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Hello, and welcome to a very special edition of DiS Does Singles. In case you hadn't guessed already, it's dedicated to the one and only Christopher Owens.
Having made so many of favourite songs over the past five years, both as a solo artist and as part of Girls, we asked him some nerdy questions about nine of them. Want to know know the inside scoop on 'Hellhole Ratrace' and 'New York City'? You came to the right place.
Also, 'Never Wanna See That Look Again' is Single of the Week. Because, of course it is.
Single of the Week
Christopher Owens
Never Wanna See That Look Again (Turnstile)
Whenever Christopher Owens talks about his new album, he always seems to be teasing the next one. The former Girls frontman has claimed he'll make 20 records and, with 100 unrecorded demos kicking around on his hard drive, you wouldn't bet against him. Give it a decade and you'll be debating the blue-eyed dreamer's best songwriting era.
For now, Owens is in full-on-solo-whimsy mode having stripped away the scuzz from his days spent with JR White. Following on from last year's Lysandre, 'Never Wanna See That Look Again' is a simple, sincere love song. As all too often the case for the man behind 'Heartbreaker' and 'Forgiveness, there's trouble afoot with his beau.
"There was one time when I drank too much / Two times when I said too much," simpers Owens in his trademarked waifish tremble. You know the tone, it could make even the shipping forecast seem drenched in aching subtext. For A New Testament's latest single, the story is plain to see: Christopher is in a fix and needs to get out of it.
Ever the romantic, his saving grace is an earnest number that swings from guitar skiffle to gospel-tinged magnificence - like a country-fied fusion of 'Nothing More Than Everything To Me' and 'It Comes Back to You'. Rodeo-lovers, this is your new jam. Everyone else, you'll adore it for the key change schmaltz.
'Never Wanna See...' is a song to make your heart go squewiff, but we've come to expect this of Christopher Owens. His four albums to date have the same familiar knack for feeling out your fuzzy bits while hopscotching across genres. Here's to more of the same from the next 16 or so.
Playlist: Best of Christopher Owens
Christopher Owens: Song Stories
Lust For Life
Your first Girls single costs $30 to buy secondhand on Discogs. Would you say that's undervalued, overvalued or just right?
I'd have to say just right, since I have no understanding of these things. I'm just going to trust that there's some reason that cost was picked. I do believe the thing is of value, but I'm not too familiar with what a five year old single typically goes for.
Hellhole Ratrace
Which do you prefer: slow dancing or just letting rip?
I'd say I'm a good slow dancer, for sure. For me letting it rip would be some version of a frenzy. Madness. I think I could frenzy well, but I don't know if it would be good.
A lot of your songs are rooted in classic language and concepts like dancing through sadness in 'Hellhole Ratrace'. 'Carolina' is about online abuse aimed at a former Miss Carolina contestant.
Do you think the present day is an inspiring place to live in and write about?
Oh yeah. Plenty going on, and all very "in your face" these days. I've pretty much only written from current experiences. I think it's interesting how nothing really changes though, I can read Shakespeare or Oscar Wilde or Updike or Karl Ove Knausgaard and things seem to be fundamentally the same. The human condition doesn't seem to change much.
"Alex has a band, so who cares about war?"
What's the difference between love and obsession?
Love is tender and not selfish, obsession is the opposite. That line in 'Alex' was meant to describe the way I felt young people seemed to feel (and I'll admit it's a generalization), I honestly don't know many young people who are bothered by America's war mongering. It does bother me, and it was back when I wrote that too. There are some moments of bitterness in that song, which luckily give in to tenderness by the end.
This is one if your many tracks to feature a gospel choir. When did you realise that was exactly what the song needed?
I heard those back up vocals when I wrote those songs. I've heard them and wanted them before that too, like on 'Hellhole Ratrace' or 'Laura'. Father, Son, Holy Ghost was just the first time we could afford to hire fancy people. I worked with them again because we developed a relationship over touring, and I had more for them to do on this record. It's a pleasure for me to work with people in that way.
Jamie Marie
'Laura'. 'Alex'. 'Lauren Marie'. 'Jamie Marie'. 'Stephen'.
What's the appeal of naming songs after people?
Well, if the song is about someone I tend to go for that option. It's nice and easy. It also gives just a little more understanding to the listener - I think, about what inspired the song. It's a tender gesture to me - sentimental.
New York City
This is the complete opposite of what you usually write: dark lyrics matched with a relentlessly cheery tune. It must have been a lot of fun to record?
Oh yeah, that whole record was fun. There's a big part of me that considers the writing of Lysandre to be my greatest achievement. The story I had to tell on this song defined the lyrics though, I didn't have much choice. I was recalling where I came from and things I'd been through, and then expressing the shock of landing in the position I had landed in - on stage in New York, being loved and celebrated.
Here We Go/Here We Go Again - acoustic
One is a love song, the other relates more to drugs. We only realised this when listening to the acoustic Lysandre album.
Was this sort of experience why you released that acoustic record: to put more emphasis on the album's story?
I recorded the classical guitar and vocals for Lysandre first, then layered the other instruments over that with the friends I worked with. We all had that first acoustic recording on our iPods before doing the sessions, mainly so the other musicians could reference them. I found myself really liking the acoustic version and listening to it a lot even after we finished the album proper. One time in the van the other musicians told me they still listened to it too. I thought it would make a nice 10-inch record. You know, you only live once. Luckily Fat Possum and Turnstile obliged me.
Nothing More Than Everything To Me
You're wearing a red cowboy suit in this song's video. Where did you get it from and did you get to keep it?
I got it at this little store in San Francisco that sells random vintage clothing. I had hats and boots for years that I'd bought in Amarillo Texas, I thought they'd look good together. Yes, I bought it and expensed it as a video prop... but it's mine forever now.
Playlist: The best songs of 2014… so far
Also released this week
Alexander Wolfe - Trick of the Light (MITA Records) ATTU - We Are Ordinary People (Beatnik Creative) Candy Darling - Money (self-released) Foxsmith - Pentimento (Pavement Records) Frances - Fire May Save You (Kitsuné) Ghost Culture - Arms (Phantasy) Joan As Policewoman - Shame (PIAS) Johnny Wore Black - A Cut Above (self-released) Living Eyes - Guilty Pleasures (Agitated Records) Mountainear - Distant Camps EP (Cocktail Music / Believe Digital) School - SoLong (self-released) Teenage Wildlife - Most Beautiful Thing (self-released) The Pierces - Creation (Polydor) The Svens - Odéon (Greco-Roman) The Wytches - Burn Out The Bruise (Heavenly Recordings) Vaults - Lifespan (Virgin EMI) **Zeusv - 27 Is The New 17 (So Recordings)


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Event description
Event Overview
In this course, you will learn about the Fortinet Security Fabric and the necessary skills for administering a FortiGate security appliance. In your own virtual environment, you will be able to explore the GUI, CLI, and many of the next-generation features mentioned in the FortiGate marketing documentation.
Target Audience
- Network and/or Security Operations Management
- Network and/or Security Admins/Analysts/Engineers
- Laptop
- IPv4 subnetting and basic IP operations and concepts
- Course Introduction
- Firewall Iterations
- Classroom Scenario
FortiGate Basics
- Fortinet Security Platform Overview
- Initial Setup and Registration
- Interfaces
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Network Address Translation
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Additional Material if Time Permits
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Fine Print
We reserve to right to cancel RSVPs.


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In order to plan for the 2018-2019 school year, the Star city School District must know the number of students that will be attending kindergarten. It is essential that all children eligible for next year's kindergarten be registered.
Registration for children residing in the Star City School District will be held Tuesday, April 24th from 9-11 a.m. and 1-3 p.m. To enter kindergarten for the 2018-2019 school year, your child must be 5 years of age before August 1st.
If you have a child that will start kindergarten in 2018-2019, please bring a copy of your child's birth certificate, social security card, and shot records.
Forms are available in all offices. If you have any questions, please call Jimmy Brown Elementary at 870-628-5111 or email Principal email@example.com or Dean of Students firstname.lastname@example.com


