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by Jennifer Katz
In 1982 Dr. George Kelling and James Q. Wilson published a criminology theory titled "Broken Windows" in which the social scientists argued that urban decay erodes the well being of a community and leads to crime.
"A stable neighborhood of families who care for their homes, mind each other's children, and confidently frown on unwanted intruders can change, in a few years or even a few months, to an inhospitable and frightening jungle. A piece of property is abandoned, weeds grow up, a window is smashed.
"Adults stop scolding rowdy children; the children, emboldened, become more rowdy. Families move out, unattached adults move in. Teenagers gather in front of the corner store. The merchant asks them to move; they refuse.
"Fights occur. Litter accumulates. People start drinking in front of the grocery; in time, an inebriate slumps to the sidewalk and is allowed to sleep it off. Pedestrians are approached by panhandlers."
The article, originally published in the Atlantic Monthly, affected policing policies and criminology studies throughout the U.S. For a group of neighbors in East Mt. Airy, a 100-year-old wall that stretches 428-feet along Sprague Street between East Mt. Pleasant Avenue and East Durham Street is their equivalent of a broken window.
"You see the wall, and it shows no one cares," said Lawrence Canty, who has lived at 7208 Sprague St. since 1984.
The cement block and brick wall that runs along the SEPTA R7 tracks serves as a canvas for graffiti and a retaining wall for the new development, Devon Village.
Once known as the Enclave at Devon, the 16-townhome development was purchased in early 2010 by Regan Construction, owned by Chestnut Hill resident Jeff Regan.
On Monday night, Regan met with a dozen or so near neighbors and representatives from East Mt. Airy Neighbors at the community organization's offices at the Lutheran Seminary. The neighbors, led by Kelly O'Day, who with his wife, Paula, lives at the corner of East Durham and Sprague streets, is concerned with several hundred feet of the wall's façade that is alternately in disrepair or unsightly.
"It detracts from the quality of life and sends the wrong message," O'Day said.
When Regan purchased the project from the bank, there were eight houses left to build and a new wall had been erected on the inside of the old wall to enclose the development's parking lot. It is unclear why this was done, but to work on the existing wall, the contractors would have needed to obtain permits and safety training from SEPTA. The wall is situated adjacent to SEPTA's property, with just inches to spare, making it virtually impossible to work on the outside of the wall without interfering with the train line.
Regan placed a decorative cement cap on the wall to join the new wall and the old wall together and recently rebuilt a 130-foot portion of the wall as it extends north along the train track.
But the greater portion of the wall remains an eyesore and a frequent target for graffiti artists and a source of ongoing frustration for the neighbors.
When the O'Days purchased their home four years ago, they knew they would have to work to beautify the triangular field that belongs to SEPTA.
A retired environmental engineer, Kelly O'Day moved back to Mt. Airy after an 18-year stint creating new storm water management techniques in Boston. A friendly and self-described "talkative" guy, O'Day quickly befriended his neighbors and the SEPTA representatives he needed to work with to improve the Sedgwick Station Area.
Over the last three years, the neighbors and SEPTA have worked together to clear overgrown brush, remove debris, plant new grass and repair cracked concrete along the sidewalk. The appearance of the station has dramatically improved.
The neighbors, now organized as the Sedgwick Station Neighbors, have put together a new five-point plan to further beautify the area. Their wish list includes removing the last remains of a chain link fence and extending a lower, black rod iron fence along the length of the area, gaining access that will enable them to plant and maintain the area, and planting other attractive vines along the base of the Mt. Airy Avenue bridge on the south side.
O'Day and his neighbors see the wall as part of their efforts and, in fact, as central to deterring urban decay.
"The goal is to have the wall look like it's part of a cared-for community," said Sharon Levy, who lives in the 400 block of East Mt. Airy Avenue.
Regan, who from the beginning agreed to paint the wall the color of the neighbors' choice, was amenable to alternate solutions.
"I would like to improve the view of this wall from the street in a manner that does not damage the wall and is economically feasible," he said at Monday's meeting.
Before the meeting there was growing tension between Regan and the neighbors over what should be done with the wall. O'Day would like the older portion, approximately 70 feet, to be torn down and rebuilt. Regan said it would be too costly for him to consider.
At the meeting, the neighbors and Regan agreed that he would paint the wall as a first step. The timeline is to be determined by SEPTA, as it will likely be done in coordination with a planned outage at the Sedgwick Station this summer.
More importantly, the group agreed to look into the feasibility of planting attractive vines along the wall to further improve its appearance without the costs associated with repairing the brick.
"I'm open to any reasonable solution," said Regan, who seemed to favor a "green" solution. "In my opinion cementing the wall will be inviting more graffiti, while making it green helps solve the graffiti problem."


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Advanced Nurse Practitioner Role, High Wycombe
- Recruiter
- Prospect Health
- Location
- High Wycombe
- Salary
- FTE £34,440 based on 20.5 hours
- Posted
- 26 Mar 2019
- Closes
- 25 Apr 2019
- Ref
- Contact
- GP Support
- Function
- Practice Staff
- Hours
- Full Time
- Contract Type
- Permanent
Please read on to discover more about an excellent surgery in the High Wycombe area seeking to bring in a new ANP.
The incoming ANP provide advanced levels of autonomous nursing practices to assess, investigate, diagnose, treat and refer patients by acting within the parameters of the NMC Code of Professional Conduct, Emergency Nurse Practice and NP Scope of Practice. They will provide services to meet the needs of the registered patients who attend the practice. Working autonomously, the post holder will provide holistic health care for patients with undifferentiated and undiagnosed problems using advanced nursing skills. The right candidate will be an experienced nurse who, acting within their professional boundaries, will provide care for the presenting patient from initial history taking, clinical assessment, diagnosis, treatment and evaluation of care.
They will need to prioritise and triage the needs of patients accordingly making any necessary referrals for investigations in the appropriate manner.
- Triage and treat patients wishing to see a health care professional making any necessary referrals to other members of the primary health care team
- Provide direct access to patients seeking healthcare management and advice
- Deal with emergency, including assessing, stabilizing, treating and managing patients within the practice.
- Independently and autonomously assess, diagnose, plan, implement and evaluate treatment/interventions and care for patients presenting with undifferentiated and undiagnosed problems with attention to physical, emotional, social, cultural and mental health issues
- Providing support on professional nursing issues, providing advice, guidance and training
Key Information
- Up to £34,440 FTE based on 20.5 hours
- NHS Pension enrolment
- Annual Leave
- Many other benefits
- Excellent training and development opportunities
What Happens Next?
If you would like to find out more please click the 'Apply' button. This will send a notification to the consultant looking after this vacancy who will get in touch at a suitable time to share further details on this opportunity. Any communication will be in complete confidence, without obligation and we will NOT send your details to any practice unless you give us your permission, so there is nothing to lose in finding out more! If you wish to contact us about this opportunity and other suitable positions please call Dave within the General Practice Division on 01423 850421.
Looking for a different challenge? Click here for more General Practice Jobs

subset: commoncrawl


text:
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Talented field slated to compete in annual Incline lacrosse tourney
More than 60 lacrosse teams from around the country will gather in Incline Village this weekend for the annual Lake Tahoe Lacrosse Tournament.
The fundraising event, sponsored by High Sierra Lacrosse (HSL) Foundation, will feature a men's, women's and, in its inaugural year, a masters' division. It takes place Friday through Sunday at Village Green and Incline High School.
"This is our 24th year for the adult tournament, and our biggest ever," said director and HSL Foundation Treasurer Curt Wegener, adding that there will be 16 women's teams, 32 men's teams and five masters' teams.
The Adrenaline Tropics out of San Diego enter the tournament as the three-time defending champs. They'll have to get through many high-caliber teams to earn a fourth straight title, including a squad from Marin County that fields players from Duke University, Wegener said.
The local team, the Tahoe Dawgs, also will be in the mix.
"There's going to be a lot of talented teams this weekend," Wegener said.
The first half of the tournament, the high school division, took place last weekend and featured 10 teams from the Bay Area, San Diego, Colorado and Oregon, as well as two local High Sierra Select teams made of up Reno/Tahoe-area high school players.
The high school-age version of the Adrenaline Tropics, which featured Division I college prospects, won the tournament.
Wegener said the proceeds from both weekends of the tournament are channeled back in to the HSL Foundation.
"In fact, since its inception, we've given more than $100,000 to area teams for fields, goals, coaches, officials, equipment, uniforms … really every facet of the game," he said.
Find the tournament schedule at http://www.highsierralax.org. All games are free and open to the public.


