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Using 5-Aminolevulinic Acid and Pulsed Dye Laser for Photodynamic Treatment of Oral Leukoplakia
19/01/2017 | Tags:
Laser for Photodynamic,
Objective To determine the safety and efficacy of photodynamic therapy in the treatment of oral leukoplakia with 5-aminolevulinic acid and pulsed dye laser.
Design Nonrandomized, single-arm, single-site phase 1/2 pilot study.
Setting Academic referral center.
Patients A total of 23 patients, aged 37 to 79 years, having a confirmed diagnosis of leukoplakia with or without dysplasia measuring at least 10 mm in diameter.
Interventions Application of 5-aminolevulinic acid to lesions followed by activation with high-power 585-nm pulsed dye laser.
Main Outcome Measures Maximum tolerated dose of laser, postprocedure complications, objective response to treatment, and immunohistochemical changes in treated tissue.
Results No significant adverse events occurred; minor local adverse effects were observed during and following photodynamic therapy in the safety phase of the study. The maximum tolerated dose was 8 J/cm2. Of 17 patients, 7 (41%) had more than 75% regression (significant response) and 9 (53%) had more than 25% regression (partial response), for an overall response rate of 94% at 90 days. This response rate was far higher than the null-hypothesis 20% rate (P < 10−10) and the alternative-hypothesis 50% rate (P = .0001) for which the study was powered. When compared with baseline levels immunohistochemically, p53 expression was increased in 8 of 11 available samples (73%) and Ki-67 expression was decreased in 7 of 12 available samples (58%).
Conclusions Photodynamic therapy with 5-aminolevulinic acid and pulsed dye laser could be used to achieve regression of oral leukoplakia. The treatment is safe and well tolerated. An application time of 1.5 hours and laser radiant exposure of 8 J/cm2 with 1.5-ms pulse time were found to be the optimal settings in this study. The high-power laser used in this study allows completion of laser therapy within 1 to 3 minutes. Further studies are necessary to determine the optimal laser radiant exposure and drug application to maximize the response rate.
Trial Registration clinicaltrials.gov Identifier: NCT00571974
Oral leukoplakia (OL) can be a precursor lesion to oral cavity cancer.1 Currently, the conventional care options for premalignant lesions in the oral cavity and oropharynx are observation, laser ablation,2,3 or aggressive surgical resection. Topical treatments have been attempted to achieve regression of the lesions, including vitamin A (isotretinoin),4 bleomycin sulfate,5 and fenretinide.6 These agents have had varying degrees of success, but none has led to a satisfactory treatment for OL. Surgical resection has been shown1 to be curative, but it is an aggressive intervention associated with significant morbidity when used for large lesions.
Recent clinical pilot studies in Asia7 and Europe8 have shown that photodynamic therapy (PDT) with topical application of 5-aminolevulinic acid (5-ALA) is an effective treatment modality to achieve regression of OL and erythroplakia. 5-Aminolevulinic acid is a metabolite of the heme biosynthesis pathway, which is taken up actively and to a greater extent in tumor cells than in normal cells.9 The agent can be applied topically, and it penetrates well into the skin within 1 to 3 hours.10 The application of 5-ALA to the tissue leads to an accumulation of protoporphyrin IX (PPIX) in the cells. Protoporphyrin IX absorbs light in the visible range (400-700 nm) with distinct 10-nm-wide absorption peaks at wavelengths of 410, 500, 532, 585, and 635 nm. When illuminated with high-energy external light (ie, >4 J/cm2) with a wavelength at either of the absorption peaks, PPIX undergoes a chemical reaction that produces singlet oxygen and other free radicals that are cytotoxic to cells and vessels.
Chen et al7 used a twice-weekly PDT regimen with 5-ALA and a 635-nm light-emitting diode to treat OL in 24 patients. Before administration of PDT, 5-ALA, 20%, was topically applied for 1.5 hours. The optimal application time was determined via fluorescence diagnosis (FD). The maximal fluorescence intensity of the PPIX excited at 410 nm correlates to the maximum PPIX level in the lesional cells. Each lesion was treated repeatedly in 8 sessions separated by 6 to 8 weeks. In each treatment session, the lesions were irradiated with a power density of 100 mW/cm2 for 1000 seconds to a total dose of 100 J/cm2 per treatment. The investigators achieved complete response in 8 patients (33%) and partial response in 16 patients (67%) by the eighth treatment session. Sieroń et al8 treated 24 OL lesions in 12 patients using 6 to 8 treatment sessions separated by 2 weeks with PDT at 635 nm delivered by argon-pumped dye laser with a power density of 150 mW/cm2 for 11 minutes to a total dose of 100 J/cm2. They achieved complete response in 10 patients vs no response in the remaining 2 patients.
In the United States, 5-ALA (Levulan Kerastick; DUSA Pharmaceuticals, Inc, Valhalla, New York) is approved by the Food and Drug Administration to be used in conjunction with a blue light illumination (BLU-U) system for the treatment of actinic keratoses.11 The illumination system consists of a large concave lamp designed to illuminate large areas, such as the face and scalp. The lamp is placed over the patient's head and illuminates 0.01 W/cm2 to the targeted region for 1000 seconds (16 minutes 40 seconds) to provide a 10-J/cm2 light dose. During this light treatment, the patients and medical personnel are provided with blue-blocking protective eyewear. The illumination system cannot be used as an intraoral light source.
In this study, a clinical pulsed dye laser (PDL) (ScleroPLUS; Candela Corp, Wayland, Massachusetts) was used for lesional illumination. This laser can deliver up to 12 000 W/cm2 of 585-nm light wavelength (fourth absorption peak of the PPIX) through an optical fiber, with radiant exposures that can vary from 6 to 18 J/cm2 in 1.5-ms pulse time. Photodynamic therapy using 5-ALA with a 585-nm PDL has been used to treat skin lesions12- 14 as well as Bowen disease15 and laryngeal keratosis with atypia16 in pilot studies; it has never been used to treat OL.
In this article, we report the results of a combined phase 1/2 nonrandomized prospective study that was designed to determine the safety and assess the clinical efficacy of PDT in the treatment of OL with 5-ALA and 585-nm PDL with a 1.5-ms pulse time. In the first part of the study, we determined the maximum tolerated dose (MTD) of the PDL radiant exposure in combination with 5-ALA. In the second phase of the study, this dose was used to treat patients with the MTD to determine the efficacy of the treatment by documenting the regression of the treated lesions.
This prospective, nonrandomized, single-arm, single-site phase 1/2 pilot study was conducted at the Department of Otolaryngology Head and Neck Surgery at the University of Arkansas for Medical Sciences under investigational new drug number 73269. The study was approved by the University of Arkansas for Medical Sciences institutional review board. Candidates were identified in the head and neck oncology clinic. Patients with at least 1 grossly visible leukoplakia lesion, with or without dysplasia, measuring 10 mm or more in diameter were included in this study. The exclusion criteria included sensitivity to porphyrins or photoactive medications or invasive carcinoma of the lesion as demonstrated by biopsy. Twenty-eight patients were enrolled in the study between January 1, 2007, and November 18, 2009. During the study, 4 patients did not meet inclusion criteria or were disqualified secondary to meeting exclusion criteria, and 1 patient was removed from the study because of nonadherence. In phase 1, 3 cohorts, each including 3 patients, were enrolled. Five participants were women and 4 were men, aged 50 to 79 years (mean, 61.8 years). In phase 2 of the study, 11 men and 6 women aged 37 to 79 years (mean, 62.6 years) were enrolled. Included in phase 2 were the 3 patients from phase 1 who received the MTD. Photodynamic therapy was performed in the outpatient head and neck cancer clinic at the University of Arkansas for Medical Sciences. The patients were seen at 30, 90, and 365 days after therapy.
dental laser tips
At screening, or 60 days before therapy, 3-mm punch biopsy specimens were obtained from the center of the lesion with the patient under local anesthesia. Lesions determined by pathologic examination to be invasive carcinoma or carcinoma in situ were excluded from the study and treated with surgical intervention. Baseline documentation of the area of leukoplakia was performed by standardized digital photography immediately before PDT.
Initially, 5-ALA was applied to the lesions topically. Before each treatment, the 5-ALA product containing 345 mg of active 5-ALA in 1.5 mL of solution was used to create a 5-ALA, 20%, solution. The 5-ALA solution then was dissolved onto gauze, and the saturated gauze was placed against the lesion. If the lesion was on the palate, a customized temporary dental prosthesis was used (Figure 1). The 5-ALA solution was topically applied for 1.5 hours. Application of 5-ALA in some patients proved to be difficult secondary to dilution by saliva as well as difficulty maintaining positioning. Hence, in the last 6 patients, an equivalent dose of 5-ALA was administered by intralesional injection to optimize the bioavailability of the drug; the remaining methods were identical in these participants.
Fluorescence diagnosis was used to confirm that the 5-ALA was absorbed and converted into PPIX after application (Figure 2). The lesion was photographed before and after drug application with an FD camera (Dyaderm; Biocam GmbH, Regensburg, Germany). This imaging technique has been described and validated.10 Briefly, the photographic system is a portable passive device consisting of a highly sensitive digital camera and light-emitting diode array that emits low-power (0.85-mW/cm2) light with a 405-nm wavelength. The camera system superimposes side-by-side display of fluorescent and color images in real time under normal room light conditions.
A PDL that emits light with a 585-nm wavelength in pulses of 1.5 ms was used. Initially, a single laser pulse was delivered to assess the level of pain. If the patients reported that the pain was intolerable, local anesthesia was administered. The entire area of the lesion was treated with 1.5-ms pulses delivered at intervals of 1 to 3 seconds. Routinely, the laser treatment was completed within minutes and the patients were immediately released.
Phototoxic effects and adverse events were evaluated in the clinic within 48 hours after treatment. Additional clinical evaluations were conducted 30 and 90 days after treatments. At the 90-day follow up visit, a 3-mm punch biopsy specimen was taken from the center of the lesion and a sample of healthy mucosa was obtained from a distant normal-appearing site within the oral cavity. The response was determined by examination by an experienced head and neck surgeon (E.V., B.C.S., or J.Y.S.) and classified as follows: significant response, more than 75% resolution of the lesion; partial response, reduction of at least 25%; and no response, reduction by less than 25%.
All biopsy specimens taken before and after 5-ALA and PDT treatment from both the lesion and adjacent grossly normal mucosa were evaluated for morphologic evidence of tissue damage. The biopsied tissues were submitted for routine pathologic diagnosis. The tissue was processed, embedded in paraffin, sectioned, and stained with hematoxylin-eosin for routine examination. Additional slides were evaluated
dental laser
immunohistochemically using monoclonal antibodies against p53 and Ki-67 (Zymed Laboratory, Inc, San Francisco, California). An experienced head and neck surgical pathologist (C.-Y.F.) examined all the slides. Expression in p53 and Ki-67 markers was evaluated by pathologic scoring, using a scale of 0 (negative) to 3 (strongly positive). Slides of samples taken before and after treatment were stained at the same time. Breast carcinoma was used as a positive control for p53 and Ki-67 markers. As demonstrated in previous studies, p53 is a marker for the apoptosis pathway and Ki-67 is a marker for cellular proliferation.17 Hence, it would be expected that, after the PDT, the p53 staining of the lesions would increase and Ki-67 staining would decrease.
The objective of this study was to determine the safety and efficacy of PDT in the treatment of OL with 5-ALA and pulsed PDL. Phase 1 of the study used the traditional 3 + 3 dose escalation design.18 Three cohorts, each with 3 patients, were enrolled and treated with escalating radiant exposures (laser doses) of 6, 7, or 8 J/cm2. In each cohort, the number of dose-limiting toxic effects was observed. Dose escalation rules were the same as those provided by Storer.18 The highest radiant light dose attained that did not produce 2 or more dose-limiting toxic effects was declared to be the MTD. Patients from phase 1 who were treated at the MTD were considered a part of phase 2.
In phase 2 of the study, all patients were treated with the MTD. This part of the study used a Simon 2-stage minimax design, with 9 patients in the first stage and 8 in the second stage, yielding 17 participants overall. The primary efficacy end point was objective response (significant + partial response) determined at 90 days. This design's early termination rule was 3 or fewer of 9 responses in the first stage, and its success criterion was 7 or more of 17 responses overall. This design had 80% power at 5% α to distinguish an efficacious 50% response rate from a null-hypothesis 20% response rate.
We originally planned to use the 1-sided exact binomial test to compare the observed response rate with the 20% rate envisioned under the original null hypothesis. Because all but 1 patient responded to treatment within 90 days, a second comparison was added in which the 1-sided exact binomial test was used to determine whether the observed response rate was significantly higher than the 50% rate originally envisioned under the alternative hypothesis. The Fisher exact test was used to determine whether the proportion of patients specifically attaining significant response differed between the first 11 patients who received topical 5-ALA and the last 6 patients who received injected 5-ALA.
The 5-ALA and 585-nm PDL therapy was safe in treating OL. No major adverse events occurred during the study; minor adverse effects encountered during treatment included sensitivity, pain, swelling, burning sensation, taste alteration, ulceration, and loss of sensation. These all occurred at the local area of treatment. Most had resolved by the 90-day follow-up, and all had resolved by the 365-day follow-up. The highest laser radiant exposure dose of 8 J/cm2 produced acceptable levels of phototoxic effects and adverse events. This radiant exposure was declared to be the MTD, and all patients in phase 2 of the study were treated with this radiant exposure. Results of phase 1 of the study are given in Table 1.
Of the 17 patients with OL treated with 5-ALA plus PDT, 7 patients (41%) achieved significant response (Figure 3), 9 patients (53%) showed partial response (Figure 4), and 1 patient (6%) showed no response (Table 2). The objective response rate was 16 of 17 patients (94%), which not only was far higher than the study's null-hypothesis rate of 20% (exact binomial P < 10−10) but also was significantly higher than the study's alternative-hypothesis rate of 50% (exact binomial P = .0001). A comparison was drawn to look specifically for an imbalance in significant response between patients who had topical application vs injection of 5-ALA. Five of 11 patients (45%) who received 5-ALA had a significant response compared with 3 of 6 patients (50%) who received injected 5-ALA (Fisher exact test, P = 1.00). Immunohistochemically, when compared with baseline levels, p53 expression increased in 8 of 11 patients (73%) and Ki-67 expression decreased in 7 of 12 patients (58%) with available samples (Table 3). A correlation could not be found between response of the lesion and degree of dysplasia.
Our findings support the notion that PDT with 5-ALA and 585-nm PDL is safe for treatment of OL with radiant exposures of 6 to 8 J/cm2 delivered in 1.5-ms pulses and 7-mm-diameter spot size. These results are in agreement with those of Karrer et al,12 who used a similar PDL system (ScleroLaser; Candela Corp) to deliver 585-nm light in 1.5-ms pulse and radiant exposure of 18 J/cm2 for the treatment of actinic keratoses. The short laser illumination time (1.5 ms) may have also contributed to the relatively moderate pain that was reported in the present study and that was also reported by Karrer et al. The mean (SD) pain level on a 10-point scale in their study was 3.2 (1) during 5-ALA PDT with PDL in comparison with 7.7 (2.3) during the time exposure of incoherent light. In our study, the mean (SD) pain level was 2.7 (1.1) with low laser doses. However, 2 patients reported severe pain (level 8 on a 10-point scale) with the MTD, and thereafter local anesthesia was used by injection of lidocaine, 1%, which was sufficient to alleviate treatment-related pain. Notably, we did not observe photosensitivity in our study, although it is a common adverse effect of PDT.11 We attribute this outcome to the topical and local application of 5-ALA.
The use of a relatively small beam size (7 mm in diameter) required the physicians to constantly reposition the laser beam across the lesion to treat the entire target region. Although this manual scan was quick, it could have resulted in incomplete treatment of the lesion. To overcome this problem in future studies, we plan to attach the laser hand piece to a robotic arm. Of note, we assert that the manual scanning did not cause overtreatment. This assertion is supported by the minimal adverse effects that we observed and by the fact that the laser pulses and cytotoxic action time intervals (1.5 × 10−3 and 0.04 × 10−6 sec) are much shorter than the time between pulses (1-3 seconds).
Photodynamic therapy with 5-ALA and 585-nm PDL was effective in achieving regression of OL, seeing that 8 of the 18 lesions (44%) had a significant response and an additional 9 (50%) had a partial response (Table 2). Only 1 eligible participant had no response to this treatment. These outcomes are comparable to the results reported in other pilot studies7,8 in which topical application of 5-ALA was activated with low-power diode laser. Conversely, in those studies, 6 to 8 sessions and treatment times up to 17 minutes were required to obtain an overall objective response of more than 90%. In our study, we achieved an overall objective response of 94% with 1 or 2 sessions and a laser treatment time of 1 to 3 minutes, thus making PDT with 5-ALA and 585-nm PDL an alternative to the long exposure times and multiple treatments required with the diode laser.
All immunostains for p53 and Ki-67 were performed on OL with or without dysplasia (smoke-related preneoplastic lesions) and adjacent normal-appearing squamous mucosa (nonneoplastic and nondysplastic control) before and after 5-ALA–PDT treatment. The conclusion of increased expression of p53 and decreased expression of Ki-67 in most posttreatment lesions in most samples was made by comparison between leukoplakia lesions and matched nondysplastic control samples from normal-appearing mucosa adjacent to the leukoplakia lesion before and after PDT treatment. Comparison was also made between samples obtained before and after PDT treatment. The expression levels of p53 were low and sporadic in both lesions and the matched control before PDT treatment, indicating that there is no overexpression of mutant p53 in all OL lesions. After PDT treatment, most OL lesions showed significantly increased p53 compared with the same lesions before the treatment as well as with the nondysplastic control (normal-appearing mucosa) taken at the same time after PDT treatment. We speculated that the increased p53 protein expression in these OL lesions is most likely the result of overexpression of wild-type p53 protein, a common cellular response to DNA damage. It is also possible that PDT treatment has induced mutation in the p53 gene, with subsequent overexpression of this mutant protein, even though this scenario is much less likely. In summary, we performed protein expression analysis for p53 and Ki-67 primarily to document the molecular changes in association with clinical responses of these lesions to PDT treatment. Small sample size precludes any meaningful statistical analysis; however, we observed increased p53 expression and decreased Ki-67 expression, which may be directly linked to DNA damage induced by PDT treatment.
An observation made but not measured in our study was that many of the lesions that showed significant regression were thin and superficial. The larger and more hyperkeratotic the lesion, the less of a response obtained. Our hypothesis is that this is likely secondary to the shallow penetration of the PDL (1-1.5 mm). These lesions may require treatment with PDT with a diode laser emitting 635 nm that has deeper penetration than the PDL.
Midway through phase 2 of the study, injection of 5-ALA into the lesion was undertaken to improve the mode of application of the drug. No significant difference was observed between injection and topical application. The use of FD was of some help to determine drug uptake (as shown in Figure 2). However, FD was not useful in determining the response of the lesion to PDT. Immediately after laser therapy, the FD intensity did not change significantly (data not shown).
The efficacy of PDT with short-pulse high-power lasers, such as PDLs, is the subject of an ongoing debate in the literature.19 In a study including 4 consecutive patients, Passeron et al20 found that PDT with 5-ALA using PDL as a light source is not effective in the treatment of acne inversa. Orringer et al14 showed that PDT with topical 5-ALA and PDL may be beneficial in the treatment of inflammatory acne in a subgroup of patients in a randomized, controlled, split-face clinical study. Karrer et al12 demonstrated that, although PDL alone had no therapeutic effects, 5-ALA in conjunction with PDL caused significant regression of actinic keratoses, a result that is in agreement with a study by Alexiades-Armenakas.13 It is safe to assume that data concerning skin lesions are similar to those concerning mucosal lesions, since the absorption of these has been proven to be similar.21 Therefore, although a laser control was not used in our study, it is reasonable to assume that our PDT, which combined 5-ALA with a 585-nm PDL, induced the regression of OL rather than the laser alone. Other pilot studies have shown that 5-ALA in conjunction with PDL is effective in the treatment of laryngeal keratosis with atypia16 and Bowen disease.15 The mechanism that dictates the clinical response of superficial lesions to PDT with PDL is not clear.


