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What counts as reliable evidence for public health policy: the case of circumcision for preventing HIV infection
There is an ongoing controversy over the relative merits of randomized controlled trials (RCTs) and non-randomized observational studies in assessing efficacy and guiding policy. In this paper we examine male circumcision to prevent HIV infection as a case study that can illuminate the appropriate role of different types of evidence for public health interventions.
Based on an analysis of two Cochrane reviews, one published in 2003 before the results of three RCTs, and one in 2009, we argue that if we rely solely on evidence from RCTs and exclude evidence from well-designed non-randomized studies, we limit our ability to provide sound public health recommendations. Furthermore, the bias in favor of RCT evidence has delayed research on policy relevant issues.
This case study of circumcision and HIV prevention demonstrates that if we rely solely on evidence from RCTs and exclude evidence from well-designed non-randomized studies, we limit our ability to provide sound public health recommendations.
Randomized controlled trials (RCTs) are widely regarded as the most scientifically rigorous method of evaluating the effect of interventions. However, there is an ongoing controversy over the relative merits of RCTs and non-randomized observational studies in assessing efficacy and guiding policy. According to the prevailing view, RCTs provide evidence far superior to observational studies. Evidence from observational studies by itself is reliable only if there is a very strong association between the intervention and the effect, such as a relative risk greater than 5
Those who criticize this hierarchical view maintain that no one study design has an absolute advantage over any other design. On the whole, the results of any study, however well designed, cannot be taken by themselves to reveal the truth about the effect of an intervention. All studies are subject to confounding and bias. Accordingly, it is imperative to evaluate the totality of evidence, while trying to correct and adjust for confounding and trying to explain why there may be remaining differences in the results of existing studies
Recently the debate has focused on whether investigators should include the results of observational studies in systematic reviews, when well designed RCTs are available. Those who argue for excluding observational studies from such reviews point out that the results from these studies are unreliable, by either under- or overestimating the true effect size
In this paper we will examine male circumcision to prevent HIV infection as a case study that can illuminate the appropriate role of different types of evidence for public health interventions. During the previous twenty years, multiple observational studies in the aggregate demonstrated a clear association between circumcision and HIV infection. Despite such consistent evidence, experts called for initiating RCTs because of the possibility of unknown confounders in the observational evidence. Only after the results of three RCTs were available was the public health community convinced that there was sufficient evidence to initiate provision of circumcision services in high prevalence areas
We shall use this case to argue that ignoring or discounting observational evidence is a serious methodological error. To focus the analysis, we will compare two systematic reviews performed by the influential Cochrane Collaboration. The first assessed the evidence from observational studies; the second only assessed the evidence from recently completed RCTs. We limit ourselves to a discussion of these two reviews, recognizing that there are other reviews taking a different approach, such as
Although we do not question the methodological advantages of RCTs, we argue that it is important to recognize that in the case of complex public health interventions the results from even well designed RCTs in isolation rarely provide enough evidence to guide sound public health policy. Only if we take into account the observational data do we have enough evidence to recommend circumcision as a public health policy to prevent HIV infection. Data from observational studies therefore need to be considered for inclusion and included when appropriate in systematic reviews of available evidence.
The assumption that only RCTs can provide reliable evidence for policy
The Cochrane Collaboration is an international network dedicated to providing high quality systematic reviews of health care interventions. It is recognized as setting the standards for systematic reviews of evidence for the effectiveness of particular interventions. During the 1990s, based on data from multiple observational studies showing differences in HIV infection among circumcised and uncircumcised men, several experts recommended circumcision as a public health measure
Despite the positive results of a number of observational studies, there are not yet sufficient grounds to conclude that male circumcision, as a preventive strategy for HIV infection, does more good than harm. The results of current ongoing RCTs will need to be carefully considered before circumcision is implemented as a public health intervention for prevention of sexually transmitted HIV.... It would be prudent for consumers to await the findings of ongoing randomised trials before deciding on the balance between benefits and risks of male circumcision in the context of HIV infection
The main reason for this negative conclusion was selection bias:
Selection bias was problematic in all studies, and results were potentially confounded by other risk factors for transmission of HIV, such as sexual behaviour and religion. Circumcised and uncircumcised groups (in cohort and cross-sectional studies) and HIV-positive and HIV-negative groups (in case-control studies) were seldom balanced for all or most of the ten risk factors that we identified as potential confounders prior to the quality assessment ... Statistical adjustments for measured confounding factors were made in 14 of the 35 included studies. The adjusted confounders differed across studies in number and type (p. 15).
At the time of this review, three RCTs were either in planning stages or had already started. The reviewers therefore saw no need to go into more detail with regard to an evaluation of the evidence
A second Cochrane review in 2009, in clear contrast to the negative conclusion in 2003, concludes quite forcefully that
Male circumcision can be considered as an effective measure to partly prevent HIV acquisition in heterosexual men. Current evidence is lacking for whether it also confers protection for women. Policy-makers can consider implementation of male circumcision as part of prevention measures if considered feasible and socially and culturally acceptable for local conditions
It is noteworthy that the 2009 review was based
Is circumcision causally related to risk reduction of HIV infection?
Both versions of the Cochrane reviews examine the causal role of circumcision in preventing HIV infection. The first concluded that observational studies have not demonstrated sufficiently that it is circumcision as such that prevents HIV infection, whereas the second concluded that RCTs have been able to identify this factor as contributing causally to HIV infection. The principal reason for these different conclusions is the impossibility of excluding confounders in observational studies, while RCTs are uniquely able to isolate the effect of the intervention of interest, in this case circumcision. Although this may be true for placebo-controlled drug trials where everything except the active substance is the same in the two comparison groups, this is generally not possible for an inherently complex intervention such as circumcision to prevent HIV infection, in which behavioral factors can interact with the medical procedure to influence the outcome under investigation. Obviously, the circumcision RCTs could not be conducted as a double-blind investigation. The lack of blinding with regard to the intervention received, as the Cochrane reviewers point out, is unlikely to affect the outcome assessment itself, as it is an objectively measured endpoint, HIV infection established by laboratory analysis. But since both the study personnel and the research participants would know who was circumcised or not, the RCT design cannot exclude differential distribution of behavioral interventions by the study personnel in the two groups (and thus the risk of HIV infection) independent of circumcision. This unequal distribution of behavioral interventions is independent of any effect circumcision may have on the risk behavior of the subjects themselves, as a result of circumcision.
