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Put an Old Trans Behind Your New Gen III V-8Written by Jeff Smith on October 1, 2008 Score A Junkyard 6.0L? Save Money And Put an Early Transmission Behind a Gen III Block
Engine and transmission swapping is the heart of car crafting. The GM Gen III/IV (4.8L through 6.2L engines from 1998 to present) engine swap is quickly becoming the new classic with GM musclecar movers and shakers. Up until now, a Gen III/IV engine also demanded using a late-model transmission, either a Gen III/IV-dedicated 4L60E automatic or a six-speed manual. These trans choices not only limit creativity but also tend to be more expensive. The latest move is using older transmissions, such as Gen I four- and five-speed manual gearboxes along with the classic TH350/TH400 three-speed autos and the 700-R4 and 200-4R four-speed automatic overdrives. All these transmissions can be adapted to Gen III/IV engines if you know the tricks, and that's what this story will detail. Car Craft has done all the research so all you have to do is follow the outline and save yourself money, time, and effort.
We'll break this story into sections for manual transmissions and automatics. The automatic side is pretty easy, so we'll save that for last. The manual trans info isn't difficult, but there are a few essential details that make the swap a bolt-in, so we'll start there.
Manual Trans Swaps
When GM decided to build the new Gen III small-block that would become the LS1, GM's engineers carried over a couple of important design characteristics that make it easy to retrofit newer engines into older cars. It's doubtful that GM considered car crafters' requirements when it designed these new Gen III/IV engines, but regardless of the company's agenda, it did us a couple of big favors. The first gift is that the Gen III/IV bellhousing pattern is almost identical to the original small-block Chevy. Five of the six bellhousing bolts are in exactly the same location, as are the size and location of the two dowel pins. This one fact allows us to make everything else work. The Gen III/IV bolt pattern is not symmetrical, which is odd, and the top center bolt is employed while the upper passenger side bolt is not. But if using five of the six bolts works for you, then everything else is easy. As you will see, there are plenty of options that allow you to use all six bolts.
Unfortunately, GM engineers also added a few hurdles just to make this swap game more challenging. First and foremost, the crankshaft flange on a Gen III/IV engine is essentially even with the bellhousing flange on the block. On the original small-block and big-block Chevy engines, the crankshaft flange extends 0.400 inch farther rearward (aft, if you're nautically inclined) of the bellhousing flange. This is the critical differential measurement that defines all the other modifications we have to make to adapt earlier transmissions.
Another important piece to this swap puzzle is that all Gen III/IV engines use a distinct crankshaft mounting flange. This means now we have three separate crank flanges: the Gen I small-block with a two-piece rear main seal, the Gen I with a one-piece rear main seal, and now the Gen III/IV engines with their one-piece rear main seal. While this should come as no surprise, the Gen III/IV engines are now completely metric, demanding all new fasteners. Obviously, this means Gen I flywheels and flexplates will not interchange with a Gen IIII/IV engine. One other important tech tidbit is that all Gen III/IV engines use a 168-tooth flywheel or flexplate.
Given all this, the quickest way to adapt an early four- or five-speed manual trans to a Gen III/IV engine is to make up this 0.400-inch difference in crankshaft flange position. McLeod Clutches, which was recently purchased by B&M, has solved this problem with a 168-tooth flywheel that will bolt up to the Gen III/IV crankshaft and extends the flywheel face by exactly 0.400 inch. This places the clutch and pressure plate surface at the correct height so you can either bolt on a new clutch and pressure plate assembly or use a Gen I clutch and pressure plate assembly you already have. This custom McLeod flywheel is drilled to accept the traditional 11-inch Borg & Beck/diaphragm-style pressure plate bolt pattern using original 3/8-inch shouldered pressure plate bolts.
Before we bolt on the bellhousing, there is one other crucial step that must not be overlooked. It should be common knowledge that a pilot bushing positioned in the end of the crankshaft supports the transmission input shaft, preventing deflection when the clutch is disengaged. In our trans-swapping effort, remember that while the depth of our bellhousing is the same as with a Gen I engine, the crankshaft flange is 0.400 inch farther forward. Since the input shaft length on our traditional four-speed or five-speed transmission has not changed, we also have to move the position of the pilot bushing rearward to compensate for the discrepancy. McLeod has again come to the rescue with an adapter pilot bushing that sits in the larger recess in the crank and therefore supports the input shaft in the proper location. If you don't pay attention and incorrectly place a stock pilot bushing in the original spot in the Gen III/IV crank, the transmission input shaft will not be supported and the input shaft bearing will fail almost immediately. We also discovered that GM makes a special LS2/LS7 pilot bearing that will adequately support the shorter input shaft.
This brings us to the bellhousing. Because all Gen III/IV engines use a 168-tooth flywheel and flexplate diameter, not all small-block Chevy bellhousings will work when it comes to bolting on an older four- or five-speed manual trans. This larger flywheel requires the rare 11-inch-style bellhousing. To use the larger flywheel, you'll either have to dig up a used 11-inch bellhousing or scattershield, or you can order a brand-new aluminum factory-style bellhousing from Keisler that will not only accommodate the larger flywheel but is drilled for the Gen I and Gen III/IV bolt patterns. One thing we discovered is the Keisler bellhousing is cast 0.200 inch deeper than a standard GM bellhousing. The standard GM bellhousing depth is 6.290 inches from the engine bellhousing face to the transmission mounting face, while the Keisler specs out at 6.490 inches. This affects input shaft placement relative to the crank as well as the position of the clutch disc. Another option is using a scattershield from Quick Times that also combines the Gen III/IV bolt pattern with the standard Gen I-style bell-housing depth.
