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Friday, September 15, 2006
Tales From the Right Lower Quadrant: appendixes I have known. Part one.
Dr. Dunphy (J. Englebert "Bert" Dunphy, Chairman of the Surgery Dep't, UCSF, RIP) used to tell us: when evaluating abdominal pain, never have appendicitis lower than second on your differential. It's a good thought to keep close: whereas classic appendicitis is most often a fairly straightforward bedside-makeable diagnosis, it can do pretty strange things, and be a major diagnostic challenge. Not to mention being the cause of a few good stories.
First, some background: the appendix -- its spanking name is appendix vermiformis, which means wormlike thingy -- looks, in its normal state, like a little worm, 'bout half a night-crawler. Doing nothing that any (reliable) research has ever identified, it hangs down from the cecum like a sad little rat-tail in the right lower part of your belly. Most people never have any reason to know it's there. When they do, in by far the most of cases, it's because it becomes infected: infection of the appendix is called appendicitis.
Your mom may have told you if you swallow cherry pits you'll get appendicits. I know your mom: she wasn't wrong often, but this is one of the times. That rumor may have gotten started because of an item called an appendicolith, which means a stone in the appendix. ("I gave my love a cherry, without a stone... I gave my love a chicken...." etc.) The other, less impressive, name is fecalith. What it is is a piece of stool that got stuck in there and become so inspissated it's like stone. This is one presumed cause of appendicitis; it also can lead to a rare situation of recurring appendicits (more, later.) But the fact is, in most cases there's not an identifiable reason when it happens; and in the vast majority of instances, it's a one-time deal. (I always made a point of telling kids with appendicitis, and their parents, that it's no one's fault: it's nothing they ate, nothing they did. It just happened.)
The gut doesn't have a large trick-bag; meaning, it only has a few ways it can respond to illness, and it doesn't have the sort of pain nerves that allow localization. If I pinch you on your skin, you'd know exactly where, with your eyes closed. Pinch a spot on your intestines, and you'd likely only muster a "yuck." So the early signs of infection or inflammation of one part of the gut have a way of sounding like and feeling like those in another. When appendicitis starts, therefore, it's usually with a vague yucky feeling, loss of appetite, nausea. Pain is hard to put a finger on, at first. It's only when the inflammation progresses to the point that it involves surrounding tissues -- specifically, the parietal peritoneum, which has LOTS of nerves, of the kind the brain can pinpoint -- that the pain begins to localize where the appendix is (or is supposed to "is"), in the right lower abdomen. Typically it takes a half a day or a day for the symptoms to localize. Appendicitis can happen at any age, but is significantly more common in kids (around five years old to teenage, and there's another spike of frequency in us senior citizens.) Luckily, it's rare in babies, which is good: it's hard as hell to diagnose early in them.
As the infection evolves, the appendix gets red and swollen, going from worm-size to -- sometimes -- finger-size. And left to its own devices, the infection eventually rots away all or part of the appendix (gangrenous appendicitis) and it falls apart, allowing the pus inside to leak out. Ruptured appendix, as you've no doubt heard. When that happens, things generally go in one of two ways, depending on several factors, including the location of the tip-end of the appendix: either pus flows all over the place, causing generalized peritonitis, or it gets walled off into an abscess. In the former case, you'll get sick as hell; in the latter, you won't feel great but it's possible to limp along without disaster.
The cecum is always the starting point, anatomically, of the appendix, and the cecum is nearly always situated in the right lower part of the abdomen. But the tip of the appendix can be in a lot of places, depending on its length, and resting place. Some far ends of the thing are way down in the pelvis; some are across to the left, or aiming north. Quite a few take off from the cecum and run backwards behind it, and can go as high as the liver in that "retro cecal" orientation. Major bummer for the victim and his/her surgeon.
OK. So now, assuming you didn't already, you have a background for a few stories I'm going to tell.
22 comments:
- Jordan said...
I see appendicitis in the office usually a few times a year. Its funny about half the time I know the diagnosis immdiately and send to the er. The other half i usually send to Cat scan and have them sit in radiology while I wait for the answer. Occasionally I get one that has been brewing for a few weeks and has already ruptured yet the patient is only now starting to get sick. Appendicitis really makes me envy surgeons. Talk about cut to cure! Problem + surgery=problem solved. At least most of the time!
- Moof said...
This promises to be very interesting! I'm definitely watching! Bring it on! :o)
aside from feeling a little 'ew' from the backgroud...and i thought i was over most of my queeziness...
my grandma had a ruptured appendix, and was succesfully opporated on was back when. im glad, or i wouldnt be here. way back in the early 1900's i think...
- S. R. said...
Sing it doc! very interesting.
I believe masturbating can cause appendicitis. I'm totally serious cause even though im embarrased to admit it, that is what i believe caused mine. but i never told anyone until now. by the way I'm female. And i have paid dearly
- Sid Schwab said...
anonymous: cut yourself some slack. Most people masturbate. Few people get appendicitis. I'm guessing earthquakes have happened, fires started, heart attacks occurred while people were doing it. That does not make a connection. If it were the cause, I'd have taken out a million appendixes in my career. Relax. Coincidence: 100% guaranteed.
Thank You Dr. Schwab, i kind of feel better. I'd like to believe there is no connetion between both, since i have paid $$ dearly (and in full) I thought to myself stupid stupid stupid (after i got the hospital bill). If only I could tell you how it all happened and what i felt. Maybe just maybe masturbating may cause appendicitis in women. I think I'm on to something here. Ciao
Just wanted to say three things...
1.) Great information and stories.
2.) Thanks for doing what you do.
3.) A doctor such as yourself saved my life when I had a burst appendix. The "story" with mine was it happened while I was in Afganistan. Unfortunately, got a permanent vertical belly scar out of it, but more importantly I'm alive. I never really stopped to think what amazing things surgeons, doctors, and nurses do on a daily basis. God bless!
I need some help. My husband went into the emerge on fri and was diagnosed with it being his appendix.( x-ray,blood,urine,ect) The doc said they would monitor him and the surgeon would do it in the AM. The new AM doc on call (not the surgeon) decided that since the symptoms were getting better, and his white count was down from 19000 to 16000, we should wait it out until it became acute again. Im worried, should it just come out? Why did it get better. It is now 3 days later, he still has pain, usually if he bends or coughs, but his fever is gone. Should we wait?? No one else I talk to thinks we should wait. The doc said "come back when you are in excruciating doubled over pain" Problem is Jason has an incredible high pain tolerance. I have seen him put his own dislocated thumb back in place. YUCK! Thanks
- Sid Schwab said...
I'm sorry but I simply have no way to offer meaningful advice from so far away from the situation. But it seems the safest move would be to be re-evaluated.
You probably don't have appendicitis, I'm not really a expert on masturbation and it's effects, but appendicitis is more of a bacterial condition.
- LittleoftenAnnie said...
hi there,
i swallowed a cherry seed just now
is it ok to force myself to throw it up?
- Sid Schwab said...
Well, as I wrote, it's sort of a myth that cherry seeds don't cause appendicitis; so I guess you'll have to make your own decision on that.
Hi Dr. Schwab. Your blog is so informative, I enjoy it immensly. On a personal note, I had an appendectomy done in the 80's for typical symptoms of appendicitis. The surgeon said the appendix was not inflammed but he removed for diagnostic purposes since it was "thickened" He also said I had alot of adhesions which was unusal since this was my first abdominal surgery. He wanted additional consults and tests, but the HMO would not approve them. About 1 year later I began having abdominal pain and was seen by another surgeon who drained an abdominal wall abcess and did a colonoscopy. The surgeon then told me I had "classical Crhons disease. This suprised me as I was 60lbs overweight and this fact was used by the HMO to rule out Crohns.
Have you ever done an appendectomy and then later Crohns was discoverd? I am now doing great thanks to immune modifiers and am now very lean.
- Sid Schwab said...
Yes. It's one of the well-known situations when finding a normal appendix when operating for what appears to be appendicitis. In surgical training, in that situation, we were taught always to inspect the terminal ileum, i.e. the last part of the small bowel, where it joins the colon right next to where the appendix is: often the anatomic signs of Crohn's can be seen, if that's what's going on. The terminal ileum is the most common place for Crohn's to show up.
Glad you're doing well, and thanks for your comment.
My guess is that when anonymous posted that she thought masturbation caused her appendicitis, it was because she inserted something into her vagina that caused a bacterial infection. Is that possible?
- Sid Schwab said...
I suppose it's possible that that's why she thinks so. But virtually impossible that it's a cause.
- Rachel Ahmed said...
Hi ive been having right lower side abdominal pain for a few months. Until 2 weeks ago it was just an uncomfortable throb that would last an hour a few times a month until two weeks ago i went to the ER with severe sharp pains in the same area that made me scream. But even that came and went for a few hours. Ct scan at the ER reveild an apendolith but no apendicitis. So the doc said if it got worse to come back. Doing the wait and see aproach. Right before the pain I feel like my apendix moves with every pain and the pain last for a split second. Also i feel cramping in that spot most of the time and today i feel like i have gas pains in that spot that is moving to my belly button,again that pain comes and goes to. But my question is, how often do apendoliths turn into apendicitis with the symptoms I have?
