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Table Of Contents
About Cisco Validated Design (CVD) Program
Overview of the Cisco Next-Generation WAN Architecture
Enterprise Interconnect Module
Application Visibility and Control
Overview of the Cisco Next-Generation
WAN ArchitectureLast Updated: April 17, 2013
Building Architectures to Solve Business Problems
About the AuthorsTom Schepers, Director, Borderless Networks Architecture,
Cisco Systems
Tom Schepers is the Director for the Borderless Networks Architecture team. Tom is responsible for next generation enterprise network architectures and sales enablement that relates to Borderless Networks architecture. Prior to his current assignment, Tom was a Distinguished Systems Engineer for the US Enterprise segment, focused on WAN architecture and technology. During his 17-year tenure at Cisco, Tom has also worked as a Systems Engineer and Consulting Systems Engineer, focused on large-scale network design for Enterprise.Scott Van de Houten, Distinguished Architect,
Borderless Networks Architecture, Cisco Systems
Scott Van de Houten is a Distinguished Communications Architect on the Borderless Networks technical strategy team focusing on enterprise network architectures. Scott has been with Cisco for 20 years and has over 25 years of industry experience. Scott has a broad range of expertise and has held many different positions at Cisco including Product Line Manager for IOS routing protocols as well as multiple Systems Engineering roles in Cisco Federal Sales.
About Cisco Validated Design (CVD) Program
The CVD program consists of systems and solutions designed, tested, and documented to facilitate faster, more reliable, and more predictable customer deployments. For more information visit http://www.cisco.com/go/designzone.
The Cisco implementation of TCP header compression is an adaptation of a program developed by the University of California, Berkeley (UCB) as part of UCB's public domain version of the UNIX operating system. All rights reserved. Copyright © 1981, Regents of the University of California.
Cisco and the Cisco Logo are trademarks of Cisco Systems, Inc. and/or its affiliates in the U.S. andr countries. A listing of Cisco trademarks can be found at http://www.cisco.com/go/trademarks. Third-party trademarks mentioned are the property of their respective owners. The use of the word
partner does not imply a partnership relationship between Cisco and any other company. (1005R)
Any Internet Protocol (IP) addresses and phone numbers used in this document are not intended to be actual addresses and phone numbers. Any examples, command display output, network topology diagrams, and other figures included in the document are shown for illustrative purposes only. Any use of actual IP addresses or phone numbers in illustrative content is unintentional and coincidental.
Overview of the Cisco Next-Generation WAN Architecture
© 2013 Cisco Systems, Inc. All rights reserved.
Overview of the Cisco Next-Generation WAN Architecture
The Cisco Next-Generation WAN (NGWAN or Next Gen WAN) for enterprises is a comprehensive architecture developed for large enterprise and public-sector entities that targets large-scale routed wide area network (WAN) deployments. The architecture encompasses branch and metro connectivity, IP and Multiprotocol Label Switching (MPLS) core backbones, and emerging enterprise edge functions.
Related Documents
This document provides the initial details of the architecture, the component architectures, and the integration of Cisco Borderless Networks services on IPv4 and IPv6 infrastructures.
Several companion documents located under the Regional WAN and Enterprise Edge tabs provided at http://www.cisco.com/en/US/solutions/ns340/ns414/ns742/ns816/landing_overall_wan.html provide a more detailed definition of the component architectures and their designs. Deployment and configuration guides are provided as well as specific supplemental guides for detailed deployment recommendations for specific items. The release of some of these documents will follow in subsequent phases.
•Regional WAN At-A-Glance
•Regional WAN Deployment Guide
•Best Practice Guide (Cisco PfR, AVC, and WAAS)
•IPv6 Migration Deployment Guide
•Regional WAN Management Supplemental Guide
•Video Deployment Guide
•Remote Access VPN Design Guide
•Remote Access VPN Deployment Guide
•IPv6 Deployment at the Internet Edge At-A-Glance
•DMVPN-to-GET VPN Migration Guide
•Cisco Performance Routing Deployment Guide (Coming Soon)
•CWS Deployment Guide (Coming Soon)
•RWAN TrustSec Supplemental Design Guide (Coming Soon)
•Unified Collaboration Supplemental Guide (Coming Soon)
•AppNav Design Guide (Coming Soon)
•LTE Deployment Guide (Coming Soon)
•BYOD For the Branch Whitepaper (Coming Soon)
•VDI-In-A-Box Guide (Coming Soon)
•CSR Whitepaper (Coming Soon)
•WAN Core Solution Overview (Coming Soon)
•Metro Solution Overview (Coming Soon)
•Enterprise Edge Solution Overview (Coming Soon)
This document provides an architecture overview of the NGWAN for enterprises and takes an architectural approach to designing and deploying routed WAN solutions for Borderless Networks. This document provides a breakdown of the architectural components and an overview of the Borderless Networks services that are integrated within the architecture.
This document is intended for the reader who is interested in these topics:
•Large national or global WANs
•Regional branch networks with up to 15,000 sites
•MPLS VPN, Internet, and third and fourth generation (3G and 4G) transport for branch connectivity
•Metro networks using Carrier Ethernet or self-deployed optical networks of up to 100 sites
•Enterprise edge with collaboration (voice and video) or public cloud requirements
•WAN core networks within theater (country) and global, based on self-deployed MPLS or IP
•Incorporating security for privacy and regulatory requirements
•Addressing the need for mobility of users and machines
•Migration requirements for IPv6
•Upgrading or addressing growth to new regions or countries
Architecture Benefits
NGWAN is a comprehensive architectural approach to defining the enterprise routed WAN. You can realize several benefits when you implement a Next Gen WAN:
•Reduced operating costs
•Increased scalability
•Improved security and risk management
•Improved application performance
•Maximized network availability
•Flexibility and "services on demand"
•Reduced overall complexity
•Faster time to market for new IT services
•Accelerated merger and acquisition return on investment (ROI)
•Regulatory compliance
Architecture Overview
The NGWAN architecture is modular and hierarchical, and it provides a scalable solution across the enterprise customer segments as shown in Figure 1.
Figure 1 High-Level Architecture Abstract
The NGWAN architecture is comprised of five core modules:
•Regional WAN: Used to connect branch offices and aggregate remote locations
•Metro: Used to connect remote offices and data centers across metro transports
•WAN core: Used to interconnect regional networks and data centers within a country, theater or globally
•Enterprise edge: Used to connect the enterprise network to other external networks and services
•Enterprise interconnect: Connects all WAN, campus, and data center network modules together
This modular and hierarchical approach allows a NGWAN to be designed that uses basic building blocks to increase availability and scalability. Availability is increased by providing fast convergence and fault isolation within a building block. The three-tier hierarchy allows the enterprise network to scale from a regional two-tier design up to a global three-tier network design. These NGWAN modules are tied together, along with campus and data center modules, using the enterprise interconnect, which acts as an enterprise distribution network. The WAN core peers with multiple regional interconnects to scale the network across the country or theater. In the largest cases, a top-tier global core backbone can interconnect such theater networks.
The NGWAN architecture also focuses on the enterprise edge and includes emerging strategies such as connectivity to the cloud (private, public, and hybrid) and collaboration services, as well as business-to-business rich-media capabilities such as telepresence.
The NGWAN architecture provides more than advanced routing functionality. Another major goal of the architecture is to deliver the applications and services that are relevant and fundamental to the enterprise business along with the routing elements that provide reliable delivery of those services. The architecture delivers services like these:
•Application Velocity and Control (AVC)
•cloud connectors
The incorporation of these services within the routing architecture is an important consideration when considering a WAN solution. The NGWAN architecture allows for services to be added as they are needed, and large-scale replacement of equipment or redesign is unnecessary.
Finally, the NGWAN architecture examines the linkages between the Cisco Virtualization, Collaboration, and Service Provider architectures. The NGWAN includes linkages to the enterprise Virtualization and Collaboration architectures, which provides additional functionality and true end-to-end value. The NGWAN leverages the Service Provider architectures to use carrier-class network technologies and products to build high-performance, highly available enterprise networks.
NGWAN Architecture Modules
The NGWAN architecture has multiple tiers:
•Access: regional WAN and metro
•Aggregation: interconnect
•WAN core: in-theater and global cores
An additional access module provides external access through the enterprise edge (next-generation Internet edge). Today the enterprise, or Internet, edge is centralized, but in the future we can expect a more distributed method for accessing public networks for cloud, mobility, and collaboration. This hierarchical structure allows the architecture to be separated into elements that are relevant to any customer environment. When a global footprint is required, all aspects of the architecture can be used. On the other hand, a footprint that is contained solely within a single theater does not require the global core, but it can be added when the network expands into other theaters.
The NGWAN architecture also introduces the concept of the enterprise interconnect. The enterprise interconnect connects the regional WAN, metro networks, enterprise edge, and WAN core to integrate them into a single architecture. The interconnect also can connect the local data center and campus that may be co-resident at the location. Figure 2 depicts the NGWAN architecture and the individual components.
Figure 2 Hierarchical Architecture Overview
To fully understand the architecture and the ability to provide Borderless Network services, read the next sections, which describe what each module contains.
Regional WAN Module
The regional WAN combines branch access and WAN aggregation routing into a single network system. Branch locations in this context are remote locations that provide connectivity to a central site, typically campus or data center locations (see Figure 3):
•Standard branch: A standard branch requires application availability and performance, but it does not require the higher-level of availability of a high-end branch. Although a standard branch may or may not have telepresence installed, it has requirements for collaboration and video services.
