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Ok, this isn't really a Technical question, or comment, but it didn't fit in any of the other categories, either. I'm still rather new here, and I've been reading through all the old posts just out of general curiousity. I'm a pretty good observer, and a problem solver, meaning I can usually put two and two together to make four. Many times I'll read something, or see something, and I'll get an idea for something totally different. This is one of those times, and I'm really interested in some feedback, plus I expect someone will tell me if this isn't anything new.
Here's what I'm thinking; what about a Martin Owner's Group? A WHAT? What if Martin established an enthusiast's group comprised of Martin owner's, would-be owner's, and other interested parties, with the purpose of consolidating it's customer base, and leveraging that customer base to attract, and then keep new customers?
Someone else said it best, but I don't remember who; "The archery buisness these days is about selling tackle. It isn't about servicing archer's." Now that's a crying shame, and it's a very narrow-minded, short-term buisness model!
A new shooter is free to walk into any store, or pro shop, and be overwhelmed by a huge array of makes and models of new bows, and related equipment. They've seen quite a few colorful ads in the magazines, maybe a commercial or two on tv, they have the SURELY knowledgable suggestions of friends and family...they may even know just what they want....even if they don't know what they really need.
On the other end of the spectrum, you have an expert archer, maybe even pro shooter. This person has owned many bows, probably tried just about every brand, and has years of experience tweaking and fine-tuning what the factory sells. He likely also has a few engrained opinions based on personal experience. This person knows exactly what he needs, but everything he wants may not be available, or he may not know that it is, so he sticks with what he knows, and makes do.
Either way you go, or at any point in-between, the truth is there is a mass of potential customers roaming around in the dark, so to speak, looking for a product to meet a need. And there are several manufacturers of archery equipment making such a vast array of bows in all sizes, colors, and at prices, that just about everyone can find something that will work for them...if they could just find it! What we DO NOT have is an archery tackle manufacturer that is willing to reach out and make a direct, personal connection with it's customers, meet their needs, anticipate future needs, and provide solutions BEFORE that customer is back in the market for a new model. What we do not have is a manufacturer who is educating it's customers, informing them, EXCITING them; creating a strong brand loyalty, and then giving the customer the tools to back it up. What I'm talking about here is a CUSTOMER EXPERIENCE!
Right now speed is king...speed sells. All bows made today are FAST compared to those made less than a decade ago. If you've got the fastest bow, you're going to sell a ton of them, regardless of your products reliability, it's shootability, the value of your product's warrantee, or the knowledge and skill of your customer service department. But bow speed is limited by a theoretical "wall" that we are now approaching at Mach 9...there just isn't that much room left for improvement! So, in the near future, when speed is a much less as critical selling point, what then?
Soon, those currently "lesser priorities" will become what distinguishes one brand from another. And while some companies will likely maintain the status quo for quite some time, with cheap, non-durable finishes, ill-fitting parts, and bow-tech that might not have been quite ready for the market...the company that establishes itself FIRST, no longer as being the fastest, but as being the BEST...with the highest quality product, the most knowledgable, helpful, and friendly employees, and the best overall CUSTOMER EXPERIENCE...that company will have everyone else playing catch-up! And once you're in the lead, it's much easier to stay in front...especially if you have a good head-start!
Here's one way Martin can sprint to the front while nobody is looking, and put some distance between itself and all the "also-rans". Martin creates, then offers voluntary membership to an official, factory sponsored group collective comprised of Martin product owners. Each new bow, and every other new Martin product should have a membership signup card included, or even better, a prominent, highly visible informational flyer with a link to the company home page, where they can sign up, or find out more.
This group...let's call it the "Martin Pride", after an older model bow, out of pride for owning the Martin brand, and also because a pride descibes a family unit of big cats, the long-time Martin brand identifier...and that is what we're trying to do, create a "family". The members of this group are provided special perks by the company. They get a Martin newsletter every month in their inbox that tells them all the exciting news related to the company, and the sport. They get free stickers, and patches. They get the new model year catalogs a month or more before they are made available to the general public. They get to place their orders in advance, and get their orders filled first. They are eligible for factory sponsored shooting clinics. They get to attend special Martin "member only" shoots, with pros and instructors in attendance. They get to come to the factory and try out the new equipment, as well as try out pre-production models, and offer direct customer input while the equipment is still in development. Maybe they get to sign up for a chance at receiving a new product that they can test out for a few weeks, then offer a testimonial, and suggestions for other potential customers. This creates that important CUSTOMER EXPERIENCE. It makes a customer feel like they are more than just a potential sale, but part of something, part of a family...makes them feel like they have a say, that their opinions are important, that THEY are important!
Martin, in turn gets valuable, direct input from the very people who buy it's products. They acquire something very rare, and priceless....a crystal ball with a direct view to their customer's future wants and needs! They create an unbreakable brand loyalty. They get to build excitement for their products, and then directly market their product to customers that are eagerly awaiting an opportunity to buy it! They get to educate their customers about their products, not just give them a quick sales pitch. They get to directly SHOW the customer how their product meets a need...how their customer is important, and how the company will be there now, and in the future to take care of them.
Now here's the important part: These excited, loyal, educated customers move about freely within all areas of the archery world. They meet and interact with all manner of other archery enthusiasts from all walks of life. And they are armed with the knowledge and the tools to defend their brand choice, demonstrate how it is a superior product, explain how Martin is not just a company, but a family, AND educate other's as to why they should become a part of that family!
For this to work, Martin is going to have to step up it's game. It's not enough to SAY their bows are the fastest, or the most accurate, or the BEST. They actually have to BUILD them that way...if they talk the talk, they MUST walk the walk!
What about increased costs? Negligible. It is no more expensive to make a quality product that is correct when it leaves the factory, than it is to make a sub-par product that must be continually serviced with warranty claims, customer complaints, and lost buisness.
To summarize, Martin is a good company, with a long history. There is an opportunity here to to move from the middle of the pack, and set itself up as THE go-to company in the archery universe. By building a quality, durable, desirable product...a product that it's customer's not only want, but helped design...and then not just offering it among a slew of similar products, but presenting it and the company that made it as the singular, best solution to meet the customers current, and future needs...Martin can transform itself into the busiest, fastest growing, most profitable, customer-oriented company to ever string a bow!
Ok, that's a rough idea of what I was thinking. If you read it all, I thank you, and appreciate your patience, and attention. Now, what do you think? Is this idea worthy of further development? What suggestions do you have that could improve the Martin Customer Experience, and help drive this company to a leadership position among it's competitors? There was a thread started about what you would like to see for future product improvements, but what would you like to see the company improve about itself? What could Martin do to better meet your needs, improve your perception of the company, and remain your number one choice for archery tackle?
Thank you again.


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Wednesday, 14 April 2010
The Onus is on the Nursing Staff
This is the trust's latest trick in fighting infection control.
They continue to ignore the issues of safe staffing while scoffing at any suggestions made by the professional nursing staff regarding this matter. They are unable to address the issue of high bed occupancy as a result of being forced to meet targets. In a nutshell, this means that the ward is always to full to clean properly. We continue to get slammed with admissions we cannot handle at mealtimes, during rounds, change of shift, and when we are struggling to care for the patients we already have. We don't have enough domestics. We have no right to have an uninterrupted block of time at any point in our shifts to do our jobs. We are doing so many things at once that nothing, NOTHING gets done well.
None of this gets addressed. Ever.
But the trust behaves as if it is quaking in their boots at the thought of getting busted over poor hygiene, super bugs and poor care. They cannot deal with the real issues that lead to these problems so they are covering their assess and putting the onus on the Nursing Staff.
I attended a study update the other day to learn about the trusts requirements for the cleaning of all 30 beds on the ward. The process that we were instructed upon is to be implemented daily and between every discharge and admission. They want each bed completely dismanted and every part cleaned in a certain way, every single day and between each patient. It is heavy work that requires at least 2 members of staff. It takes at least 45 minutes to do one bed.
There are 30 beds. We have between 5 and 15 discharges and admissions per day. There are 2 nurses and 2 assistants for a 12 hour shift during the day who cannot even attend to all the Nursing care that needs to be accomplished.
Do the Math.
We cannot even get around to everyone fast enough to prevent pressure sores, dehydration, notice changes in condition quickly enough or medicate properly. Here's a newsflash for the doctors: you know those IV antibiotics that you prescribe to be given 4 times a day? They are getting given two times a day max because the nurse has so damn many of them to mix and give that it takes hours. Yeah, doses get missed regulary.
Now you need to take into account that in addition to this we must clean and dismantle 30 beds that take 45 minutes each to clean every day. And in addition to that we have to dismantle and clean them between each patient.
They won't bring more staff on board. They don't want the domestics doing the beds and there are not enough of them anyway.
During the course of the study update we did explain that we will be unable to follow this bed policy due to a lack of time and staff.
This statement was met with ridicule of the Nursing Staff in the form of eye rolling and the inferred notion that Nurses are too thick and lazy to do their job properly.
And I quote: " The trust is implementing this policy to prevent the spread of infection. There will be spot checks to ensure that these actions are being carried out. If they are not, the blame is on the professional Nursing staff."
Did I tell you that they want us to spend 11 minutes exactly in a cramped room cleaning and dismantling commodes and documenting it between each patient use. Four commodes are being used over 15 times an hour on some days. They are swabbing them to ensure that this is done. The swabs are never clear. And infection control is up our asses over it. They have devised even more cleaning checklists and paperwork. Same with pressure sore audits etc.