text:
Pregnancy care planner NHS Choices
Pregnancy Calculator BNF extra
Obstetrics Rural Health West au Mar 2009
Preconceptual/antenatal counselling
NICE CG62 Antenatal care Mar 2008
NICE CG63 Diabetes in pregnancy Mar 2008
Obstetric history
Obstetric history drcog-mrcog.info
Obstetric history en.wikiversity.org
|Gravida Para Abortus
|number of pregnancies
|the total number of times a woman has been pregnant, regardless of whether these pregnancies were carried to term. Any current pregnancy is included
|number of viable births
|Para indicates the number of viable (>20 wks) births
Pregnancies consisting of multiples, such as twins or triplets, count as ONE birth for the purpose of this notation.
|the number of pregnancies that were lost for any reason, including induced abortions or miscarriages. The abortus term is sometimes dropped when no pregnancies have been lost.
nulligravida no pregnancies G0
nullipara no births P0
primigravida 1 pregnancy G1
secundigravida 2 pregnancies both of which resulted in live births G2
G4, P3, A1 A woman who had 4 pregnancies, one of which was miscarried
Gravida – total number of times a woman has been pregnant (including the current), regardless of whether these pregnancies were carried to term.
Para – number of viable (>20 wks) births(and stillbirths) (Multiple pregnancies count as ONE)
Abortus – number of pregnancies lost including induced abortions or miscarriages.
miscarriage – pregnancy loss before 24 weeks resulting in expulsion of foetus showing no signs of life
stillbirth – as above with delivery after 24 weeks
early neonatal death – death within 1 week of delivery of live newborn regardless of gestation
late neonatal death – as above between 1-4 weeks
perinatally related infant death – death from a perinatallly related cause between 4 weeks and 1 year.
GTPAL = Gravida / Term / Preterm / Abortions / Living
Antenatal timeline
|Physiological changes in pregnancy
Physiological Changes In Pregnancy PUK
|Pregnancy booking visit ANC
|1. History
(i) Menstrual, LMP EDD
(ii) Previous obstetric and gynaecological history
(iii) Marital and social history
(iv) Family history (twins, diabetes, etc.)
|2. Physical parameters
(i) Height and shoe size
(ii) Weight
(iii) Physical examination if appropriate
|3. Antenatal parameters as per cooperation card (urine, weight, BP etc.)
|4. Advice about antenatal care, breast feeding, smoking, alcohol, taking of iron supplements and self medication
|5. Tests
(i) Blood group and rhesus antibodies
(ii) VDRL or other test for syphilis
(iii) Test for immunity to rubella
(iv) AFP at 16-18 weeks
(v) Scan if unsure dates, large for dates, etc.
(vi) MSU often included
(vii) Check on cervical cytology status
|LMP EDD Gestational Age
|9 months+7 days from the 1st day of last menstrual period
Nageles Rule: EDD = first day LMP – 3m + 7 days
Low risk pregnancies
1. Nulliparae over 5 ft in height, aged between 20 and 30 years
2. Second or third pregnancies, providing patient under 35 years
3. No previous abnormality in the medical (e.g. diabetes), obstetric (e.g. previous post partum haemorrhage, previous manual removal of placenta, caesarean section, etc.) or gynaecological history
4. No rhesus antibodies
5. No previous psychiatric problems
Every 4 weeks to 28 weeks
Every 2 weeks from 28 to 36 weeks
Weekly from 36 weeks
Palpable abdominally at 12 weeks
Usually below umbilicus at 20 weeks but above it at 24 weeks
Palpation not as accurate as measuring height of fundus from the symphysis pubis in centimetres
1. Proteinuria: if not due to preeclampsia may be due to asymptomatic UTI take an MSU
2. Glycosuria: may be low renal threshold but if on two occasions or once in early pregnancy « 16 weeks) it is advisable to do a GTT (glucose tolerance test), usually at 32 weeks, to detect a gestational diabetes
Most women gain between 10kg and 12.5 kg during pregnancy.
In latter half of pregnancy excess weight gain (1 kg or more a week) may be a sign of developing preeclampsia
Static weight or weight loss may mean intrauterine growth retardation
1. Haemoglobin aim to keep above 10 g/dl
2. If rhesus negative a blood test(s) will be needed for antibodies later in pregnancy
4. AFP is taken at 1618 weeks as a screen for neural tube defects. Refer if raised, after taking a repeat sample. May of course have been taken at wrong gestation (confirm dates) or be a twin pregnancy
High risk pregnancy early booking
rcog.org.uk high risk pregnancy management
Dietary advice NHS Choices
|Pregnancy dietary advice
|General Advice
|As always, a sensible balanced diet, rich in fruit and vegetables, is recommended.
However, the following specific dietary advice should be given:
Dairy products are a good source of calcium (ideally the low-fat varieties), as are oily fish with edible bones (eg sardines), bread, green vegetables and nuts. Some seafish contain high levels of mercury, which may affect the fetus.Pregnant women on Income Support or income-based Jobseeker's Allowance can get seven pints of cow's milk free per week. Unpasteurised milk and milk products are not recommended (eg some goat's milk and sheep's milk).
|Folic Acid
|Women should take 400 mcg folic acid during the first 12 weeks of pregnancy
(or 5 mg per day if on antiepileptic medication, previous NTC, DM coeliac disease or other malabsorption syndromes).
|Other Vitamins
|Other vitamin supplements are rarely needed, although a small percentage of women with inadequate diets or lack
of exposure to sunlight may need additional vitamin D; this can be obtained free of charge if they receive Income Support or income- based Jobseeker's Allowance.
|Anaemia in pregnancy is defined as a haemoglobin level of <11 g/dl initially or <10.5 g/dl at 28 weeks.
These women may need iron supplements.
|Alcohol should be limited to no more than 7 units per week, spread out over the week.
|All fruit and vegetables should be washed, eat and poultry handled properly and cooked fully.
Ready-made meals should be heated through thoroughly
|Cook eggs fully and avoid softboiled.
|All pates and mouldripened soft cheeses should be avoided, as should blue-veined cheeses such as stilton; Soft cheeses and sptrads made from pasteurised milk are fine.
|should be avoided because of its high vitamin A content.
|Women who have a personal history of atopy (eg eczema, asthma or hayfever), or who have an affected partner should avoid peanuts and foods containing peanuts
Community midwife
birth choice uk.com Maternity Care
Mat B1
Abdo pain in pregnancy
Abdo pain in pregnancy medscape
Abdo pain in pregnancy Cork Emergency Medicine
Abdo pain in pregnancy bestpractice.bmj.com
Early pregnancy bleeding
Vaginal bleeding in pregnancy Medline plus
Management of bleeding in early pregnancy in accident and emergency departments BMJ 1994
what to expect.com subchorionic bleeding
Management of early pregnancy bleeding and miscarriage by general practitioners in Victoria
Antepartum haemorrhage (bleeding after 28 weeks) – refer all cases and never do a vaginal examination (VE) prior to referral
Ectopic pregnancy
Pregnancies are being terminated unnecessarily after an incorrect diagnosis of miscarriage BBC news Oct 2011
Rhesus in pregnancy (maternity)
NICE TA 156 Aug 08 Rhesus prophylaxis QRG
Medical conditions in pregnancy
|UTI /frequency
|Send sample in pregnant females to confirm UTI plus post-treatment sample required to confirm cure.1st line First trimester, nitrofurantoin (Macrobid m/r capsules) 100mg twice daily or 50mg four times daily for seven days.
Second or third trimester, trimethoprim 200mg twice daily for seven days.
2nd line Cefalexin 500mg every 8 hours for a minimum of seven days.
Obtain post-treatment sample.Infection UTI and asymptomatic bacteriuria must be treated (risk of pyelonephritis). Penicillins are safe and nitrofurantoin a second choice for UTI.
Avoid tetracyclines (and cotrimoxazole and metronidazole in first trimester)
|Vaginal discharge
|Candidiasis Canesten pessaries are safe
|Heartburn antacids safe in 2nd and 3rd trimester, e.g. Mucaine or Gaviscon
|Constipation best treatment is to increase fibre intake
|highfibre diet and Anusol ointment
|Varicose veins
|support tights and avoid excess standing
|Ankle swelling
|Hyperemesis NHS ChoicesNausea and vomiting usually resolves about 14-16 weeks.
|Skin changes
|americanpregnancy.org skin changesSkin Changes in Pregnancy aafp
|Women who have a personal history of atopy (eg eczema, asthma or hayfever), or who have an affected partner should avoid peanuts and foods containing peanuts
|Anaemia In Pregnancy PUKAnaemia in pregnancy BTS UKMidwifery.org.uk anaemia in pregnancy
DVT in Pregnancy
RCOG reducing risk of thrombosis
Hypertension in pregnancy
Chronic hypertension in pregnancy NeLM Aug 11
Pre eclampsia
Syndrome of hypertension + proeinuria + oedma occuring in second half of pregnancy of mainly in primips.
Hypertension = 140/90 or an increase of 30/15 mHg over baseline.
NICE CG107 Hypertension in pregnancy Aug 2010
Proteinuria in pregnancy
Proteinuria in Pregnancy
Renal disease in pregnancy
Renal disease in pregnancy PUK
Renal disease in pregnancy Medscape
Chronic kidney disease in pregnancy BMJ 2008
Renal disease in pregnancy RCOG
Cardiovascular disease in pregnancy
Cardiac disease in pregnancy PUK
Cardiovascular disease in pregnancy European Society of Cardiology
Management of Cardiac Disease in Pregnancy Medscape
Pregnancy and Heart Disease Cleveland Clinic
Thyroid problems in pregnancy
Thyroid problems in pregnancy PUK
TFTs should be checked at least once every trimester.
Thyroxine dose usually needs to be increased; if the mother is hypothyroid, there is a risk that the fetus will be affected.
Postpartum thyroid disease affects 5-7% of previously euthyroid women after delivery, especially women who have a positive family history or who have other autoimmune disease. May resolve spontaneously.
source GPCSG?
Diabetes and IGT in pregnancy
Lifestyle and drugs in pregnancy
Molar pregnancy
Molar pregnancy / trophoblastic disease / choriocarcinoma
American pregnancy.org molar pregnancy
|Antenatal Infections
|Toxoplasmosis is caused by the Toxoplasma gondii parasite, which can be acquired by eating undercooked meat and by coming into contact with cat faeces. Pregnant women should be advised not to change cat-litter trays or to
handle soil that might have been contaminated. All fruit and vegetables should be washed thoroughly and rubber gloves should be used when gardening.Women who have 'flulike' symptoms in pregnancy or who believe themselves to be at significant risk from toxoplasmosis can be offered serological testing. A negative result implies that the patient has never had toxoplasmosis and is not immune. One in three women has a positive result, usually because of previous exposure; in this case, the blood sample is sent to a reference laboratory to exclude current infection.
It is thought that it takes between 4 and 6 weeks for toxoplasmosis to pass from mother to baby and the risk of congenital infection depends on when the woman was affected. If infection occurred shortly before conception (ie 23 months before1, there is a very low risk of transmission «1 %1. Most affected fetuses will miscarry at this stage. If infection occurs in the first trimester, the transmission rate is about 15%. This rate increases as the pregnancy
progresses and is as high as 65% by the third trimester. Most affected babies will be symptomatic. The severest disabilities are found in children whose mothers were infected early on in pregnancy, and include hydrocephalus and retinochoroiditis.
Children whose mothers were infected in the third trimester often appear healthy at birth, but most will develop symptoms later on (months or even years afterwards), usually visual problems. Amniocentesis testing can be offered to affected women. Treatment with spiramycin reduces the risk of transmission from mother to baby, but cannot prevent damage to a fetus who is already infected.
|for parvovirus IgG and IgM should have a repeat test 1 month after the time of contact. Those with proved parvovirus B19 infection in the first 20 weeks of pregnancy should be followed up by serial ultrasound and referred to a regional specialist centre for consideration of fetal blood sampling and intrauterine transfusion if hydrops fetalis is detected. (Communicable Disease and Public Health Vol 5, No 1, March 2002)
|Group B Streptococcus
Group B Streptococcus (GBS) is the most common cause of severe infection in neonates within the first 7 days of life. In some counties women with are screened at 35-37
weeks of gestation is recommended and affected women are given intrapartum iv penicillin or ampicillin.
Approximately 25% of women of childbearing age in the UK are GBS carriers UAntimicrobial Chemother; 1986; 18: 5965), so
In general practice, women are sometimes incidentally found to be GBS carriers. In these cases, oral antibiotics at the time of diagnosis are not recommended; giving them does not reduce the likelihood of the woman
becoming recolonised at the time of delivery (Am JObstet Gynaeco/1979;
135: 10625). The decision of whether or not to give intrapartum antibiotics
is more difficult. If the swab was taken at 3537 weeks, there is a 0.2%
chance of the baby being affected, although this risk may be greater if the
swab was taken from the upper vagina or if there is GBS present in the urine.
In any case, the final decision will be made by an obstetrician, and the main
responsibility of the GP is to record the swab result in the woman's antenatal
records and to explain the situation to her.AAP Recommendations for the Prevention of Perinatal Group B Streptococcal (GBS) DiseaseGroup B streptococcal disease in infants aged younger than 3 months NELM/Lancet Jan 2012 youtu.be/iScO_bJaev4youtu.be/RdeXGB8fulcyoutu.be/T8jCOxTERwg
|Genital herpes
|Neonatal herpes infection is rare in the UK (incidence 1.65/100 000 live births per year UAntimicrobial Chemother 2000; 45 Suppt 3: 713) but potentially very serious. The risk is highest if the mother acquires the infection for the first time during the later stages of her pregnancy. Oral aciclovir is often used for women who develop a first episode of genitalnherpes during pregnancy (RCOG Clinical Guideline No 30, March 2002).
Caesarean section is recommended for all women presenting with their first episode of genital herpes at the time of delivery (or within 6 weeks of the expected date of delivery), but not for women presenting in the first or second
trimester. For women presenting with recurrent genital herpes at the time of delivery, the risk to the baby is small and elective Caesarean section is not mandatory. Operative delivery is not recommended if there is a recurrent
episode of genital herpes occurring at any other time during pregnancy.
|Maternal chickenpox
|Chickenpox Contact and Pregnancy PUKNeonatal infections rch.org.auNHS Choices Maternal Chickenpoxyoutu.be/63lcTKz4L3
|Rubella and Viral Rashes
|TORCH'S non-bacterial infections affecting the foetus
Other STDs eg syphilis
Herpes eg chickenpox
Slapped cheek (parvovirus B19)HPA Viral Rashes In Pregnancy Downloadbettertesting.org.uk/?id=-1193youtu.be/krgIMlxwaksyoutu.be/CkK9fTykGLE
leedsteachinghospitals antenatal infection screening
Twins and multiple pregnancy
The management of twin and triplet pregnancies in the antenatal period NICE CG 129
Polyhydramnios oligohydramnios
Excess liqour which may be idiopathic or due to
Open spina bifida
Oesophageal atresia
Duodenal atresia
Monozygotic twin pregnancy
Small for dates
Wrong dates
Twins/ Multliple pregnancy
Big baby (macrosomia >4.5kg)) eg in diabetes
Gravid fibroid uterus
Large for dates
CP disproportion
Flexed breech – breech presentation with flexion at knees and hips
Frank breech – flexion at hip and extension at knees
Footling breech – one or both feet or knees presenting
Abnormal lie
Antepartum haemorrhage
Any bleeding from 24 weeks to delivery.
Abrupion – normally sited placenta separates prematurely from uterine wall
Placenta praevia (vas praevia) – placenta overlies lower uterine segment
Hardly known/idiopathic (40%) (may include marginal haemhorrage cervical polyp/ca and spurious causes suchh as haematuria and rectal bleedibg)
Premature/Preterm Rupture of membranes
Rupture of membranes without onset of labour before 37 weeks
Antenatal kick charts
Fetal movements are usually felt between 16 and 18 weeks in multips, 18 and 20 weeks in primigravidae
Caesarian Section LSCS
Proposed NICE Caesarian Section guidelines Oct 2011 @ NHS Choices
Placental functions
|Placental functions
Postnatal exam
1. Uterus never returns to size of nullip. By 10 days has usually returned to pelvis. Also check episiotomy site
2. Breasts-encourage breast feeding
3. Check on rubella and cervical cytology status. Organize as appropriate
4. Discuss any problems of the pregnancy, e.g. check BP of those who were hypertensive, consider referral for IVP if pyelonephritis of pregnancy, etc.
5. Contraception. An IUCD may be fitted postnatally, the mini-pill prescribed for those breast feeding or the combined pill for those not
6. The baby. A good time to mention immunization, check on registration of baby and ask about any worries
7. Ensure claim forms for maternity work and contraception are submitted to the FPC
(old revise)
GPs are paid a fee for up to five postnatal visits (although these can be carried out by the midwife) and the postnatal examination between 6 and 12 weeks
Postnatal problems include:
1. Pyrexia > 38C consider genital tract infection, UTI, breast and chest infections. Also remember DVT
2. Secondary postpartum haemorrhage (PPH)blood loss more than 24 h after confinement. Many settle. Exclude infection. If more than slight or uterus enlarged and non involuting (?retained products)refer
3. Psychiatric problems~baby blues' common on third and fourth day but can get a true psychosis. Do not underestimate a psychosis or a true postnatal depression there is a real risk to mother and baby. Refer for a psychiatric opinion
4. DVT Remember' Older patients, obese patients and after caesarean, especially at risk. Pulmonary embolism commonest cause of death in puerperium
Postnatal Depression
Depression and other psychological morbidity
Ask how the woman is feeling
Be especially aware if:
there is a history of psychiatric illness;
her relationship with her partner is difficult or she is unsupported;
what appeared to be the blues does not resolve
Woman showing symptoms of puerperal psychosis
Woman who the healthcare professional considers to be at risk of suicide or child abuse
If concerned that a woman may be depressed, discuss this and refer (urgent action).
Encourage support of partner (and/or close relative or friend) in caring for baby.
Ensure that the woman knows how to contact the healthcare professional at any time.
Avoid conflicting advice.
Offer self-help and support group literature.
If at any time the healthcare professional suspects the existence of any other psychological morbidity, such as severe anxiety disorders or stress reactions, the woman should be referred (urgent action)
The summary below sets out the main features of the blues, depression and psychosis, and action to be taken by the healthcare professional.
Postpartum blues Postnatal depression Puerperal psychosis
Frequency 50°1080% 713% 1 in 500
Symptoms Tearfulness; Lethargy; tearfulness; Thought disorders; irritability; oversensitivity; delusion; confusion; lability of hopelessness; anxiety; ag itation; fear;
mood; guilt; irrational fears; insomnia; severe sometimes disturbed sleep depression. Rarely headache patterns suicide! infanticide
Onset Few days after Mainly within first Most commonly in first
delivery month or two of four weeks after
delivery delivery
Duration A few days or Most resolve within Variable
less about 3 months or less, especially with treatment, but can persist
Action Transient If suspected refer Immediate referral
condition. (urgent action) (emergency action).
No action except Do not leave woman
reassurance alone.
needed unless Explain to family
does not
|Postnatal problems
|Primary PPH – vaginal bleeding > 500mls within 24hrs delivery
Secondary PPH excessive vaginal bleeding 24 hrs-6weeks post delivery.Causes
Caesatrian section
Retained placental tissue
Cervical trauma
Atonic uterusNICE CG55 Intrapartum care Sep 2007
|Endometritis and abnormal blood loss
|Obtain 'baseline' recording of involution for all women
Assess blood loss
Note problems with delivery or third stage from delivery detailsEMERGENCY ACTION IS REQUIRED IF:
Secondary PPH
Tender and/or bulky uterus
Pyrexia above 38
Offensive lochiaENDOMETRITIS AND ABNORMAL BLOOD LOSSGENERAL ADVICE
Change maternity pads regularly, each time toilet visited if pads are stained, and at least four times a day for the first few days
Blood loss may be heavy for the first few days, but it will gradually become less. It should have a nonoffensive smell
The healthcare professional should be contacted if the loss becomes:
bright red after the first week of delivery
|Breast-feeding problems
Evaluate breastfeeding:
on course to feed effectively
problem already present
Ask about the behaviour of the baby
Assess knowledge and give general advice as appropriateURGENT ACTION IS REQUIRED IF:
Maternal or infant thrush
Infective mastitis
Breast abscess
Concern about baby's well-being
Concern about onset and/or severity of jaundicePAINFUL NIPPLES
Assess positioning and attachment of baby on the breast
Advise mother of appropriate nursing position
No evidence to justify use of creams, ointments or sprays
Further visit(s) to reviewENGORGEMENT
If areola engorged, mother may need to express milk before a feed
Pain relief (paracetamol) may be required
Unrestricted feeding will help relieve problem
If engorgement is not relieved the mother may develop mastitis
Further visit(s) to reviewINSUFFICIENT MILK
Reassure that this can almost always be dealt with
Discuss importance of positioning and attachment of baby on breast
Emphasise importance of baby taking foreand hind milk
There should be no limit on the duration of feeds
If above do not solve problem and there is concern about baby's
growth, refer (urgent action)Emphasise the importance of correct positioning and attachment of
the baby on the breast
Advise about different nursing positions; as long as correct positioning
and attachment on the breast are achieved, no one position is better
than another
If suckling causes pain take the baby off the breast, re-position and
Reassure that colostrum will fully meet the needs of the baby and
supplementary feeds are not necessary
Emphasise the importance of unrestricted feeding on demand
Include partner and any close relatives involved in care of the baby, in
discussion of breastfeeding advantages
If problem develops, midwife can be contacted
Provide addresses/telephone numbers of local breastfeeding support
groupsADVICE ON HAND EXPRESSING BREAST MILK
Advise the woman to practise hand expressing before stored supplies
are required, for example, before she recommences employment. As the
mother becomes more confident, she may find other ways of expressing
milk which she feels are better for her
To hand express, the mother should place her thumb flat on the upper
edge of the areola and cup the rest of her hand under her breast. Her
forefinger should rest on the lower edge of the areola. She should then
gently squeeze her thumb and forefinger together, and at the same
time, gently press her whole hand back and in, towards the chest wall.
Doing these movements together enables milk from the deep breast
tissue to be expressed as well as the ducts beneath the areola and
nippleBLOCKED MILK DUCT
Show mother how to 'milk' the duct
Discuss different feeding positionsNON-INFECTIVE MASTITIS
Advise analgesia (paracetamol) prior to feed
Feed from affected side first
Frequent feeds
Encourage bed rest, until flu-like symptoms have resolved
If symptoms not eased in 6-8 hours (telephone to find out), refer (urgent
If symptoms have eased, increase visit frequency until resolved
|Suppression of lactation
|Postnatal wound problems
|Caesarean section wound care and pain relief
Ask about wellbeing; any signs of fever
Determine current medication and reason for prescription
Discuss pain relief requirements and need for vigilance repossible infection
Assess condition of the wound for: Separation (dehiscence) of wound edges; tenderness; discharge (type, e.g. pus/serous); redness spreading from incision line; localised heat or swelling; odourCAESAREAN SECTION WOUND CARE AND PAIN RELIEF
Inspect wound at each postnatal visit
Retain high index of suspicion for infection
If sutures/clips in situ, remove as policy
If wound appears suspect at any assessment, follow relevant sections of guidelineDEHISCENCE
If dehiscence severe, immediate referral (emergency action).
Apply sterile, nonocclusive dressing if available wet sterile pack or pad if bowel visible
Explain to woman and partner that hospital admission may be required
If dehiscence superficial, treat as other symptoms of infectionSUMMARY GUIDELINE: 3
Inspect wound and record findings
Record pulse 8: temperature
If there is exudate, take swab, apply simple occlusive dressing and
refer (urgent action)
If sutures or clips in situ, remove alternate ones if appropriate
If pyrexial, advise paracetamolbased analgesia unless
contraindicated. Refer if temperature over 38°C or fails to settle after
24 hours (emergency action)
Look for other possible sources of infection
Reassure, and advise woman to contact healthcare professional if the
symptoms worsen
Review as appropriateGENERAL ADVICE
Take prescribed pain relief as necessary
If prescribed antibiotics complete the full course
Take care of the wound: bath or shower daily; do not apply a dressing unless supplied by the doctor or midwife
Wear loose clothing, use cotton underwear
Take care to find a comfortable position to feed the baby
Do not lift heavy objectsNICE CG37 Postnatal care Jul 2006 QRGrcog.org.uk management of third and fourth degree perineal tearsAll women who have had a thirdor fourth degree tear should be followed up for 12 months after delivery, as symptoms may not appear straight away. If the woman is suffering from faecal incontinence, she should be offered an endoanal ultrasound and anorectal manometry. Secondary sphincter repair can be considered. Subsequent deliveries may worsen symptoms of faecal
incontinence, or cause them to develop, so elective Caesarean section may be an option.
Broadspectrum antibiotics and laxatives (usually an osmotic laxative such as lactulose, in combination with a bulking agent such as Fybogel®) are often prescribed after a thirdor fourth degree tear has been repaired: this is to reduce the incidence of wound dehiscence and postoperative infection.
Metronidazole is usually included as part of the treatment, in order to cover anaerobic infection from faecal matter.
|Postnatal headache
|exclude diagnoses other than tension headache/migraine
Obtain baseline recording of BP (at least one BP measurement should be obtained within 6 hrs of the birth)Ask about onset, location and duration of headache.
History of trauma?
Did the woman have epidural/spinal analgesia, and is headache postural (possible PDPH)?
Are there other conditions which produce, exacerbate or relieve the headache?
Is there a history of hypertension?
What degree of incapacity does the headache produce?EMERGENCY ACTION IS REQUIRED IF:
Diastolic BP 2:90 mmHg, with signs or symptoms of preeclampsia
Diastolic BP remains 2:90 mmHg when repeated 4 hours after baseline in absence of signs or symptoms of preeclampsia
Severe headache and history of hypertension during pregnancy
Severe and sudden onset of 'thunderclap' headache.
Headache associated with trauma.
Headache associated with pyrexia, signs of fever.
Severe or persistent headaches.HEADACHE
What to do
If known migraine sufferer, continue with usual medication.
Advise on relaxation.
Discuss childcare and sleep ways to have a rest during the day?
Mild analgesia (paracetamol) can be advised. If analgesia insufficient refer (urgent action).
Attempt to identify factors which trigger headache.
Reassure that headache is common and is generally no cause for concern.SYMPTOMS OF PDPH
Contact anaesthetic department at hospital where delivered.
Bed rest will alleviate symptoms but not prevent a headache.
Record BP, temperature and pulse.
Paracetamol can be taken as necessary.
Avoid bending/lifting until headache resolved.
Dehydration should be avoided.
Tell woman about possible diagnosis and that treatment is available.
Support with infant care.
Review as required.HEADACHES AND HYPERTENSIVE DISORDERS
If diastolic BP is 2:90 mmHg, with signs and symptoms of preeclampsia, refer (emergency action)
If diastolic BP is 2:90 mmHg but no signs and symptoms of preeclampsia, repeat measurement within 4 hours. If pressure has not fallen, refer (emergency action).
Known hypertension management as described, observe for symptoms of preeclampsia.
Review the next day in all cases.GENERAL ADVICE
Provide information on signs and symptoms of preeclampsia.
Avoid factors which precipitate or exacerbate headache.
Take short rest periods when possible during the day.
Do relaxation exercises.
|Postnatal fatigue
Exclude depression anaemia and hypothyroidism
Help the woman plan her time each day to include short periods of rest. If possible ask a relative or friend to help
|Post natal depression PND
|NICE CG45 Antenatal and postnatal mental health Feb 2007
Edinburgh Post Natal Depression Scale Download pdf
Post Natal Depression direct.gov http://youtu.be/Ey3M6hFo3Mw
Postnatal Exercises