- Sidney Schwab said...
I don't think there's a way to answer your specific question, Ms Ahmed, because whereas there have been some studies of people found to have an asymptomatic appendicolith, I'm not aware of something similar for people who presented with symptoms. I'd guess most people in that category underwent appendectomy.
As to people found incidentally to have an appendicolith, the evidence is that it confers increased risk for developing appendicitis, but isn't an absolute indicator, absent symptoms, for having it removed. So the question in your case is whether your symptoms could be due to the stone. (For the record, I doubt you can actually feel your appendix moving.) Since your symptoms aren't classical for appendicitis, I guess it's hard to say for sure: typically appendicitis is a single steady progression with signs of infection leading to treatment. However, there are cases, as I've written, of recurrent appendicitis wherein symptoms come and go. In my experience those cases have often been associated with appendicolith which, I assume, can sometimes act like a ball valve, plugging up the appendix temporarily but releasing before serious infection occurs.
I can't say if your symptoms are due to the stone or not. The doctors caring for you are better able to make that decision. If those docs haven't included a surgeon, you could consider seeing one. Without the benefit of being able to examine you, especially during an episode, I can't say what I'd recommend. I'd say, in general, that it's possible that what's going on is due to the stone and that appendectomy would end it. It would also reduce risk of future appendicitis. But in your specific case, the decision needs to be between you and your doctors, not a person so far removed as I am.
- Sidney Schwab said...
P.S. Cute picture.
- Arshad Shaikh said...
I have been diagnosed with Appendicolith. The CT Scan report says "The Appendix is retrocaecal, predominantly air filled and shows multiple (3-4) calcified Appendicolith, largest measuring 2.0 X 1.4 X 1.0 cms in size." What does this mean? Is it something to worry about?
- Sidney Schwab said...
It's best to discuss the meaning with whomever it is that ordered the CT scan. As a general information, appendicoliths are bits of hardened stool (feces) that form and remain in the appendix. They are associated with increased risk of getting appendicitis, but not everyone who has them gets the infection.
Retrocecal means it lies behind the cecum, which is the first part of the colon. That location makes appendectomy potentially more difficult; and it can mean the symptoms of appendicitis, were it to occur, can be a little more difficult to diagnose.
For the record -- and I don't know the significance -- I've seen plenty of appendicoliths, but never as big as described in your report.


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Vacancies, Training & Volunteering
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If you are new to publishing you would have the opportunity to try a range of key aspects, including marketing, editorial and text-formatting tasks in a non-corporate environment. We are a small team and there is always lots to do, so you can get involved rather than simply observe.
If you have some experience, we would love to hear from you if you would be willing to help us in any aspect of our work: proofreading, typesetting, copy editing, marketing, peer-reviewing, developing our website, or providing specialist expertise in your own field of research.
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Performance 2008: Productivity, Employment, and Growth in the World's Economies
- Authors:
Publication Date:
March 2008
Low productivity growth (under 2 percent) in the United States, Europe, and Japan in 2007 contrasts sharply with high growth (more than 8 percent) in the BRIC countries—Brazil, Russia, India, and China. Productivity levels in emerging economies are only 10 to 40 percent as high as those in the United States, but lower wages give them a competitive advantage, keeping their manufacturing costs at 20 percent of U.S. levels. Meanwhile, the spending gap between emerging and established economies in research and development and information technology is narrowing, reflecting newer economies' commitment to competing based on innovation and not just cost.


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Swimming Pool Blog
by Guest Blogger Chris Miles, February 28, 2011
General Swimming Pool Maintenance
Pool maintenance is one of those tasks in life that we have to do, and it's essential to keep a regular maintenance schedule in order to keep your swimming pool water crystal clean.
It is one of those tasks that if you forget to do it for a few days, it can rapidly turn to greater work and expense. It is far easier to prevent algae growing in your pool in the first place than it is to try and get rid of it once it has taken over your pool. In extreme cases of neglected pools, you may well end up changing all of the water, and the internal pool surfaces will also have been affected.
The two main things you need to concentrate on in your pool are keeping the pool filtration system clean and ensuring that a good chemical balance of the water in the pool is maintained.
You will need to check the pool filter at least once a week, or ideally twice. Take a look at the pressure gauge, this gives an immediate view into how the water is flowing, and how clean the filter is. If the pressure gauge is 8-10 lbs over the clean reading, it is time to clean or backwash the pool filter. Also use your ears each time you check your system; over time you will recognize the sound of your pool pump - if it sounds different, you may have flow problems. Check for any water leakage on any of your pipes or equipment.
With regards to the chemicals you will need to check your pool weekly to ensure that the Chlorine, pH, Alkalinity, and the water hardness are all within the correct parameters. A liquid dropper style pool test kit gives more accurate readings than test strips, and can better help determine adjustment dosages for your pool.
The most important chemical level to maintain is the chlorine level - chlorine is responsible for killing organic matter and germs that otherwise will grow and gradually block the filter system. Left untreated this organic/algae growth can take over your whole pool, and in addition such growth may cause such a strain on the pump and filter, overloading them to an ineffective degree.
Also every now and again you will have to carry out what is called a "Shock" to your pool to super chlorinate the water and totally kill off bacteria. Some dealers recommend weekly shocking, but this can be too much for most residential pools. Shock the pool if:
- High pool usage
- After cleaning up from a bit of a storm
- Algae treatment in the pool
- Hazy, cloudy pool water
- If Chlorine level in pool reaches 0.0
Swimming Pool Maintenance Schedule:
In order to keep your pool in good condition you will need to establish a pool maintenance routine. At the start this may seem tiresome and you may wonder why you have to keep checking pH levels, Chlorine and Alkalinity. This is all done for good reason, as any one of these, left unchecked, and hence untreated for any short period of time can ruin the water quality of your pool, and in extreme cases, ruin the pool itself.
It is much easier to maintain a crystal clear pool than it is trying to clean up a dirty one. Prevention is far easier than cure, as the saying goes, and this is particularly true of a swimming pool.
The first thing I would say is that each pool will have its own demands and needs with regards to maintenance, as a pool that is in use daily by a large family will need more regular checks than one that is only used by one or two swimmers every few days. So you will need to "Get to know your pool" over a period of time, at the start this maybe daunting but with practice you will get a "Feel" for your pool's specific requirements.
Sample swimming pool maintenance schedule -
- Test water pH, Alkalinity, Chlorine
- Remove debris from surface of pool
- Remove debris from floor of pool
- Brush your pool, especially important for plaster pools.
- Empty skimmer and pump basket(s)
- Clean your main pool filter
The real schedule, for your pool, may vary. Seasonal variation is the most common. When it's very hot, or there are many summer storms, spring or fall tree debris, high rainfall. Also other conditions such as low chlorine, high pool usage ... many variables come into play that will require adjustment to your schedule. Over time, you will be able to simply look at the pool, and give the system a listen, and you will instinctively know what to do.
Pool maintenance, for the average pool, should take no more than 1hr per week. If it takes longer, look for scalability in your tools or methods.
Chris Miles is the Director at Splash and Relax, the leading supplier of swimming pools products in the UK.
Splash and Relax specialise in Above Ground Swimming Pools from major brands world wide.


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Dear Slice: 'You into Nettles on Pizza?'
Slice mail answered.
"It's like French kissing a forest nymph!"
Leslie Kelly (former critic for the Seattle Post-Intelligencer and columnist on Serious Eats) just emailed me. Subject line: Ever had nettles on pizza?
That's the thang this "spring" in Seattle... at Serious Pie and Delancey. At Serious Pie (picture) they were creamed and served with black trumpet mushrooms... YUM!! Might be of interesting to ask Slice readers: What's the most exotic ingredient you've had on a pizza?
Nice! Thanks, Leslie. I haven't had nettles on a pizza yet. I should have gotten them last time I was in SF. Gialina there does them, and from what I understand, people in the Bay Area go NUTS for them every year. How are they on pizza? What's the flavor on a pizza like?
Hasta la pizza, Adam
Surprisingly delicate. Like the most tender baby spinach, but with the slightest hint of citrus. It's like French kissing a forest nymph!!
They're gathered in Seattle by a very cool outfit called Foraged and Found.... I bought a bag at the farmers market for $3! Haven't cooked them yet.
So, folks, what is the most exotic ingredient you've had on a pizza?
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France expels Tunisian as national security threat
PARIS (AP) — France has expelled a Tunisian man suspected of a role in several plans involving violence.
The Interior Ministry said Friday that two journalists were among targets of the plans, but did not elaborate on the plans or the journalists in question.
A ministry statement said the 36-year-old Tunisian man, who wasn't named, "represented a real threat to national security and public safety."
The ministry said the Tunisian was close to the radical Islamist movement and had several times shown a desire to go to Syria to join fighters in the al-Qaida-linked Jabhat al-Nusra, one of the rebel groups fighting Bashir Assad's regime.
The Tunisian, based in a southern Paris suburb, had been living illegally in France for several years, according to the Interior Ministry.


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How to help a hearing impaired child increase their fluency, esp when they are reading above grade level?
