text:
One transgender's story: 'It's not one size fits all'
Christopher Argyros, 31. Lives in Albany with his girlfriend, Laura. Works as transgender rights organizer for Empire State Pride Agenda. Holds a law degree from University of Connecticut School of Law and a bachelor's degree from Vassar College. Graduated from Shaker High School in 1998.
"I look so young, I surprise people when I tell them my age, but in trans years I feel much younger. I'm an only child. I grew up in Loudonville. I had a very stable, calm childhood. I didn't have words for what I was feeling growing up. It's been all kind of retroactive for me. As a little kid, I wanted to grow up to be Luke Skywalker, who is a male figure, but mostly I just wanted Jedi powers. I was a tomboy. In high school, I rowed crew, played soccer, was on the swim team, played French horn in the Empire State Youth Orchestra. I was Christina, but everyone called me Chris."
Gender neutral: "I didn't identify myself as anything. I had a girlfriend for four years in high school, but I didn't consider myself lesbian. I was in love with this person, but we didn't talk about it or have public displays of affection. We were totally closeted until my senior year. I'm sure everybody knew because we got harassed in school. Nothing major, just some nasty comments here and there. I'm not sure why people felt threatened. I wasn't particularly butch. I dressed more like a girl so I wouldn't get picked on. I still didn't know what to call myself. I never heard the word transgender until college. I finally started reading about trans issues on the Internet and it was liberating. My girlfriend and I came out my senior year and it was better to be truthful. We didn't have to hide anymore. My family accepted me no matter what. There wasn't any one big coming-out moment. We discussed it through a long series of conversations and letters."
Experimenting: "I tried on a lot of different identities in terms of gender and sexual expression. I tried being more feminine and then more butch. I had my hippie phase. I didn't know a lot of teenagers who were settled into their identity. At 19, I was reading about transgender and it was like a light bulb went on. I knew the term woman didn't cover me. But I didn't identify as a man and I still don't. I identify as transgender and queer. I don't try too hard to parse the meanings. Transgender is an umbrella term. It's not one size fits all. Gender is all about custom fit."
Transition: "People were very open and accepting at Vassar, but I didn't meet anyone like myself. I met my first trans guy at Smith College, which is pretty ironic since it's an all-women's school. I spent my junior year at Smith. I was interested in women's studies. I was educating myself, but I was being called a male half the time and a female the other half. I lived between genders from ages 20 to 28. I was binding my breasts and was passing as a man about half the time. I had a variety of jobs, from building trails in Texas to working in the kitchen of a vegan tea house on the Lower East Side of Manhattan, where everybody was strange. I waited all those years to transition because I wanted to be sure it was the right thing for me. I also wasn't sure how I would be accepted. At 29, I started hormone therapy and got counseling as part of the process. All of the sudden, I started getting facial hair, my voice lowered and I started passing as a man all the time. I had top surgery (double mastectomy) and I'm happy with where I'm at. It cost more than $6,000 and I've paid it off. My family helped me out. I'm not planning any more surgery at this point."
Fluid sexuality: "One of the key aspects of identifying as queer is flexibility in terms of sexuality. Who I'm attracted to is not going to be determined by the person's gender. Calling myself bisexual doesn't ring true to me because I don't see gender as either-or. I've been lucky in love. My girlfriend, Laura, and I have been together for more than a year. She works for an architectural firm. I am certain that I would not have been happy as a woman. It was a feeling that something was not quite right. I felt fraudulent living as a woman. I know a lot of trans people who want to live queer, which is outside gender. My utopian vision is that we can all live free from prejudice and discrimination one day, without gender terms. I've legally changed my name and gender to male on my passport, driver's license and Social Security card. When I took the name Christopher instead of Christina, I needed to change my middle name, too, which was Katherine. I decided to change my middle name to Boone, which is my dog's name. I like the sound of Christopher Boone. But I can't change my birth certificate unless I get a hysterectomy. That's discrimination and it's a human rights issue we're working to change through the Pride Agenda."
Male privilege: "Now that I look like any normal white guy, I find that people are friendlier. Men nod to me when I pass them on the street. There's a whole male communication thing going on I never knew about. My girlfriend and I are taking a ballroom dancing class now. Before, I worried about what people would think of us dancing as a gay couple. Now, since I have this heterosexual privilege, the instructor makes guy jokes with me."


text:
IQS Directory provides an extensive list of hard case manufacturers and suppliers in Saskatchewan. Utilize our website to review and source hard case manufacturers with our easy-to-use features which allow you to locate hard case companies that will design, engineer, and manufacture hard cases for your exact specifications. Our request for quote forms make it easy to connect with leading hard case manufacturers. View company profiles, website links, locations, phone number, product videos, customer reviews, product specific news articles and other production information. We are a leading manufacturer directory who will connect you with the right manufacturers whether you are looking for plastic cases, instrument cases, or ATA cases.
No companies under the searched state. You can see below the companies serving under neighboring states if any.

subset: commoncrawl


text:
The Republican National Committee (RNC) has passed a resolution that "encourages Republican lawmakers to immediately take action to halt current unconstitutional surveillance programs and provide a full public accounting of the NSA's data collection programs."
The resolution, according to Time, was approved by an overwhelming majority voice vote at the Republican National Committee's Winter Meeting General Session, going on this week in Washington, DC.
The Republican statement comes just one day after the White House said it disagreed with the findings of a Congress-approved watchdog group that also called for the shutdown of the NSA telephone metadata program.
The RNC, which did not immediately respond to Ars' request for comment, is refining its political platform as it gears up for the 2014 Congressional elections this November and the 2016 presidential race.
The resolution also states that "unwarranted government surveillance is an intrusion on basic human rights that threatens the very foundations of a democratic society and this program represents a gross infringement of the freedom of association and the right to privacy and goes far beyond even the permissive limits set by the Patriot Act."
However, the document seems to conflate the PRISM surveillance program with the ongoing metadata dragnet that has been validated by the Foreign Intelligence Surveillance Court.
Its opening paragraph states:
Whereas, the secret surveillance program called PRISM targets, among other things, the surveillance of U.S. citizens on a vast scale and monitors searching habits of virtually every American on the internet; whereas this dragnet program is, as far as we know, the largest surveillance effort ever launched by a democratic government against its own citizens, consisting of the mass acquisition of Americans' call details encompassing all wireless and landline subscribers of the country's three largest phone companies.
In fact, PRISM is the title of an intelligence program through which the National Security Agency accesses user data handed over from major tech companies collected under legal authorities such as the Foreign Intelligence Surveillance Act Amendments Act (FISA AA) Section 702 and Executive Order 12333.
The RNC appears to also have ignored the fact that much of the NSA's surveillance capability that is now being roundly criticized in the wake of the Snowden leaks first began under President George W. Bush, a Republican. Further, elements of the program were approved by a Republican-majority Congress, such as the FISA AA, which passed both houses of Congress in 2008 and was signed by Bush.