•High-end branch: A high-end branch is a branch where the customer demands the latest technology for collaboration and application availability, regardless of size. A high-end branch also encompasses more services that support critical applications, such as telepresence, IP video surveillance, and digital signage. This branch is critically important, so high availability and application performance capabilities must be provided.
•Ultra high-end branch: An ultra high-end branch requires the highest availability and performance, above those of the high-end branch. This location has a high user count, more like a remote campus. An ultra high-end branch has very high bandwidth and encryption requirements, usually at speeds of OC-12 or line-rate Gigabit Ethernet, and beyond. The ultra-high-end branch has such high performance and availability requirements, so it employs appliances to deliver WAN optimization, public switched telephone network (PSTN) breakout, and other similar services. Support for multiple simultaneous high-definition (HD) video streams is also required.
•Mobile branch: A mobile branch takes advantage of a wireless WAN (WWAN) connection that allows for the entire branch to move. Temporary workspace and locations without wired connectivity are examples of the mobile branch. Mobility of the entire branch is the primary requirement, but application performance and security are also important over the high-latency links of cellular 3G, 4G, or satellite.
Figure 3 Regional WAN Architecture
Metro Module
The metro networks are divided into the access and transport models. A typical metro access model is based on the regional WAN but uses a Layer 2 Ethernet hand-off instead of a Layer 3 IP hand-off from the service provider. Self-deployed metro transport models use privately owned or leased fiber assets to deliver a richer set of services as part of the NGWAN infrastructure. Enterprise metro networks get their primary requirements from the Cisco Data Center Interconnect (DCI) services used across the metro network.
•The metro access model provides connectivity to remote offices and data centers over Layer 2 Metro Ethernet service offerings (Figure 4). The Metro Ethernet service offering could be provided by a service provider or by the enterprise-owned metro network (Figure 5). The metro access branch and aggregation design is very similar to the regional WAN design except that Metro Ethernet services are typically Layer 2 Ethernet and offer higher speeds.
Figure 4 Metro Network Access Models
–The small branch models use carrier-supported Metro-E over a service such as Ethernet line (E-Line) between sites. The typical deployment model employs E-Line point-to-point service with redundancy to a failover Ethernet circuit or to an IPsec DMVPN network in an active/standby model.
–The standard branch model offers redundant active/active E-Line or Ethernet LAN (E-LAN) Ethernet connections. The E-LAN service is a multipoint Ethernet service that emulates a LAN between sites. E-LAN service-level agreements (SLAs) are strictly on "access" information rates into the Ethernet cloud with rate-limits on multicast and broadcast traffic.
–The high-end branch model builds on the standard branch with redundant routers with active/active E-Line or E-LAN Ethernet. The ultra high-end, campus or critical branch model adds higher performance routers and higher bandwidth Ethernet circuits to meet the needs of the users at this site.
Figure 5 Metro Access Network Architecture
•The self-deployed metro transport models are used when the network service requirements justify a privately owned and managed metro network infrastructure. Critical drivers for metro networks include data center interconnect, legacy time-division multiplexing (TDM), storage networking, and HD video. Cost-effective access to fiber can easily justify deploying an enterprise-owned metro transport network for these drivers. The metro access models discussed would leverage an enterprise metro transport in the same manner as a service provider metro service. The self-deployed enterprise metro transport models in this architecture include the MPLS and Metro-E, optical, and enterprise service provider (ESP) designs (Figure 6).
–The enterprise MPLS and Metro-E deployment model includes an enterprise-owned and operated MPLS and Metro-E network to interconnect remote sites and data centers. These networks provide higher availability, faster change control, and flexible network virtualization options.
–The enterprise optical deployment model provides benefits similar to those of the previous model plus optical transport of other non-IP traffic types, such as native Fibre Channel, native video, and TDM circuit services.
–The ESP model combines a self-deployed optical and an MPLS and Metro-E metro network for the customers who need the maximum availability, capacity, virtualization, and transport flexibility. The scale and autonomous users of this type of network typically dictate a service provider operating model, thus the name ESP design.
Figure 6 Metro Transport Network Architecture
Enterprise WAN Core Module
Often, enterprises have multiple backbones for different services, such as, user, DCI, storage, and TDM. The convergence of applications and systems to IP and Ethernet with advances in network virtualization (Layer 2 and Layer 3 VPNs) has made it possible to collapse multiple isolated backbones into a single converged core network. Converged cores can reduce transport circuit costs, simplify operations, and increase the efficiency of network assets. Converged cores can be based upon IP or MPLS technologies. IP cores are very common and can address the majority of enterprise requirements. MPLS cores are common when the scale and operating requirements dictate service provider-like operating model. The additional capabilities of an MPLS core increase the complexity and operating costs as compared to an IP core.
The enterprise interconnect provides the connectivity between the regional WANs, MANs, data centers, enterprise edge, and campus networks. The WAN core network provides connectivity between regional enterprise interconnects within a theater as well as globally between theaters (Figure 7). The WAN core networks are sometimes referred to as the WAN backbone. Figure 2 shows how the WAN core is positioned within the architecture.
Figure 7 Enterprise WAN Core Topology
The in-theater core provides connectivity within a territory with common requirements, geography, service providers, and regulatory authorities. For example, the European core could provide connectivity between regional networks in Europe and the U.S. core could provide similar connectivity in the United States.
A global core provides connectivity between in-theater cores, which allows for scalability of the architecture on a global basis.
The vital nature of the enterprise core network requires that it be high-performance, highly available, and resilient. The enterprise core network must balance the costs of transport circuits, bandwidth, and network operations. The use of separate cores for in-theater and global networks provides additional scalability, better fault isolation, and policy control. In addition, multiple planes (multiplanar cores) can be used to improve availability of up to six nines for in-theater and global cores.
Enterprise Edge Module
Requirements for IP connectivity outside of the organization are changing. Enterprises must consider the outside edges of their networks to be something beyond simple, highly centralized Internet access. These new edge requirements mean new types of external peering relationships for voice, video, and cloud services that require new SLAs. These new requirements also introduce new security concerns and have more instances of external connectivity. This situation requires that the Internet edge evolve into a new multiservice "enterprise edge".
The enterprise edge is defined as the interface between the controlled enterprise network, users, or resources and those that are outside of the enterprise's control or visibility as shown in Figure 5. Users are employees, partners, customers, and guests. Resources are Internet access, business-to-business connectivity, collaboration resources, remote user access, and application services. The enterprise edge is also a place where services such as security and collaboration acceleration reside (Figure 8).
Figure 8 Enterprise Edge
The enterprise edge is divided into five submodules:
•web services
•mobility services
•communications services
•cloud services
•business-to-business services
These submodules are installed optionally at each location where the enterprise edge connectivity is required, such as central sites, regional hubs, or branch offices (Figure 9). Mobile devices that have simultaneous connectivity to corporate and Internet resources can be considered an enterprise edge as well.
Figure 9 Enterprise Edge Component View
Enterprise Interconnect Module
The enterprise interconnect is the location in the NGWAN where the WAN core, regional WAN, metro, enterprise edge, and local data center or campus network modules are interconnected. The interconnect may consist of any or all of the architecture modules, depending upon the requirements and overall enterprise architecture (Figure 10). The interconnect is the network peering point between modules and not necessarily a physical part of the network infrastructure.
Figure 10 Enterprise Interconnect Framework
Within a regional location, the interconnect is the peering point between the regional WAN, metro, campus, and data center network modules. The WAN core module provides the connectivity between multiple regional network locations within a theater and globally across multiple theaters.
The enterprise interconnect infrastructure delivers services between the other component modules of the architecture, which provides the end-to-end integration of Borderless Network services, such as medianet. The interconnect supports any co-located data center or campus networks, but those component architectures (campus and data center) are well-defined elsewhere and are outside the scope of this document.
Borderless Network Services
Cisco has positioned a framework for the next-generation network called the Borderless Network Architecture. NGWAN is an underlying foundation for the Cisco Cloud Intelligent Network (CIN), which is one of the three pillars of the Borderless Networks framework in Figure 11. The NGWAN architecture enables the Borderless Network systems and services over integrated IPv4 and IPv6 infrastructures.
Figure 11 Borderless Network Architecture
The key components of the Borderless Networks Architecture that are used in the NGWAN are described in the next sections.
Cisco Prime Management
Cisco Prime provides a portfolio of network management services that enables enterprises and service providers to more effectively deploy and operate their networks, speed troubleshooting, and improve operational efficiency. Cisco Prime products offer many advantages, including these benefits:
•Converged management and troubleshooting of wired and wireless access, branch, and wide area networks
•Network lifecycle management: User access visibility, inventory, configuration management, "plug-and-play", radio frequency planning, and best practices reporting
•End-to-end application and service assurance visibility for isolation and troubleshooting of performance issues
•Simplified deployment and management of Cisco advanced technologies such as VPN, Zone-based Firewall, ScanSafe, and Application Visibility and Control (AVC)
•Configuration, provisioning, and troubleshooting of Carrier Ethernet, Unified MPLS, and converged packet-optical transport networks
The Cisco Prime portfolio of products is extensive. However, these key products, or suites of products, are several that may be used in the NGWAN:
•Cisco Prime for IT: This product suite simplifies network management, improves operations efficiency, reduces errors, and increases network predictability. Cisco Prime for IT includes Cisco Prime Infrastructure, Cisco Prime Collaboration, and Data Center.