We're not quite there yet. We prefer to keep everything simple by retaining the original mechanical clutch linkage, avoiding the added expense of a hydraulic system. The problem is Gen III/IV engines do not have a provision in the block for the engine-mounted ball stud pivot for the clutch linkage Z-bar. While discussing this with Scoggin-Dickey Parts Center's (SDPC) Nickey Fowler, he mentioned SDPC makes an adapter bracket originally designed for the Gen V/VI factory Rat blocks that also did not come with this ball stud provision. This SDPC bracket bolts to the lower two bellhousing bolts on the driver side and places the ball stud in exactly the right position for the Z-bar. This is the best scenario for adapting a Gen I-style manual trans behind a Gen III/IV engine that is easy and not overly expensive.
Not-So Shortcuts
Car crafters are the masters of adapting parts to achieve a solution. As you might have guessed, there are other ways to arrive at adapting a Gen I four- or five-speed manual trans behind a Gen III/IV engine. One idea involves using a Gen III/IV flywheel. Bolting on a stock metric Gen III/IV flywheel is easy, but again, it will also be short by 0.400 inch. According to McLeod, a production Gen III/IV pressure plate and clutch assembly stands roughly 1 inch taller than a Gen I diaphragm pressure plate. Even accounting for the shorter Gen III/IV flywheel, this places the metric pressure plate fingers roughly 0.600 inch taller than a Gen I system. Since this does not allow sufficient room for the release arm bearing, it won't work.
However, if you have a good Gen III/IV flywheel, you could have a machine shop drill it for the standard diaphragm counterbored bolt pattern using the correct 3/8-inch shouldered bolts. As you will discover, the stock metric pressure plate bolt pattern is the same as the Gen I 11-inch diaphragm pressure plate pattern. Do not use the Gen III metric bolt holes to attach an old-style pressure plate because these bolt holes are not counterbored and will not properly locate the pressure plate. All Gen III/IV metric pressure plates use a pair of small drive pins as locators. Since this conversion will use the 3/8x16 shouldered bolts, machining a separate bolt pattern and counterboring the bolt holes for the shouldered bolts will be necessary.
This combination of a short flywheel and standard-height pressure plate package will also place the pressure plate fingers roughly 0.400 inch farther forward, which screws up the linkage geometry. There are actually two quick fixes for this situation. McLeod makes an adjustable-height throwout bearing that is taller and will compensate for the shorter flywheel. It runs a little less than $95, compared with the standard bearing of around $65. The second route is a taller GM release arm ball stud or an adjustable ball stud from McLeod that allows you to set the proper height of the release arm and optimize the release arm geometry. Ideally, you want to position the outboard portion of the release arm (the part actuated by the clutch linkage) angled slightly toward the front of the car. This position minimizes linkage movement while maximizing throwout bearing travel. The best choice would probably be the taller GM ball stud at less than $15.
Unfortunately, there's a downside to this approach. Because the Gen III/IV flywheel is 0.400 inch short in relation to the transmission input shaft, the clutch disc hub will ride on the input shaft very close to the end of the splines. While the input shaft is supported, this unusual location may create an additional load that could adversely affect the longevity of the pilot bushing and/or the transmission input shaft bearing. This condition is made even worse when using the Keisler bellhousing with its 0.200-inch increased depth. Buying a new Gen III/IV flywheel and then investing additional money in machine work may end up costing more than the McLeod flywheel. Given those realities, there are several reasons why the McLeod custom flywheel is the best overall choice.
Gen I Automatics Behind Gen III/IV Engines
The same mismatch between the 0.400-inch-shorter crank flange position relative to the bellhousing is what makes matching up a typical TH350/TH400/200-4R or early 700-R4 to a Gen III/IV engine a bit different. The beauty of this swap is most of the mismatch situations can be solved with the use of a simple steel adapter. GM actually faced an identical situation when bolting the 4L80E automatics behind 5.3L and 6.0L engines in larger trucks. The 4L80E automatic is basically a Gen I-style automatic, which required an adapter. To compensate, GM created a simple steel spacer that bolts on the Gen III/IV crank flange and combines with a flat flexplate. All this information is published in the GM Performance Parts LS1 engine swapping performance pamphlet. The adapter and flat flexplate, along with longer metric bolts, are intended to be used together and will allow you to bolt any Powerglide, TH350, TH400, 700-R4, or 200-4R automatic to a Gen III/IV version engine. The part numbers for these pieces can be found in the parts list at the end of this story.
Unfortunately, there are also a few minor details that need to be addressed. For example, the flat flexplate used with the spacer is designed for a 300mm (11.8-inch) bolt pattern, while most Gen I transmission torque converters use an 11.7-inch bolt pattern. The difference between these two bolt patterns ends up being roughly around 1/8 inch. As you can see in the photo, the 300mm bolt pattern holes can be carefully elongated with a file or die grinder to accommodate the smaller Gen I converter bolt pattern.