text:
Search our database of handpicked sites
Looking for a great physics site? We've tracked down the very best and checked them for accuracy. Just fill out the fields below and we'll do the rest.
You searched for "moon"
We found 11 results on physics.org and 66 results in our database of sites
(of which 65 are Websites, 1 is a Videos, and 0 are Experiments)
Search results on physics.org
Moon Watch
How do we know how far away the moon is?
Why is Pluto no longer considered a planet?
Who is... Neil Armstrong
How powerful is the Hulk?
Sci-Art: The final frontier
What causes the Earth's magnetic field?
The physics.org web awards
All about... the Venus transit
A brief history of space
All about... the International Space Station
Google moon
Explore the moon's surface with this map: a mosaic of landing site images and a tour of the Apollo moon landings.
Inconstant moon
Multimedia guide to the moon including a phase calculator which lets you see what the moon will look like at any time of year. Visually attractive site
Moon phase calculator
Does exactly what the title suggests provides an image of the moon as it would appear on your chosen date (1800-2199 AD). The depiction of lunar surface features suffers geometric distortion but the ...
Why Doesn't the Moon Spin?
Find out how the rate of rotation of the Earth and Moon cause an effect where is seems the Moon doesn't spin.
Moon Zoo
Count craters and help explore the moon in this great citizen science project.
Why can I sometimes see the moon during daylight hours?
Q & A site. Explains visibility of Moon (and Venus) in daytime sky.
The Moon
A useful page from NASA all about the moon, its origin, movements, craters, interior and more.
The Moon
A very good fact file on the moon covering lots of different aspects and finishing with a short quiz.
To the moon
A page about lunar exploration and the Apollo moon landings.
Why You Can See the Moon During Daylight Hours
A simple description of why the moon is visible during the day.


text:
Wednesday, 8 August 2012
19 comments:
Adore this outfit! The skirt is so cute :) I really love your style so I followed you!ReplyDelete
It'd be great if you could check out my blog too, and maybe follow if you like it.
Bethany Paige (www.paigeoffashion.blogspot.co.uk) X
Love this outfit! :)ReplyDelete
kisses from I want to live in L.A
- Anonymous8 August 2012 at 10:26
wow :)ReplyDelete
amazing outfit :)
love it all :)
I follow your blog now :)
visit my blog
This is such a lovely outfit, Imogen! I know exactly what you mean about finding an item of clothing that has the same name as you - if you already liked that piece prior to knowing, then as soon as you find out what it's called, it feels as though that item is destined to be a part of your wardrobe. Though, my recent reaction to finding a skirt with my name was rather strange and maybe - a tad - over the top!ReplyDelete
Best Wishes,
You're so pretty (as always) and the shirt looks very nice as well! C:ReplyDelete
love the top!ReplyDelete
- Anonymous8 August 2012 at 17:02
I love your skirt, this outfit is gorgeous :)ReplyDelete
Have a nice holiday! xx
Love the detailing of the top! <3 Looks well with the skirt!!ReplyDelete
gorgeous looks, love it!ReplyDelete
just fanned you on Lookbook and now following your blog. hope you can also visit and follow my blog dear :)
This is beautiful. I love how feminine the top is.ReplyDelete
This blouse is gorgeous! As is your hair!ReplyDelete
http://deonnep.blogspot.co.uk/ :)
The blouse is very pretty on you and I LOVE the skirt you have teamed it with. You really know how to style girl, always enjoy your blog.ReplyDelete
see you around x
love the skirtReplyDelete
Hayley xx
Beautiful blouse;) You look gorgeous;) Follow you on Twitter and bloglovin;)ReplyDelete
love all of the embellishments on the shirt/blouse! http://thestyleshedblog.blogspot.co.uk/ReplyDelete
omg, i love your blog! we should follow each other dear!ReplyDelete
♥ http://hello-strawberryswing.blogspot.pt/
Your blouse is gorgeous! I love it!ReplyDelete
I love your blouse...you look lovely! <3 xReplyDelete
I love your blouse.you look so pretty and slim!ReplyDelete
isabel marant