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Do I need a Living Trust or a Will?
You may need both. If you have a Living Trust (this means it is revocable during your lifetime) you should also have a "pour over will" that is drafted at the same time. This will direct any property not already placed in your trust to "pour over" into your trust and be distributed by the trustee according to the directions of the trust.
Not everyone needs a revocable living trust, however. Below are some considerations when investigating your options. First determine your end objectives, THEN you can pick the options that get you there. The most important thing is to do SOMETHING to plan for your incapacity or death. This will allow your family to be present with you during your illness rather than be buried in paperwork during a time that is often full of stress and grief.
As part of any estate planning discussion, keep in mind most trust/will packages will also include naming someone to make health care decisions if you cannot, naming someone who will manage your finances if you cannot, and naming someone who will become the guardian for any minor children if you die. You can also direct what life sustaining measures you want or don't want implemented if you are gravely injured or in a coma. The document that does this is called a "Living Will" and is a different document from a Revocable Living Trust.
Revocable Living Trust:
- A living trust is a cost-saving device: in most states, it allows you to avoid the expense and delay of probate proceedings, which can take years to complete. CA attorney fees are based on the value of the assets probated. Currently this is 4% of the first $100,000 and a reduced percentage thereafter. There are also filing fees (currently $435) and other notices that would need to be paid. The executor of the will can charge the same fee as the attorney, so this can double the cost.
- If you own property in another state, a living trust eliminates the need to probate that property in that state.
- A living trust can immediately transfer management of your property to the trustee if you become incapacitated either physically or mentally. There is no need to go to the court to appoint a guardian or conservator.
- A living trust protects your privacy; it remains confidential and does not become a matter of public record.
- A living trust enables you to name someone you trust to manage trust property for young beneficiaries.
- There is no need to hire a lawyer when the time comes to distribute your estate, although depending on the complexity of the assets, you may still want to consult with one.
- Setting up the trust requires quite a bit of initial paperwork and can be expensive, although it depends on the complexity of your assets. Some trust packages are less than a single court filing fee and it can go up from there.
- Setting up the trust also requires you to transfer ownership of all the property you wish to place in the trust. This may include revising title documents and recording them with the county recorder. Most attorneys will prepare these documents for you and recording fees run about $25.
- You may run into some difficulty when you want to refinance property that is in your living trust. The mortgage company may require you to re-deed the home back to your own name, and then deed it back to the trust after the refinancing is completed.
- Creditors do not have a final cut-off date for bringing claims against your trust.
- You cannot designate a guardian for any minor children in a living trust (but this may be done easily in a will that supplements your trust).
- The successor trustee, just as an executor in a will, has accounting and appraisal duties upon the death of the grantor.
- Setting up a will is much simpler and less expensive than setting up a living trust.
- Creditors face a final cut-off date for bringing claims against your estate.
- You may name a guardian for your minor children in a will.
- You do not need to transfer any property to another entity in order to create a will or make it valid.
- Upon probate, a will becomes a matter of public record.
- While you may appoint whomever you wish to act as executor of your will, it is usually the probate lawyers who control that actual distribution of your property. This can be both expensive and unpleasant.
- Probate, which is necessary for the implementation of your will, can be both costly and slow.
- A will does not provide for the management of your assets or property if you should become physically or mentally incapacitated.