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FocalBlade 1.05 does not show on Filter menu
FocalBlade specific discussions
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FocalBlade 1.05 does not show on Filter menu
I just installed FocalBlade but it doesn't show on my Filter menu! I am running Vista Home Premium 64 bit. Do I need to restart my computer for it to show? I followed the instructions in my email for installing to Program files and then running the plugin installer.
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I liked the shortcut for opening a terminal and if I remember correctly it was Ctrl+Alt+T that opened a terminal window.
Now with a later version of Ubuntu this shortcut is no longer predefined, I must add it myself from the shortcut settings.
Do you know why this shortcut was removed?
Thanks for any answer
$ uname -a
Linux ubuntu 2.6.38-8-generic #42-Ubuntu SMP Mon Apr 11 03:31:24 UTC 2011 x86_64 x86_64 x86_64 GNU/Linux


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Thirty-six percent of the energy consumed in the United States comes from petroleum. Gasoline is produced year-round and more is usually produced during the summer months when demand is higher.
About 157,393 retail gas stations across the United States supplied commercial-grade gasoline in 2011. There are three main grades, with different octane levels. They are regular, mid-grade and premium. Although pricing varies by grade, the price difference between grades generally remains consistent.
What components contribute to the retail price of gasoline?
The cost of crude oil, refinery processing costs, marketing and distribution, retail station costs and taxes all contribute to the price at the pump.
Crude oil accounts for 64 percent of the cost of a gallon of gas.
The cost of transporting gasoline from the refineries to the distribution centers, and then gas stations, is also reflected in the price at the pump.
Marketing of the oil company's brand is also included. Both of these factors account for roughly 7 percent of the gasoline price.
Federal excise taxes are 18.4 cents per gallon, and state excise taxes average 35.3 cents per gallon. Applicable state sales taxes, gross receipts taxes, oil inspection fees, underground storage tank fees and other miscellaneous environmental fees are also added. When all that is totaled, the average increases to 49.3 cents.
Refining crude oil takes up the remaining 18 percent of gasoline cost.
Some of the money spent at the pump goes to the gas station itself, which adds a few cents to the cost per gallon. While there is no set amount for how much can be added on to the price, some states have markup laws barring stations from charging less than a certain percentage over invoice. These laws were set up to protect individually owned gas stations from being run out of business by bigger chains that can afford to cut prices at certain locations.
Most of the time, the difference in price at local stations comes from operating costs. Stations have varying traffic patterns, rents and supply sources that inevitably influence the price.
Why are gasoline prices higher in California?
California has a reformulated gasoline program with stricter requirements than federally mandated clean gasoline. In addition to the higher cost of cleaner fuel, there is a combined state and local sales and use tax on top of a 18.4 cent-per-gallon federal excise tax and a 35.3 cent-per-gallon state excise tax.
California requires a unique blend of gasoline, which only a few sources outside the state can supply. Therefore, the state's refineries must run near full capacity to meet fuel demands. If more than one but the farther away the relief supplies are, the higher and longer the price spike will be.
The OPEC factor
The price of crude is determined by worldwide supply and demand. It is also significantly influenced by the Organization of Petroleum Exporting Countries, whose members account for 40 percent of the world's production of crude oil and hold more than two-thirds of the world's estimated crude oil reserves. Since being formed in 1960, its goal has been to keep global oil costs at its target level by setting an upper production limit on its members.
There are three categories of membership: founder member, full member and associate member.
Founder members are those countries that were represented at the first conference, held in Baghdad, and signed the original agreement establishing OPEC.
Full members are founder members and those countries whose applications for membership have been accepted by the conference.
Associate members are countries that do not qualify for full membership, but are admitted under special circumstances determined by the conference.
Can domestic and world events impact gasoline prices?
Rapid hikes in gasoline prices can occur as a reaction to dramatic events both foreign and domestic. For example, in 2005 Hurricane Katrina had a devastating impact on U.S. gasoline markets by initially taking out more than 25 percent of U.S. crude oil production and 10-15 percent of U.S. refinery capacity. The chart below illustrates the impact of historical events on yearly average California gasoline prices per gallon. Figures are based on 2012 dollars, peak price adjusted for inflation.
Sources: Energy Information Administration; U.S. Department of Energy; Organization of Petroleum Exporting Countries; California Energy Commission


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Books, Movies, Music
JCPL Catalog
Reading programs and Book Groups
Kids & Teens
Kids Zone
Teens Only
For Parents and Teachers
Student Portal
Main Content
Communities matter @ your library
Celebrate National Library Week April 14-20
This week, Jasper County Public Library, located in Rensselaer, DeMotte and Wheatfield, joins libraries in schools, campuses and communities nationwide in celebrating National Library Week, a time to highlight the value of libraries, librarians and library workers.
Libraries today are more than repositories for books and other resources. Often the heart of their communities, campuses or schools, libraries are deeply committed to the places where their patrons live, work and study. Libraries are trusted places where everyone in the community can gather to reconnect and reengage with each other to enrich and shape the community and address local issues.
Whether through offering e-books and technology classes, materials for English-language learners, programs for job seekers or those to support early literacy, librarians listen to the community they serve, and they respond.
Service to the community has always been the focus of the library. While this aspect has never changed, libraries have grown and evolved in how they provide for the needs of every member of their community.
This year, National Library Week will be observed with a Daily Prize Giveaway, during which prizes will randomly be given out to patrons each day of the week.
Also, children ages 3 through 11 are invited to "Dig Into Reading" by picking up a coloring page from any branch of JCPL, located in Rensselaer, DeMotte or Wheatfield, and enter the completed page in a Coloring Contest. This Coloring Contest is held in conjunction with the library's upcoming "Dig Into Reading" Summer Reading Program
Coloring pages will be judged by age categories and one winner will be chosen from each age category. Coloring sheets will be available at the circulation desk of any branch of JCPL.
There are also benefits for those choosing to "check in" at their library this week using social media. Patrons who check in using Foursquare, Twitter or Facebook can receive special collectible items, including phone charms and other items to be announced.
First sponsored in 1958, National Library Week is a national observance sponsored by the American Library Association (ALA) and libraries across the country each April.
For more information about National Library Week at JCPL, visit or call the Rensselaer Library, 866-5881, the DeMotte Library, 987-2221 or the Wheatfield Library, 956-3774, or visit us online at www.myjcpl.org.


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Speakers in the video
- Walter Andrews
Professor of Ottoman Literature, University of Washington
Dr. Andrews is a scholar of Ottoman poetry and professor of Ottoman and Turkish literature at the University of Washington. He also assisted with the translation of My Name Is Red, and was author Orhan Pamuk's high school basketball coach in Turkey.
- Michael Barry
Lecturer in Near Eastern Studies, Princeton University
Mr. Barry is in Persian and Islamic studies in the Department of Near Eastern Studies at Princeton University, and a special consultant on Islamic art and museum issues for the Aga Khan Trust for Culture. He has written a definitive study of Persian miniature paintings called Figurative Art in Medieval Islam and the Riddle of Bihzâd of Herât (1465-1535). He also served as consultative chairman of the Metropolitan Museum's Department of Islamic Art.
- Melvin Jules Bukiet
Novelist and Teacher, Sarah Lawrence College
Mr. Bukiet teaches fiction writing at Sarah Lawrence College. He is an author and a critic and has reviewed My Name Is Red for the Chicago Tribune.
- David Damrosch
Professor of Comparative Literature, Harvard University
Dr. Damrosch is professor of comparative literature at Harvard University and the author of many books, including What is World Literature?
- Erdağ M. Göknar
Translator, My Name Is Red
Mr. Göknar is professor of Turkish studies at Duke University, and the award-winning translator of My Name Is Red. Mr. Göknar has also translated Rahimi's Earth and Ashesand Ahmet Hamdi Tanpınar's iconic novel A Mind at Peace.
- Chip Kidd
Book Cover Designer and Writer
Mr. Kidd is a well-known book cover designer, artist, and writer. He designed the U.S. book cover for My Name Is Red, as well as several other Orhan Pamuk titles.
- Pelin Kivrak
Literature/History Student, Harvard University
Ms. Kivrak is a native of Istanbul, Turkey, who studied comparative literature at Harvard University. She has read My Name Is Red both in the original Turkish and in the English translation―and found the latter easier to read.
- Christopher Lydon
Radio Host, Brown University
A longtime television and radio journalist, Mr. Lydon hosts "Open Source," a radio program on the arts and politics from the Watson Institute for International Studies at Brown University, and has conducted multiple interviews with Orhan Pamuk.
- Orhan Pamuk
Author, My Name Is Red
Mr. Pamuk has won numerous awards, including the Nobel Prize for Literature in 2006. Turkish novelist. His most recent book is The Museum of Innocence. Mr. Pamuk also served as a visiting professor of literature at Columbia University.
- Shahzia Sikander
Ms. Sikander trained as an artist in miniature painting style at the National College of the Arts in Lahore, Pakistan, one of the few schools in the world that still teaches this style. She has incorporated miniature painting into contemporary themes and different media, including video.
- Susan Yelavich
Writer and Assistant Professor, Parsons, the New School for Design
Dr. Yelavich is a writer and professor of art and design studies at Parsons, The New School for Design in New York. She lectures frequently on design and architecture and has incorporated My Name Is Red into her curriculum.