text:
The Greek government's
base case scenario builds in GDP growth of -0.3% and 1.5% in 2010 and
respectively, which is simply unrealistic vis-à-vis analyst
expectations. A
recent Reuters poll revealed consensus estimates for GDP growth of -1.5%
0.5% in 2010 and 2011, respectively. Local subject matter experts such Gikas
Hardouvelis, Chief Economist at EFG
Eurobank and professor of economics at the University of Piraeus are
a deeper recession with GDP declining 2.8% in 2010. Deeper
recession and
delayed recovery is expected primarily on the back of reduced private
public consumption as a result of the government's austerity measures. Economic
lower than the government's estimates will result in lower tax base
and lower tax revenues, and shall consequently offset the projected
impact of
the revenue measures like increase in tax rates. Evidence of
this is
already apparent in the ability of Greek labor unions to shot down much
Greece during 24 hour strikes which effectively eliminate large swaths
revenue and productivity for the day. Tax collectors, customs
inspectors, the
police, doctors, teachers... The striking populace apparently
encompasses a very
broad swath. This has happened several times in the last month and
future strikes are planned as well.
The Greek government's
macroeconomic assumptions also
seem overstated when compared with EU estimates.
Revenue Generation Measures? It appears more like hoping one can change the centuries worth of behavior by the end of the year...
The Greek government
has so far announced revenue measures with budgeted impact of nearly € 10.7
billion, or 4.4% of GDP. The announced revenue measures range across an increase
in VAT rates, excise rates, fuel tax, property tax; unique taxation scale and
elimination of tax exemptions; and reduction in tax evasion.
However, there are very serious
concerns to be raised concerning the successful implementation of these measures and
meeting the targets. The perception of performance of these measures (largely consisting of an increase in tax
rates and reduction in tax evasion) in Greece is seriously undermined (at
least in the eyes of the prudent practitioner) by the lengthy history of high tax
evasion in the country. Over the years, the authorities have failed to crack
down on the rampant tax evasion and there is no evidence to suggest that this will
change, particularly amidst the current environment of declining income levels
and higher tax rates.
1. Friedrich Schneider,
chairman of the department of economics at the Johannes Kepler University. - Greece's
unreported -- and untaxed -- shadow economy is one of the largest and equals
about one-quarter of GDP. That compares with 22% of GDP in Italy (keep in mind that this is inclusive of the evasion performed by the
famed La Cosa Nostra as well as the lesser known Camorra, the 'Ndrangheta or the Sacra Corona Unita,
as well as foreign organized groups) and 20% in Spain and
Portugal, according to his estimates.
2. Bloomberg - Prime Minister Papandreou
says that the Greek workers and companies have skirted tax worth € 31 billion,
more than 10% of GDP. According to EU statistics, Greece's revenue from income
tax was 4.7% of GDP in 2007, compared with an EU average of 8%. Tax revenue
fell 2.5 percentage points of GDP between 2000 and 2007 to a Euro region-low of
32% even as economic growth averaged 4.1% a year.
3. Analyst Ed Sollbach,
Desjardins Securities - Tax evasion in Greece is a huge problem. Nearly 94%
of personal income declared relates to annual incomes of less than € 30,000.
4. Matsaganis, Hellenic
Observatory, The European Institute - Under-reporting of income in Greece is estimated at
10%, resulting in a 26% shortfall in tax receipts.
Announced expenditure
measures are expected to cut the government's expenditure by nearly € 8.1
billion or 3.3% of GDP. Expenditure measures include salary cuts, freeze in
hiring and salary hikes, as well as cuts to other public sector expenditures.
The biggest risk
factor in the implementation of these measures is the growing social unrest,
which is likely to put political pressure on the government to roll back some
of the planned actions. The newly elected socialist government is facing strong
resistance against the announced austerity measures in the form of nation-wide
strikes, clashes by thousands of people, and growing public fury may force the
government to cut certain targets for salary reductions, pay and hiring freeze,
The government is planning
to procure funds by offloading stakes in some of the government owned entities,
and plans to raise € 5.6 billion or 2.3% of GDP over the next three years, with
€ 2.5 billion planned to be raised in 2010. In the Stability and Growth
Program, the government has outlined a list of companies in which the government
owns equity, and gave estimates of values of the government's equity stakes. We
back-calculated the government's estimates for total equity of the companies
and compared the same with the current market values (market cap) of the total
equity of the companies and observed that in most of the cases the government's
estimates were overstated (and in some cases, drastically) when compared with
the current market value.
It can be argued that
the Greek government is factoring in a control premium for their majority
holdings. Theoretically this is acceptable, but realistically this will be very
difficult to translate into cash. The government would have to find large
buyers who are willing,to purchase the entire stake at the premium
suggested, from a seller who is in obvious and globally publicized distress -
and the Greek government will have to do this several times over, all within a
period of less than 8 months to meet the 2010 deadline. We find this to be
highly unlikely. It has been our experience that distressed seller's often take
DISCOUNTS to the market value of
their assets, not PREMIUMS!
1. Since the Greek
government is seen as a distressed seller, it will have to take a discount from
any prudent buyer
2. If the government sells
directly into the equity market (the most expedient and likely scenario), the
control premium is not applicable.
3. It will take time to
market the properties, negotiate the terms and close on the large deals to capture
the control premium, if one is actually attainable. This is not going to happen
for all of the properties slated for sale in 2010.
4. If the government is
being aggressive in valuation of public properties, it is most likely to be even
more aggressive with non-public properties, where pricing is considerably more
2010-03-15 11:33:27 694.35 Kb/ report that should visually drive the point of overvaluation home. Ironically, mismarkng the value of its assets is what contributed to Lehman Brothers downfall.
Click image to enlarge
The Greek government is expecting payback of the
financial aid provided to the ailing Greek banks, and has built in total proceeds
of € 3.8 billion in the coming years in its public finance projections. However,
the Greek banks are still struggling under the current financial and economic
crisis gripping the country with added (and quite material) pressures coming
from the drastic austerity measures. The
deep recession expected in 2010, with only mild recovery in 2011, will not only
see sharp declines in public and private consumption that will inhibit credit
growth, but will also result in deterioration (rising NPAs) in the credit
quality of their consumer and commercial loans portfolio. Thus, the banks are
far from reaching a stage where they can generate incremental operational cash
flows or raise equity from the market to pay back the capital injections from
the government, or at least do so on a
prudent basis. Consequently, financial assistance is expected to stay, with the
possibility (probability?) of some additional assistance being injected (or at
least needed) into the banks in the coming years. Subscribers should download
our overview of key Greek banks here: Greek Banking Fundamental Tear Sheet.
The Greek government has accumulated significant debt
over the years to finance its annual fiscal deficits. The government debt has
risen from 97.1% of GDP in 2006 to 113.4% of GDP in 2009. The implications of
this massive debt are reflected in its overwhelming interest burden which has
precipitated its current weakened fiscal situation - all of which culminates
into high sovereign risk. This creates a feedback loop, and self-devouring
cycle that increases the interest costs on debt roll-over and new issuance in
the market which again adds additional burden to the weakened Greek fiscal
situation that requires additional funding at ever higher interest rates. The Greek
government is trapped in a vicious circle where the interest expense as well
the primary deficits are adding to the debt levels which itself goes on to
increase the interest expense. While the government is aiming to reduce its debt
in the coming years by generating primary surplus (through austerity measures)
as well as by collecting funds from the privatization and payback of financial
assistance package, this is expected (by us) to yield much lower proceeds than
budgeted, in light of the observations mentioned above.
An immediate and much larger concern is an increase in
interest cost owing to refinancing of the maturing debt as well as raising new
debt (to finance the fiscal deficits) under distressed credit conditions for
the government. Nearly 55% of the total debt is maturing over the next five
years, with nearly 10% maturing in 2010. Additionally, new borrowing will be required
to finance the fiscal deficits of the coming years.
Interest cost on government debt is on the rise as
reflected by the yield on Greek government 10yr bonds, which has risen to 6.2%
in March, 2010 from 5.7%, a year ago.
Given the higher borrowing cost for the Greek government
and the large debt roll-over and new issuance lined up, the average interest
cost is expected to increase or remain the same rather than decline. However, while making projections for 2010 and later
years, the Greek government is assuming a decline in the average interest rate
on the government debt, which would underestimate the interest expense
projected in the coming years.
While the government outlined complete projections of
revenues and expenditure along with a change in government debt in its Stability
and Growth Program, January 2010, it subsequently announced additional measures
with impact of nearly € 1.2 billion or 0.5% of GDP and € 4.8 billion or 2% of
GDP in February and March, respectively. We have built in the announced impact
of additional measures in the government projections, and based on new
projections, the government is expecting a primary deficit of 1.0% and fiscal
deficit of 6.2% in 2010, against primary deficit of 7.7% and fiscal deficit of
12.7% in 2009.
However, in light of the observations discussed in the
earlier sections, there is a strong possibility of deviation from the targeted
performance. We have therefore built three scenarios, each with a set of
assumptions about the variation from the budgeted impact of the various revenue
and expenditure measures as well as variation in the budgeted proceeds from
privatization and payback of financial assistance by Greek banks.
Over the next week or two I will comment on several other European nations whom I feel have very little practical chance of accomplishing what they have stated in public and the likely consequnces of their failure to accomplish such. I will also be releasing my pan-European stress model to subscribers, along with a public excerpt by the end of the week. In the meantime, anybody who has not caught up on my Pan-European Sovereign Debt Crisis series should click the links below.
Earlier installments of the Reggie Middleton's Pan-European Sovereign
Debt Crisis
- The
Coming Pan-European Sovereign Debt Crisis - introduces the
and identified it as a pan-European problem, not a localized one.
- What
Country is Next in the Coming Pan-European Sovereign Debt Crisis? -
illustrates the potential for the domino effect
- The
Pan-European Sovereign Debt Crisis: If I Were to Short Any Country,
What Country Would That Be.. - attempts to illustrate the highly
interdependent weaknesses in Europe's sovereign nations can effect
the perceived "stronger" nations.
- The
Coming Pan-European Soverign Debt Crisis, Pt 4: The Spread to
European Countries
Depression is Already Here for Some Members of Europe, and It Just
Might Be Contagious!
Think It's Confirmed, Greece Will Be the First Domino to Fall
Swap Guns Are Beginning to Litter EuroLand, Sovereign Debt Buyer
- Financial
Contagion vs. Economic Contagion: Does the Market Underestimate the
Effects of the Latter?


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Basics of the Immune System
Let's start at the beginning. What does it mean when someone says "I feel sick today?" What is a disease? By understanding the different kinds of diseases it is possible to see what types of disease the immune system helps you handle.
When you "get sick", your body is not able to work properly or at its full potential. There are many different ways for you to get sick -- here are some of them:
- Mechanical damage - If you break a bone or tear a ligament you will be "sick" (your body will not be able to perform at its full potential). The cause of the problem is something that is easy to understand and visible.
- Vitamin or mineral deficiency - If you do not get enough vitamin D your body is not able to metabolize calcium properly and you get a disease known as rickets. People with rickets have weak bones (they break easily) and deformities because the bones do not grow properly. If you do not get enough vitamin C you get scurvy, which causes swollen and bleeding gums, swollen joints and bruising. If you do not get enough iron you get anemia, and so on.
- Organ degradation - In some cases an organ is damaged or weakened. For example, one form of "heart disease" is caused by obstructions in the blood vessels leading to the heart muscle, so that the heart does not get enough blood. One form of "liver disease", known as Cirrhosis, is caused by damage to liver cells (drinking too much alcohol is one cause).
- Genetic disease - A genetic disease is caused by a coding error in the DNA. The coding error causes too much or too little of certain proteins to be made, and that causes problems at the cellular level. For example, albinism is caused by a lack of an enzyme called tyrosinase. That missing enzyme means that the body cannot manufacture melanin, the natural pigment that causes hair color, eye color and tanning. Because of the lack of melanin, people with this genetic problem are extremely sensitive to the UV rays in sunlight.
- Cancer - Occasionally a cell will change in a way that causes it to reproduce uncontrollably. For example, when cells in the skin called melanocytes are damaged by ultraviolet radiation in sunlight they change in a characteristic way into a cancerous form of cell. The visible cancer that appears as a tumor on the skin is called melanoma. (See How Sun Tans and Sunburns Work for more information.)