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When I got pregnant with Madeline, Aaron and I were just dating. Madly in love, and talked of marriage and kids and all that, but not there yet. We didn't even get engaged until she was 6 months old. Within 7 months, I had a baby, a husband and all of my hopes and dreams answered. I was 19. I was the luckiest girl in the world. I never really thought about parenting. I knew you fed a baby, changed her, loved her and took care of her. But PARENTING was not something that I thought about. I was focused on being a MOM. So poor Madeline became our learning tool.
I breastfed Madeline. For about 9 weeks. Everytime I would nurse her, within minutes she would be screaming. I turned to my mom for help. My mom said it was something I was eating so I cut out all dairy. It continued. I quit. Bottles and formula. SOY formula. Everything inside of me said this wasn't right, but, I still did it. NOW I KNOW DIFFERENT. The problem was over-active letdown. When Madeline ate, the milk let down so fast, she ate too fast, causing a stomach ache. All I had to do was to redirect gravity and lay down to nurse her and it would have been fine. Guilt much? Yep. Madeline was also fully vaccinated. I mean, who doesn't vaccinate their kids? That would be irresponsible. Right? Man, the government brainwashing DOES work. Until you get older and wiser.
Along comes baby #2, less than 2 years later. Joseph. Oh, he was a needy little thing. Always wanted Mommy. Always on the boob. So much in fact that he was weaned by about 7 months. Bottle for Joey (and he loved that damn bottle. Had it until he was 3!) And he had to be held. All the time. So, we venture to Portland and discover a Moby wrap. The answer to our prayers. But once we got home, it was not as easy as it looked. I thought I had him all wrapped up so good. I go to show my mom how it looked. Thinking I was all smart and cool, I bend forward and say "Look, I can even have both hands now WHILE I carry him". Well, obviously, he wasn't in real good. He kinda fell out of the wrap. Well, not all the way out, but enough that is scared the hell out of me. I never wore him again. Vaccinated? Yep. (Even after he had a reaction of inconsolable crying after a round of vax's. Duh me! )Circumcised? Yep. This is my biggest guilt. BIGGEST. So big in fact, I can't really even go there yet. Maybe someday I can blog about it, but for now, the guilt is too fresh still. Almost 16 years later.
Almost 4 years later. (Yep, it took us 4 years after Joey, I told you he was needy) Baby #3. Sweet little Noah. The.best.baby.ever. Calm, sweet, quiet, perfect. Breastfed for almost a year. (see, I'm getting longer and longer here ) Noah too, full vaxed and circumcised. He was an amazing little boy. In fact, he was so amazing, that.....
Baby #4 is in the works. Again, less than 2 years later, Miss Juliette is here. Good baby. A little babywearing going on when she was a bit older (the backpack and Bjorn thing) breastfed for 14 months! I was so proud of that. Again, fully vaxed. ( I'm a slow learner it seems)
I am getting to a point here. As I'm having these babies, and raising them, I'm learning. With each baby. Learning a new trick. It seems that things change so much, even with what you know now, it will be different tomorrow, or next week or next year. When Madeline was born, babies slept on their tummies. Now, the tummy sleeping could be deadly. EVERYTHING CHANGES.
Mommy-hood is full of guilt. If I could list all my guilts on a piece of paper, it would probably go around the world. Twice. You live and learn. You do and learn. You try and fail, just to succeed the next time 'round. Raising a child is kind of like that.
A full 6 years later, Annabel is born. This is almost the turning point for me. I grew up. I wasn't just wanting to be a Mommy. I wanted to PARENT. I wanted to learn from the things that I regretted with the older 4 kids (babywearing, cloth diapers, breastfeeding, vaccinations, etc. etc.) I researched things. I questioned things. I thought for myself and my baby. I learned to trust my instincts.
Annabel changed the way I Mommied. I became a parent. She was fussy, I wore her. All the time. She was breastfed. For 18 months. She was very selectively vaccinated, only getting a select few and very spaced out. She has yet to get her MMR's. I'm not sure when/if we'll do those until they separate them. She wore cloth diapers. She slept with us, still does.
Along comes Delilah. Same thing. Breastfeeding, cloth diapers, no vax's, co sleeping. I finally felt like I was doing it all right. Just the way I wanted.
Then, WHAM! Triplets. What?!! That thought lasted only a minute. Why change everything I've worked so hard to learn and do? Why? Because having multiples changes the rules. Tests you more. Stretches you farther, physically and emotionally than you ever thought possible.
Babywearing? ?Do-able, but not easily. By the time you strap a baby on your back, another is hungry.
Cloth diapering? A must with 3. Not only are disposables expensive, that's alot of diapers for the landfills. No thanks.
Breastfeeding? A challenge. I learned that I am much more stubborn than I thought. At 5 months old, these babies are exclusively breastfed. No bottles. No formula. Just boobs.
Vaccinations? No thank you. My babies are preemies, and you want me to shoot them up with what??!!! I'll pass.
And had these babies been boys? No circumcising here. If they were born with skin there, WHY do we feel the need to take it off? Really?
Co sleeping? The more the merrier!
So, my parenting/mommy-hood has come full circle. I always knew what I wanted and where I wanted to be from the beginning, it just took me 18 years to get here. And I'm hoping, that in my journey, that my older kids didn't suffer too much while I was learning.
So to Amy who posted this on my Facebook:
"Nicole, I wish I had met you before I had my kids. I feel like I walked into everything so blind. Things would have been so different."
You do your best with the knowledge that you have at that time. I can't change 18, 16, or even 12 years ago, but I can learn from it. Whether it be mistakes, or successes, you take it with you and remember it. And learn from it. Soon, you'll see an evolution in your life too. It may not be how you expect or what you think it will be, but it will happen.