We dug a little deeper and discovered TCI makes a similar package that offers an SFI-approved performance flexplate and includes the adapter and bolts, all for an excellent price through SDPC. This flexplate bolts up to the Gen III/IV crankshaft and also features a dual converter bolt pattern that will accommodate both the early and metric torque converter bolt patterns, so no modifications are necessary. Just bolt it up and go. It doesn't get any easier than that.
|(ft-lb, unless specified)
|Flywheel bolts
|15 (1st pass)
37 (2nd pass)
74 (final pass)
|Bellhousing bolts
|Pressure plate bolts, ARP
|Gen I '55 to '86
|Gen I '87 to current
|Gen III/IV '97 to current
|GMPP flexplate spacer
|GM flexplate for spacer
|GM metric flexplate bolts (6)
|2.52 ea.
|GM LS1 Engine Kit Install Guide
|Hughes SFI flexplate, 168-tooth
|{{{Summit}}} Racing
|Hughes crankshaft adapter
|Summit Racing
|TCI Gen III/IV flexplate w/ext.
|TCI Gen III/IV pilot extension
|Summit Racing
|Scoggin-Dickey clutch bracket
|Keisler LS1 bellhousing
|Keisler Engineering
|Quick Time bellhousing
|Speedway Motors
|McLeod flywheel
|{{{Summit}}} Racing
|McLeod disc, 11-inch, 26-spline
|Summit Racing
|McLeod pressure plate, 11-inch
|Summit Racing
|McLeod clutch fork
|Summit Racing
|McLeod adjustable ball stud
|Summit Racing
|McLeod stock throwout bearing
|Summit Racing
|McLeod adjustable throwout bearing
|Summit Racing
|McLeod adapter pilot bushing
|Summit Racing
|GM Gen III/IV flywheel
|GM metric pressure plate bolts (6)
|0.56 ea.
|GM LS2/LS7 pilot bearing
|GM ball stud, short
|GM ball stud, long
|ARP metric flywheel bolts
|Summit Racing
|ARP metric flexplate bolts
|Summit Racing
|ARP metric pressure plate bolts
|Summit Racing
|ARP metric bellhousing bolts
|Summit Racing
|Throwout fork boot
|Year One
Breaking news!!! Roswell UFO incident turns out to be a pressure plate.
More Photos From This Article View Slideshow
To use the stock mechanical clutch linkage when swapping in a Gen III/IV engine means placing the new engine in the correct position in relation to the bellhousing mounting face. To ensure accurate engine location, Scoggin-Dickey makes the Gen III/IV custom engine mounts shown here on an iron 6.0L block.After we removed the machining block provision, the Scoggin-Dickey clutch linkage ball adapter still hit the outside edge of the Keisler bellhousing, which will require minor filing and a thin AN washer under the adapter to compensate for the Keisler spot facing. This positioned everything properly using the two lower bolt holes on the driver side of the bellhousing.Adapting an early manual transmission using a Gen I-style pressure plate on a Gen III/IV flywheel places the clutch hub too far forward on the input shaft. In certain situations, this could lead to only half the disc hub engaged on the input shaft -which is not good. By using the McLeod 0.400-inch-taller flywheel, the clutch disc hub is positioned farther back on the input shaft splines.The adapter installs on the crank flange first and then the flexplate is bolted place. Note the two threaded holes in the adapter. These holes are used to mount a puller to remove the adapter from the crank flange because the register between these two parts can be tight. Longer bolts are also necessary to ensure the adapter is properly attached to the crank flange.The steel adapter extends the crank flange rearward by 0.400 inch to support the end of the torque converter.The GM flexplate is designed for the late-model 300mm (11.8 inches) converter bolt pattern, while older transmissions like the TH350 and TH400 use a slightly smaller 11.75-inch pattern. Minor die-grinder work to elongate the bolt holes will remedy the situation. As an alternative, TCI sells a Gen III/IV SFI flexplate and spacer package that will bolt up to the older converter pattern.


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i fitted a set of cheap "thin" (racing bike size) rims with 32 mm tyres. the fork allows even bigger tyres to be mounted. is it a problem if i fit the bike with Deore LX v-brakes ? will it brake decently ? and what handles would u recommend?
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32mm tires with v-brakes is a very common configuration on hybrids. You should have no problem with this.
Assuming that your frame has the mounts for v-brakes, there is no reason why the rim should prevent you from using them.
There are a number of bicycle types which use standard road rims which are designed with v-brakes or mini v-brakes.
You do need to pay attention to the type of brake lever, since most road levers and a lot of older MTB levers are not compatible with v-brakes, or at least require mini v-brakes because of the amount of cable pull required.

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Millions of women experience involuntary loss of urine called urinary incontinence (UI). Some women may lose a few drops of urine while running or coughing. Others may feel a strong, sudden urge to urinate just before losing a large amount of urine. Many women experience both symptoms. UI can be slightly bothersome or totally debilitating. For some women, the risk of public embarrassment keeps them from enjoying many activities with their family and friends. Urine loss can also occur during sexual activity and cause tremendous emotional distress.
Women experience UI twice as often as men. Pregnancy and childbirth, menopause, and the structure of the female urinary tract account for this difference. But both women and men can become incontinent from neurologic injury, birth defects, stroke, multiple sclerosis, and physical problems associated with aging.
Older women experience UI more often than younger women. But incontinence is not inevitable with age. UI is a medical problem. Your doctor or nurse can help you find a solution. No single treatment works for everyone, but many women can find improvement without surgery.
Incontinence occurs because of problems with muscles and nerves that help to hold or release urine. The body stores urine—water and wastes removed by the kidneys—in the bladder, a balloon-like organ. The bladder connects to the urethra, the tube through which urine leaves the body.
Figure 1.-Front view of female urinary tract.