text:
Modern Solid Oak Tall Glazed Corner Unit
Product Description
Welcome to our stunning Modern Solid oak range of 100% solid oak assembled furniture (unless specified), in a light oak lacquered finish, comprising lounge, dining, office and bedroom furniture. Dovetailed drawer joints both front and back, plus drawer stopper.
Metal handle as standard with option to change to wooden handle (+ £1.50 per handle) if the mood takes you! Over 70 pieces to the range and top quality 100% solid oak, including drawer bases and backs.
Where there is glass, it is toughened and bevelled. Most shelves are adjustable and there are lights as standard in the display cabinets and dresser.
59Kg3 Adjustable glass shelvesIncludes light.Simple assembly.
Available to order
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text:
HP: 1 Condition: Good
"Oh yeah." Charlie answered as she leaned over to look at a poster from a Musical that had been playing a few months ago. "That wasn't fun. Well I mean... She was fine everything kind of actually worked out with her but I got covered in Acid Vomit and that kind of hurt."Trouble wrote:"I ... heard that you fought that person again, when she came here. I'm glad you're okay."
She looked back to Trouble, "I'd rather get blown up again to be honest. Burns hurt." She shrugged, "But hey if I was afraid of a little pain I'd be in the totally wrong profession." She smiled, "You hear a lot of stuff Ladybug, Keeping your ears to the ground is a good habit."


text:
Prizefighter Music necesitaba un nuevo diseño de página web y lanzó un concurso de diseño en 99designs.
Un ganador ha sido elegido entre 81 diseños de 13 diseñadores freelance.
I'm a 29-year-old writer and business owner. I'm experienced in many industries and my formal education is diverse. I've loved writing since childhood. And I've always been told (by non-family members) I was really good. So one day I started writing copy in my spare time for friends and family and by popular demand, it grew into a business. Now I actually have clients, am co-writing a funded screenplay, and believe it is important to develop a strong web presence.
Through business, I know the importance of the customer and everything that this site is about should convey that. The culture of esotervik is very simply "copy that excites our clients."
Target markets:
1) any new business or organization
2) grassroots, up-and-coming politicians
3) existing businesses or organizations that need a refresh
4) people with an idea that need help communicating it
5) anybody who needs complex material simplified
6) anybody who understands the correlation between good copy and bigger bottom lines
1) The closest thing on the web as far as a look or relevant content is: http://allday.cc/ .
I like the site because it is clean, minimal, informative, and sexy. But the calls to action could/should be a little stronger.
Instead of a portrait of myself, I'm looking for creative imagery, a custom design, or something ORIGINAL.
2) I've attached a PDF of a "mindmap" of what I think are important points about the project. Please have a look.
3) I want a logo, something that I can use to brand. I had thought about a cartoon/drawing of a starry night, a high rise apt building with a light on in a top floor window, but darkness every where else. This just came to my mind randomly, but it's a start.
4) Please note that "esotervik" is a play on the word esoteric. My first name is Vik. Just some context.
5) I don't want to be too restrictive so I won't write too much more. Feel free to get in touch if you need more ideas or information. But mostly, I want you guys to work your magic.
6) Files must be PSD
7) Robust estimate/proposal submission page
8) Call to action on every page: "get a no obligation estimate for your next project."
9) menu items: about, services, portfolio, rates, blog, contact


text:
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text:
The Water Revolt
I. The Water Revolt
In January 2000, just months after it took over control of the water system of Bolivia's third largest city, Cochabamba, a Bechtel Corporation subsidiary hit water users with enormous price increases. These increases forced some of the poorest families in South America to literally choose between food and water. The people came out into the streets in protest, and were met with violent repression by government troops that left one 17-year-old boy dead and more than a hundred people wounded. In April 2000, the people finally forced Bechtel to leave.
Today, more than 10 years later, global attention is focused on the revolt as a spark of a new wave of resistance to the economic policies of neoliberalism. To mark the 10-year anniversary of the uprising, the Democracy Center compiled a variety of information on the revolt, ranging from excerpts of our original dispatches from the streets during the revolt, to the chapter on the revolt from our 2008 book, Dignity and Defiance: Stories of Bolivia's Challenge to Globalization, available here in English and in Spanish. This chapter is a complete history of the Water Revolt, including how it began, what happened in those days in the streets of Cochabamba, and what has happened afterward, including the lawsuit that Bechtel brought against Bolivia and subsequently dropped in the face of enormous international pressure.
1. Dispatches from the Streets – 2000
Excerpts from the Democracy Center's complete dispatches from the Cochabamba water revolt, which was the winner of the 2000 Project Censored award for top story. The unabridged blow-by-blow version of the dispatches is also available here.
2. Cochabamba's Water Bills From BECHTEL
The direct proof of Bechtel's continued mistruths about what it did in Bolivia – viewable copies of the water bills with Bechtel's increases and a chart of the water rate hikes drawn directly from the water company's computers.
3. The World Bank
The background on the World Bank's role in the Bolivian water takeover, including exchanges of correspondence between The Democracy Center and World Bank officials.
4. In pictures
Tom Kruse's photographs of the Water Revolt, from February – April 2000
II. Bechtel vs. Bolivia
Eighteen months after it was kicked out of Bolivia, Bechtel and its co-investor, Abengoa of Spain, filed a $50 million legal demand against Bolivia before a closed-door trade court operated by the World Bank, the International Centre for Settlement of Investment Disputes (ICSID). For four years afterwards Bechtel and Abengoa found their companies and corporate leaders dogged by protest, damaging press, and public demands from five continents that they drop the case.
On January 19, 2006 Bechtel and Abengoa representatives traveled to Bolivia to sign an agreement in which they abandoned the ICSID case for a token payment of 2 bolivianos (30 cents). This is the first time that a major corporation has ever dropped a major international trade case such as this one as a direct result of global public pressure, and it sets an important precedent for the politics of future trade cases like it.
1. How Bechtel Lost its $50 Million Case Against Bolivia:
The people of the world join with Bolivia to beat back Bechtel in its legal demand for $50 million.
2. The Bechtel Corporation:
The background on Bechtel's role in the Bolivian water takeover and its legal actions against Bolivia. Includes exchanges of correspondence between The Democracy Center and Bechtel officials and a link allowing you to write directly to Bechtel's CEO.
3. International Citizen's Petition to the World Bank:
In August 2002 more than 300 citizen groups from 41 different countries filed this petition, demanding that the Bechtel vs. Bolivia case be opened to public participation and scrutiny. Read the petition and see who endorsed it.
III. After the Water Revolt
1. Water in Cochabamba After the Water Revolt: a Legend With Mixed Results
What happened in Cochabamba afterwards? What did the Water Revolt mean for the people and their thirst for clean, affordable water. In this paper, The Democracy Center takes an unvarnished look at the track record since April 2000. The paper is an excerpt from a chapter on the Water Revolt, in the Center's book: Dignity and Defiance: Stories from Bolivia's Challenge to Globalization (University of California Press, 2008).
2. Cochabamba's Poorest Neighborhoods Take on the Challenge of Water
In this video and report, we focus on a very specific piece of the post-Water Revolt story, one that is not as well known: How the neighborhoods of Cochabamba's impoverished south side have taken into their own hands the challenge of getting water. We examine the issue up close by bringing you right into the neighborhoods involved and through interviews with those neighborhoods' leaders.
IV. Other Resources
1. The Cochabamba Water Revolt and Its Aftermath
Jim Shultz's complete chapter in the Center's book: Dignity and Defiance: Stories from Bolivia's Challenge to Globalization (University of California Press, 2008). This in-depth analysis covers the gamut, from an explanation of the situation that led to the water privatization and the subsequent revolt through the case Bechtel brought against Bolivia, to what problems are left to be resolved years after the Revolt.
2. The Right to Water – Fulfilling The Promise:
A chapter by Jim Shultz from the book, Economic, Social and Cultural Rights in Latin America: From Theory to Practice. A look at the larger issue of access to water across the world and the Bolivian water revolt in the context of the struggle to secure water as a human right.
3. Bolivia's War Over Water
A general chapter on the history, background, and consequences of the Water Revolt written for the Verso book 'We Are Everywhere'.
4. Leasing the Rain – the video
Web site for the powerful film on the Bolivian water revolt aired in July 2002 by Bill Moyers on PBS in the U.S., produced by two good friends, David Murdoch and Bill Finnegan. Includes clips, facts, links and other well-organized resources. You can also find the full transcript here.
5. "Leasing the Rain" – the New Yorker article
Bill Finnegan's masterful and complete April 2002 article on the water revolt, putting it into the context of the world's growing water shortage.
6. Texts of the Coordinadora from the Revolt
A Collection of the Coordinadora's communiqués and local reporting on the Coordinadora from the time of the Revolt.
7. The Network for Justice in Global Investment
When Bechtel brought its 50 million dollar suit against Bolivia, it did so through the mechanism of the World Bank's International Court for the Settlement of Investment Disputes (ICSID). ICSID is the most widely used of the secretive investment tribunals that allow transnational corporations to make agreements, called Bilateral Investment Treaties (BITs), that bypass domestic courts and sue governments behind closed doors. The Bechtel vs. Bolivia case is one of the only cases in which the corporate plaintiff was not awarded damages from the government it sued—and Bolivia's victory in this case was due to the powerful movement that sprung up in protest, making Bechtel's suit an untenable public relations disaster and forcing it to settle the dispute for a token payment of two Bolivianos.
This is an issue that has threatened the sovereignty of many countries around the world, as foreign corporations haul countries into secretive trade courts, suing them for millions for the crime of seeking to protect their environment or regain control of their natural resources.
The Network for Justice in Global Investment is a joint effort by citizens and organizations in a variety of countries to challenge this anti-democratic system of international investment rules. On this website you will find a wide variety of resources to help you become more knowledgeable about these issues and to help you get involved in the global effort to bring democracy and real justice into the rules governing international investment.