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She's not yet 30, but singer-songwriter Garrison Starr has already seen the highs and lows of the music business. Her first recording was released shortly after she graduated from high school, and less than two years later she dropped out of college to pursue a full-time music career. Soon she was on a major U.S record label, receiving good reviews, and touring the States on the Lillith Fair circuit. But before she could work on her next project, Garrison Starr fell victim to the restructuring of Geffen Records, and found herself out of work and having to start over again.
Garrison Starr's comeback CD is entitled Airstreams And Satellites and the opening track on the new release is called "Gasoline."
Those bluesy guitar licks, and drawling vocals brings a young Lucinda Williams to mind, but that's Garrison Starr singing "Gasoline," off her new CD Airstreams And Satellites. And like her sound-alike, Garrison Starr spent her growing-up years in Mississippi, a southern U.S. state known for producing good musicians and storytellers. The songs Garrison Starr has written for Airstreams And Satellites are stories of female empowerment, love, heartbreak, and coming of age confusion. One of the highlights is the optimistic "Sing," an anthem about remaining positive in a world gone mad.
Being signed, lauded, and then dropped from a major record label before the age of 25 would cause a crisis of confidence for most performers. Garrison Starr is no exception. At the age of 22, she walked away from music, feeling unsure about her skills, and frustrated by a lack of creative control. A friend convinced her to move from Nashville to Los Angeles, and soon things began to change.
Garrison decided to go back to doing things her way, and then found herself back in the recording studio with veteran Steve Earle at the controls. Earle also issued an invitation for Garrison to be the opening act on what turned out to be an almost year-long tour. Once off the road, she re-entered the studio and began work on Airstreams And Satellites. The CD is made up of new material, with the except of "Superhero," a song from Garrison Starr's 1997 CD, Eighteen Over Me. The new version is a minute longer, and longtime fans will find that it rocks a bit harder than the original.
Despite her years on a major record label, and making several solid records, Garrison Starr is still unknown to many music fans. If you know someone into roots rock, likes good songwriting, or is searching for quality music that isn't overhyped or overproduced, tell them about Airstreams And Satellites.