And they want to know why we have so many pressure ulcers, and drug errors as well. And they have demanded that the RN on duty drop what she is doing as soon as the consultants arrive (we don't know when they are coming and cannot plan for it) and attend every ward round, following the medical teams around the ward for hours while they see their patients.
And if my patient suffers harm because I am off on a ward round or dismantling a bed I must take full responsibility. It's tough shit really.
Fuck them. I am going to Nurse my patients starting with the high priority actions and working my way down. I will turn the patient and if that doesn't leave time to document that I have turned them it is too bad. The trust wants documentation that it is done more than they want it to actually get done.
24 comments:
So, what do we do? Maybe you could get a regular spot in the Guardian now that nhsblogdino has apparently expired? Doesn't change the fact that nobody (including our pathetic simpering 'unions' gives a shite about nurses unless they are one (or married to one and tired of the moaning). When we do tell people how it really is they don't fucking believe it anyway. Still planning on voting with your feet?
- 14 April 2010 02:49
In the theory your hospital should have a 'policy' that deals with harassment & bullying.
Might be worth dusting down ......... it will probably give you a bit of laugh, if nothing else?
- 14 April 2010 07:00
It would be a good idea if you took Crippen's place on the Guardian. These posts need a wider audience!
- 14 April 2010 12:06
- Dino-nurse said...
Your Trust sounds an awful place to work. I know that the NHS has a bad reputation regarding whistleblowers but it may well be the only thing left to do. As a group, nurses are piss poor at standing up for themselves in this country- problem ingrained within the public sector. Its about time that we actually did something constructive and went on strike. I'm not advocating that we walk of the wards but leaving on time at the end of a shift, not doing overtime to save money on agency, working to your job description...would do for starters.
- 14 April 2010 12:17
- TonyF said...
I think it's about high time that some of our so called 'leaders' were shown the truth of their incompetence. If only one ore two could get their faces out of the trough, and actually visit some of the places and things that that they have ruined. Without SMT hanging around. I suggest enlisting Guy Fawkes (or similar) to create some er, customers...
- 14 April 2010 12:48
- TonyF said...
I think it's about high time that some of our so called 'leaders' were shown the truth of their incompetence. If only one ore two could get their faces out of the trough, and actually visit some of the places and things that that they have ruined. Without SMT hanging around. I suggest enlisting Guy Fawkes (or similar) to create some er, customers...
- 14 April 2010 12:48
- TonyF said...
I have an echo...
- 14 April 2010 13:13
Dear Anne
those managers are nicompoops and don't understand their job is to FACILITATE clinical staff. Be real sweet and ask them for a demonstration in the ward ? just to be real sure as to how it's done and whilst someone is dismantling ask them to take over some nursing eg iv medication or get a bedpan for a patient. Bet u they won't bother. Is this coming from infection control people ? I get so mad on your behalf.
- 14 April 2010 18:19
- Nikita said...
Have you seen www.nursingtimesnet/5013601.article Perhaps your message is getting through at last?
- 15 April 2010 04:34
- The Shrink said...
"And they have demanded that the RN on duty drop what she is doing as soon as the consultants arrive "
Quite right too, and mop my fevered brow, and make me a nice hot cup of tea, in fine bone china, with a doily and a nice biccie on the side, too ;-)
You really do work in a shithole of a police state, don't you :(
- 15 April 2010 08:35
I just found your blog and am liking it.
Just wondered where you are from though? I know you work in the UK, but a lot of what you write sounds like it was written by an American because of the phrases and words (e.g. "You do the Math", "up our asses" etc).
Keep up the good work :)
- 16 April 2010 05:59
- Nurse Anne said...
Hi Anonymous,
I spent years and years in the US and Canada.
- 16 April 2010 08:41
I am a student nurse on community placements and I love it, its way better than on a ward.
Maybe Nurse Ann should hang up her pinny and go to the community, one to one patient care, time to teach students, its great!
- 16 April 2010 11:59
Our trust had a similar little directive to the on-call doctors recently - apparently there has been a problem with on-call jobs and patient reviews not being done in a timely enough fashion, on a completely unrelated note doctors are not documenting in the notes with enough detail when they see patients on-call.
Fortunately the solution is quite simple, the doctors will spend more time writing in the notes and also see more patients - problem solved.
When it was suggested that perhaps these were conflicting priorities and that maybe the problems highlighted a need for more on-call staff it was made quite clear that these recommendations will be implemented, there will be no more staff, and it will be a 'professional misconduct' issue if doctors are not able to comply.
A similar issue was seen with medical staffing where they did not attempt at all to find locum cover for known abscences, then at the last minute they ring up the rest of the doctors to inform them that they are obliged to cover the shifts* between themselves and failure to do so would again be 'professional misconduct'.
What is interesting is that there is apparently no concept of professional misconduct for these admin and management arseholes who get to tell everyone else what to do while going home early and apparently taking no responsibility for the mess they leave preside over.
* Of course the ensuing failure to meet European Working Time Directive limits is, funnily enough, the responsibility of the individual doctors and can be subject to 'disciplinary action' for working too many hours!
- 16 April 2010 13:59
- DEAR ERMINTRUDE said...
Hallo Anne,
I am new to blogland and am still not quite sure of what I am doing. I have mentioned this post in my third blog. If I have infringed blog etiquette - I apologise and would ask that you advise me of same.
- 17 April 2010 17:19
- Nurse Anne said...
No breach of etiquette whatsover my dear. I appreciate the link.
- 18 April 2010 01:09
- Eileen said...
Watched a programme the other day on German TV about the new super-hospital in Nuremburg which opened a couple of years ago. It has a "dishwasher" for beds - between patients every bed is pushed into a room which is like the dishwasher you see in pubs for the glasses. It's washed with high-pressure jets, subjected to a disinfection cycle and dried. All automatically, just pushed in by the technician running it, doors closed, push the button and hey presto!
As far as I remember, the patient is picked up from wherever they are admitted in the bed so 1 patient equals 1 bed reducing cross-contamination - they do have the advantage of a new purpose-built building which allows enough space for a bed rather than having to put your patient onto a trolley just so they fit in the space and of course there is also a reduction in the risks to backs of moving patients back and forth.
- 19 April 2010 01:56
Great Blog. Glad to see nurses talking about how broken the system (s) is (are), not just where I work but everywhere. Not only that, but from what you describe at your work, I will be a bit more cognizant of how good my job is. Not to ignore that we do also have problems galore, but nothing on the level of what you endure.
- 19 April 2010 09:18
Hah. Infection Control. You gotta love their poor nitpicking little hearts.
Our lot recently came up with the genius idea of attaching checklists in little plastic pockets to all the dripstands so that instead of doing anything remotely useful we nurses could fill in these checklists every time we cleaned a dripstand.
They were quite proud of their little notion until I said "But who is going to clean the plastic pockets attached to the dripstands? Don't we need a second checklist for that?"
Awww I think I rained on the parade.
- 26 April 2010 07:59
- JSAbetterthanMRSA said...
I am so glad to have found this blog. WTF is going on? How can these baw bags get away with this? The NHS was never perfect but it did at one time strive to deliver quality care. I left 2 yrs ago mid shift after working for 16yrs and it just seems to be getting more cynical. It seems to be the people that give a shit that are being isolated and burned out. They keep on putting posters up about violence against nurses not being tolerated. But keep on putting violent patients alongside very ill patients and we have to jump in like fukkin super heroes to stop some poor bastard getting a hospital acquired facial injury to accompany their o/a presentation.The worst part of it is that the person who needs restrained is wired to the fukkin moon and is not responsible for what they are doing and have usually been banged up with benzos for so long that when paradoxical aggression kicks in the whole thing is fukkin chaos. I am going to leave it there but it gets me so fukkin angry they can stick their posters and benzos up there arse. We need proper units with appropriate staffing to meet the very complex needs of potentially aggressive patients.
- 28 April 2010 07:35
Your place sounds like mine.... we know have weekly cleaning lists, including toilets, changing rooms, visitors rooms, overnight accomodation and staff rooms added to our list of things we are supposed to clean,thats on top of the beds, multiple equipment and stock trolleys and rooms, oh and lets not forget the hour long computer assessment on clunky old NHS software that is worse than useless.
all the while working a 13 and a half hour day.. and looking after our Intensive care patient.
If I see another 'tick list' from management for some target they want us to reach so they get a fancy logo to stick on their letterhead I think I,m going to scream.
- 1 June 2010 15:57
With reference to Ulrike's comments it isn't the good HCA's that are a problem it's the bad ones. I could kiss the good ones, I really could. Also, am a bit surprised you are not allowed to write in notes. Hell, even the lowest level support staff on our ward were allowed to write in the patient's care plans. One snitch used to monitor what the nurses did and write down comments on whether they had done things well or not in her opinion. She was 'bestest fwiends' with the ward sister, they were like siamese twins - if she had got any closer at handover she would have been perched on the sister's lap! You can't fight this set-up. Why was an auxiliary (with only a couple of years experience) allowed to behave this way? One day when I was with a consultant doing the ward round I told her to clean up a patient who had just messed himself and she actually refused and started arguing with me (and it wasn't the first time this had happened. Management just let her get away with this sort of thing. How I longed to kick her up her fat lazy little backside. How can nurses do a proper job with support staff who indulge in challenging behaviour like this? A hospital ward is no place for a worker who acts like a primary school child, it just isn't fair to the patients, it really isn't.