Blogs About Reading
Sound It Out
Dr. Joanne Meier
Along with her background as a professor, researcher, writer, and teacher, Joanne Meier is a mom. Join Joanne every week as she shares her experiences raising her own young readers, and guides parents and teachers on the best practices in reading.
Reading at home: "You either get angry or you can bribe them"
Last week's blog post about Accelerated Reader generated some great comments, both here on the blog and also on our Facebook page. I love that the audience for this blog appears to be a combination of parents, teachers, principals, reading specialists, grandparents, special education teachers, graduate students….
A comment from last week's post inspired this week's title. Alex's comment was a dead-on piece of reality:
From a parent's point of view, when you are sitting with your kid and encouraging them to read, meanwhile they are tired and bored and guessing at words and making up games, what can you do? You either get angry and say, "just read this, I know you can and it's getting late and I'm tired!" or you can bribe them...."if you read this, you'll get some sort of special treat." I really haven't seen a deep discussion of how to help during those little times. No practical tips. I hear things like, "pick a regular time each day, continue to read to the kids, make it fun!" but not a lot of practical advice.
Haven't we all been there at some point with a reluctant reader?
Sadly, the "practical advice" needed isn't quick and easy to communicate, and it really is darn hard work. But, if I were to pick one piece of advice to help during those times, it would be this: make sure your child is reading at his or her independent level at home.
A child's independent level is the level at which the material is relatively easy for the student to read, and can be read with at least 95% accuracy. Books at this level aren't hard for the child to read, and dont require the child to sound out lots of words. Most of the words are read quickly and easily.
When a child spends time reading at his independent level, he's getting a chance to practice word recognition and word analysis skills (the ones hopefully being taught at school). Repeated readings of the same book over and over again enable each reading to become smoother. Soon, the reading will begin to "sound like talking." These are all important steps in becoming a fluent reader.
So, get ready to hear those favorite beginning reader books over and over again. Build up a basketful of independent-level books to be read at night, and then read 4 or 6 a night.
A side note: In our house, we "retire" a book when it can be read with eyes closed.
Related: How to Read with a Beginning Reader
Helping parents with how to help their children learn how to read is a deep concern and passion of mine. There are many underlying causes for children who appear bored and guess at words when attempting to read. First, in order for children to enjoy reading, the material being read must be something that is of interest to them. A competent reader will read it halfheartedly just to get through it. Imagine a child who struggles to read being required to read something that is as exciting as watching glue dry. Try this, find a book that is interesting to the child, one at their independent level. Let them pick the book. After reading the book of their choice, then let them know "We need to read this book now. I know it is not as interesting as the other one. But it's going to help you become a better reader." As adults, we can even tell when a book is as dry as chalk. I am under the assumption that the book with which the child was bored to pieces was sent home from school. This book is at the child's instructional level. The level at which they can comfortably receive instruction in with support to progress toward. Being so, your child will have difficulty reading some of the words. You could let them read a sentence then, you read a sentence. Or take turns reading page by page. Additionally, to decrease the guessing at words, you could play word games that focus on the phoneme with which the child is having problems. Lastly, don't be afraid to take a break or work in smaller time segments. When your child sees that you are frustrated, they become less apt to try and become frustrated themselves which manifest in many ways. Natasha Moorer, Reading Specialist http://www.the-reading-pak.com/
Joanne, this is a wonderful article - so heartfelt, and so helpful for parents and kids. Spot on. Thanks,Mary Ann ScheuerLibrarianhttp://greatkidbooks.blogspot.com


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>>>Full Teams
MILLEDGEVILLE, Ga. – The Georgia College softball team put two on the Daktronics All-Southeast Region teams, the organization announced Tuesday. Outfielder Whitney Okvist (Kennesaw, Ga.) was picked for the first team and utility player Abi LeRoy (Dublin, Ga.) earned a second-team slot.
Okvist finished the 2014 season hitting .435, scoring 45 runs and stealing 44 bases in 50 tries. The senior posted a .505 on-base percentage, upping that to .518 in Peach Belt Conference (PBC) contests. She ranks fifth in the nation in steals at 0.93 per game.
LeRoy finished the season with a .325 batting average, 43 RBI, 32 runs and 16 steals, playing in left field and at second base.
Okvist was last selected to the Southeast Region First Team in 2012. This is LeRoy's first all-region honor.
As a first-team selection, Okvist will move on to the All-America ballot, with winners announced May 21. The Daktronics All-America programs honor student-athletes in Division II athletic programs. The voting, nomination and calculations are all conducted by the school's sports information directors.
The D2SIDA All-America softball team is sponsored by Daktronics, Inc., an acknowledged world leader in scoring, timing and programmable display systems for virtually every sport at every level of competition. The teams are voted on by the members of D2SIDA, NCAA Division II Sports Information Directors Association.
The online nomination and voting processes are powered by Sidearm Sports. Headquartered in Syracuse, N.Y., Sidearm Sports is the official provider of college athletic websites for over 600 sports organizations at all levels of competition. To receive more information on how your institution can partner with Sidearm Sports for a customized website solution, visit www.sidearmsports.com.
The Georgia College Department of Athletics, two-time winners of the PBC Commissioner's Cup, sponsors 11 varsity athletic programs at the NCAA Division II level. As a Division II program, Bobcat Athletics prides itself on balancing the life of the student-athlete, evidenced by the teams' multiple appearances in post-season competition as well as documented academic success and community-service involvement. Sign up at @GCBobcats on Twitter and Facebook for up-to-the-minute reports, and visit GCBobcats.PhotoReflect.com to purchase photo prints from home athletic contests.


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Quick Search: Choose Model and Year, then enter search topic.
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Sending a destination via the Bluetooth® interface
Please note that the radio connection
between the two devices must be activated
for data transfer using Bluetooth®. To find out
how to activate this radio connection, please
refer to the section "Switching Bluetooth on"
on page 51.
You will only be able to access the transfer method if there is a USB memory stick connected to the USB interface. To find out more about the permissible USB memory media, please refer to the section "Notes on the media supported" on page 42.
Deleting a destination
Deleting a destination from the list
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Points of interest
Points of interest are gas stations, parking
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They are divided into different categories to make them easier for you to find.
This function is also available in reduced form in the menu of the map display under the menu item.
Searching for points of interest by category


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The Anthropology News website won the 2012 EXCEL Award!
The announcement was made in today's press release:
Association Media & Publishing is pleased to announce the winners of the 32nd Annual EXCEL Awards, which honor the best and the brightest in association media and publishing.
With over 1,000 entries submitted this year, 180 winners, representing 104 non-profit organizations and associations, have been chosen for displaying exemplary work in editorial, design, advertising and marketing, online publishing, mobile applications, digital editions and electronic newsletter categories.
"We are continually impressed with the innovative and creative work that associations submit each year, and the entries we received this year really illustrate the trends prevalent in this industry. The EXCEL Awards honor those who are pioneering ideas in association media, and this year's winners certainly deserve to be recognized," said Amy Lestition, CAE, Association Media & Publishing Executive Director.
The Anthropology News website won bronze in the Web Publishing: Redesign category. Click here to see the complete list of Excel Award winners.
Congratulations to staff, editors, contributors and readers who continue to make Anthropology News an award winning publication!


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Outdoor activities
Argentina is a highly exciting destination for outdoors enthusiasts: world-class fly-fishing, horseriding, trekking and rock-climbing opportunities abound, as do options for whitewater rafting, skiing, ice climbing and even – for those with sufficient stamina and preparation – expeditions onto the Southern Patagonian Ice Cap.
Nature tourism
Argentina's network of national and provincial parks offers wonderful opportunities for nature tourism across this country's range of ecosystems. Highlights for wildlife viewing include the Península Valdés, a superb destination for marine wildlife and fauna of the Patagonian steppe, the humid swamplands of Esteros de Iberá, and the subtropical jungles of Iguazú.
For an overview of the national park system, visit the National Park Headquarters in Buenos Aires at Santa Fe 690 (Mon–Fri 10am–5pm; t011 4311 0303, wparquesnacionales.gov.ar). There is an underfunded and not terribly helpful information office on the ground floor that may be able to provide some introductory leaflets, and they can give you tips if you're intending to visit some of the more isolated places like Baritú, Perito Moreno, San Guillermo and Santiago del Estero's Copo, which have limited infrastructure and require some prior planning. A wider range of free material is available at each individual park, but these are of variable quality – many only have a basic map and a brief park description. Each national park has its own intendencia, or park administration, although these are often in the principal access town, not within the park itself. An information office or visitors' centre is often attached. Argentina's guardaparques, or national park rangers, are some of the most professional on the continent: generally friendly, they are well trained and dedicated to jobs that are demanding and often extremely isolated. All have a good grounding in the wildlife of the region and are happy to share their knowledge, although don't expect them all to be professional naturalists – some are, but ranger duties often involve more contact with the general public than with the wildlife.
A good port of call in the capital for nature enthusiasts is the Fundación Vida Silvestre, located at Defensa 251, 6th floor, Buenos Aires (Mon–Fri 10am–1pm & 2–6pm; t011 4343 4086, wvidasilvestre.org.ar), a committed and highly professional environmental organization, and an associate of the WWF. Visit its shop for back issues of its beautiful magazine (in Spanish) and for books and leaflets on wildlife and ecological issues, as well as for information on its nature reserves.