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Perry Communications Group Celebrates 20th Anniversary: Founder reflects on lessons learned, success, vision for future
Sacramento, Calif. – One of Sacramento's top public affairs firms for the past 20 years, Perry Communications Group, founded in 1996 by Kathryn Edgington "Kassy" Perry, defied the odds of new business startups, used a major economic recession to restructure for future success, and is on track to a record breaking year and an expansion in 2017.
"We are grateful that for two decades our clients have placed their trust in us to help them successfully advance their missions and achieve their communications and policy goals," said PCG Chief Executive Officer and Founder Kassy Perry.
Known for their depth of experience in health care and advocacy, PCG's award-winning public affairs and public relations work doesn't stop there. Perry and her team of full-time professionals and subcontractors apply the same strategic thinking and fresh creativity to consumer, education, environment, business, housing, legal, and non-profit issues.
"Kassy's creativity and out-of-the-box approach to managing issues is what prompted PhRMA to seek PCG's help 20 years ago," said Jill Kronisch, Deputy Vice President, Alliance Development and Public Affairs for PhRMA. "Kassy's expertise and experience in the life sciences and biopharmaceutical industries, and her creativity and ability to communicate with a variety of stakeholders is a significant reason for the firm's continued success on our issues, and is what has kept us coming back."
PCG's highly respected employees are former reporters, government advisors, campaign staff, event planners, and advocates, and that expertise guides their success on behalf of the firm's clients in the areas of issue and campaign management, crisis communications, media relations, social media, grassroots advocacy, and coalition development and mobilization.
Perry opened her firm in 1996 after working in television and radio news, and as a strategic communications advisor to two California Governors and a California State Assembly Member. In her final years in public service, as Deputy Communications Director for Governor Pete Wilson, Kassy oversaw communications for the administration's health and welfare portfolio, including public health, Medi-Cal, welfare reform, the Ward Valley Low Level Radioactive Waste Site, immigration reform, and Prop 65, as well as a host of other high profile and complex subject areas.
In 1985, while in her first year of public service as the Communications Director for the California Department of Health Services, Perry drew on her background in science at the University of California, Davis, as a summer laboratory technician at the Scripps Research Institute in La Jolla, CA, and experience with three biotech company startups to help negotiate the state's first research grant for an AIDS vaccine with the late Dr. Jonas Salk of the Salk Institute.
She helped create more than a dozen state programs including Access for Infants and Mothers (AIM) and Check Up, a health prevention program for low-income children that became Healthy Families. She also worked with policy experts throughout the Wilson Administration to help create and communicate a variety of programs to close insurance coverage gaps in an incremental and sustainable strategy.
In the 20 years since the firm's inception, Kassy has continued to ensure that individuals have access to health insurance coverage and that the coverage provides adequate access to providers and treatments. Those programs include; the California Partnership for Access to Treatment (CPAT); California Chronic Care Coalition's MyPatientRights.org; ACCESS for Mental Healthcare; Get Hip to HepC; a variety of campaigns to increase awareness of and destigmatize lung cancer for the Bonnie J. Addario Lung Cancer Foundation; AWARxE, a campaign to increase awareness of antibiotic resistance for the California Medical Foundation; Citizens for the Right to Know and Access to Care and Treatment Alliance (ACT) to educate consumers about the need to advocate for the care they need; and the first SMARxt Card for the Senior Medication Awareness and Training Program, a partnership between the California Congress of Seniors and the California Pharmacists Association, to reduce prescribing errors for seniors with multiple physicians and providers.
One of PCG's first nationally-recognized campaigns was created for then Today Show host Katie Couric through PCG client the Entertainment Industry Foundation. Couric's husband died of colon cancer and the television host was passionate about increasing survival rates. Perry suggested to Couric that a bold campaign was needed, one that would encourage the public to undergo colonoscopies and reduce the stigma of the procedure because if "Katie can do it, I can do it."
"Katie Couric was passionate about making a difference and we knew we needed to get people talking about a place on their bodies they didn't even want to think about," says Perry. "When I suggested that she undergo a colonoscopy and produce a segment for the Today Show about her experience, her producers and the NBC lawyers didn't think much of the idea," said Perry with a smile. "However, Katie loved it. She fully embraced the concept and ran with it."
When Couric underwent a colonoscopy live on national TV in March 2000, colonoscopy rates nationwide jumped more than 20 percent in the days and months that followed. The live colonoscopy was part of a weeklong series promoting colon cancer awareness. In a USA Today news article, the University of Michigan School of Medicine dubbed the phenomenon the "Katie Couric Effect."
Through PCG's wide-ranging work the team has built trusting relationships with policy makers, advocates, reporters, and business leaders to help educate constituencies on the most critical issues of our time. Those include Fed Up at The Pump, a campaign by the California Independent Oil Marketers Association (CIOMA) to increase awareness of a fuel tax; the launch of a marine mammal preserve at Año Nuevo State Park; and the successful Save Our State Parks Campaign to prevent a toll road from being constructed through a state park and the destruction of California's remarkable state park system on behalf of the California State Parks Foundation.
In 1994, before Perry started her company, she began working with a group of patient advocates who had formed Citizens for the Right to Know to ensure that managed healthcare in California was patient-centered. The partnership with Liz Helms, then of the TMJ Society and now founder of the California Chronic Care Coalition was formed. Helms and Perry have become close friends and colleagues. At one point Helms worked for Perry as an advocate for the firm, and now Perry works for Helms providing pro bono public affairs consulting services. This year, Liz Helms published her first book, one that was more than a decade in the writing, entitled "Healthcare Unhinged: The Making of a Healthcare Advocate". In her book, Helms describes the history that brought the two together and starting on page 61, details the ways that Perry helped her achieve her goals.
"Sometimes life simply demands that you be bigger than you see yourself and stronger than you think you are. Liz shows you how to step into the shoes you were born to wear," says Perry on the HealthcareUnhinged.com website about her friend Liz Helms.
"Kassy met me as an angry, brand new patient advocate and coached me into becoming a change maker who has testified before Congress, been the focus of a front page New York Times story, the founder of two non-profit organizations and a tireless advocate for people with chronic disease to ensure that patients are at the center of every healthcare discussion," said Helms.
Much of PCG's award winning work has been conducted on behalf of the Mental Health Association of California and NAMI California to reduce stigma of mental illness and increase funding. "When we started that work in 1996, we were told by several lobbyists that they had never talked to a Republican about mental health funding, that they only lobbied Democrats," said Perry. "We helped change that dynamic and brought together ALL of the stakeholders in the mental health community, including law enforcement, mental health providers, physicians, consumers, hospitals and community stakeholders," said Perry. "To make significant change, you have to do something significant."
"Without Kassy Perry's vision for a collaborative and strong coalition of mental health stakeholders to increase funding and create new programs in a significant way, we would never have laid the foundation for the passage of proposition 63," said Darrell Steinberg, former Senate President Pro Tem, incoming Mayor of Sacramento and author of the major reforms of the mental health system and Prop 63. "She has been a driving force behind changing the way we communicated the needs of those with mental illness."
"Our business is all about change," says Perry. "It's about facts and figures, statistics and statutes, but at the end of the day, in order to affect change for our clients and the people of California, our work requires strong relationships. We recognize that our success depends on the integrity of our collaborations and commitments to people.
"We love what we do and we care about our clients and partners and treat them as members of the family."
For the past 20 years PCG has been courted for acquisition by virtually every national public relations firm and has former employees in leadership positions throughout the community.
As the company's President and Chief Executive Officer, Perry has led the company through a variety of business challenges and changes. Early in the business, when the booming 90s demanded that CEO's build a business to sell it for profit, Perry started down that path with a large office in Sacramento and an office in Washington D.C. with more than 25 employees. "I was managing people and their problems, rather than client solutions," said Perry.
With the recession on the horizon and recovering slowly from a serious horseback riding injury that required major surgery, Perry consolidated employees in Sacramento, and made other changes to ensure the viability of the company. Those efforts were successful and the firm was able to continue through the recession without negatively impacting the core of the employee base and business functions.
While a merger or acquisition was not something Perry saw in the company's future, the business discussions and restructuring over the past 20 years have solidified her vision of the future of the firm. With one daughter now in the public affairs arena working for Miller Public Affairs, a friendly competitor, and Julia Spiess Lewis, the firm's Senior Vice President, 15 year employee and now Perry's right-hand, the founder sees a bright future that includes expanding the ownership of the firm to a limited number of partners and the imminent signing of a new 10 year lease in Downtown Sacramento, closer to clients and the Capitol with room to grow.
"At the end of the day, I have done a couple of things well," said Perry. "I have raised two successful daughters who are in their 20s, living on their own with careers they love. I have worked with clients to create programs that positively impact people's lives, and I've created a company that provides exceptional benefits and salaries to young (mostly) women allowing them the flexibility to start families and raise their children while engaging in meaningful work on behalf of our clients. I think that's a pretty darn good legacy."
For a list and biographies of PCG's team please go to: https://perrycom.com/about
For a list of PCG case studies, go to: https://perrycom.com/results/client-case-studies
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Bhutan: Dates for Festivals 2016
Bhutan has a lot of monastery and not-religious festivals to offer. It is difficult to choose among them all. Our advice: If you have the time/possibility, visit festivals in the off-season. They are very special because they have less foreign visitors. Also travelling in off-season […]0 Read More


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Life Fitness ST55 Treadmill
Quick Overview
Cleaned & Serviced
Out of stock
Brand: Life Fitness
Category: Treadmills
Looking for Finance: Click here for details
The Life Fitness Sport ST55 treadmill is an interactive model featuring heart rate monitoring via a telemetry chest strap. It also offers the user heart rate controlled training, a console with message centre and both pre-set and custom workout programmes. The ST55 includes superior cushioning to most other folding treadmills on the market. The special reading ledge makes it easy to enjoy a good book whilst burning off calories, and the convenient folding design and built-in transport wheels make the treadmill extremely easy to position, and to store away at the end of a workout.
- Motor: 2.0 hp Leeson continuous duty DC motor.
- Speed range: 0.5 -10 mph (1-16 km/h)
- Incline: 0 -10 % incline (in 0.5 % increments)
- Folding/non-folding: Light and easy dual-pivoting folding mechanism.
- Pulse/heart rate monitor: Telemetry chest strap.
- Running deck: multi-ply.
- Deck design and shock absorbers provide better cushioning than many other folding treadmills.
- Robotically welded steel frame.
- Accessory tray.
- Control panel: Easy to program console with two LCD windows that display speed, incline, time, calories, distance heart rate and heart rate %. Also features message centre and racetrack workout profile display.
Buy Life Fitness ST55 Treadmill online. If you are interested in the Life Fitness ST55 Treadmill for sale, feel free to enquire above.


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Wisconsin Center
400 West Wisconsin Ave, Milwaukee, WI 53203
Milwaukee, WI
Starts in 6 Months
Your free pass will be emailed to you or you can print it.
Pass is valid for one bride or partner and all of their guests.
No purchase necessary. Prize restrictions apply.See Official Rules for details.
If you are not automatically redirected, please click here.
Please check the form and try again.


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The ankle socks feature each of the five emotions and have some fun details like metallic thread to help bring a little sparkle to the emotion's hair. The thick 16 ounce pint glass featuring Sadness against a cloudy grey backdrop which ties in perfectly with the rain cloud theme. In addition to the socks and glass, some additional items will be coming soon like a Bing Bong shirt, some pins and some more accessories (like the bracelets shown below - online now).
For a limited time, take 20% off when you shop Disney at HotTopic.com! Combinable with $5 Off $50 exclusive - use code: HTLUCK15. New items just added - Shop Disney at HotTopic.com!


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GLENDALE, Ariz. -- The Arizona Coyotes have three players who grew up near Montreal. Each of them took turns torturing the Canadiens before 14,338 fans on Monday at Gila River Arena.
Rookie right winger Anthony Duclair had a goal and an assist, goaltender Louis Domingue made 17 saves, and veteran center Antoine Vermette added a goal as the Coyotes swept the two-game season series against Montreal with a 6-2 win.
The Arizona franchise, formerly the Winnipeg Jets, swept the Canadiens for the first time.
"I grew up rooting for them; I was a big Habs fan," Duclair said. "I didn't go to too many games because it was hard to get tickets, but every time I went, my eyes would pop out, so it was pretty special to get one (goal) against them."
Thirteen players recorded points for Arizona, which also got goals from centers Martin Hanzal and Brad Richardson and defenseman Oliver Ekman-Larsson and Kevin Connauton. Hanzal and Ekman-Larsson added two assists apiece.
With the win, Arizona (26-24-6, 58 points) eclipsed its point total from all of last season (56).
Left winger Dale Weise and right winger Brendan Gallagher scored for Montreal (27-26-4). Goalie Mike Condon made 22 saves for the Canadiens, who are 10-22-2 since starter Carey Price sustained a knee injury on Nov. 25.
"As long as you can't make good reads defensively, you don't check well and you have no chance to win," Montreal coach Michel Therrien said. "I was disappointed with the response we had."
Arizona wasted little time giving Domingue a lead when Hanzal redirected defenseman Michael Stone's shot from the point past Condon at 4:47 of the first period. It was Hanzal's third goal in his past four games and his ninth of the season.
Montreal tied the game at the 9:02 mark when right winger Jacob De La Rose circled the net and fed Weise for a tap-in at the far post. It was Weise's 13th goal of the season.
Arizona retook the lead when Hanzal fished the rebound of Ekman-Larsson's shot off Condon's pads and fed Duclair at the far post for the rookie's 16th goal of the season at 15:48 of the first period. Duclair has notched at least a point in all four of his career games against Montreal.
The Coyotes widened the lead to 3-1 just 24 seconds into four-on-four play when Richardson beat the Montreal defense and wrapped a puck around Condon at the 8:04 mark of the second period.
Montreal answered two minutes and two seconds later when Gallagher beat Domingue between the pads from the right wing at 10:06 for his 15th goal of the season.
Ekman-Larsson restored the Coyotes' two-goal when his shot from the right point struck the crossbar and dropped into the net at 11:52 on the power play with Duclair providing a screen. Montreal looked lifeless from that point on.
"There's a lot of hockey left to be played," Montreal defenseman P.K. Subban said. "We didn't bring enough today. We just didn't do enough to win a hockey game."
Connauton gave the Coyotes an insurance goal when he took a cross-ice feed from left winger Kyle Chipchura and beat Condon inside the near post as he was falling to the ice for a 5-2 lead at 15:30 of the second period. It was just Connauton's second career NHL point.
Vermette capped the scoring when deked Condon to the ice and slid the puck in the far side at 4:19 of the third period.
"We were pretty solid," Arizona coach Dave Tippett said. "It was a pretty good team effort all the way through."
NOTES: Coyotes D Jarred Tinordi faced the Canadiens for the first time since Montreal traded him to Arizona on Jan. 15 for D Victor Bartley and LW John Scott. Montreal drafted Tinordi with its first-round pick (22nd overall) in 2010.. ... Canadiens D Nathan Beaulieu was back in the lineup after missing Friday's game against Buffalo with a lower-body injury. ... Coyotes backup G Anders Lindback sustained an off-ice injury Monday prior to warmups for Arizona's game against Montreal. The Coyotes said the medical staff would evaluate him and provide an update Tuesday. In Lindback's absence, GM Don Maloney accessed his list of emergency goalies -- every team has a list -- and activated Nathan Schoenfeld to serve as Louis Domingue's backup against Montreal. Schoenfeld is the son of ex-Coyotes coach and current New York Rangers assistant GM Jim Schoenfeld. He is also the son-in-law of Coyotes equipment manager Stan Wilson. He plays in a local men's league.