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Situated on the outskirts of the town of Kathu in the Northern Cape Province, this
is truly a unique setting in which to play a round of golf - the course winds its
way through a 500 hectare Camelthorn forest on the edge of the Kalahari Desert.
Built and maintained by Sishen Iron Ore mine and officially opened in 1979, this
is the last course designed by Robert (Bob) Grimsdell, which he unfortunately could
not see completed. Considering its surroundings, its lush green fairways and greens
have surprised many a visitor to this arid region.
Being situated off the beaten track, the course is blissfully un-congested and visitors
are always assured of getting a game here. Sishen's par 72, 18 hole course is currently
highly rated amongst the various rating bodies and is truly one of the hidden golfing
gems in Southern Africa.
The course is approximately 6450 meters long, and has a rating of 72. With the large amount of Camelthorn trees on the course, it makes for a spectacular view and game. The player is always amazed at our lush forest within the Kalahari desert.
View detailed info such as yardage, signage and high-resolution fly-overs of our
winning course from e-Caddy.
Join us on Facebook, and make your comments and suggestions. Find the most recent
photo's and posts by general users.
The Kalahari Country Club, formerly known as the Kathu Club, is situated on the
outskirts of Kathu, one of the prettiest towns in the Northern Cape.
Your session is about to expire, due to inactivity.


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CLANNAD ~AFTER STORY~ – Kyou Chapter
One rainy day, Ryou confesses her feelings to Tomoya, and even he's initially hesitant, he ultimately decides to try going out with her.
One rainy day, Ryou confesses her feelings to Tomoya, and even he's initially hesitant, he ultimately decides to try going out with her.
Ulquiorra Cifer artwork courtesy of 餅和 on pixiv (account needed to access)Continue Reading "The Daily Dose"
This recap episode was actually better than I thought it'd be, and I'm a bit impressed that they managed to get through so much of the main story in one go.Continue Reading "CLANNAD ~AFTER STORY~ – Recap"
Back when Nagisa was starting her third year of high school, she found that she wasn't in the same class as any of her old friends.
Buried in snow in the illusionary world, the robot tries to get the girl to move, but she doesn't.
The doctor informs Tomoya, Sanae, and Akio that Ushio's illness is the same as Nagisa's, and he still doesn't know the cause.
When Tomoya finally gets to meet Ushio's kindergarten teacher, he finds out that it's actually Kyou, and a grown-up Botan is the kindergarten's pet.
Upon his return to the Furukawa home with Ushio, Tomoya enters Nagisa's old room and finds it just like it used to be.
In the illusionary world, the girl and the robot start walking towards what the girl describes as a warm and fun place.
It's been five years since Ushio was born, and Tomoya's life has been a cycle of eating, working, and sleeping.
In the illusionary world, the girl who can no longer help build the flying machine wants the robot to stay by her side forever, but the robot knows that he has to go back out for that to happen.
With Nagisa now two months pregnant and Tomoya vowing to protect the child, Sanae is reminded of how Akio had said something similar a long time ago.
Even though they've put off a wedding ceremony until they save enough money, Tomoya and Nagisa move in together.
Despite his father being in jail, Tomoya shows up at the Furukawa house to talk with Akio about something serious.


text:
Beware sting in KMT's tail
As a new Gregorian year approaches, many people around the world will be hoping and praying for peace and goodwill on Earth. In East Asia, the trend toward a stable and sustainable peace has been dealt a number of blows, as both China and the US have sought to respectively affirm and defend their hegemonic power and influence. The recent changes in leadership in North Korea, China, South Korea and Japan do not indicate a lessening of tensions or rivalries any time soon.
Despite the much-touted "warmest-ever cross-strait relations," China has not eased up on threatening rhetoric aimed at cowing Taiwanese into self-annexation. This might puzzle foreign analysts who could be forgiven for thinking that Taiwan and China were on a path to peaceful relations. Their mistake, an easy one to make, is in conflating Taiwan with the Chinese Nationalist Party (KMT). Thus, when they buy at face value the propaganda of "developing and stable cross-strait relations," they fail to understand that those relations are largely Chinese Communist Party (CCP)-to-KMT.
What is interesting about President Ma Ying-jeou's (馬英九) touting of a peace agreement with China is that the hostility that would supposedly be ameliorated by the signing of such an agreement is one-way only. Taiwanese have no conflict with Chinese or China. Taiwanese make no claim on China's territory nor seek to usurp their national identity. Taiwan has no desire to attack, colonize or go to war with any other nation on Earth. A peace agreement then is only necessary because the KMT continues to insist that Taiwan is the "real China" and that the territory of the People's Republic of China (PRC) belongs to the Republic of China (ROC). It is the KMT who have dragged Taiwan into their own civil war with the CCP and who are now working with the CCP to deprive Taiwanese of the choice over their future status as a nation.
In April 2009, then-national policy adviser to President Ma, Stephen Chen (陳錫蕃) stated that "only Taiwan has unilaterally terminated its civil war with China. They still think the civil war is not over. That is why the peace agreement is necessary." Chen's comment illustrates how Ma and the KMT conflate Taiwan with "The Party," but this only exposes their colonial mindset — Taiwanese are not a people, they are to be regarded as little more than peons of the Republic of China and as such they are required to participate, willingly or otherwise, in the corrupt and self destructive Chinese politics of saving face and exacting revenge.
Furthermore, one wonders how a peace agreement could bring an end to the Chinese Civil War, since the primary goal of the People's Republic of China in that war remains the dissolution of the Republic of China in its entirety. Why else would Ma have taken such care to avoid showing the ROC flag in front of Association for Relations Across the Taiwan Straits Chairman Chen Yunlin (陳雲林) if it were not for the fact that he knew the PRC official found the flag offensive?
Finally, since China would never sign an agreement between "Taiwan" and "China," or the ROC and PRC, surely the only names that could be used would be either the KMT and the CCP, or the Mainland Affairs Council and the Taiwan Affairs Office, thereby immediately absenting the voices and participation of Taiwanese in such an agreement.
Taiwanese then need to beware of the KMT and its offer of peace. Like the fable of the scorpion and the frog, it would be yet another historical tragedy for Taiwanese to carry the KMT across the strait only for the party to sting its host halfway across and, on asking why, to be met with a cold eye and the answer: "It's my nature."
Ben Goren