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Inspired by the sensuality, shape and natural beauty of a woman, discover a collection of rings, earrings and pendants that are as feminine and beautiful as the women in your life. Each piece is finely crafted with our unique "floating diamond setting" maximizing the brilliance of every diamond. The elegant simplicity & subtle detail that goes into every Sirena® piece makes it perfect for every level of love.
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Discussion in 'Photos' started by W4lnutz, Oct 3, 2012.
Thats a nice garage anywhere! jealous.
Replacing the seals on my ELR.
Are you able to obtain waste oil heaters? And do you produce enough waste oil with your fleet to make it worthy? If I had to worry about garage heating that's what I would do (and maybe it would give me some motivation to do timely fluid changes)!
Another thing I'm really fussy about is tidiness. There are some excellent examples of neat workshops on here and a few of utter chaos. I cannot and will not work in chaos, tools and bike parts scattered on the floor and so on. All my spanners are now in steel tool cabinets with drawers. With thin black non-slip foam in the drawers, all of the spanners are clean and in size order. That way I can go immediately to the right size spanner and also see if any are missing. I have mislaid so many tools in the past and stumbled over so many bits on the floor. My temper is too short these days and I enjoy working in good light, in a comfortable temperature and surrounded by neatness. I've even been known to vacuum the bloody carpet.:eek1
Wow some bad ass man caves
But Paul, please be careful with this heating things. . .
As a townboy I have to deal with normal garage sizes. The other picture, older post, is my "workshop" garage, in an other part of town.
This is only the "garage". It is close to the flat.
Years ago, we had a lot of old company sheds. Some used later as a workshop. But this buildings are long gone
I move stuff around when there is a project in the works. So sometimes the bikes are parked at odd angles.
Normally, this is what it looks like in the "bike parking". The other half is for the cars and shelves with Rubbermaid tubs of random shit I won't throw out
My ultimate workshop would resemble those F1 workshops - tiled floors, superb lighting and everything immaculate with the vehicles at just the right height to make working on them a pleasure. I have a sheet of inch thick high density foam to kneel on when I have to. My knees don't take kindly to kneeling these days.
Need to finish the garage project
But I keep getting distracted with car and bike projects (new bike hauler)
Love it...especially the awning off the side. You can never have enough shelter from the elements.
Very nice, inside and out!
Thank you thank you.
Here is my other garage. Every man should have an ice machine!!
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Love that nighthawk
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He burned a zThou. Kill.... him... now.
Seriously, all he got was probation? I think a one way camping trip would be in order.
My current (somewhat temporary) house.
This picture is a bit outdated though... missing a few bikes
Can i get you do this trick again for a few cases of beer?
Mine a few years ago during some tideing up on the R100RS