•Cisco Prime for IP Next Generation Networks (NGN): A comprehensive suite of network management applications that helps simplify the design, provisioning, and management of carrier-grade networks. Some of the products in Cisco Prime for IP NGN that are applicable to the NGWAN are these:
–Cisco Prime Provisioning: Provides service fulfillment across the entire network including the core, aggregation, access, and Internet/enterprise edge
–Cisco Prime Optical: Provides scalable configuration provisioning and troubleshooting of converged IP and optical transport networks
Individual Cisco Prime products and their application to the NGWAN are discussed in further detail within the documentation provided for each of the NGWAN network modules.
Security for enterprise networks, internal and external through the enterprise edge, is a critical requirement for the architecture. The solutions employed include the ability to protect data, create separate logical networks for privacy, and protect the infrastructure itself from attack.
Five security use cases are included with the architecture:
•Cloud (for example, the effect of a public or hybrid cloud at the enterprise edge)
•Infrastructure hardening
•Extranet and partner access
•Segmentation (such as closed user groups for regulatory compliance and mergers and acquisitions)
•Secure connectivity and data privacy, including IP Security (IPsec) encryption models and Cisco TrustSec support
Rich media applications are creating increased demands on the enterprise routing infrastructure. These technologies are being delivered within the enterprise routing architecture as necessary within each tier:
•Medianet (video): For ensuring quality of experience, monitoring, and deployment
–Resource control
–Media Services Interface (MSI)
–Media trace
•Hierarchical and consistent end-to-end QoS
•Cisco Performance Routing (Cisco PfR): Optimizing routes based on factors such as packet loss, latency, and jitter
•Video optimization: Providing the ability to scale video to branch-office locations
•Cisco Service Advertisement Framework (SAF): Scaling the Cisco Unified Communications environment
With "bring your own device" (BYOD), enterprise networks must now support a variety of devices including personal mobile devices. The TrustSec architecture provides an integrated solution that offers authentication, access control, and user policies to secure network connectivity and resources and authorization of all users on the network through the Cisco Identity Services Engine (ISE). Use cases include:
•Authentication and authorization
•Guest access management and enforcement
Application Visibility and Control
Cisco AVC is a powerful integrated solution for cloud services (public, private, and hybrid) with four primary use cases:
•Application visibility into difficult-to-classify applications obscured by HTTP or virtual desktop infrastructure (VDI) transports
•Application response time (ART) monitoring of application performance
•Media monitoring (MMon) to tracking the performance of voice and video applications
•Application optimization
The Cisco WAAS and WAAS Express technologies are used along with integrated Cisco IOS® Software technologies such as Cisco PfR, Next Generation Network-Based Application Recognition (NBAR2), Flexible NetFlow, quality of service (QoS), and Cisco IOS IP Service Level Agreements
(IP SLAs) to provide a full complement of functions including classification, optimization, monitoring, and troubleshooting.
Cloud Connectors
Cloud computing is a significant driver that is revolutionizing the enterprise and service provider industries. The routed WAN infrastructure provides a key role in these enterprise cloud strategies:
•Inter-cloud routing: The NGWAN metro and WAN cores provide reliable transport services between private clouds, public clouds, and virtual private clouds.
•Cloud security: Encryption for privacy protection between clouds and threat prevention, detection, and mitigation when public and virtual private cloud services are accessed.
•AVC: AVC is used to improve the monitoring and optimization of cloud applications to remote branch offices.
Cloud connectors improve the delivery and performance of cloud services. Some examples include Cisco ScanSafe, Hosted Collaboration Solution (HCS) connector, and WebEx cloud connectors. Find a complete list of available cloud connectors at this link: http://www.cisco.com/en/US/prod/routers/cloud_connectors.html.
The primary business case for IPv6 is being driven by the explosion of mobile devices and the fact that new IPv4 address space is very limited. The NGWAN architecture enables the use of IPv4 and IPv6 simultaneously. Customer scenarios are divided into four categories:
•Those who, through a government mandate or similar requirement, are being compelled to implement IPv6
•Those who want to deploy IPv6 to resolve problems such as IPv4 address exhaustion, globalization needs, mobile device adoption, or IT consumerization
•Thought leaders who are looking for differentiation or competitive advantage: Typical scenarios involve building smart grids, peer-to-peer applications, and mergers and acquisitions
•Those who are looking at the evolution of IPv6 and are concerned about investment protection
The use cases in this architecture are focused on the internal usage of IPv6 within IP and MPLS networks, as well as the interface to external partners and Internet applications. The focus is on supporting IPv6 and IPv4 in a dual-stack approach (preferred), while enabling a non-disruptive migration and transition strategy as more IPv6 hosts and applications become available.
The Cisco NGWAN provides a modular, hierarchical architecture for deploying routed WAN solutions that provide the services necessary to support the emerging technologies and user environment of the Borderless Network. This approach also allows the customer to adopt services incrementally and smoothly, rather than requiring large-scale redesigns and changes.
The architecture provides a blueprint for building services-led WAN architectures for branch, metro, core, and enterprise edge connectivity for enterprise networks that scale from a single branch network to a large global network that spans multiple continents.
The other documents in this series describe the specific use cases and deployment scenarios that provide the necessary guidance for success in deploying the Cisco NGWAN architecture.
For More Information
Read more about the Cisco NGWAN or contact your local account representative.


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|Generic Name
|Brand Name
|acetylsalicylic acid (aspirin)
|Asaphen, Aspirin, Entrophen, Novasen
How It Works
Aspirin slows the blood's clotting action by reducing the clumping of platelets. Platelets are cells that clump together and help to form blood clots. Aspirin keeps platelets from clumping together, thus helping to prevent or reduce blood clots.
During a heart attack. Blood clots form in an already-narrowed artery and block the flow of oxygen-rich blood to the heart muscle. When taken during a heart attack, aspirin slows clotting and decreases the size of the blood clot that is forming.
After a heart attack. Aspirin can help prevent a second heart attack. Taken daily, aspirin's anti-clotting action helps prevent a first or second heart attack.
Why It Is Used
For people who are having a heart attack. You can take aspirin to help you during a heart attack. After you call 911 or other emergency services, the operator may tell you to chew 1 adult-strength or 2 to 4 low-dose aspirin. Or you might be given aspirin in the ambulance or emergency room. Aspirin slows blood clotting. So a blood clot that is causing the heart attack stays smaller.
For people who have had a heart attack. Aspirin can help prevent a second heart attack.
For people who have never had a heart attack. Aspirin may reduce your chance of having a heart attack or a stroke if you have certain risk factors, such as diabetes, high blood pressure, high cholesterol, or smoking. If you have a higher risk for a heart attack or stroke, aspirin will have even more benefit for you.
Low-dose aspirin may also be used by people who have:
- Coronary artery disease.
- Stable angina.
- Unstable angina.
- Had bypass surgery or angioplasty.
- Had a stroke or transient ischemic attack (TIA).
But in people with a relatively low risk for cardiovascular disease, the benefits of preventive aspirin therapy may be outweighed by the increased risk of bleeding problems.
How Well It Works
- Aspirin can lower the risk of a first heart attack and recurrent heart attacks.
- Aspirin may reduce the severity of a heart attack when taken immediately after symptoms begin.
- Aspirin may help improve the symptoms of unstable angina.
- Aspirin may lower the risk of death caused by heart disease.
Generic or store brands are as effective as brand-name aspirin.
Side Effects
All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.
Here are some important things to think about:
- Usually the benefits of the medicine are more important than any minor side effects.
- Side effects may go away after you take the medicine for a while.
- If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.
Allergic reaction
Call 911 or other emergency services right away if you have:
- Trouble breathing.
- Swelling of your face, lips, tongue, or throat.
Call your doctor if you have:
- Hives.
Call 911 or other emergency services right away if you have:
- A sudden, severe headache that is different from past headaches. (It may be a sign of bleeding in the brain.)
Call your doctor now or seek medical care if:
- You have any abnormal bleeding, such as:
- Nosebleeds.
- Vaginal bleeding that is different (heavier, more frequent, at a different time of the month) than what you are used to.
- Bloody or black stools, or rectal bleeding.
- Bloody or pink urine.
Common side effects of this medicine include:
- Stomach pain or discomfort.
- Nausea.
See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)
What To Think About
For more information about taking daily aspirin, see the topic Aspirin to Prevent Heart Attack and Stroke.
If you have had a heart attack or stroke, your doctor has probably already prescribed aspirin for you.
If you do not take aspirin, talk to your doctor before you start taking aspirin every day.
Taking medicine
Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.
There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.
Advice for women
If you are pregnant, breastfeeding, or trying to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breastfeeding, or planning to get pregnant.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments. And call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
Complete the new medication information form (PDF) ( What is a PDF document? ) to help you understand this medication.
Current as of: October 5, 2017

subset: commoncrawl


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Does This Baby Make Me Look Fat?
Kathy is 17 weeks pregnant, and it's making her want to vomit.
It isn't morning sickness triggering her impulse: It is bulimia. And each time she sees her swelling belly in the mirror, feels her clothes growing tighter or thumbs through a magazine and spots yet another pregnant celebrity with a marble-sized baby bump, she wants to throw up again.
Before her pregnancy, Kathy (who asked SELF not to publish her last name) thought she had recovered. Her eating disorder had begun in college, and for seven years, it ruled her life. A voice louder than her own good sense and judgment told her, You aren't worthy of food. You are disgusting. "Purging calmed my mind," she admits. "I didn't feel anything for 5 or 10 minutes afterward, and that was alluring when my mind was spinning out of control."