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For the past few months, I have had the pleasure of meeting with Doug Harper and a handful of eager scholars to talk etymology, online, in our LEXinars. Doug and I plan and deliver a series of cozy online seminars in which we discuss etymology, cognates, historical roots, historical languages, Proto-Indo-European, reconstruction, attestation, and spelling (okay, that last one is more me than Doug). It's mindblowing. And it's hilarious, as real language study should be. Doug is one smart cookie, and, while this shouldn't surprise me, he has a way with words. So along the way, he says stuff like this:
"The language has mud on it."
"Latin is in its pupa in the Middle Ages."
"Old English is like clay."
"It's like jumping from house to house through the neighborhood looking for a fugitive."
"I've seen seven-year-olds take to it like it's birthday cake."
I can't even write it all down. It's epiphanic. This stuff makes me understand language better, know words more intimately. Doug has spent a lot of time with language, and has the mind to prove it. Not once have I come out of a 90-minute session stupider.
We talk about words and their relationships. We talk about the Online Etymology Dictionary, Doug's website (which could just as easily have been a model railroad or a million-piece puzzle, but we're glad it's not). We read through entries together, clarifying their structure. I've learned that since Doug and I began orbiting each other a few years ago, he has included more Middle English examples in the dictionary's entries, and has given more attention to spelling along the way.
I'm not gonna lie: it feels amazing to be part of this dictionary in this way, to have my thinking affect what ends up on this website that gets millions of hits every month, from all over the world. Not because it means I'm cool, but because "my thinking" is part of a global network of scholars thinking on these questions of word histories and word structures. Not because I have influence, but because the dictionary is an influenceable thing, responsive to evidence, informed by this living scholarship community as well as by the deep, well-researched historical sources Doug mines for the building blocks of his website.
It's so cool.
Longtime readers of this space will recall that I have had several encounters wherein I have challenged something someone — an expert — said about language, and have been met with less-than-enthusiastic responses. The experts responded generally by reasserting their expertise and persisting in their misapprehensions. When I first contacted Doug a few years ago, however, he responded by asserting his non-expertise ("I'm a compiler, not a linguist") and by being responsive to linguistic evidence laid out before him, even when it contradicted the lexicographical status quo. So, you know, that's a genuinely scholarly response, right?
This spring, Doug and I are taking our show on the road. After two years of Etymology! weekend workshops in greater Philadelphia, we'll be offering this third annual event — affectionately dubbed WordStock III — in greater Chicago (Bensenville, to be exact; see the registration information below), March 28-29, 2015. We hope to have — we are planning for — an audience with many new faces as well as seasoned participants.
This year, we'll consider the question of time in etymology and in language itself. We'll look at the past of the field, and at its present realities. We'll consider why Latin cannot be confined to a single layer of English, and how French is unruly enough to have changed over the millennium over which English has borrowed from it. We'll view the present day language as a snapshot, and we'll posit a future both for English and for etymology as a field of study, one in which a global audience and digital connectivity will continue to play a role, and one in which rigor and precision cannot be compromised.
If you look up the name Douglas in the Online Etymology Dictionary, you will learn that it derives from a Gaelic compound meaning 'dark water.' Somehow, this fits my experience, given that it was from a conversation with Doug that I gleaned the phrase "a holler up the well" when referring to the study of word stories. The study of etymology, and Doug himself, are a lot like dark water. Not in a scary way, but in a deep and reflective way.
Okay, maybe a teeny tiny bit scary.
Come and join us.