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In a nearby town there is the most wonderful little store with an amazing collection of books at good prices. I have spent quite a bit of time and money there buying books for school. Occasionally, I stumble upon a really good deal or fantastic title. And this is one of them.
Biblioteca de los experimentos is an exceptional textbook filled with fun scientific information and activities. I'm not sure how something of this quality ended up in my little store, but I was quick to grab every last one so that I could share them with you.
The book is actually a compilation of four different books. Each section covers a different concept and includes a hands-on activity that reinforces the subject matter. Students are encouraged to make observations and to create their own hypotheses. At the beginning of each section there is a table of contents, a brief introduction, and a list of materials needed for the activities. There is also an index at the end of each section for quick reference.
The first book is on maps and cartography (mapas y cartografía). Children learn how to read a map and are introduced to related concepts such as scale, symbols, elevation, angle measurement, and latitude and longtitude.
Section two covers weather and climate (tiempo y clima). Students learn about the types of weather, seasons, the power of the sun, air pressure, changes in weather and meteorology/predicting the weather. This section has some of the best activities in my opinion.
Section three discusses rivers and oceans (ríos y océanos). It covers key concepts such as the water cycle, contamination, and glacier movement, as well as more detailed information about rivers (their origin, winding rivers, how they affect the land, etc.) and oceans (currents, waves, coast formation, filtration, etc.)
And finally, section four focuses on mountains and volcanoes (montañas y volcanes). Kids may like this section best for the fun activities (who doesn't like making a volcano?). But fun activities aside, kids will learn about the layers of the earth's crust, plate tectonics, earthquakes, mountain formation, erosion, fossils, igneous rocks, hot springs, etc.
This book is written completely in Spanish and I have not seen an English version. But bilingual families can easily translate the lessons. This textbook is definitely geared for older children (ages 7 and up).
This book seems to be extremely hard to find in this country. I don't know how my bookstore was able to get these, but there is only one on Amazon and it is crazy expensive. I haven't found any other stores on-line that carry it. If you'd like to purchase a copy, I have a few available on a first-come, first-served basis. Just visit the Mommy Maestra Specials page.
Con cariño…
Friday, June 18, 2010
Mommy Maestra Specials: Biblioteca de los experimentos
by Monica
4 comments:
This looks like a neat book. I just discovered a great website that takes a similar approach to teaching science through experiments. It's www.curiosikid.com. There are dozens, if not hundreds, of experiments, some of which you can complete entirely online, and it's all in Spanish!ReplyDelete
Wow! Thanks, Tricia! SO glad I started this so we can share such valuable information!!!ReplyDelete
Un abrazo,
I actually think this book would be great for my husband (he is currently learning Spanish). By the time our daughter will be old enough for this book he should be a pro :)ReplyDelete
I still have copies left! :)ReplyDelete
Sometimes that's the best thing about having kids: You get to learn things all over again.
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I use a huge variety of software. I write, take photos, enter genealogical information, teach classes, and participate in conferences. In course of a day, I use the Internet almost continually, for doing my own writing, for teaching classes and individually helping patrons at the Mesa Family History Center and elsewhere. So I thought it might be interesting to list the software I use most frequently. Notably, almost none of the programs I use the most could be classified as genealogy programs although they are used for genealogical purposes. The software is listed in the order of my most frequent use, not the total time using the program and for the purposes of this list, I am excluding any online programs, such as Google, which would top the list because it is the host for this blog. I am also excluding those programs I use on my iPhone/iPad. I will make separate lists for online, mobile and other programs at a later date.
Here it goes. You might see some surprises and you might not. Oh, one more qualification, these are the program I use today, they may have changed since last week. I am continually finding and using new programs.
This is an obvious number one. You might think of a browser as an online program, but it resides on my computer and I use it all the time, almost constantly. Right now, I am using it to write this blog post.
This is an email program and I have moved over to using Sparrow quite recently when all my other programs essentially stopped working. The reason this is number two is because I have such a heavy influx of email. I would guess over 50+ an average day. I review email many times during the day, partly because I receive updates from my law office also.
This comes near the top because it is like Sparrow, used for daily communication. I have a constant stream of posts most of the day and into the night. I hesitated to mention this program here because technically it is an online program. But it resides on my computer, so I am classifying it as a local program. It is interesting that all three of my most used programs as for communication. I must do a bit of that.
I find this to be a hugely useful program for keeping all kinds of notes to myself and copying websites and many other uses.
I am not sure what comes next, I think there is pretty much a tie for the next few programs.
Adobe Photoshop CS6
I doubt that there is a day that goes by that I am working on my computer that I do not use Photoshop. The current version CS6 is much better than previous versions. I really like the program and enjoy editing photos. Photoshop includes Adobe Bridge and Camera Raw. I am including their use in with Photoshop
Microsoft Word
This is probably one of the most used programs that I do not really like all that well. Microsoft has managed to add so many features to the program as to make it almost impossible to use. I use it in a real basic way and do a minimum of formatting. I am fully aware of alternatives, but I like PowerPoint and Excel, even though I don't use them all that often and so I have Microsoft Office for the Mac 2011.
This Apple program is my calendar and I have it synced with my iPhone. I think I could understand how to use it somewhat better than I do now.
Remote Desktop Connection
I used to use this more frequently when I was working remotely from my office, but I still use this program to enter time and respond to emails from my office computer.
This is a screen grabber program that I use constantly.
Now I do use various genealogy programs but in keeping with my policy not to endorse one over an other, I do not mention them by name. Next I will talk about the online programs I use most frequently. Some of those programs might also be considered to be local, but I will separate them from local by their nature.
Monday, May 21, 2012
What software do I use the most?
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Caverject (alprostadil) Prices, Discount Comparisons & Savings Options
Caverject (alprostadil) 40 MCG discount prices start at . Before you buy caverject, compare the lowest discounted caverject prices at U.S. Pharmacies.
There are currently no PharmacyChecker-verified pharmacies shipping refrigerated products internationally to patients in the U.S. We hope Canadian pharmacies will supply refrigerated medications, such as insulin, to U.S. customers with a valid prescription in the near future.
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For more information, please see our policy outline: PharmacyChecker Verification Program Policies.
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It will be awesome.
Back on Monday!
Lori Anderson creates jewelry and bead kits as well as collaborative mixed media art with her son, Zack. Visit her shops by clicking on the right side bar of this blog (please and thank you!). She is also the creator of the Bead Soup Blog Party® and author of the book "Bead Soup" via Kalmbach Publishing.


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NK Cross Country 9-25-2010
Feel free to use any of these images for personal or School use. Click on any of the images to see the larger version. The larger the image file the better the resolution. You can choose the "O" at the top of the screen, then save this full size file to print. You can also right click and save to desktop, it makes a nice desktop background.Read More


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Baltimore County schools to spend $4M to beef up security
Money will purchase high-tech equipment to keep schools safer
Baltimore County is expected to spend almost $4 million to beef up school security. In a plan announced Tuesday, the money will go toward buying a lot of high-tech equipment.
School officials said the recent Connecticut school shooting and the first day of school shooting at Perry Hall High School caused them to speed up plans to try and make buildings more secure.
Most of the new security dollars will be spent in Baltimore County elementary and special education schools. The plan is to replace outdated cameras and visitor-video surveillance systems.
The county will also equip school resource police officers with mobile tablets to monitor video throughout the district. This new technology will allow police to survey an entire campus by way of streaming video.
"We have not greater responsibility as leaders than to protect our children when they go to school each and every day," Baltimore County Executive Kevin Kamenetz said.
The county executive said his police chief and the school superintendent have been working on the plan for months.
"Everybody recognizes that this is right time again to take a fresh new look at the issue. What else can we do? What else is reasonable?" Baltimore County Police Chief Jim Johnson said.
The plan comes more than six months after the Perry Hall shooting, which took place on the first day of school, and the first few months on the job for the county's new school superintendent. He supports the extra spending but said he's not relying on technology alone.
"Every single day in Baltimore County Public Schools there is an incident that we prevent because we have a system in place where kids will share incidents with us, as school administrators, where we have teachers who will share with school administrators," Baltimore County Schools Superintendent Dr. Dallas Dance said.
Baltimore County parents said they welcome the new high-tech changes.
"I think the more security we can have in our schools, the more protection we have for our kids, all the better," parent Rebecca Kliman said.
The county said a phase two security plan will be announced in the next couple of months. It'll set aside money for mental health services and hiring new employees.
The police chief said school staff will be trained on how to react to an active shooter. The county council is set to approve the school security money by early next week. The new equipment could be in schools by the fall.


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RC419. EWS YELLOW 14ml Acrylic Pots A water-based acrylic paint with a matt finish. This is a range of popular railway colours developed to suit the many variations on the UK rail network. These paints are also ideally suited for weathering, dry-brushing and re-touching, taking your model railway hobby to a new level.