During urination, muscles in the wall of the bladder contract, forcing urine out of the bladder and into the urethra. At the same time, sphincter muscles surrounding the urethra relax, letting urine pass out of the body. Incontinence will occur if your bladder muscles suddenly contract or the sphincter muscles are not strong enough to hold back urine. Urine may escape with less pressure than usual if the muscles are damaged, causing a change in the position of the bladder. Obesity, which is associated with increased abdominal pressure, can worsen incontinence. Fortunately, weight loss can reduce its severity.
If coughing, laughing, sneezing, or other movements that put pressure on the bladder cause you to leak urine, you may have stress incontinence. Physical changes resulting from pregnancy, childbirth, and menopause often cause stress incontinence. This type of incontinence is common in women and, in many cases, can be treated.
Childbirth and other events can injure the scaffolding that helps support the bladder in women. Pelvic floor muscles, the vagina, and ligaments support your bladder (see figure 2). If these structures weaken, your bladder can move downward, pushing slightly out of the bottom of the pelvis toward the vagina. This prevents muscles that ordinarily force the urethra shut from squeezing as tightly as they should. As a result, urine can leak into the urethra during moments of physical stress. Stress incontinence also occurs if the squeezing muscles weaken.
Figure 2. Side view of female pelvic muscles.
Stress incontinence can worsen during the week before your menstrual period. At that time, lowered estrogen levels might lead to lower muscular pressure around the urethra, increasing chances of leakage. The incidence of stress incontinence increases following menopause.
If you lose urine for no apparent reason after suddenly feeling the need or urge to urinate, you may have urge incontinence. A common cause of urge incontinence is inappropriate bladder contractions. Abnormal nerve signals might be the cause of these bladder spasms.
Urge incontinence can mean that your bladder empties during sleep, after drinking a small amount of water, or when you touch water or hear it running (as when washing dishes or hearing someone else taking a shower). Certain fluids and medications such as diuretics or emotional states such as anxiety can worsen this condition. Some medical conditions, such as hyperthyroidism and uncontrolled diabetes, can also lead to or worsen urge incontinence.
Involuntary actions of bladder muscles can occur because of damage to the nerves of the bladder, to the nervous system (spinal cord and brain), or to the muscles themselves. Multiple sclerosis, Parkinson's disease, Alzheimer's disease, stroke, and injury—including injury that occurs during surgery—all can harm bladder nerves or muscles.
Overactive bladder occurs when abnormal nerves send signals to the bladder at the wrong time, causing its muscles to squeeze without warning. Voiding up to seven times a day is normal for many women, but women with overactive bladder may find that they must urinate even more frequently.
Specifically, the symptoms of overactive bladder include
People with medical problems that interfere with thinking, moving, or communicating may have trouble reaching a toilet. A person with Alzheimer's disease, for example, may not think well enough to plan a timely trip to a restroom. A person in a wheelchair may have a hard time getting to a toilet in time. Functional incontinence is the result of these physical and medical conditions. Conditions such as arthritis often develop with age and account for some of the incontinence of elderly women in nursing homes.
Overflow incontinence happens when the bladder doesn't empty properly, causing it to spill over. Your doctor can check for this problem. Weak bladder muscles or a blocked urethra can cause this type of incontinence. Nerve damage from diabetes or other diseases can lead to weak bladder muscles; tumors and urinary stones can block the urethra. Overflow incontinence is rare in women.
Stress and urge incontinence often occur together in women. Combinations of incontinence—and this combination in particular—are sometimes referred to as mixed incontinence. Most women don't have pure stress or urge incontinence, and many studies show that mixed incontinence is the most common type of urine loss in women.
Transient incontinence is a temporary version of incontinence. Medications, urinary tract infections, mental impairment, and restricted mobility can all trigger transient incontinence. Severe constipation can cause transient incontinence when the impacted stool pushes against the urinary tract and obstructs outflow. A cold can trigger incontinence, which resolves once the coughing spells cease.
The first step toward relief is to see a doctor who has experience treating incontinence to learn what type you have. A urologist specializes in the urinary tract, and some urologists further specialize in the female urinary tract. Gynecologists and obstetricians specialize in the female reproductive tract and childbirth. A urogynecologist focuses on urinary and associated pelvic problems in women. Family practitioners and internists see patients for all kinds of health conditions. Any of these doctors may be able to help you. In addition, some nurses and other health care providers often provide rehabilitation services and teach behavioral therapies such as fluid management and pelvic floor strengthening.
To diagnose the problem, your doctor will first ask about symptoms and medical history. Your pattern of voiding and urine leakage may suggest the type of incontinence you have. Thus, many specialists begin with having you fill out a bladder diary over several days. These diaries can reveal obvious factors that can help define the problem—including straining and discomfort, fluid intake, use of drugs, recent surgery, and illness. Often you can begin treatment at the first medical visit.
Your doctor may instruct you to keep a diary for a day or more—sometimes up to a week—to record when you void. This diary should note the times you urinate and the amounts of urine you produce. To measure your urine, you can use a special pan that fits over the toilet rim. You can also use the bladder diary to record your fluid intake, episodes of urine leakage, and estimated amounts of leakage.
If your diary and medical history do not define the problem, they will at least suggest which tests you need.
Your doctor will physically examine you for signs of medical conditions causing incontinence, including treatable blockages from bowel or pelvic growths. In addition, weakness of the pelvic floor leading to incontinence may cause a condition called prolapse, where the vagina or bladder begins to protrude out of your body. This condition is also important to diagnose at the time of an evaluation.