subset: commoncrawl


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Nov 01, 2016 | ISBN 9780147510167 | Young Adult
Jun 09, 2015 | ISBN 9780803740709 | Young Adult
Now a Morris Award Honor Book, Golden Kite Honor Book, Booklist Editors' Choice, New York Public Library Best Book for Teens, Georgia Peach Book Award Nominee and a Texas TAYSHAS Top Ten Book!
* "In beautiful and harrowing prose, Stephanie Oakes' debut peels back the veneer of fairytales to reveal their inherent darkness."—Booklist, STARRED REVIEW
* "Suspense, dread, and hope intermingle in Oakes's charged, page-turning debut."—Publishers Weekly, STARRED REVIEW
* "A truly thought-provoking and spectacular story." —VOYA, Perfect 10/STARRED REVIEW
"The Scared Lies of Minnow Bly is a psychological thriller, a commentary on our justice system, and a must read book."—Hypable
"A page-turner in the truest form of the phrase."—Bustle
"A profoundly thoughtful and meaningful read…if you care about girls, you should read it. And since everyone should care about girls, everyone should read it."—Teen Librarian Toolbox
"The unravelling of the mystery and the timing of the revelations is masterful, culminating in an explosively rewarding ending. Unflinching, unrelenting and visceral, this one has undeniable adult crossover appeal."—The Globe and Mail
"Based on Grimm's fairy tale, "The Handless Maiden," the powerful, fluent writing; engrossing and well-layered mystery; compelling characters; and provocative ideas about family, faith, honesty, loyalty, and friendship are engaging….Ellen Hopkins devotees and fans of The Chosen One by Carol Lynch Williams will seek this one out."—School Library Journal


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Ah, toddlerhood. The time of climbing, trying to run, and getting into everything. With those new wobbly legs and adventurous feats often come cuts, bruises, bumps, and black eyes.
Heck, my 21-month-old daughter is sporting a nice fat lip right now from going down a slide face first. There is also a bruise on one cheek from a collision with my desk, and another mysterious bruise on the other -- I have no clue where it came from.
I do know the source of most of the things that make her look like a little trouble-maker, but strangers don't, and that sometimes makes us moms worried about what they think. And I think we've all been guilty of wondering if the source of the bruise we see on a child at the playground was from being a typical kid or from abuse.
In some states, many of these bruises in question require caregivers, or even witnesses, to report any suspicions to the police. It's tough to read, but it's important that parents -- all adults -- be aware of signs to look for in abused children.
Extreme behavior
If you see a child who is incredibly shy or scared of strangers, or on the opposite side, one who is pushy and forceful with new strangers, especially if it's a drastic change in behavior, that might be a warning sign that something isn't going right.
Multiple, repetitive, or unexplained serious injuries
It's tough to tell what's normal for toddlers, but if they're constantly injured in the same spots, the same way, have bites or bruises in odd places, or ones that are odd shapes in multiple places, it can be cause for concern Some shapes that indicate abuse include loops like the corner of a clothes hangar, straight lines like a spoon or ruler, bruises on the back or back of legs, or burns on the feet, butt, and back.
Hiding injuries
If a child is dressed in warm clothing (long sleeves, pants) in warm weather and the parent or child refuses to remove it, doesn't want to be touched, or often has bandages in multiple places, or home treatments where a doctor's treatment should have happened, there is cause for concern.
Agitation from the parent
If asking innocent, non-accusatory questions such as, "Have you noticed she's been walking with a little limp?" gets an aggressive or short answer, or if the parent can't/won't explain or act concerned over issues, it may be time to get help.
If you're worried, it's better to call authorities than to wait it out. If you're wrong, nothing should happen to anyone innocent, but if you're right, you may have saved a child's life.
Can you think of other warning signs for parents and ways to discern normal toddler injuries from abusive ones?
Image via iStock.com/vidka


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Image: Courtesy of eOne Films
Writer/Dir: Todd Solondz (Happiness, Storytelling, Welcome to the Dollhouse)
Cast: Shirley Henderson, Michael Kenneth Williams, Allison Janney, Ally Sheedy, Charlotte Rampling, Chris Marquette, Dylan Riley Snyder
Reason to see: The trailer sucked me in every time & the cast is phenomenal.
Life During Wartime is the second film I've seen from Todd Solondz, the first being Storytelling, and I didn't put the two and two together until after viewing. In fact, I was intrigued by the film purely on the power of the trailer so I didn't dive into to research mode and therefore had no idea it was a part-sequel to Happiness, with different actors playing the same characters 10 years later. Retrospectively, I'm not sure would have wanted to see Happiness first and then this sequel-esque film as following the characters on the journey was a rough road, and I'm not sure I could do it for 2 films in a row. I will give that the formidable ensemble cast of Life During Wartime gave us strong and often vulnerable performances throughout the film, and I have to commend them for giving the audience their all.
In terms of theme, tone & story, the film is very dark, which which I had not anticipated. I was expecting quirky and keenly insightful, and although I think those are elements are present, they aren't are the forefront. The theme of forgiveness, especially the need, desire or request for forgiveness are very prominent and I honestly found that very challenging as it kept us with people that had done some pretty awful things. There was also a fair amount of questioning, confusion and vaguenss that felt like seeing the seeds of later dysfuction being sown right before our eyes, all due to the inability or unwillingness to have open conversations. That was tough to watch, especially because it felt so real.
Dark & questioning dramas often don't appeal to me, often because I have optimistic perspective and find it a challenge to stay somewhere so dismal for so long. But with Life During Wartime, I really feel like I was missing something, like I just wasn't 'getting' it. I did feel like it was making a statement, but I'm not sure what statement. Definitely something around forgiveness, and associated with the people who are the creators, recievers and surrounders of 'bad things', but I could feel it was something more. Any time I got a clearer idea of what it could be, I felt like I was misinterpreting. I'm usually quite a fan of seeing dysfunction families in film, but on this one I couldn't quite connect.
DVD Extras:
- Cast & Crew Interviews (20 minutes) Split into 2 sections: The Cast of Life During Wartime (15 minutes) film clips and interview discussing their characters and their trials & tribulations and at time connection to the film Happiness; and The Cast and
- Crew talk about Life During Wartime (5 minutes) film clips an interviews with cast & crew on the characters, their worlds, what the film is about and the possible interpretation or relationship to the characters in Happiness
- B-Roll Footage (3 sections, 33 minutes) Quite lengthy amount of B-roll here, with different selections of from The Crew on Set of Life During Wartime (8 minutes), Actors & Crew on Location (22 minutes) and Puerto Rico (3 minutes).
Shannon's Overall View:
I didn't love it
I might give it another try
I'd recommend it as dark drama
Return to Film Reviews or see more DVD Reviews
© Shannon Ridler, 2011
Paul Rubens as Andy and Shirley Henderson as Joy in Todd Solondz's LIFE DURING WARTIME. Photo credit Francisco Román. Courtesy of eOne Films
Ciaran Hinds as Bill in Todd Solondz's LIFE DURING WARTIME. Photo courtesy of Francisco Román. Courtesy of eOne Films