- 11 July 2010 12:03
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INGLEWOOD, Calif. (June 10, 2012)—Only two players remain alive in the $3,000 winner-take-all Show Me The Money –Presented by Golden Nugget Las Vegas – contest at Betfair Hollywood Park.
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A City Wings employee was making a delivery in the area of Franklin Drive off Cassville Road when he stopped at a vacant house after being flagged down by a female. While speaking with the female, he allegedly was struck in the neck and head with a hard object multiple times. His car, wallet, cash and other items were taken.
On Thursday, Feb. 7, the victim spotted his stolen vehicle traveling on Burnt Hickory Road. Officers and deputies responded and arrested Danielle Lefevbre and Bobby Wehunt.
Investigators determined that the pair was involved in the original incident. Both have been charged with armed robbery and aggravated battery and are awaiting bond in Bartow County Superior Court.
More arrests and charges are possible as investigation continues into the incident.
The victim is still recovering from his injuries at home.


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Area Sports Briefs
From staff reports
East Rowan's baseball team won 5-3 in eight innings at West Iredell in an NPC game played on Friday night.
Connor Johnson (3-0) was the winning pitcher for the Mustangs (3-2, 2-0 NPC).
Hunter Poston had the go-ahead hit in the eighth for East, and Luke Setzer drove in a big insurance run.
Ike Freeman started the winning rally with a walk and a stolen base.
East played well defensively, making only one error.
East plays at R.J. Reynolds this afternoon.
• Salisbury is home against Davie today in a game scheduled to start at 3 p.m.
It's been moved back a bit because of SATs at Davie.
"We're playing murderer's row," said Salisbury coach Scott Maddox, whose team is facing Carson, Davie, East Rowan and West Rowan in consecutive games to prepare for CCC play.
• In the CCC on Friday, West Davidson won 3-2 against Ledford. Chandler Simerson was the winning pitcher for the Green Dragons (2-0).
Justin Norman's sacrifice fly plated the winning run.
• CCC club East Davidson is playing really well and won 7-3 at home against Randleman on Friday. Ryan McIntyre had three RBIs. Trevor Jones had three hits.
Catawba signee Avery Bowles was the winning pitcher. He pitched five innings and struck out four.
Prep softball
Catherine Whitley's two-run triple and Kristin South's two-run double sparked West Rowan to a 10-5 NPC win against South Rowan on Friday.
Leah McCoy was the winning pitcher.
West overcame an early deficit with a four-run third and a six-run fourth.
Logan Lowery homered for the Raiders (4-1, 1-1), who suffered their first loss.
• East Rowan beat West Iredell 6-2 on the road in an NPC game played on Friday.
• In South Rowan's 7-4 win against West Iredell on Thursday, Caitlin Waters, Emma Pope and Katherine Starnes had two hits each.
McKenzie Ward had a triple and scored three runs. Pope and Caroline Hubbard had doubles.
Samantha Kennerly (2-0) was the winning pitcher. She pitched out of two bases-loaded jams.
Prep golf
Medalist Davis Richards shot 30 at Warrior and led South Rowan (149) to a win against Salisbury (153) and Mooresville (170).
Scorers for South were Evan Neas (39), Josh Pope (39) and Dalton Little (41).
Scorers for Salisbury were Eric Edwards (34), Alex Austin (39), Joseph Rusher (40) and Gabe Steinman (40).
Jacob Whitcomb and Shane Dodd led Mooresville with 42s.
Prep basketball
All five of East Surry's starters scored in double figures Friday in a 73-65 win against Hendersonville in a 1A Western Regional semifinal.
The Cardinals will play Winston-Salem Prep for the regional title this afternoon in Greensboro.
Prep track
Carson's boys scord 94 points and won a meet with Mount Pleasant (46) and West Davidson (35).
Andrew Hower won all the jumps (triple, high and long) to lead the Cougars.
Zachary Marchinko won the 1600. Myquon Stout won the shot put. Nick Thornton won the 3200. Daniel Sherer won the 800.
Spencer Issac won the 400 and ran on winning 4x200 and 4x400 relays. Jaelen Brown, Tyrese Paul and Tyler Reynolds ran on the 4x200 team, while Sherer, Paul and Nixk Cox were on the 4x400 unit.
Prep tennis
Salisbury's boys lost to Statesville 7-2.
Clint Comadoll won 6-4, 6-0 at No. 2 singles for the Hornets. Brock Overcash-David Derrick won 8-1 at No. 1 doubles.
College baseball
Catawba used a seven-run second inning to blow out Brevard 13-0 in a SAC game played at Newman Park on Friday night.
Nick Lomascolo was the winning pitcher for the Indians. He pitched seven shutout innings and tied Tim Smith for Catawba's all-time wins lead.
It was the 31st victory for the senior from Lake Norman. Lomascolo also became the third Indian in school history to surpass 300 career strikeouts.
Cameron Cockman had a two-run double for the Indians. Chris Dula had a two-run single. Paul Kronenfeld also had two hits. Julio Zubillaga (Carson) knocked in two runs. Craig Brooks hit a solo homer.
Brevard starter Kevin Hamilton (NW Cabarrus) struck out the side in the first but ran into trouble in the second. Alex Litaker (East Rowan) got the final out in the second and kept the Indians off the scoreboard in the third.
Litaker has a 1.54 ERA in nine relief appearances this season.
The teams are scheduled for a doubleheader at Newman today, starting at 1 p.m.
7th-grade hoops
Jailen Williams scored 15 points and Jay Wilkerson had 10 as Southeast's boys beat Mooresville 46-38.
A.J. Banks added eight points for the Patriots (13-1), who shared first place with Knox.
The tournament starts today at North Rowan.
8:30 — (1) Southeast vs. (8) China Grove (girls)
10 — (1) Southeast vs. (8) China Grove (boys)
11:30 — (4) Mooresville vs. (5) West Rowan (girls)
1 — (3) Erwin vs. (6) Mooresville (boys)
2:30 — (3) Erwin vs. (6) Corriher-Lipe (girls)
4 — (2) Knox vs. (7) Corriher-Lipe (boys)
5:30 — (2) North Rowan vs. (7) Knox (girls)
7 — (4) West Rowan vs. (5) North Rowan (boys)
Local golf
In the eGolf Tour's Irish Creek Classic, Ryan Nelson leads after two rounds at 136.
The third round was suspended by darkness on Friday.
Frank Adams III is tied for 43rd at 73-74 — 147.
Women's basketball
Pfeiffer's Christina Harvey (first team), Brittany Cox (second team) and Kellie Rhonye (third team) made the All-Conference Carolinas team.
Pfeiffer's Jill Thomas was named Conference Carolinas Coach of the Year.
• No. 3 seed Pfeiffer advanced to the Conference Carolinas championship game with a 78-55 romp at No. 2 Barton on Friday.
Since No. 4 Mount Olive upset No. 1 Limestone 79-66 on Friday, Pfeiffer hosts the tournament title game at 2 p.m. on Sunday. Harvey scord 21 points. Cox and Bridget Rothert scored 17 each.
Homeschool Stallions
Both Greater Cabarrus Homeschool Stallions baseball teams have reached the championship games in the Baseball Bash held in Kannapolis.
Hunter Shepherd drove in six runs as the Stallion jayvees beat North Hills 12-2.
Dalton Lankford had two hits, while Caleb Threadgill had a triple.
Josh Endicott pitched four innings for the win and struck out nine. He combined on a one-hitter with Tyler Hartsell.
The Stallions play the Charlotte Stampede today at 5:30.
• The Stallions middle school team beat Covenant Classical 12-1. Drake Boger and Travis Cone combined on a no-hitter. Boger fanned 11. Boger and Cone had two hits each. McConner Wallace tripled. The Stallions play the Stampede today at noon.


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Non-GMO corn has its place
There is no definitive market share shift from GMO corn and soybeans, but the convergence of several factors appears to be pushing some growers away from paying the higher price for traited seed when conventional seed might perform just as well.
There has been an increase in non-GMO varieties entered in the Iowa Crop Performance tests, noted Jim Rouse, director of the Iowa Crop Improvement Association. The big increase in non-GMO varieties is with seed corn. In the corn hybrid test for 2012, 56 out of 259 were conventional hybrids; that is 21 percent. As for soybeans, 23 varieties were conventional out of 226 varieties tested, or 10 percent.
"Some companies mostly enter GMO hybrids, but they have now started to enter one or two conventional hybrids, too, that they might not have entered in the past," said Rouse. "It is about the same percentage as last year, but it is higher than in 2010. And before that, there didn't seem to be as much interest in conventional hybrids."
Spectrum Premium Genetics from Linden, Ind., is an example of a new company entering non-GMO hybrids in the tests. Company President Scott Odle started the company to provide alternatives to GMO hybrids about three years ago. The estimate is that non-GMO corn is about 9 percent of the seed corn market, and Odle predicts that it might be 20 percent in five years.
He suggests that farmers are realizing that traits protect yield and genetics are the underlying yield determinant. And he can show that non-trait hybrids are testing quite well against traited seed.
"If we had used GMOs as a tool instead of the rule, we wouldn't have a lot of the issues that we have today," he said. Odle refers to insects showing resistance to Bt seed traits, weeds showing resistance to glyphosate herbicides and stacked trait hybrids that haven't performed as promised in some cases.