She stuck her finger down her throat after every breakfast, lunch and dinner—up to 12 times in a day. She exercised relentlessly to burn off what she did eat. Yet nothing changed. "I felt like a total failure for having an eating disorder but not being able to lose weight," she says. Depression set in—and anxiety. She couldn't sleep. Her stomach hurt from all the heaving. She hid her problem from her friends and family, drawing herself ever more inward.
During graduate school for social work, Kathy's obsession with food and weight left little room for studying. "It was taking up 150 percent of my mental capacity," she says. "I thought my eating disorder was going to kill me. I didn't want to leave my house, but I did so that people wouldn't know something was wrong."
Finally, she got outpatient eating disorder treatment at Park Nicollet Melrose Institute in St. Louis Park, Minnesota. Even that step made Kathy feel, perversely, like a failure. "I figured if I were skinny enough, they would have hospitalized me. But they didn't, so I felt that I couldn't even be good at having an eating disorder," she says.
Through intensive therapy and nutritional counseling, Kathy slowly got better. She stopped bingeing and purging, even though she still wanted to. Soon she met the man who would become her husband. Getting married made her feel like a normal, healthy person for the first time in her life. Deciding to get pregnant was another story entirely. "I knew I'd be weighed a lot and that I was going to get bigger, a lot bigger," she says. "I wanted a baby so bad—but the eating disorder side of me really did not want that to happen."
When she got pregnant, Kathy had been in treatment for three years and hadn't purged for two. But at 17 weeks, she feels her hard-won recovery is threatened. "Anytime I eat, my disorder tells me, It's too much; you are going to gain weight; you are out of control," she says. She has to choke down even healthy food, like the bagel with peanut butter she eats for breakfast. "To that, my eating disorder voice says, That's too many calories, too many carbs. It will make you gain weight," she says.
She tries to imagine her growing baby depending on her, even judging her. "I don't throw up because the baby would know," she says. "Everything I do is influencing that baby, and I want it to be healthy. [But] the way my body is changing terrifies me."
Would having a baby make you appreciate your body—or hate it? It's a question many women ponder long before they ever take a pregnancy test. When women do conceive, many—both disordered and nondisordered eaters alike—are motivated to eat more healthfully. But others struggle. "Some women with a history of severe eating disorders, although they are a small minority, become so unhappy with what their pregnancy is doing to their body that they intentionally try to sabotage it, beating on their stomach with their fists," says Ovidio Bermudez, M.D., chief medical officer and medical director of child and adolescent services at the Eating Recovery Center in Denver. "That's how overwhelming their feelings can be."
SELF wondered how widespread these emotions are. So we teamed with CafeMom.com, the website for mothers and mothers-to-be, for a no-secrets survey of about 300 pregnant or recently pregnant women. About 10 percent of the women surveyed had been diagnosed with an eating disorder at some point, like Kathy. But the body-image fears were widespread even in women without that history. Among their confessions:
Forty-eight percent said they engaged in disordered-eating behavior such as restricting calories, overexercising, restricting entire food groups and eating lots of low-cal or lowfat foods. A few even confessed to fasting or cleansing, purging and using diet pills or laxatives.
Fifty-two percent said pregnancy made them more insecure about their body image. Only 14 percent said pregnancy made them more confident.
Seven in ten worried about weight gain. Yet many also did a poor job controlling the scale: Twenty percent of normal-weight women didn't gain enough, and about 30 percent of women gained more than they should have, according to Institute of Medicine (IOM) guidelines.
Women who practice disordered habits do so with hopes of preventing weight gain. And a small group—"pregorexics," as the popular (but not medical) label has it—doesn't put on enough weight and becomes dangerously skinny, eating disorder experts say. But in truth, disordered eating is more likely to increase weight because trying to restrict what you eat can lead to bingeing. Either way, these habits are a bad idea. "Gaining too much or too little during pregnancy is unhealthy and can cause problems later on for the mother and child," says Anna Maria Siega-Riz, Ph.D., professor of epidemiology and nutrition at the University of North Carolina Gillings School of Global Public Health.
Research shows that despite the risks, about half of doctors fail to assess disordered eating. And the SELF survey suggests some women aren't getting basic weight-management advice. "A couple of scientific studies indicate a major gap between doctors and patients on weight," says Kathleen M. Rasmussen, Sc.D., nutrition professor at Cornell University and lead author of the IOM weight guidelines. "Doctors report giving more advice than women say they are receiving." In our survey, 21 percent of women with a history of eating disorders heard nothing from their doctor about weight gain, and another 10 percent didn't get advice until they asked. That's an ominous statistic, given that pregnancy can exacerbate a disorder or reignite one that had seemed left in the past. "It's the same as women who smoke or drink," says Cynthia M. Bulik, Ph.D., director of the University of North Carolina Eating Disorders Program in Chapel Hill. "They know the dangers, but for some women, the drive of the disorder can be so overwhelming that they can't combat it even when pregnant."
Bulimia like Kathy's can ravage the body, causing anemia, dehydration and weakened heart muscles, so women with a recent history of the disorder start pregnancy with more stress on their body than other women do. Women with eating disorders may weigh more than is healthy, too. That's because—contrary to the stereotype of stick-thin disordered eaters—women with bulimia and eating disorder not-otherwise-specified (EDNOS) tend to fall on the higher end of the normal-weight spectrum, Bulik says, and binge eaters are often overweight or obese. However often a woman purges, throwing up can never rid the body of all the calories eaten during a binge, she explains.
It makes sense that if a woman goes into pregnancy overweight, she'll find it much harder to reach a healthy weight afterward, further raising her risk for obesity-related diseases. Her prepregnancy weight may also impact the baby. "A women's nutritional status before pregnancy sets the stage for growth of the placenta and how pregnancy progresses, which can have long-term impact on the health of the child," Siega-Riz says.
If Kathy gives in to her eating disorder, she'll raise her risk for gestational diabetes, heart problems, a cesarean section and postpartum depression. For the baby, potential complications of eating disorders include miscarriage, stillbirth, prematurity, low birth weight and breech delivery. The cause of problems in anorexics is pretty clear: inadequate nourishment. But why would babies of bulimics and binge eaters suffer, too? Scientists aren't sure yet, although they presume it's tied to what they call nutritional dysregulation. "In binge eaters, the baby is exposed to variable energy—bouts of high calories alternating with fasting," Bulik explains. "We're following these kids now to see what the influence of maternal diet is on their weight and growth trajectories." Women with eating disorders often experience clinical depression, which, if left untreated, can raise the risk for miscarriage, premature birth and low birth weight. Many disordered eaters also take up smoking to try to keep their weight down—some even after they become pregnant.
The encouraging news is that if Kathy does manage to keep on track, she can protect her baby. Women with the healthiest diets before and during pregnancy are 51 percent less likely to have an infant with anencephaly (when the baby is born without part of her brain or skull) and 34 percent less likely to bear a child with a cleft lip, finds a 2011 study of 10,000 women by Stanford University. Researchers have long believed folic acid is a magic bullet that protected against some of these conditions. But the Stanford findings suggest it's only part of the picture. "Our study showed for the first time that the overall quality of the diet, and not just a single nutrient, matters in terms of reducing the risk for birth defects," says lead author Suzan Carmichael, Ph.D., professor of pediatrics at Stanford. "In our bodies, nutrients don't just act in isolation. They depend on each other."
Few people knew how poorly Hillary Coggins was eating. Coggins, a 31-year-old graduate student in Bel Air, Maryland, was anorexic as a teenager and has struggled with bulimia for much of her adult life. When she learned she was pregnant nearly three years ago, she hoped the baby would be a catalyst to clean up her diet. Instead, she says, pregnancy brought on still another disorder—binge eating. "I took the 'eating for two' thing a little too seriously," she says. "I'd bake an entire pan of brownies and eat them all right after they came out of the oven. It was the first time in my life I ate whatever I wanted and didn't worry about it." (Even among nondisordered eaters, this attitude is pervasive and problematic, Siega-Riz notes. "The 'eating for two' myth is the reason for a tremendous increase in gestational weight gain," she says. Most women need only an extra 300 calories a day.)
A petite 5 feet 3 inches, Coggins weighed 139 pounds at her first prenatal visit. By the time she delivered her son, she says she topped 200 pounds. Coggins says she ate "five or six times what someone should," making midnight runs to McDonald's, where she would buy several value meals at a time, or eating six Snickers bars a night for an entire week. She resisted her strong desire to purge, although a few times she vomited simply because she'd overeaten. "I'd eat a carton of ice cream, and then I'd throw up. The irony is that I kept telling myself how unhealthy it was to purge, and yet here I was eating piles of cheeseburgers."
The weight piled on. Between weeks 25 and 36 alone, Coggins packed on 30 pounds. By 37 weeks, she had gained 57 pounds and says she was borderline hypertensive. But despite the signs of overeating, Coggins says, she received only casual lectures on healthy eating. "I vaguely remember my doctor telling me to gain no more than 30 pounds, but by that point, I had already gained that much or more," Coggins says. "Eventually, he commented that eating for two was an expression not to be taken literally, but he never mentioned the health of the baby, only that it would be hard to take off the weight. The message was: You know what to do." Coggins blames herself for her disordered eating. But, she adds, "if my doctor had said that my weight was endangering me or the baby, I would have tried to curb my habits."