Your doctor may measure your bladder capacity. The doctor may also measure the residual urine for evidence of poorly functioning bladder muscles. To do this, you will urinate into a measuring pan, after which the nurse or doctor will measure any urine remaining in the bladder. Your doctor may also recommend other tests:
By looking at your bladder diary, the doctor may see a pattern and suggest making it a point to use the bathroom at regular timed intervals, a habit called timed voiding. As you gain control, you can extend the time between scheduled trips to the bathroom. Behavioral treatment also includes Kegel exercises to strengthen the muscles that help hold in urine.
The first step is to find the right muscles. One way to find them is to imagine that you are sitting on a marble and want to pick up the marble with your vagina. Imagine sucking or drawing the marble into your vagina.
Try not to squeeze other muscles at the same time. Be careful not to tighten your stomach, legs, or buttocks. Squeezing the wrong muscles can put more pressure on your bladder control muscles. Just squeeze the pelvic muscles. Don't hold your breath. Do not practice while urinating.
Repeat, but don't overdo it. At first, find a quiet spot to practice—your bathroom or bedroom—so you can concentrate. Pull in the pelvic muscles and hold for a count of three. Then relax for a count of three. Work up to three sets of 10 repeats. Start doing your pelvic muscle exercises lying down. This is the easiest position to do them in because the muscles do not need to work against gravity. When your muscles get stronger, do your exercises sitting or standing. Working against gravity is like adding more weight.
Be patient. Don't give up. It takes just 5 minutes a day. You may not feel your bladder control improve for 3 to 6 weeks. Still, most people do notice an improvement after a few weeks.
Some people with nerve damage cannot tell whether they are doing Kegel exercises correctly. If you are not sure, ask your doctor or nurse to examine you while you try to do them. If it turns out that you are not squeezing the right muscles, you may still be able to learn proper Kegel exercises by doing special training with biofeedback, electrical stimulation, or both.
Figure 3. Front view of bladder. Weak pelvic muscles allow urine leakage (left). Strong pelvic muscles keep the urethra closed (right).
If you have an overactive bladder, your doctor may prescribe a medicine to block the nerve signals that cause frequent urination and urgency.
Several medicines from a class of drugs called anticholinergics can help relax bladder muscles and prevent bladder spasms. Their most common side effect is dry mouth, although larger doses may cause blurred vision, constipation, a faster heartbeat, and flushing. Other side effects include drowsiness, confusion, or memory loss. If you have glaucoma, ask your ophthalmologist if these drugs are safe for you.
Some medicines can affect the nerves and muscles of the urinary tract in different ways. Pills to treat swelling (edema) or high blood pressure may increase your urine output and contribute to bladder control problems. Talk with your doctor; you may find that taking an alternative to a medicine you already take may solve the problem without adding another prescription.
Scientists are studying other drugs and injections that have not yet received U.S. Food and Drug Administration (FDA) approval for incontinence to see if they are effective treatments for people who were unsuccessful with behavioral therapy or pills.
Biofeedback uses measuring devices to help you become aware of your body's functioning. By using electronic devices or diaries to track when your bladder and urethral muscles contract, you can gain control over these muscles. Biofeedback can supplement pelvic muscle exercises and electrical stimulation to relieve stress and urge incontinence.
For urge incontinence not responding to behavioral treatments or drugs, stimulation of nerves to the bladder leaving the spine can be effective in some patients. Neuromodulation is the name of this therapy. The FDA has approved a device called InterStim for this purpose. Your doctor will need to test to determine if this device would be helpful to you. The doctor applies an external stimulator to determine if neuromodulation works in you. If you have a 50 percent reduction in symptoms, a surgeon will implant the device. Although neuromodulation can be effective, it is not for everyone. The therapy is expensive, involving surgery with possible surgical revisions and replacement.
One of the reasons for stress incontinence may be weak pelvic muscles, the muscles that hold the bladder in place and hold urine inside. A pessary is a stiff ring that a doctor or nurse inserts into the vagina, where it presses against the wall of the vagina and the nearby urethra. The pressure helps reposition the urethra, leading to less stress leakage. If you use a pessary, you should watch for possible vaginal and urinary tract infections and see your doctor regularly.
A variety of bulking agents, such as collagen and carbon spheres, are available for injection near the urinary sphincter. The doctor injects the bulking agent into tissues around the bladder neck and urethra to make the tissues thicker and close the bladder opening to reduce stress incontinence. After using local anesthesia or sedation, a doctor can inject the material in about half an hour. Over time, the body may slowly eliminate certain bulking agents, so you will need repeat injections. Before you receive an injection, a doctor may perform a skin test to determine whether you could have an allergic reaction to the material. Scientists are testing newer agents, including your own muscle cells, to see if they are effective in treating stress incontinence. Your doctor will discuss which bulking agent may be best for you.
In some women, the bladder can move out of its normal position, especially following childbirth. Surgeons have developed different techniques for supporting the bladder back to its normal position. The three main types of surgery are retropubic suspension and two types of sling procedures.
Retropubic suspension uses surgical threads called sutures to support the bladder neck. The most common retropubic suspension procedure is called the Burch procedure. In this operation, the surgeon makes an incision in the abdomen a few inches below the navel and then secures the threads to strong ligaments within the pelvis to support the urethral sphincter. This common procedure is often done at the time of an abdominal procedure such as a hysterectomy.
Sling procedures are performed through a vaginal incision. The traditional sling procedure uses a strip of your own tissue called fascia to cradle the bladder neck. Some slings may consist of natural tissue or man-made material. The surgeon attaches both ends of the sling to the pubic bone or ties them in front of the abdomen just above the pubic bone.