text:
Keeping Your Beginner Hockey Players Injury Free
As coach, you can and should minimize the chances of your players getting injured in the first place. Taking certain preventative measures ahead of time will also help you deal with potential injuries so that they don't become any more serious than necessary.
Establishing a safe base
You can take a few steps at the very beginning of the season to limit some potential for injury from arising:
Know the health history of your players. Collect confidential information from the parents so that you know which of your players might potentially suffer a medical incident, such as asthma, allergies, diabetes, or seizures. Then do your homework to know how to handle such an occurrence calmly and safely.
Prevent dehydration problems. Have players bring their own water bottles and establish a practice of having players drink a quarter cup (a few swallows) every 15 minutes throughout practices and games. Do not allow sugar or glucose drinks in the bottles (with the possible exception during all-day tournament play). And at no time should your players take salt tablets.
Have medical assistance at your fingertips. Keep a working cellular phone with you at all times or know where the nearest working payphone is and always keep a couple of quarters in your kit bag. If 911 is not an option in your area, also keep the local ambulance, hospital, and police numbers with your quarters.
Ensuring a safe environment
Another way to minimize injuries is to take precautions at the rink before practices and games:
Check equipment. Do what you can to make sure that players wear proper-fitting protective pads, helmets, and skates. Cheap-quality, worn-out, or loose-fitting equipment is an invitation to injury.
Check the rink. Skate around observing the rink boards and glass. See that doors to the ice are closed and that the ice surface is clear of debris, is not soft, and does not contain holes that skate blades could catch in. If a problem exists, fix it.
Compete against your own size. As much as possible, match players for size and weight. Ideally the league helps, but players grow at different rates. If you face a team with bigger players, try to get the opposing coach to agree to match lines, at least by size and skill level, especially when contact hockey is introduced.
Set rules. Everyone on the team should know that you don't condone horseplay, you expect cleanliness and hygiene in the locker room and on the bench, and you expect players to stay home with a flu or cold so that they do not spread it to teammates.
Warming up
Warm, flexible joints have not traditionally been a concern with young players because they always used to do plenty of moving before they got to practice. However, with so many kids now sitting with video games, television, and rides to the rink, your players' muscles may be cold and stiff as they step onto the ice. These conditions may predispose them to injury. Therefore, a brief warm-up may be warranted.
Players need ten minutes of whole body exercise, such as skating forward, backwards, and sideways with arm action, to increase heat, followed by a few minutes of loose stretching, such as arm and leg rotations, to prepare the muscles and joints for practices and games. With ice time being at such a premium for minor hockey, you may want to do this off-ice using the same principles, or make your first drill as "whole body" and loose as possible and follow that with some dynamic stretching, particularly for the shoulders and hips.
Working on fitness and conditioning
The more elementary the level of hockey, the less important it is that you spend time on fitness and conditioning for your players. Their hockey activity is their fitness activity, so long as you make sure they don't stand or sit around too much at practices and games. However, as skill level increases, the relevance of fitness increases for players. Players who want to excel in hockey will need a strong fitness habit.
Good fitness training can reduce the risk of injury and can speed up recovery if a player does get injured. Aside from the impact on injury, fitness gives a player more strength to generate power for shooting and skating, and more endurance to be strong longer. So elite hockey players need to be in great shape; youth players need to be safe and feel sufficiently strong.
Basic fitness needs for hockey begin with flexibility. This reduces the chance of strain and sprain-type injuries. After that, some muscle strength and endurance work is useful so that their muscles are strong enough first to grip and skate and then to shoot and check safely. Balanced muscle strength and flexibility help prevent over-use types of injuries, such as bad backs. Aerobics becomes more important as speed and full-length competitive games become part of their hockey level.
Serious fitness training is easiest to do off-ice, but most coaches don't have the time, facilities, or necessity at these levels to conduct serious conditioning sessions. Therefore, we recommend you use an on-ice, fun circuit like the one presented here to top up fitness elements in your players. This also provides an opportunity for you to see whether any players have particular weaknesses that need attention. For players who need specific hockey conditioning, a variety of books are available for their reference.
The circuit in the figure below is designed to make good use of your ice time by combining fitness work with work on some hockey skill elements. The circuit also uses a player's own body weight for strength elements, which makes it safe for all ages.
Discourage young, growing players from experimenting with weight training to increase strength. Weight training can cause more harm than good and is generally unnecessary. For older players who aspire to elite hockey levels, weight training under the supervision of a certified professional who understands hockey is appropriate.
A circuit like the one that follows should be fun for the players. It should also help them develop a fitness activity habit that will serve them well as they advance in hockey — as well as down the road of life.
This circuit continues nonstop for 13.5 minutes. To begin, assign each player to an exercise station so that two or three players are at each station. Players must note the number they start at and rotate in numerical order. You signal the start of the circuit.
After one minute at an exercise station, blow the whistle and all players skate at a moderate pace up the middle of the ice and down the outside boards, crossing over at center so that they alternate the direction of their turns. After 30 seconds, blow the whistle again and players move on to and immediately begin the next exercise station in their rotation.
So the circuit alternates one minute of nine different strong exercises with 30 seconds of moderate skating, finishing with a skate. The circuit works on power, strength, and aerobics at the same time as key skating and shooting skills. It is good for all players of all ages. Pace is the factor to change to appropriately challenge the different skill levels. Give breathers (five- to ten-count breaks mid-exercise) or allow a more moderate pace for the little kids so that they focus on their skills. For advanced players, increase the time for lap skating (to 60 seconds) and/or the pace (to strong). Provide loads of encouragement for all.
Mark pylons each with a number 1 to 9. Also write the name of an exercise station based on the following list (or make up your own names) on each pylon. Then set the corresponding pylon at each exercise station as indicated in the rink diagram. Players will rotate from pylon station to pylon station performing the following tasks:
Push-ups: Place hands under shoulders as you lie face-down on the ice. Keep your body straight while you press up until your elbows are straight, then lower back to lying on the ice. Repeat at a steady pace.
Shuttle skate: Start at the blue line. Going as hard as possible, skate forward to the center line. Stop. Turn facing the boards and skate back to the blue line. Stop. Turn facing the boards and skate to the far blue line. Stop. Skate slowly back to the starting point. If skill allows, use pucks.
Twisting sit-ups: Lie on your back on the ice with your skate blades flat on the ice (knees bent). Place your hands on your helmet. Curl your right elbow up until it touches your left knee, then return to the starting position. Then curl your left elbow up until it touches your right knee and return to the starting position. Repeat alternating to left and right.
Pivot skate: Start on the blue line. Skate fast backwards to the center line. Pivot to your left to skate forward to the far blue line. Stop. Skate forward to the center line. Pivot to your left to skate backwards to the starting blue line. Stop. Repeat pivoting to your right for the next lap. Alternate left and right laps.
Rapid shot: Stand outside the goal crease with seven pucks. Pick a spot low at the back of one side of the net and rapid fire all seven pucks into that spot using a forehand shot with no pause between shots. Be sure your teammate has finished at his side of the net before you retrieve your pucks and repeat using a backhand shot.
Figure-eight skate: Using the face-off dots between the blue lines, skate a figure eight as fast as possible for three laps. Then do one slow lap. Repeat the sequence. If skill allows, use pucks.
Down-ups: From a standing position, drop to a crouch, place your hands on the ice, extend your legs straight out to a push-up position, then back to the crouch, and then explode into a maximum jump straight up. Repeat this sequence. Take a five-count breather every five reps if the power of your jump fades.
Cross-circle skate: Start on the face-off dot. Moving as quickly as possible, skate forward to the edge of the circle. Stop. Skate backwards to the dot. Stop. Side step right to the circle. Stop. Side step back to the dot. Stop. Crossover left to the circle. Stop. Crossover back to the dot. Stop. Skate backwards to the circle. Stop. Skate forward to the dot. Stop. Repeat the sequence.
Dips: Place chairs, a bench, or the net on its face against the end boards. Sit on the bench placing your hands on the edge of the seat at your hips and extend your legs straight out in front. Shift your hips off the bench and lower them as close to the ice as possible and press back up until they are even with the bench. Repeat.