Argentina has an incredible diversity of birdlife – you can see some ten percent of all the world's bird species here. Birdwatchers should visit the headquarters of the country's well-respected birding organization, Aves Argentinas, at Matheu 1246, Buenos Aires (nearest subte station is Pichincha on Linea E; Mon–Fri 10.30am–1.30pm & 2.30–8.30pm; t011 4943 7216, wavesargentinas.org.ar). It has an excellent library and a shop, and organizes regular outings and birding safaris.
Argentina offers some truly marvellous trekking, and it is still possible to find areas where you can trek for days without seeing a soul. Trail quality varies considerably, and many are difficult to follow, so always get hold of the best map available and ask for information as you go; the Club Andino in Bariloche (see Park information) can offer excellent advice, as well as sell you maps. Most of the best treks are in the national parks – especially the ones in Patagonia – but you can often find lesser-known but equally superb options in the lands bordering them. Most people head for the savage granite spires of the Fitz Roy region around El Chaltén, an area whose fame has spread so rapidly over the last ten years that it now holds a similar status to Chile's renowned Torres del Paine. Tourist pressures are starting to tell, however, at least in the high season (late Dec to Feb), when campsites are packed. The other principal trekking destination is the mountainous area of Parque Nacional Nahuel Huapi, south of Bariloche. This area has the best infrastructure, with a network of generally well-marked trails and mountain refuges. In the north of the country, some of the best trekking is in Jujuy Province, especially in Calilegua, where the habitat ranges from subtropical to bald mountain landscape.
Camping is possible in many national parks, and sites are graded according to three categories: camping libre sites, which are free but have no or very few services (perhaps a latrine and sometimes a shower block); camping agreste sites, which are run as concessions and usually provide hot water, showers, toilets, places for lighting a campfire and some sort of small shop; and camping organizado sites, which have more services, including electricity and often some sort of restaurant.
You should always be well prepared for your trips, even for half-day hikes. Good-quality, water- and windproof clothing is vital: temperatures plummet at night and often with little warning during the day. Keep spare dry layers of clothing and socks in a plastic bag in your pack. Boots should provide firm ankle support and have the toughest soles possible (Vibram soles are recommended). Gore-Tex boots are only waterproof to a degree: they will not stay dry when you have to cross swampland. A balaclava is sometimes more useful than a woollen hat. Make sure that your tent is properly waterproofed and that it can cope with high winds (especially for Patagonia). You'll need a minimum of a three-season sleeping bag, to be used in conjunction with a solid or semi-inflatable foam mattress (essential, as the ground will otherwise suck out all your body heat). Also bring high-factor sunblock and lipsalve, plus good sunglasses and headgear.
Park authorities often require you to carry a stove for cooking. The Camping Gaz models that run on butane cylinders (refills are fairly widely available in ferretería hardware shops) are not so useful in exposed areas, where you're better off with a high-pressure petrol stove such as an MSR, although these are liable to clog with impurities in the fuel, so filter it first. Telescopic hiking poles save your knees from a lot of strain and are useful for balance. Miner-style head torches are preferable to regular hand-held ones, and gaffer tape makes an excellent all-purpose emergency repair tool. Carry a first-aid kit and a compass, and know how to use both. And always carry plenty of water – aim to have at least two litres on you at all times. Pump-action water filters can be very handy, as you can thus avoid the hassle of having to boil suspect water.
Note also that, in the national parks, especially on the less-travelled and overnight routes, you should inform the park ranger (guardaparque) of your plans, not forgetting to report your safe arrival at your destination – the ranger will send a search party out for you if you do not arrive. You'd be advised to buy all your camping equipment before you leave home: quality gear is relatively expensive in Argentina, and there are few places that rent decent equipment, even in some of the key trekking areas.
For climbers, the Andes offer incredible variety. You do not always have to be a technical expert, but you should always take preparations seriously. You can often arrange a climb close to the date – though it's best to bring as much high-quality gear with you as you can. The climbing season is fairly short – November to March in some places, though December to February is the best time. The best-known challenge is South America's highest peak, Aconcagua (6962m), accessed from the city of Mendoza. Not considered the most technical challenge, this peak nevertheless merits top-level expedition status, as the altitude and storms claim several victims a year. Only slightly less lofty are nearby Tupungato (6750m), just to the south; Mercedario (6770m), just to the north; Cerro Bonete (6872m) and Pissis (6793m) on the provincial border between La Rioja and Catamarca; and Ojos del Salado, the highest active volcano in the world (6885m), a little further north into Catamarca. The last three can be climbed from Fiambalá, but Ojos is most normally climbed from the Chilean side of the border. The most famous volcano to climb is the elegant cone of Lanín (3776m), which can be ascended in two days via the relatively straightforward northeastern route. Parque Nacional Nahuel Huapi, near Bariloche, offers the Cerro Catedral massif and Cerro Tronador (3554m). Southern Patagonia is also a highly prized climbing destination. One testing summit is San Lorenzo (3706m), which, from the Argentine side, can best be approached along the valley of the Río Oro, although the summit itself is usually climbed from across the border in Chile. Further south are the inspirational granite spires of the Fitz Roy massif and Cerro Torre, which have few equals on the planet in terms of technical difficulty and scenic grandeur.
On all of these climbs, but especially those over 4000m, make sure to acclimatize thoroughly, and be fully aware of the dangers of puna, or altitude sickness.
As a destination for fly-fishing (pesca con mosca), Argentina is unparallelled, with Patagonia drawing in professionals from around the globe. Trout, introduced in the early twentieth century, is the sport's mainstay, but there is also fishing for landlocked and even Pacific salmon. The most famous places to go are those where the world's largest sea-running brown trout (trucha marrón) are found: principally the Río Grande and other rivers of eastern and central Tierra del Fuego, and the Río Gallegos on the mainland. The reaches of the Río Santa Cruz near Comandante Luís Piedra Buena have some impressive specimens of steelhead trout (sea-running rainbows, or trucha arco iris), and the area around Río Pico is famous for its brook trout. The Patagonian Lake District – around Junín de los Andes, San Martín de los Andes, Bariloche and Esquel – is the country's most popular trout-fishing destination, offering superb angling in delightful scenery.
The trout-fishing season runs from mid-November to Easter. Regulations change slightly from year to year, but permits are valid countrywide. They can be purchased at national park offices, some guardaparque posts, tourist offices and at fishing equipment shops, which are fairly plentiful – especially in places like the north Patagonian Lake District. With your permit, you are issued a booklet detailing the regulations of the type of fishing allowed in each river and lake in the region, the restrictions on catch-and-release and the number of specimens you are allowed to take for eating. Argentine law states that permit holders are allowed to fish any waters they can reach without crossing private land. You are, in theory at least, allowed to walk along the bank as far as you like from any public road, although in practice you may find that owners of some of the more prestigious beats try to obstruct you from doing this.
For more information on fly-fishing in Argentina, contact the Asociación Argentina de Pesca con Mosca, Lerma 452, Buenos Aires (t011 4773 0821, waapm.org.ar).
Argentina's ski resorts are not on the same scale as those of Europe or North America and attract mainly domestic and Latin American tourists (from Chile and Brazil), as well as a smattering of foreigners who are looking to ski during the northern summer. However, infrastructure is constantly being upgraded and it's easy to rent gear. The main skiing season is July and August, although in some resorts it is possible to ski from late May to early October. Snow conditions vary from year to year, but you can often find excellent powder.
The most prestigious resort for downhill skiing is modern Las Leñas, which also offers the most challenging skiing and once hosted World Cup races. Following this are Chapelco, near San Martín de los Andes, where you also have extensive cross-country options, and the Bariloche resorts of Cerro Catedral and Cerro Otto, which are the longest-running in the country, with wonderful panoramas of the Nahuel Huapi region, albeit with rather too many people. Ushuaia is an up-and-coming resort, with some fantastic cross-country possibilities and expanding – if still relatively limited – downhill facilities; the resort's right by the scenic town, so it's a good choice if you want to combine skiing with sightseeing. Bariloche and Las Leñas are the best destinations for those interested in après-ski.
Though it does not have the same range of extreme options as neighbouring Chile, Argentina nevertheless has some beautiful whitewater rafting possibilities, ranging from grades II to V. Many of these are offered as day-trips, and include journeys through enchanting monkey-puzzle-tree scenery on the generally sedate Río Aluminé; along the turbulent and often silty Río Mendoza (see Tour operators); through deep canyons carved by the Río Juramento in Salta; on the Río Manso in the Alpine-like country south of Parque Nacional Nahuel Huapi; and along the similar but less-visited Río Corcovado, south of Esquel. Esquel can also be used as a base for rafting on Chile's fabulous, world-famous Río Futaleufú, a turquoise river that flows through temperate rainforest and tests rafters with rapids of grade V. You do not need previous rafting experience to enjoy these, but you should obviously be able to swim. Pay heed to operators' safety instructions, and ensure your safety gear (especially helmets and life-jackets) fits well.