Midurethral slings are newer procedures that you can have on an outpatient basis. These procedures use synthetic mesh materials that the surgeon places midway along the urethra. The two general types of midurethral slings are retropubic slings, such as the transvaginal tapes (TVT), and transobturator slings (TOT). The surgeon makes small incisions behind the pubic bone or just by the sides of the vaginal opening as well as a small incision in the vagina. The surgeon uses specially designed needles to position a synthetic tape under the urethra. The surgeon pulls the ends of the tape through the incisions and adjusts them to provide the right amount of support to the urethra.
If you have pelvic prolapse, your surgeon may recommend an anti-incontinence procedure with a prolapse repair and possibly a hysterectomy.
Figure 4. Side view. Supporting sutures in place following retropubic or transvaginal suspension (left). Sling in place, secured to the pubic bone (center). The ends of the transobturator tape supporting the urethra are pulled through incisions in the groin to achieve the right amount of support (right). The tape ends are removed when the incisions are closed.
Recent women's health studies performed with the Urinary Incontinence Treatment Network (UITN) compared the suspension and sling procedures and found that, 2 years after surgery, about two-thirds of women with a sling and about half of women with a suspension were cured of stress incontinence. Women with a sling, however, had more urinary tract infections, voiding problems, and urge incontinence than women with a suspension. Overall, 86 percent of women with a sling and 78 percent of women with a suspension said they were satisfied with their results. For more information, please visit www.uitn.net. Women who are interested in joining a study for urinary incontinence can go to www.ClinicalTrials.gov for a list of current studies recruiting patients.
Talk with your doctor about whether surgery will help your condition and what type of surgery is best for you. The procedure you choose may depend on your own preferences or on your surgeon's experience. Ask what you should expect after the procedure. You may also wish to talk with someone who has recently had the procedure. Surgeons have described more than 200 procedures for stress incontinence, so no single surgery stands out as best.
If you are incontinent because your bladder never empties completely-overflow incontinence-or your bladder cannot empty because of poor muscle tone, past surgery, or spinal cord injury, you might use a catheter to empty your bladder. A catheter is a tube that you can learn to insert through the urethra into the bladder to drain urine. You may use a catheter once in a while or on a constant basis, in which case the tube connects to a bag that you can attach to your leg. If you use an indwelling—long-term—catheter, you should watch for possible urinary tract infections.
Many women manage urinary incontinence with menstrual pads that catch slight leakage during activities such as exercising. Also, many people find they can reduce incontinence by restricting certain liquids, such as coffee, tea, and alcohol.
Finally, many women are afraid to mention their problem. They may have urinary incontinence that can improve with treatment but remain silent sufferers and resort to wearing absorbent undergarments, or diapers. This practice is unfortunate, because diapering can lead to diminished self-esteem, as well as skin irritation and sores. If you are relying on diapers to manage your incontinence, you and your family should discuss with your doctor the possible effectiveness of treatments such as timed voiding and pelvic muscle exercises.
The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support research into many diseases and conditions.
What are clinical trials, and are they right for you?Clinical trials are part of clinical research and at the heart of all medical advances. Clinical trials look at new ways to prevent, detect, or treat disease. Researchers also use clinical trials to look at other aspects of care, such as improving the quality of life for people with chronic illnesses. Find out if clinical trials are right for you.
What clinical trials are open?Clinical trials that are currently open and are recruiting can be viewed at www.ClinicalTrials.gov.
This information may contain content about medications and, when taken as prescribed, the conditions they treat. When prepared, this content included the most current information available. For updates or for questions about any medications, contact the U.S. Food and Drug Administration toll-free at 1-888-INFO-FDA (1-888-463-6332) or visit www.fda.gov. Consult your health care provider for more information.
The U.S. Government does not endorse or favor any specific commercial product or company. Trade, proprietary, or company names appearing in this document are used only because they are considered necessary in the context of the information provided. If a product is not mentioned, the omission does not mean or imply that the product is unsatisfactory.
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings through its clearinghouses and education programs to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
The NIDDK would like to thank:Linda Brubaker, M.D., Loyola University Medical Center; Susan Meikle, M.D., M.S.P.H., Agency for Healthcare Research and Quality; William Steers, M.D., University of Virginia
This information is not copyrighted. The NIDDK encourages people to share this content freely.
September 2013
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MUI304: Jazz Ens (2013-2014)
CURRICULUM PROGRAM: Music
COURSE TITLE: Jazz Ensemble
COURSE LENGTH: 36 weeks
SUGGESTED PREPARATION: Advanced Band
Major Concepts/Content: The jazz ensemble course is designed to acquaint students with jazz music skills. The content includes, but is not limited to, the following concepts: interpretation and analyzation of musical scores; application of jazz musical nuances in playing from a musical part; improvisation; advance rhythm patterns; performance as a soloist and in small and large group ensembles; a variety of music repertoire such as style, periods, and forms; and sight-reading exercises.
Major Instructional Activities: Instructional activities will be Provided through the following processes: using daily sight-reading exercises during regular full-group rehearsals; practicing aural dictation and ear-training; improvising to a given chord progression; play-rig in tune; performing as a soloist and in small and large group ensembles; playing a wide variety of jazz and big-band repertoire; training in, and the development of, good practice habits; and training in the basics of jazz harmony.
Major Evaluative Techniques: Students will be required to pass an examination on all major, minor, blues, and modal scales and to perform in group ensembles observing all critical markings of interpretation from the score
Course Objectives: Upon completion of the jazz ensemble course, students should be able to:
- Develop individual performance to a high level.
