry Bixler, 86, of West Union, passed away Wednesday, Jan. 30, 2013, at his residence. Funeral services will be held Sunday, Feb. 3, 201, at 7 p.m. at Thompson-Meeker Funeral Home in West Union, Ohio. Interment is in Harris Creek Cemetery in Bradford, Ohio. Visitation is from 5 to 7 p.m. the day of the service at the funeral home.


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Despite champ's hesitation, White believes he'll convince Silva to fight Jones or GSP
Despite champ's hesitation, White believes he'll convince Silva to fight Jones or GSP | MMAjunkie.comAnderson Silva has three words, basically, about a potential superfight with Jon Jones. His boss has a three-word response.
Silva (33-4 MMA, 16-0 UFC) cruised past Stephan Bonnar (14-8 MMA, 8-7 UFC) in the UFC 153 main event on Saturday in Rio de Janeiro. The fight took place at light heavyweight, and speculation started immediately as to Silva's next challenge a possible superfight with light heavyweight champion Jon Jones.
Silva is hesitant to consider such a fight, but UFC President Dana White believes he can make it happen.
"I know my man says 'No, no, no,'" White said at Saturday's UFC 153 post-event news conference. "But the amount of money that would be offered for that fight, I guarantee you I will make Anderson Silva say, 'Yes, yes, yes.'"
Silva says such a fight, or any fight he's ever taken, has nothing to do with the money he makes.
"Since I started training martial arts, I never thought about the money," Silva told MMAjunkie.com UFC blog for UFC news, UFC rumors, fighter interviews and event previews/recaps | MMAjunkie.com. "I think everything I was able to get was because I did it with pleasure and love. When I started, there was no money in this and I didn't fight for money. Obviously, the money is important. We all need money, but I don't fight for the money."
Silva also believes there are potential challengers for Jones' 205-pound belt, including from within his own team of training partners, and he doesn't think Jones has much interest in the fight, either.
"This is not something I would like to happen because the times I've seen Jon Jones, he's also mentioned that he would not like to fight. (me)," Silva said. "We are UFC employees. I wouldn't like for this to happen because in our team, we have (Antonio Rodrigo) 'Minotauro' (Nogueira), we have (Rafael) 'Feijao' (Cavalcante), we have (Wagner) 'Caldeirao' (Prado).
"We have athletes in his division that can fight him. And I'm old. I'm getting old, guys."
But White believes he'll be able to sit in a rom with Silva and his manager, Ed Soares, and negotiate either a superfight with Jones or with welterweight champion Georges St-Pierre.
"There are so many options for him right now," White said. "He never ceases to amaze. And like he says, there's a lot of talented guys now in that 185-pound division. But as he says, he's at this point in his career where there are some superfights there. The Georges St-PIerre fight is a big fight. I think the Jon Jones fight is a big fight."


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We we so honored to be a part of the 3rd Annual Vintage Bridal Show in the Ackerman Ballroom at UCLA.
I love stepping back onto a college campus. There is something exciting and hopeful about it. You have an entire life ahead to look forward too...including getting married. The UCLA campus was a perfect spot for newly engaged brides and their friends and family to see what the LA bridal scene has to offer.
Check out the video of the event here: SF Productions LA Vintage Bridal Show Video
Also, check out photos from the event below.
And we can't forget Kassandra and Yasmine - two of our amazing sales associates!
Mariela Campbell Photography did a great job on the video and photography in conjuntion with SF Productions.
We loved being a part of this amazing event. Stay tuned for future events!


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LEXINGTON – Several Perry County grade school wrestlers competed in the State Youth Wrestling Tournament on Sunday at the Kentucky Horse Park, with one wrestler bringing home the state championship in his weight group.
Ian Montgomery, a kindergarten student at Viper Elementary, swept the competition during his first appearance at the state wrestling tournament. He competed in the 40-pound weight class.
Montgomery faced some tough competition in the semifinal round, jumping out to a 2-0 lead before his opponent would tie the score. He again took to a two-point lead in the second period, and eventually fell behind 6-4 in the third period before making a dramatic comeback. In the down position with time running out, Montgomery reversed his opponent's hold for two points with only one second remaining, forcing a sudden death period. In the final frame Montgomery made the first move, quickly taking his opponent to the mat and crossing over for the take down, giving him the win and a shot at the state title.
Montgomery's victory propelled him into the final round, where he would pin his opponent 12 seconds into the match before going on to win the state championship.
Montgomery is the son of Mike and Jamie Montgomery of Viper, and the grandson of Tony and Linda McGuire of Jeff, Emiline Montgomery of Hazard, and Dallas Montgomery of Lee County.
Three other Perry County wrestlers came away with medals from Sunday's competition. Greg Day scored a second place medal, while Gage Feltner, of A. B. Combs Elementary, finished fourth in his weight group.
Also competing in the tournament were Harley Combs and Braiden Howard, who finished just outside the medals.