The impetus for Odle to start a seed company was his worry that in five to seven years, without smaller seed companies focusing on non-GMO seed, these alternatives wouldn't exist, but he is now optimistic about the future.
"I know that we don't need to plant GMO hybrids every year," he said. In his own farming operation, he isn't completely averse to using a Bt-trait seed or Roundup Ready hybrid occasionally if a specific situation calls for it.
Jon Lundgren, Ph.D., entomologist with the USDA Agricultural Research Service in South Dakota, said, in general, there seems to be a "developing market for non-GM corn."
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Comments (6) Leave a comment
What happens to GMO seed demand if purchases start to be made based on food quality versus just yield, which the industry seems to be stuck on. GMO beans are some of the weakest seed in the market, in respect to succeptablility to fungal disease, according to land grant pathology reports. And Bt is not something I would want on or in my corn flakes in the morning. Roundup residue is starting to effect soil negatively creating more soil disease organisms, versus having farmers move towards a healthy more efficient soil system that creates plants with better disease resistance. It's all in the 'culture' and the type of culture that is being created with GMO's is really not what 'food' and 'farming' should be about.
I agree for the most part, GMO's may have their place, but conventional corn and beans give growers more options for dealing with markets and production systems. On a side note - lets stop the trend toward calling GMO crops "hybrids" (as every grower should know, a "hybrid" is a result of breeding while GMO is a result of genetic manipulation - not the same thing).
Joe, glad you are well fed enough to worry about trivial if not imaginary risks. It's also nice you can earn a living at a computer keyboard instead of hoeing or pulling weeds all summer under a hot sun(real cancer risk). Never before in human history has our food supply been more plentiful, safe and wholesome or produced by a smaller share of people at less risk to their physical health than now, thanks to advanced technology. That you can work an easy job, spend time at a computer and shelter from hot summers safe inside air conditioned buildings is all due to advanced food production methods. I'm all for mixing up the acreage planted with non-GMO to protect against further resistance development, but spare me the fear mongering over nothing. TQ
Well said TQ
Hello TQ, please reread your post and see if you can explain yourself without labeling or belittling others. Then I invite you to open up to the fact that you do not know the truth regarding GMOs. Your post here suggests you suffer from confirmation bias and I would hazard a guess you experience cognitive dissonance when discussing GMOs. Science is not as exact as the PR folks on either side of an issue would have us believe. The health aspects of GMOs are a tough sell either side of the coin. Aside from the health issues there are many socio economic and environmental reasons why GMOs are not what they purport to be. I could list them here but you would get a broader understanding if you look into it yourself. Starting with the acknowledgement that you do not know the truth will help you and us all. You are not alone -no one knows the truth. Here's a little story: An apple farmer Grows a crop and his neighbor Johny homeowner does not manage pests on his side of the fence and the pests keep infesting his crops infringing on his right to livelihood and severely impacting his pocketbook. Should that farmer just go away? Here is something I would like you to consider: How much do you want to be controlled and influenced by corporations?
Nothing wrong with gmo just the greedy monsatin
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Mon, 06/25/2012 - 11:28
Research by Marketing Professor Rajenda Sisodia is referenced to find a correlation between management and engagement of employees in the workforce.
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Arthur M. Sackler Museum, 485 Broadway, Cambridge, MA 02138
Elizabeth Rudy, Theodore Rousseau Assistant Curator of European Paintings, Division of European and American Art, Harvard Art Museums
This talk will focus on portraits of two well-known public figures of the 18th century, Mme. de Pompadour and Emmanuel Sièyes. One the official mistress to Louis XV, the other a prominent statesman in the shifting governments of the French Revolution, they both attracted public attention and provoked discourse. The comparison of how these celebrities were represented at particular moments in their respective careers will provide the framework for a larger discussion of 18th-century French portraiture in the exhibition.
Free with price of admission. Admission is free for MA residents on Saturdays before noon.
Gallery talks are informal and include discussion. Limited to 25 participants; please arrive early.


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INGLEWOOD, Calif. (May 20, 2012)—One day after he moved a step closer to history, jockey Mario Gutierrez was back at work at Betfair Hollywood Park.
Gutierrez, who delivered another flawless ride aboard I'll Have Another in Saturday's Preakness two weeks after winning the Kentucky Derby with the son of Flower Alley, failed to score with any of his four mounts Sunday while still savoring his achievement at Pimlico.
A native of Veracruz, Mexico, the 25-year-old rider is looking forward to collaborating again with the Betfair Hollywood Park-based I'll Have Another in less than three weeks.
A victory in the Belmont Stakes June 9 would make I'll Have Another, who is trained by Doug O'Neill and owned by CashCall Futurity sponsor J. Paul Reddam, the first Triple Crown winner since Affirmed in 1978.
"I got in this morning,'' he said. "It seems all I do is talk to the press. I keep answering the same questions.
"When I go to Belmont depends on what Mr. O'Neill and Mr. Reddam want me to do. If they want me to go early, I'll go early.
"I did my homework at home for the Kentucky Derby and I'm going to do the same thing for the Belmont.
"I knew (the Preakness) was a shorter race and (Bodemeister) would be tough, but I had no doubts about my horse. Like I've said, I believe in him. He still has a lot more to show.
"I only listen to people that I care about and people that believe in me. Those are the people I look and listen to. Any other comments I just put to the side, good or bad.''
Gutierrez, who spent more than five years riding at Hastings Park in Vancouver, British Columbia, Canada, added he relished the time he spent there Mother's Day (May 13). "I really enjoyed it when I went up to Hastings,'' he said. "It worked out pretty well. That's a place I feel real comfortable.''
Gutierrez, who won the Wilshire Handicap earlier in the Spring/Summer meet aboard 15-1 shot Quiet Oasis for Reddam, is named on three mounts Thursday at Betfair Hollywood Park and one Friday night.
Copyright © 2009-2014, Hollywood Park. All rights reserved.


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Tigran Khzmalyan: Armenia has linked its Noah's Arc to Russia's sinking Titanik that is still selling tickets
Irina Kamkhadze: We see no downward tendency of Visa growth rates in Armenian market
VTB Bank (Armenia) Visa cardholder becomes winner of Summer with VTB campaign and gets a vacation package to Malta for two persons
Delegation of IFC and EBRD visits Amulsar Gold Project site
Oppositionist: The case with ASALA veteran demonstrates state terrorism in Armenia
Armenia's Health Care Ministry organizes a training course to assess local doctors' readiness for Ebola
Naira Zohrabyan: There is no sector in Armenia where human rights are not breached
Speaker of the Armenian parliament agrees to the idea that there are numerous unsettled conceptual problems in the republic
Gabor Brodi: Armenia must not choose between European Union and its neighbors in the region
A delegation of South Caucasus Railway to attend 61st meeting of CIS Rail Transport Council in Baku
Georgian Ambassador: Armenia and Georgia are facing problems in their trade relations
ACBA-Credit Agricole Bank sums up CASHBACK QUEST results
Social Democratic (Hnchakyan) Party (SDHP) urges Armenia's leadership to inform the world community of Ankara's intention to seize Kessab
Heritage: Shant Haroutiunyan was convicted after Serzh Sargsyan's notorious speech at Columbia University in U.S.
Eduard Sharmazanov: Fairy-tales of the Turkish authorities about the Armenian genocide are simply funny
Between October 25-31 the 6th edition of ReAnimania to be held in Yerevan
Opposition MP Nikol Pashinyan urges Armenian Parliament to define concept of political prisoner
Armenian National Congress to do its best to free Shant Harutyunyan and his friends
Expert: Armenia's path and prospects in Eurasian Economic Union are vague
MP: Armenia, which has a ruined agriculture, can offer nothing to Eurasian market
Orphan Rug showcase in Washington is connected with tension in Turkish-US relations, Turkish media report
Naira Zohrabyan: Verdict against Shant Harutyunyan demonstrates that Armenia's judicial system is not independent
Armen Martirosyan: Armenian authorities do not want Armenia to lag behind Azerbaijan by number of political prisoners
OSCE MG Co-Chairs discuss preparations for upcoming summit hosted by French President later this month in Paris
VivaCell-MTS is the General Partner of the International Microelectronics Olympiad of Armenia
World Day for Decent Work Marked in Georgia
Georgia Toughens Punishment for Illegal Abortions
Georgia, Lithuania to Conduct Joint Military Exercises
Lukashenko calls for increased trade with Azerbaijan
Ministers of Defense, Transport and Foreign Affairs of Lithuania to visit Azerbaijan
Azerbaijan marks Kurban Bayram
Leyla Yunus: Pressure continues
Georgian President Does not Intend to Form Oppositional Force - MP
The UN mission prematurely leaves Azerbaijan due to obstacles in the work
Azerbaijan and Iran are increasing energy cooperation
Average export price of Azerbaijani oil still above $110 per barrel
Average income per capita also rose 3.8%
Georgian Platoon Participates in Rapid Trident - 2014 - MoD
The U.S. Senate to Vote Bill, Granting Georgia Major Non-NATO Ally Status
Tigran Khzmalyan: Armenia has linked its Noah's Arc to Russia's sinking Titanik that is still selling tickets
Alexander Iskandaryan: Peace and war are the two things Russia does not need in the South Caucasus
Ariel Cohen: Putin may be compensating for reputational damage to Russia in the conflict in Ukraine by trying to resolve the Karabakh conflict
Hovhannes Igityan: Serzh Sargsyan's geopolitical choice is an obstacle for investments in Armenia's economy
Andrey Areshev: Russia wants to see Armenia as its strong and dynamically developing ally in the South Caucasus
Vahan Vardapetyan: October 10 will become the day of culmination of consolidation of the society around the Armenian centrist parties
Manvel Sargsyan: The myth of Russia's importance for Armenia is based on the formula "We will defend you"
Thomas De Waal: The society and power in Armenia and Azerbaijan are strongly linked by a vicious circle
Ukraine's Ambassador to Armenia: The next phase of development of the Ukraine-EU relations may be only Ukraine's EU membership
Hakob Andreasyan: Current reforms are as important as those conducted in privatization period
Hakob Andreasyan: We try to ring-fence farmers from untypical risks
Giorgi Gvimradze: Russia's fate hangs in the balance in Ukraine
In NK peace, it is necessary to pay attention to other processes in Scotland and Catalonia
Armenia's ex Defense Minister: We have enough options to advance to the north of Azerbaijan
by Tatevik Shahunyan
"Azerbaijani army is equipped with the most modern, precise and newest weapons that will destroy any military infrastructure or military facilities in Armenia's territory," Azerbaijan's Defense Ministry says in a statement in response to Armenian President Serzh Sargsyan's statements that Armenia has cutting-edge ballistic missiles capable of hitting the most 'prosperous' community in Azerbaijan.