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Health risks of e-cigarettes emerge
Vaping pollutes lungs with toxic chemicals and may even make antibiotic-resistant bacteria harder to kill
Electronic cigarettes, marketed as safer than regular cigarettes, deliver a cocktail of toxic chemicals including carcinogens into the lungs, new studies show. Using e-cigarettes may even make bacterial infections resistant to antibiotics, according to one study.
Engineers developed e-cigarettes several years ago to provide tobacco users a smoke-free source of nicotine. The devices heat up a liquid that a user inhales, or "vapes." Because e-cigarettes burn nothing, they release no smoke.
"There's no question that a puff on an e-cigarette is less toxic than a puff on a regular cigarette," says Stanton Glantz, director of the Center for Tobacco Control Research and Education at the University of California, San Francisco. But few studies have looked at the toxicity of their vapors. As a result, scientists have been circumspect about describing e-cigarettes as safe.
For a May 13 review in Circulation, Glantz and his team pored over emerging data on what vapers are inhaling and found, he says, greater risk than scientists had thought. E-cigarettes deliver high levels of nanoparticles, the researchers found, which can trigger inflammation and have been linked to asthma, stroke, heart disease, and diabetes (SN: 7/18/09, p. 26). The levels "really raise concerns about heart disease and other chronic conditions where inflammation is involved," he says.
E-cigarettes are no longer niche products, he and others note. Vaping product sales last year were projected to hit an estimated $1.7 billion, report Ii-Lun Chen and Corinne Husten of the Food and Drug Administration's Center for Tobacco Products in Rockville, Md., in a special May issue of Tobacco Control on e-cigarettes. E-cigarette sales may exceed those of traditional cigarettes within 10 years, the pair reports. At least 1 in 5 smokers has tried e-cigarettes, as have 10 percent of U.S. high school students, according to the U.S. Centers for Disease Control and Prevention.
Those people may think vaping is safe, but FDA has seen no data establishing anything like that, writes the agency's Priscilla Callahan-Lyon in the same journal. She reviewed data from 18 studies on e-cigarettes' vapors and found that most contain at least traces of the solvents in which nicotine and flavorings had been dissolved. Those solvents, she reports, are known as lung irritants.
And the solvents can transform into something even more worrisome: carbonyls. This group includes known cancer-causing chemicals, such as formaldehyde, and suspected carcinogens, such as acetaldehyde. Because early e-cigarettes didn't deliver the same powerful hit of nicotine that burning tobacco does, engineers developed second-generation technology that allows users to increase an e-cigarette's voltage, and thus temperature, to atomize more nicotine per puff.
But the higher temperatures also can trigger a thermal breakdown of the solvents, producing the carbonyls, explains Maciej Goniewicz of the Roswell Park Cancer Institute in Buffalo, N.Y. If users of second-generation e-cigarettes maximize the power on their devices while using vaping liquids containing a solvent mix of glycerin and propylene glycol, formaldehyde levels can reach that found in tobacco smoke, his team reports May 15 in Nicotine & Tobacco Research.
Such compounds in smoke are mainly a concern if they make it all the way into the lungs. Many biologists think particle size and count are key, says Glantz. Vapers can inhale huge numbers of very small aerosols — the most toxic size — that can then deposit into the lung's tiniest airways, which are pivotal to moving air into the body.
The mass of particles in the vapors is about 3 milligrams per cubic meter of air, he says, or about 100 times as high as the Environmental Protection Agency's 24-hour exposure limit for levels of fine air particles. Thornburg's group's analyses predict that some 40 percent of these inhaled particles would deposit in the lungs' smallest, deepest airways.
In addition to nicotine and solvents, vapors also contain chemical flavorings and food preservatives from the vaping liquid. Although they may be GRAS, or "generally recognized as safe" by FDA, Thornburg says, the designation is based on tests of the compounds when they are ingested. "No one has considered their safety when it comes to inhalation," he says.
And e-cigarette vapors can even make dangerous germs harder to kill, Laura Crotty Alexander reported May 18 at an American Thoracic Society meeting in San Diego. A pulmonary and critical care physician and scientist with the VA San Diego Healthcare System, she exposed methicillin-resistant Staphylococcus aureus, better known as MRSA, to e-cigarette vapors.
In a lab dish, these antibiotic-resistant bacteria, which can cause pneumonia, proved harder to kill using a germ-killing protein fragment — a natural antibiotic that people's bodies make. One reason: Germs exposed to nicotine-rich vapors secreted a thicker biofilm coating that protected them.
Crotty Alexander also allowed mice to breathe in air containing MRSA that had been exposed to e-cigarette vapors. One day later, mice getting vapor-exposed germs had three times as many bacteria growing in their lungs as did mice that got unexposed germs.
"We started these studies so that we could advise our smoking patients on whether they should try switching to e-cigarettes," she says. "My data now indicate they might be the lesser of the two evils. But e-cigarettes are definitely not benign."
I.-L. Chen and C.G. Husten. Introduction to tobacco control supplement. Tobacco Control. Vol. 23, May 2014, p. ii1. doi: 10.1136/tobaccocontrol-2013-051504.
P. Callahan-Lyon. Electronic cigarettes: human health effects.Tobacco Control. Vol. 23, May 2014, p. ii36. doi: 10.1136/tobaccocontrol-2013-051470.
L.E. Crotty Alexander et al. Electronic cigarette vapor (ECV) exposure decreases Staphylococcus aureus susceptibility to macrophage and neutrophil killing. American Thoracic Society International Conference, San Diego. May 18, 2014.
R. Grana, N. Benowitz and S.A. Glantz. E-cigarettes: A scientific review. Circulation. Vol. 129, May 13, 2014, p. 1972. doi: 10.1161/circulationaha.114.007667.
L. Kosmider et al. Carbonyl compounds in electronic cigarette vapors — effects of nicotine solvent and battery output voltage. Nicotine & Tobacco Research. Published online May 15, 2014. doi: 10.1093/ntr/ntu078.
J. Raloff. FDA announces plans to regulate e-cigarettes and more. Science News for Students, April 24, 2014.
J. Raloff. E-cigarette makers focus on teens. Science News for Students, April 17, 2014.
J. Raloff. Poisonings linked to e-cigarettes. Science News for Students, April 8, 2014.
N. Seppa. E-cigarettes don't help smokers quit, study finds. Science News. Vol. 185, May 3, 2014, p. 16.
J. Raloff. Many teens try alternatives to cigarettes. Science News for Students, November 29, 2013.
J.Raloff. Bad breath. Science News. Vol. 176, July 18, 2009, p. 26.
J. Czogala et al. Secondhand exposure to vapors from electronic cigarettes. Nicotine & Tobacco Research. Vol. 16, June 2014, p. 655. doi:10.1093/ntr/ntt203.
F.C. Fuoco et al. Influential parameters on particle concentration and size distribution in the mainstream of e-cigarettes. Environmental Pollution. Vol. 184, January 2014, p. 523. doi:10.1016/j.envpol.2013.10.010.
W. Schober et al. Use of electronic cigarettes (e-cigarettes) impairs indoor air quality and increases FeNO levels of e-cigarette consumers. International Journal of Hygiene and Environmental Health. Published online December 6, 2013. doi:10.1016/j.ijheh.2013.11.003.


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Titans owner Bud Adams has chosen not to fire coach Mike Munchak or, for now at least, G.M. Ruston Webster.
That same benefit of the doubt wasn't extended to the guy who hired them, and who was promoted a year ago from G.M. to the team's senior executive V.P. and Chief Operating Officer.
Yes, Adams took off the mittens and gave a double-barreled middle finger to Mike Reinfeldt.
"He has two more years to go on his contract but I think we'd be better off without him," Adams said, via Jim Wyatt of the Tennessean. "I don't think he was getting the job done. Mike Reinfeldt is out."
But what ultimately was Reinfeldt's "job," once he put Munchak and Webster in place? And if Reinfeldt hired a head coach who is good enough to stay, didn't Reinfeldt do his job well enough to stay, too?
It looks like Adams was determined to fire someone, and that Reinfeldt was the one that was the easiest to fire and in turn replace.


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http://www.youtube.com/watch?v=C4cfo0f88UgIt seems Red and Blu finally got over their differences and decided to unite against a common enemy: the machines. Team Fortress 2 is getting a new co-op mode on August 15 called Mann vs. Machine, pitting six players against waves of robotic dopplegangers.
The players must defend Mann Co. as the robots attempt to plant a bomb, their only respite during the onslaught the "opportunity to upgrade abilities and weapons" as the waves progress. If the players do make it to the end, they can look forward to unlocking new achievements and earning "incredible loot."
This Horde mode variant will include new maps and content, bit by bit of which will be showcased daily leading up to Mann vs. Machine's launch on August 15.
http://www.joystiq.com/2012/08/13/team- ... august-15/


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Fellow Matthew Lunning describes a retrospective study that examined event-free and overall survival among patients with relapsed/refractory follicular lymphoma and remission duration of a year or less to their last chemotherapy session (prior to re-induction therapy), who subsequently received either high-dose therapy/autologous stem cell rescue or allogeneic stem cell transplantation. Among the subgroup with poor remission duration, three-year event-free survival was significantly longer for the allogeneic transplant group (79 percent) than with the autologous rescue group (36 percent).