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Author- Chester Ryan Azurin
Top Contributors - Chester Ryan Azurin, Vidya Acharya, Evan Thomas, Rachael Lowe and Amanda Ager
Diabetes is a metabolic disorder in which the body is unable to appropriately regulate the level of sugar, specifically glucose, in the blood, either by poor sensitivity to the protein insulin, or due to inadequate production of insulin by the pancreas. Type 2 diabetes accounts for 90-95% of all diabetes cases. Diabetes itself is not a high-mortality condition (1.3 million deaths globally), but it is a major risk factor for other causes of death and has a high attributable burden of disability. Diabetes is also a major risk factor for cardiovascular disease, kidney disease and blindness.[1]
Be sure to also read:
Clinically Relevant Anatomy and Pathophysiology
Diabetes Mellitus primarily affects the Islets of Langerhans of the pancreas, where glucagon (from the alpha cells) and insulin (from the beta cells) are produced. Glucagon raises the blood glucose level, while insulin lowers it. In Type 1 DM (Insulin Dependent), the loss of function of the beta cells leads to an absolute insulin deficiency. In Type 2 DM (Non-insulin Dependent), the impaired production and secretion of insulin by the beta cells is concomitant with the impaired ability of the tissues to utilize insulin (termed insulin resistance). The resulting accumulation of glucose in the blood is further elevated by the greater synthesis of glucose in the liver, which releases it to the general circulation.
Prevalence and Incidence
Diabetes Mellitus (both Type 1 and Type 2) is now a global epidemic. Usually correlated with being overweight and obese, a sedentary lifestyle and familial history are also being considered as risk factors.
According to the research entitled "Global Prevalence of Diabetes" by Sarah Wild, MB, BCHIR, PhD, and associates[2], "the total number of people with diabetes is projected to rise from 171 million in 2000 to 366 million in 2030. The prevalence of diabetes is higher in men than women, but there are more women with diabetes than men. The urban population in developing countries is projected to double between 2000 and 2030. The most important demographic change to diabetes prevalence across the world appears to be the increase in the proportion of people greater than 65 years of age."
Diabetes can be categorized as acquired or hereditary. The lack or decrease in exercise, elevated stress levels, and unhealthy diet all predispose an individual to Type 2 Diabetes Mellitus even without a clear family history.
Considered an endocrine disorder, this could also occur in pregnant women during a gestational stage. Susan Y. Chu, PhD, MSPH, and associates[3], in their research entitled "Maternal Obesity and Risk of Gestational Diabetes Mellitus", concluded that "high maternal weight is associated with a substantially higher risk of GDM."
In general, Diabetes Mellitus is a chronic disorder characterized by hyperglycemia or hypoglycemia (or impaired glucose tolerance), with subsequent disruption of the metabolism of carbohydrates, fats and proteins. Over time, it results in serious small and large vessel vascular complications and neuropathies.
Clinical Presentation
Classic triad of Diabetes Mellitus are polydipsia (increased thirst), polyphagia (increased appetite and ingestion), and polyuria (increased urination caused by osmotic diuresis).
Amidst the increased appetite and craving for food, persons with DM (usually Type 1) may still experience weight loss because of the improper fat metabolism and breakdown of fat stores.
Other striking features include the presence of glucose and ketone bodies in the urine. Fatigue with weakness, irritability, blurred vision, numbness or tingling sensations in the hands and feet are also present.
Diagnostic Procedures
Fasting glucose level of greater than 126 mg/dl on two separate occasions is considered positive.
The strictest procedure is according to the World Health Organization, which states that the diagnosis is positive if "venous plasma glucose concentration is greater than 11.1 mmol/L 2 hours after a 75g glucose tolerance test."
The study by Pooja Bhati et al. suggests that biomarkers of inflammation and endothelial function are correlated with Cardiac Vagal Tone and global Heart Rate Variability (HRV), which indicate some pathophysiological link between subclinical inflammation, endothelial dysfunction and cardiac autonomic dysfunction in Type 2 Diabetes Mellitus[4].
For Type 1 (insulin dependent) Diabetes, intramuscular administration of insulin is needed. Dosage is always expressed in USP units. Humalog is the fastest acting insulin, acting within 15 minutes. The PZI has the longest peak of 8-20 hours and has the longest total duration of 36 hours. On the other hand, the Lantus is the only one "without peak" and lasts for 24 hours.
For Type 2 (non-insulin dependent) Diabetes, popular oral hypoglycemics include Metformin and Sulfonylureas. Insulin sensitizers such as Rosiglitazone and Pioglitazone are also prescribed.
Weight management, nutritional and diet counselling combined with physical therapy/exercise prescription completes the holistic treatment approach.
Physiotherapy Management
Therapeutic exercise programs comprise the major aspect of management. Patient education for proper foot care is an essential part of the physical therapy program for diabetic patients.
Exercise Therapy
A sound, individually tailored exercise prescription is a cornerstone in the management of Diabetes Mellitus.
The goal is to address the beyond normal BMI score (25 and above) for overweight and obese patients. Numerous studies show that a regular exercise program for diabetics has a profound effect on the regulation of their blood glucose levels.
From the archives of the Journal of the American Medical Association (JAMA), a research conducted by Daniel Umpierre, MSc and associates[5] entitled "Physical Activity Advice Only or Structured Exercise Training and Association With HbA1C Levels in Type 2 Diabetes, A Systematic Review and Meta-analysis", it was concluded that "structured exercise training that consists of aerobic exercise, resistance training, or both combined is associated with HbA1C reduction in patients with Type 2 diabetes. Structured exercise training of more than 150 minutes per week is associated with greater HbA1C declines than that of 150 minutes or less per week. Physical activity advice is associated with lower HbA1C, but only when combined with dietary advice."
Similarly, a randomized controlled trial by Timothy S. Church, MD, MPH, PhD and associates[6] which was entitled "Effects of Aerobic and Resistance Training on Hemoglobin A1C Levels in Patients With Type 2 Diabetes" made a conclusion that "among patients with Type 2 Diabetes Mellitus, a combination of aerobic and resistance training compared with the non-exercise control group improved HbA1C levels. This was not achieved by aerobic or resistance training alone."
Guidelines for a sound exercise program are as follows:
- Do not exercise if the blood glucose level is less than 100 mg/dl or greater than 250 mg/dl.
- Preferably, exercise indoor instead of outdoor to minimize the risk of integumentary and musculoskeletal trauma, as well as for the patient to have an immediate access to necessary things to address hypoglycemia, hyperglycemia or diabetic ketoacidosis.
- Patients are highly advised to wear the medical tag for diabetics each time they come out of their house to go somewhere else.
- Always have a carbohydrate snack at hand every exercise session. A glass of orange juice or milk is a good pickup for a patient who is experiencing hypoglycemia.
- Exercise in a comfortable temperature. Never exercise in extreme temperatures.
- For Type 1 (Insulin Dependent) patients, never exercise during the peak times of insulin. Collaborate with the nurse in charge for the patient regarding the type of insulin administered.
- Type 2 diabetics are advised to have an average of 30 minutes of exercise duration per session.
- Always wear proper footwear and exercise in a safe environment.
- Type 1 diabetics may need to reduce insulin or increase food intake prior to the start of an exercise program. Physical Therapists must coordinate with the referring physician for this case.
- During prolonged exercise duration, 10-15 grams of carbohydrate snack is recommended for every 30 minutes.
- Clients who are on Sulfonylureas are red flags because it can cause exercise-induced hypoglycemia. Closely coordinate with the referring physician if this was missed prior to referral.
- Menstruating women need to increase insulin during menses, especially if they're not active.
- There should be no short-acting insulin injections close to the muscles to be exercised within one hour of exercise.
- Patients should eat 2 hours before exercising. If planning to exercise after meal, patients must wait 1 hour prior to start.
- Patients must always carry their own portable blood glucose monitor. They must check their glucose levels before and after exercise.
- Patients are advised to drink 17 oz. of fluid before exercise.
- If blood glucose is less than 100 mg/dl but not less than 70mg/dl, the physical therapist may provide carbohydrate snack and then recheck the glucose level after 15 minutes.
- Make sure exercise doesn't contribute unnecessary stress to the patient. Stress increases insulin requirements. A gradual progression from aerobic and resístance exercises is the key.
- Avoid exercising late at night.
- If faced with an unexpected and difficult situation wherein the physical therapist is in doubt whether the patient is experiencing hyperglycemia or hypoglycemia, always give a glass of orange juice or milk, or a carbohydrate snack. This is the safest action because this can relieve hypoglycemia (if it is indeed) and cannot harm if it is hyperglycemia.
- Exercise five times a week as a maintenance (or at least every other day) and at the same schedule / time, preferably.
- As much as possible, patient must not exercise alone, so that there will always be someone to help in unexpected situations.
- Good examples of carbohydrate snacks (10-15 grams of carbohydrates) are half a cup of fruit juice or cola, 8 oz. of milk, 2 packets of sugar, 2 oz. tube of honey or cake deco gel.
Diabetics are more prone to hypoglycemia than hyperglycemia during exercise. But physical therapists must be efficiently adept in distinguishing the differences in the signs and symptoms, including the dangerous Diabetic Ketoacidocis (DKA).
During Diabetic Ketoacidosis (DKA) the patient might experience abdominal pain, anorexia, nausea, vomiting or diarrhea. This occurs more in children. Patient will have confusion and dull mental state which can lead to coma. There is an increase in pulse rate, yet weak. There is an initial deep and rapid breathing which could lead to Kussmaul respiration. Cardinal sign is a fruity or acetone breath. Urine output is increased and the glucose level is extremely high (greater than 300 mg/dl). Ketones are high and pH is acidotic (less than 7.3). The skin is warm and dry. Onset is rapid, which is less than 24 hours.
While on hyperglycemia, there are no gastrointestinal symptoms, usually occur in adults with underlying chronic disease and the patient is also in a dull, confused mental state. Skin is warm and dry, pulse and respiratory rate are high, ketone and pH level are normal, relatively high glucose level and the onset is slow (may take days).
On the other hand, hypoglycemia can occur with all ages. The patient may feel hungry with difficulty in concentration and coordination which could eventually lead to coma. Skin is cold and clammy, there is profuse sweating, increased pulse rate, shallow respiration, considerably low glucose level, ketones and pH are normal and the onset is rapid.
- WHO. Diabetes Programme. The World Health Organisataion [accessed 18 July 2016]
- WCPT (2011) Diabetes
- ↑ Bloom, D.E., Cafiero, E.T., Jané-Llopis, E., Abrahams-Gessel, S., Bloom, L.R., Fathima, S., Feigl, A.B., Gaziano, T., Mowafi, M., Pandya, A., Prettner, K., Rosenberg, L., Seligman, B., Stein, A.Z., & Weinstein, C. (2011). The Global Economic Burden of Noncommunicable Diseases. Geneva: World Economic Forum</ref>.
- ↑ Sarah Wild,Gojka Roglic, Anders Green, Richard Sicree, and Hilary King. Global Prevalence of Diabetes: Estimates for the year 2000 and projections for 2030. Diabetes Care May 2004 vol. 27 no. 5 1047-1053
- ↑ Susan Y. Chu, William M. Callaghan, Shin Y. Kim, Christopher H. Schmid, Joseph Lau, Lucinda J. England,Patricia M. Dietz. Maternal Obesity and Risk of Gestational Diabetes Mellitus. Diabetes Care August 2007 vol. 30 no. 8 2070-2076
- ↑ Bhati P, Alam R, Moiz JA, Hussain ME. Subclinical inflammation and endothelial dysfunction are linked to cardiac autonomic neuropathy in type 2 diabetes. Journal of Diabetes & Metabolic Disorders. 2019 Dec;18(2):419-28.
- ↑ Daniel Umpierre, Paula A. B. Ribeiro, Caroline K. Kramer, Cristiane B. Leitão, Alessandra T. N. Zucatti,Mirela J. Azevedo, Jorge L. Gross, Jorge P. Ribeiro, Beatriz D. Schaan. Physical Activity Advice Only or Structured Exercise Training and Association With HbA1c Levels in Type 2 Diabetes: A Systematic Review and Meta-analysis. JAMA. 2011;305(17):1790-1799.
- ↑ Timothy S. Church, Steven N. Blair, Shannon Cocreham, Neil Johannsen,William Johnson, Kimberly Kramer, Catherine R. Mikus,Valerie Myers, Melissa Nauta, Ruben Q. Rodarte, Lauren Sparks, Angela Thompson,Conrad P. Earnest. Effects of Aerobic and Resistance Training on Hemoglobin A1c Levels in Patients With Type 2 Diabetes: A Randomized Controlled Trial.JAMA. 2010;304(20):2253-2262.