Even though both the intervention (circumcision) and the outcome (HIV infection) can be standardized and objectively verified in an RCT, it is impossible to ensure that everything else of potential causal relevance in the two groups is exactly the same. For example, counseling is provided to everyone, but both those who are circumcised and the counselors know who are circumcised. Counseling may therefore be done differently in the two groups. Being members of the research team with an interest in proving the study hypothesis that circumcision prevents HIV, the counselors might more intensively counsel the circumcised group regarding risk behavior. Also, suspecting that the fact of circumcision might promote more risky behavior, the counselors might be inclined to deliver more forceful counseling to the circumcised group. Accordingly, it is possible that the specific counseling provided to the circumcised group causes the prevention of HIV infection, and not circumcision itself. We are not suggesting this as a plausible hypothesis for the RCT results; however, it does reflect a potential confound in the RCT evidence, which the Cochrane review did not address.
One also needs to monitor the effect of circumcision on the risk behavior of study participants. Changes in risk behavior following circumcision can complicate assessment of the causal impact of circumcision itself. A well designed RCT would, of course, monitor risk behavior in the two groups, which these trials did; however, they found variable effects on risk behavior in the two groups. The Ugandan trial did not report any difference in risk behavior in the two groups
In the case of circumcision and HIV infection there is an additional, more complex type of causal relationship. Circumcision may be related to HIV infection via its effect on sexually transmitted infections (STIs). It is known that, in particular, ulcerative STIs such as syphilis may increase HIV infection. If circumcision reduces the risk of acquiring such STIs, this may explain the relationship between circumcision and HIV infection, even though circumcision has no direct, causal influence on HIV infection. It is therefore important to control for this risk factor when evaluating the causal role of circumcision in preventing HIV infection. Even if a well designed RCT demonstrates a clear difference in HIV infection between the two groups, this is not in and of itself a proof that circumcision has a causal effect independent of prevention of STIs. This factor needs to be controlled for in all types of studies. Only one of the RCTs did this by giving the numbers objectively diagnosed with STDs in the two groups
The point here is not to express skepticism about whether circumcision has a causal role in HIV infection, nor to claim that confounding or bias are likely explanations of the protective effect demonstrated in the three RCTs, but to show that the prevailing approach to research evidence reflects an inherent bias against observational studies and in favor of RCTs. RCTs of complex interventions can rarely be designed with pristine experimental control; accordingly, they are subject to biases that need to be assessed. Nevertheless, factors that are considered decisive against the reliability of observational studies, often are not considered or are discounted when evaluating evidence from RCTs. In other words, the methodological limitations of observational studies are exaggerated at the same time that those of RCTs are underappreciated.
Importantly, the observational studies may help to correct the methodological limitations of RCTs for the evaluation of complex public health interventions. The rigor of observational studies of circumcision and HIV infection varies considerably. Although not all cross sectional studies have controlled for all possible behavioral confounders, many have controlled for quite a number of them, and in total, there is little evidence that there is an association between circumcision and behavioral risk factors that would explain the relationship between circumcision and risk of HIV infection. Further confidence comes from the several prospective studies where the number of HIV infections in two groups of initially HIV negative men, one circumcised and the other uncircumcised, were recorded
External validity: Will introduction of circumcision services reduce HIV infection?
When deciding policy, we not only need to know whether provision of circumcision protects against HIV infection (in the setting of an RCT). We also would want to know whether introduction of circumcision services will reduce HIV infection in the population. Even if we accept that circumcision has a causal role in HIV infection, we cannot necessarily conclude from this that implementing circumcision services will lead to a reduction in the incidence of HIV infection.
Based solely on evidence from the three RCTs it would be difficult to recommend a policy of promoting circumcision. We would have to assume that the situation of a population studied in the clinical trial, and the way circumcision was performed, is similar in all relevant respects to the situation when future populations decide to get circumcised. Specifically, we would have to assume that there are no behavioral risk factors for HIV infection that are associated with a decision to enter a circumcision trial versus a decision to utilize circumcision services promoted by public health authorities. This possible bias cannot be controlled for in any RCT. This is not merely a theoretical worry. A proportionally larger number of high risk individuals may decide to get circumcised if a nationwide program was introduced, who might subsequently increase risky behavior because they believe themselves to be protected. Additionally, sexually active HIV-positive men may decide to get circumcised if the perception is that circumcised men are less likely to be HIV-positive. Both of these factors could increase HIV infections and diminish or obliterate the positive causal role of circumcision in preventing HIV infection on a population level.
An additional weakness in the data from the RCTs is the lack of assurance that the circumcision method used in an RCT can be replicated in nationwide programs. Circumcision was provided in specialized clinics, with highly trained personnel, providing state of the art counseling. In particular, the trials included counseling to avoid any risk activity in the period right after circumcision due to the increase in risk of infection during this period. If circumcision is introduced on a large scale, it is highly likely that longer healing times after the procedure will be observed, and less adherence to reduction in risk behavior. It is also possible that circumcision might increase risk of HIV infection for women. Finally, if scaled up, the strict procedures for the performance of circumcision during a clinical trial setting may not be replicable. Less adherence to sterilization procedures may in fact increase the risk of HIV infection. Finally, the RCTs at the time they were reviewed by the Cochrane collaboration provided follow-up for no more than two years, and they were all stopped earlier than planned, providing even less data on longer term effects. All of this implies that we do not know, based on the evidence from only the RCTs, that there will be any long term, large scale positive effects of policies implementing circumcision at a population level.
If, on the other hand, we allow an equal consideration of the observational evidence, we may be more confident that introduction of circumcision services will reduce HIV infection. The cross-sectional studies provide long term data, and they focus on circumcision practices in settings that are closer to what one would reasonably expect in a nationwide program. While not completely reducing uncertainty, taking this evidence into consideration would strengthen the case for a policy promoting circumcision.
The results from the RCTs may overemphasize the effects we can expect in reducing HIV infection on a population level. Adult circumcision may not be as effective in preventing HIV in the general population because a relatively high number of adults will be infected before they are circumcised. The results from an adult HIV-negative population that is circumcised as adults in an RCT may therefore not be generalizable to what will happen if a public health circumcision program is introduced in an adult population because most HIV infections will occur before they are circumcised. If age of circumcision is an issue, therefore, the results from the three RCTs might overestimate the preventive effect of circumcision.
What all of this demonstrates is that if we
Ignoring observational studies leads to suboptimal policy
The 2003 Cochrane review essentially concluded that no reliable evidence existed to infer that circumcision was causally responsible for preventing HIV infection and that it would therefore not be appropriate for individuals or policy makers to even consider introducing circumcision services. Based on the evidence available at that time, we think it would have been more appropriate to follow the recommendations published by experts a few years earlier. In 1999, Halperin and Baily argued that "The hour has passed for the international community to recognize the compelling evidence that show a significant association between lack of male circumcision and HIV infection"
• Provide communities with accurate balanced information so that individuals can make informed choices
• Provide training and resources needed to offer safe, voluntary male circumcision in which pain is kept to a minimum
• Begin investigations of the feasibility of acceptable male-circumcision interventions in communities with high HIV and STD seroprevalence where circumcision has traditionally not been practiced.