It is noteworthy that Serzh Sargsyan's statement followed Baku's constant military rhetoric and threats to 'seize Yerevan.'
Azerbaijan's Defense Ministry claims that it is not frightened with Sargsyan's statements. They are sure that Armenia has no modern military equipment, only "old, disordered, obsolete weapons and ammunition left from the former Soviet-era as well as fuel-engine Scud missiles that are not just incapable of destroying any facility, but also don't even have the capability to rise into air."
Meanwhile, military experts say that Scud is a top-class ballistic missile due to its impressive destruction potential. In addition, the Armenian Armed Forces have thoroughly improved the preciseness of the missiles.


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The Pancreas
Cancer Cells
Risk Factors
Second Opinion
Supportive Care
Follow-up Care
Sources of Support
Taking Part in Cancer Research
About This Booklet
This National Cancer Institute (NCI) booklet (NIH Publication No. 10-1560) is about cancer that starts in the pancreas. This disease is also called pancreatic cancer.
In 2013, more than 45,000 Americans will be diagnosed with cancer of the pancreas. Most will be over 65 years old.
There are two main types of pancreatic cancer.
Most often, pancreatic cancer starts in the ducts that carry pancreatic juices. This type is called exocrine pancreatic cancer. This booklet is about this type.
Much less often, pancreatic cancer begins in the cells that make hormones. This type may be called endocrine pancreatic cancer or islet cell cancer. This booklet is not about endocrine pancreatic cancer. NCI's Cancer Information Service at 1–800–4–CANCER (1–800–422–6237) can provide information about this disease.
Learning about medical care for cancer of the pancreas can help you take an active part in making choices about your care. This booklet tells about:
- Diagnosis and staging
- Treatment and supportive care
- Taking part in research studies
This booklet has lists of questions that you may want to ask your doctor. Many people find it helpful to take a list of questions to a doctor visit. To help remember what your doctor says, you can take notes. You may also want to have a family member or friend go with you when you talk with the doctor—to take notes, ask questions, or just listen.
The Pancreas
The pancreas is an organ that is about 6 inches long. It's located deep in your belly between your stomach and backbone. Your liver, intestine, and other organs surround your pancreas.
The widest part of the pancreas is called the head. The head of the pancreas is closest to the small intestine. The middle section is called the body, and the thinnest part is called the tail.
The pancreas makes pancreatic juices. These juices contain enzymes that help break down food. The juices flow through a system of ducts leading to the main pancreatic duct. The pancreatic juices flow through the main duct to the duodenum, the first part of the small intestine.
The pancreas is also a gland that makes insulin and other hormones. These hormones enter the bloodstream and travel throughout the body. They help the body use or store the energy that comes from food. For example, insulin helps control the amount of sugar in the blood.
Cancer Cells
Cancer begins in cells, the building blocks that make up tissues. Tissues make up the pancreas and the other organs of the body.
Normal cells grow and divide to form new cells as the body needs them. When normal cells grow old or get damaged, they die, and new cells take their place.
Sometimes, this process goes wrong. New cells form when the body doesn't need them, and old or damaged cells don't die as they should. The buildup of extra cells often forms a mass of tissue called a growth or tumor.
Tumors in the pancreas can be benign (not cancer) or malignant (cancer). Benign tumors are not as harmful as malignant tumors:
- Benign tumors (such as cysts):
- are usually not a threat to life
- can be removed and usually don't grow back
- don't invade the tissues around them
- don't spread to other parts of the body
- Malignant growths:
- may be a threat to life
- sometimes can be removed but can grow back
- can invade and damage nearby tissues and organs
- can spread to other parts of the body
Pancreatic cancer can invade other tissues, shed cancer cells into the abdomen, or spread to other organs:
- Invade: A malignant pancreatic tumor can grow and invade organs next to the pancreas, such as the stomach or small intestine.
- Shed: Cancer cells can shed (break off) from the main pancreatic tumor. Shedding into the abdomen may lead to new tumors forming on the surface of nearby organs and tissues. The doctor may call these seeds or implants. The seeds can cause an abnormal buildup of fluid in the abdomen (ascites).
- Spread: Cancer cells can spread by breaking away from the original tumor. They can spread through the blood vessels to the liver and lungs. In addition, pancreatic cancer cells can spread through lymph vessels to nearby lymph nodes. After spreading, the cancer cells may attach to other tissues and grow to form new tumors that may damage those tissues.
Risk Factors
When you get a diagnosis of cancer, it's natural to wonder what may have caused the disease. Doctors can't always explain why one person gets pancreatic cancer and another doesn't. However, we do know that people with certain risk factors may be more likely than others to develop cancer of the pancreas. A risk factor is something that may increase the chance of getting a disease.
Studies have found the following risk factors for cancer of the pancreas:
- Smoking: Smoking tobacco is the most important risk factor for pancreatic cancer. People who smoke tobacco are more likely than nonsmokers to develop this disease. Heavy smokers are most at risk.
- Diabetes: People with diabetes are more likely than other people to develop pancreatic cancer.
- Family history: Having a mother, father, sister, or brother with pancreatic cancer increases the risk of developing the disease.
- Inflammation of the pancreas: Pancreatitis is a painful inflammation of the pancreas. Having pancreatitis for a long time may increase the risk of pancreatic cancer.
- Obesity: People who are overweight or obese are slightly more likely than other people to develop pancreatic cancer.
Many other possible risk factors are under active study. For example, researchers are studying whether a diet high in fat (especially animal fat) or heavy drinking of alcoholic beverages may increase the risk of pancreatic cancer. Another area of active research is whether certain genes increase the risk of disease.
Many people who get pancreatic cancer have none of these risk factors, and many people who have known risk factors don't develop the disease.
Early cancer of the pancreas often doesn't cause symptoms. When the cancer grows larger, you may notice one or more of these common symptoms:
- Dark urine, pale stools, and yellow skin and eyes from jaundice
- Pain in the upper part of your belly
- Pain in the middle part of your back that doesn't go away when you shift your position
- Nausea and vomiting
- Stools that float in the toilet
Also, advanced cancer may cause these general symptoms:
- Weakness or feeling very tired
- Loss of appetite or feelings of fullness
- Weight loss for no known reason
These symptoms may be caused by pancreatic cancer or by other health problems. People with these symptoms should tell their doctor so that problems can be diagnosed and treated as early as possible.
If you have symptoms that suggest cancer of the pancreas, your doctor will try to find out what's causing the problems.
You may have blood or other lab tests. Also, you may have one or more of the following tests:
- Physical exam: Your doctor feels your abdomen to check for changes in areas near the pancreas, liver, gallbladder, and spleen. Your doctor also checks for an abnormal buildup of fluid in the abdomen. Also, your skin and eyes may be checked for signs of jaundice.
- CT scan: An x-ray machine linked to a computer takes a series of detailed pictures of your pancreas, nearby organs, and blood vessels in your abdomen. You may receive an injection of contrast material so your pancreas shows up clearly in the pictures. Also, you may be asked to drink water so your stomach and duodenum show up better. On the CT scan, your doctor may see a tumor in the pancreas or elsewhere in the abdomen.
- Ultrasound: Your doctor places the ultrasound device on your abdomen and slowly moves it around. The ultrasound device uses sound waves that can't be heard by humans. The sound waves make a pattern of echoes as they bounce off internal organs. The echoes create a picture of your pancreas and other organs in the abdomen. The picture may show a tumor or blocked ducts.
- EUS: Your doctor passes a thin, lighted tube (endoscope) down your throat, through your stomach, and into the first part of the small intestine. An ultrasound probe at the end of the tube sends out sound waves that you can't hear. The waves bounce off tissues in your pancreas and other organs. As your doctor slowly withdraws the probe from the intestine toward the stomach, the computer creates a picture of the pancreas from the echoes. The picture can show a tumor in the pancreas. It can also show how deeply the cancer has invaded the blood vessels.
- ERCP: The doctor passes an endoscope through your mouth and stomach, down into the first part of your small intestine. Your doctor slips a smaller tube through the endoscope into the bile ducts and pancreatic ducts. (See picture of ducts.) After injecting dye through the smaller tube into the ducts, the doctor takes x-ray pictures. The x-rays can show whether the ducts are narrowed or blocked by a tumor or other condition.