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Lawmakers Press Trump Health Official On Marijuana As Opioid Alternative
A bipartisan group of members of Congress is pushing the Trump administration to consider medical marijuana as a safer alternative to opioids.
"As you know, our country is grappling with an opioid epidemic that is now taking 91 lives every single day," the lawmakers wrote in a letter to Acting Health and Human Services Secretary (HHS) Eric D. Hargan. "Recent studies published by qualified academic researchers suggest that marijuana may prove to be a useful alternative treatment for chronic pain instead of harmful, addictive prescription opioids, and that marijuana may reduce the overall number of opioid overdose deaths."
After citing a number of studies demonstrating cannabis's efficacy and that legal marijuana access is associated with reduced opioid issues, the House members lay out a series of questions they want answered:
The evidence that marijuana may have a positive therapeutic warrants additional attention from the federal government. We request that you provide answers to the following questions:
1. Please describe in detail what the Department of Health and Human Services (HHS) is doing to fill the gap in our knowledge about the use, uptake, and effectiveness of medical marijuana as an alternative to opioids for pain treatment in states where it is legal.
a. Please describe in detail any federal efforts to conduct research the impact of state medical and recreational marijuana laws on opioid overdose deaths.
b. Please also describe in detail efforts by other federal agencies under the jurisdiction of HHS.
2. Please describe in detail what HHS and other federal agencies are doing to work with states that have implemented medical marijuana laws to collect data on the impact of these laws on opioid overdose deaths.
3. Is HHS committed to implementing evidence-based policies regarding the use of medical marijuana as an alternative pain treatment in an effort to promote public health?
4. Is HHS committed to making any research on the therapeutic benefits of marijuana available to states including as a more benign alternative to opioids for pain management, so that they can implement evidence-based policies to address the opioid epidemic?
5. Please describe in detail any ongoing efforts to share this research on marijuana's potential as an alternative pain treatment to addictive and dangerous prescription medications with other federal agencies, including but not limited to the Office of National Drug Control Policy, the Drug Enforcement Administration, and the Department of Justice.
"We should not ignore any information that suggests there may be a tool available to fight the opioid epidemic that we are not using to the fullest extent," the legislators conclude in the letter, which is dated Tuesday. "While it is clear that more research is necessary, it is equally clear that medical marijuana is an alternative pain treatment that merits the attention of the federal government."
Congresswoman Tulsi Gabbard (D-HI) posted a series of tweets about the issue on Thursday evening.
As the opioid epidemic continues to ravage communities across the country, we must pursue every available path to prevent, treat, and ultimately end America's reliance on these highly addictive drugs.
— Rep. Tulsi Gabbard (@TulsiPress) December 7, 2017
With 91 lives lost every single day to the opioid epidemic, Acting Secretary Hargan should immediately authorize additional research into medical marijuana as an alternative treatment to urgently address this opioid crisis.
— Rep. Tulsi Gabbard (@TulsiPress) December 7, 2017
The letter comes amid increasingly prominent discussion about marijuana's potential to reduce opioid overdoses. The federal government's top health research official was asked about the topic in two separate Senate hearings this week.
Legal Marijuana Tied To Opioid Death Reductions, Federal Health Official Says
Last week, Sen. Elizabeth Warren (D-MA) sent questions about marijuana and opioids to Alex Azar, President Trump's nominee for HHS secretary.
See the full text of the House lawmakers' new letter below:
Members of Congress: Marijuana Is An Opioid Alternative by tomangell on Scribd
Congresswoman Wants Ban On DC Marijuana Sales Lifted Through Coronavirus Legislation
A congresswoman is calling on the government to end a policy prohibiting Washington, D.C. from legal marijuana sales, arguing that the jurisdiction is in particular need of tax revenue from cannabis commerce due to the coronavirus outbreak.
Rep. Eleanor Holmes Norton (D-DC) has repeatedly condemned the congressional rider barring the District of Columbia from allowing retail sales that has been extended each year since 2014, shortly after local voters approved a ballot measure to legalize low-level possession and home cultivation. But given the need for resources to combat the pandemic, she said a reversal of the provision should be included in the next COVID-related relief bill.
"At this moment of unparalleled need, D.C. should be able to collect tax revenue from all available sources, like every other jurisdiction, including from recreational marijuana, which is believed to be widely used in the District," the congresswoman said in a press release on Friday, adding that D.C. was shorted in the last stimulus because Congress treated it as a territory rather than a state.
"While I am working for a retroactive fix in the next coronavirus bill, it is imperative that Congress also repeal the D.C. recreational marijuana commercialization rider in the next bill to help D.C. shore up its finances," she said. "It is beyond unreasonable that congressional interference keeps only the District from commercializing recreational marijuana, while all other jurisdictions are free to do so."
The next #coronavirus bill is the time for Congress to finally permit DC to commercialize recreational marijuana. It is legal to possess two ounces but #DC can't tax it.
Commercialization would help DC in this moment of great need for revenue. https://t.co/xhEOyY1mbS pic.twitter.com/3haXv1L8Wf
— Eleanor Holmes Norton (@EleanorNorton) April 3, 2020
"Bringing the District in line with other jurisdictions would create a critical source of tax revenue in our time of need."
Last year, the House approved an appropriations bill that excluded the D.C. rider, but it was included in the Senate version and ultimately made its way into the final package that the president signed. The cannabis commerce ban was also included in President Trump's budget proposal earlier this year.
"True to form, Representative Eleanor Holmes Norton continues to be one of the best allies to the cannabis reform movement," Justin Strekal, political director for NORML, told Marijuana Moment. "During this unprecedented COVID-19 outbreak, it is critical that lawmakers analyze and reform any and every aspect of public policy to mitigate the health crisis and build a foundation for a strong recovery."
"As the majority of states that regulate cannabis have deemed the industry essential to the continued functioning of their jurisdictions, the continued congressional prohibition of the District of Columbia enacting it's own adult-use program becomes even more ridiculous," he added.
Norton, in an interview about her push, said that the congressionally mandated prohibition on sales doesn't prevent people from accessing cannabis but does block the city from collecting tax revenue.
"You can buy two ounces but, by the way you've got to do that on the black market," she told WUSA-TV. "But there's nobody to tax it. And I'm simply trying to get the taxes the District is due for merchandise, in this case marijuana that's being consumed readily in the District of Columbia."
I spoke to D.C.'s Delegate @EleanorNorton
She's pushing for fully legal commercial marijuana sales in the District in a 4th Congressional stimulus package.
The District needs the money.
And people are smoking weed anyway. pic.twitter.com/PL9yoDKlrj
— Adam Longo (@adamlongoTV) April 3, 2020
Legislative priorities for Congress have shifted significantly as lawmakers attempt to address the outbreak, and that's meant putting some reform efforts on hold. However, the issue isn't being ignored entirely, and it's possible that other members may look to attach modest marijuana proposals to additional coronavirus legislation.
For example, Rep. Katherine Clark (D-MA) said this week that U.S. Department of Veterans Affairs policy preventing its doctors from recommending medical cannabis in legal states puts service members at risk in Massachusetts because the state is shuttering recreational shops (but not medical dispensaries) and some veterans fear registering as patients out of concern that they could lose federal benefits.
Eleven senators wrote a letter to Appropriations Committee leadership asking that they allow small cannabis businesses to access federal loans and disaster relief programs. While the lawmakers said it should be enacted through an annual spending bill, advocates have argued that the policy change should be pursued through coronavirus legislation since these businesses are facing challenges just like those experienced by many other companies during the pandemic.
Eleven Senators Push To Let Marijuana Businesses Access Federal Loan Programs
Photo courtesy of WeedPornDaily.
North Dakota Activists Say Marijuana Legalization Initiative Unlikely In 2020 Due To Coronavirus
North Dakota activists announced on Thursday that they are suspending their campaign put marijuana legalization on the November ballot due to the coronavirus outbreak.
In a Facebook post, Legalize ND said "we are going to have to face a few hard realities going forward" as businesses are shuttering, public events are being cancelled and individuals are encouraged to shelter in place. The pandemic means in-person signature gathering can't take place, and the state does not allow for alternative signing options such as by mail or online.
"Due to the virus all of our major avenues for signature collection have been cancelled or indefinitely postponed, and going door to door is not safe for both those knocking and those getting knocked," the group said. "Businesses will continue to collect, but we don't want to create another vector for the coronavirus. As a result, at this time if something major doesn't change we will not be able to make the 2020 ballot."
Legalize ND said there's no way for state policies related to signature gathering to be changed ahead of the November election. They needed to collect 13,452 valid signatures from voters before July 6 in order to qualify. In all likelihood, the campaign said it would have to shift its focus to the July 2022 primary election.
"This isn't the solution we want, but given the situation it is what will have to happen," the post states. "Stay safe, and hopefully we can make a major push when the quarantine ends."
The proposed initiative would allow individuals to purchase and possess up to two ounces of cannabis. Unlike a much more far-reaching measure the same group pushed in 2018 that included no possession or cultivation limits, which voters rejected, this version would prohibit home growing, impose a 10 percent excise tax and establish a regulatory body to approve licenses for marijuana businesses.
North Dakota voters approved a medical cannabis initiative in 2016.
The coronavirus outbreak has dealt several blows to drug policy reform efforts in recent weeks.
California activists for campaigns to amend the state's legal cannabis program and legalize psilocybin mushrooms are asking for a digital signature option.
Likewise in Washington, D.C., advocates for a measure to decriminalize psychedelics asked the mayor and local lawmakers to accept online signatures for their ballot petition.
An effort to legalize medical cannabis in Nebraska is facing similar signature gathering challenges. A campaign to legalize cannabis in Missouri is also in jeopardy.
In Oregon, advocates for a measure to decriminalize drug possession and a separate initiative to legalize psilocybin for therapeutic purposes have suspended in-person campaign events amid the pandemic.
In New York, Gov. Andrew Cuomo (D) recently conceded that legalization was "not likely" going to happen through the budget, as he hoped. Coronavirus shifted legislative priorities, and comprehensive cannabis reform seems to have proved too complicated an issue in the short-term.
Idaho activists announced on Thursday that they are suspending their campaign, though they are still "focusing on distributing petitions through online download at IdahoCann.co and encouraging every volunteer who has downloaded a petition to get them turned in to their county clerk's office by mail, regardless of how many signatures they have collected."
Finally, in Arizona, a legalization campaign is petitioning the state Supreme Court to instruct the secretary of state to allow individuals to sign ballot petitions digitally using an existing electronic system that is reserved for individual individual candidates seeking public office.
Virginia Groups Push Governor To Amend Marijuana Decriminalization Bill On His Desk
Photo courtesy of Philip Steffan.
Arizona Legal Marijuana Campaign Asks Supreme Court To Allow Electronic Signatures Amid Coronavirus
Several campaigns to put initiatives on Arizona's November ballot—including one to legalize marijuana—are asking the state Supreme Court to allow electronic signature gathering amid the coronavirus pandemic, which has made in-person ballot petitioning all but impossible.
Smart and Safe Arizona, the group behind the cannabis measure, along with three other campaigns, filed a petition with the court on Thursday, requesting that it direct the secretary of state to let them digitally collect signatures. They stressed that the infrastructure already exists, as residents are able to use a system called E-Qual to sign ballot petitions for individual candidates running for office.
While the marijuana campaign has already gathered more than 320,000 signatures, which is well over the required 237,645 signatures for statutory proposals, they have yet to be verified and activists would like to continue collection efforts to ensure that they qualify for the ballot.
In the filing, the groups argued that limiting the E-Qual system to office seekers is unconstitutional. However, state law stipulates that it can only be used for that purpose, so it remains to be seen whether court action will produce the intended result. There was a bill filed last year to expand its utility to allow digital signature gathering for initiatives, but it has not advanced in the legislature.
Breaking: four initiative campaigns (criminal justice, invest in ed, recreational marijuana and save our schools) are asking the Arizona Supreme Court to allow for them to collect signatures online. pic.twitter.com/GvNSA5NoKh
— Dillon Rosenblatt (@DillonReedRose) April 2, 2020
"Legal access to E-Qual for these citizen initiatives is the right thing for public health and democracy," attorneys representing the groups said in a statement. "Following Governor Doug Ducey's stay-at-home order issued Monday and current CDC recommendations, gathering hundreds of thousands of signatures on paper, at people's homes, or in public spaces, is impossible to do safely and responsibly during this pandemic. E-Qual is a very reasonable remedy."
The legalization petition would allow individuals 21 and older to possess and purchase cannabis from licensed retailers. People could possess up to an ounce of marijuana at a time and cultivate up to six plants for personal use.
The measure also contains several restorative justice provisions such as allowing individuals with prior marijuana convictions to petition the courts for expungements and establishing a social equity ownership program
Cannabis sales would be taxed at 16 percent. Tax revenue would cover implementation costs and then would be divided among funds for community colleges, infrastructure, a justice reinvestment and public services such as police and firefighters.
The Department of Health Services would be responsible for regulating the program and issuing cannabis business licenses. It would also be tasked with deciding on whether to expand the program to allow for delivery services.
"The Committees have explored potential alternatives, such as mailing petitions to interested persons to circulate within their families," Smart and Safe Arizona Campaign Manager Stacy Pearson said in a declaration filed with the court. "This, however, is expensive, inefficient, and has no realistic likelihood of permitting the Committees' to gather large numbers of valid petition signatures."
The legalization group was joined by campaigns to limit school vouchers, provide sentencing reform and increase taxes on the wealthy to fund public education in the petition. Separately, two other campaigns—to enact voting reform and end surprise hospital billings—filed a similar lawsuit in a federal court on Thursday.
Smart and Safe Arizona is not the only drug policy reform campaign to request electronic signature gathering since the COVID-19 outbreak.
Activists in California released a video last month asking officials to allow digital signatures for a petition to revise the state's adult-use marijuana program. In Washington, D.C., advocates for a measure to decriminalize psychedelics similarly wrote to the mayor and local lawmakers, imploring them to accept online signatures for their ballot petition.
Another California campaign to legalize psilocybin mushrooms is struggling and asking for electronic signature gathering to qualify for the ballot.
Others have generally shut down campaign activities in light of the pandemic, which has resulted in shutter businesses and shelter-in-place orders across the country.
An effort to legalize medical cannabis in Nebraska is facing similar signature gathering challenges. A campaign to legalize cannabis in Missouri is also in jeopardy.
In Oregon, advocates for a measure to decriminalize drug possession and a separate initiative to legalize psilocybin for therapeutic purposes have suspended in-person campaign events amid the pandemic.
In New York, Gov. Andrew Cuomo (D) recently conceded that legalization was "not likely" going to happen through the budget, as he hoped. Coronavirus shifted legislative priorities, and comprehensive cannabis reform seems to have proved too complicated an issue in the short-term.
Idaho activists announced on Thursday that they are suspending their campaign, though they are still "focusing on distributing petitions through online download at IdahoCann.co and encouraging every volunteer who has downloaded a petition to get them turned in to their county clerk's office by mail, regardless of how many signatures they have collected."
Idaho Activists Suspend Campaign To Legalize Medical Marijuana Due To Coronavirus
Photo courtesy of Mike Latimer.