While it may have been necessary to conduct RCTs in order provide more definitive evidence that could convince policy makers, more careful thought should have been given to how these trials should be designed and conducted, given the predictable uncertainties with regard to the additional evidence that one may obtain from RCTs pointed out above. Paradoxically, we are not able to provide much stronger recommendations than the above even
Intersection of ethics and methodology
One should also consider the decision to stop all three trials early as a potential source of bias
Stopping the three RCTs early diminished the knowledge regarding the effects of circumcision with respect to preventing HIV over time. Subjects entered the trial with the expectation that they would have a 50% chance of being circumcised and would be offered circumcision free of charge after completion of the trial if they were randomized to no circumcision. If it was reasonable and fair to invite men to participate on these terms, then we contend that it was also reasonable and fair to continue the trial to its planned endpoint. All the subjects had other means available to them to reduce their risk of becoming HIV-positive, including use of condoms and avoiding multiple sexual partners. The perceived imperative to stop the trials and offer circumcision to all the subjects confuses the individualistic, patient-centered ethics of medical care--the therapeutic obligation to offer optimal treatment--with the ethics of public health research, aimed at informing health policy
The prevailing ethical perspective mirrors the prevailing epistemology. It is as if there was no knowledge at all about the efficacy of circumcision prior to undertaking RCTs and that definitive knowledge emerged as soon as a statistically significant difference in efficacy was detected in the RCT. Just as we need to correct epistemic biases that overvalue RCTs and undervalue well-designed observational research, so we need to correct ethical biases that needlessly impede the development of policy-relevant knowledge.
This case study of circumcision and HIV prevention demonstrates that if we rely solely on evidence from RCTs and exclude evidence from well-designed non-randomized studies, we limit our ability to provide sound public health recommendations. One cannot, of course, generalize from one case only. RCTs, however, are increasingly being advocated for more complex public health interventions
Competing interests
The authors declare that they have no competing interests.
Authors' contributions
Both authors have been involved in the development of the ideas expressed in the paper and in the writing of the paper. Both authors approve of the final version of the paper.
This research was supported by the Intramural Research Program of the NIH Clinical Center. The opinions expressed are the author's own. They do not reflect any position or policy of the National Institutes of Health, Public Health Service, or Department of Health and Human Services. We would like to thank Steve Pearson and Asbjørn Hrobjartsson for helpful comments on earlier drafts of the paper.
When are randomised trials unnecessary? Picking signal from noise
The unpredictability paradox: review of empirical comparisons of randomised and non-randomised clinical trials
Should meta-analyses of interventions include observational studies in addition to randomized controlled trials? A critical examination of underlying principles
Randomized trials and observational studies: still mostly similar results, still crucial differences
A comparison of observational studies and randomized, controlled trials
Randomized, controlled trials, observational studies, and the hierarchy of research designs
Comparison of evidence of treatment effects in randomized and nonrandomized studies
Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: the ANRS 1265 Trial
Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomised controlled trial
Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial
Male circumcision and HIV prevention: current knowledge and future research directions
Male circumcision and HIV infection: 10 years and counting
Male circumcision for prevention of heterosexual acquisition of HIV in men
Male circumcision for prevention of heterosexual acquisition of HIV in men
Male circumcision in Siaya and Bondo Districts, Kenya: prospective cohort study to assess behavioral disinhibition following circumcision
Circumcision status and risk of HIV and sexually transmitted infections among men who have sex with men: a meta-analysis
Cost-effectiveness of male circumcision for HIV prevention in a South African setting
Randomized trials stopped early for benefit: a systematic review
Stopping randomized trials early for benefit and estimation of treatment effects: systematic review and meta-regression analysis
Equipoise and the ethics of clinical research
Principles of early stopping of randomized trials for efficacy: a critique of equipoise and an alternative ethical framework
In defense of the randomized controlled trial for health promotion research
The World Bank is finally embracing science
Evidence-based public health: moving beyond randomized trials
Evidence-based public health: what does it offer developing countries?
Pre-publication history
The pre-publication history for this paper can be accessed here:


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Chiisana Tankendan
English Title: Small Exploration GroupChiisana Tankendan (Small Exploration Group) (1992) Season 1 Episode 11- Watashi To Watashi: Futari No Lotte Anime Episode Guide by Dave Koch
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- Tokyo Movie Shinsha
- Animated Characters: Lotte Kerunaa, Linne Kogel, Louise Parufii, Miria, Maria, Ruutovihhi Parufii, Toruude, Mr. Gellach, Christine, Ilze, Anthony, Brigit, Belnau, Nina.
- First Aired in 1992.
- Episode Number: 11
- Running Time: 30 minutes.
- Season: 1
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English Title: "Small Exploration Group."
Alternate Series Title: "わたしとわたし."
Alternate Series Title: "わたしとわたし."
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A series of twenty-nine episodes.
The Disney live action feature film The Parent Trap is based on the same novel as this series.
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Value, Obligation and the Asymmetry Question
Tooley, Michael
Bibliographic Citation
Bioethics 1998 April; 12(2): 111-124
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Arrow - "Full Circle" Extended Trailer
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Moms Thanksgiving Stuffing
shirley terhaar
My Mamaw Woodall made this when i was a child her mother before her and my mother and now me .Down home Kentucky recipe .
- 1 large
- onion
- 1 1/2 c
- diced celery
- 3 c
- chicken stock
- 2
- bags herbed bread crumbs
- 2
- bags plain bread crumbs
- 2 c
- cooked pototoes chunks
- 1
- small skillet of corn bread crumbled
- poultry seasoning just a pinch or two
- 2 c
- tomato juice
- 1/2 c
- butter, melted
- 1 tsp
- pepper
- 1 tsp
- salt
- 6
- hard boiled eggs optional
- 1 c
- turkey drippings when turkey is done
How to Make Moms Thanksgiving Stuffing
- 1mix all ingredients together add some of the broth from the pototoes too . and if it is to thin add some bread crumbs or corn bread after all ingredients are mixed together put in butterd cock pot or baking pan.You want it moist but frim. If its to dry add any of the liquids .you can put it in your cockpot on low for 6 hours or cover with foil and at 350 for 2 hours. you can stuff your turkey if you like and plus have stuffing on the side thats how we do it.And when your turkey is done put about a cup of drippings over your stuffing.
About Moms Thanksgiving Stuffing
Course/Dish: Other Side Dishes
Other Tag: Healthy
Hashtag: #stuffing


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Client is a leading tier 1 contractor based in Qatar is looking for a specialist construction manager who has Marine / Port experience. Salary packageRead More
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Timeline for the years 1100 through 1199 for the Harald's England timeline.