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This week's Agents of S.H.I.E.L.D. proves that a full-on Marvel Cinematic Universe crossover can not only work and be fun, but that effects-heavy superheroics can be scaled-down to a television budget while still remaining believable. More so, Coulson (Clark Gregg) decides to go after the heart of S.H.I.E.L.D.
In this week's episode, "Yes Men," written by Shalisha Francis, Lorelei (Elena Satine) continues her plans to build an army and take over the world, while Lady Sif (Jaimie Alexander) travels from Asgard to Earth, to recapture her escaped prisoner. When Ward (Brett Dalton) falls under Lorelei's spell, and Fitz is coaxed to "not muck her plans", Coulson calls upon his femme fatales to help Lady Sif quiet the man-eater. Elsewhere, Agent Sitwell (Maximiliano Hernández) is mocked, and Nick Fury (Samuel L. Jackson) is put in the crosshairs.
There are quite a few interesting developments that occur within this episode. The success of Lady Sif's inclusion is clearly the most apparent; however, the subtle nudges many of the characters receive while involved in this adventure will likely be the most important, long-term. Skye (Chloe Bennet) and Ward show that a one-off, awkward whisper conversation can reveal a bit of range we've not seen from them before; Fitz (Iain De Caestecker) proves he can absolutely stand on his own, comedically-speaking; Melinda May (Ming-Na Wen) wins every battle – including fighting her way out of her relationship with Ward; and Agent Phillip Coulson draws a line in the sand and goes after Fury.
Coulson taking on Fury might be most interesting, as it allows Coulson to create a logical divide between the theatrical universe and its television counter-part. Now there's a real reason for the team to be somewhat distant from the rest of the group, and now any appearance from Fury – or even Sitwell – will bring with it the promise of a confrontation – not just the quarterly "Hey, we still exist in the same world" check-in we've seen previously. Additionally, it plants the seeds of S.H.I.E.L.D shenanigans, which Captain American: The Winter Solider will play into upon its release.
As for the actual tale at hand, Lady Sif and Lorelei help bring some of the fun that the show promised from the start. The story may not be as compelling as the inner-workerings of S.H.I.E.L.D. that "The Hub" brought, but as a "do over" of sorts for the previous Thor: The Dark World tie-in, fans should be more-than pleased with how successful this crossover is. Asgardian powers work just as well on the small screen as they do in the films, and when the budget to allow Lady Sif and Lorelei to realistically punch through anything ran out, they relied on established knowledge to help sidestep their limitations: S.H.I.E.L.D. has developed Asgardian-proof items before.
Agents of S.H.I.E.L.D. has clearly been attempting to find itself throughout its many episodes, and this is really the first time that this experimental synergistic universe can truly be called successful. Sure, the helping hand of a theatrical voice does make things a bit easier; however, they made good use of Sif's inclusion and earnestly attempted to include some actual character development. Whether or not this continues still remains to be seen, but Coulson's newfound "uprising" will certainly give them something to play off of.
Anthony Ocasio blogs at Screen Rant.


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BioChef Savana 6/9/12 Tray Mesh Sheet - Packs
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So, Ciera and I have moved back to NOLA… Here is a 10 minute video we made on our way down. Hope yall enjoy it, tell me what you think.
Shot on Canon 5DMK3 and GoPro Hero HD
So, Ciera and I have moved back to NOLA… Here is a 10 minute video we made on our way down. Hope yall enjoy it, tell me what you think.
Shot on Canon 5DMK3 and GoPro Hero HD
It's been a long, eventful summer. After the Celtics laid an egg in Game 7, I hopped in my '94 Nissan pickup and headed north. 1800 miles later and after a brief pit stop on Martha's Vineyard, I pulled into the dirt driveway of our family's house on Cross Point Rd. The next 5 weeks would be spent living on my pop's 27 foot sailboat, working on our property for some cash, and a whole lotta nothin much…
During six months of Federal Unemployment, I realized one thing. Being broke sucks. So I did what any red-blooded 25-year-old would do, got drunk… No seriously, I started thinking of greener grass, the other side, and all that nonsense. I began to think about moving back East, and soon had decided that Boston was the answer. So I popped open the Mactop and got to looking for work in BOS. In a stroke of luck I hit on a listing that seemed perfect, inquired, and had an interview within 24 hours.
After the interview (and another pit stop to the Vineyard) my girl and I packed up the truck and headed back to NOLA. A few days later, all I could do was think about moving. Mentally I was already living in Boston.
A week later the phone rang. I got the job! I could hardly believe the words as I told pop and my boys. In two weeks I would be living in Boston working a steady job. I didn't waste any time. Three days later the truck was packed (for the 3rd time this summer), the tank was full, and I was gone…
Once in New England I stopped to see the folks, but within the week I moved into a sublet in Jamaica Plain. I took a few days to learn my route on the Orange line and find the nearest liquor store ("packy" up here). After getting settled (and another trip to the island), I started work at Simply Interactive Inc on Newbury St.
I've been here a month now, and I'm loving every minute of it. I miss my southern city and all my friends, but its only bye for now… The girlie is movin up in 2 months!
Whatch out yall, Boston's got a new photographer!