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Dear, Anita,
I just graduated from college with a degree in business. But I have no idea what I really want to do! I'm paralyzed with fear that I'll start down the wrong career path and wind up doing something I hate. What should I do?
Dear, Dazed Diploma Holder,
It's only natural to feel some trepidation as you begin your job search and your career. But rest assured, you'll never be stuck in a bad situation – career or otherwise – unless you choose to be. You can always change jobs. And life is funny; even if you did have your one-year, five-year, and 25-year career goals all nicely laid out, fate often has a different plan.
So just get started! Here's a great excerpt from Careerealism on why you may want to consider a temporary job.
"Some job seekers are hesitant to accept temporary or contract assignments because they are concerned if they commit to something short-term, they will miss out on opportunities for full-time assignments. This may be a bit short-sighted because many employers are now using staffing agencies (and sometimes internal recruiters) to 'try before they buy' job candidates.
In many cases, short-term assignments are being extended and even becoming full-time opportunities for some workers.
If you're currently unemployed, determine if this assignment could give you some valuable income and also help build your resume. If you can answer 'yes' to both of these items, it might be worth accepting the assignment. If you do a good job, you may also be able to obtain a reference for future employers."
Read the entire blog post at http://www.careerealism.com/job-seekers-temp-jobs/#rfDuA8cQybt8SwJV.99
While the blog mentions that employers can "try before they buy" job candidates, you as the job seeker can "try on" different positions to see what interests you and suits your personality best.
Readers: Readers, what was your first job out of college? Did it prepare you for your dream career?
Have a question you would like to ask? Visit http://anitaclew.com/ask-anita/.
Want to receive these tips by email? Simply subscribe for once-a-week advice for career success!


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- Published in Facts About Paris
Foreign student accommodation: Here's how you can afford a 1000 Euros furnished apartment rent in Paris.
There's no doubt that Paris is an expensive city, especially for the students who are coming from all over the world to earn a degree in the city of light. The cost of studying alone in France has skyrocketed in recent years, leaving lots of students wondering how to cover extra expenses such as food, cost of renting an apartment and other necessary living costs.


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CONTACT: Dorinda White (DHCF) (202) 727-9226; [email protected]
(WASHINGTON, DC) – The Department of Health Care Finance today announced that the Office of Contracting and Procurement (OCP) has submitted a package to Council with a notice of intent to award the District's third managed care contract to Medstar Family Choice. Upon approval, the contract will take effect October 1, 2012 and end on April 30, 2013. This would be the first time that the District of Columbia will have three managed care providers since 2010.
"This is an important milestone for the Department of Health Care Finance (DHCF). With the selection of a third managed care provider (MCO), we immediately increase competition in the program and gain a level of security by having one more plan under contract than required by federal law," said DHCF Director Wayne Turnage. "Moreover, we are not finished. As we approach the beginning of the new contract year, which will begin in May 2013, we will seriously examine the feasibility of establishing a program that will provide beneficiaries with four plans. Regardless the number of plans however, our objective is to ensure that each MCO in the District's program will have a demonstrated commitment to innovation as a means to drive increased access and quality care through cost effective management of health services for our beneficiaries in both the Medicaid and Alliance programs."
This selection ends nearly a 12-month effort by DHCF to secure a third managed care plan for the District's Medicaid and Alliance programs in response to a directive issued by the Gray Administration in early 2011.


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STATE POLICE INVESTIGATING NEVADA COUNTY HIT AND RUN FATALITYNovember 02, 2016
Crystal Davis, 42, of Rosston (Nevada County) died last night after she was apparently struck and killed by a vehicle that fled the crash scene. Arkansas State Troopers responded to a location along Arkansas Highway 200, two miles east of Rosston, about 10:45 Tuesday night to begin their investigation.
Special Agents of the state police Criminal Investigation Division and troopers assigned to the Highway Patrol Division are working together to investigate the crash and identify a possible suspect vehicle and driver.
Davis' body has been transported to the Arkansas State Crime Laboratory for determination of a precise manner and cause of death as well as to remove any forensic evidence that can be found on the body.
Anyone with information pertaining to the crash, particularly if someone knows of a vehicle in the area that may have fresh damage today is asked to contact the Arkansas State Police Highway Patrol Division, Troop G by calling (870) 777-4641.