- 1101: The First Crusade and the Norman civil war draw to a close.
- 1102: Garcia IV of Navarre completes his father's conquest of the Taifa of Zaragoza. Conrad's Rebellion begins in Italy.
- 1106: Conrad's Rebellion draws to a close following negotiations between Conrad I of Lombardy and Henry V of the Holy Roman Empire.
- 1107: The Republic of Italy is created.
- 1108: Following the death of Philip I, the unpopular Louis the Fat assumes the French throne.
- 1110: Garcia IV of Navarre dies without issue, leaving the throne of Navarre to Alfonso the Fighter. The Republic of Italy begins issuing Confidences (similar to OTL letters of Marque) against Venetien shipping.
- 1113: An expedition from the Republic of Italy conquers the Balaeric Isles. Reistance will continue until 1115.
- 1136: Alfonso the Fighter weds Eleanor of Aquitaine, adding the Duchy of Aquitaine to Navarre's domains, though it is still held legally under the French crown.
- 1137: Louis the Fat dies. His son, Philip II, assumes the French throne.


text:
- gloppy
- adjective see glop
New Collegiate Dictionary. 2001.
New Collegiate Dictionary. 2001.
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gloppy — glop·py … English syllables
gloppy — adjective see glop I … Useful english dictionary
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glop — noun Etymology: origin unknown Date: circa 1944 1. a thick semiliquid substance (as food) that is usually unattractive in appearance 2. tasteless or worthless material • gloppy adjective … New Collegiate Dictionary
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Our World (American TV series) — infobox television show name = Our World caption = Our World title card format = Documentary runtime = 60 min. (including commercials) creator = Roone Arledge producer = Avram Westin starring = Linda Ellerbee Ray Gandolf country = United States… … Wikipedia


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SANITY DECAY - "Open Your Eyes / Открыть Глаза" (Live in PLAN B, 29.01.11)... http://myspace.con/sanitydecay.
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Artist: Edge of Sanity Album : The Unorthodox, CD Track : 1 + 2 * Track 2 Enigma consists out of : a The Blessing b Celestial Dissension c Hallowed Life CD ...
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(Area Visits in this video) [0:01] N. Sanity Island Gems: Green + Purple [2:32] Totem Hokum *1 Death* Gems: Blue + Clear + Green + Purple + Red + Yellow ...
Moni B - Stripped (Sanity Mix) MP3
Moni B. – Stripped Label: DJ Beat Records Scandinavia – DJB001CD Format: CD, Maxi-Single Country: Norway Released: 2000 Genre: Electronic Style: ...
Kuo Climax - B-BOY EP // Sanity MP3
Kuo Climax - B-BOY EP // Sanity [SNR074] Genre: Tech-House, Release Date: Feb 18 2013 Beatport: http://www.beatport.com/search?query=Sanity Label: ...
Crash Twinsanity (PS2) - 01/08 - N. Sanity Island, Jungle Bungle & Cavern Catastrophe MP3
The last good Crash game in my opinion and it strays away from the Classic Crash Bandicoot games in a way. Crash Twinsanity is more of a free-roam in which ...
GO TO BEACH - INTERACTIVE CHOICE - Sanity Not Included: Flappy Bird Ballad (S05E06) MP3
GO TO BEACH - INTERACTIVE CHOICE - Sanity Not Included: Flappy Bird Ballad (S05E06) Subscribe to Director's channel's! Dexterboy124: ...
Sermon - Key to Sanity- At Peace with Life. Philip Ensley MP3
The Key to Sanity 6-9-2013 Daniel 4 I. Nebuchadnezzar's Experience and Declaration A. An anxious man finally. (1-3) 1. Ch. 2 - 2. Ch. 3 - II. The Key to Sanity...


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$1,600.00 1 year ago
Honda B16 engine swap - $1600 (Grant Township)
I have a B16 engine and hydro trans with shift linkage. Not pictured but included are the starter and distributor. The trans is tight with no grinds. The engine was pulled from a running vehicle for another car, but we didn't end up using it. Located in the Grant Township/Lakeport area.email or txt to 716.479.two two two 8
1 year ago
Port Huron, MI


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US Sailing Basic Keelboat Course
Lake Travis; Austin, TX
Year Round; By Appointment
Group instruction consist of two full weekend sessions, scheduled 10:00 AM to 5:00 PM, Saturday and Sunday, the first two weekends of each month.
Private instruction is taught in four days, custom schedule to meet to student's needs.
- This course is designed to provide new sailors with a foundation on which to build future sailing skills
- Receive a U.S. sailing certification upon completion.
- Certified instructors and a school with more than 40 years of teaching experience
- Class is taught aboard a 23 monohull sloop
For the person who has always wanted to learn to sail, but never had any formal training, this is the experience for you!
This course is designed to provide the new sailor with a foundation on which to build future sailing skills. Upon completion of this course, you will be able to responsibly skipper in familiar waters with light to moderate wind and sea conditions.
The class is taught aboard a 23' monohull sloop. Among other abilities, you will learn parts of the boat, sailing terminology, knots, rigging the boat, leaving and returning to the dock, points of sail, safety procedures, sailing a course, maneuvering and securing the boat.
Once you complete the course, you'll be able to confidently sail for relaxing outings on the water.
Essential Information:
Upon completion of the course, participants will receive US Sailing Keelboat Certification. Established in 1898, US Sailing is a non-profit, volunteer organization, which serves as the national governing body of the sport of sailing.
Price includes sailboat, instruction, books, and certification.
Instruction consists of 4 six-hour days.
Maximum Participants:
4 participants
Not Allowed
Weather Dependent:
This experience is weather dependent. Always contact the Experience provider with any questions regarding weather conditions.
What to Wear:
Dress for weather. Remember that it may be a bit cooler on the water. You may also want to wear a hat, sunglasses, and bring sunscreen for protection from the sun. Please no dark soled shoes. Don't forget your camera!
Booking Information:
For this experience, it is recommended to request bookings at least 14 days in advance
Cancellation Policy:
Once you have received a booking confirmation, cancellations and rescheduling are allowed up to 14 days prior to the Experience. Failure to appear on your booked date, cancel, or reschedule at least 14 days prior to your booked date will result in the loss of the value of your Experience.