- MRI: A large machine with a strong magnet linked to a computer is used to make detailed pictures of areas inside your body.
- PET scan: You'll receive an injection of a small amount of radioactive sugar. The radioactive sugar gives off signals that the PET scanner picks up. The PET scanner makes a picture of the places in your body where the sugar is being taken up. Cancer cells show up brighter in the picture because they take up sugar faster than normal cells do. A PET scan may show a tumor in the pancreas. It can also show cancer that has spread to other parts of the body.
- Needle biopsy: The doctor uses a thin needle to remove a small sample of tissue from the pancreas. EUS or CT may be used to guide the needle. A pathologist uses a microscope to look for cancer cells in the tissue.
You may want to ask the doctor these questions before having a biopsy:
- Do you recommend that I have a biopsy? If so, why?
- How long will it take? Will I be awake? Will it hurt?
- Is there a risk that a needle biopsy procedure will cause the cancer to spread? What are the chances of infection or bleeding after the biopsy? Are there any other risks?
- How soon will I know the results? How do I get a copy of the pathology report?
- If I do have cancer, who will talk with me about treatment? When?
If cancer of the pancreas is diagnosed, your doctor needs to learn the extent (stage) of the disease to help you choose the best treatment.
Staging is a careful attempt to find out the following:
- The size of the tumor in the pancreas
- Whether the tumor has invaded nearby tissues
- Whether the cancer has spread, and if so, to what parts of the body
When cancer of the pancreas spreads, the cancer cells may be found in nearby lymph nodes or the liver. Cancer cells may also be found in the lungs or in fluid collected from the abdomen.
When cancer spreads from its original place to another part of the body, the new tumor has the same kind of abnormal cells and the same name as the original (primary) tumor. For example, if pancreatic cancer spreads to the liver, the cancer cells in the liver are actually pancreatic cancer cells. The disease is metastatic pancreatic cancer, not liver cancer. It's treated as pancreatic cancer, not as liver cancer. Doctors sometimes call the new tumor in the liver "distant" disease.
To learn whether pancreatic cancer has spread, your doctor may order CT scans or EUS.
Also, a surgeon may look inside your abdomen with a laparoscope (a thin, tube-like device that has a light and a lens for seeing inside the body). The surgeon inserts the laparoscope through a small incision in your belly button. The surgeon will look for any signs of cancer inside your abdomen. You'll need general anesthesia for this exam.
These are the stages of cancer of the pancreas:
- Stage I: The tumor is found only in the pancreas.
- Stage II: The tumor has invaded nearby tissue but not nearby blood vessels. The cancer may have spread to the lymph nodes.
- Stage III: The tumor has invaded nearby blood vessels.
- Stage IV: The cancer has spread to a distant organ, such as the liver or lungs.
Treatment options for people with cancer of the pancreas are surgery, chemotherapy, targeted therapy, and radiation therapy. You'll probably receive more than one type of treatment.
The treatment that's right for you depends mainly on the following:
- The location of the tumor in your pancreas
- Whether the disease has spread
- Your age and general health
At this time, cancer of the pancreas can be cured only when it's found at an early stage (before it has spread) and only if surgery can completely remove the tumor. For people who can't have surgery, other treatments may be able to help them live longer and feel better.
You may want to talk with your doctor about taking part in a clinical trial. Clinical trials are research studies testing new treatments. They are an important option for people with all stages of cancer of the pancreas. See the Taking Part in Cancer Research section.
You may have a team of specialists to help plan your treatment. Your doctor may refer you to a specialist, or you may ask for a referral. Specialists who treat cancer of the pancreas include surgeons, medical oncologists, radiation oncologists, and gastroenterologists. Your health care team may also include an oncology nurse.
For help relieving or reducing pain, you may work with a specially trained doctor, a nurse, a palliative care team, or another pain control specialist. See the Supportive Care section.
For help reducing eating problems and maintaining your weight, you may work with a registered dietitian. See the Nutrition section.
Your health care team can describe your treatment choices, the expected results of each, and the possible side effects. Because cancer treatments often damage healthy cells and tissues, side effects are common. These side effects depend on many factors, including the type and extent of treatment. Side effects may not be the same for each person, and they may even change from one treatment session to the next. Before treatment starts, ask your health care team about possible side effects and how treatment may change your normal activities. You and your health care team can work together to develop a treatment plan that meets your needs.
You may want to ask your doctor these questions before you begin treatment:
- What is the stage of the disease? Has the cancer spread?
- Do I need any more tests to find out whether I can have surgery?
- What is the goal of treatment? What are my treatment choices? Which do you suggest for me? Why?
- What are the expected benefits of each kind of treatment?
- What can I do to prepare for treatment?
- Will I need to stay in the hospital? If so, for how long?
- What are the risks and possible side effects of each treatment? How can side effects be managed?
- How will you treat my pain?
- What is the treatment likely to cost? Will my insurance cover it?
- How will treatment affect my normal activities? Am I likely to have eating problems or other problems?
- Would a research study (clinical trial) be a good choice for me?
- Can you recommend other doctors who could give me a second opinion about my treatment options?
- How often should I have checkups?
SurgerySurgery may be an option for people with an early stage of pancreatic cancer. The surgeon usually removes only the part of the pancreas that has cancer. But, in some cases, the whole pancreas may be removed.
The type of surgery depends on the location of the tumor in the pancreas. Surgery to remove a tumor in the head of the pancreas is called a Whipple procedure. The Whipple procedure is the most common type of surgery for pancreatic cancer. You and your surgeon may talk about the types of surgery and which may be right for you.
In addition to part or all of your pancreas, the surgeon usually removes the following nearby tissues:
- Duodenum
- Gallbladder
- Common bile duct
- Part of your stomach
Also, the surgeon may remove your spleen and nearby lymph nodes.
Surgery for pancreatic cancer is a major operation. You will need to stay in the hospital for one to two weeks afterward. Your health care team will watch for signs of bleeding, infection, or other problems.
It takes time to heal after surgery, and the time needed to recover is different for each person. You may have pain or discomfort for the first few days. Medicine can help control your pain. Before surgery, you should discuss the plan for pain relief with your health care team. After surgery, they can adjust the plan if you need more pain control. See the Supportive Care section.
It's common to feel weak or tired for a while. You may need to rest at home for one to three months after leaving the hospital.
After surgery, it may be hard to digest food. For four to six weeks after Whipple surgery, you may feel bloated or full, and you may have nausea and vomiting. A dietitian can help you change your diet to reduce your discomfort. Problems with eating usually go away within three months. See the Nutrition section.
You may want to ask your doctor these questions before having surgery:
- What type of surgery do you recommend for me? Why?
- Will tissues other than the tumor in the pancreas be removed? Why?
- How many times have you performed this surgery? How many pancreatic cancer patients do you treat each year?
- How will I feel after surgery?
- Am I likely to have eating problems? Will I need a special diet? Who can help me if I have a problem?
- If I have pain, how will you control it?
- How long will I be in the hospital?
- Will I have any long-term effects because of the surgery?
Chemotherapy uses drugs to kill cancer cells. Most people with pancreatic cancer get chemotherapy. For early pancreatic cancer, chemotherapy is usually given after surgery, but in some cases, it's given before surgery. For advanced cancer, chemotherapy is used alone, with targeted therapy, or with radiation therapy.
Chemotherapy for pancreatic cancer is usually given by vein (intravenous). The drugs enter the bloodstream and travel throughout your body.
Chemotherapy may be given in an outpatient part of the hospital, at the doctor's office, or at home. Rarely, you may need to stay in the hospital.
The side effects depend mainly on which drugs are given and how much. Chemotherapy kills fast-growing cancer cells, but the drugs can also harm normal cells that divide rapidly:
- Blood cells: When drugs lower the levels of healthy blood cells, you're more likely to get infections, bruise or bleed easily, and feel very weak and tired. Your health care team will check for low levels of blood cells. If your levels are low, your health care team may stop the chemotherapy for a while or reduce the dose of the drug. There are also medicines that can help your body make new blood cells.
- Cells in hair roots: Chemotherapy may cause hair loss. If you lose your hair, it will grow back after treatment, but the color and texture may be changed.
- Cells that line the digestive tract: Chemotherapy can cause a poor appetite, nausea and vomiting, diarrhea, or mouth and lip sores. Your health care team can give you medicines and suggest other ways to help with these problems. They usually go away when treatment ends.
Some drugs used for pancreatic cancer also may cause tingling or numbness in your hands and feet. Your health care team can suggest ways to control many of these side effects.
You may wish to read the NCI booklet Chemotherapy and You.
Targeted Therapy
People with cancer of the pancreas who can't have surgery may receive a type of drug called targeted therapy along with chemotherapy.
Targeted therapy slows the growth of pancreatic cancer. It also helps prevent cancer cells from spreading. The drug is taken by mouth.
Side effects may include diarrhea, nausea, vomiting, a rash, and shortness of breath. You may want to read the NCI fact sheet Targeted Cancer Therapies.
You may want to ask your doctor these questions about chemotherapy or targeted therapy:
- Why do I need this treatment?
- Which drug or drugs will I have?
- How do the drugs work?
- When will treatment start? When will it end?
- Will I have any long-term side effects?
Radiation Therapy
Radiation therapy uses high-energy rays to kill cancer cells. It can be given along with other treatments, including chemotherapy.
