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Stimulation trains that exploit the catchlike property [catchlike-inducing trains (CITs)] produce greater forces and rates of rise of force than do constant-frequency trains (CFTs) during isometric contractions and isovelocity movements. This study examined the effect of CITs during isotonic contractions in healthy subjects. Knee extension was electrically elicited against a load of 10% of maximum voluntary isometric contraction. The stimulation intensity was set to produce 20% of maximum voluntary isometric contraction. The muscle was tested before and after fatigue with a 6-pulse CFT and 6-pulse CITs that contained an initial doublet, triplet, or quadruplet. For prefatigue responses, the greatest isotonic performance was produced by CITs with initial doublets. When the muscles were fatigued, triplet CITs were best. CITs produce greater excursion, work, peak power, and average power than do CFTs, because CITs produced more rapid rates of rise of force. Faster rates of rise of force enabled the preload on the muscle to be exceeded earlier during the stimulation train.
- human quadriceps femoris muscle
- catchlike property
- isotonic
- fatigue
- functional electrical stimulation
functional electrical stimulation (FES) is the use of electrical stimulation of skeletal muscle to produce functional movements in individuals with central nervous system problems (33). Most applications of FES, such as stimulation-assisted ambulation, require repetitive activation of paralyzed muscle. One primary limitation to the widespread implementation of FES is muscle fatigue (31, 34). Most improvements in FES applications have involved technological improvements in system design and implementation, but little systematic investigation of the most appropriate stimulation frequencies or patterns for activating the muscle has been performed (8). Stimulation frequency affects force production of muscle (19, 30) and influences fatigue (2, 6, 28). High stimulation frequencies are associated with higher forces and greater fatigue than are low stimulation frequencies (2, 6, 28). Thus, although the use of low frequencies may reduce the rate of fatigue, they may not generate sufficient forces for all FES applications. Optimal stimulation trains, therefore, need to be identified.
Investigation of stimulus patterns to optimize force production from skeletal muscle has been a long-standing interest of our laboratory (3-5). Recent work suggests that optimal stimulation may consist of a train of pulses containing more than one instantaneous frequency (10). By using trains that exploit the catchlike-property of skeletal muscle (catchlike-inducing trains), higher forces can be elicited than if traditional constant-frequency stimulation trains are used (1, 9,10, 14). The catchlike property of skeletal muscle is the tension enhancement produced when an initial brief high-frequency burst of pulses (2–4 pulses) is used at the onset of a subtetanic constant-frequency train to activate the muscle (4, 5, 14, 15). The catchlike property is a fundamental property of muscle that is not due to properties of the motor axon or neuromuscular junction (1, 14, 29).
Our previous investigations of the human quadriceps femoris found that, during isometric contractions with the knee at 90° of flexion, catchlike-inducing trains were highly effective in augmenting force compared with comparable constant-frequency trains when the muscle was in a fatigued state (9-11). When the muscle was fresh, however, catchlike-inducing trains generally produced about the same force as did comparable constant-frequency trains, with the only added advantage of producing faster rates of rise of force (9, 10).
We have recently also investigated the use of catchlike-inducing trains during isovelocity movements (7). During concentric isovelocity movements, catchlike-inducing trains produced greater force-time integrals, peak forces, average forces, and more rapid rates of rise of force than did comparable constant-frequency trains when the muscle was fresh, and these enhancements were more pronounced during fatigue. In contrast to concentric contractions, catchlike-inducing trains were less effective in enhancing force production during eccentric isovelocity contractions but did produce marked enhancements in the rate of rise of force. Interestingly, no studies to date have identified the effects of catchlike-inducing trains to produce isotonic contractions, which are more similar to movements produced during FES than to those types of contractions previously studied. Most studies investigating the catchlike property during isovelocity conditions used force as the primary indicator of muscle performance (7, 38); few have reported values of excursion, work or power when studying the effects of catchlike-inducing train simulation (cf. Ref. 41) from either fresh or fatigued muscle. The use of force as the only measure of functional impairment during dynamic fatiguing contractions, however, may lead to incomplete and even misleading results (21, 22, 27). The study of work and power is important, because measuring only the changes in force production may be incomplete and even misleading when functional performance of dynamic contractions is evaluated (21, 22,27). Fatigue has been shown to develop more rapidly in isotonic contractions than in isometric contractions (36, 39). Additionally, a greater loss in the power produced during shortening contractions has been observed than the loss in force during isometric contractions (21,22, 27, 39). Thus assessment of fatigue on the basis of loss of isometric force can seriously underestimate functional impairment of isotonic contractions (21, 27). The purpose of this study, therefore, was to determine whether catchlike-inducing trains could augment excursion, work, peak power, and average power vs. comparable constant-frequency trains from both fresh and fatigued human quadriceps muscles during isotonic contractions. Additionally, the high-frequency burst characteristics of catchlike-inducing trains were investigated to determine the number of pulses and the interpulse intervals required to produce optimal performance.
Data were obtained from 11 healthy volunteer subjects (6 men, 5 women) ranging in age from 19 to 31 yr old [22.64 ± 4.08 (SD) yr], with no history of lower extremity orthopedic problems. This study was approved by the University of Delaware Human Subjects Review Board, and all subjects signed informed consent forms.
Experimental setup.
Subjects were seated on a computer-controlled dynamometer (KinCom III, Chattecx, Chattanooga, TN) with hips flexed to ∼75° (Fig.1). The trunk, pelvis, left leg, and thigh were stabilized with Velcro straps. The dynamometer axis was aligned with the knee joint axis, and the force transducer pad was positioned ∼3 cm proximal to the lateral malleolus and placed against the anterior surface of the leg. The left quadriceps femoris muscle was stimulated by using a Grass S8800 stimulator with a SIU8T stimulus isolation unit. All stimulation pulses were 600 μs in duration. Two self-adhesive, 3 × 5-in. electrodes were used to stimulate the muscle. With the knee positioned at 90°, the anode was placed proximally over the motor point of the rectus femoris portion of the quadriceps femoris muscle. Because the skin over the thigh shifts with respect to the quadriceps femoris muscle as the knee moves into extension, the knee was then placed at 15° of flexion, and then the cathode was placed distally, over the motor point of the vastus medialis portion of the quadriceps. This electrode placement produced consistent force responses when the muscle activation produced knee extension. The stimulator was driven by a personal computer that controlled all timing parameters of each stimulation protocol. Force, angle, and velocity data were digitized on-line at a rate of 200 samples/s and stored for subsequent analysis.
Training sessions.
Before the commencement of the experimental sessions, all subjects participated in one training session. Subjects were familiarized with the experimental protocol and trained to relax during stimulation of their quadriceps muscle during both isometric and isotonic contractions. For each subject, the maximum voluntary isometric contraction (MVIC) was determined by using a burst superimposition technique (40) in which a 100-Hz, 10-pulse train at supramaximal stimulation intensity was delivered to the quadriceps muscle during an attempted maximal volitional contraction. If the stimulation produced a <5% increase in force, the force produced by the subject was determined to be the subject's MVIC. Conversely, if the stimulation produced a >5% increase in force, the subject rested 5 min before attempting another MVIC. All subjects produced MVICs within three trials during the training session. For all subjects, a minimum of 24 h elapsed between the training session and their experimental sessions.
Experimental sessions.
All subjects were instructed to refrain from strenuous activity for at least 24 h before testing. Each of the 11 subjects participated in 1 experimental session that consisted of a prefatigue-testing sequence, a fatigue-producing sequence, and a fatigue-testing sequence (Fig.2).
Before the experimental session, MVIC testing was conducted. The session was conducted only if the subject could perform an MVIC that was ≥95% of the MVIC produced during the training session. If a subject was unable to meet this MVIC standard within approximately three attempts, the experimental session was rescheduled for another day.
For gravity correction purposes, the subject's leg was positioned at 0, 30, 45, and 60° of knee extension. The subject was encouraged to relax, and the leg was weighed at each angle by using the dynamometer's force transducer. Ten seconds of force data were collected at each angle, and the average force was used to calculate the limb's weight at each angle. For each knee joint angle, the weight of the limb was determined by using a cosine function that reflected the angle of the leg with respect to the ground. All four estimates of the limb's weight were averaged and used for gravity correction during data analysis.
Next, with the knee positioned at 90°, a 6-pulse, 100- pulses/s (pps) train was delivered to the muscle once every 5 s, first to potentiate the muscle and then to set the stimulation intensity. Stimulation intensity initially was adjusted to elicit an isometric force ≅20% of the subject's MVIC. Stimulation was continued until the force did not increase over three successive trains, which usually required ∼10 stimulation trains. After force potentiation, the intensity was lowered and readjusted as necessary to produce a force equal to 20% of the subject's MVIC. The intensity was then kept constant throughout the remainder of the session in an attempt to recruit a consistent population of motor units from each subject's muscle.
After the stimulation intensity was set, the dynamometer was set in the isotonic mode by using the maximum available velocity setting (250°/s). Inspection of the velocity data revealed that the maximum velocity setting of 250°/s was never reached. The dynamometer settings were adjusted so that all movement began at 90° of knee flexion and provided resistence to knee extension that was equal to 10% of the subject's MVIC. The dynamometer's hydraulic system dampens the rate of acceleration at the turn points of movement. The dynamometer has three available accelerations: "low," "medium," and "high." The medium setting was used as a trade-off to reduce the dampening effects while maintaining system stability. Any dampening effect due to the dynamometer's hydraulic system is thought to be inconsequential because fluctuations in velocities that coincide with fluctuations in force could clearly be discerned.
Prefatigue-testing sequence.
Immediately before the prefatigue-testing sequence, the muscle was repotentiated isometrically by using ten 6-pulse, 100-pps trains delivered once every 5 s. Within ∼5 s after the last potentiating train, the dynamometer's isotonic mode was enabled, and the prefatigue-testing sequence commenced. The prefatigue-testing sequence consisted of a 70-ms interpulse interval constant-frequency train and 12 different catchlike-inducing trains (Fig.1 B). The 12 catchlike-inducing trains had an initial burst that contained 2, 3, or 4 pulses (i.e., a doublet, triplet, or quadruplet, respectively). For the doublet catchlike-inducing trains, the initial interpulse intervals were 5, 10, 20, or 30 ms. For triplet and quadruplet trains, the first one and first two interpulse intervals, respectively, were always 5 ms, whereas the last interpulse interval in the burst was 5, 10, 20, or 30 ms. The interpulse interval for all the pulses of the catchlike-inducing trains after the initial doublet, triplet, or quadruplet was 70 ms (see Fig. 1 B for additional details). One train was delivered every 10 s to prevent muscle fatigue. The order of the 13 trains was randomized for each subject and was repeated in reverse order for a total of 26 trains (Fig. 2).
Fatigue-producing sequence.
The fatigue-producing protocol followed the prefatigue testing protocol after a 5-min rest. Before commencement of the fatigue-producing protocol, the muscle was repotentiated isometrically, and then the isotonic mode was enabled. A modified Burke's fatigue protocol (13) consisting of 6-pulse, 40-pps trains delivered to the muscle once every 1.5 s for a total of 150 contractions was used to fatigue the muscle. Unlike Burke's fatigue protocol that used isometric contractions, all contractions were isotonic. Six-pulse trains were used to allow the stimulation to end before the knee reached full extension. Additionally, short-stimulation trains were used because short bursts of activity typify activation patterns used to produce functional movements (26). Hennig and Lømo (26) showed that motor units typically fire in short bursts (up to 6 pulses) during normal activity in rats. Stimulators in cardiomyoplasty, a procedure in which a skeletal muscle is wrapped around the heart and stimulated to assist systole, all use 6-pulse trains (17) because the duty cycle is constrained by the cadence of the heartbeat. Finally, we anticipate that, as FES technology becomes more sophisticated, such applications will use shorter duration stimulation trains that more closely resemble physiological patterns of activation. The 1.5-s period allowed sufficient time for the leg to return to the start position.
Fatigue-testing sequence.
Fatigue testing began immediately (1.5 s) after the last fatigue-producing train was delivered. All trains continued to be delivered in 1.5-s intervals. The subject's same prefatigue sequence (13 testing trains) was delivered with the exception that two fatigue-producing stimulation trains (6 pulse, 40 pps) were delivered before the presentation of each testing train. This was done to control for prior activation history and to ensure a stable level of fatigue during the fatigue-testing sequence.
Data management.
All force responses were gravity corrected, and the four dependent variables were calculated by using custom-written software (Labview 4.0). The dependent measures of muscle performance were joint excursion, work, peak power, and average power produced during the shortening portion of each contraction. All performance measures were calculated by using the force, angle, and velocity data from the dynamometer during the period between force onset and maximum shortening (Fig. 3). Excursion was calculated as the maximum knee-joint displacement in degrees; work was calculated as the numerical integration (trapezoidal method) of force with respect to excursion over the time interval of force onset to the time of maximum shortening of the muscle; peak power was the maximum instantaneous power (force × velocity); and average power was calculated by dividing the work by the time interval from force onset to maximum shortening of the muscle (Fig. 3). The prefatigue data analysis used the responses of the constant-frequency train and 12 catchlike-inducing trains collected during the prefatigue-testing protocol. The two occurrences of each train were averaged to help to control for previous muscle activation history. The responses to each train in the fatigue-producing sequence were recorded, and the percent decline for each dependent measure of muscle performance was calculated from the maximum response and the average response of the last three fatiguing trains. The fatigue data analysis used the responses of the 70-ms constant-frequency train and each catchlike-inducing train during the fatigue-testing sequence.
Data analysis.
Separate analyses were performed for each dependent measure and for prefatigue and fatigued responses. First, the data were inspected to determine for which condition (fresh or fatigued) and for which performance measures the catchlike-inducing trains augmented performance. For each performance measure for which the catchlike-inducing trains produced augmentation, a one-way repeated-measures ANOVA was used to determine the optimal interpulse interval duration within each group of catchlike-inducing trains (i.e., doublet, triplet, or quadruplet). As an example, if the doublet catchlike-inducing trains appeared to augment performance, a one-way ANOVA would be used to compare the four interpulse interval durations tested (5, 10, 20, and 30 ms). If the one-way ANOVA was significant, post hoc testing was used to identify the best interpulse interval. On the basis of prior studies (7, 9), an a priori assumption was made that the 5-ms interpulse interval for each catchlike-inducing train group would produce the best performance for all measures. Post hoc tests, therefore, used paired t-tests to compare the 5-ms duration with the 10-, 20- and 30-ms durations within each catchlike-inducing train group. Because this assumption was upheld (i.e., no interpulse interval produced greater augmentation than did the 5-ms interpulse interval), pairedt-tests were used to compare the 5-ms catchlike-inducing trains with the constant-frequency train to determine whether the catchlike-inducing trains augmented force. If only one of the three catchlike-inducing trains (i.e., the doublet, triplet, or quadruplet) was significantly greater than the constant-frequency train, that catchlike-inducing train was designated as the optimal catchlike-inducing train. If more than one catchlike-inducing train type produced greater performance than did the constant-frequency train, then appropriate pairedt-tests were used to determine the best overall catchlike-inducing train across catchlike-inducing train groups. For all analyses, an observation was significant atP ≤ 0.05.