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Gulf Fritillary Sightings
Though Gulf Fritillaries (Augraulis vanillae) are not native to this region, the migrant stray can be fairly common from year to year depending on season. Today we had a chance to see a few down at El Cerrito's Ohlone Greenway at Lincoln Ave.!
Typical of migratory butterflies, the Gulf Fritillary is is incapable of diapause. The butterlies are virtually year-round and generations are constantly overlapping. However, it is still more common during certain parts of the year though it is very difficult to pinpoint exactly when. Here in the Bay Area we have observed that they are common during the winter since they are so mild here. In the past, they have also been extremely common later in the summer like in August. Today, we decided to search for them anyway.
The caterpillar's host plant is the tropical Passionflower (Passiflora spp.), but due to the fact that the vine has become so popular due to its edible fruit many species in the genus have been cultivated. In addition, it is a favorite in nurseries and gardens since it has very showy flowers and it is not difficult to locate the plant even here in Albany, CA. This is partly why the Gulf Fritillary's range extends so far, all over the U.S.
Even though we had already searched a few passion vines this year and were unable to find any caterpillars and eggs despite occasionally seeing the butterflies all throughout the season, we still took our chances and went down to El Cerrito's Ohlone Greenway at Lincoln Ave. where there is an enormous passion vine along the trail. This is the vine where we had first encountered Gulf Fritillaries (caterpillars and eggs) three years ago in 2013 and since then has consistently the best place to find them.
We don't know why it is so difficult to find any eggs anywhere despite having seen so many butterflies this year but perhaps the unwilling butterflies have a broader agenda than we know of. Today, we had a chance to see several butterflies fluttering around the vine, though they were either refusing to lay eggs or were males competing with each other. At the same time the the majority of the vine was dead due to the dryness of summer, but we doubt that this would really have discouraged egg laying. We were only able to collect a single newborn caterpillar, though we lost it at some point and were unable to bring it home. However, we were also able to catch a butterfly which we do believe is female, so perhaps we could get some eggs out of it. . .
- Brian
Timeline 2012–2017
Albany, California
This timeline is a series of daily posts recording our observations on and experiences with various insects around our residence in Albany California, from 2012-2017. Starting in August 2017, we moved to Ithaca, New York; posts from there on can be viewed at Timeline 2017-present: Ithaca, New York.
Archives (1,011)
August 2017 (49)
July 2017 (121)
June 2017 (79)
May 2017 (77)
April 2017 (91)
March 2017 (35)
February 2017 (12)
January 2017 (10)
December 2016 (12)
November 2016 (26)
October 2016 (49)
September 2016 (84)
August 2016 (94)
July 2016 (99)
June 2016 (53)
May 2016 (21)
April 2016 (4)
January 2016 (1)
August 2015 (3)
July 2015 (3)
June 2015 (2)
June 2014 (3)
May 2014 (1)
April 2014 (3)
March 2014 (3)
December 2013 (2)
November 2013 (2)
October 2013 (5)
September 2013 (11)
August 2013 (15)
July 2013 (9)
June 2013 (5)
May 2013 (4)
April 2013 (3)
March 2013 (2)
February 2013 (3)
January 2013 (2)
December 2012 (2)
November 2012 (1)
October 2012 (2)
September 2012 (2)
August 2012 (5)
July 2012 (1)
June 2012 (1)
Full Species List
(Alphabetical by scientific name)
Actias luna
Adelpha californica
Agraulis vanillae
Allancastria cerisyi
Antheraea mylitta
Antheraea polyphemus
Anthocharis sara
Argema mimosae
Attacus atlas
Battus philenor hirsuta
Bombyx mori
Caligo atreus
Callosamia promethea
Coenonympha tullia california
Citheronia regalis
Cricula trifenestrata
Danaus plexippus
Eacles imperialis
Erynnis tristis
Estigmene acrea
Eumorpha achemon
Eupackardia calleta
Furcula cinerea
Heliconius erato
Heliconius hecale
Heliconius sapho
Heliconius sara
Hyalophora cecropia
Hyalophora columbia
Hyalophora euryalus
Hylephila phyleus
Hyles lineata
Junonia coenia
Langia zenzeroides formosana
Lophocampa maculata
Manduca sexta
Morpho peleides
Nymphalis antiopa
Orgyia vetusta
Orthosia hibisci quenquefasciata
Pachysphinx modesta
Papilio cresphontes
Papilio eurymedon
Papilio glaucus
Papilio machaon oregonius
Papilio multicaudata
Papilio polyxenes asterius
Papilio rumiko
Papilio rutulus
Papilio zelicaon
Phyciodes mylitta
Phyciodes pulchella
Pieris rapae
Plejebus acmon
Poanes melane
Polites sabuleti
Polygonia satyrus
Pyrgus communis
Rothschildia jacobaeae
Samia cynthia advena
Samia ricini
Smerinthus cerisyi
Smerinthus ophthalmica
Strymon melinus
Trichoplusia ni
Uresephita reversalis
Vanessa annabella
Vanessa atalanta
Vanessa cardui
Lepidoptera Hybrids
Papilio glaucus × Papilio rutulus
Papilio polyxenes asterius × Papilio zelicaon
Melanoplus devastator
Phaneroptera nana
Pristoceuthophilus celatus
Scudderia mexicana
Trimerotropis pallidipennis
Carausius morosus
Phyllium giganteum
Mantis religiosa
Phyllocrania paradoxa
Apis mellifera
Bombus vosnesenskii
Brachymeria ovata
Linepithema humile
Pediobius sp.
Polistes dominula
Xylocopa varipuncta
Lucilia sericata
Brochymena sp.
Leptoglossus sp.
Nezara viridula*
Argia vivida
Libellula croceipennis
Coccinella septempunctata
Cycloneda polita
Diabrotica undecimpunctata
Hippodamia convergens
Araneae (Class: Arachnida)
Araneus diadematus
Phidippus johnsoni
Full Species List
(Alphabetical by common name)
Butterflies & Moths
Achemon sphinx
Acmon blue
African moon moth
Anise swallowtail
Atlas moth
Black Swallowtail
Cabbage looper moth
Cabbage white
"California" pipevine swallowtail
Calleta silkmoth
California ringlet
California sister
Carolina sphinx
Ceanothus silkmoth
Cecropia moth
Cerisyi's sphinx
Common buckeye
Common checkerspot skipper
Columbia silkmoth
Cricula silkmoth
Cynthia silkmoth
Domesticated silkmoth
Eastern festoon
Eastern giant swallowtail
Eastern tiger swallowtail
Eri silkmoth
Field crescent
Fiery skipper
Genista broom moth
Gray furcula moth
Gray hairstreak
Gulf fritillary
Imperial moth
Indian tussar moth
Jacobs' silkmoth
Luna moth
Modest sphinx
Mournful duskywing
Mourning cloak
Mylitta crescent
"Ophthalm" sphinx
Oregon swallowtail
Painted lady
Pale swallowtail
Peleides blue morpho
Polyphemus moth
Promethea silkmoth
Red admiral
Red postman
Regal moth
Salt marsh moth
Sandhill skipper
Sapho longwing
Sara longwing
Sara Orangetip
Satyr comma
Speckled green fruitworm moth
Spotted tussock moth
"Taiwan" Saw-winged sphinx
Tiger longwing
Two-tailed swallowtail
Umber skipper
Yellow-edged giant owl
West coast lady
Western giant swallowtail
Western tiger swallowtail
Western tussock moth
White-lined sphinx
Butterfly & Moth Hybrids
Black swallowtail × anise swallowtail
Eastern tiger swallowtail× western tiger swallowtail
Grasshoppers, Katydids, & Crickets
Camel cricket
Devastating grasshopper
Mediterranean katydid
Mexican bush katydid
Pallid-winged grasshopper
Stick & Leaf Insects
Giant leaf insect
Indian walking stick
European mantis
Ghost mantis
Ants, Bees, Wasps, & Sawflies
Argentine ant
Black and white chalcid wasp
European paper wasp
Pediobius chalcid wasp
Valley carpenter bee
Western honey bee
Yellow-faced bumble bee
Common green bottle fly
True Bugs
Leaf-footed bug
Rough Stink Bug
Southern green stink bug
Dragonflies & Damselflies
Neon skimmer
Vivid dancer
Convergent lady beetle
Seven-spotted lady beetle
Spotted cucumber beetle
Western blood-red lady beetle
Spiders (Arachnid)
European garden spider
Red-backed jumping spider
Collecting Sites
Albany Hill/Cerrito Creek
Berkeley Hills/Tilden
Canyon Trail Park