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Poor quality sleep not only leaves us feeling tired, sore and cranky, but modern research shows that it also effects our health. Improving your sleeping environment with the most comfortable pillow combined with a cosy bed can make a significant improvement to your quality of sleep.
Buying the best pillow for your body type and preferred sleep position will not only help to avoid back pain, but also lead to better health and well-being.
To help you choose the the most suitable pillow from the hundreds of different models on the market, we've created a list of the leading brands available.
Best Pillow Reviews
- Coop Home Goods – Adjustable Shredded Memory Foam Pillow
- Sleep Better Iso-Cool Memory Foam Pillow, Gusseted Side Sleeper
- Mediflow Original Waterbase Pillow
#1 – Coop Home Goods – Adjustable Shredded Memory Foam Pillow
If you're looking for the most comfortable pillow available Coop Home Goods adjustable memory foam pillow is a must have. Featuring fully adjustable inner material which enables you to add or remove shredded elastic memory foam according your preferred sleeping position. It's proprietary memory foam design has also been formulated to improve sleepers breathing and temperature regulation.
If you suffer from allergies or side effects due to dust mites this pillow is certified by the CertiPUR-US standards as hypoallergenic and dust mite resistant. Also important protection features including TCEP flame retardants have been confirmed by the Certi-PUR US accredited testing labs. Cleaning is simple with a fast cycle in your washing machine.
Backed by a 5 year warranty against flattening and also a 30 day full refund with no questions asked, try the Coop Home Goods Adjustable pillow – we're sure you'll love it.
#2 – Sleep Better Iso-Cool Memory Foam Pillow
For many sleepers with back pain, it's difficult to find the perfect pillow which supports their head and neck overnight. One of the best pillows for a comfortable night's sleep is the Sleep Better Gusseted Side Sleeper pillow. Whether you're a side sleeping looking for a new pillow or suffering from ailments such as a herniated cervical disk – Sleep Better's well design pillow has many positive buyer reviews.
Iso-Cool pillows, mattress toppers, and mattress pads feature Outlast Adaptive Comfort material that adjusts to your body's changing temperature. The microscopic Phase Change Material (PCM) beads sense whether the body's mean temperature is too warm or too cool. If the body's temperature is too warm, the product absorbs heat and feels cool in order to regulate body temperature. If the body's temperature is too cool, the product releases heat and feels warm in order to regulate the body temperature.
If you prefer a pillow which sits lower than others on the market – we rate Iso-Cool's pillow as our preferred unit.
#3 – Mediflow Original Waterbase Pillow
Another pillow that's received glowing reviews from suffers of cervical and lumbar disk problems is the Mediflow Waterbase Pillow. It's Waterbase design allows owners to fill or remove water according to their preferred sleeping height for greater control over your night-time comfort.
The Mediflow Waterbase pillow was ranked best of all pillows tested in a clinical study at Johns Hopkins University. In fact, study participants ranked Mediflow best in every category tested! The unique Mediflow pillow has a top 5" layer of soft hypo-allergenic polyester fiber with a thin water pouch on the bottom which provides user-adjustable support for the neck. Most soft polyester filled pillows feel good at first but collapse during the night, interrupting sleep for constant adjustment.
Some memory foam pillows are great for neck support but are too hard on the face and head to achieve a comfortable sleep all night. With the Mediflow Waterbase pillow you get the soft comfort needed to achieve sleep quickly and the customizable support from the waterbase to maintain support to reduce sleep interruptions. The waterbase adjusts automatically as you move during sleep!
Your head rests on a soft, plump layer of hypoallergenic polyester fiber which is supported by a thin waterbase at the bottom of the pillow. Simply adjust the firmness of your pillow by adding or removing the amount of water that provides the perfect level of support.
With over 2,000 reviews on Amazon and millions of buyers since its release, many people trust their sleep to Mediflow – try their Waterbase pillow with the reassurance of a money back guarantee within 30 days of purchase.
Buying Guide for Pillows
Wether you spend most of your day sitting in an office, or working outside on your feet – the thing that all adults look forward to when we're at home is enjoying the comfort of our own bed. Our bed is our sanctuary, complete with comfy blanket and snug fitting pillows. According to medical research the average adult spends approximately one third of their life sleeping. That's a lot of time being comforted with a pillow. Aside from providing our head with the comfort required while we sleep, our pillow also plays a vital role in achieving a deep sleep, correct posture and most of all a healthy condition.
1. Determine Your Sleeping Style
The first thing to decide when buying a pillow is whether you're a back sleeper, side sleeper or stomach sleeper. Depending on which style you sleep determines the respective type of pillow. If you buy the wrong type, it will put too much pressure on the your spine that could result in back pain when you wake.
- a. Back Sleepers – need a flatter and thinner pillow to support the cervical spine.
- b. Side Sleepers – need a firmer pillow that would support the head and neck so as to maintain the natural line of the spine.
- c. Stomach Sleepers – need a flat pillow under the stomach and the head and neck directly resting on the mattress.
2. Check the Pillow Fill
The firmness of a pillow differs from each model depending on the filling being used. Most pillows utilize down feathers, synthetic/polyester fibers and foam. However, some manufacturers use goose down feathers since it's considered to be the most long lasting and excellent quality filling.
3. Thread Count Matters
If you want a durable pillow, opt for a pillow with 300 thread counts for a standard one. If you've got some extra budget and would like to splurge on something luxurious, go for a a pillow that has 500 to 800 thread counts.
4. Fluffiness
Most importantly, choose a pillow that allows air to travel through the sides as fluffy pillows can do. Aside from the fact that it provides better cushion to your head, it also assures you a fresher pillow since air can just easily pass through it.
With these buying tips coupled with enough hours of sleep, you'll be sure to not only have a huge smile on your face, but also a more positive disposition and in perfect health after you wake each morning.


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An international team of researchers at the University of Groningen has conducted a study regarding oral bacteria and the chewing of gum. Their findings provided evidence that bacteria are trapped inside gum pieces and are thereby removed from the oral cavity.
Bacteria are a central cause of many oral diseases, including caries and periodontal disease. Toothbrushing and flossing are essential ways to remove bacteria from the oral cavity. The chewing of gum is also considered to contribute to the maintenance of oral health. In order to investigate this hypothesis, researchers at the University Medical Center Groningen, Department of Biomedical Engineering developed novel methods to qualify and quantify oral bacteria trapped in chewed gum.
Two different methods were applied to determine the number of bacteria within chewing gum. The first method used the sonication of gum moulded to standard dimensions. The second method used an analysis based on the quantitative polymerase chain reaction and microbial composition. The researchers then had five volunteers chew gum for up to 10 minutes. After that, the numbers of colony-forming units and the total numbers of bacteria trapped in the chewed gum were determined using the two different methods.
The scientists could clearly visualise the bacteria trapped in the gum using scanning electron microscopy. Around 100 million bacteria were identified in each piece of gum. According to the researchers, this number is comparable to the number of bacteria removed by toothbrushing or flossing. They estimate that around 10 per cent of the bacteria in saliva can be removed by chewing one piece of gum. Thus, chewing gum on a daily basis can contribute to reducing the bacterial load in the oral cavity in the long term.
According to the researchers, their findings may promote the development of gum that selectively removes specific disease-related bacteria from the oral cavity and that can contribute to an overall healthy and diverse oral microbiome.
Original Source: The Dental Tribune.com


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With three months to go before the July deadline for a final agreement, Iran and the six major powers are still searching for ways to resolve differences over Iran's nuclear program. Even so, the negotiations keep confounding skeptics by making steady progress and showing that investing in this process is worth the risk.
The most alarming feature of Iran's nuclear program has been its ability to enrich uranium to 20 percent purity, which is a short technological hop to the higher level needed for nuclear bomb-grade fuel. Iran began producing this grade of fuel in 2010. Western officials toughened sanctions, and in 2012 Prime Minister Benjamin Netanyahu of Israel dramatized the threat by brandishing a chart portraying a time bomb during a United Nations speech. By 2013, Iran was believed to be one or two months away from having enough uranium, at slightly more enriched levels, for a weapon.
Lately, however, things have been quieter. On Jan. 20, Iran stopped enriching uranium to 20 percent under an interim agreement reached in November with the United States, China, Russia, Britain, France and Germany that has effectively frozen the nuclear program. Earlier this month, the International Atomic Energy Agency confirmed that Iran had gone further and reduced the stockpile of 20 percent enriched uranium by nearly 75 percent.
Under the interim deal, Iran promised to dilute half the enriched uranium to a grade that is less susceptible to proliferation and to convert the rest to oxide for use in nuclear reactors. Both processes are well underway, with completion expected before the July deadline.
Another potential bright spot is a proposal by Vice President Ali Akbar Salehi, head of the Atomic Energy Organization of Iran, to redesign Iran's heavy water reactor near Arak to use low enriched uranium and limit the amount of plutonium the facility can produce.
Mr. Salehi may have been too optimistic when he told state television that the Arak issue, a major dispute, "has been virtually resolved"; the West at one point had demanded that the facility be closed entirely because it could give Iran a second plutonium-based path to a nuclear weapon, in addition to uranium. But the proposal, also raised by Foreign Minister Mohammad Javad Zarif in March, could offer a potential compromise.
Meanwhile, Iran's Atomic Energy Organization has hinted it may finally come clean on the country's past nuclear activities, which international inspectors believe involved weapons-related pursuits. Transparency could go a long way toward building trust between Iran and the West. A spokesman for the organization was vague on details and said the report may not be done until after the deadline for a final nuclear agreement.
For all this positive momentum, which includes a reciprocal easing of some Western sanctions, many of Iran's policies remain indefensible, such as the detention of political prisoners, support for President Bashar al-Assad of Syria and support for Hezbollah. Mr. Zarif failed to address those issues in an article he wrote on Iranian foreign policy in Foreign Affairs magazine. But he firmly committed Iran to "prudent moderation" and to fostering peace and security. A durable nuclear agreement is an important first step in fulfilling that promise.