Fatigue-producing sequence.
Complete data sets were collected for all 11 subjects. All of the muscle performance measures showed potentiation from the onset of the fatiguing protocol until approximately the 15th to 20th contractions, after which a steady decline was observed until approximately the 80th contraction (Fig. 4). After the 80th contraction, fatigue for each measure was relatively stable with ∼42, ∼47, ∼50, and ∼51% decline, respectively, in excursion, work, peak power, and average power from their respective maximum potentiated responses.
Burst interpulse interval.
Overall, for the prefatigue data, only 6-pulse doublet and triplet catchlike-inducing trains produced greater excursion and work than did the 6-pulse constant-frequency trains. For peak and average power, however, all variable-frequency trains produced greater responses than did the constant-frequency trains (see Fig.5). Although, whenever the catchlike-producing trains produced greater performance than did the constant-frequency trains, the 5-ms interpulse interval generally produced the greatest performance. No significant differences were noted in any of the performance variables as a function of varying the last interpulse interval within the burst of the catchlike-inducing trains (Fig. 5).
For fatigue-testing data, all catchlike-inducing trains produced greater responses than the constant-frequency trains for all performance measures. Significant differences were noted for the duration of the varied interpulse interval for some responses to doublet and triplet catchlike-inducing trains (Fig. 5), but for all dependent muscle performance variables, the 5-ms duration was as good as, if not better than, all other interpulse-interval duration. Thus our a priori assumption that the best interpulse interval was 5 ms was supported for both the prefatigue- and fatigue-testing conditions.
Number of pulses in the burst.
For prefatigue data, the doublet catchlike-inducing train produced ∼17, ∼21, ∼27, and ∼38% greater excursions, work, peak power, and average power (all significant atP ≤ 0.05), respectively, than did the constant-frequency train (Fig. 6). Although augmentations produced by the optimal triplet catchlike-inducing train were also significant for the peak and average power measures, the relative augmentations were not significantly different from the optimal doublet catchlike-inducing trains. Because only the doublet catchlike-inducing train showed significant augmentations for all performance measures, the doublet catchlike-inducing train was chosen as the overall optimal catchlike-inducing train to produce isotonic contractions when the muscle was fresh.
For fatigued muscle, however, the doublet catchlike-inducing train did not produce significant augmentations over the constant-frequency train. Augmentations were nearly significant for excursion and average power (Fig. 6). In contrast, triplet and quadruplet catchlike-inducing trains consistently produced significantly greater excursion, work, peak power, and average power than did the constant-frequency train. The triplet catchlike-inducing train produced 67, 91, 121, and 173% greater excursion, work, peak power, and average power, respectively, than did the constant-frequency train. Similarly, the quadruplet catchlike-inducing train produced 64, 86, 147, and 188% greater excursion, work, peak power, and average power, respectively, than did the constant-frequency train. No significant differences in the relative amount of augmentation were noted between the optimal 5-ms interpulse interval triplet and quadruplet catchlike-inducing trains.
The present study demonstrated that catchlike-inducing train activation was effective in augmenting joint excursion, work, peak power, and average power over constant-frequency train activation when isotonic contractions are elicited from the human quadriceps femoris muscle. Catchlike-inducing trains could augment muscle performance when the muscle was either fresh or fatigued. For fresh muscle, the optimal catchlike-inducing train was a doublet catchlike-inducing train with an initial interpulse interval equal to 5 ms. In fatigued muscle, the optimal catchlike-inducing train had an initial triplet of pulses, with the first two interpulse intervals equal to 5 ms. Both 5-ms interpulse interval triplet and quadruplet catchlike-inducing trains produced greater performance than did the constant-frequency train, but because no significant differences were noted between them for any measure, and because triplet catchlike-inducing train showed better performance than did the quadruplet catchlike-inducing train when the muscle was not fatigued, the triplet catchlike-inducing train was chosen as the optimal catchlike-inducing train. The relative augmentation was greater in the fatigued condition than when fresh.
As anticipated, the present study found that a catchlike-inducing train with one, two, or three initial interpulse intervals equal to 5 ms produced the greatest joint excursion, work, peak power, and average power. Previous investigations of the human quadriceps femoris muscle revealed that 5 ms was the best initial interpulse interval for catchlike-inducing trains during isometric contractions (3, 9, 29) and during concentric and eccentric isovelocity contractions (7). Thus it appears that burst-interpulse interval duration of 5 ms is a robust interval to use for catchlike-inducing train activation no matter what the mode of activation (i.e., isometric, concentric and eccentric isovelocity, and isotonic contractions) of the human quadriceps femoris muscle.
In animal models, initial catchlike-inducing train interpulse intervals of 5–10 ms were also optimal. In isometric contractions of cat medial gastrocnemius muscle, Zajac and Young (44) found that an initial doublet of 5–10 ms produced the greatest force-time integrals. In cat single tibialis posterior motor units, Bevan and colleagues (1) used "optimized" variable-frequency trains with two short initial interpulse intervals equal to 10 ms. Hennig and Lømo (26) found that the optimal initial interpulse interval was 5 and 10 ms, respectively, in fast and slow motor units of rat extensor digitorum longus muscles. Binder-Macleod and Barrish (4) also have found catchlike-inducing trains with one or two initial interpulse intervals equal to 10 ms to be optimal for the rat soleus muscle. In frog sartorius muscle, Stevens (41) found that 5-ms interpulse-interval doublet and triplet initiated trains produced the greatest net work during isovelocity oscillatory length changes. A triplet train with 5-ms interpulse intervals and a total of 6 pulses could produce 80% of the net work that a 17-pulse constant frequency train could produce. Thus, although there are subtle differences in burst characteristics (i.e., 5- to 10-ms initial interpulse interval; one or two brief initial interpulse intervals) among species and muscle types, the presence of augmentation in performance when catchlike-inducing trains are used over constant-frequency trains is robust.
Previous studies examining the use of catchlike-inducing trains during nonisometric contractions have noted that the relative augmentation by catchlike-inducing trains tended to be less than the augmentations observed for isometric contractions (7, 16). Sandercock and Heckman (38) showed that force augmentation produced by catchlike-inducing activation decreases during isovelocity shortening movements compared with isometric contractions for cat soleus whole muscle and single motor units. Callister and colleagues (16) reported a slight decline in the force augmentation with catchlike-inducing train stimulation during shortening and lengthening isovelocity contractions compared with isometric contractions for the turtle external gastrocnemius muscle. In previous studies, we observed as much as 72% augmentation in peak force and 52% augmentation in force-time integrals during isometric contractions (9); however, we showed only ∼5, 6, 14, and 35% greater force-time integral, peak force, average force, and rate of rise of force, respectively, during concentric isovelocity contractions when the muscle was fresh (7). Similar to isometric contractions, these enhancements were more pronounced during fatigue (∼18, 30, 28, and 41%, respectively) but less than that observed isometrically (7). In contrast, catchlike-inducing trains are less effective in enhancing force production during eccentric isovelocity contractions but did produce a marked enhancement in the rate of rise of force (7). Augmentations by catchlike-inducing trains in the present study on isotonic contractions (see results) are relatively large, however, especially when the muscle is fatigued. The relative performance of catchlike-inducing trains vs. constant-frequency trains is related to the rate of rise of force in response to the stimulus trains.
Catchlike-inducing trains produce greater excursion, work, peak power, and average power than do constant-frequency trains, because catchlike-inducing trains produce more rapid rates of rise of force. Faster rates of rise of force enable the preload on the muscle to be exceeded earlier during the stimulation train. This allows more of the train to contribute to muscle shortening. For example, when the muscle is fresh (Fig. 3), constant-frequency trains produce movement that started ∼165 ms after onset of force production, whereas the optimal catchlike-inducing train produced movement ∼75 ms after the onset of force. When the muscle is fatigued, constant-frequency trains and the optimal catchlike-inducing train produced movement at ∼320 and ∼85 ms after force onset, respectively. Thus, when the muscle is fatigued, catchlike-inducing trains retain their ability to produce rapid rates of rise of force and to cause muscle shortening, whereas constant frequency trains displayed slowing in the rate of rise of force. Slowing in the rate of rise of force caused the constant-frequency trains to become functionally ineffective because they could not exceed preload until near the end of the stimulus train and could not produce appreciable displacement. This functional impairment of the constant-frequency train resulted in augmentations by the catchlike-inducing trains that were of greater magnitude than that previously observed for isometric (9-11, 32) and isovelocity contractions (7). Stevens (41) also noted that catchlike-inducing trains augmented net work per cycle during oscillatory length changes in isolated frog sartorius muscles to a much greater extent than augmentations observed during isometric contractions.
Interestingly, catchlike-inducing trains could produce modest augmentations in isotonic performance when the muscle was fresh. Generally, for isometric contractions, no augmentation has been noted by catchlike-inducing trains over constant-frequency trains when the muscle was near optimum length and was not fatigued (9). For isometric contractions when the quadriceps femoris muscle was held in a shortened position, catchlike-inducing trains, comparable to those used in this study, elicited augmentations of 21% in peak force and 7% in force-time integral when the muscle was fresh (32). During concentric isovelocity movements (7), modest augmentations were noted when the muscle was fresh. Only a small augmentation of average force was noted during eccentric isovelocity movements for the fatigue state. The ability to produce greater augmentation in performance at short vs. near optimal length isometric contractions and for concentric vs. eccentric isovelocity movements when the muscle is fresh may be due to enhanced muscle stiffness and enhanced Ca2+ release produced by the initial burst of the catchlike-inducing train.
Parmigianni and Stein (35) proposed that enhanced muscle stiffness caused by catchlike-inducing train stimulation is due to greater efficiency in taking up the series elastic components of the muscle. They likened the series elastic component to an elastic band held at slack length in which the first pulse delivered to the muscle must take up the slack in the series elastic component before force is produced; subsequent pulses in the train contribute primarily to increasing force (35). Wilson and colleagues (43) suggested that a stiff musculotendinous system helped to maximize isometric and concentric performance by improving contractile component length, rate of shortening, and transmission of force from the contractile component to the skeletal structures. The common factor in force augmentation observed for the present and previous studies when the muscle was fresh is that, in all cases, the effective series elastic component was greater when isometrically held in a shortened position (32) or continually increasing as the muscle was moved to a shorter position (7) than when held near optimal length. In contrast, during eccentric conditions (7) or when the muscle was held isometrically at a long length (10, 11), the muscle was either being passively stretched or placed in a stretched position so that there would be less of an advantage in taking up the series elastic component by the catchlike-inducing trains.
Changes in muscle stiffness may also explain the greater augmentation seen during fatigue. Curtin and Edman (20) noted a decrease in the stiffness of frog muscle fibers with fatigue and attributed the decrease in muscle stiffness to fewer attached cross bridges. Thus, if stiffness decreases with fatigue, then improving muscle stiffness with catchlike-inducing train activation may be more efficacious in augmenting force when the muscle is fatigued.
Duchateau and Hainaut (23) showed that another mechanism by which catchlike-inducing trains augment force is through increased Ca2+ release from the sarcoplasmic reticulum by the initial high-frequency burst. This present study and previous studies showing force augmentation in fresh muscle (7, 32) investigated muscle that was either shortening during the contraction or already in a shortened state. Ca2+ release per pulse (12, 42) and Ca2+ sensitivity of the myofibrils (18, 24, 25) have both been found to be diminished at short vs. long muscle lengths. Thus greater Ca2+ release by catchlike-inducing trains could partially compensate for the decreased Ca2+ release or sensitivity when the muscle is shortening or held at short lengths.
Recent work suggests that augmentation by catchlike-inducing trains parallels the development of low-frequency fatigue (37). In fresh muscle, catchlike-inducing trains may not produce augmentation over constant-frequency trains because of their shorter train duration unless Ca2+ release or sensitivity was reduced (i.e., when shortening or held at a short length). Because catchlike-inducing trains augment Ca2+ release from the sarcoplasmic reticulum, catchlike-inducing trains are less susceptible to impairments in excitation-contraction coupling associated with low-frequency fatigue (37) and can maintain their rates of rise of force when fatigued (9, 7, 10). Thus, although the catchlike-inducing trains in the present study have shorter train durations than do the constant-frequency trains, the ability to produce a more rapid rate of rise of force allows the catchlike-inducing trains to markedly enhance isotonic muscle performance.
Clinical implications.
This study demonstrated the efficacy of 6-pulse catchlike-inducing trains in producing isotonic shortening contractions, which more closely mimic physiological movements than other conditions we have studied. Because catchlike-inducing trains produce greater joint excursion, work, peak power, and average power than do constant-frequency trains, regardless of fatigue condition, they may help to improve functional electrical stimulation applications that require stimulation to produce limb movements. One possible limitation is that the population of motor units activated with transcutaneous stimulation may vary because of shifting of the electrodes as the leg goes into extension. No gross discontinuities in the force trace were observed (e.g., see Fig. 2), which suggests that the motor unit population being recruited by the stimulation is consistent throughout the movement. Regardless, transcutaneous stimulation in which muscle shortening and limb movement occurs is often required in FES applications.
This study shows that, for the load condition tested, 6-pulse catchlike-inducing trains produced greater joint excursions, work, peak power, and average power than did 6-pulse constant-frequency trains, regardless of fatigue condition. When the muscle was fresh, a catchlike-inducing train with a single brief initial interpulse interval equal to 5 ms produced the greatest performance, whereas two initial interpulse intervals of 5 ms were optimal when the muscle was fatigued. Because catchlike-inducing trains were effective during shortening isotonic contractions, which closely mimic physiological movement, they may be of benefit during functional electrical stimulation applications. This study, however, only tested a single catchlike-inducing train base frequency, corresponding to an interpulse interval of 70 ms. Additionally, only one load condition was investigated. Future studies of catchlike-inducing trains to produce repetitive isotonic contractions are needed to explore the boundary conditions of base frequency and load on the efficacy of catchlike-inducing trains to produce isotonic contractions.
This research was supported in part by grants from the Foundation for Physical Therapy, the American Physical Therapy Association, and the University of Delaware Office of Graduate Studies (to S. C. K. Lee) and by National Institute of Child Health and Human Development Grant HD-36797 (to S. A. Binder-Macleod).
Address for reprint requests and other correspondence: S. A. Binder-Macleod, Dept. of Physical Therapy, Univ. of Delaware, 303 McKinly Laboratory, Newark, DE 19716 (E-mail:sbinder{at}udel.edu).
The costs of publication of this article were defrayed in part by the payment of page charges. The article must therefore be hereby marked "advertisement" in accordance with 18 U.S.C. §1734 solely to indicate this fact.
- Copyright © 1999 the American Physiological Society