Experience ID:
Other Austin Gift Ideas:(View all 40 Austin experiences)
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text: Home > Business > Connecting All Contractors Business Connecting All Contractors A retrospective on 25 years of builder technology: How did we get here, and where are we going next? By Joe Stoddard Login or Register to download the PDF version of this article. (169.6 kB) Almost 25 years ago to the day — in October of 1982 — I finally graduated from Newbie Remodeler U and began building my first start-to-finish new house for a paying customer (even if it was my sister). Reliable job-site information was hard to come by in those days, so when one of my fellow workmen pulled out a dog-eared newspaper called New England Builder, I couldn't subscribe fast enough. It was the first publication I'd ever seen that had real information for builders about what did and didn't work, written and distributed by people who were actually doing it.What does my subscribing to NEB in 1982 have to do with you being a "connected contractor" in 2007? Ironically, quite a lot. In 1982, Mike Reitz, the original publisher of NEB/JLC, was a contractor in rural Vermont who was having the same kinds of problems finding information that I was having in rural Pennsylvania. There was no Internet, of... Login or Register to continue reading


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Need local breastfeeding help? Use our searchable Local Resources Directory.
The State of Breastfeeding in Kansas report has been created by the Kansas Breastfeeding Coalition. This 4 page summary will assist you with community conversations. Our goal is to summarize the current breastfeeding rates as well as suggested actions for improving these rates.
View our spreadsheet summarizing Breastfeeding Support by Kansas County, a detailed database of information regarding breastfeeding support and breastfeeding rates by county.
"Feeding Tips" card (updated 4.2017)
KBC Resource Flyer (4.2017) To connect families and providers to local breastfeeding support, download and share the attached "KS Resources" flyer which directs them to the KBC Local Resource Directory where they can find local breastfeeding help.
Our goal is to provide quality, helpful resources to families, advocates and health care professionals. This resource page is part of that effort. Please let us know if you have any suggestions for websites, articles or resources or if you find a broken link. Contact us.
KBC work focuses on statewide breastfeeding issues, and cannot answer individual questions about breastfeeding or provide medical or legal advice. Please contact your local health care providers and community resources with these questions. The National Breastfeeding Helpline has trained breastfeeding peer counselors to provide support by phone in English or Spanish.
Website links are provided for your convenience and are not endorsed by the Kansas Breastfeeding Coalition, Inc.
Breastfeeding help:
National Breastfeeding Helpline – 1-800-994-WOMAN (9662) or 888-220-5446 (TDD) to answer breastfeeding questions in English and Spanish, Monday through Friday from 8:00 am to 5:00 pm. For more information, visit the National Women's Health Information Center.
Academy of Breastfeeding Medicine – http://www.bfmed.org/
The Adoptive Breastfeeding Resource Website – http://www.fourfriends.com/abrw/
Ask Dr. Sears – http://www.askdrsears.com/topics/feeding-eating/breastfeeding
Baby gooroo – http://babygooroo.com/category/breastfeeding/
Biological Nurturing – http://www.biologicalnurturing.com/#
Breastfeeding After Reduction – http://www.bfar.org/index.shtml
Breastfeeding Basics – http://www.breastfeedingbasics.com/
Breastfeeding Online – http://www.breastfeedingonline.com/
Breastfeeding and Mental Health
Breastfeeding USA – https://breastfeedingusa.org/breastfeeding-information
BreastFeeding, Inc. (Dr. Newman's site) – http://www.breastfeedinginc.ca/index.php
Breastmilk: Every Ounce Counts – http://www.breastmilkcounts.com/
Common Sense Breastfeeding – http://www.normalfed.com/
Glossary of Breastfeeding Supporters – http://massbreastfeeding.org/landscape/Human Milk Banking Assoc. of North America – https://www.hmbana.org/
Infant Risk Center Forum (medication questions) – http://www.infantrisk.com/content/webforum
Instructional videos from Stanford Medical School – http://newborns.stanford.edu/Breastfeeding/
Instructional videos from Dr. Jack Newman – http://www.breastfeedinginc.ca/content.php?pagename=videos
It's Only Natural (African-American mothers) – http://womenshealth.gov/ItsOnlyNatural/index.html
Kangaroo Care – http://www.kangaroomothercare.com/
Kansas WIC – http://www.kansaswic.org/breastfeeding/
KellyMom – http://kellymom.com/
Lactavist – http://www.lactivist.com/howto.html
La Leche League – http://www.kansaslll.org/
Forums & FAQs – http://forums.llli.org/index.php
Medications – http://mommymeds.com/mobile-apps/mommymeds
Mothering Magazine Forum on Breastfeeding –http://www.mothering.com/community/f/27/breastfeeding
The National Women's Health Information Center's Hotline
Nursing in Public Harassment Hotline – 1-855-NIP-FREE http://www.bestforbabes.org/announcing-1-855-nip-free-the-best-for-babes-nursing-in-public-harassment-hotline
Postpartum Depression
"Speak Up: What you Need to Know About Breastfeeding" – http://www.jointcommission.org/assets/1/18/breastfeeding_final_7_19_11.pdf
Stanford School of Medicine- Newborn Nursery at LPCH
Vitamin D Supplementation recommendation – http://www.cdc.gov/breastfeeding/recommendations/vitamin_d.htm –
Working and Pumping – http://www.workandpump.com/
Additional Resources for Black Breastfeeding Mothers:
African American Breastfeeding Network of Milwaukee
African American Breastfeeding Alliance
Black Mothers' Breastfeeding Association ~ On Facebook
Blacktating Breastfeeding News & Views form a mom of Color on Facebook
Fathers Supporting Breastfeeding
Huffington Post article: Breastfeeding Myths Busted In Surgeon General's 'It's Only Natural' Campaign
Indiana Black Breastfeeding Coalition – http://indianablackbreastfeedingcoalition.com/
It's Only Natural (African-American mothers) – http://womenshealth.gov/ItsOnlyNatural/index.html
Uzazi Village – provides direct breastfeeding support services and education for those wanting to become an IBCLC. Uzazi Village serves the KC metro area.
Video from Dad/Doctor perspective: Brothers United – Breastfeeding
Find local help:
Breastfeeding Support by Kansas County – detailed database of information regarding breastfeeding support and breastfeeding rates by county. Last updated 7/28/2016.
La Leche League Leaders & Groups – http://www.kansaslll.org/kansasgroups.htm
Registered Lactation Consultant (IBCLC) – http://www.ilca.org/i4a/pages/index.cfm?pageid=3345
Breastfeeding USA – https://breastfeedingusa.org/breastfeeding-information
Breastfeeding PODCASTS
Resources for Fathers and Families:
The American Academy of Pediatrics:
- A Message for Dads
- Managing Older Siblings While Breastfeeding
- Selecting a Caregiver that Supports Breastfeeding
American College of Nurse Midwives: Questions and answers for fathers
Fathers Supporting Breastfeeding is a U.S. Department of Agriculture (USDA) Food & Nutrition Service project targeted to African American fathers so that they may positively impact a mother's decision to breastfeed.
Family Guide to Bonding with a Baby
"Advantages of Breastfeeding to the Father and to Siblings"
Video created by a WIC peer counselor: Teach Me How to Breastfeed.