Most ob/gyns are sensitive about looking for eating disorders when women consult them for problems with their period, says Ann Honebrink, M.D., associate professor of clinical obstetrics and gynecology at the University of Pennsylvania Perelman School of Medicine. "But because one of the main side effects we see in women with eating disorders can be infertility," she says, "I don't think we are as sensitive to the problem once a woman is pregnant." Only half of physicians surveyed by the American College of Obstetricians and Gynecologists screen for eating disorders and 86 percent said they had "barely adequate" training to diagnose and care for them. "I think we are less likely to look for something we don't know how to treat," Dr. Honebrink says, although she says that OBs are getting better about giving general weight-management advice and nutritional information to pregnant women.
If doctors don't bring up the issue of disordered eating, women are unlikely to, says Athena Kourtis, M.D., senior service fellow with the Division of Reproductive Health at the Centers for Disease Control and Prevention in Atlanta. Like Coggins, they may not understand how dangerous it can be. Or they may recognize the danger but stay quiet anyway. "Women are ashamed and secretive about having these problems and probably aren't forthcoming about them," Dr. Kourtis says.
It's little wonder that a patient already uncomfortable in her body wouldn't feel like discussing her eating habits with someone who isn't comfortable hearing about them. "There is still so much prejudice and stereotyping," Bulik says. "We have had patients whose OBs have gotten angry at them for 'choosing' to continue to 'practice' their eating disorder during pregnancy. Well, I have never heard of an OB getting angry at a mom for continuing to 'practice' her diabetes." Bulik suggests that every OB office should keep a list of psychologists, dietitians and psychiatrists who can treat an eating disorder, "to decrease concerns about being uncomfortable when they detect one."
The clinic Coggins went to refers women with past or current eating disorders to a nutritionist and encourages them to seek psychological counseling, says a nurse practitioner involved in Coggins's prenatal care. Coggins didn't bring up her history: She says she thought she didn't have to because she had been a patient there since she was 15. The nurse practitioner adds that because Coggins came into pregnancy with health issues, including anxiety and mitro valve prolapse, that "her weight went under the radar."
When Coggins went into labor, her dilation stalled at 4 centimeters, and she ended up requiring an emergency C-section—a complication that has been linked to bulimia and obesity. "She might have gotten by with a vaginal delivery without so much weight gain," the nurse practitioner says. Luckily, Coggins's son, Jackson, was healthy. But her disordered thinking continued.
She helped fight the urge to throw up by breast feeding: "It felt like purging and gave me the sense that I was burning more calories, like I was getting rid of something," she says. Some women even breast-feed or pump only to shed calories, sometimes after the baby is weaned. This so-called pump purging "is something we have just started to notice," Bulik says. It can be unhealthy for the mom if she starts to deplete her nutrients—for instance, if she is also purging food. And it's disordered because, Bulik says, "psychologically, it's twisting the function of lactation from something essential for life—feeding a child—to something that is part of the disorder—purging."
Jackson is now 2 1/2 years old, and Coggins weighs 27 pounds more than she did pre-pregnancy. She wants to trim down, but her disordered eating makes it impossible. She tends to skip both breakfast and lunch, then "eat everything in sight" around midafternoon. "I was miserable about my weight when I was pregnant, and I still am," she says. "I convinced myself that I could look the same as I did before I was pregnant, no matter what I ate. Now I worry I will never lose all this weight."
Kathy is in a happier place. She managed to stave off bulimia and gave birth a week past her due date to a boy weighing more than 9 pounds. "I'm proud of myself even though I fought with my eating disorder during my entire pregnancy," she says. "I knew I couldn't vomit because I didn't want that negative energy to go through the baby."
And yet, only two days after she stopped breast feeding, she purged. "I was more consumed with worries about my son and whether or not he would get good nutrition from formula and if he would sleep through the night than I was about coping with my eating disorder," she says. A couple of visits to her psychologist at Park Nicollet helped her reconnect with her more "rational voice."
It also reminded her to reach out. "The most helpful moment in my early treatment was when my parents came to a therapy session with my psychologist, and we figured out ways they could help me," she says. When she relapsed after her pregnancy, her husband was an anchor. "On bad days, I'd call him and say, 'I want to throw up' or 'I don't want to eat,' and he'd remind me that it's my eating disorder talking," she says. "I had all the skills I needed. I just needed to say out loud my disordered thoughts to a supportive person. Once I was able to make my rational voice stronger and louder, the symptoms went away."
Two years later, Kathy has come full circle and is pregnant again. But the second time around, she hasn't felt the same urge to purge. Heartened by her successful first pregnancy, she says, "I barely remember the tendency I had to binge, purge and restrict my food. I finally learned how to eat right and to feel at peace with my body as it is. Life is so much better when my eating disorder voice is quiet."
I'm not a disordered eater.
All I do is...
Nearly half of women polled use disordered eating to control their weight while preggers.
Eat only certain foods: 49% of the disordered eaters do this. Pregnant women need to avoid some foods for safety reasons, but experts warn against doing so to control your weight.
Restrict calories: 21%. Although it's important not to gain an unhealthy amount of weight, you shouldn't ever try to lose during pregnancy, the March of Dimes says.
Exercise too much: 4%. Pregnant women should get 30 minutes of aerobic exercise most days. But this minority takes it to extremes, risking metabolic effects or injuries that could harm the baby.
Use diet pills or laxatives: 3%. No one should do this, period. To be safe, pregnant women should get the nod from a doc before taking any meds, over-thecounter or prescription.
Purge: 2%. Bulimia during pregnancy raises the mom's risk for gestational diabetes, heart problems, a cesarean section and postpartum depression.
Fast or cleanse: 1% Fasting is never OK for a growing baby or her mother, says Anna Maria Siega-Riz, Ph.D.
A baby bump takes a toll
on my body image.
Large percentages of women say that "pregnancy made me more insecure."
68% of thin women. Only 5 percent of thin women say pregnancy raised their body confidence; 28 percent say it stayed the same.
61% of normal-weight women. Although 11 percent of normal-weight women got a body-image benefit from pregnancy, and 28 percent felt no change, most still say they lost confidence.
46% of women with a history of eating disorders. Women with current or past eating disorders felt marked pressure to gain less weight than other pregnant women.
45% of slightly overweight women. Slightly overweight women were most likely (at 20 percent) to say pregnancy gave them more body love; 35 percent felt no difference.
30% of obese women. Big women felt confidence in their baby body. But, perhaps with heightened health risks on their mind, they also worried about weight gain and felt pressure to control it.
So how much should I gain?
It depends on what you weigh now. The Institute of Medicine outlines what's ideal.
28–40 lb for thin women. In our poll, 35 percent of thin women gained less than this, and 38 percent gained more.
25–35 lb for normal-weight women. Got twins on board? If you start out at a healthy weight, the IOM says you can up that to 37 to 54 pounds healthfully.
15–25 lb for overweight women. Only 39 percent of slightly overweight women surveyed were able to keep their gain under the limit.
11–20 lb for obese women. More than half of obese women polled exceeded the 20-pound limit. Yet a mere 13 percent of obese women had docs who told them they were gaining too much.
Your Guide to a Happy, Healthy Pregnancy
Running While Pregnant: One Woman's Story
The Plus-One Workout: Stay Fit During & After Your Pregnancy


text: Introducing himself as a salesman, to a rousing reception including more than a few wolf whistles, Bono told the assembled women he was there to sell One and (RED). He went on to explain the work the One campaign is doing towards justice and equality, before describing RED as the "consumer wing of our movement". Bono urged the American audience to maintain the fight against AIDS and poverty in the face of economic hardship. "Clearly these are momentous times in America... times of crisis, times of chaos. Capitalism is on trial....The US, the world, is changing shape in unsettling ways. But this is exactly the right time to think about the world. Even to change it" he said. He asked attendees to sign up to One's Petition calling on John McCain and Barack Obama to keep their commitments to the poorest in the world should they enter the White House. You can sign up for the petition here Watch the highlight's of Bono's speech below and to see all the coverage visit ONE here".


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Aides Debated Obama Health-Care Coverage Promise
Behind the Scenes, White House Officials Worried About Insurance Pledge
As President Barack Obama pushed for a new federal health law in 2009, he made a simple pledge: If you like your insurance plan, you can keep your plan. But behind the scenes, White House officials discussed whether that was a promise they could keep.
When the question arose, Mr. Obama's advisers decided that the assertion was fair, interviews with more than a dozen people involved in crafting and explaining the president's health-care plan show....


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This week's Heroes & Super Villains installment is not Holiday-themed (like you really need another spoonful of gross, insincere commercialism shoved down your throat, right?) There are no songs dedicated to Saint Nick, lyrics telling of romantic, snowy mornings or catchy, seasonal jingles, because, let's face it, Christmas is so not hip-hop. But while you are enjoying the blessings of the Holiday season, here's five releases from this week that any grumpy hip-hop head can bump in their headphones (because I know you're not humming to any radio tunes). Merry Christmas, y'all – shouts to Asher Roth, The Yancey Boys, Erick Arc Elliott, Talib Kweli and Maffew Ragazino for the dopeness.


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It would be interesting to ask people in Taiwan whether the biggest question they have after watching the film Kano is: Was that what life was like about 80 years ago when Taiwan was under Japanese rule?
It could be that people just quickly decide whether they like the film or not, although it is fair to say that most people were ignorant of the facts on which it was based before the film came out.
The film is about a ragtag baseball team in Chiayi overcoming sloppiness to eventually advance to the finals at the Koshien championship, Japan's longest-running nationwide high-school baseball tournament, under the instruction of a Japanese coach in 1931.