Dr. Lunning addresses the need for clinical trials that reduce the risk of graft-versus-host disease without harming efficacy.


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Look, just forget about that one.
Certainly Dillon Gee would like to.
I came out of Gee's nightmare of a second inning thinking that Objects on Scoreboard Are Less Dire Than They Appear — several of the hits had just found holes, the Mets were driving balls off Cliff Lee, and it was Citizens Bank Park.
But then came Gee's nightmare of a third inning, in which a quarter-mile worth of home runs did substantial harm to such optimism. It was the alternate path to the same lousy destination, speedy and overwhelming instead of gradual and cumulative, but equally awful. Would you rather fight one horse-sized duck or a hundred duck-sized horses? Gee can say he's duked it out with the baseball version of both and neither one was pleasant.
At 7-0, well, you could still dream — but then Cliff Lee relaxed or found himself or remembered he was Cliff Lee, and then aside from the heroics of John Buck and the histrionics of Jordany Valdespin this one was over.
We're still at the point in the season when you can remember every game and are just glad that baseball is a nightly habit again, meaning games like tonight's don't hurt so much as they're just kind of annoying. 5-3 on the season, back at 'em tomorrow for the rubber game (weather permitting), grounds for optimism and all that.
But still, let's have no more like this one, OK?


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Ovation to Premiere New Series THE FASHION FUND, 11/12
Ovation, America's only arts network, today announced the official premiere date for The Fashion Fund -- Tuesday, November 12th at 10PM ET. Offering unprecedented access to the world of fashion, this one-hour series documents emerging fashion designers vying for the chance to be named the 2013 CFDA/Vogue Fashion Fund winner.The CFDA/Vogue Fashion Fund is in its 10th year and has transformed emerging designers into true fashion icons. Working alongside some of the top names in fashion, ten innovative, American-based designers, compete for the top award that carries an incredible $300,000 grant and a one-year mentorship with an industry titan. The CFDA/Vogue Fashion Fund selection committee is comprised of iconic names from Anna Wintour and Diane von Furstenberg to top-level fashion executives such as Ken Downing of Neiman Marcus, Andrew Rosen of Theory, Jenna Lyons of J.Crew, and more. "It's truly an honor to be working with the CFDA/Vogue Fashion Fund and Anna Wintour herself," said Robert Weiss, Ovation's Chief Creative Officer. "The Fashion Fund is the real deal. This is not another made-for-TV fashion competition series. Nothing has ever come this close to matching the authenticity and talent found in The Fashion Fund." In The Fashion Fund, viewers are given exclusive access into the fashion world as they journey into the lives of the emerging designers. We get to know the designers as their visions, technical abilities, and business acumen are all tested - pushing them to their highest potential. The series takes viewers inside legendary studio visits, a Vogue fashion photo shoot and culminates with a presentation at NYC Fashion Week and the announcement of the 2013 CFDA/Vogue Fashion Fund winner. Episode Guide: · "Call of a Lifetime" - Inside the "war room," The Fashion Fund committee reviews submissions and deliberates over which designers - of the hundreds who applied - will be selected as the 10 finalists. · "Facing the Committee" - The 10 finalists deliver nerve-wracking final presentations to the committee, including an intense interview, and offer a look at their past, present, and future collections. · "In Front of the Camera" - In addition to site visits to the finalists' studios from Anna Wintour and other committee members, a shoot for the November issue of Vogue pairs each designer with a celebrity counterpart for a stunning portrait. · "Fashion Week Frenzy" - During New York City Fashion Week, finalists work frantically to stage their shows while also meeting with buyers whose reactions can determine their fate. · "Cocktails with the Committee" - As the Uniqlo design challenge is revealed, and past finalists mentor this year's top 10, designers attend the cocktail party of a lifetime - hosted by Anna Wintour. · "The Final Cut" - After a fashion show at LA's Chateau Marmont, the committee meets to make a final decision, and a special guest announces this year's winner at the annual CFDA/Vogue Fashion Fund awards dinner. The series is produced by Condé Nast Entertainment, Break Thru Films and Ovation. Season One of The Fashion Fund is comprised of six, one-hour episodes which will premiere on Ovation beginning Tuesday, November 12, with new episodes airing weekly at 10pm ET. For a special sneak peek of The Fashion Fund, please visit: http://www.ovationtv.com/the-fashion-fund/ About Ovation Ovation is America's only arts network, whose mission is to connect the world to all forms of art and artistic expression. Ovation programming is a one-of-a-kind mix of original and selectively curated art-centric series, documentaries, films and specials. Ovation's signature programming includes The Art of, A Young Doctor's Notebook, The Fashion Fund and James Franco Presents. Ovation reaches a national audience of nearly 50 million homes and is available on national cable companies, satellite systems and telco TV companies such as Comcast Xfinity, DIRECTV, DISH, Verizon FiOS, AT&T U-Verse. Ovation is also available on VOD (in both standard and high definition). Ovation's diversified viewer experiences extend across its linear network, the popular ovationtv.com, and active social presence on Facebook, Twitter, Youtube and more. See the Ovation Facebook page for the latest information and conversations happening across the Ovation brand and the arts: www.facebook.com/OvationTV. About Condé Nast Entertainment (CNE) Condé Nast Entertainment (CNE) is a division of Condé Nast that focuses on the development, production and distribution of original television, feature film and digital video offerings based on the company's iconic media brands, which for more than 100 years, have created the world's greatest content for the world's most influential audiences. Follow us on Twitter @CNE. Condé Nast is home to some of the world's most celebrated media brands. In the United States, Condé Nast publishes 18 consumer magazines, four business-to-business publications, 27 websites, and more than 50 apps for mobile and tablet devices, all of which define excellence in their categories. The company also owns Fairchild Fashion Media (FFM), whose portfolio of brands serves as the leading source of news and analysis for the global fashion community. Condé Nast has won more National Magazine Awards over the past 10 years than all of its competitors combined. For more information, visit condenast.com or follow us on Twitter @CondeNastCorp. About Break Thru Films Break Thru Films is headed by Emmy nominated directors, writers, and producers Ricki Stern and Annie Sundberg. Their mission is to create powerful character-driven documentaries and dramatic films. Ricki and Annie's films Joan Rivers - A Piece Of Work, The Devil Came on Horseback, Burma Soldier, and The Trials of Darryl Hunt have been Sundance and Tribeca Film Festival favorites winning numerous awards airing on HBO, National Geographic, Showtime. Other projects include: Secret Access: UFO's On the Record (History Channel), and short films for Kenneth Cole, Sundance Institute / Bill & Melinda Gates Foundation (BMGF) and The American Foundation for Suicide Prevention. Most recently, they created the national marriage equality spots for the Human Rights Campaign. Annie and Ricki have been recognized with the Best Female Filmmakers Award-San Diego Film Festival, Adrienne Shelly Excellence in Filmmaking Award and Lena Sharpe/Women in Cinema Persistence of Vision Award-Seattle International Film Festival.


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Sierra Leone Population: 6,018,888NO VISITORS FROM HERE YET!
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|The British set up a trading post near present-day Freetown in the 17th century. Originally the trade involved timber and ivory, but later it expanded into slaves. Following the American Revolution, a colony was established in 1787 and Sierra Leone became a destination for resettling black loyalists who had originally been resettled in Nova Scotia. After the abolition of the slave trade in 1807, British crews delivered thousands of Africans liberated from illegal slave ships to Sierra Leone, particularly Freetown. The colony gradually expanded inland during the course of the 19th century; independence was attained in 1961. Democracy is slowly being reestablished after the civil war (1991-2002) that resulted in tens of thousands of deaths and the displacement of more than 2 million people (about one third of the population). The military, which took over full responsibility for security following the departure of UN peacekeepers at the end of 2005, has developed as a guarantor of the country's stability; the armed forces remained on the sideline during the 2007 and 2012 national elections. In March 2014, the closure of the UN Integrated Peacebuilding Office in Sierra Leone marked the end of more than 15 years of peacekeeping and political operations in Sierra Leone. The government's stated priorities include furthering development - including recovering from the Ebola epidemic - creating jobs, and stamping out endemic corruption.