Video from Dad/Doctor perspective: Brothers United – Breastfeeding
California WIC – Help Dads to Support Moms and Breastfeeding http://calwic.org/storage/documents/MenDadsToolkit/4_DadsToolkit_Breastfeeding_Section.pdf
Additional articles:
Fathers Can Support Breastfeeding
Breastfeeding Your Baby: Making the Decision Together
14 Ways For Dads to be Engaged with their Breastfed Babes
Insurance Coverage for Breastfeeding Support and Breastpumps:
HealthCare.Gov–What are my breastfeeding benefits?
HRSA – Women's Preventive Services: Required Health Plan Coverage Guidelines
The Center for Consumer Information & Insurance Oversight-Shining a Light on Health Insurance Rate Increases
Medela's FAQ – http://www.medelabreastfeedingus.com/breastfeeding-insurance
Model Policy for Commercial Payers – http://www.usbreastfeeding.org/LegislationPolicy/ExistingLegislation/ModelPolicyPayerCoverage/tabid/344/Default.aspx
Questions to Ask You Insurance Company Regarding Lactation Support (Missouri Breastfeeding Coalition) – http://www.mobreastfeeding.org/wp-content/uploads/2013/10/Questions-to-Ask-Your-Insurance-Company-Regarding-Lactation-Support.pdf
Commonly used ICD-9-CM Codes Related to Breastfeeding –
For baby – http://www.dcbfc.org/pdfs/ICD9CMcodes.pdf
For Mother – http://www.dcbfc.org/pdfs/BillingForMother.pdf
A sample breast pump prescription from the Maryland Breastfeeding Coalition can be found here.
CMS Issue Brief: Medicaid Coverage of Lactation Services
AAP Federal Support For Breastfeeding
AAP President Thomas K. McInerny, MD, FAAP Letter to Payers – Advocating for Coverage and Payment for Lactation Support and Breast Pumps–
Milk Banking, Sharing and Donating
Kansas Milk Banks and Depots:
Heart of America Mother's Milk Bank (St. Luke's, KC, MO) – firstname.lastname@example.com
Via Christi (Wichita, KS) – http://www.via-christi.org/body_nobanner.cfm?id=1311&action=detail&ref=340
Human Milk Banking Association of North America
International Milk Banking Initiative
Statement on the Safe Use of Donor Human Milk (USBC)
Donor Human Milk: Ensuring Safety and Ethical Allocation (HMBANA)
Breastfeeding during Emergencies & Disasters:
AAP – "Infant Feeding During a Disaster: Breastfeeding and Other Options"
CDC Features – Be Ready! September is National Preparedness Month
USBC Features – Breastfeeding and Emergencies
DHHS – Infant Feeding During Disasters
IBFAN – "Infant Feeding in Emergency Situations"
Wellstart International (2005): "Infant and young Child Feeding in Emergency Situations"
World Alliance for Breastfeeding Action (WABA) and IBFAN (International Baby Food Action Network) (2005): "Fact Sheet on Feeding Babies in Emergencies"
World Health Organization's Guidelines for Feeding Infants and Young Children in an Emergency:
WHO 2004: "Guiding Principles for Feeding Infants and Young Children During Emergencies"
WHO 2007: "Infant and Young Child Feeding in Emergencies: Operational Guidance for Emergency Relief Staff and Programme Managers"
Consumer Reports
Pumping and Milk Storage (Office on Women's Health) – http://www.womenshealth.gov/breastfeeding/pumping-and-milk-storage/
Position Statements / Policies
The American Academy of Family Physicians
The American Academy of Pediatrics
The Association of Women's Health, Obstetric, and Neonatal Nurses
The Association of Women's Health, Obstetric, and Neonatal Nurses – Newborns & Neonates
The National Association of Pediatric Nurses Practitioners
The National Association of Pediatric Nurses Practitioners – NAPNAP Position Statement on Breastfeeding (PDF)
Professional Organizations
Academy of Breastfeeding Medicine
American Academy of Family Physicians
American Academy of Pediatrics
American College of Nurse-Midwives (ACNM)
American College of Obstetricians and Gynecologists (ACOG)
American Dietetic Association
American Nurses Association
Association of Women's Health, Obstetric and Neonatal Nurses
Doulas of North America
Human Milk Banking Association of North America
International Baby Food Action Network
International Board of Lactation Consultant Examiners
International Childbirth Education Association (ICEA)
International Lactation Consultant Association
Lamaze International
National Alliance for Breastfeeding Advocacy
National Association of Pediatric Nurse Practioners (NAPNAP)
National Black Nurses Association
National WIC Association
United States Breastfeeding Committee
United States Lacatation Consultant Association
Wellstart International
La Leche league USA
Breastfeeding Advocacy:
American Academy of Pediatrics "Health Professionals Resource Guide" – http://www2.aap.org/breastfeeding/healthProfessionaIsResourceGuide.html
Academy of Breastfeeding Medicine – http://www.bfmed.org/Default.aspx
Ban the Bags (hospital discharge formula industry bags) – http://banthebags.org/
Breastfeeding, Maternal & Infant Health Outcomes (AHRQ, 2007) – http://archive.ahrq.gov/clinic/tp/brfouttp.htm
Centers for Disease Control & Prevention (CDC) Breastfeeding Resources – http://www.cdc.gov/breastfeeding/
- The CDC Guide to Strategies to Support Breastfeeding Mothers and Babies
- Current "Breastfeeding Report Card"
- 2011 Surgeon General's "Call to Action to Support Breastfeeding"
- Resources for Improving Maternity Care Practices (mPINC survey, crib cards, etc.)
Coalition for the Improvement of Maternity Care – http://www.motherfriendly.org/
Human Milk Banking Assoc. of North America – https://www.hmbana.org/
International symbol for breastfeeding download
MomsRising – http://www.momsrising.org/
National Alliance for Breastfeeding Advocacy – http://www.naba-breastfeeding.org/
National Partnership for Women and Families
Reaching Our Sisters Everywhere (ROSE) for African-American mothers – http://www.breastfeedingrose.org/
Surgeon General's Call to Action to Support Breastfeeding (2011) – http://www.surgeongeneral.gov/library/calls/breastfeeding/index.html
Women's Health.gov – http://www.womenshealth.gov/breastfeeding/index.cfm
USDA WIC – http://www.fns.usda.gov/wic/women-infants-and-children-wic
US Breastfeeding Committee– http://www.usbreastfeeding.org/
- Subscribe to "Wednesday Weekly Wire" for updates
- Breastfeeding Advocacy Headquarters – http://www.usbreastfeeding.org/LegislationPolicy/BreastfeedingAdvocacyHQ/tabid/109/Default.aspx
Baby Friendly Hospital Initiative – http://www.babyfriendlyusa.org/
Healthy People 2020 Breastfeeding Goals – http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=26
"Tale of Two Births" video – http://www.youtube.com/watch?v=N9KptD3t110
"Speak Up: What you Need to Know About Breastfeeding" – http://www.jointcommission.org/assets/1/18/breastfeeding_final_7_19_11.pdf
Sample Hospital Policies – http://azdhs.gov/phs/bnp/gobreastmilk/documents/AzBSBS-Model-Hospital-Policy-Guide.pdf
Economic Benefits of Breastfeeding – http://iabreastfeeding.org/wp-content/uploads/2010/03/medicaid_savings.pdf
09 /15/16 The First 1,000 Days, Nourishing America's Future – This first-of-its kind report examines the nutritional health of America's mothers, infants and toddlers and highlights a set of "wins" to ensure that every child in the U.S. can have a healthy first 1,000 days.