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In all my years of studying Japanese, I never learned the word I need right now. How do you say "nocturnal emission"? I need to know because my 10-year-old son is starting sex education at school, and I haven't told him that part of "the facts of life." His Japanese is pretty good, but I think he'll understand the lesson better if I explain it to him in English first. And give him the Japanese words he'll be hearing.
In Japan, seikyoiku (sex education) generally begins in fifth grade, when kids get a very basic lesson about how their bodies will change when they enter puberty. But Japanese children are maturing earlier. This year, for the first time, the health teacher at our school decided to start seikyoiku with the fourth-graders.
I was a little surprised. My son may be the biggest kid in his class, but his hormones have definitely not kicked in yet. Girls are still gross. His only passions are computers and basketball. But one of the girls in the fourth grade just started menstruating, the health teacher told me. That means it is time to talk to the kids about the birds and the bees.
I thought the health teacher did a great job of introducing the subject in a natural way. In January, during the bimonthly shintaisokutei (height and weight check), she made a chart for the fourth grade. The girls, she pointed out, are taller and heavier on average than the boys. "Know why?" she asked. "Because the girls' bodies are preparing so they can become mothers later."
The teacher used color charts to explain — to the girls and the boys — how girls' bodies change during puberty. She explained menstruation and why girls use sanitary napkins during their periods. Later, she said, she'd show the girls how to use them. And at the next height-weight check in March, she promised to explain the changes that boys' bodies undergo.
This is why I have the health textbook for fifth- and sixth-graders open on my desk. I'm making a list of vocabulary I need before I talk to my son. The section on shishunki (puberty) covers hensei (change of voice), shasei (ejaculation), seieki (semen) and musei (yup, that's "nocturnal emission"). Somehow, these words never came up in Japanese 101.
I found the health textbook pretty interesting. It's a 41-page paperback with lots of color illustrations. Six of those pages deal with puberty, including physical changes as well as emotional changes such as increased self-consciousness and moodiness. In April, when the new school year starts, third- and fourth-graders will get a health textbook for the first time, in part to encourage teachers to start sex education earlier.
The problem with sex education in Japanese schools is that there isn't much of it. At most, my kids will get about an hour of seikyoiku while they are in elementary school. And because the Education Ministry gives schools discretion about how much sex education they teach, some schools — even middle schools and high schools — don't teach it much at all.
I'd like to see the Education Ministry take some leadership and add sex education to the national curriculum guidelines, conduct teacher training and provide lectures or handouts to encourage parents to talk to their kids about sex. But the bureaucrats seem to believe in the fallacy that giving kids information about sex will encourage them to have sex too soon. That attitude is usually expressed as nemutta ko o okosu na ("Don't wake a sleeping baby").
I've got news for the bureaucrats: The baby is already awake, and it's having sex. Probably without protection.
These days, most young Japanese become sexually active in high school, according to the Japanese Association for Sex Education. The association's most recent survey, conducted in 1999, showed an earlier onset of sexual activity among all the age groups surveyed (middle school, high school and university students) compared to six years before. Both boys and girls were most likely to have had their first sexual experience at 16.
A separate survey, conducted last year among teen couples in Tokyo, found that more than half of both boys and girls said they had already had more than two sex partners. But only about 20 percent of those having sex said they took precautions every time against pregnancy and sexually transmitted diseases.
Although teenage pregnancy is less of a problem in Japan than in other developed countries, Japanese girls are getting pregnant, more now than ever before. In 1995, there were 26,117 abortions performed on women under 20. In 1999, that figure jumped to 39,637, a 52 percent increase. The actual number is probably higher — many underage abortions are not reported.
The rate of HIV infection among young people is also on the rise. Until last year, people under 20 made up less than 30 percent of those infected. In 2001, the figure rose to more than 40 percent.
When JASE asked young people how they learned about sex, most said they learned from friends, television and manga (comic books). Kids learning about sex from manga? Japanese comic books are full of violent sex and warped male-female relationships. Now that's a frightening thought.
It's sad that so few respondents said they learned about sex in school. Sadder still that none of them said they learned about sex from their parents. Sex is so much more than a physical act. It involves emotions and spirituality and morals. Schools can't teach all that. Parents need to help their kids figure out how to incorporate sexuality into their lives.
It's really not that hard. I just sat my son down for our little shasei-musei chat. I showed him the health textbook. It took about four minutes. When I was finished, he said, "OK, Mom, thanks. Now can I go play basketball?"