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The first wave of E3 2014 is over and done with, and there's plenty to dissect from the Microsoft and Sony keynotes.
Both next-gen consoles are duking it out in the first E3 since their release, with Microsoft bringing out Halo's big guns to counter Sony's hardware innovations – the Project Morpheus VR kit and PlayStation TV.
Normally, by this point in the release cycle, one of the consoles would be pulling ahead of the pack, bolstered by a killer app – some exclusive game or feature that makes it a must-have.
Trouble is, that killer app doesn't seem to have materialised – on either console. The few exclusive titles haven't really grabbed my attention, and the glut of familiar cross-platform IPs are hardening my resolve to bite the bullet and pick up a gaming PC.
Familiarity breeds...
The exclusives largely trod familiar ground; Microsoft leaned heavily on Halo; Sony on Uncharted. If you're not already invested in those franchises, there are some new IPs – Xbox One gets Sunset Overdrive, which has an interesting multiplayer co-op mechanic, but its energy-drink-fuelled visuals and knowingly sarky tone remind me of all those desperate corporate attempts at cool in the 1990s. Remember Poochie from The Simpsons? Exxtreme to the maxx, dude.
Over on PS4, there's Bloodborne and The Order: 1886. Bloodborne, a "spiritual successor" to Demon's Souls and Dark Souls, can reasonably be expected to be more of the same; fine, if you like that sort of thing. As for The Order: 1886; I'm not really one for cyber-monocles and laser blunderbusses and other steampunk trappings.
READ MORE: All the latest news from E3 2014
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Like many, I've been waiting to see which of the next-gen consoles is worth investing in; the exciting prospect for me was what they could do that PCs couldn't. Both Microsoft and Sony initially talked up their consoles as being the centre of an entertainment hub; swiping through TV stations with Kinect, game-sharing on PS4, and so forth. But there seems to be little of that in evidence in the titles on display at E3 – bar a few flashes of innovation, buried in Microsoft and Sony's indie games presentations.
For the most part, the story was one of a retreat from interesting new technologies and game mechanics, back towards tried-and-tested franchises. Since neither of the next-gen consoles is making the most of their unique features (indeed, Microsoft's even releasing an Xbox One minus the previously-essential Kinect), you're left with a numbers game based around specs and titles – and on both counts, the PC looks to have the consoles trumped.
It's PC gone mad
Now, I'm no PC gaming evangelist; I do most of my gaming on a PS3, and my antiquated notebook struggles to run Skyrim on low settings. But spec up a current gaming PCs and you have something that's easily on par with the PS4 and Xbox One on raw graphical grunt. And almost all of the non-exclusive titles are making their way over to the PC; Call of Duty: Advanced Warfare, Rise of the Tomb Raider, Far Cry 4 and GTA V are all releasing on PC alongside the console versions.
PC specs are as good as you're prepared to shell out for; upgradeability means that you can start small and upgrade as cashflow allows, and with Steam's Big Picture mode, you finally have a PC gaming interface that sits happily in your living room. The launch of Valve's Steam Machine project may have been delayed, but then, PCs are an open platform, and if you want to bung SteamOS on your machine, there's nothing stopping you – once it launches, of course.
The library of titles available on PC includes all the big cross-platform franchises, plus some exclusives like the expansive Star Citizen and Syndicate throwback Satellite Reign – both of which employ the interesting game mechanics that the big console-exclusive titles seem to shy away from. There's also a vibrant indie scene on PC that the consoles are only just catching up to.
I could be wrong; Sunset Overdrive might turn out to be the best thing I've ever played. But on the current evidence, neither of the next-gen consoles are making the most of their unique features – and that leaves me wondering what, exactly, they do that a PC can't.
READ MORE: Save game: how Kickstarter's resurrecting your favourite games


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The House GOP's top recruit
TUCSON, Ariz. — She's the first female Air Force fighter pilot to fly in combat, a retired colonel who once sued the Pentagon over a policy on Muslim dress, and a self-described moderate who rails against government overreach.
Republicans consider Arizona's Martha McSally their top House recruit of 2014, and few have generated as much excitement in GOP circles.
Story Continued Below
The 48-year-old is battling for the highly competitive House seat from Arizona's swing 2nd District, a position once held by Democrat Gabby Giffords, who gave it up after a near-fatal shooting in 2011. McSally is trying to oust Rep. Ron Barber, the former Giffords aide who also was wounded in the shooting and who barely beat McSally in 2012.
( Also on POLITICO: Grimes mum on coal at fundraiser)
McSally, a die-hard athlete, has had her share of stumbles on the political field.
She's been criticized for comparing herself to Giffords and accused of evading issues that might antagonize either base GOP voters or moderates, declining, for instance, to say if she would have voted for the deal that ended last fall's government shutdown. Giffords is watching the race closely, and her well-funded pro-gun control super PAC is expected to pump money into the contest to shore up Barber, who describes McSally as being in "hiding" on the issues.
Fellow Republicans brush off concerns about McSally, preferring to focus on her lengthy résumé. That she is a woman doesn't hurt, given the party's struggle to elect more females.
( Also on POLITICO: Clinton: Benghazi 'more of a reason to run')
"Her personal story is so powerful," said Duff Hearon, a Tucson real estate developer and prominent GOP donor. "I think she'll be in leadership early on."
McSally says she doesn't think much about about the hype ("I appreciate it, but I'll leave the labels to others."), and that it doesn't add pressure ("No, God no."). Sticking to talking points with military precision, she stresses she's simply focused on the task at hand, "racing to the finish to replace Barber."
At a time when moderates are an increasingly rare species in the GOP, the fact that McSally is running as one is crucial in a district with a long history of electing them.
( Also on POLITICO: Cruz country)
The politicians who have won here, including Republican Jim Kolbe and Giffords, succeeded because they straddled the middle ground and sold themselves as independents. Democrats have held the district since Kolbe retired in 2006, and the GOP candidates who've fallen short here since then, many Republican strategists believe, did so because they cut a hard-line conservative image.
McSally has taken some positions, such as supporting the recent Democratic-sponsored equal pay bill, that collide with many on the right. During a recent meet-and-greet with constituents here, she was asked several times if she embraced the principles of the tea party. Each time, she pushed back.
"I need you to be pragmatic," she told one questioner.
McSally also is making gender a central part of her campaign — a tactic, Republican strategists say, aimed at cutting into the Democratic Party's traditional advantage among female voters.
When she's on the trail, she stresses her female-related firsts in the military, while also noting women-related awards she's won over the years. McSally's first combat mission came in January 1995, when she flew into Iraq to help enforce the U.N.-backed no-fly zone. She retired from the Air Force in 2010 having flown more than 325 combat hours, including missions to Afghanistan post-Sept. 11, 2001.
McSally often tells audiences about how she sued Defense Secretary Donald Rumsfeld over a requirement that female servicewomen wear a headscarf and an abaya, a traditional body-covering robe worn by many conservative Muslim women, when traveling off base in Saudi Arabia. McSally had internally asked for changes to the policy for years, but filed a lawsuit in late 2001 after spending some time being posted in the country. The policy was eventually overturned.
Still, in other areas, she hews more closely to standard GOP lines.
During her 2012 campaign, in a questionnaire from a conservative group, McSally said she supported repealing Obamacare and prohibiting abortion except when it was necessary to prevent the death of the mother. She also said she supported amending the Constitution to define marriage as a union between one man and one woman.
Few handicappers gave McSally a chance in 2012, when she launched two bids for the seat after Giffords, still recovering from being shot in the head, decided to step down in January of that year.
Following Giffords' resignation, McSally returned to the U.S. from Germany, where she was teaching national security studies at the George C. Marshall Center. But she had little time to launch her campaign and introduce herself to voters.
She first ran in the special election, but failed to win the GOP nomination. Barber, who cut a sympathetic figure following the mass shooting that killed six and wounded 13, comfortably won the June race.
McSally tried again in the regularly scheduled November election, this time nabbing the Republican nod. She came so close to winning that it took more than a week for her race to be called. Out of more than 292,000 ballots cast in her contest with Barber, she lost by fewer than 3,000 votes.