Breastfeeding Training and Education Resources for Healthcare Professionals
Web-Based Training Sites (offering free training and resources):
Tulane Knowledge to Practice Program
Uzazi Village – provides direct breastfeeding support services and education for those wanting to become an IBCLC. Uzazi Village serves the KC metro area.
Other Training/Education Resources:
American Academy of Pediatrics- Breastfeeding Residency Curriculum
America Academy of Pediatrics– Breastfeeding Support and Promotion Speaker's Kit, American Academy of Pediatrics Section on Breastfeeding, 2012
Birth and Beyond California-Hospital Breastfeeding Quality Improvement and Staff Training Demonstration Project
Breastfeeding Coalition of Washington's Physician Lactation Education-Increasing Breastfeeding Success
Breastfeeding Conference Listings
Breastfeeding-Friendly Consortium
Breastmilk Solutions: Dr. Jane Morton
Breastfeeding Support Consultants – http://www.bsccenter.org/
Bright Future Lactation Resource Centre, Ltd.
Carolina Global Breastfeeding Institute
Dr. Nils Bergman-Kangaroo Mother Care "Hold Your Prem" book and DVD
Gold Lactation Online Conference
Hale Publishing e-Learning Courses
Healthy Children Project, Inc. Center for Breastfeeding
InJoy Birth and Parenting Education
International Lactation Consultant Association Continuing Education
Mother Journey – http://www.motherjourney.com/professional-trainings.html
"Skin to Skin in the First Hour After Birth: Practical Advice for Staff after Vaginal and Cesarean Birth" Click here to download the order form.
Texas Dept. of State Health Services-Breastfeeding Trainings
The Academy of Breastfeeding Medicine Podcasts
The Gift Breastfeeding Training Program
United States Breastfeeding Committee Publication- "Core Competencies in Breastfeeding Care and Services for All Health Professionals"
Academy of Breastfeeding Medicine Protocols – http://www.bfmed.org/Resources/Protocols.aspx
Free pamphlets from Hale Publishing – http://www.ibreastfeeding.com/free-pamphlets
World Health Organization Growth Charts
Traveling with Breastmilk
National Institute of Health Drugs and Medications Database
Thomas Hale's Breastfeeding and Medication Forum (health care professionals only)
Infant Risk
Commonly used ICD-9-CM Codes Related to Breastfeeding –
For baby – http://www.dcbfc.org/pdfs/ICD9CMcodes.pdf
For Mother – http://www.dcbfc.org/pdfs/BillingForMother.pdf
Implementing The Joint Commission Perinatal Care Core Measure on Exclusive Breast Milk Feeding – http://mnbfc.files.wordpress.com/2013/03/phljtcoexclbf.pdf
International symbol for breastfeeding download
Sample Hospital Policies – http://azdhs.gov/phs/bnp/gobreastmilk/documents/AzBSBS-Model-Hospital-Policy-Guide.pdf
Handouts and products (for families and health care workers) – http://massbreastfeeding.org/handouts/
"Your Breastfeeding Guide" pdf (Office on Women's Health) – http://www.ibreastfeeding.com/free-pamphlets
Instructional Videos:
Baby Gooroo on YouTube – http://www.youtube.com/watch?v=hD-d1m7oKBo
Every Drop Counts (pumping for your preemie) – http://www.medelabreastfeedingus.com/video-page/6/every-drop-counts
How to Relieve Engorgement (Reverse Pressure Softening) – http://www.youtube.com/watch?v=2_RD9HNrOJ8
"Hand-on Pumping + others on latch and positioning (Stanford Medical School) – http://newborns.stanford.edu/Breastfeeding/
Latch and breast compression from Dr. Jack Newman – http://www.breastfeedinginc.ca/content.php?pagename=videos
Paced Bottle Feeding (baby led bottle feeding) –https://www.youtube.com/watch?v=UH4T70OSzGs
"Tale of Two Births" video – http://www.youtube.com/watch?v=N9KptD3t110
Working and Breastfeeding – http://www.youtube.com/watch?v=S2XmUPpQsFc


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For Immediate Release
Contact: Jean Weinberg
(July 19)-- Today, Congressional Candidate Jim Craig issued the following statement on President Bush's veto of the HR 810 to lift the ban on federal funding for stem cell research legislation:
"George Bush has placed the narrow interests of the extreme right-wing above the interests of American families. Today, President Bush stood in the way of important scientific research which holds hope for tens of millions of Americans. Stem Cell research holds promise for families as new treatments for Parkinson's Disease, Alzheimer's, heart disease, diabetes, and rheumatoid arthritis are developed. I will continue to strongly support federal funding for stem cell research."


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2, Piplod Plaza, Surat-dumas Road, Piplod, Opp. Lancer Army School, Surat, Gujarat 395007
Locate a Tata Dealership in Surat. CarDekho.com makes it easy to find authorized Tata dealerships and showrooms in Surat. Locate over 1Tata Dealers in Surat. We aim to provide you with all important contact details about the Tata car dealers in Surat at your convenience. Details of which are listed above:
It will help us serve you better content and best deals


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Fernloft City (River Valley) Inn
Website: http://www.fernloft.com
Address: 301 River Valley Rd Singapore 238342
Contact: (+65) 6297 6495
Fernloft @ River Valley offers the best value if not the cheapest hostel one can find in the city central. Located just 501m from Orchard road, one can be sure of the convenience of close proximity to Singapore's main shopping belt, eateries and major entertainment districts. View Fullscreen Map
Search ComeSingapore for articles, events and directories matching your keywords.


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March 6th, 2014 by John Kim
Nike is all about innovation, and there's no better platform to springboard into uncontested advancement with Flyknit. In just two years, Flyknit has managed to redefine lightweight running in both the performance and style aspects, and this Summer, the breakthrough technology will make its foray into the sport of international football. Today, Nike introduces the Magista Boot – the first Flyknit-built footwear for the pitch; the shoe is four years in the making, arriving just in time for the grandest stage of the world's most popular sport – the 2014 World Cup. Of all the upgrades made to this shoe, the most intriguing is NIKESKIN; it measures just 0.1mm in thickness and is placed above the Flyknit upper to protect it from water and the elements. The Magista will be available for pre-order on April 29th at Nike.com and will be available for purchase on May 22nd, so check out the official gallery below and stay tuned for a release.