subset: commoncrawl


text:
Tabs too difficult? Try these video lessons and learn fast
There is a simple finger picking pattern that you can pickup by ear, or from watching
(Note: I didn't copy paste the chords everywhere, so where the chords aren't shown it's
same as previous line/verse.)
I am a honey bee,
Shunned off from the colony
Fmaj7 G C
and they won't let me in
So I left the hive,
They took away all my stripes
and broke off both my wings
C E Am
So I'll find another tree
Fmaj7 G C
and make the wind my friend
I'll just sing with the birds
They'll tell me secrets of the world*
Am G C
But my other honey bee
Stuck where he doesn't wanna be*
But my darling, honey bee
I'll come save you
Even if it means I'd have to face the queen
C E Am Fmaj7 G C
~ Pa da bum ba dam bum ba da bum pum bum ~
So I'll come prepared,
My new friends said they would help me
get my loved one back
They say it isn't right,
The bees have control of your mind,
but I choose not to believe that
C E Am
So we'll meet in the darkness of the night,
Fmaj7 G C
and I promised I will be there on time
We'll be guided by my new friends, the butterflies,
bring us back to our own little hive*
Am G C
Oh my other honey bee,
No longer stuck where he doesn't wanna be*
Oh my darling, honey bee,
I have saved you
And now that you're with me,
we can make our own honey
C E Am Fmaj7 G C
~ Oh Pa da bum ba dam bum ba da bum pum bum ~
At the * there is a lead in before going to Am:
Submit corrections
Hard to play? Try these video lessons and learn fast


text:
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text:
County: 211 can help but doesn't have info on power outages
EUGENE, Ore. - The 211 call enter has helped people still without power to obtain water, fuel and firewood.
And a caller who needed help caring for his wife with Alzheimer's got the information he needed.
"These are the types of calls that 211 are set up for," said Linda Cook, Lane County emergency manager.
But Lane County Emergency Management asks that callers looking for information on when their power will be restored to call their power utility.
"211 does not have that information," Cook said. "Those types of calls create an unmanageable volume of calls and jeopardizes our ability to sustain the call center."


text:
'The mafia never dies'; 'the state can destroy mafiosi but not the mafia' – such proclamations are common, especially among mafiosi, who believe the Thing, the Organization, is always out there ready to sanction them. Few law enforcement officials or criminologists are prepared to declare any mafia dead either. For the former, the mafia makes for a colourful enemy, while the latter would have a hard time knowing whether a mafia, as a secretive organization that attempts to sell protection and regulate illegal and legal markets, truly has died. Police departments can get extra funding and government support by playing up to the threat of a conspiratorial, hydra-headed mafia monster. Governments can blame shadowy mafia figures or immigrant alien conspiracies for problems of crime and violence and other failings, while 'transnational organized crime' can be invoked to demonize and justify meddling in other countries, particularly in the age of the 'war on terror'.
Nevertheless, states do occasionally attack mafia-like organizations. There are numerous examples of anti-mafia policies from different countries all with varying levels of success. One such case is the post-Soviet republic of Georgia. An anti-mafia campaign launched there in 2005 has been heralded an overall success. This is curious given how weak the Georgian state is and the supposed embeddedness of organized crime in the post-Soviet part of the world. This leads to a puzzle then: what factors might weaken the strength of mafias and cause their decline, if not their death?
Many studies focus on state-centric factors to explain decline. Governments must make strategic decisions about when to attack the mafia as it may prove to be an expensive activity which reaps few gains in crime control or at the ballot box. In some countries, governments face violent backlashes if the mafia is challenged. In Brazil for example, the First Command of the Capital (the PCC, a prison gang that controls illegal markets on the streets) is able to virtually shut down the city of Sao Paolo if it chooses to oppose the state. Thus, mafias and states often simply exist in wary equilibrium of each other, often maintaining a negotiated connection through corrupt links on local levels. Still, at certain moments states can launch full out attacks on mafias, though success is rarely a given.
Italy and the United States are examples of states that have gone after the mafia. In these countries, anti-mafia legislation has enabled greater punitive measures against those who order the commission of crime and engage in patterned acts of racketeering. In Italy, law enforcement reform as well as civil society mobilization, emerging after the mob killings of the judges Falcone and Borsellino in 1992, has been relatively effective, at least in Sicily. These measures include new law enforcement techniques and heightened police coordination, including longer investigation times, the greater use of wire-tapping, entrapment, state's witnesses, and confiscation of mafia assets and the criminalization of activities that aid the mafia. Such state policies have been recreated elsewhere, for example and most recently, in post-Soviet Georgia.
In Georgia, anti-mafia laws were introduced in 2005 along with a willingness to trample civil liberties and human rights in the name of battling organized crime. However, a simple emphasis on the policies of the state and the changes in the socio-economic environment does not account for the vulnerabilities or resilient qualities that decide whether a mafia survives or succumbs to state attack. In Georgia, I argue that, regardless of the state's anti-mafia policy, internal contradictions within a group called the 'thieves-in-law,' a particularly fearsome mafia, was the real reason for the decline of this network of mafiosi there.
Strength in recruitment, for example, is a key variable in survival. Just like any organization mafias require a flow of high quality individuals to reproduce themselves. The thieves-in-law failed to do this. This failure was due to maladaptive institutional change in difficult conditions: wider criminal conflict in conditions of state-collapse led to quicker recruitment and lower quality human capital. The video embedded below discusses this in more detail.
Similarly, internal and external structuring of relations is vital for robust organization, effective adaptation, flows of information, and efficient monitoring and sanctioning. Yet the organization of criminal activities is often risky, and constantly changing in conditions of permanent insecurity and uncertainty. The thieves-in-law in Georgia did not negotiate the violent, difficult conditions of state collapse that occurred in Georgia in the 1990s at all well. It affected their ability to coordinate and regulate their network. All that was then required was the political will to go on the offensive against what was in fact disorganized crime.
One general conclusion from the Georgian case is that rather than enjoying a vacuum of state power such as the one in Georgia in the 1990s, the mafia actually struggles just as much as any legitimate organization in such conditions due to the instability and uncertainty it generates. Moreover, focusing on organizational vulnerabilities of organized criminals might aid our understanding of how best to tackle established and seemingly indestructible mafia groups, helping to explode the myth that the mafia is forever.
Image credit: Historical building in the center of Batumi, Georgia. © Kenan Olgun via iStockphoto.