Rainfall along the coast can reach 495 cm (195 inches) a year, making it one of the wettest places along coastal, western Africa
|Western Africa, bordering the North Atlantic Ocean, between Guinea and Liberia
|Geographic coordinates:
| total: 71,740 sq km
land: 71,620 sq km
water: 120 sq km
Size comparison: slightly smaller than South Carolina
|Land Boundaries:
|total: 1,093 km border countries (2): Guinea 794 km, Liberia 299 km
|402 km
|Maritime claims:
| territorial sea: 12 nm
contiguous zone: 24 nm
exclusive economic zone: 200 nm
continental shelf: 200 nm
|tropical; hot, humid; summer rainy season (May to December); winter dry season (December to April)
|coastal belt of mangrove swamps, wooded hill country, upland plateau, mountains in east
|Elevation extremes:
|Natural resources:
|diamonds, titanium ore, bauxite, iron ore, gold, chromite
|Land use:
| agricultural land: 56.2% arable land 23.4%; permanent crops 2.3%; permanent pasture 30.5% forest: 37.5%
other: 6.3% (2011 est.)
|Irrigated land:
|300 sq km (2012)
|Natural hazards:
|dry, sand-laden harmattan winds blow from the Sahara (December to February); sandstorms, dust storms
|Current Environment Issues:
|rapid population growth pressuring the environment; overharvesting of timber, expansion of cattle grazing, and slash-and-burn agriculture have resulted in deforestation and soil exhaustion; civil war depleted natural resources; overfishing
|International Environment Agreements:
| party to: Biodiversity, Climate Change, Climate Change-Kyoto Protocol, Desertification, Endangered Species, Law of the Sea, Marine Life Conservation, Ozone Layer Protection, Ship Pollution, Wetlands
signed, but not ratified: Environmental Modification
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| noun: Sierra Leonean(s)
adjective: Sierra Leonean
|Ethnic groups:
|Temne 35%, Mende 31%, Limba 8%, Kono 5%, Kriole 2% (descendants of freed Jamaican slaves who were settled in the Freetown area in the late-18th century; also known as Krio), Mandingo 2%, Loko 2%, other 15% (includes refugees from Liberia's recent civil war, and small numbers of Europeans, Lebanese, Pakistanis, and Indians) (2008 census)
|English (official, regular use limited to literate minority), Mende (principal vernacular in the south), Temne (principal vernacular in the north), Krio (English-based Creole, spoken by the descendants of freed Jamaican slaves who were settled in the Freetown area, a lingua franca and a first language for 10% of the population but understood by 95%)
|Muslim 60%, Christian 10%, indigenous beliefs 30%
|6,018,888 (July 2016 est.)
|Age structure:
| 0-14 years: 41.9% (male 1,257,997/female 1,263,961)
15-24 years: 18.57% (male 542,975/female 574,669)
25-54 years: 32.04% (male 924,331/female 1,003,895)
55-64 years: 3.74% (male 104,415/female 120,953)
65 years and over: 3.75% (male 94,520/female 131,172) (2016 est.)
|Dependency ratios:
| total dependency ratio: 81.9%
youth dependency ratio: 77.1%
elderly dependency ratio: 4.9%
potential support ratio: 20.6% (2015 est.)
|Median age:
| total: 19 years
male: 18.4 years
female: 19.6 years (2016 est.)
|Population growth rate:
|2.36% (2016 est.)
|Birth rate:
|36.7 births/1,000 population (2016 est.)
|Death rate:
|10.6 deaths/1,000 population (2016 est.)
|Net migration rate:
|-2.4 migrant(s)/1,000 population (2016 est.)
| urban population: 39.9% of total population (2015)
rate of urbanization: 2.75% annual rate of change (2010-15 est.)
|Major urban areas - population:
|FREETOWN (capital) 1.007 million (2015)
|Sex ratio:
| at birth: 1.03 male(s)/female
0-14 years: 1 male(s)/female
15-24 years: 0.94 male(s)/female
25-54 years: 0.92 male(s)/female
55-64 years: 0.86 male(s)/female
65 years and over: 0.73 male(s)/female
total population: 0.95 male(s)/female (2016 est.)
|Mother's mean age at first birth:
|19.2 note: median age at first birth among women 25-29 (2013 est.)
|Maternal mortality rate:
|1,360 deaths/100,000 live births (2015 est.)
|Infant mortality rate:
| total: 70 deaths/1,000 live births male: 78.4 deaths/1,000 live births
female: 61.4 deaths/1,000 live births (2016 est.)
|Life expectancy at birth:
| total population: 58.2 years male: 55.6 years
female: 60.9 years (2016 est.)
|Total fertility rate:
|4.76 children born/woman (2016 est.)
|Contraceptive prevalence rate:
|16.6% (2013)
|Health expenditures:
|11.1% of GDP (2014)
|Physicians density:
|0.02 physicians/1,000 population (2010)
|Hospital bed density:
|0.4 beds/1,000 population (2006)
|Drinking water source:
| improved:
urban: 84.9% of population
rural: 47.8% of population
total: 62.6% of population
urban: 15.1% of population
rural: 52.2% of population
total: 37.4% of population (2015 est.)
|Sanitation facility access:
| improved:
urban: 22.8% of population
rural: 6.9% of population
total: 13.3% of population
urban: 77.2% of population
rural: 93.1% of population
total: 86.7% of population (2015 est.)
|HIV/AIDS - adult prevalence rate:
|1.34% (2015 est.)
|HIV/AIDS - people living with HIV/AIDS:
|51,100 (2015 est.)
|HIV/AIDS - deaths:
|2,500 (2015 est.)
|Obesity - adult prevalence rate:
|6.6% (2014)
|Children under the age of 5 years underweight:
|18.1% (2013)
|Education expenditures:
|2.7% of GDP (2014)
| definition: age 15 and over can read and write English, Mende, Temne, or Arabic
total population: 48.1%
male: 58.7%
female: 37.7% (2015 est.)
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|Country name:
| conventional long form: Republic of Sierra Leone
conventional short form: Sierra Leone
local long form: Republic of Sierra Leone
local short form: Sierra Leone
etymology: the Portuguese explorer Pedro de SINTRA named the country "Serra Leoa" (Lion Mountains) for the impressive mountains he saw while sailing the West African coast in 1462
|Government type:
|presidential republic
| name: Freetown
geographic coordinates: 8 29 N, 13 14 W
time difference: UTC 0 (5 hours ahead of Washington, DC, during Standard Time)
|Administrative divisions:
|3 provinces and 1 area*; Eastern, Northern, Southern, Western*
|27 April 1961 (from the UK)
|National holiday:
|Independence Day, 27 April (1961)
|several previous; latest in effect 1 October 1991; amended several times, last in 2013 (2016)
|Legal system:
|mixed legal system of English common law and customary law
|18 years of age; universal
|Executive branch:
| chief of state: President Ernest Bai KOROMA (since 17 September 2007); note - the president is both chief of state and head of government
head of government: President Ernest Bai KOROMA (since 17 September 2007)
cabinet: Ministers of State appointed by the president, approved by Parliament; the cabinet is responsible to the president elections/appointments: president directly elected by absolute majority popular vote in 2 rounds if needed for a 5-year term (eligible for a second term); election last held on 17 November 2012 (next to be held in 2017)
election results: Ernest Bai KOROMA reelected president; percent of vote - Ernest Bai KOROMA (APC) 58.7%, Julius Maada BIO (SLPP) 37.4%, other 3.9%
|Legislative branch:
| description: unicameral Parliament (124 seats; 112 members directly elected in single-seat constituencies by simple majority vote and 12 seats filled in separate elections by non-partisan members of Parliament called "paramount chiefs;" members serve 5-year terms)
elections: last held on 17 November 2012 (next to be held in 2017)
election results: percent of vote by party - NA; seats by party - APC 69, SLPP 43
|Judicial branch:
| highest court(s): Superior Court of Judicature (consists of the Supreme Court - at the apex - with the chief justice and 4 other judges, the Court of Appeal with the chief justice and 7 other judges, and the High Court of Justice with the chief justice and 9 other judges; note – the Judicature has jurisdiction in all civil, criminal, and constitutional matters judge selection and term of office: Supreme Court chief justice and other judges of the Judicature appointed by the president on the advice of the Judicial and Legal Service Commission (a 7-member independent body of judges, presidential appointees, and the Commission chairman) and subject to the approval of Parliament; all Judicature judges appointed until retirement at age 65
subordinate courts: magistrates' courts; District Appeals Court; local courts
|Political parties and leaders:
|All People's Congress or APC [Ernest Bai KOROMA] Sierra Leone People's Party or SLPP [Somano KAPEN] numerous other parties
|Political pressure groups and leaders:
|other: student unions; trade unions
|International organization participation:
|ACP, AfDB, AU, C, ECOWAS, EITI (compliant country), FAO, G-77, IAEA, IBRD, ICAO, ICCt, ICRM, IDA, IDB, IFAD, IFC, IFRCS, IHO (pending member), ILO, IMF, IMO, Interpol, IOC, IOM, IPU, ISO (correspondent), ITU, ITUC (NGOs), MIGA, MINUSMA, NAM, OIC, OPCW, UN, UNAMID, UNCTAD, UNESCO, UNIDO, UNIFIL, UNISFA, UNWTO, UPU, WCO, WFTU (NGOs), WHO, WIPO, WMO, WTO
|National symbol(s):
|lion; national colors: green, white, blue
|National anthem:
| name: "High We Exalt Thee, Realm of the Free"
lyrics/music: Clifford Nelson FYLE/John Joseph AKA
note: adopted 1961
|Diplomatic representation in the US:
| chief of mission: Ambassador Bockari Kortu STEVENS (since 28 March 2008)
chancery: 1701 19th Street NW, Washington, DC 20009
telephone: [1] (202) 939-9261 through 9263
|Diplomatic representation from the US:
| chief of mission: Ambassador John HOOVER (since 4 November 4 December 2014))
embassy: Southridge-Hill Station, Freetown
mailing address: use embassy street address
telephone: [232] (76) 99 1055 00
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Sierra Leone is extremely poor and nearly half of the working-age population engages in subsistence agriculture. The country possesses substantial mineral, agricultural, and fishery resources, but it is still recovering from a civil war that destroyed most institutions before ending in the early 2000s. In recent years economic growth has been driven by mining - particularly iron ore. The country's principal exports are iron ore, diamonds, and rutile, and the economy is vulnerable to fluctuations in international prices. Until 2014, the government had relied on external assistance to support its budget, but it was gradually becoming more independent. The Ebola outbreak of 2014 and 2015, combined with falling global commodities prices, caused a significant contraction of economic activity in all areas. While the World Health Organization declared an end to the Ebola outbreak in Sierra Leone in November 2015, economic recovery will depend on rising commodities prices and increased efforts to diversify the sources of growth. Pervasive corruption and undeveloped human capital will continue to deter foreign investors. Sustained international donor support in the near future will partially offset these fiscal constraints.