The box-office hit has aroused much discussion since it opened in theaters just two weeks ago.
Some people have argued that the film uncritically glorifies the Japanese era by centering on the baseball team composed of three ethnicities — Japanese, Han Chinese and Aboriginal boys — in parallel with the Chianan Irrigation System (嘉南大圳) built by Japanese architect Yoichi Hatta as the theme.
Others have found themselves emotionally attached to the film's vivid visualization of what they have heard from parents or grandparents about some of the "good old colonial days," a piece of the past deliberately buried in oblivion in the education system under the previous Chinese Nationalist Party (KMT) regime.
The ambivalent attitude toward the period of Japanese colonial rule from 1895 to 1945 reflects deep divergence regarding national identity.
Through tracing the roots of Taiwanese baseball culture to the era of Japanese rule in what it portrays as a rosy period of time, the film makes a strong contrast between the Japanese era and the subsequent period of KMT rule.
As pointed out in some scholarly articles, the then-KMT regime had tried unsuccessfully to eradicate baseball — due to its Japanese roots in Taiwan — after retreating to Taiwan in 1949. It was not until the 1960s — when Taiwan faced international isolation — that the KMT regime began to use the game as a political tool to build a collective national sentiment.
The one-time textbook myth of the Hongye Elementary School little league team (紅葉少棒) developed by the KMT was once again debunked.
Over the decades, long-standing political division has repeatedly overshadowed other values that could have helped bridge gaps — like multicultural harmony, which is what the film is about.
However, this cannot be achieved when people in power maintain the mindset that they have a mandate to set the frame for how history should be interpreted.
This mindset is embodied in the proposed changes to the national high-school curriculum on Chinese literature, history and other social sciences.
In rebuffing criticism from historians, academics, teachers, students and Aboriginal groups over the Chinese and Han-centered historical perspectives adopted to revise the textbook guidelines, government officials defend the plan by saying that there is no deviation from historical facts in the proposed changes.
History is probably a field in which education and indoctrination can be easily distinguished, because a fair question to ask about history when it is taught based on a partisan or an ideological point of view is: Whose history is it anyway?
Taiwan is a multiethnic, multicultural country that can trace its history of immigration back to the early 17th century. That should have helped the nation foster robust public discourse, but this is not the case.


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Diplomacy is a part of Miriam Dean's skill set but there is a steely side to the highly regarded lawyer, litigator and chairwoman of New Zealand On Air.
Dean stood out when she was appointed to NZ On Air eight months ago - the first woman in the role and the first not to come from the public sector.
Two of her predecessors - founding chairman Merwyn Norrish and Neil Walter - had headed the Ministry of Foreign Affairs and Trade.
Another former chairman, broadcaster David Beatson, said Dean was treading carefully but had made a good move in governance.
Beatson, like other critics of NZ On Air's focus, said it had to address the funding of commercial content.
Dean said she was a bit shocked at her first meeting.
"I was handed 2500 pages of funding applications and the following month it was 3200 pages. As a lawyer I'd never been given more than 200 pages of briefing notes," she said.
"The board had started to get really involved in the nitty gritty, doing the work of management."
Changes implemented in October will lead to TV projects of less than $1 million and radio projects under $300,000 approved with less involvement from the politically appointed board and an end to its special oversight of documentary series.
NZ On Air's role in funding local content for TV, radio, music and increasingly digital has gone from being a foundation stone for Kiwi culture to a crutch for the commercial TV industry.
"Next year I would like the board to sit back and think about what the world will look like in the future," she said.
Dean is intelligent and inquiring but she is new to the media world and is being schooled by industry players on how it works.
She was told about the edict that broadcasting was there to "inform, educate and entertain" - Lord Reith's foundation for the BBC.
The good news is that producers seeking NZ On Air funding need agreement from broadcasters, meaning that it has only once funded a show that did not make it to air.
The downside is that in the trinity of the funder, the producer and the broadcaster, the TV networks have the upper hand.
Tacit government support was revealed last year when the Broadcasting Minister approved TVNZ's statement of intent with its main aim to take more taxpayer funding for commercial shows.
As advertising has collapsed the networks have tended to try to avoid risk.
In a long interview at her legal chambers in Princes St, Auckland, Dean repeats the argument advanced by networks that exclusively funding local content does not make commercial sense and commercial shows such as The GC, as with overseas format shows including NZ's Got Talent and The X Factor are a good use of taxpayer money.
The GC attracted a lot of flak and the first episode was too glitzy "but there was more cultural content as it went on and it was watched by 300,000 people and 300,000 online. It was a good use of money because it is better that young Maori were watching that rather than Neighbours at War," she said.
Next month NZ On Air looks set to fund $1.6 million of the second series of NZ's Got Talent on top of $1.6 million given to X Factor on competing channel TV3.
Dean said NZ On Air was bound by statute to take account of ratings and popularity.
But the death of TVNZ 7 has released a vocal minority who believe that NZ On Air is ignoring their needs.
Dean said allocations should be viewed in their entirety and the organisation was obliged to fund minority programming, radio and, increasingly, digital media. Shows such as 7 Days, The Almighty Johnsons and Nothing Trivial were important.
At the same meeting that gave $1.6 million to The X Factor, NZ On air also funded TVNZ 7 shows Back Benches and Media 3.
But she said one of the issues was that worthy shows such as Strongman, about the West Coast mining disaster, could garner acclaim but small audiences.
New media services such as On Demand and On Screen are becoming more popular and The GC, for instance, had as many viewers online as it did on TV.
It may be that digital media could become not just a source of additional viewers but also funding, she said.
After changes in the way people consume media many believe television will face the same upheavals that confront newspapers.
The Government is promoting Ultra Fast Broadband, opening up new media services.
Dean has expertise in the area as a director of Crown Fibre Holdings - the company that will run UFB.
And it is in this area where many believe Dean may provide the lead when the role of NZ On Air is to service commercial TV networks.


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In this hot weather, I'm keeping makeup to a minimum.
Kiehl's Deep Moisture Clarifying Crème – £41
As the sun can make skin discolouration and hyperpigmentation worse, I've been wearing Kiehl's Deep Moisture Clarifying Crème. The latest addition to Kiehl's skin-clarifying product range, this cream helps improve the appearance of dark spots and discolorations. It contains white birch and peony extract to hydrate and help provide long-term radiance. It was formulated with Asian skins in mind but I think it works just as well on brown skins. Wear daily to help improve skin clarity.
Estee Lauder Pure Colour Cheek Rush – £24
These cute pots of cheek stain are a great way to add a subtle hint of colour to the face. They give you a lightweight, natural, fresh finish and in this weather, won't sit on your face and melt into your lap. Creative Makeup Director for Estée Lauder, Tom Pecheux said: "This season, I've been working a lot with what I call "aqua colour". It's a gentle, watery look with just a touch of bright, vibrant colour." I tried the Cheek Rush in Turbo Jam and loved the watery gel finish and the way it complimented my skin tone. Estee Lauder advises quickly blending a tiny drop of this silky liquid-gel in a circular motion on to the apples of cheeks for a 'just pinched' look. Worked for me!
Jurlique Deluxe Edition Rosewater Balancing Mist – £41
In hot weather, facial mists were a must and my favourite was the Jurlique Deluxe Edition Rosewater Balancing Mist. Exclusive to M&S Your Beauty stores this lightweight mist provides a wonderfully refreshing shot of precious Rose flower extracts and plant botanicals to help hydrate the skin. A portion of the proceeds from the sale of this product go to the Jurlique Ideas of Beauty Fund which supports beautiful ideas that empower and educate women globally. I spritz myself before bed, before applying make up; I even lug it around to my bag to stay fresh when I'm out and about. It may not be hot anymore but central heating is not our skin's friend.


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U.S. at borrowing limit, moves to avoid default
WASHINGTON The U.S. government is running up against its $16.4 trillion borrowing limit and is taking steps to avoid default.
Reaching the limit Monday sets up another dispute between the White House and Congress over taxes and spending in the new year.
Treasury Secretary Timothy Geithner says the government will take a series of accounting measures to avoid defaulting on its debt. On Monday, it suspended the issuance of new debt for two government retirement funds.
Last week, Geithner said the measures would save about $200 billion and avoid default for about two months.
Geithner said it is difficult to predict how long default can be avoided because of ongoing negotiations over tax and budget policies.
The debt limit is the amount the government can borrow to help finance its operations.


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The only team that looks interesting were the Afghanimals.
Quote from: gamerfan09 on June 12, 2013, 08:41:22 PMThe only team that looks interesting In the M/M teams were the Afghanimals. I know why we get along well <3
The only team that looks interesting In the M/M teams were the Afghanimals.
Great avi Xarles <3(Yes, off topic, but I don't have anywhere else to put it so please don't delete it Peachies )
"The Amazing Pace": At 5 days per country we will not be seeing more than five countries!!!
Where in the world are they?? I'm curious to know if the females survived the first to legs
I don't like when teams are cast, or not cast, on the basis of their gender make-up. To me it is not a relevant factor. As many pointed out during the last season (TAR 22) no so-called alpha-male team had won since TAR 10; although male same-gender teams did win some seasons, they had flaws (and I would suspect were probably cast to throw those flaws into the mix. And there were several seasons where strong male teams did not make to the finish mat first, although they made final four.Female same-gender teams likewise were cast, and won some of those seasons between TAR 10 and 22, and some of them missed opportunities to win because of their mistakes that had nothing to do with their perceived physical strength or lack thereof.So I admit I get irritated by talk about there being too many or too few same gender teams in a particular season. TPTB seem to have found their sweet spot in casting teams that aren't totally perfect and giving them all chances to succeed or fail on their own choices and decisions. That's why you won't be hearing me complain ever about the superficial categorization of teams by their gender make-up.