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Is Your Child Sick?
Medical Library
What is hypothyroidism?
What causes hypothyroidism?
Who gets hypothyroidism?
How does hypothyroidism cause disease?
What are the common findings?
How is hypothyroidism diagnosed?
How is hypothyroidism treated?
What are the complications?
How can hypothyroidism be prevented?
What research is being done?
Links to other information
Thomas P. Foley, Jr., M.D.
Professor of Pediatrics
School of Medicine
Professor of Epidemiology
Graduate School of Public Health
University of Pittsburgh
Children's Hospital of Pittsburgh
Pittsburgh, PA
Hypothyroidism is a deficiency in thyroid hormone secretion and a reduction of action of its hormones on the cells of the body. In children, there are two forms: (1) congenital hypothyroidism, present at birth; and (2) acquired hypothyroidism, a disease with an onset at any time after birth, usually after six months of age. In each of these two forms, there are two categories: (1) primary hypothyroidism, a failure of secretion by a damaged, defective, or absent thyroid gland; and (2) hypothalamic/pituitary hypothyroidism, a failure of the mechanism that stimulates the thyroid gland from the base of the brain, called the hypothalamus and the pituitary gland.
The thyroid hormones are called thyroxine, or T4, and triiodothyronine, or T3. The pituitary hormone that stimulates the thyroid gland is called thyroid stimulating hormone, or TSH.
In most cases, the cause of congenital hypothyroidism is not known. A few cases of inherited hypothyroidism are caused by mutations in the genes producing specific proteins (known as enzymes) that are required to make thyroid hormones. These mutations are inherited as autosomal recessive traits, i.e., the parents are unaffected, and the child is affected because the child receives a mutation from each parent. The parents have a one-in-four chance of having an affected child. Occasionally, a maternal disease or a medication can interfere with the thyroid gland of the unborn child. In certain areas of the world, a dietary lack of iodine causes hypothyroidism.
Most cases of acquired hypothyroidism are caused by autoimmune thyroiditis, a self-inflicted destruction of the thyroid by the body's immune system. The processes that cause this condition are poorly understood. An inappropriate immune response is directed against the thyroid; the body does not recognize its own thyroid gland and generates an immune response against the normal thyroid cells to cause inflammation, irritation, or damage. Infrequently, surgical removal of the thyroid, certain medications or chemicals, or damage by radiation treatment for cancer may cause hypothyroidism.
In most cases, congenital hypothyroidism is sporadic. It occurs worldwide, once in every 4,000 newborn infants, and affects girls twice as often as boys. In the inherited forms, an equal number of males and females are affected. An infant born to a mother with iodine deficiency, or an infant receiving, or exposed to a mother given, excessive amounts of iodine for antiseptic reasons may have hypothyroidism. The problem will continue until exposure to deficient or excessive iodine is corrected.
The majority of cases of acquired hypothyroidism occur in females with autoimmune diseases. It may occur: (1) as autoimmune thyroid disease only; (2) in association with other autoimmune diseases, such as insulin-dependent diabetes mellitus, alopecia (hair loss), rheumatoid arthritis, and lupus erythematous; or (3) in association with other diseases, such as Down syndrome and Turner's syndrome.
Thyroid hormones regulate metabolism, i.e., the amount of energy that is available for body functions. The production of proteins, especially those called enzymes, is controlled by thyroid hormones. They regulate how much sugar is converted to energy, how much protein is converted into muscle, and how much fat is stored and available for energy. From early in fetal life through two to three years of age, thyroid hormones acquired from the mother and those produced by the unborn child in the second and third trimesters of pregnancy are essential for normal brain development.
The common findings of hypothyroidism are summarized in the table. The appearance of a specific symptom and sign depends upon the age when hypothyroidism develops and its severity. Often, the findings in a child may not be obvious to the parents or the physician.
Table. Common findings of hypothyroidism.
Congenital hypothyroidism
Acquired hypothyroidism
Findings during first two weeks of life - Prolonged yellow jaundice - Swelling of the eyelids, hands, and feet - Gestation more than 42 weeks - Birth weight more than 4 kg - Poor feeding - Low body temperature - An enlarged, swollen abdomen - Large midline fontanelles Findings beyond age one month - Darkening and mottling of the skin - Stressful, frequent, and labored breathing - Failure to gain weight; poor sucking ability - Decreased stool frequency - Decreased activity and lethargy Findings after age three months - Swollen and protuberant umbilicus - Infrequent and hard stools - Dry skin with yellow coloration - Large tongue - Generalized swelling - Hoarse cry
Findings between six months and three years - Deceleration of linear growth - Coarse facial features - Dry skin with yellow coloration - Hoarse cry and large tongue - Swollen and protuberant umbilicus - Enlargement of the arm and leg muscles Findings during childhood - Slow growth and short stature - Delay in eruption of teeth and in shedding primary teeth - Muscle weakness; enlargement of the arm and leg muscles - Infrequent and hard stools - Dry skin with yellow coloration - Generalized swelling - Early sexual development Findings during adolescence - Late onset of puberty - Slow growth and short stature - Delay in eruption of teeth and in shedding primary teeth - Infrequent and hard stools - Dry skin with yellow coloration - Discharge from the breasts (in girls) - Generalized swelling
For newborns in many areas of the world, there are routine, mandated screening programs for congenital hypothyroidism. An elevated TSH on the newborn screening test requires that a repeat TSH test be performed. Other tests are performed to define the cause (inherited or sporadic) and the severity of hypothyroidism. In older infants and children, hypothyroidism is suspected by: (1) the presence of a large thyroid gland, or goiter, on examination of the neck; (2) a failure to maintain a normal rate of growth in height; (3) the symptoms and signs of hypothyroidism (see table); (4) a suspicion of it because members of the family have thyroid diseases; or (5) a routine screening for TSH in children at increased risk for hypothyroidism.
Hypothyroidism is diagnosed by blood tests for TSH and free T4. An elevated TSH is the most sensitive test for thyroid gland failure. A low free T4 is the diagnostic test for hypothalamic/pituitary hypothyroidism, and, usually, it is low in primary hypothyroidism, except in mild cases. Typically, the cause of thyroid gland failure is autoimmune thyroiditis, which is diagnosed by finding thyroid antibodies from a blood test. When the TSH value is increased and the T4 value is decreased, treatment with thyroxine is started. Thyroxine treatment usually is started when the TSH value is increased, yet the T4 value still is normal, as long as the cause of hypothyroidism is known.
In patients with hypothalamic/pituitary hypothyroidism, there usually are other pituitary hormone deficiencies, such as low levels of growth hormone (when the patient is subjected to growth hormone secretion tests); low levels of the sex hormones at the pubertal ages; and, less often, low levels of hydrocortisone and high levels of prolactin, which is the pituitary hormone that stimulates the secretion of milk in the mother after delivery.
Treatment for hypothyroidism is easy and inexpensive. Typically, levothyroxine (L-thyroxine) is prescribed, and the tablets should be given at least 30 minutes before a meal or infant feeding. The daily dose per body weight steadily decreases from early infancy to childhood to an adult dose in adolescence. Treatment must be individualized; the amount that is absorbed and handled by the body differs among individuals. Careful monitoring of blood tests (TSH and free T4 or T4) until the values are normal, and then annually after three years of age once the tests become normal, is essential for optimal management.
There are no complications from L-thyroxine treatment when the proper dose is taken and the blood tests are monitored on a regular basis. There are complications associated with unrecognized or inadequately treated hypothyroidism, and the worst outcome occurs if treatment is delayed in early infancy. Severe hypothyroidism before birth, and a delay of treatment after birth, is associated with an impaired intellect (as determined by IQ tests) and other neuropsychological abnormalities. After two or three years of age, there are adverse effects of untreated hypothyroidism; however, in most cases, they are reversible with adequate treatment.
Usually, if hypothyroidism is not adequately treated within approximately the first 6 to 12 months after its onset, a decrease in the rate of growth and, in many instances, shortness of stature occur. If prolonged into the adolescent years, the final adult height may be less than expected despite appropriate treatment. Prolonged hypothyroidism also is associated with high levels of cholesterol, slowing of mental function and school performance, an occasional episode of hip or knee pain from a slippage of the growth center of the hips (usually requires surgical intervention), and chronic constipation. Except for the normalization in growth, these abnormalities should disappear with appropriate treatment.
Hypothyroidism cannot be prevented unless it is caused by a nutritional deficiency of iodine; excessive iodine intake; certain drugs, like lithium, that block the ability of the thyroid gland to produce thyroid hormones; or drugs that impair the absorption of thyroxine in those individuals who are taking it for hypothyroidism. If taken with thyroxine, iron medications and high fiber in food will prevent the absorption of thyroxine. Calcium tablets also may interfere with its absorption.
In congenital hypothyroidism, research is being focused on the mutations that cause the familial thyroid disorders, the cause(s) of the sporadic disease, and the effects of maternal hypothyroidism on the unborn child. There is considerable interest in discovering the mechanisms that cause autoimmune diseases, with a focus on autoimmune thyroid diseases, the occurrence of diabetes mellitus in specific families with autoimmune thyroid diseases, and an understanding of those antibodies that injure thyroid cells and other antibodies that bind to and block the TSH receptor.
Familial Thyroid Diseases Including Hypothyroidism
Vassart G, Dumont JE, Refetoff S. Thyroid disorders. In: Scriver CR, Beaudet AL, Sly WS, Valle D, eds. The Metabolic and Molecular Bases of Inherited Disease. New York: McGraw-Hill, 1995:2883-2928.
Fisher DA. Management of congenital hypothyroidism. J Clin Endocrinol Metab 1991;72:523.
Foley TP Jr. Congenital hypothyroidism. In: Braverman LE, Utiger RD, eds. Werner and Ingbar's The Thyroid. 8th ed. Philadelphia: Lippincott-Raven, 2000:chap 82, part B, 977-983.
Foley TP Jr. Acquired hypothyroidism in infants, children and adolescents. In: Braverman LE, Utiger RD, eds. Werner and Ingbar's The Thyroid. 8th ed. Philadelphia: Lippincott-Raven, 2000:chap 82, part C, 983-988.
Foley TP Jr. Hypothyroidism. In: Hoekelman RA, Friedman SB, Nelson NM, Seidel HM, Weitzman M, eds. Primary Pediatric Care. 4th ed. St. Louis: Mosby-Year Book, Inc., 2000:chap 218. In press.
LaFranchi S, Dussault JH, Fisher DA, Foley TP Jr, Mitchell ML. Newborn screening for congenital hypothyroidism: recommended guidelines. Pediatrics 1993;91:1203-1209.
About the Author
Thomas P. Foley, Jr. MD is Professor of Pediatrics in the School of Medicine and Professor of Epidemiology in the Graduate School of Public Health at the University of Pittsburgh and a member of the Medical Staff of the Children's Hospital of Pittsburgh since 1971. Areas of scientific interest include (1) pediatric thyroidology with specific interests in congenital hypothyroidism, acquired hypothyroidism, hyperthyroidism and thyroid cancer; (2) auxology; and (3) international pediatrics with specific interests in radiation-induced thyroid cancer associated with the Chernobyl accident, autoimmune thyroid diseases, iodine deficiency disorders, newborn screening, toxicology and the effects of maternal hypothyroidism on fetal development. My personal interests are my family (wife, son and step-children), music (opera, classical music and traditional bluegrass music as lead vocal and guitar for The Allegheny River Boys, Revonah RS-506, 1978), sports (spectator and participant) and humanitarian assistance for children and child health through Child Health International.
Copyright 2012 Thomas P. Foley, Jr., M.D., All Rights Reserved
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