The radiation comes from a large machine. The machine aims beams of radiation at the cancer in the abdomen. You'll go to a hospital or clinic 5 days a week for several weeks to receive radiation therapy. Each session takes about 30 minutes.
Although radiation therapy is painless, it may cause other side effects. The side effects include nausea, vomiting, or diarrhea. You may also feel very tired. Your health care team can suggest ways to treat or control these side effects.
You may find it helpful to read the NCI booklet Radiation Therapy and You.
You may want to ask your doctor these questions about radiation therapy:
- Why do I need this treatment?
- When will the treatments begin? When will they end?
- How will I feel during treatment?
- How will we know if the radiation treatment is working?
- Will I have any long-term side effects?
Second Opinion
Before starting treatment, you may want a second opinion about your diagnosis, the stage of cancer, and the treatment plan. You may also want to find a medical center that has a lot of experience treating people with pancreatic cancer.
Some people worry that the doctor will be offended if they ask for a second opinion. Usually the opposite is true. Most doctors welcome a second opinion. And many health insurance companies will pay for a second opinion if you or your doctor requests it. Some companies require a second opinion.
If you get a second opinion, the second doctor may agree with your first doctor's diagnosis and treatment plan. Or, the second doctor may suggest another approach. Either way, you have more information and perhaps a greater sense of control. You can feel more confident about the decisions you make, knowing that you've looked at all of your options.
It may take some time and effort to gather your medical records and see another doctor. In most cases, it's not a problem to take several weeks to get a second opinion. The delay in starting treatment usually will not make treatment less effective. To make sure, you should discuss this delay with your doctor.
There are many ways to find a doctor for a second opinion. Ask your doctor, a local or state medical society, or a nearby hospital or medical school for names of specialists.
Also, you can request a consultation with specialists at the National Institutes of Health Clinical Center in Bethesda, Maryland. Specialists in NCI's Surgery Branch provide consultations and surgical care for people with pancreatic cancer. The telephone number is 301– 496– 4164.
In addition, you can get information about treatment centers near you from NCI's Cancer Information Service at 1–800–4–CANCER (1–800–422–6237) and LiveHelp.
Other sources can be found in the NCI fact sheet How To Find a Doctor or Treatment Facility If You Have Cancer.
Supportive Care
Cancer of the pancreas and its treatment can lead to other health problems. You can have supportive care before, during, and after cancer treatment.
Supportive care is treatment to control pain and other symptoms, to relieve the side effects of therapy, and to help you cope with the feelings that a diagnosis of cancer can bring. You may receive supportive care to prevent or control these problems and to improve your comfort and quality of life during treatment.
Go to NCI's Web site at http://www.cancer.gov/cancerinfo/coping or contact NCI's Cancer Information Service at 1–800–4–CANCER (1–800–422–6237) or LiveHelp for information about supportive care.
Pain Control
Cancer of the pancreas and its treatment may lead to pain. Your doctor or a specialist in pain control can suggest ways to relieve or reduce pain. You may want to ask if your hospital has a palliative care team.
There are many ways to relieve or reduce pain:
- Pain medicine: Your health care team can suggest medicines that will relieve pain. If you have constipation or other side effects from the medicine, your health care team will help you manage the problems.
- Nerve block: The doctor may inject alcohol into the area around certain nerves in the abdomen to block the pain.
- Other methods: You may find that massage or acupuncture helps relieve pain. Also, you may learn other methods, such as hypnosis, relaxation, music therapy, imagery, and biofeedback.
More information about pain control can be found in the NCI booklet Pain Control.
If the tumor in the pancreas grows large enough to squeeze the common bile duct or block the duodenum, your health care team can suggest ways to help:
- Surgery: The surgeon can create a bypass through the blocked bile duct or duodenum. A bypass allows fluids to flow through the digestive tract. It can help relieve jaundice and pain resulting from the blockage.
- Stent: The doctor uses an endoscope to place a stent in the blocked area. A stent is a tiny plastic or metal mesh tube that helps keep the duct or duodenum open.
Sadness and Other FeelingsIt's normal to feel sad, anxious, or confused after a diagnosis of a serious illness. Some people find it helpful to talk about their feelings. See the Sources of Support section.
Nutrition is an important part of your care. Getting the right nutrition can help you feel better and have more strength. However, pancreatic cancer and its treatment may make it hard for you to digest food and to maintain your weight. You may not feel like eating for a variety of reasons, such as feeling tired or feeling full soon after eating.
You may find it helpful to work with a dietitian. A dietitian can help you choose foods and nutrition products that will meet your needs and can make you feel more comfortable with eating. Your health care team will check you for weight loss and ask whether you are having problems with nausea, vomiting, or diarrhea. If your nutrition problems do not get better quickly enough, you may be offered another way of getting nutrition, such as a feeding tube.
For general information about nutrition during cancer treatment, you may want to read the NCI booklet Eating Hints. It contains useful ideas and recipes.
Nutrition after Surgery
After surgery, your health care team will check you for problems with digestion or with your blood sugar level, and they will help you manage such changes. If you have problems with digestion, you may need to take a supplement to replace the digestive enzymes that are normally made by the pancreas. You may also need to take minerals and vitamins. If you have problems with the sugar level in your blood, you may need to take medicine to control blood sugar.
Follow-up Care
You'll need regular checkups (such as every 3 months) after treatment for cancer of the pancreas. Checkups help ensure that any changes in your health are noted and treated if needed. If you have any health problems between checkups, you should contact your doctor.
Cancer of the pancreas may come back after treatment. Your doctor will check for return of cancer. Checkups may include a physical exam, blood tests, or CT scans.
NCI has publications to help answer questions about follow-up care and other concerns. You may find it helpful to read the NCI booklet Facing Forward: Life After Cancer Treatment. You may also want to read the NCI fact sheet Follow-up Care After Cancer Treatment.
Sources of Support
Learning that you have cancer of the pancreas can change your life and the lives of those close to you. These changes can be hard to handle. It's normal for you, your family, and your friends to need help coping with the feelings that a diagnosis of cancer can bring.
Concerns about treatments and managing side effects, hospital stays, and medical bills are common. You may also worry about caring for your family, keeping your job, or continuing daily activities.
Here's where you can go for support:
- Doctors, nurses, and other members of your health care team can answer questions about treatment, working, or other activities.
- Social workers, counselors, or members of the clergy can be helpful if you want to talk about your feelings or concerns. Often, social workers can suggest resources for financial aid, transportation, home care, or emotional support.
- Support groups also can help. In these groups, patients or their family members meet with other patients or their families to share what they have learned about coping with the disease and the effects of treatment. Groups may offer support in person, over the telephone, or on the Internet. You may want to talk with a member of your health care team about finding a support group.
- NCI's Cancer Information Service at 1–800–4–CANCER (1–800–422–6237) and at LiveHelp can help you locate programs, services, and NCI publications. They can send you a list of organizations that offer services to people with cancer.
For tips on coping, you may want to read the NCI booklet Taking Time: Support for People With Cancer.
Taking Part in Cancer Research
Doctors all over the world are conducting many types of clinical trials (research studies in which people volunteer to take part). Clinical trials are designed to find out whether new treatments are safe and effective.
Doctors are studying new drugs, other treatments, and their combinations, including combinations of surgery, chemotherapy, targeted therapy, and radiation therapy.
Even if the people in a trial do not benefit directly, they may still make an important contribution by helping doctors learn more about cancer of the pancreas and how to control it. Although clinical trials may pose some risks, doctors do all they can to protect their patients.
If you're interested in being part of a clinical trial, talk with your doctor. You may want to read the NCI booklet Taking Part in Cancer Treatment Research Studies. It describes how treatment studies are carried out and explains their possible benefits and risks.
NCI's Web site includes a section on clinical trials at http://www.cancer.gov/clinicaltrials. It has general information about clinical trials as well as detailed information about specific ongoing studies of cancer of the pancreas. NCI's Cancer Information Service at 1–800–4–CANCER (1–800–422–6237) and at LiveHelp can answer questions and provide information about clinical trials.
Also, you may wish to contact NCI's Surgery Branch at the National Institutes of Health Clinical Center in Bethesda, Maryland. The telephone number is 301– 496– 4164.


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Latest News
Recipes Remembered
We are delighted to announce the publication of Recipes Remembered, a collection of dishes and stories compiled from the refugees from Central Europe who fled Nazi oppression and who rebuilt their lives in Britain.
Recipes Remembered is not your average recipe book; it is a miscellany of tastes, aromas and recollections of times of privation or prosperity, prepared and eaten at a time when the world was a very different place. The book conjures up memories of childhood and of recipes passed down through generations of families, beautifully preserved for posterity
AJR Director Michael Newman said: "We are very grateful to AJR member Dorothy Fleming who conceived the idea and to AJR volunteer Pippa Landey for all her hard work to compile this wonderful and evocative collection. The recipes and accompanying stories in Recipes Remembered are tinged with nostalgia and are a fitting legacy of the people whose lives were devastated by the Holocaust."


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I have special needs, how can the New York State Public Service Commission help me?
The New York State Public Service Laws and the Public Service Commission's Telephone Rules offer protection for residential gas, electric, and steam consumers, including special protections for gas, electric, steam and telephone consumers with special skills.