- Perform for the community in concerts.
- Demonstrate good practice habits.
- Display advanced development through solos or ensembles.
- Demonstrate independence in reading notation rhythmically and melodically.
- Understand "swing" style as well as traditional style.
- Begin using improvisation.
- Understand harmonic construction and use chord symbols.
Course Notes: Repeatable Course - Subsequent Enrollment Requires More Rigor.


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A Tour of U.S. National Parks
7 of 11
Florida Everglades National Park
The Florida Everglades is the largest subtropical wilderness in the United States and home to rare and endangered species, including the American crocodile, Florida panther, and West Indian manatee. The Everglades National Park protects over 1.5 million acres of land, making it the third largest national park in the lower 48 states. The Park offers 156 miles of canoe, kayak, and walking trails, as well as thousands of acres of shallow water flats, channels, and mangrove keys for fishing. The Everglades has been designated an International Biosphere Reserve, a World Heritage Site, and a Wetland of International Importance.
Fun Fact: Many people consider the Everglades to be a large swamp, but it is technically a slow-moving river.
Photo source: Carol M. Highsmith
Next: Mesa Verde National Park
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Just about every recipe advises to preheat the oven before using it. I often forget this, but luckily this doesn't seem to matter all that much. Hence my question: why would it be necessary to preheat the oven?
When you don't preheat, you cook your food at a lower temperature as your oven heats up for the first 5-15 minutes, depending on the target temperature and your oven's strength.
For forgiving foods, like a casserole, this may not affect you much - you'll just have to bake longer than the recipe says to. As long as you're careful, you'll be fine.
But if you're baking something that should be baked for a short time at a relatively high temperature, your results are going to be very different. For example, take traditional Southern biscuits: they're baked very hot for less than ten minutes. This cooks them all the way through, and browns the top and bottom. If your oven starts out cold, they're going to be done in the middle before they're brown! Beyond under-browning, you'll also run into problems like lack of rising in steam-leavened foods. Pastries, in particular, could probably be disastrous.
I have noticed that when I forget to do this, the elements on the bottom of the oven are running very hot. So, if I put a pan in the oven, then the bottom of the pan gets much hotter than the topside.
For example, quick dinner rolls - refrigerated croissants. (Dinner in 15 minutes - forget to buy or make rolls... Oven cold...) If I do not preheat, they come out burned on the bottom, but barely done on the top. Wait 3-4 minutes for oven to pre-heat and they come out fine.
As Jefromi said, some items, when baked, will have a very different reaction to warming slowly than to going into a hot oven. Consider a dough, like a biscuit or puff pastry dough that has butter layered or dotted in it. If the dough heats slowly, the butter will melt and run out, altering texture. If it heats quickly, the butter will do its job of shortening the dough or preserving layers.
The concerns about browning are also there, in that a pre-heated oven for the right amount of time will create the browning and bubbling and melting that is called for in certain recipes.
All that being said, it is easy to modify recipes and adjust for pre-heating times, but until you are very comfortable with this I'd be careful.
The baking times in your recipes would be almost useless if you would not preheat your oven. Yet it could spare you energy, but every different oven takes a different time to heat up...
The effect a particular recipe has on the ingredients is often dependent on applying a specific temperature for a specific amount of time. You have quite a bit of latitude when you're making a roast, a casserole, or something similar. However, you have almost none when you're baking. You should treat a baking recipe more like a chemical equation -- be as precise as possible with ingredient measurements and the amount of heat you apply. There are chemical reactions in the food that depend on this level of precision.
In most cases, when packaged food advises you to preheat your oven (often giving a ridiculously long time), it's in the interest of having a "ready in 10 minutes" highlight on the packaging.
You can just put the food immediately, set the timer to the suggested time plus half your normal preheating time, and go spend your time on something more fulfilling like doing the laundry.
It also helps you tell if your oven's actually working. If you're a good judge of temperature (or if you have an oven thermometer), you can also judge if the oven's keeping the correct temperature before you close it up and ignore it for a lengthy period of time.
(from Pork shoulder put in broken oven for 10 hours, safe to eat?)
Because it's important to follow directions, else we would live in chaos! "up would be down; left would be right; cats living with dogs..."
That and if you pre-heat you have a quicker 'bounce-back' to cooking temp because the walls of the oven are heated up and not just the air in the oven box.
I only saw 1 post that stated a very important reason to preheat . And it is not so the instructions can give the correct cooking time . No one leaves something in the full time with out making sure it is not burning , and they also dont pull something out at the exact time with out visual that it is looking done . The big reason to preheat is the lower element stays on red hot for 5 or 10 minutes when you first turn it on . Thats long enough to burn the bottom on something and the whole oven wont be warmed enough to start cooking much . After the preheat the lower burner cuts off by the thermostat and the food cooks evenly . The lower unit cuts on and off to hold the temperature but doesnt usually stay long enough to turn red. . Thats why mama always scolded us for opening the oven door to look at whats cooking , every time you do that the lower element comes on again to replace the lost heat that went out the door .