|GDP (purchasing power parity):
| GDP (purchasing power parity): $10.64 billion (2016 est.) $10.2 billion (2015 est.) $12.92 billion (2014 est.)
note: data are in 2016 dollars
|GDP (official exchange rate):
|GDP (official exchange rate): $4.289 billion (2015 est.)
|GDP - real growth rate:
|4.3% (2016 est.) -21.1% (2015 est.) 4.6% (2014 est.)
|GDP - per capita (PPP):
| GDP - per capita (PPP): $1,700 (2016 est.) $1,600 (2015 est.) $2,100 (2014 est.)
note: data are in 2016 dollars
|Gross national saving:
|2% of GDP (2016 est.) 2.1% of GDP (2015 est.) -7.2% of GDP (2014 est.)
|GDP - composition, by end use:
| household consumption: 83.7%
government consumption: 9.5%
investment in fixed capital: 33.7%
investment in inventories: 0.1%
exports of goods and services: 15.2%
imports of goods and services: -42.2% (2016 est.)
|GDP - composition, by sector of origin:
| household consumption: 83.7%
government consumption: 9.5%
investment in fixed capital: 33.7%
investment in inventories: 0.1%
exports of goods and services: 15.2%
imports of goods and services: -42.2% (2016 est.)
|Agriculture - products:
|rice, coffee, cocoa, palm kernels, palm oil, peanuts, cashews; poultry, cattle, sheep, pigs; fish
|diamond mining; iron ore, rutile and bauxite mining; small-scale manufacturing (beverages, textiles, footwear)
|Industrial production growth rate:
|14% (2016 est.)
|Labor force:
|2.678 million (2016 est.)
|Labor force - by occupation:
| agriculture: 61.1%
industry: NA%
services: 33.4% (2014 est.)
|Unemployment rate:
|9.1% (2014 est.)
|Population below poverty line:
|70.2% (2004 est.)
|Household income or consumption by percentage share:
| lowest 10%: 2.6%
highest 10%: 33.6% (2003)
|Distribution of family income - Gini index:
|34 (2011) 62.9 (1989)
| revenues: $558.1 million
expenditures: $738.6 million (2016 est.)
|Taxes and other revenues:
|13% of GDP (2016 est.)
|Public debt:
|43.3% of GDP (2016 est.) 41.6% of GDP (2015 est.)
|Fiscal year:
|calendar year
|Inflation rate (consumer prices):
|Inflation rate (consumer prices): 7.1% (2016 est.) 8% (2015 est.)
|Current account balance:
|-$696 million (2016 est.) -$681 million (2015 est.)
|$886.4 million (2016 est.) $569.4 million (2015 est.)
|Exports - commodities:
|Iron ore, diamonds, rutile, cocoa, coffee, fish
|Exports - partners:
|China 31.3%, Belgium 27.8%, Romania 11.3%, US 7.3%, India 4% (2015)
|$1.303 billion (2016 est.) $1.575 billion (2015 est.)
|Imports - commodities:
|foodstuffs, machinery and equipment, fuels and lubricants, chemicals
|Imports - partners:
|China 23%, India 7.9%, US 6.4%, Netherlands 5.1% (2015)
|Debt - external:
|$1.561 billion (31 December 2016 est.) $1.403 billion (31 December 2015 est.)
|Stock of direct foreign investment - at home:
|$1.629 billion (31 December 2016 est.) $1.296 billion (31 December 2015 est.)
|Stock of direct foreign investment - abroad:
|$9.7 million (31 December 2015 est.) $6.7 million (31 December 2014 est.)
|Market value of publicly traded shares:
|Exchange rates:
|leones (SLL) per US dollar - 6,201.4 (2016 est.) 5,080.8 (2015 est.) 5,080.8 (2014 est.) 4,524.2 (2013 est.) 4,344 (2012 est.)
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|Electricity - production:
|300 million kWh (2014 est.)
|Electricity - consumption:
|200 million kWh (2014 est.)
|Electricity - exports:
|0 kWh (2013 est.)
|Electricity - imports:
|0 kWh (2013 est.)
|Electricity - installed generating capacity:
|100,000 kW (2015 est.)
|Electricity - from fossil fuels:
|33.3% of total installed capacity (2012 est.)
|Electricity - from nuclear fuels:
|0% of total installed capacity (2012 est.)
|Electricity - from hydroelectric plants:
|66.7% of total installed capacity (2012 est.)
|Electricity - from other renewable sources:
|0% of total installed capacity (2012 est.)
|Crude oil - production:
|0 bbl/day (2015 est.)
|Crude oil - exports:
|0 bbl/day (2013 est.)
|Crude oil - imports:
|0 bbl/day (2013 est.)
|Crude oil - proved reserves:
|0 bbl (1 January 2016 es)
|Refined petroleum products - production:
|0 bbl/day (2013 est.)
|Refined petroleum products - consumption:
|7,500 bbl/day (2014 est.)
|Refined petroleum products - exports:
|0 bbl/day (2013 est.)
|Refined petroleum products - imports:
|7,354 bbl/day (2013 est.)
|Natural gas - production:
|0 cu m (2013 est.)
|Natural gas - consumption:
|0 cu m (2013 est.)
|Natural gas - exports:
|0 cu m (2013 est.)
|Natural gas - imports:
|0 cu m (2013 est.)
|Natural gas - proved reserves:
|0 cu m (1 January 2014 es)
|Carbon dioxide emissions from consumption of energy:
|1.4 million Mt (2013 est.)
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|Cellular Phones in use:
|total: 5.657 million subscriptions per 100 inhabitants: 96 (July 2015 est.)
|Telephone system:
| general assessment: marginal telephone service with poor infrastructure
domestic: the national microwave radio relay trunk system connects Freetown to Bo and Kenema; while mobile-cellular service is growing rapidly from a small base, service area coverage remains limited
international: country code - 232; satellite earth station - 1 Intelsat (Atlantic Ocean) (2010)
|Broadcast media:
|1 government-owned TV station; 3 private TV stations; a pay-TV service began operations in late 2007; 1 government-owned national radio station; about two-dozen private radio stations primarily clustered in major cities; transmissions of several internati (2016)
|Internet country code:
|Internet users:
|total: 147,000 percent of population: 2.5% (July 2015 est.)
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|8 (2013)
|Airports (paved runways):
| total 1
over 3,047 m: 1 (2013)
|Airports (unpaved runways):
| total 7
914 to 1,523 m: 7 (2013)
|2 (2013)
| total 11,300 km
paved: 904 km
unpaved: 10,396 km (2002)
|800 km (600 km navigable year round) (2011)
|Merchant marine:
| total 215
by type: bulk carrier 22, cargo 120, carrier 2, chemical tanker 19, container 6, liquefied gas 3, passenger/cargo 2, petroleum tanker 28, refrigerated cargo 7, roll on/roll off 4, specialized tanker 1, vehicle carrier 1
foreign-owned: 98 (Bangladesh 1, China 19, Cyprus 2, Egypt 3, Estonia 2, Hong Kong 7, Japan 4, Lebanon 2, North Korea 2, Romania 2, Russia 7, Singapore 9, Syria 13, Taiwan 7, Turkey 9, UAE 1, UK 1, Ukraine 5, Yemen 2) (2010)
|Ports and terminals:
|major seaport(s): Freetown, Pepel, Sherbro Islands
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|Military branches:
|Republic of Sierra Leone Armed Forces (RSLAF): Army (includes Maritime Wing and Air Wing) (2013)
|Military service age and obligation:
|18 is the legal minimum age for voluntary military service (younger with parental consent); women are eligible to serve; no conscription; candidates must be HIV negative (2012)
|Military expenditures:
|0.72% of GDP (2012) 0.8% of GDP (2011) 0.72% of GDP (2010)
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|Transnational Issues
|Disputes - International:
|Sierra Leone opposes Guinean troops' continued occupation of Yenga, a small village on the Makona River that serves as a border with Guinea; Guinea's forces came to Yenga in the mid-1990s to help the Sierra Leonean military to suppress rebels and to secure their common border but have remained there even after both countries signed a 2005 agreement acknowledging that Yenga belonged to Sierra Leone; in 2012, the two sides signed a declaration to demilitarize the area
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Back to Flag Counter Overview
Source: CIA - The World Factbook