Quote from: themikko95 on June 14, 2013, 09:56:36 PMWhere in the world are they?? I'm curious to know if the females survived the first to legs They're probably in a rural area without a lot of technology, like rural Peru or rural Bolivia.Incidentally, the two F/F teams were on the first flight to Chile, so I'm pretty sure they survived the first leg.
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Post Katrina New Orleans
Douglas Brinkley has a great op-ed in the Washington Post about the administration's current policy toward post-Katrina New Orleans. The article is pasted below:
Over the past two years since Hurricane Katrina, I've seen waves of hardworking volunteers from nonprofits, faith-based groups and college campuses descend on New Orleans, full of compassion and hope.
They arrive in the city's Ninth Ward to painstakingly gut houses one by one. Their jaws drop as they wander around afflicted zones, gazing at the towering mounds of debris and uprooted infrastructure.
After weeks of grueling labor, they realize that they are running in place, toiling in a surreal vacuum.
Two full years after the hurricane, the Big Easy is barely limping along, unable to make truly meaningful reconstruction progress. The most important issues concerning the city's long-term survival are still up in the air. Why is no Herculean clean-up effort underway? Why hasn't President Bush named a high-profile czar such as Colin Powell or James Baker to oversee the ongoing disaster? Where is the U.S. government's participation in the rebuilding?
And why are volunteers practically the only ones working to reconstruct homes in communities that may never again have sewage service, garbage collection or electricity?
Eventually, the volunteers' altruism turns to bewilderment and finally to outrage. They've been hoodwinked. The stalled recovery can't be blamed on bureaucratic inertia or red tape alone. Many volunteers come to understand what I've concluded is the heartless reality: The Bush administration actually wants these neighborhoods below sea level to die on the vine.
These days a stiff Caribbean breeze causes residents to jerk into a high-alert state of anxiety. Still unfinished is the overhaul of what some call the "Lego levees," the notoriously flawed 350-mile "flood protection system" that the U.S. Army Corps of Engineers starting building in 1965.
The Corps has been busy fixing the three principal holes that opened in August 2005. Its hard work has, in fact, paid a partial dividend. A decent defensive floodwall is now on the east side of the Industrial Canal, attempting to protect the Lower Ninth Ward.
Unfortunately, that is where the upbeat news nosedives. The federal government has refused to shut the Mississippi River-Gulf Outlet canal that helped cause the Katrina "funnel effect" flooding two years ago. In addition, entire neglected neighborhoods still have no adequate flood control.
The answer to New Orleans's levee woes is painfully obvious: money and willpower. Common sense dictates that the endangered areas -- if repopulated (and that is a big if) -- demand levees that can sustain Category 5 storms. It's a national obligation. Entire blocks are moldering away while the federal government lifts only a cursory hand to reverse the desultory trend.
Unfortunately, one of the biggest misperceptions the American public harbors is that Katrina was a week-long catastrophe. In truth, it's better to view it as an era. Remember, the Dust Bowl of the 1930s lasted eight or nine years. We're still in the middle of the Katrina saga.
Bold action has been needed for two years now, yet all that the White House has offered is an inadequate trickle of billion-dollar Band-aids and placebo directives. Too often in the United States we forget that "inaction" can be a policy initiative. Every day the White House must decide what not to do.
The stubborn inaction appears to fall under the paternalistic guise of helping the storm victims. Bush's general attitude -- a Catch-22 recipe if ever there was one -- appears to be that only rank fools would return when the first line of hurricane defense are the levees that this administration so far refuses to fix.
New Orleans appears to be largely abandoned by the Department of Homeland Security, except for its safeguarding of the Port Authority (port traffic is at 90 percent of pre-Katrina numbers) and tourist districts above sea level, such as the French Quarter and Uptown. These areas are kept alive largely by the wild success of Harrah's casino and a steady flow of undaunted conventioneers.
The brutal Galveston Hurricane of 1900 may be a historical guide to the administration's thinking. Most survivors of that deadly Texas storm moved to higher land. Administration policies seem to tacitly encourage those who live below sea level in New Orleans to relocate permanently, to leave the dangerous water's edge for more prosperous inland cities such as Shreveport or Baton Rouge.
After the 1900 hurricane, in fact, Galveston, which had been a large, thriving port, was essentially abandoned for Houston, transforming that then-sleepy backwater into the financial center for the entire Gulf South. Galveston devolved into a smallish port-tourist center, one easy to evacuate when hurricanes rear their ugly heads.
To be fair, Bush's apparent post-Katrina inaction policy makes some cold, pragmatic sense. If the U.S. government is not going to rebuild the levees to survive a Category 5 storm -- to be finished at the earliest in 2015 and at an estimated cost of $40 billion, far eclipsing the extravagant bill for the entire Interstate Highway System -- then options are limited.
But what makes the current inaction plan so infuriating is that it's deceptive, offering up this open-armed spin to storm victims: "Come back to New Orleans." Why can't Bush look his fellow citizens in the eye and tell them what seems to be the ugly truth? That as long as he's commander in chief, there won't be an entirely reconstructed levee system.
Shortly after Katrina hit, former House speaker J. Dennis Hastert declared that a lot of New Orleans could be "bulldozed." He was shot down by an outraged public and media, which deemed such remarks insensitive and callous. Two years have shown that Hastert may have articulated what appears to have become the White House's de facto policy. He may have retreated, but the inaction remains.
The White House keeps spinning Bush's abysmal poll numbers by claiming that his legacy will rise decades from now the way Harry S. Truman's did. But Truman had a reputation for straight talk and bold vision. If Bush wants history to perceive him as Trumanesque, then he must act Trumanesque.
Bush's predecessors moved mountains. Theodore Roosevelt set aside 230 million acres for wildlife conservation (plus built the Panama Canal). Franklin D. Roosevelt began a kaleidoscope of New Deal programs to calm the Great Depression and Truman oversaw the Marshall Plan rebuilding of Western Europe after World War II. Bush could seize the initiative and announce a real plan to rebuild, a partnership between the government, Fortune 500 companies and faith-based groups.
Unfortunately, right now New Orleans is having a hard time lobbying on its own behalf. Minnesota's Twin Cities have about 20 Fortune 500 companies to draw in private-sector money to help rebuild the bridge that collapsed in Minneapolis. New Orleans has one, Entergy, which is verging on bankruptcy. So besides U.S. taxpayers and port fees, New Orleans must count on spiked-up tourist dollars to jumpstart the post-Katrina rebuild.
But this is where the bizarre paradox of living in a city of ruins comes into play. Out of one side of its mouth the New Orleans Chamber of Commerce says, "Come on down, folks! We're not underwater!" Yet these same civic boosters -- viscerally aware that the Bush administration is treating the desperate plight of New Orleans in an out-of-sight, out-of-mind fashion -- don't want to bite the hand that feeds them large chunks of reconstruction cash. New Orleans is both bragging about normalcy and poor-mouthing itself, confusing Americans about what the real state of the city is.
Recently Mayor C. Ray Nagin, born with the proverbial foot in his mouth, tried to explain why the homicide rate in New Orleans is so appallingly high. When a TV reporter asked, Nagin merely shrugged: "It's not good for us, but it also keeps the New Orleans brand out there." This absurd comment -- and dozens like it -- hurts New Orleans's recovery almost as much as Bush's policy of inaction.
Everywhere I travel in the United States, people ask, "Why did you guys reelect such a doofus?" There is a feeling that any community that reelected a "first responder" who stayed in a Hyatt Regency suite during Hurricane Katrina, never delivered a speech to the homeless at the Superdome or Convention Center in New Orleans, and played the "chocolate city" race card at a historic moment when black-white healing was needed probably deserves to get stiffed by the federal government.
And Nagin isn't the only bad ambassador New Orleans has. It also has City Council member Oliver Thomas, Sen. David Vitter and Rep. William J. Jefferson -- all currently in deep trouble for potentially breaking the law. Dismayed by such political buffoonery, Americans have simply turned a blind eye to New Orleans's reconstruction plight. There is a scolding sentiment around the country that Louisiana needs to get its own house in order before looking for fresh levee handouts.
Then there are egregious contractor crimes such as over-billing and price-gouging. The medical infrastructure has largely collapsed. Mercy and Charity hospitals remain closed. A severe crisis in mental health care has erupted and gang violence is on the rise. The Environmental Protection Agency refuses to clearly state that it's safe to live in the metro area. Young professionals, recognizing that there are greener pastures all over the nation, are fleeing in droves.
Even with our trillion-dollar debt and excessive military expenses in Iraq, the American people, if presented with a bold plan, might be ready to save the beleaguered city. Perhaps the people haven't lost their good Samaritan grit.
Let's, for once, put New Orleans on the front burner. After all, Katrina exposed all the ills of urban America -- endemic poverty, institutionalized racism, failing public schools and much more. New Orleans is just a microcosm of Newark and Detroit and hundreds of other troubled urban locales.