text:
Customer Reviews
* FTC Disclaimer: The views and opinions expressed by contributors of the product reviews are their own and not necessarily those of Netrition.com. These reviews should not be taken as recommendations but rather customer opinions of the products that they may or may not have used. Furthermore, Netrition.com makes no warranty or representation, expressed or implied, as to the accuracy or sufficiency of the information contributed by outside sources, and assumes no responsibility or liability regarding the use of such information. Netrition.com does not warrant the performance, effectiveness or applicability of any materials listed or linked to on Netrition.com.
3 of 3 people found the following review helpfulJuly 01, 2010Reviewer: Marilyn in Tennessee* This is great stuff! I add an extra tablespoon of butter, 2 tablespoons erythritol, and a teaspoon of cinnamon to the basic mix and it makes a jammin' delicious crust. So easy. I use it in my strawberry pie that I make weekly during strawberry season.
2 of 2 people found the following review helpfulOctober 26, 2009Reviewer: Amy in Minnesota* I just made some pumpkin cheesecake and used this for the crust- very nice flavor, and adds fiber to your cheesecake! Ordering more... :)
September 12, 2017Reviewer: A guest* This is my second order. The pie crust is delicious and very quick and easy to make. Great service, highly recommended.
August 28, 2017Reviewer: A guest* First time user, will use again. I was very pleased with the product and shipping here. Excellent taste and easy to make. Highly recommended.
April 10, 2014Reviewer: Kate in New York* This is a great mix. I use it with the carb counters cheesecake mix. Wonderful low carb option.
February 28, 2014Reviewer: Rebecca in California* Both myself and my husband have enjoyed this mock graham cracker style pie crust... on our low carb diet. I simply add 2 T. melted butter and 1/2 c. Splenda and mix well, press into the bottom of a 9" pie plate sprayed with non stick spray and bake at 350 for 10-12 minutes, cool completely and then fill. You really can't tell the difference and the carbs are A LOT lower per serving than graham crackers!
December 08, 2011Reviewer: carol in Mississippi* I used this with a low carb cheesecake and it worked great. I have placed a second order to get me through the holidays.
October 10, 2011Reviewer: Karen in New Hampshire* I used this crust for a low carb cheesecake and really liked it very much. I think it's an excellent substitute for a high carb graham cracker crust. It tastes very good and my family couldn't tell the difference. They loved it.
September 30, 2010Reviewer: Angela in North Carolina* Absolutely, love love love this crust. As a diabetic, I control my blood sugar with diet and exercise. I developed a sugar free, low carb cheesecake recipe and with this crust, it is so good! I have had others taste it and it is hard to tell it's a "healthy" product. AWESOME
June 14, 2010Reviewer: Judy in Florida* We love this graham cracker crust mix to use with the cheesecake mix. Of course it does not taste exactly like a real graham cracker crust but it is very, very good for low carb cheesecake!
April 16, 2010Reviewer: Stephanie in North Carolina* Try this with one of the low carb cheese cakes, your own homemade low carb pudding, or key lime pie...you will never know the difference.
March 17, 2010Reviewer: Suzanne in California* These were truly great, I made a lo carb cheesecake with these as the crust. I was surprised how good they were. I am ordering more.
0 of 1 people found the following review helpfulDecember 31, 2009Reviewer: troy in Illinois* Will use again


text:
Owner Of 23 Malnourished Horses In Central Valley Foothills Speaks Out
AUBERRY, Calif. (KMPH) —
For almost 11 years, Kim Anderson has taken care of horses.
By the time she moved onto a ranch in Auberry earlier this year, she had 23 to provide for -- many of which she said she rescued because they had nowhere else to go.
But now, the tables have turned for Anderson.
She's lost her job. The lush, green grass that once covered her ranch has now dried. And now, many of the horses she once provided for are malnourished and will be removed from the ranch.
"You know just over a period of four weeks they started losing weight a lot of weight," Anderson said.
The dramatic weight loss of the horses caused some concerned neighbors to take notice.
Neighbors said they insistently called the Central California SPCA For help.
Anderson says the SPCA came out, but did very little to help.
KMPH has attempted to call SPCA media representative Beth Caffrey nearly 25 times since late last month. No phone calls have been returned.
Anderson says that she was never against the idea of receiving help from the SPCA. But, she says that she was never given the opportunity.
The SPCA finally stepped in after several stories from KMPH, but Anderson says it was not the kind of intervention she was expecting.
"They didn't even ask the history of the horses.They didn't ask if they were registered. They didn't ask if they had any problems like a previous injury or if they were ride-able, what there temperament was, what they liked, what they didn't like. They just wanted to know their names and that was it," Anderson said. "It's almost like slash and grab."
The SPCA took four horses from Anderson.
"And then they showed up on Monday with the horse trailer and they told me that since I had talked to the media over the weekend . . . that they were going to seize my horses," she said.
On Wednesday, Anderson gave a few more horses to Silver Wings Rescue, a nonprofit organization she knows wants her horses.
Since KMPH aired the first story, donations have poured in to help feed the starving horses. And for that, Anderson says that she is thankful.
"That's one of the warm spots in all of this, is that people really do love horses and people really do look out for other people and they do care," she said.


text:
JERUSALEM (Aug. 31)
Israel violated the armistice with Transjordan by expelling across the armistice lines 200 Arab civilians from the Israel-occupied village of Wadi Fukin, west of Bethlehem, on July 15, it was ruled today by the mixed Israel-Transjordan armistice commission here.
The Arabs should be allowed to return to their homes within one week, the Commission ordered, according to a joint communique released after a seven-hour conference. The decision was reached by a majority vote, with the U.N. chairman of the group, Col. A. Coverdale, an American, casting his ballot with the Arabs against the Israelis.
The Israel delegation to the commission said the Jewish state will not be bound by any point of the decision, which instructed Israel as to what action to take within her own borders. The Israel representatives consider such instructions outside the Commission's jurisdiction.
Israel contends that the expelled Arabs infiltrated into the new state after the establishment of the armistice. The Israelis state that the decision to expel the Arabs was agreed to by both Arab and Israel commanders in the Wadi Fukin area in the presence of U.N. observers.


text:
McCluster in, Johnson likely out in Tennessee
Marcas Grant | Tags: Three and out, Andrew Hawkins, Chris Johnson, Cincinnati Bengals, Cleveland Browns, Dexter McCluster, Tennessee Titans
Titans eyeing McCluster as RB: The efforts of the Kansas City Chiefs to transform Dexter McCluster into a wide receiver never produced much. Now that McCluster has moved to Tennessee, coach Ken Whisenhunt would prefer to have the speedy player move back to his college position of running back. That's a win for McCluster … and fantasy owners. The former Ole Miss star is likely to split time in the backfield with Shonn Greene, but will have some nice value as a PPR option. In his four seasons in Kansas City, McCluster averaged 43 receptions per season. That's a respectable number for a PPR back — not so much for a receiver.
Johnson still on trade block: The man that McCluster is ostensibly replacing, Chris Johnson, is still being shopped in trade offers by the Titans. And where once Johnson said he wouldn't take less money, he is now reportedly willing to lower his price in order to help push a deal through. As the days of the featured back continue to wane, Johnson won't find a team willing to give him anywhere near the 317 touches he's averaged over the past three seasons. He's likely relegated to a platoon situation anywhere he goes and won't rise above the level of a No. 2 fantasy back with any franchise.
Browns could lock up Hawkins: Signs are pointing toward Andrew Hawkins landing with the Cleveland Browns. Earlier in the week, the Bengals appeared ready to match the offer sheet for the slot receiver. Now that the numbers have been made public, the Bengals seem less either less interested or less capable (or a combination of both) of retaining Hawkins. The Browns could certainly use a wide receiver complement to Josh Gordon, but a player whose best season was 51 catches for 533 yards doesn't seem like the answer. Add in the quarterback quandary in Cleveland and there won't be much fantasy demand for Hawkins.
— Follow Marcas on Twitter @MarcasG