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Collaborative Stream Project Site Assessment and History:
By Cece Mercer, Jeff Feng, Kevin Will, Elexis Evans, and Tresa Reynolds
Bishop College Historical Context:
How was the stream used by Bishop College?
- Flood Control
Future questions to ask former Bishop College administrators or students
- Who originally owned the land and donated it to Bishop College?
- How was Bishop College developed?
- What did the landscape look like prior to development and agriculture?
- What are some nice amenities (i.e. Green space)?
Aerial maps of Bishop College to be added
Newton Tributary Geography, Location:
The Newton Tributary Creek (Stream) is located in the southern sector of Dallas, Texas and has latitude of 32.6776 and longitude of -96.7356. Newton Creek rises just southwest of Cedar Valley College in Lancaster, Texas. Intermittent in its upper reaches, the creek flows northeasterly for five miles to its mouth on Five Mile Creek, just east of Interstate Highway 45 (at 32°41′ N, 96°44′ W). The area around the creek is heavily wooded, with elm, ash, pecan, red oak, red cedar, cedar elm, and hackberry (TSHA, 2010). One of the interesting things about the creek is that a stand of horsetail club has been discovered near the midpoint of Newton Creek. Horsetail is perennial plant that grows in temperate northern hemisphere areas of Asia, Europe, North America, and North Africa. The plant is typically found in or near watery areas such as marshes, streams, or rivers. This plant is considered to be the most primitive living vascular plant. Interestingly, horsetail is not known to exist anywhere else in Dallas County.
"NEWTON CREEK," Handbook of Texas Online
(http://www.tshaonline.org/handbook/online/articles/rbn16), accessed February 10, 2015. Uploaded on June 15, 2010. Published by the Texas State Historical Association.
Stream Hydrology:
Water Science Glossary of Terms [Internet]; c2014 [cited 2015 February/8]. Available from: http://water.usgs.gov/edu/dictionary.html .
- The Paul Quinn College Creek is a tributary of the Trinity River
- USGS data specifically provides insight in stream discharge and gage height.
- Stream discharge, measured in cubic feet per second, is "the volume of water that passes a given location within a given period of time." (USGS 2014)
- Gage height, on the other hand, signifies "the height of the water surface above the gage datum (zero point)" (USGS 2014)
- These two factors are accurate gauges for understanding both the velocity and height at which water flows
- We cannot control the downstream effects of the Paul Quinn College Creek Restoration
- PQC Creek first flows into Newton Branch (5 Mile Creek) before transitioning to Trinity River
- Disturbances in stream discharge and gage height upstream in our restoration site may normalize before entering Trinity River.
USGS 08057000 Trinity Rv at Dallas, TX [Internet]; c2015 [cited 2015 February/11]. Available from: http://waterdata.usgs.gov/usa/nwis/uv?08057000
Understanding urban streams
CADDIS Volume 2: Sources, Stressors & Responses [Internet]; c2012 [cited 2015 February/11]. Available from: http://www.epa.gov/caddis/ssr_urb_urb2.html .
Urbanization has numerous effects on stream ecosystems. In particular, sediment loads increase, erosion is more common, flashiness rises, and the physical habitat is degraded.
- As the number of impervious surfaces rises, the channel will more likely degrade.
- The flashiness of a stream increases due to high runoff and eroding of the floodplain.
Wang et al. 2000 JAWRA
- More impervious surfaces also imply the degradation of species diversity.
Site Assessment:
Our restoration site is on Paul Quinn College's campus. Prior to Paul Quinn College, Bishop College, a historically black college, resided at this Dallas site from 1961 to 1988 when it closed.
Paul Quinn College is located in a residential area. One of the tributaries to Newton Branch runs through the surrounding suburban area. The tributary eventually connects to 5-mile creek and then continues into the larger Trinity River. Paul Quinn College is located in the Trinity Watershed. The health of the streams, creeks, and tributaries linked to the river are important to the overall health of the watershed. Map 1 depicts the location of Paul Quinn College in relationship to the community and rivers.
Impervious surfaces decrease the land's ability to absorb water into the ground. Parking lots, buildings and roofs that surround the stream are all impervious surfaces, which block the water from infiltrating the ground. When the land does not absorb rainwater naturally, the rapid flow of the water will erode the banks of waterways.
Maps Key:
|Earth: Location of Paul Quinn College
|Map 1
|Map 2
|Map 3
|Shaded in Pink: Impervious Surfaces
|Map 2
|Green Mesh: Park
|Map 3
|Red dots: Stormwater outputs
|Map 3
|Dark pink insect: Insect population
|Map 3
|Light pink beaker: Lack of insects
|Map 3
Map 1: Depicts the location of Paul Quinn College in relationship to the community and rivers
Map 2: shows the impervious surfaces close to Paul Quinn College that may contribute as on-site stressors
Map 3: Indicates the placement of stormwater outputs which detail the origins of subsurface stressors
- Inconsistent Water flow
- Trash pollution in and around the stream
- Inconsistent Water Levels
- Broken Pipes
- Fallen tree branches
- Debris
- Unknown underground waterways
- Erosion
- Discoloration
- Dr. Samuel Eguae of Paul Quinn will assist in testing the water, identifying invasive species, and specifying on-site stressors
The Newton Tributary does not flow consistently. The amount of water is dependent on rain, runoff of the day, and the position of the stream that is being observed. When the water levels are low, trash, algae, broken pipes and other debris can be seen in the bottom of the stream; however when levels are higher, tree trunks are submerged in water and the only visible observation is the color of the algae that has covered the floor of the stream. In observing the stream, one could find the strangest things, such as car seats, clay pots, and bricks. There are fallen tree branches that have blocked trash so that some spots of the stream are clean. The first visible opening is covered by trees and can only be found by following the sound of running water. The opening is cavernous and surrounded by debris from what appears to be a construction project. The water runs strongly there, leading to the belief that this is the initial runoff pipe.
Changes in the condition
There are not any direct signs of data showing what the steam looked like previously. After reviewing the current observations, it is easy to spot a few things that have changed. The climate influences the water quality and the stream can reach its tolerance level if it is overheated. The stream's PH balance has to be off because there has not been any sign of maintenance. The turbidity of the stream has increased, and the stream is continuously eroding. The water in the stream does not flow continuously. The stream is wide which means it will flow much slower than an average water source. Since the stream moves slowly it is more likely to heat quicker which may harm organism longevity.
Why restore PQC Creek?
- Address symptoms of urban stream syndrome
- Improve health of the ecosystem
- Increase Paul Quinn and community engagement with environmental issues
- Create aesthetic center in community with both environmental and social amenities


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The beloved 1970s British sit-com gets the big screen treatment, although there's been very little attempt to do anything clever with it aside from A-list casting. There are some terrific gags in Hamish McColl's script, but director Oliver Parker (Johnny English Reborn) fails to find the comical potential in the material. So the film feels clumsy and muted, which is certainly not going to attract a new generation of fans to the premise.
It's 1944 in the small village of Walmington on the southern English coast, where the men who were unfit to serve in the regular army have volunteered for the Home Guard when they're not working their normal jobs. The platoon's captain is bank manager Mainwaring (Toby Jones), who leads a ragtag group of retirees (Tom Courtenay, Michael Gambon and Bill Paterson) and younger army rejects (Daniel Mays and Blake Harrison) through a series of exercises along the seaside cliffs. They've been tipped off that there's a Nazi spy in the area, but they're all so smitten by the curvy visiting journalist Rose (Catherine Zeta-Jones) that they fail to notice that she's up to something nefarious.
The material is ripe for political-edged comedy, which the script touches on in between the relentless double entendre. And the cast is definitely up for it, delivering solid performances that bring out character details while playing up the goofy interaction between them. But Parker leaves them looking adrift on-screen, never cranking up either a sense of pace or a spark of life. Each set-piece falls utterly flat, starting with the movie's opening scene in which the gang is chased around afield by a supposedly angry bull. And everything that follows feels half-hearted, which means that the Carry On-style innuendo, physical slapstick and nutty action all fall flat.
Continue reading: Dad's Army Review
Bill Paterson - Dad's Army film premiere held at Odeon - London, United Kingdom - Tuesday 26th January 2016
Bill Paterson - The World Premiere of 'Dad's Army' held at the Odeon Leicester Square - Arrivals at Odeon Leicester Square - London, United Kingdom - Tuesday 26th January 2016
Bill Paterson , Hildegard Bechtler - Stars and guests arrive for the 2015 BAFTA Scotland Awards in Glasgow at Radisson Blu - Glasgow, United Kingdom - Sunday 15th November 2015
Everybody's favourite British regiment is back in the new version of Dad's Army. Director Oliver Parker has recruited the much loved classic British TV Show with the help of some of the UK's best known actors. Like the TV show, the movie is set in 1944 and World War II is almost at its peak. The Home Guard is patrolling the streets of Walmington-on-Sea and their spirits are rather dampened by the thought of the imminent invasion. Their only light relief comes from a visit from a beautiful journalist going by the name of Rose Winters. Rose soon has all the men on their best behaviour and all the ladies of the town attempting to up their game. However it's soon 'back to work' for the men when they find out there's a spy living amidst the residents in their small seaside town.
Continue: Dad's Army Trailer
And they're back! The hilarious band of men that put their lives on the line for their country return in an all new adventure on the big screen. World War II is at its very peak during the 1940s and the Home Guard at Walmington-on-Sea are about to have an unusually eventful episode. Hours of patrolling the army base at Dover - trying to keep spirits up on the eve of the soldiers' impending journey to France to take on the Germans - are over for now, because UK intelligence have just uncovered a mysterious secret signal over the radio - apparently someone has been sending messages from Walmington to Berlin, and now nobody can be trusted. The Home Guard aid the mission to uncover the spy - though nobody dares put too much faith in this bumbling lot.
Continue: Dad's Army Trailer
Bill Paterson and Hildegard Bechtler - Harold Pinter Theatre London United Kingdom Thursday 31st January 2013
Bill Paterson Monday 4th April 2011 outside the ITV studios London, England
Brit John McKay's debut feature, based on his play, is a real girl's club, U.K. style. MacDowell plays Kate, an American living in an idyllic British country home, working as headmistress at a stuffy-looking school. Molly (Rachel Ward look-alike Anna Chancellor, from TV's Longitude) is a tough, sexy doctor, and Janine (Imelda Staunton of Rat and Chicken Run) is a sympathetic divorced Mom and a top police inspector. The three women, all single and in their early forties, stick together like bonding glue.
Continue reading: Crush Review
"Bright Young Things" is a terribly witty romp through 1930s pre-war London with a pack of idle young swells who live scrumptious but superficial lives of joyous gossip-page decadence and complacent scandal that has the potential to ruin them.
Very cleverly adapted (from Evelyn Waugh's novel "Vile Bodies") and directed by the gifted comedic actor Stephen Fry ("Wilde," "Peter's Friends"), our surrogate in this world is Adam Symes (newcomer Stephen Campbell Moore), a well-connected but flat broke novelist and fringe member of this society who is railroaded into writing an anonymous gossip column about his pals -- although he's soon inventing entirely fictional members of the circle just to keep his readers amused.
An ironic failure at schemes to get rich quick so he can ask the "frantically bored" and beautiful but secretly vulnerable and melancholy Nina (subtly heartbreaking and simply wonderful Emily Mortimer) to marry him, Adam's fortunes -- which practically fluctuate with the tides -- are just one source of endless humor. But director Fry furtively hints at shades of compunction and misfortune under the film's carefree surface that bubble up as world events encroach on these lives of leisure, eventually taking the film to an unexpected level of empathy, nuance and humanity.
Continue reading: Bright Young Things Review
It's been five years since Purity Ring released Another Eternity, but little has changed in their overall sound and macabre lyrical themes now that...
We need music now more than ever.
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Just over two years since the release of her vibrant debut album, Anna Burch is back with her second full-length album: 'If You're Dreaming'.
What have we been listening to on repeat?
The Chats' debut album High Risk Behaviour is the most punk thing we've heard in years.
Nature-inspired songs we just can't get enough of.
What do you need to know about buying headphones?
The beloved 1970s British sit-com gets the big screen treatment, although there's been very little...
Everybody's favourite British regiment is back in the new version of Dad's Army. Director Oliver...
While Andie MacDowell has spent much of the last few years in little-seen bombs like...
"Bright Young Things" is a terribly witty romp through 1930s pre-war London with a pack...


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Sexism is an incomplete explanation for why men lecture women.
In her book, You Just Don't Understand, Deborah Tannen talk to determine and achieve status. Women talk to determine and achieve connection. To use a metaphor, for men life is a ladder and the better spots are up high. For women, life is a network, and the better spots have greater connections.
In patriarchal businesses, or any command-and-control environment, the ladder is worshipped. But not all the lessons should be aimed at getting women to speak more like men. Both genders should be taught that there are, at the very least, three reasons to talk with others:
- To exchange information
- To achieve status
- To achieve connection
In conversation, if one party expects an equal exchange and the other is expecting a competition, things get asymmetrical and frustrating.
So, girls and boys, if you have something to say, speak up – your partner may not necessarily hand you the opportunity. And if you find yourself having talked for a while, shut up and listen – your partner isn't necessarily thick; it could be the other person is waiting for you to show some skill by asking a question.
Yes, both sexes need to learn the old-fashioned art of good conversation… and that is: Be both interesting and interested.