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One of the most asked questions we get is how do you do the "stripes" the answer to this can actually be very lengthy but I'll save you some time. It is a complex process that boils down to a few main items.
- quality of grasss
- sharpness of blades
- proper equipment
- operator knowledge
- time


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Staverton Village Hall
The Village Hall hosts a number of regular events.
Click here for Direct Link to the Village Hall Website
Click here for list of Village Hall events 2018
Click here for the Village Hall Tote results – 2017
Mums and Tots
10.30am – 12.00pm, Thursdays in term time.
For further details contact Emma Ashby on 01327 703397.
Parish Council
The Parish Council meet on the first Tuesday of the month at 7.30pm. The public are welcome to attend as observers.
For further details contact Tony Glover on 01327 311449.
Musical Monkeys
Boogie Beanies entertain your little ones by providing interactive musical fun for pre-school children and babies. Their shows encourage infants to build the children's confidence in a fun and interactive environment. It's also a great way for parents to make friends too.
For further details phone 07746 717104.
Website: www.boogiebeanies.com
Yoga for Adults
The yoga classes incorporate warm up exercises, sun salutations, asanas (poses), pranayama (breath control) and relaxation.
The one hour classes are at 9.30am on Tuesdays and 12.30pm on Thursdays.
For further details contact Rebecca Gartshore on 07963 038873 or email firstname.lastname@example.com.
Enjoy the very best of ballroom and latin, mixed with the latest proven ways to get fit fast, with the most fun and fabulous workout ever, plus dance experience not required and no partner needed!
Classes are held on Mondays at 9.30am. All welcome!
For further details contact Emma Pettitt on 07734 910343 or email on email@example.com.
Classes are held on Mondays 8.00pm – 10.00pm. All welcome!
For further details contact Emma Pettitt on 07734 910343 or email on email@example.com.
Upholstery Workshop
One workshop per month, 10am – 4pm. 3rd Friday of month from 16th January 2015
£25 – £30 per session (subject to numbers, min 8, max 10. Fully insured)
Breathe new life into tired chairs and other items of furniture.
Techniques covered include modern and traditional upholstery.
Tools and equipment supplied for the day including sewing machines if required.
Upholstery materials can be purchased from the tutor.
Any special requirements may need to be discussed and ordered in advance.
To book your place for the Spring Term please contact Ruth Brewin on 077235 306795 or email firstname.lastname@example.com
|Bookings and Enquiries – Please contact: Diana Kilshaw
Tel 01327 872321
firstname.lastname@example.com Village Hall Website: http://www.stavertonvillagehall.co.uk/page1.php
Hall Hire Charges:
Residents: £12 per hour (up to 7 hours)
£90 for the whole day
Non-residents: £14 per hour (up to 7 hours)
£110 for the whole day
Discounts available for on-going or group bookings.
All charges include lighting, heating and cooking.


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MAYHEM FESTIVAL @ FIDDLER'S GREEN | SUN, 7/7/13 Established in part by Kevin Lyman, one of the founders of the Warped Tour, this traveling showcase features a stacked lineup that caters to metal fans, with side activities for your downtime throughout the day. With a roster including acts as diverse as Rob Zombie, Five Finger Death Punch, Children of Bodom, Mastodon and Job for a Cowboy, among others, Mayhem offers a fine slice of metal from across the genre's spectrum. Mayhem lets you see all these acts in one place without going broke in the process.
See also: - Q&A with Alex Webster of Cannibal Corpse - The ten geekiest metal bands - The ten best faceless metal bands
EVERY TIME I DIE @ SUMMIT MUSIC HALL | SAT, 7/27/13 A more apt name for Every Time I Die might be "Every Time I Turn Around I Need a New Bassist." Since forming in 1998, the Buffalo-based outfit has gone through a string of four-stringers with an almost predictable frequency that could rival Spinal Tap and its infinite and seemingly inexhaustible pursuit of a permanent drummer. Fortunately, the low-end isn't really the centerpiece here, but more like a weight-bearing pillar propping up the intensity of act's metalcore savagery, Keith Buckley's eviscerating vocals and the torrent of relentless riffs. Catch Every Time I Die on this stop of the Allstars Tour with Chelsea Grin, Veil of Maya, Terror and many more acts.
SHAI HULUD @ MARQUIS THEATER | SUN, 7/21/13 Since its 1995 inception, Shai Hulud has blurred the line between hardcore and metal. Along the way, the band has helped to establish and somewhat define the elements of what later came to be called metalcore. Shai Hulud's influence can be heard in later bands playing music in a similar vein such as Unearth, Silverstein and As I Lay Dying, among others. Shai Halud is currently touring in support of its latest release, Reach Beyond the Sun, the band's fourth full-length.
WEEDEATER @ MARQUIS THEATER | TUES, 7/30/13 "Dixie" Dave Collins started this band in 1997 while still a member of the pioneering and influential sludge-metal band Buzzov*en. The name kind of says it all, but while Weedeater's shows seem to incite less violence than Buzzov*en's did at its peak, the former's riffs sound more menacing and gargantuan by comparison. It's also like Dave "Shep" Shepherd is playing in the same register on guitar as Collins does on bass. Keith "Keko" Kirkum's highly expressive drumming also drives and accents the music like a huge steam engine running out of control until it damn well feels like stopping.
Marijuana Deals Near You
ASG @ LARIMER LOUNGE | TUES, 7/16/13 Wilmington, North Carolina's ASG started as All Systems Go in 2001 but changed to the three initials to head off any possible conflict with another band with the same moniker. Its music is that kind of sludge/stoner rock akin to that of Fu Manchu and Clutch but with a bit more aggression and all the groove. Over the course of the last decade, ASG has a handful of releases under its belt and it has made connections in that loose affiliation of like-minded bands from the American Southeast like Baroness, Torche, Weedeater and Kylesa, whose Philip Cope recorded ASG's split with Black Tusk. The group's debut release on Relapse, 2013's Blood Drive, finds the band further exploring a fusion of 70s hard rock psychedelia and blues-based metal.
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Larry Simonelli's email signature says a lot about him. The signature says, "Your future will be better than your past." That optimism was put to the test when he found himself not making ends meet.
"When you are not working, there is no purpose in life," Simonelli said. "It felt absolutely hopeless."
Simonelli, a Greece, New York native and father of two, tried everything. He had his own struggling business and aggressively sent out resumes to online job listing sites like Indeed.com. Despite a wealth of experience in sales and managing facilities, the phone stopped ringing. The weight of rejection hung on Larry and his family.
"Things became disastrous at home," Simonelli said. "If your family is counting on you to supply their needs and you're not doing so, what do you do?"
Like thousands of people every year, Larry was eager for a change. He found himself in a RochesterWorks! career center looking for hope and some options. He was referred to Finger Lakes Hired, a program funded by a federal grant to help the long term unemployed get training and work in Advanced Manufacturing, Information Technology, and Health Care sectors.
"I never heard of Finger Lakes Hired before," Simonelli said. "So, I had no expectations."
It didn't take long for Simonelli to meet Finger Lakes Hired Employment and Educational Specialist Alexandria Vattimo. Larry credits Alex with showing him how to reshape his resume.
"Larry is highly motivated and a quick learner," Vattimo said. "He's diligent and was
actively seeking opportunities in his career."
Alex sees 6 to 10 customers like Larry every week. One of the many hurdles that the long term unemployed face is dealing with the frustration and high stress that comes with any job search, let alone a prolonged one. High stress and frustration can cause simple mistakes that can keep a job seeker out of the workforce. One thing that Alex shared with Larry and other customers is that patience is key.
"Larry was so eager to land a job that it sometimes distracted him," Vattimo said. "I reminded him that sometimes finding the right job takes time and that's OK."
Armed with a new modern resume, a fresh point of view, and the drive that lead him through a 20-plus year career he tried again. Before he knew it, the phone started to ring. He interviewed with companies in his target industry that Alex referred him. He also got responses on Career Builder. He landed a position with TruGreen as Sales Representative. He started on March 13, 2017.
"I was so impressed and blessed by Finger Lakes Hired," Simonelli said. "I don't know what I would have done without them."


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all images via pinterest + personal archive
Well, things are finally getting back to normal. Today was the first day back to school for Rob and the kiddkes. And I am finally able to sit at my desk uninterrupted for a few hours. I use the term uninterrupted loosely. My mind has a bad habit of reminding me of the thousands of other things I could/should be doing around the house as soon as I sit down to work. But, I digress… we had a great holiday vacation, which actually seemed longer than the 2 weeks that it was (in a good way)! I am excited about things to come both business and work wise. Keep an eye out, I'm super excited that The LookBook Philosophy will be getting a new look soon. I've been wanting to change things up a bit, refine them if you will, and what better way to start the year off than with a new look?☺
Do you like today's mood board? It's another board I created to help with the direction of the new line. I'm excited to say that I am excited again about designing. It's been a long slow road back, but I can't wait to share the new bags with you! In the meantime, enjoy this fabulous Monday! Keep creating, being, and doing everything you can to get closer to your goals and dreams. It will all be worth it in the end!