text: MainWhat We DoHealthy AthletesProviding Health Services Worldwide for the Most Underserved Providing Health Services Worldwide for the Most UnderservedWhat if you could help millions of people worldwide who suffer needlessly from chronic pain and disease, blindness and hearing loss, shortened life span, and other health conditions? That's what we aim to do every day!A growing part of Special Olympics health outreach brings a year-round focus on healthy habits. At a school in Lilongwe, Malawi, students learned how to use a tippy tap, a low-cost way to allow people without plumbing to wash their hands effectively. Good hand washing helps keep diseases from spreading. The lesson was presented by Special Olympics in partnership with Catholic Relief Services. Healthy AthletesWith more than 1.6 million free health examinations conducted in more than 130 countries, the Special Olympics Healthy Athletes® program offers health services and information to athletes in dire need. In the process, Special Olympics has become the largest global public health organization dedicated to serving people with intellectual disabilities.That record of success and benefit of Special Olympics' health program led U.S. businessman and philanthropist Tom Golisano to commit $12 million to expand Special Olympics' health-related services and launch a new Healthy Communities initiative in 2012. The donation was announced by former U.S. President Bill Clinton at the 2012 Clinton Global Initiative event in New York City.Seven DisciplinesHealthy Athletes currently offers health examinations in seven areas: Fit Feet (podiatry), FUNfitness (physical therapy), Health Promotion (better health and well-being), Healthy Hearing (audiology), MedFest (sports physical exam), Special Olympics-Lions Clubs International Opening Eyes (vision) and Special Smiles (dentistry). Officially launched in 1997, Healthy Athletes organizes its events in a welcoming, fun environment. Its events educate athletes on healthy lifestyle choices and identify problems that may need additional follow-upA Gift That Will Change Lives WorldwideThe Golisano Foundation and Special Olympics announced the commitment of $25 million dollars over five years by the Golisano Foundation to support Special Olympics health programs.Special Olympics announced in July that it has received its largest single private gift in the organization's history. Ann Costello, Director of the Golisano Foundation, announced that the foundation, established by long-time Special Olympics supporter, Paychex chairperson and philanthropist Tom Golisano will provide $25 million to expand Special Olympics' health services globally for people with intellectual disabilities.This gift is not only the largest received by Special Olympics, it is also the largest single gift ever given by Golisano and his foundation. It is more than double his initial gift of $12 million to Special Olympics in 2012, which helped launch the new Healthy Communities initiative in 14 countries and states to ensure that people with ID receive access to healthcare in their communities on a year-round basis. Read more about the gift in our press release.The Expanding Healthy Communities InitiativeSpecial Olympics Mexico is part of the Healthy Communities program. Karina Bates, a Special Olympics athlete in Merida, Mexico, has been learning how to shop for and prepare healthful meals.The Special Olympics Healthy Communities initiative takes the principles of the Healthy Athletes program and expands them from a series of single events to a steady presence in the lives of our athletes and their families that includes a focus on follow-up care, wellness opportunities, access and education. Now, Healthy Communities is clearly demonstrating that health needs to remain a priority for the Special Olympics movement.Special Olympics Programs in eight countries (Mexico, Peru, Romania, Malawi, South Africa, Malaysia, Thailand and Kazakhstan) and six U.S. states (Arizona, Florida, Kansas, New Jersey, Wisconsin and New York) are official Healthy Communities.Across the 14 locations, 65,747 Healthy Athletes exams have been held, with 16,274 in locations where Healthy Athletes have never been held before. To date since the pilot began, these Programs have trained 6,457 health advocates (family members, coaches, athlete leaders) on important, locally relevant health topics that they can use to educate others in their community. Additionally, more than 13,000 athletes participated in wellness opportunities and 3,000 athletes received follow-up care after a Healthy Athletes exam through Programs recognized as Healthy Communities.Education for ProfessionalsGeraldine Ogando (right) and Adi Levy, dentistry students in Panama, volunteered for the Special Olympics Healthy Athletes health clinic as part of the Special Olympics Central American Games.Part of the Healthy Communities concept also extends to educating health-care professionals and students. To address health-care disparities, specific training has been provided to more than 16,000 health-care professionals and students, enabling them to return to their communities with increased knowledge of people with intellectual disabilities and a greater willingness to have them as patients. New partnerships have also been created with more than 200 organizations, universities and health-care providers at the local level.The successful pilot and the lessons learned by these Programs led to a 2014 announcement that all Special Olympics Programs now can seek to achieve Healthy Community recognition by providing follow-up care after Healthy Athletes, as well as year-round programming in health and wellness opportunities for local athletes. Miracles at Every TurnMoise Ahoussimou, a poor West African boy with an intellectual disability and next to no vision, is one example. While volunteering at Healthy Athletes, a doctor realized Moise had been blinded by cataracts. He was referred for a simple operation, and Moise left his appointment with restored sight. He saw his father for the first time. "I can see." He grabbed his father's hand. "Hey! Dad, I didn't know you are that tall!" Miracles like Moise's happen at every screening. A volunteer dentist from California, USA saved athlete Dustin Plunkett's life by finding his mouth cancer. Mariam Zakhary of Egypt, fitted with a hearing aid, heard her language and her coach for the first time in her life. Stories like Mariam's are inspiring nations like Egypt to expand their offerings to athletes. All Special Olympics Egypt athletes now receive medical exams and follow-up care.Did You Know?Despite a mistaken belief that people with intellectual disabilities receive the same or better health care than others, they typically receive sub-standard care, or virtually no health care at all.Healthy Athletes has the world's largest database of health data for people with intellectual disabilities.Through Healthy Athletes, more than 136,000 health care professionals have been trained to treat people with intellectual disabilities. These health care professionals provide improved care to millions.Special Olympics has given out more than 100,000 pairs of prescription eyeglasses to athletes who needed them.