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This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http://cancer.gov or call 1-800-4-CANCER.
Note: Separate PDQ summaries on Skin Cancer Screening, Skin Cancer Treatment, and Levels of Evidence for Cancer Screening and Prevention Studies are also available.
Individuals whose skin freckles, tans poorly, or burns easily after sun exposure are particularly susceptible to developing skin cancer.[1] Observational and analytic epidemiologic studies have consistently shown that increased cumulative sun exposure is a risk factor for nonmelanoma skin cancer.[1,2] Organ transplant recipients receiving immunosuppressive drugs are at an elevated risk of skin cancer, particularly squamous cell carcinoma (SCC). Arsenic exposure also increases the risk of cutaneous SCC.[3,4] In the case of melanoma, it seems that intermittent acute sun exposure leading to sunburn is more important than cumulative sun exposure;[5] such exposures during childhood or adolescence may be particularly important.[6] Nonmodifiable host factors, such as a large number of benign melanocytic nevi and atypical nevi may also increase the risk of developing cutaneous melanoma.[6]
Factors Associated With an Increased Risk of Nonmelanoma Skin Cancer
Sun and ultraviolet (UV) radiation exposure
Based on solid evidence, sun and ultraviolet radiation exposure are associated with an increased risk of SCC and basal cell carcinoma (BCC).
Magnitude of Effect: Substantial, depending upon amount of exposure.
Factors Associated With an Increased Risk of Melanoma
Sun and UV radiation exposure
Based on fair evidence, intermittent acute sun exposure leading to sunburn is associated with an increased risk of melanoma.
Magnitude of Effect: Unknown.
Sunscreen Use and Ultraviolet (UV) Radiation Avoidance
The evidence that interventions designed to reduce exposure to UV radiation by the use of sunscreen, protective clothing, or limitation of sun exposure time decrease the incidence of nonmelanoma skin cancer is inadequate. A randomized study suggested a possible reduction in incidence of squamous cell carcinomas (SCCs), but study design and analysis problems complicate interpretation of the results.[1,2]
Magnitude of Benefit: Not applicable (N/A) (inadequate evidence).
The harms of sunscreen use are poorly quantified but are likely to be small, including allergic reactions to skin creams and lower production of vitamin D by the skin with less sun exposure.
Chemopreventive Agents
There is inadequate evidence to determine whether the use of chemopreventive agents reduces the incidence of SCC or BCC of the skin.
Magnitude of Effect: N/A (inadequate evidence).
Beta carotene use has been associated in RCTs with an increased risk of lung cancer incidence and mortality in smokers. Isotretinoin has dose-related skin toxicity. COX-2 inhibitors, such as celecoxib, have been associated with cardiac toxicity in RCTs for the prevention of colorectal cancer.
There is inadequate evidence to determine whether the avoidance of sunburns or the use of sunscreen alters the incidence of cutaneous melanoma.
Magnitude of Benefit: Unknown.
Incidence and mortality
There are three main types of skin cancer:
BCC and SCC are the most common forms of skin cancer but have substantially better prognoses than the less common, generally more aggressive, melanoma.
NMSC is the most commonly occurring cancer in the United States. Its incidence appears to be increasing in some,[1] but not all,[2] areas of the country. Overall U.S. incidence rates have likely been increasing for a number of years.[3] At least some of this increase may be attributable to increasing skin cancer awareness and resulting increasing investigation and biopsy of skin lesions. The total number and incidence rate of NMSCs cannot be estimated precisely, because reporting to cancer registries is not required. However, based on extrapolation of Medicare fee-for-service data to the U.S. population, it has been estimated that the total number of persons treated for NMSCs in 2006 was about 2,152,500.[3] That number exceeds all other cases of cancer estimated by the American Cancer Society for that year, which was about 1.4 million.[4]
Melanoma is a reportable cancer in U.S. cancer registries, so there are more reliable estimates of incidence than is the case with NMSCs. In 2012, it is estimated that 76,250 individuals in the United States will be diagnosed with melanoma and approximately 9,180 will die of the disease.[5]
The incidence of melanoma has been increasing for at least 30 years.[5]
Risk Factors
Epidemiologic evidence suggests that exposure to UV radiation and the sensitivity of an individual's skin to UV radiation are risk factors for skin cancer, though the type of exposure (high-intensity and short-duration vs. chronic exposure) and the pattern of exposure (continuous vs. intermittent) may differ among the three main skin cancer types.[6,7,8] In addition, the immune system may play a role in pathogenesis of skin cancer. Organ transplant recipients receiving immunosuppressive drugs are at an elevated risk of skin cancer, particularly SCC. Arsenic exposure also increases the risk of cutaneous SCC.[9,10]
The visible evidence of susceptibility to skin cancer (skin type and precancerous lesions), of sun-induced skin damage (sunburn and solar keratoses), and the ability of an individual to modify sun exposure provide the basis for implementation of programs for the primary prevention of skin cancer.
Factors associated with increased risk of nonmelanoma skin cancer
Ultraviolet (UV) radiation exposure
Most evidence about UV radiation exposure and the prevention of skin cancer comes from observational and analytic epidemiologic studies. Such studies have consistently shown that increased cumulative sun exposure is a risk factor for NMSC.[7,8] Individuals whose skin tans poorly or burns easily after sun exposure are particularly susceptible.[7]
Factors associated with an increased risk of melanoma
UV radiation exposure
The relationship between UV radiation exposure and cutaneous melanoma is less clear than the relationship between UV exposure and NMSC. In the case of melanoma, it seems that intermittent acute sun exposure leading to sunburn is more important than cumulative sun exposure;[11] such exposures during childhood or adolescence may be particularly important.[6]
Interventions With Inadequate Evidence as to Whether They Reduce Risk of Nonmelanoma Skin Cancer
Sunscreen use and UV radiation avoidance
It is not known if interventions designed to reduce exposure to UV radiation through the use of sunscreens and/or protective clothing or through limitation of exposure time reduce the incidence of NMSC in humans. Some studies have used solar keratoses rather than invasive skin cancer as the study endpoint. It is generally felt that half or more of SCCs arise from solar keratoses. However, nearly half of SCCs occur in clinically normal skin.[12] A longitudinal study has shown that the progression rate from solar keratoses to SCC is about 0.075% to 0.096% per year, or less than 1 in 1,000 per year.[12] Moreover, in a population-based longitudinal study, there was an approximately 26% spontaneous regression rate of solar keratoses within 1 year of a screening examination.[13] Therefore, it is likely that solar keratosis is a poor surrogate endpoint in SCC prevention trials.
One very small randomized placebo-controlled study of a sunscreen (sun protection factor [SPF] 29) was conducted in 53 volunteers who had either clinical evidence of solar keratoses or NMSC.[14] Only 37 of the participants returned for the planned 2-year follow-up (attrition rate of 30%). The rate of new solar keratoses was lower after 2 years in the sunscreen group than in the placebo (base-cream) group (estimated 36% reduction in annual rate, P = .001). Another study showed that regular sunscreen use helps reduce the incidence of solar keratoses and increase remission of existing lesions.[15] In Australia, 588 persons aged 40 years and older who attended a free skin cancer screening clinic and had 1 to 30 solar keratoses were enrolled in a randomized controlled trial (RCT) assessing the effect of regular sunscreen (SPF 17) use on solar keratoses; 431 persons completed the study. Individuals in the sunscreen group developed fewer new lesions and had more remissions of existing lesions than those in the base-cream placebo group. There was an increase of 1.0 in the mean number of solar keratoses in the base-cream group versus a decrease of 0.6 in the sunscreen group (difference = 1.53; 95% confidence interval [CI], 0.81–2.25). The rate ratio of new lesions was 0.62 (95% CI, 0.54–0.71). Furthermore, in the sunscreen group, the development of new lesions and the remission of existing lesions were related to the amount of sunscreen used. Such a relationship was not observed in the base-cream group.
However, a different Australian randomized study (the Nambour Skin Cancer Prevention Trial) showed that, after 4.5 years of follow-up, there was no statistically significant difference in the incidence of BCCs or SCCs with regular SPF 16 sunscreen use. This study did not include a sunscreen placebo. Although a secondary subset analysis of the overall number of tumors showed a reduction in the frequency of SCCs on the sites of daily sunscreen application, the validity of the finding is questionable because of the possible effects of extensive multiple statistical testing.[16] An 8-year post-trial observational follow-up demonstrated statistically significant reductions in both the frequency and the overall incidence of SCCs in the regular sunscreen-use arm, but the reliability of these findings is uncertain given their occurrence outside of the controlled-trial environment.[17]
Chemopreventive agents
Beta carotene
In the Physicians' Health Study, 21,884 male physicians with no reported history of BCC or SCC were randomly assigned to take 50 mg doses of daily oral beta carotene versus placebo in a 2 × 2 factorial trial of beta carotene and aspirin.[18] Incidence of NMSCs was a secondary endpoint in the trial. After 12 years of beta carotene or placebo administration, there was no difference in incidence of either BCC or SCC. RCTs of long-term treatment with beta carotene in individuals previously treated for NMSC also showed no benefit in preventing the occurrence of new NMSCs.[16,19]
High-dose isotretinoin was found to prevent new skin cancers in individuals with xeroderma pigmentosum.[20] However, a RCT of long-term treatment with isotretinoin in individuals previously treated for BCC showed that this agent did not prevent the occurrence of new BCCs but did produce side effects characteristic of isotretinoin treatment.[21,22]
A multicenter, double-blind, randomized, placebo-controlled trial of 1,312 patients with a history of BCC or SCC and a mean follow-up of 6.4 years showed that 200 µg of selenium (in brewer's yeast tablets) did not have a statistically significant effect on the primary endpoint of BCC development and may increase the risk of SCC and total NMSC.[23,24] The cumulative incidence of NMSC was 0.20 versus 0.16 per person year of follow-up in the selenium and placebo groups, respectively (unadjusted relative risk = 1.27; 95% CI, 1.11–1.45).
The use of celecoxib as a chemopreventive agent for actinic keratosis was assessed in a double-blind, randomized, placebo-controlled trial. Two hundred forty high-risk men and women (each with 10–40 actinic keratoses and a history of previous skin cancer) received 200 mg doses of celecoxib twice daily or a placebo for 9 months with an additional 2-month follow-up. No difference was found in the incidence of actinic keratosis, but a post-hoc analysis revealed a statistically significant difference in the mean number of NMSCs per patient (rate ratio = 0.43; 95% CI, 0.24–0.75; absolute difference, 0.2 lesions per patient). The ultimate utility of celecoxib in preventing NMSCs remains unclear, given the exploratory nature of the analysis, the challenge of interpreting benefits in fractions of lesions, and the potential for serious adverse cardiovascular effects associated with long-term use of nonsteroidal anti-inflammatory drugs. However, the unexpected finding of the lack of effect of celecoxib on actinic keratosis but apparent effect on SCC and BCC incidence raises questions about the use of actinic keratosis as an intermediate endpoint for SCC and BCC and our understanding of the natural history of NMSCs.[25]
Alpha-difluoromethylornithine (DFMO), an ornithine decarboxylase inhibitor used in intravenous form to treat African trypanosomiasis and in topical form to treat female hirsutism, was investigated as a chemopreventive agent in patients with prior NMSCs.[26] After a 4-week placebo run-in period, 291 volunteers who took at least 80% of their placebos were randomly assigned to oral DFMO (500 mg/m2 /day) versus placebo for up to 5 years (average 4 years). At baseline, the placebo group had a higher mean number of prior NMSCs than the DFMO group (4.9 vs. 4.2; P = .1), and a longer history of NMSC (P = .002), possibly favoring the DFMO group. The primary endpoint of the study was the number of new NMSC events, and the rate was 0.44 new cancers per year in the DFMO group versus 0.61 in the placebo group (P = .07). In a subset analysis, there was a statistically significant difference in BCC events favoring the DFMO group (0.28 vs. 0.40 per year; P = .03) and no difference in SCC rates. DFMO is known to have ototoxicity, and the average hearing loss of audiograms was greater in the DFMO group, which was about 4 dB versus 2 dB (P = .003). In the DFMO group,10.8% discontinued the study drug because of a greater than 15 dB hearing loss, compared with a 4.5% discontinuation in the placebo group (P = .06). DFMO hearing loss is usually reversible. In summary, the efficacy of DFMO for skin cancer prevention is unclear, and it remains investigational for this indication.
Interventions With Inadequate Evidence as to Whether They Reduce Risk of Melanoma
Results from a collaborative European case-control study and one animal study suggest that sunscreens that protect against sunburn may not protect against UV radiation–associated cutaneous melanoma.[27,28] Nonmodifiable host factors, such as propensity to burn, a large number of benign melanocytic nevi, and atypical nevi may also increase the risk of developing cutaneous melanoma.[6]
A post hoc analysis of the Nambour Skin Cancer Prevention Trial (discussed above) examined the incidence of melanoma at a median of 14.2 person-years of follow-up. In the trial, participants were randomly assigned to daily or discretionary sunscreen use from 1992 to 1996. Follow-up continued until 2006 via either active participation, in which subjects completed periodic questionnaires about new skin cancers and relevant sun behaviors, or passive participation, in which subjects' medical records were reviewed for skin cancer diagnoses; 52% of the trial participants were actively participating as of 2006. Eleven melanomas were diagnosed in the daily sunscreen arm versus 22 in the discretionary-use arm (hazard ratio [HR] = 0.5; 95% CI, 0.24–1.02), of which 3 versus 11 were invasive, respectively (HR = 0.27; 95% CI, 0.08–0.97). There was no difference in the rates of melanoma on prescribed sunscreen application sites between the two groups. This study has several important limitations: melanoma was not a planned outcome of the original trial; the CIs of the outcome estimates are very wide, indicating substantial uncertainty of the magnitude of the effect; and there is potential for the introduction of confounding with the widespread use of the passive participant option during the follow-up phase of the study.[29]
A meta-analysis of 18 studies that explored the association between melanoma risk and previous sunscreen use illustrates widely differing study qualities and suggests little or no association.[30]
Behavioral Interventions to Change Sun-Protective Practices
As noted previously, direct evidence that interventions, such as sunscreen or protection from UV light exposure, decrease the risk of skin cancer is sparse. However, given the association between UV light exposure and subsequent risk of skin cancer, counseling interventions aimed at increasing sun-protective behaviors have been examined. The U.S. Preventive Services Task Force (USPSTF) commissioned a systematic review of this evidence. Although the USPSTF review found no randomized trials directly linking counseling strategies to skin cancer reduction, it found 11 trials, rated as fair in quality, that tested the effect of interventions on sun-protective behaviors.[31] Several trials of behavioral interventions in adults, sometimes as part of an intervention addressing multiple health-related behaviors, such as smoking and nutrition, showed a short-term increase in self-reported sun-protective behaviors. However, the effect sizes were small to modest, without clear evidence that the differences were clinically meaningful.[32,33,34,35,36] Likewise, appearance-based behavioral interventions in young women have had a favorable impact on self-reported indoor tanning behavior, but no long-term follow-up or health outcomes were reported.[37,38,39] A randomized, primary care office–based counseling intervention in adolescents showed an increase in self-reported midday sun avoidance and sunscreen use in the intervention group for up to 24 months.[40] A randomized trial of a provider-based sun protection promotion counseling program for parents for their infant children showed a small increase in sun-protective actions, of questionable clinical importance according to the researchers.[41]
Nevertheless, studies of intervention strategies for reducing UV radiation exposure suggest that the best approach is education about the risks associated with sun exposure and sunburn and education about sun-protection strategies.[42,43] In one study, an educational intervention at the time of treatment for skin cancer—a time when an individual may have heightened awareness of his or her susceptibility to skin cancer—seemed to have the greatest effect.[42] However, even in such a high-risk group, it was difficult for many individuals to maintain sun-protective behaviors. In a community skin cancer screening study, researchers found that, although regular use of sunscreens was not related to personal or family history of skin cancer, it was more common among persons who perceived themselves to be at moderate or high risk of developing melanoma.[43]
Sun-protective strategies may include avoiding sun exposure at times of the day when the exposure is more intense and wearing clothing that protects skin from sun exposure. Self-examination for skin-pigmentary characteristics associated with melanoma (e.g., freckling status) may be a useful way to identify individuals at an increased risk of developing melanoma.[44] Skin type (propensity to burn after sun exposure and tanning ability), alone or with other physical characteristics, such as hair color, has been used as a measure of sun sensitivity in epidemiologic studies.[45]
In summary, a number of randomized trials and other studies have suggested that counseling or health information may have an effect on sun- or UV-protective behaviors. However, in addition to lack of information on health outcomes and relatively short follow-up times, most of the studies suffer from important methodologic problems, including the possibility of self-reporting inaccuracy, high study attrition rates, and lack of information about sustainability of the interventions.
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.
Description of the Evidence
Updated statistics with estimated new cases and deaths for 2012 (cited American Cancer Society as reference 5).
If you have questions or comments about this summary, please send them to Cancer.gov through the Web site's Contact Form. We can respond only to email messages written in English.
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This PDQ cancer information summary for health professionals provides comprehensive, peer-reviewed, evidence-based information about skin cancer prevention. It is intended as a resource to inform and assist clinicians who care for cancer patients. It does not provide formal guidelines or recommendations for making health care decisions.
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This summary is reviewed regularly and updated as necessary by the PDQ Screening and Prevention Editorial Board, which is editorially independent of the National Cancer Institute (NCI). The summary reflects an independent review of the literature and does not represent a policy statement of NCI or the National Institutes of Health (NIH).
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National Cancer Institute: PDQ® Skin Cancer Prevention. Bethesda, MD: National Cancer Institute. Date last modified <MM/DD/YYYY>. Available at: http://cancer.gov/cancertopics/pdq/prevention/skin/HealthProfessional. Accessed <MM/DD/YYYY>.
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text:
something old, something new
Some new outfit snaps and some new snaps of old outfits. When the more things change, the more they stay the same.
Constants: leopard print (yes, still!), AA gray twist scarf and hats for those lazy days, and my Ray Ban Aviators (c/o ShadesDaddy.com and currently on sale). New days with recurring themes…
story comforts of my life.
xx, becs