How we deal with New Orleans's future will tell us a lot about our nation's future. In 2008 it should really be an up or down vote. Category 5 levees or not? An independent FEMA or a FEMA still ensconced in Homeland Security? Do we pour $40 billion into grandiose Louisiana engineering projects or do we instead put up "no trespassing" signs in the areas below sea level? All are hard choices with various merits and pains.
The important thing, however, is for America to decide whether the current policy of inaction is really the way we want to deal with the worst natural disaster in our history.
Douglas Brinkley is a history professor at Rice University and
the author of "The Great Deluge: Hurricane Katrina,
New Orleans and the Mississippi Gulf Coast."


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Richard Carmona's television campaign ads paint a rugged portrait of the Democratic Senate candidate: a decorated Green Beret, a trauma surgeon, a SWAT team leader and a U.S. surgeon general who battled "political interference" from higher-ups in President George W. Bush's administration.
During the Vietnam War, Carmona was awarded two Bronze Stars, two Purple Hearts and a combat medical badge. His law-enforcement experience with the Pima County Sheriff's Department includes action-packed episodes such as a risky 1992 mountainside rescue of a helicopter-crash survivor and a 1999 gunbattle in which he killed a man who was menacing a woman. Carmona was wounded in the leg during a 1988 SWAT standoff in which an armed man was killed.
"He's a local hero and a national hero," said veteran Pima County Sheriff Clarence Dupnik, a Democrat. "I have nothing but admiration and respect for this guy. He's a brilliant doctor and an extremely talented individual."
But Carmona, 62, also has long been dogged by questions about his leadership style, which critics characterize as contentious.
The acting Health and Human Services Department deputy who supervised him as surgeon general told a congressional investigatory committee in 2007 that she felt threatened by him.
And his career in southern Arizona's health-care industry has been at times controversial, with him leaving two high-profile positions amid criticism.
Those episodes are providing fodder for Carmona's opponent, Republican Rep. Jeff Flake. Polls indicate the race is neck and neck.
But Carmona's experience working with members of both parties is complicating Flake's efforts to portray him as a "rubber stamp" for President Barack Obama, who with other senior Democrats encouraged him to seek the seat of retiring GOP Sen. Jon Kyl as a Democrat.
A lifelong registered independent, Carmona was nominated as the nation's 17th surgeon general by Bush, a Republican, in 2002 and strongly endorsed for that position by Arizona's two Republican senators.
Carmona, who lists on his campaign website priorities that include job creation, comprehensive immigration reform, women's issues and preserving Social Security, boasts that Republicans had previously tried to recruit him to run for governor and Congress.
"When I read his resume, I have to tell you that it seems it's like a resume from 10 different people," actress Lynda Carter, best known for her role as 1970s television superhero "Wonder Woman," said at a recent "Women for Carmona" event in Scottsdale. "I have played the role. He is the role."
While his ads highlight his achievements, there is more to Carmona's resume than battlefield and law-enforcement heroics.
He helped establish Tucson Medical Center's trauma unit but was let go in 1993, according to contemporary media reports. He sued and secured a public apology and a confidential settlement that the Arizona Daily Star reported at $3.9million.
Later, he took over the financially troubled Kino Community Hospital in Tucson and ran Pima County's health-care system. Under pressure over financial issues, Carmona stepped down in 1999.
Some of those issues came up a decade ago, when Bush tapped Carmona as surgeon general. Only now are they becoming election-season fodder because, unlike Flake, a six-term congressman who won the Republican Senate nomination after a no-holds-barred primary fight, Carmona ran unopposed in the Democratic primary.
Now, Flake has started making an issue of Carmona's past in campaign mailers and ads.
For his part, Carmona pointed out that the issues in his health-care-management career were known to the senators who considered his nomination as surgeon general. He said he made tough leadership decisions at the time "with compassion for the people."
"But here's the important point: Every one of those allegations was investigated by the U.S. Senate when I went up for confirmation," Carmona said after the Scottsdale event. "And I received a unanimous confirmation from the United States Senate, so that should answer any questions as to the veracity of any of those allegations."
An exhaustive 2002 Los Angeles Times report on Carmona raised questions about his temperament and management skills, spotlighting allegations that he bullied a nurse in 1991, drove off Kino Community Hospital's veteran chief of surgery in 1996 and berated a member of the Pima County Health Care Commission in 1999.
The late Sen. Edward Kennedy, D-Mass., asked about his "confrontational" style at Carmona's July9, 2002, Senate confirmation hearing and specifically cited his publicized clash with Sylvia Campoy, the health commissioner.
Carmona said some personal friction was inevitable as an "agent of change," charged with introducing "contemporary management techniques to a dying system that is struggling to care for indigent patients."
"At times, that is upsetting to people who live in the status quo for a long time," Carmona said at the hearing. "And because of that, sometimes those of us who do step out might be characterized as confrontational. ... But I would say emphatically that I always treated my patients, my staff and co-workers with the greatest respect."
However, questions about the way Carmona has treated colleagues did not end when he became surgeon general.
In May, Politico reported allegations against Carmona made in secret 2007 testimony before the Oversight and Government Reform Committee by Cristina Beato, who oversaw the surgeon general in her role as acting assistant secretary of health. According to the transcript of her testimony, Beato said Carmona "has problems with women" and "had a very difficult time having a female Hispanic supervisor."
Beato, a single mother, also alleged that twice Carmona pounded on her door after midnight in an effort to resume ongoing arguments and that she felt threatened by his behavior. Beato and Carmona both resided on the National Institutes of Health campus in Maryland.
The Carmona campaign has dismissed Beato's claims as fiction.
"This was a lady that was very politically motivated, who was aspiring to a higher position and then lied on her resume and got caught, and we held her accountable, so she lashed out," Carmona said. "But the fact is that Congress investigated those allegations, and they were all found to be false."
In a telephone interview, Beato said that her testimony was delivered under oath and was truthful and that Congress did not investigate her claims. She acknowledged making mistakes on her resume but said that Bush continued to stand by her nomination.
"No, I do not make this stuff up," Beato told The Republic. "And I did fear for my life, and I am not a little withering flower, either. It was personally very frightening."
In ads, the Flake campaign has tried to portray Carmona as a "rubber stamp" for Obama, arguing that a vote for Carmona equals a vote for the president's agenda.
Carmona counters that even as a presidential appointee, he was hardly a mouthpiece for Bush.
In fact, his battle with the Bush administration and his claim that officials tried to muzzle him on health issues such as stem-cell research and the dangers of secondhand smoke are part of his campaign narrative that he is not beholden to either political party.
Carmona, who is of Puerto Rican descent, has courted moderate voters and presented himself as an independent-minded problem solver who could forge solutions to lingering issues such as the broken immigration system and help restore the public's trust in government.
"I was an independent when I was surgeon general ... and always saw my job as really being nonpartisan in dealing with health and safety and security issues of the nation," Carmona said earlier this year in a Fox News Latino interview.
"But as I moved forward to be considering running for the U.S. Senate and I looked at where the Republican Party was on certain issues in my state, like on women's health, on immigration, some of the educational issues, I really couldn't align with them there. The fact is that the Democratic Party was more closely aligned with where my values were on key issues in our state."
Former Sen. Dennis DeConcini, D-Ariz., a Carmona supporter, described Carmona as "a take-charge guy" and speculated that might rub some the wrong way.
"When you are a leader, sometimes the people you lead don't always agree with you," said DeConcini, who held the Senate seat Carmona is seeking from 1977 to 1995. "That's what I chalk it up to. He may have a temper. Hell, I don't know who hasn't ever gotten mad. I have never seen that."
Rep. Raul Grijalva, D-Ariz., another Carmona ally, was a Pima County supervisor when Carmona headed Kino Community Hospital and the county health system. Although Carmona's tenure was turbulent, Grijalva credited him with stabilizing the hospital and laying the groundwork for its eventual transformation.
Any personality clashes stemmed from Carmona's effort to move the hospital in a different direction and "was part of making the omelet," Grijalva said. "In the heat of the battle, I didn't always agree with him, but I'll give him his due. He was very persuasive and talked about the fact that if we are going to turn this hospital around, we're going to have to take some risks. ... I'm glad we took some of those risks."
Carmona also has taken risks during his long association with the Pima County Sheriff's Department. Dupnik, the Pima County sheriff, praised Carmona as "a tremendously courageous individual" who saved lives when he returned fire and killed a violent, mentally disturbed man in a Sept.18, 1999, off-duty gunbattle in Tucson. The celebrated 1992 rescue, in which Carmona dangled from a helicopter, was so dangerous that Dupnik said he would never have allowed it had he been aware of what Carmona was planning to do.
"We have a joke around the department: When we see on TV some disaster or emergency happening on a national level, we always look to see if Carmona is there," Dupnik said. "He just has a knack for being in the right place at the right time."
Rich Carmona, a decorated Vietnam veteran, also was a lawman who killed a suspect in a gun battle.
Age: 62.
Education: Bronx Community College of the City, University of New York, associate degree, 1973; University of California-San Francisco, bachelor's degree in biology and chemistry, 1977; University of California-San Francisco, medical degree, 1979; University of Arizona, master's degree in public health, 1998.
Family: Wife Diane. Four children.
Work experience: Vice chairman, Canyon Ranch, 2006-present; president, Canyon Ranch Institute, 2006-present; and distinguished professor of public health, Mel and Enid Zuckerman College of Public Health, University of Arizona, 2006-present. Past: Department surgeon, SWAT-team leader and deputy, Pima County Sheriff's Department, 1986-2002.
Previous public office: U.S. surgeon general, 2002-06.
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