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ASHEVILLE, N.C. --- It was only fitting that the last shot came from senior Kayla Christopher.
With the Lady Mocs trailing by two with 17.6 seconds to play, the University of Tennessee at Chattanooga had the ball. The shot was supposed to come from junior Ashlen Dewart (Spartanburg, S.C.), however, her first shot glanced off the rim. She and classmate Taylor Hall (New Tazewell, Tenn.) crashed the boards on the right side and Dewart came up with the ball for another chance.
Her second shot went off the left side and Christopher (Oliver Springs, Tenn.) was there for one more Chattanooga chance. She outjumped Davidson's Laura Murray and the put back found the net to put the Lady Mocs out front 64-63 with 8.2 seconds to play.
Davidson had one shot at the win, but Murray's jumper from deep on the left fell short and Christopher gathered up the rebound for the nail-biting victory.
The Lady Mocs improve to 29-3 on the year and claim a Southern Conference record 14th league tournament title. Chattanooga is 14-0 in title games claiming its first crown since 2010. Davidson, led by Murray's 22 points, falls to 21-12.
After spotting the Lady Mocs an early six-point lead, Davidson used a 12-2 run to swing the advantage to their favor by an 18-14 margin. Chattanooga tied it up twice more late in the first half, but the Wildcats wouldn't be tamed and pushed its lead to 32-22, its largest of the half, with 1:15 to go in the opening frame.
The Lady Mocs cut it to seven on a 3-pointer from senior Kylie Lambert (Etowah, Tenn.) with 34 seconds remaining in the half.
Davidson came out strong in the second half getting the first four points and stretching its lead to the largest of the game at 36-25. They would meet that margin once more less than a minute later before Chattanooga began its climb back into the game.
Hall, after getting into foul trouble early in the game, led the way in the second half scoring 17 of her team-high 19 points in the contest. She started the comeback with a jumper at the 18:17 mark to make it 38-29. She netted one free throw and capped off a 9-2 run to cut the Wildcats lead to 40-36 with 14:44 to play.
After a 3-pointer from Murray, Dewart converted on five of Chattanooga's next seven points to cut the deficit to 45-42 with 12:22 on the clock.
The Lady Mocs would not go away and tied the game up twice before Christopher's put back finally gave Chattanooga the lead.
Hall drained a 3-pointer with 6:13 to play to tie it up for the first time in the second half and the fourth time in the game at 54-54. Davidson converted on four straight free throws from Murray and Catrin Chiemeka for a 58-54 lead with 5:15 remaining.
Dewart drew the foul on the other end a minute later and hit both free throws then hit a layup with 3:34 on the clock to tie it up for the fifth time at 58-58. However, Davidson wasn't about to lie down. Murray drained a trey then hit a layup for a 63-58 lead at the 2:13 mark of the game.
Hall, who was 11-of-11 from the free throw line Sunday in the semifinals against Appalachian State, was only shooting .500 on the day from the charity stripe. She was fouled by Davidson's Sophia Aleksandravicius with 1:57 to play and connected on both to cut the deficit to 63-60.
Davidson missed a 3-point attempt by Chiemeka and the Wildcats grabbed the rebound but a turnover gave the ball back to the Lady Mocs with 43 seconds to play. Hall drove the lane for a layup to make it 63-62. On the ensuing Wildcat possession, Murray was called for a charge and Chattanooga got its chance for the win with 24 seconds on the clock.
On the inbounds play, Lambert got a back door pass from Dewart, but the layup was blocked out of bounds by Jasmine Calin. Chattanooga called timeout and set up the final play for the win.
Dewart got her eighth double-double of the year with 15 points and 12 rebounds while Hall led the Lady Mocs for the second straight game with 19 points with six boards. Christopher had seven points, six rebounds and three assists while junior Faith Dupree (Knoxville, Tenn.) had nine points in 10 minutes off the bench.
Chattanooga outscored Davidson 30-22 in the paint and 16-10 off the bench and outrebounded the Wildcats 36-32. The Lady Mocs converted 21 offensive rebounds into 23 second chance points compared the Davidson's six points on six offensive boards. UTC forced 19 Davidson miscues and had 13 points compared to the Wildcats' four points off six UTC turnovers.
Dewart was named the tournament Most Outstanding Player. She was joined on the first team All-Tourney squad by Hall, Davidson's Murray and Aleksandravicius and Appalachian State's Raven Gary. Black was selected to the all-tournament second team along with Mountaineer Anna Freeman, Elon's Kelsey Evans, Georgia Southern's Meredyth Frye and Taylor Reece of Samford.
The Lady Mocs will learn their NCAA Tournament fate Monday, March 18. The ESPN Selection Show will air at 7:00 p.m.


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The 23-year-old winger has been linked with a move to Goodison Park from his parent club Sporting Braga in Portugal after impressing with los Verdiblancos this term.
"I have no idea about the Everton thing. I did read the other day about interest from some other teams, but I do not know," the Spaniard, whose full name is Juan Carlos Perez Lopez, told reporters.
"Nobody has said anything to me. Now I am just focused on Betis and I would like to stay.
"On the subject of my future, that is something I keep away from. I prefer to focus myself on playing.
"When the season is over, then we can look at all this."
Juan Carlos rose through the ranks at Real Madrid, but after just one first-team appearance was sold to Braga in 2011 and then immediately loaned to Real Zaragoza.
This season he has impressed during a second loan spell, this time at Betis, and the Spanish side are keen to keep him but have been told he is wanted back in Portugal for next term.


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2015 Bearcats
Olivia Mancl | Distance
- Class Year: Sophomore
- Eligibility: Freshman
- Major: Biology
- Hometown: Seattle, Wash.
- Previous School or College: Roosevelt HS
Tune in to the Bearcat Network and watch live webcasts for select competitions and see live stats for nearly all Bearcat competitions. You can also find social media links like Facebook and twitter, rss feeds and video archives.
Purchase Action Photos
Naomi Stukey is the official bearcat photographer. Click the above link to browse and purchase action shots.


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