text:
'This Is 40' review: This is not funny
This Is 40
Comedy. Starring Leslie Mann, Paul Rudd and Albert Brooks. Directed by Judd Apatow. (R. 134 minutes.)
Judd Apatow has made reviewing "This Is 40" really awkward. By doing interviews stressing the connection between his own life and the movie and by casting his wife, Leslie Mann, and his two daughters in lead roles, he has made it difficult to talk about the people in the picture. If you say they're awful, readers might think you're attacking him or his wife and kids, and nobody wants to do that.
So let's just say going in that the only thing being reviewed here is the movie. All references here to the family are to the fictional family, under the working assumption that nothing onscreen resembles any real-life person. And that's the truth, because if I had to put money on this, I would say that the real problem with "This Is 40" is its lack of truth, that Apatow wanted to express something about married life, and it eluded him. After all, no less than Kierkegaard once said that the actual dynamics of marriage are beyond the scope of art, and he was the best movie critic of the 19th century.
Sequel of sorts
A sequel of sorts to "Knocked Up," "This Is 40" takes subsidiary characters from that earlier comedy, Debbie (Mann) and Pete (Paul Rudd), and crafts a story around them. Their marriage didn't look so great in "Knocked Up," and now it's dead. Debbie and Pete don't listen to each other, they're not attracted to each other, and they don't interest each other. They're not even nice to each other. Apatow presents these marital problems as routine, but they're catastrophic. This isn't 40. This is hell's inner circle.
Individually, Debbie and Pete act like narcissistic children - and yet their empty and selfish behavior is offered up by Apatow as fey and quirky, even charming. At one point the wife yells at, curses at and even threatens a little boy who has insulted her daughter online. Later, she and her husband (Rudd) lie about the incident to the school principal. How funny.
Toilet humor
Meanwhile, Pete makes a fetish of leaving the door open when he's sitting on the toilet. And if that's not gross enough, when Pete becomes concerned about a swelling in his anus, he insists that his wife inspect it, at close range. I suppose there is a husband out there somewhere who would do that - one who never wants to have sex again, at least not with his wife.
Let's be clear: Everybody is horrible in "This Is 40," but that's not the issue. Horrible can be interesting. There are some very good movies about horrible people. The problem is that no one in the movie and no one behind the camera seems to have any clue that these people are horrible. The characters see themselves as in a rut, but we in the audience see that they're in a deep hole, and with neither the personal character nor any real motive to climb out. There is nothing in this marriage worth saving.
It's easy to see how "This Is 40" could have gone bad by accident. Apatow cataloged a series of awful things that might happen within a marriage and then stitched them into a succession of bits, perhaps not realizing that the cumulative effect would be a portrait of hopelessness. The portrayal of the children is equally bleak. Iris Apatow, as the 8-year-old, has moments of droll wit, but Apatow leads teenager Maude Apatow toward a one-note performance, in which she is almost always angry, full of herself and cursing at full volume at her parents. No one can fault a father for being charmed by his own daughter, but as a novice, she needed closer handling.
In passing, the movie offers a study in self-adoring privilege. The wife owns a clothing store, and the husband owns a record company. A concession is made to the 99 percent out there - we hear that she's just breaking even and that he's losing money - so that we shouldn't hate them for being rich. All the same, these are characters who have it remarkably easy, which presents yet another barrier to our caring whether they all come down with smallpox.
For once, Leslie Mann isn't funny. Neither is Paul Rudd. Albert Brooks is funny, as Rudd's father, a moocher who sponges off his son in order to support his brand-new family, a wife and small children. He's not an admirable character, but Brooks, with his frazzled, aggrieved humanity, makes him a true one. He lifts every scene he's in - if only he were in more.
Mick LaSalle is The San Francisco Chronicle's movie critic. E-mail: email@example.com