text:
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Meets quarterly or as needed to discuss agriculture issues affecting Somerset County.
Meets as needed. The committee addresses issues concerning retention of members and recruiting new members. Committee members also help Chamber staff at various Chamber sponsored events.
Education, Business and Workforce Development
Meets monthly during the school year to address education issues pertaining to curriculum at area high schools and colleges in relation to the needs of area businesses. Also helps Chamber staff with the annual College Technical Fair and Job Fair.
Energy/Natural Resources
Meets quarterly or as needed. The committee addresses issues affecting businesses in areas such as safety, transportation, professional services, labor and legislative issues.
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This committee addresses legislative issues affecting area businesses and keeps abreast of various concerns affecting the county's transportation and infrastructure.
Meets as needed. The committee addresses any issues related to technology that affect our county. The committee's current goal is to bring high-speed Internet Access to all of Somerset County.
Meets monthly. The committee addresses countywide tourism issues including hospitality training and promotion of tourism related businesses and attractions.
WINS (Women's Information Network-Somerset)
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text:
|Trad, 1 pitch, 100'
|YDS: 5.8 French: 5b Ewbanks: 16 UIAA: VI- ZA: 15 British: HVS 4c [details]
|1950s Hans Kraus and friends
|Page Views:
|Submitted By:
|Michael G on Aug 18, 2010
|Comments on Moby Dick
|Add Comment
|Show which comments —
By JSH
Aug 19, 2010
When I climbed this, the notch looked so much like V3 that I almost expected to climb it the same way. The holds through the notch are all like V3 ... but upside-down!
The rock just below the notch was a bit loose, if I recall.
By gblauer Blauer
From: Wayne, PA
Jun 17, 2012
|Wow, quite an exciting finish to Andrew! Traverse with teeny feet, get into the v-notch on crimpers, stem into the v-notch, and a big reach for this shorty. G-rate gear, though I did not see the pin in the v-notch.
By David Stowe
Jun 18, 2012
|Really fun pitch. Not something that I would recommend as a finish to Andrew as it is significantly harder than that climb, but a very nice pitch to do when you are on GT over that way. I don't ever remember a pin in the the notch, but there are two lower down. That notch can be really tricky. 5.8 if done right, but can feel a bit harder if you're off a bit.
By Logan Schiff
From: Brooklyn, NY
Sep 17, 2013
|Very nice worthwhile climb! Some lichen and loose rock but pro below the notch is solid.
By Kurtz
Nov 5, 2014
|The P2 Andrew "gulley" is often wet. The holds on either side are pretty good so you can usually step across (L->R) avoiding the wet stuff. The rock above stays dry (where you cross back R->L).


text:
Eight years ago, Eric H. was diagnosed with reduced kidney function, requiring immediate dialysis. Overall, he was healthy but now faced extensive medical expenses. Having the stigma of a pre-existing condition was a great concern for Eric and his family, as it made it difficult to purchase health insurance. Like millions of Americans, when President Obama signed the Patient Protection and Affordable Care Act into law, Eric felt a huge sense of relief that his current medical condition wouldn't prevent him from acquiring quality healthcare coverage he could afford.
As the Supreme Court debates healthcare reform this week, we asked Eric a few questions about his experiences with the Affordable Care Act and his support for President Obama.
How has the Affordable Care Act impacted your life?
Because the Affordable Care Act improved the Medicare Part D coverage gap, or "donut hole," I now automatically receive a 50-percent discount on my very expensive prescription medications. That's an important savings for me and my family.
Why do you think it's so important that we prevent the repeal of the Affordable Care Act?
People with pre-existing conditions should be able to get affordable health insurance and prescription drug coverage without discriminatory practices – like gender discrimination that is often embedded within coverage. Without the Affordable Care Act, people like me would struggle to pay for the care and medicines we need.
What would you say to those who view the Affordable Care Act negatively?
I find that most people who view the Affordable Care Act negatively feel that the new law gives the Federal Government "too much involvement" in healthcare. I believe the Federal Government needs to be involved in the healthcare industry to force the insurance and drug companies to lower the exorbitant rates they have been charging Americans for decades.
Why do you support the president's re-election in November?
I believe President Obama is on the right track to reverse our country's struggles after eight years of Republican leadership. I feel the President is helping to decrease unemployment, actively fight terrorism, and hold large corporations responsible for paying their fair share in taxes.
This week, the U.S. Supreme Court is debating the constitutionality of the Affordable Care Act. On Thursday, we'll be talking with women about the law as part of our Women's Week of Action. Join the conversation in Columbia here: http://OFA.BO/V5gR9J or Charleston here: http://OFA.BO/rvbtNs. And visit http://OFA.BO/9NnSFu to find out how healthcare reform is working for you.


text:
Candolim Villa CAN262 Bedrooms / Sleeps 4
- Air conditioning
- Cable TV
- Ceiling fans
- Concierge services
- Internet access
- Laundry service
- Lunch & Dinner
- Massage on request
- Private beach access
- Safe deposit
- Secure enclosed grounds
- Stereo system
- Swimming pool
- Yoga lessons on request
- Airport transfers
- Continental Breakfast
- Daily housekeeping
- Electricity
- Water & Gas
- Linen and towels
- Personal light laundry
- Staff salaries
- Caretaker
- Cook
- Driver
- Gardener
- Housekeeping
- Maintenance
- Manager
- Watchman
This beach villa can accommodate up to 4 people in 2 double bedrooms with 2 en-suite bathrooms.
This villa is ideal when it comes to location, facilities, and service.
All that stands between the villa and the beach is a 4-acre private estate and a splendid 25-meter swimming pool. The villa is unique in terms of layout with an exemplary standard of accommodation and an open plan design encompasses living and dining.
The villa has a patio and verandah enclosed in a private courtyard. The bathrooms are open roofed for a shower in the sun or under the stars. There are 2 double bedrooms, a studio style kitchenette and sitting room and the bedrooms are conditioned.
The best restaurants and nightlife of North Goa are around the corner and there are shopping options in abundance.
The villa is one of 3 similar villas in a private compound with a shared pool. All 3 villas together can be rented for groups of up to 12 people.
Maps & Location Details
- Airport is 1 hour by car
- Candolim beach 0 mins
- Aswem/Morjim beach 30 mins
- Panjim City 25 mins
- Anjuna market 15 mins
Rates Details for Beach Villa
|Price per week
|low season
|1st May
|30th September
|From £876
|mid season
|1st October
|30th April
|From £1,610
|peak season
|22nd December
|5th January
|Request price
- Minimum rental period 3 nights
- Peak season minimum rental 7 /14 nights
- Government taxes and conditions apply
Payment Options
GBPOur UK office accepts payments in British Pounds at Barclays Bank in UK
INROur India office accepts payments in Indian Rupees at HDFC bank in Goa.


text:
Average Customer Rating
(based on 5 reviews)
of respondents would recommend this to a friend.
Ratings Distribution
5 Stars
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1 Stars
Purchase Reason
Reviewed by 5 customers
Displaying reviews 1-5
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Great graphics
By Uncle Claude
from San Jose CA
See above survery!
Bottom Line Yes, I would recommend this to a friend
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i will buy this again and again
By darko
from nsw
this is a great product
great vette
By bear
from hamburg ny
Very accurate.
By Rick from Vegas
from Las Vegas, NV
This is one of two tin signs that I purchased of Rosie's Diner. They are hanging in my den as accent pieces to a large poster of Rosie's Diner that I have placed on a pot shelf. The colors are bright and vivid and the detail is great.
By talleysilver
from Florida
My husband has several 1:21 corvettes in his 50's collection display and this sign fits in perfectly with them.
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Librettist Raglan T-shirts are an Idakoos specialtiy! Idakoos has many things to offer. Whether you want to get a Librettist Raglan T-shirt for a special occasion, give a Librettist T-Shirt as a present or need to represent with a funny Librettist Raglan Tee during Holidays or Family and Friends get-togethers, Idakoos is sure to have the right Librettist Raglan T-shirt for you! Even if it turns out you can't find the right Librettist Raglan Shirt with the perfect design for your mother, father or children (or friends!); Idakoos offers all of its men's women's and children's Librettist Raglan T-shirts as Custom Librettist T-Shirts. Personalize any Librettist Raglan T-shirt the way you want to ensure the perfect gift.
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When the script for Sex Tape was first acquired by Sony in a deal that reportedly reached seven figures, there was talk that it already had three names attached. The story of a bored, suburban couple who make and then misplace a sex tape was said to be starring Jason Segel and Reese Witherspoon, and it was going to be directed by Nick Stoller. Well, various aspects of that report either didn't work out or were never true in the first place, because people are talking about Sex Tape again, and only one of those names is still attached.
THR reports that while Jason Segel is still on board to play the male lead, a deal with Stoller was never reached, and now Jake Kasdan has signed on to be the director. Witherspoon isn't mentioned at all in this new report, and, as a matter of fact, they go as far as to say that the female lead hasn't yet been cast, and Cameron Diaz is thought to be a front-runner for the role.
Jason Segel has a decent amount of momentum behind him coming off of the success of The Muppets, so this has to be seen as a good opportunity for Kasdan's career. He's a director who's made some solid comedies in Walk Hard and Bad Teacher, but it seems like his movies always go underrated when it's all said and done. Hitting a home run with a movie that's starring one of the hottest names of right now would go a long way toward showing everyone what a solid director of comedies he's been so far.
If Diaz does prove to be the choice for the female lead, this will be a re-teaming of the trio, as they all worked together previously on Kasdan's Bad Teacher. If that film had any glaring flaw, it was that it didn't utilize Segel's talents enough, so perhaps this time they'll be working with the right material for everyone to show what they can do.