More Info
The Handbook for Utility Customers with Disabilities
Highlights of the Home Energy Fair Act
URL: http://www.dps.ny.gov/disable.html


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What it Means to Learn to Cook: A Peek into the Istanbul Culinary Institute
During my recent trip to Turkey, I spent a day at the Istanbul Culinary Institute. At the outset, my intention was to share some stories and photographs with you, and encourage you to check it out the next time you're in Istanbul. Then yesterday, when I was thinking about why I started this website, something more meaningful came to my mind, and as I sorted through the photographs and the ideas I'd jotted down in my notebook that day, it became clear.
The most spirited images I had were the ones that showed how joyful this process is of learning to cook. The class was intimate, barely ten students, all women. There was laughter and focus. I even saw one little tear fall.
The setting was familiar — I too went to culinary school — but as I looked deeper, I saw that the setting was one we have all experienced; it is the kitchen. The warm, fragrant place where we make the food that feeds us, and if we're lucky, someone occasionally shows us the best way to peel an apple or dredge a piece of meat.
What this place really evoked in me is not an urge to encourage you to sign up for a class there (though if you are in Istanbul you must at least have a meal in their restaurant), but rather, a desire to talk about how we learn to cook.
I bristle when I hear the term "self-taught cook" because while I know not everyone has attended culinary school, and that this may in fact be an advantage, no one learns to cook in isolation. It's impossible. Even if you cook for yourself only, you interact with your community; your grocer, farmer, the neighbor who smells it happening, the co-worker who watches you eat the leftovers.
When I think of all the places we learn to cook, the common denominator is community. Often it starts in our childhood kitchens. Grandparents are sometimes there, too. Then we make our way into adulthood figuring out how to fill our growing bellies. Then maybe we wise-up and start looking at the quality and quantity of our food. Maybe we take a class or two, start reading more cookbooks in bed, browsing online resources and subscribing to magazines.
The heart of the action happens when we cook with others, and that's the spirit I felt during my day at this school. It wasn't the terminology or the chef's coats that made it a learning experience. It was the way the women shared it together.
For those of you learning to cook at home, know that when you have someone to dinner, and you talk about the food, the learning grows exponentially. That's what happens when we gather together to eat.
I should note that I was especially excited to visit the Istanbul Culinary Institute because the intro came through one of our writers, Leela Cyd Ross (who wrote about her time at the Institute in the post she wrote as a try-out for the job) and because it promised to be a very local, tourist-free experience. And it was. So if you do find yourself in Istanbul, I encourage you to take one of their one-day classes, or at least have a meal in their restaurant.
(Images: Sara Kate Gillingham-Ryan)
18 Comments
love this! thanks for sharing your experience and reminding me of how much i love istanbul. i also took a cooking class there once, but now i can't wait to go back to visit the ICI for more!
Beautiful pictures, too. Another destination added to the list. We seem to have forgotten in our fast-food age, but food has always been about community.
You're completely right about the term self-taught cook. It's making me rethink calling myself that. It's like with everything in life, we don't learn or make it to where we are in a vacuum. What's a better term to call ourselves if we have never attended culinary school?
I love this post. No man (or woman) is an island.
I felt a similar sense of community at a pasta making class that I recently took in NYC. Cooking with others is the best...
I also have always called myself "self-taught" because my mother was a very plain cook and, with 8 kids under her feet, she never really had the time to teach me (being the only girl!). I started learning once I moved out of my parents' house. Now I consider myself a good cook and my husband does also!
I generally start with a cookbook and make changes to make the recipe "mine".
I loved your comment about "the co-worker who watches you eat the leftovers", that happens to me everyday at work! One woman always walks by and asks "and what do you have today?".
I look forward to your posts showing up in my inbox at work, I read them while eating my leftovers! Keep them coming.
I learned the basics of cooking from my mom who was a pretty good cook and from Home Economics class when I was in high school a zillion or so years ago. But that was basics, and the good cook that I've become is a result of the many opportunities I've had to learn over the many years since. While there was certainly initiative and opportunity, it was from the influence of others that I learned. I could never say that I am self-taught. I also love your blog --keeps me inspired to try new things.
looks like such a fun class.
Stacey ann Dolenti
This post first made me smile because of the fact that the pictures from my own city. The second emotion was warmth that filled my heart, the familiar feeling of the excite behind each and every try, each and every taste. Then I felt glad and proud because this site is one of my secret joys that I occasionally share with my friends. I'm still learning to cook and I believe that one day I will be as good as my mother while she is an amazing cook. I was lucky for having such an amazing mother and an equally amazing father who also loves cooking. We all have different ways of thinking and different ideas about food so our table is mostly a mixture of these. A kitchen where you can share the ideas and food :)
I was in Instanbul last month and walked right past the Culinary Institute. I really wish I'd gone in!!
You're so right no one learns to cook in isolation. I tell people I'm a self taught cook but I'm going to stop saying that because it's not true. I learned from others around me for sure.
My mother used to say,"If you can read, you can cook. Most people can't read." Mind you she also said that about sewing as well! A couple of years ago my daughters and I took a cooking class in Ubud, Bali. It was a great way to make friends and get the lowdown on the great places to eat in Ubud.
Then how would you have those of us who learned to cook on our own, without input from a family member or friend, refer to ourselves? My mother is a spectacularly bad cook who never allowed anyone to work in her kitchen or cared that her food was awful, and neither of my grandmothers could cook or were involved enough in my life to teach me anything (they both lived in other states). What I've learned is through a combination of reading, television, and pure trial and error.
I tell people I'm an enthusiastic home cook. Sometimes I say passionate, depends on my mood. My mother hated cooking so I say I learned to cook out of self defense. ;-)
Bertholle, Beck & Child and my own senses of taste, smell & sight taught me how to cook - they and numerous other recipe-writers, published & unpublished, famous & obscure, who continue to teach me still.
When I wrote my 1st cookbook, Stir, Laugh, Repeat it was due to my daughter asking for my Banana Puddin' recipe before I died but as I went along adding other recipes I remembered stories, which I added, about the mistakes I made while learning to cook. Then it hit me! I'm a baby boomer and worked when my kids were growing up. I didn't teach them to cook! They now have families of their own and with them too working plus after school activities, they have even less time to teach. To me, teaching a young person, child and even adults to cook is so important and I'm thrilled to see others doing this.
I heard about your visit to Turkey too late to invite you to see what real Turkish cooking spirit and lifestyle is. Culinary institutes are good for learning how to cook but I wish you could have also visited homes where the real culture of cooking lies. It is a tradition handed down from generations. My grandmother taught my mom and even though I grew up in the US my mom taught me and now I am sharing it with whoever I can. This, you can't see or experiencel in a school.
great post! ...and I have to say I love those striped aprons!
I certainly learned to cook in my childhood home. Both my parents cooked well, and we sat down as a family nightly (this was the 1950s - '70s). Salads and scrambled eggs were my first talents. It's interesting now to see how my cooking varies from what I learned at home. I certainly use more fresh fruits and vegetables and less canned and frozen. And as a child I was never served fresh artichokes or broccoli! And I have never made a Jello mold. Bread, cookies and desserts came from the store, but I bake weekly. My father's cooking was original and inventive -- and quite good. My mother, however, didn't particularly like cooking but did it excellently. Out of respect for that, once he retired, my father took over the dinner cooking and clean up for a number of years.
Now I have married children and I have had the pleasure of my daughters-in-law thanking me that their husbands cook.


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March 24, 2014
March 1, 2014
February 28, 2014
NDP MPs on Wednesday morning at the corner of Metcalfe and Wellington streets outside the Langevin Block, where the prime minister has an office, across the street from Parliament Hill. They include Rosane Doré Lefebvre, far left, Hélène Laverdière, second from right, and Charlie Angus, far right.
NDP MP Charlie Angus and other MPs wait in front of the prime minister's office at Langevin Block, after leaving the Hill on Wednesday morning.
Ottawa Police cars on Wellington Street in front of the Hill on the morning of the attack.
RCMP officers on Sparks Street between Elgin and Metcalfe streets on Wednesday morning. Surroundings buildings were locked down and later evacuated.
Reporters and camera crews are pushed back to the corner of Sparks and Metcalfe streets.


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Welcome to Black Dog of Wells
The Black Dog of Wells workshop is situated in the heart of the beautiful City of Wells in Somerset. We create and market a unique range of intricate handcrafted bas relief tiles in natural terracotta which are full of detail and texture. These wall tiles are designed by prominent artist/designer Philippa Threlfall, who for many years has been making decorative tiles and ceramic murals which can be seen all over the country.
Made in Britain ~ we hand make all our wall plaques at our workshops in Wells.
Customer Reviews - click here to read many more!
Saw your tiles in various shops over the years. Thought I'd see if you were online. Thrilled to find you are!
Oxford, UK
Love the work and love the history cards on the packaging. The whats and wheres give the product even more uniqueness.
Scotts Valley, California, USA
Our Customer Gallery shows our wall plaques placed in a number of situations around the home. You may get some inspiration from here or you might have found great spots for your own tiles. If you can take a good image, you can take advantage of our free tile for your photograph(s) offer - please click here for details.


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166394536742048Water Bottle Labels
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Build brand awareness with personalized Water Bottle Labels! Change the colors to brand your event—then personalize the fonts, wording, and/or photos.


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OPTIMAXX® LED Aquarium Light Smart System. For SPS LPS Corals and Planted Biotopes.
Genuine CREE™ LED AQUARIUM LIGHT - MODULAR INTERCHANGEABLE LEDS
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