text:
Network Monitoring Policy
The purpose of network monitoring is to identify and block malicious activity in order to protect the College's data, systems, and reputation.
The scope includes all computing systems and network infrastructure owned or managed by Middlebury.
In order to protect data, designated ITS staff may use network monitoring technologies to log network activity and to scan data moving across the network. These technologies may include anti-virus software, firewalls, intrusion protection and intrusion detection systems, vulnerability management systems, and database and application monitoring systems. This information may be centrally correlated for analysis.
Server logs may be monitored for malicious activity on a routine schedule. Other network traffic may be logged as necessary for troubleshooting and resolution of network issues. Automated scans for unencrypted sensitive data are conducted on a regular basis with findings logged for appropriate management or removal. Only malicious or extraordinary activity is to be logged. These measures are not to be used for tracking and/or monitoring an individual's network activity.
Confidentiality of all information gathered as a result of network monitoring will be maintained at all times. Access to information obtained through network monitoring will be limited to designated staff and in the event of an investigation, College officials, legal counsel, or law enforcement. This information will be kept in a protected storage area. Events and incidents identified through network security monitoring will be managed in the spirit of the Technology Incident Response Policy.
Any substantive changes to the network monitoring methodology or scope must be approved by the College's senior management.
Any employee who is found to have violated this policy may be subject to disciplinary action, up to and including termination of employment. Violation of this policy may also be a violation of the Federal Computer Fraud and Abuse Act.


text:
Dear Colleagues and students,
Let us usher in the New Year with the resolve to be proactive agents of change. As the country moves towards a new phase, with digitalization, intense cleanliness drive and cashless economy, the onus to make these initiatives a reality falls upon us.
Every year we add a new chapter in the history of KVS with a reaffirmation of faith in the potential of our teachers and pursue our goals for excellence. I am very confident that the positive attitude and actions of my teachers will inspire the student body to walk that extra mile and attain their goals.
I express my gratitude to the parent body for reposing their unstinted trust in the organization and greet them on the eve of New Year.
May all students be brave enough to take on and overcome the challenges of life and continue on the path of virtuosity in the coming New Year.
Every accomplishment starts with the decision to try.
Happy New Year!
(Santosh Kumar Mall)


text: I've never been to Romania, but if I did go, I'd look for Donna Bell first. This European beauty has been shooting with Brazzers since 2010, specializing in sexy girl on girl action for Hot and Mean. Born in 1988, Donna first started shooting porn in 2006 and since then has amassed a catalog of over 70 different adult films. While we've seen her eating pussy primarily, she's not scared to delve into anal or double penetration. Variety is good to see in porn stars, and Donna isn't afraid to diversify her skill set. Donna Bell is one all natural tight porn star you can't miss out on.


text:
Brophy Bros.
119 Harbor Way, Santa Barbara
Phone: (805) 966-4418
Brophy Bros. writes: Brophy Bros. was established in 1986 and is operated by the original owners. "The Bennett family." Our restaurant is a high paced, casual and social venue. Prepare to meet people and interact with locals. We have been fortunate to have received Best Seafood and Best Clam Chowder in Santa Barbara for many, many years. Brophy's is located right on the docks and the views are amazing.
Due to our limited space, we are unable to take reservations and suggest putting aside ample time to wait and enjoy the surrounding area. Visit our website www.brophybros.com for things to do and places to stay in the immediate area.