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Decision makers
- Ontario Ministry Of EducationToronto ON M7A 1L2
Sexual consent and rape should be discussed in Ontario sex ed classrooms
The Steubenville incident has brought to our attention that rape culture is very much alive in today's western society. It has brought to our attention that some of our youth's understanding of "sexual consent" is in fact very flawed. While many people have a good understanding of what sexual consent means, some do not. Youth need to be taught that rape is rape, whether the victim was intoxicated or not, dressed scantily clad or not. With a lack of a "yes" there is a lack of consent. With an inability to give consent, there will be no consent. Rape culture in youth is extremely alarming and Ontario schools need to keep youth informed and educated about what consent really means to prevent more kids from thinking this way.
- Toronto ON M7A 1L2
Ontario Ministry Of Education
Rape education should be implemented into sex-ed programs for youth. While dashing around the uncomfortable, we have missed an opportunity to educate youth about rape, and sexual consent. Some of the youth's de-sensitized, in-compassionate reactions to rape cases and vast misunderstandings of what CONSENT means are incredibly alarming and need to be dealt with. It is for these reasons that many victimized women feel and do not come forward. It is a great opportunity to educate youth and hopefully make students feel safer when it comes to having sex.
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Conquering the huge task of organizing a child's supply of toys, games, books and stuffed animals is overwhelming. So far in this series of articles I've discussed ways to sort and store clothing and we've begun working on toys. Here are some additional pointers on working with storage for toys. Remember, we are trying to avoid a trip to the store. Learning how to organize frugally is important.
Barbies and Other Dolls
Most girls at some point in their life have Barbie dolls, baby dolls, Polly Pockets, Bratz and other types of toys. These items can be hard to store, but if you break it down it's easier. Separate the toys by type first. Barbie stuff in one pile, Happy Family in another, Polly Pocket in another and so on until everything is sorted. Along the way throw away broken items or pieces that are no longer useful. Now would be a great time to create a pile of garage sale items too.
Once you have the toys separated by type, evaluate what you have. Barbie items are large, and include many other small items too. To sort our Barbie stuff (as well as others), we separated the items into boxes and baskets by the item. Clothes and Accessories are housed in one container. Furniture in another. And the Barbie's themselves have found a home in an old laundry basket that we no longer used.
Speaking of laundry baskets, there are many unused or seldom used items around your home that you can use to store toys in.
- Laundry Baskets
- Laundry Detergent Boxes or Buckets with Handles
- Cardboard Boxes
- Shoe Boxes
- Baskets
- Food Storage Containers – like rubbermaid, cereal containers
- Bulk Food Containers (we purchase large pretzel containers from Sams Club because everyone in our household loves pretzels. We clean the containers out afterwards and save them to store toys and other items.)
- Food Containers (Plastic Jars, Containers and other types of items that food comes in can be cleaned and used for toy storage)
- Pillow Cases (a friend of mine bought a couple of 2×4's and attached them to the walls in her child's room. She then used a staple gun to hang old pillow cases from. They decorated the pillow cases, created labels and they store things inside. It actually looks kinda cool, but if you were worried about appearance you could do the same thing only attach them inside a closet.
Be creative when thinking about storage. Walk through your home and see what you can find that is not being used. Check out your storage area. Can you combine items so that you can use some of it for storage?
See the frugal living blog for the next installment of this series of articles on frugally organizing a child's space without buying a thing.
Related Articles:
Save Time and Money: Frugal Storage Tips For Your Child
Organize a Child's Room Without Buying A Thing
Organize a Child's Room Without Buying A Thing (2)
Organize a Child's Room Without Buying A Thing (3)
Organize a Child's Room Without Buying a Thing (4)
Organize A Child's Room Without Buying A Thing (5)


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CUMMING - Search teams were back in the Bald Ridge Creek area of Lake Lanier in Forsyth County Wednesday morning, looking for a missing fisherman.
DNR Sgt. Greg Colson said boats were out with side scan sonar.
"What they're doing is looking for anything, a target that may interest them that they want to send a diver down on.
The 47 year old Forsyth County man's empty boat was found Monday night. Family members have told law enforcement that the man was an experienced boater and fisherman.
Colson Tuesday said divers had some difficulty with water conditions, some of them rupturing eardrums.
"The area that we're searching right now is so large and the water is relatively deep in those areas," Colson said.
Authorities have not released the man's name.


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R.T. Legacy
Dr. R. Christopher Teichler has been an active musician for over 20 years as composer, conductor, performer, and teacher. He earned a Bachelor of Music degree in Composition from the Wheaton College Conservatory of Music, and a Master of Music and Doctor of Music degrees in Composition from Northwestern University. As a gifted composer, Dr. Teichler has received awards from ASCAP, Wheaton College, the Elmhurst Jazz Festival, WFMT 98.7 FM Chicago, and the National Band Association. His works are published by R.T. Legacy, Pelican Music Publishing, Kjos Music, TRN Music, BRS Music and Lorenz and Alfred Music. Currently, he is Composer-in-Residence for the MidCities Chamber Singers in the Dallas/Fort Worth Metroplex. Chris is Associate Professor of Music Theory and Composition at the Southwestern Baptist Theological Seminary's School of Church Music in Fort Worth, TX. Recordings can be found at www.christeichler.com.
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Buffalo – Day Off
New Hampshire 2 – Bowie 1 (11 Innings)
Sean Nolin was dealing in today's tilt, as he pitched 6 innings giving up one earned run, with one walk, and 13 strikeouts.
On the offensive side Andy Burns is slowly catching up to AA pitching, as he was 2-5 today with a triple. Kevin Nolan was the offensive star today, as he was 3-5 with a game winning single in the bottom of the 11th inning to end the game.
Dunedin 6 – Lakeland 19
Aaron Sanchez left the game after one out due to an undisclosed injury, and Dunedin had a night to forget afterwards. John Anderson, Kramer Champlin, Shawn Griffith, and Justin Jackson combined to give up 15 hits, 19 runs, of which 11 runs were unearned, with 10 walks and 4 strikeouts.
Marcus Knecht clubbed his 9th home run of the season. Shane Optiz, Mike Crouse, and KC Hobson each had a double.
Lansing 9 – West Michigan 3
Taylor Cole started tonight, and pitched 5.2 innings only giving up 1 run, 4 hits, with 1 walk, and 3 strikeouts.
Kevin Patterson had his team leading 17th home run. Emilio Guerrero had a double, and a triple.
Vancouver – Day Off
Bluefield 5 – Princeton 1
Alberto Tirado had an excellent start in which, he threw 4 innings while giving up one earned run with three walks, and six strikeouts.
Matt Dean was 3-4, with a triple and two runs scored. Jorge Saez, was 3-4, with a double, two RBI's, and one run scored.
GCL Blue Jays 10 – GCL Astros 3
Chris Rowley had another excellent outing, as today he pitched 6 innings, giving up 2 hits, and one earned run with one walk, and four strikeouts. Cale Wine gave up two runs, while pitching the 7th and 8th innings.
Sean Hurley hit a solo home run in the 4th inning. Franklin Barreto had his sixth triple of the season, and Gabriel Cenas had his second triple of the season.
DSL Blue Jays 6 - DSL Cardinals 2
Deiferson Barreto was 2-4, with a triple, and two runs scored.
Miguel Castro continues to be one of the best pitchers on the DSL Jays team, in today's outing he pitched 5 clean innings giving up two. hits, with no walks, and eight strikeouts.
Three Stars
3-Matt Dean
2-Miguel Castro
1-Sean Nolin


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Beyonce Dances in 'Mirrors' for New Pepsi Commercial
Earlier this morning Beyonce released her new pepsi commercial with a different twist. After releasing her teaser video to '#BeyHereNow' Bey dropped the pepsi commercial ad 'Mirrors' which features her in multiple ways.The ad features Beyonce's persona from her most iconic moments of her career past to present in a series of mirrors. You will see the Beyonce from 'Crazy in Love', 'Single Ladies', and even 'Bootylicious'.
If seeing six or so different Beyonce's is not a treat, I hope you enjoy the unreleased teaser track playing in the background 'Grown Woman.' The newest Pepsi spokesperson is just getting started with her Pepsi campaign affairs — the 'Mrs. Carter Tour' which is sponsored by Pepsi starts this month.
In the meantime, here is the "Mirrors' Pepsi Ad featuring Beyonce Knowles- Carter


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We're a little more than a third of the way through the season, but let's relish this tidbit as we head into the season's middle months, when moves get made and buyers and sellers are supposed to start sorting themselves out: After beating the Yankees in a mismatch between Felix Hernandez and David Phelps, the Mariners are just a half-game back in the AL wild-card race. And a game over .500. Which means while there's a whole lot of sorting left to be done, there's no reason to take the Mariners any less seriously than they no doubt take themselves.
It shouldn't come as a surprise that the Mariners are getting the most value out of King Felix and Robinson Cano and a very few others -- Kyle Seager and Michael Saunders in the lineup, Chris Young in the rotation. Use WAR as a quick cheat, and that's the extent of the guys who've been worth a win so far, several fewer than the A's or Angels have to talk about. Not that WAR is the ultimate answer to anything, but it does give you the suggestion that there are more than a few people playing for the Mariners whose value is harder to define than what statistical words of praise might provide.
That's in large part because the core of young talent in the Mariners lineup, which was supposed to have been ready to shine by now, has provided the statistical equivalent of dark matter: We know they're there, we know they're supposed to be important. But defining what Justin Smoak or Dustin Ackley or the shortstop tandem of Brad Miller and Nick Franklin or the center fielder du jour -- it's James Jones this month -- have added challenges easy explanation.
The Mariners are getting less than a .700 OPS not just from defense-first positions such as short and center, where they've been testing their prospects, but also at power positions such as first base, left field and DH. That's no way to back up a bid to contend, and it will be on Ackley and Smoak -- and also veterans Logan Morrison and Corey Hart when they come back from the DL -- to improve upon it.
But the time for excusing youth should be over. Smoak is in his fifth season and Ackley his fourth. They aren't kids -- they're long since young veterans. What you see is what you get. You can at least credit Smoak for hitting away from Safeco this season, with a .765 OPS on the road so far. That's almost exactly the average production for an AL first baseman this season (.764). Average is the new up, at least where Mariners prospects are concerned.
Now, it might seem a bit unfair to pile on the Mariners' bevvy of prospects for what they haven't been and might never be. The only teams running younger lineups than the Mariners' 27.3-year-old average are the Astros and Cubs, both of whom have unapologetically touched bottom in their comprehensive rebuilds. On the other hand, that same average age ties with the homegrown talent-laden Braves, who labor under all sorts of expectations of right-now contention -- and seem to be doing just fine. Guys such as Smoak and Ackley were mentioned in the same breath as prospects such as Freddie Freeman (a consensus top-20 prospect) or Jason Heyward (a consensus top 10). And while we're on the subject of young and disappointing, keep in mind that Ackley is only a few months younger than Justin Upton and was the second overall pick in 2009 to Upton's first overall selection in 2005. As frustrating as Upton has been for those expecting reliable greatness from one of baseball's best streak hitters, you won't confuse that for Ackley's exasperating inability to come close to his rookie season .766 OPS in any of the past three seasons.
Which is why, for as young as these Mariners might seem to be right now, their time is now. Everything can be forgiven, if not forgotten, if the Mariners make this season's September meaningful. That would be a first for a franchise that has yet to top the 85 wins they got in Jack Zduriencik's first season as GM back in 2009. This is essentially his team, a compilation of players he inherited and chose to keep (such as Erasmo Ramirez), guys he drafted (such as Ackley, both shortstops and James Paxton) or guys he signed (Cano, Young and Fernando Rodney). If it's going to add up to anything, ever, there's no time like now to find out.
For the Mariners to deliver on the opportunity of their present, their best hopes might rest on what Paxton and Taijuan Walker can add on the mound behind Hernandez and Hisashi Iwakuma. It makes for that much more of a pitching-and-defense formula, while praying for Cano and Seager to plate enough runs, for Zunino to develop unlike all the other top touts of prospect lists past. Not to mention hoping against hope that Ackley or Smoak or Franklin or Miller finally turn into something. Realistically, what alternative is there? Trade them away to surround Cano with better goodies? No matter how much club control a team might have left over Ackley or Smoak or Franklin, whatever dollar figure you assign doesn't amount to any value in trade if it doesn't amount to anything on the field now. Guys who can't play at 26 or 27 aren't likely to play ever.
It's easy to mock Zduriencik's zipping from one master plan to another with all the hyperactive schemes for world domination of a Bond villain: He's tried building a winner just about every way imaginable in his six seasons in Seattle, flitting from pitching and defense to a lineup overstuffed with veteran DHs, to trusting in his farm system, to finally, in that classic sign of late-stage, go-for-broke desperation, throwing boatloads of cash at somebody with star power when he inked Cano. In short, there is no tack he hasn't tried. The irony is the Mariners might contend for at least a wild-card slot this season, after the former player-development guy made the big-market move and signed the superstar for a budget-busting $240 million. If it works, and if the kids contribute anything, you can bet he'll be congratulated for it.
Christina Kahrl writes about MLB for ESPN. You can follow her on Twitter.


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Natural gas plant coming to Saskatchewan
REGINA – A subsidiary of SaskEnergy said Tuesday it has entered into an agreement with Calgary-based Midstral Midstream Inc. to build a $72.5 million natural gas plant in southwest Saskatchewan.
Bayhurst Energy Services Corp. (BESCO) said the state-of-the-art facility will be used to extract ethane and other hydrocarbons from natural gas being transported from Saskatchewan's Bakken formation.
The "straddle plant" will be located near SaskEnergy's pipeline system in Viewfield, Sask., where it will be used to remove the natural gas liquids so it could be transported for home and business use.
The natural gas will then be compressed and put back into the transmission pipeline.
BESCO will hold a 10 per cent share in the facility.
The plant is expected to be operational in early 2015, with construction slated to begin next year.
"This project with SaskEnergy provides the opportunity for Midstral Midstream, already a major investor in energy infrastructure in Saskatchewan, to play a unique role in our economy with a facility that develops ethane and other natural gas liquids that are in high demand by the market in Western Canada," Doug Kelln, president and CEO of SaskEnergy said in a statement.
© 2013 The Canadian Press


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No, This Doesn't Look Gay At All
KTSM-TV/NewsChannel 9 weatherman Chuck DeBroder is a really cool dude, nice guy, HETEROsexual (not that there's anything wrong with that!) and GREAT meteorologist (yes, he's fully-certified); but sometimes…well…we know it's necessary to have the make-up when you're on TV, but maybe Chuck can find a bathroom to apply it next time?
We'd make a reference to taking the shine off that growing forehead, but that would be piling on.
Thanks to Q listener (and Channel 9 viewer) Patsy Ortiz and husband.
Subscribe to KLAQ El Paso on


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Montgomery County History
1775-1776 William Calk, Isaac Davis, Enoch Smith and Robert Whitledge scouted what would become Little Mountain town. Referring to a land formation which would turn out to be an ancient Native American mound. Enoch Smith, John Lane and Isaac Davis built the first cabin and planted a crop of corn. Due to concern over attacks by Native Americans in the area, it would be the 1790's before any permanent residence would be established.
William Calk artifacts housed at the Kentucky Historical Society in Frankfort.
December 14, 1796 - Montgomery County is created. The county was named for American Revolutionary General, Richard Montgomery. Mt. Sterling was chosen as the county seat and Bennett Clarke was the first to represent the county in the state legislature. Mt. Sterling was named for the "little Mountain" and after Stirling Scotland.
1810 There were 40 families living in and around Mt. Sterling, Genealogytrails.com. The Rev. Joseph Howe, a Presbyterian minister was preaching in Mt. Sterling and operating a school. Another preacher at this time was the Rev. David Barrow of the Baptist church. This church was a member of a fraternity of emancipationists until Barrow's death in 1819. Businesses included agriculture, tanners, store keepers, tailors, a silversmith and tavern keepers.
Rev. David Barrow History at Findagrave.com
Petition by Rev. David Barrow of the "Kentucky Abolition Society" to Thomas Jefferson
Thomas Jefferson to Reverand David Barrow in response
The War of 1812 Montgomery County sent many residents to fight in the War of 1812. Captain Samuel L. Williams organized a unit as well as Captain Johnston Magowan and Colonel Thomas Deye Owings had a regiment as did others. Economically this period would prove to be a boom for Montgomery County. In order to supply the navy with rope, hemp production would increase with a hemp house and rope walk. Tanyards were established near Mt. Sterling and a tobacco factory and wool carding factory. By the 1820 census the community would grow to 624 people. The Panic of 1819 would bring this boom period to an end causing a nationwide recession.


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STARmeterSEE RANK
Down 1,079 this week
Nikolai Kinski
Nikolai Kinski was born on July 30, 1976 in Paris, France as Nanhoï Nikolai Kinski. He is an actor, known for Æon Flux (2005), Point Break (2015) and Tortilla Soup (2001). See full bio »
Born:in Paris, France
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Three East Texas women's clinics to close
From Staff Reports
July 18, 2013 at 11 p.m.
Even before Gov. Rick Perry signed House Bill 2 - predicted to doom most of the state's abortion clinics - Planned Parenthood Gulf Coast had notified employees three East Texas clinics would be closed.
Family Planning Clinics in Lufkin, Bryan and Hunstville are being shuttered along with the Planned Parenthood Center for Choice, an abortion clinic, in Bryan.
Planned Parenthood spokeswoman Alejandra Diaz said Thursday the three family planning clinics - which provide women's health care and not abortions - would close at the end of August because of funding cuts to Texas' Women's Health Program passed by the Texas Legislature in 2011.
"The Center for Choice in Bryan, we knew, we could not afford to bring up to the standards in the new law," Diaz said. "It just would not have been feasible."
The Family Planning Clinic in Tyler, which provides women's health care not including abortions, is operated by Planned Parenthood of Greater Texas. However, it is not expected to be affected.
In announcing the closures, Planned Parenthood Gulf Coast issued a statement saying Texas politicians had created a hostile environment for providers of reproductive health care in under-served communities.
"Texans with little or no access to health care services have been deeply affected by state budget cuts to programs provided by Planned Parenthood health centers and dozens of others that provided lifesaving cancer screenings, well-woman exams and birth control," said Melaney A. Linton, president and CEO of Planned Parenthood Gulf Coast. "Deplorably, the combined impact of years of budget cuts to women's health care services and the dismantling of the successful Women's Health Program will take affordable, preventive health care options away from women in Bryan, Lufkin and Huntsville - just as these policies have taken health care away from an estimated 130,000 others -when Planned Parenthood Gulf Coast is forced to close these family planning health centers at the end of August."
The bill signed into law by Perry restricts abortions to surgical centers and requires doctors who work at abortion clinics to have hospital admitting privileges.
Only five of the 42 abortion clinics in Texas currently meet those new requirements. Clinics will have a year to either upgrade their facilities or shut down after the law takes effect in October.
In 2004, the state forced clinics providing abortions after 16 weeks' gestation to meet the same standards as ambulatory surgical centers.
Abortion providers have until September 2014 to upgrade facilities.

Map of Texas clinics


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University Of Michigan MSN /worth the money??
I am looking to get my MSN in nursing administration. I am wondering if the University of Michigan is worth the high cost tuition rates. I can go to Madonna University where I received my undergraduate degree for A LOT less $$. However, I like the flexibility of the University of Michigan's program and the speciality tracks of their program....I just don't know if it's worth all of the money!?
Any nurses have advice for me? Does it really matter where I get my MSN from? Will I be more marketable with degree from the University of Michigan?
Thanks for your insight!


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Munich (Oct. 27)
Concluding a two-day tour of DP camps and Joint Distribution Committee centers in the Munich area, Dr. Joseph J. Schwartz, JDC European director, said today that he was "impressed with the high spirit of the Jewish DP's–even those who are in the sub-standard camps."
"Of course, they would like to know more definitely about their future," Dr. Schwartz added, "but they are at present full of enthusiasm. I am surprised at the small amount of griping. I expected a lot more."
Dr. Schwartz also reported that in the older camps he found an "inspiring communal spirit," in the kitchens, workshops and schools. He said he was also impressed by the universal gratitude and recognition accorded the program of the JDC, as well as its staff, by the DP's.


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GENERAL HOSPITAL is turning 50 on April 1 and the editors of Soap Opera Digest have created a must-have collector's edition honoring the ABC soap. The special tribute issue, on sale March 25, features revealing interviews, backstage gossip, photos, memories and more! This full-size tribute is can't-miss! Available on newsstands soon.
Coming Soon: Digest's Special GH Issue!