Filed under: Nike Flyknit
Tags: Nike Magista
Pages: 1 2


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Andrew Grant Deyoung
July 22, 2011 by staff
Andrew Grant Deyoung, With a video camera recording his final moments, Andrew Grant DeYoung was executed Thursday night in the Diagnostic and Classification Center in Georgia for killing three family members.
DeYoung was pronounced dead at 8:04 pm, less than 15 minutes after it began the process. Prone, which barely moved throughout the execution. His parting words were: "I feel for everyone I've hurt."
For the first time in Georgia, a cameraman was present at the execution chamber, documenting the death DeYoung and his reaction to a new three-drug lethal injection death penalty activists, said the pain and suffering unnecessary. The cameraman, accompanied by a woman taking notes, put aside and was barely visible to the witnesses.
DeYoung, however, only blinked and swallowed several times and showed no signs of violent death. That was verified by a nurse of consciousness little by implementing a new procedure in place. At 8:22 pm, was taken from prison in Butts County Coronor black van.
It is believed that this was the first execution by lethal injection was recorded in the nation. In 1992, an execution in California was videotaped, but the gas chamber was in use. The execution of Timothy McVeigh, the Oklahoma City bomber, was broadcast live on closed circuit transmission of an Indiana prison to the victims or relatives of the deceased see in Oklahoma City.
DeYoung was sentenced to death for the murder of his parents and sister 14 years old in 1993. A brother, 16, fled the chaos after hearing the commotion and the operation of the family home in Cobb County safety in a neighbor's house. DeYoung was captured several hours later.
A student at Kennesaw State University and 19 at the time, DeYoung went to the killing, apparently thinking that he would receive and 480,000 in the estate of a business.
Federal and state resources exhausted, DeYoung was scheduled to die by lethal injection on Wednesday night, but his execution was delayed 24 hours by the Department of Corrections in an attempt to litigate the matter back to film. More than three hours after the original time, the Department of Corrections and Attorney General Sam olens decided to postpone the execution. Olens said the state needs more time to deal with the videotape because it was a new situation in Georgia.
The Department of Corrections has the authority to stop the execution because the agency was given a weeklong?? Window, the African Union that DeYoung had to be executed, and that did not end until next Tuesday.
Hours before his execution on Thursday, the Fulton County Superior Court Judge Bensonetta Tipton Lane, rejected the attempt by the state for the Georgia Supreme Court to review her ruling that allowed the videotaped execution.
Lane, supervision of the appeal of death row inmate Gregory Walker, had ordered the burning DeYoung, becoming the leading run after hearing the arguments of the State, becoming the leading process of lethal injection causes pain and suffering. The record run was the first in nearly two decades at the national level, as was permitted in California. No other states with the death penalty currently allow.
DeYoung, becoming the protagonist was the second execution in Georgia in which a new anesthetic, pentobarbital, was part of the three-drug lethal ccktail. Switch when necessary pentobarbital sodium thiopental was no longer produced. Opponents of capital punishment again insisted that the anesthetic is not safe, he stressed that drug-induced coma were not deep enough to protect those convicted of the excruciating pain that comes when the other two drugs are injected, bromide paralytic pancuronium followed by potassium chloride, which stops the heart.
DeYoung, becoming the leading lawyers argued that there were problems with the June 23 execution of Roy Blankenship, the first man in Georgia to die by lethal injection of pentobarbital.
Witnesses reported that Blankenship nodded his head several times at the beginning of the procedure, although their movements and slow breathing within minutes. Prison officials said the motion was filed with the anestietic had taken place.
Walker attorneys asked the judge of Fulton County to order DeYoung, becoming protagonist-videotaped execution. Lane agreed, but said the tape had to be immediately placed under court seal. The Supreme Court upheld this decision.
However, the state feared the images could be filtered and argued in court papers that there was a risk?? Credible PDS. "They also warned of security problems if the camera operator is allowed inside the death chamber and only a few meters from DeYoung on the stretcher.
Please feel free to send if you have any questions regarding this post , you can contact on
Disclaimer: The views expressed on this site are that of the authors and not necessarily that of U.S.S.POST.


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Just as we said earlier today, Norma Jean have officially let the word out regarding their upcoming album, Wrongdoers. Along with that, the band released a YouTube video of a cover reveal set to an unnamed song off of the album which truly shows they haven't softened up since Meridional.
Wrongdoers will hit stores on August 6, and pre-orders for the Razor & Tie released album can be found here. Follow the jump to watch the video.
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PPcorn has hand-picked the top 5 classical albums of the week. The links below are courtesy of Noise Trade, one of the top 10 sites for free music downloads.
Number One: Daniel J. White – Primus – download. Daniel J. White is a composer and orchestrator from Atlanta, Georgia. White has composed original scores for short films and advertisements for four years now. He began taking violin lessons at the age of nine. Now 20, he continues to learn everything and anything about music. He enjoys well-crafted stories, studying music, watching movies and hanging out with friends on occasion. The young composer is greatly inspired by legendary classical musicians such as Alexandre Desplat, John Williams, and James Newton Howard.
Number Two: David Hollandsworth – Solo Piano – download. David Hollandsworth is a composer for film, television, videos, ads and radio. Hollandsworth has an extensive portfolio of work that he has done over the years. His inspiration comes from artists like Yanni, Enya, Pink Floyd, King Crimson and Joe Satriani.
Number Three: Lacy Rose – Ghost Music – download. Lacy Rose is a classical musician based in Austin, Texas. Rose began writing Ghost Music during her two-year stay in New Orleans. Fascinated by ghosts or spirits from the other side, she created a unique style of classical music ranging from opera to gothic horror. Her music speaks of tragedy, mystery and eternal love. She hopes to awaken the souls of her fans.
Number Four: Fontaine James – The Odd Fellows Hall – download. Fontaine James grew up with a father who loved to sing Johnny Cash around the house and a mother who hummed the tunes on Sergio Mendes and Brasil 66. Fontaine soon discovered a love for music when he saw himself using a tennis racquet as a guitar in front of the mirror. Aside from rocking out in front of a mirror, James sang soprano solos at his Catholic school. The musician's music is a fusion of classical and Americana, "fresh tunes with a nostalgic bent." His inspiration comes from Tom Waits, Elvis Costello and the Beatles.
Number Five: Michael R. Oldham – Fantasies For Piano – download. Michael R. Oldham is a 26-year old composer and pianist from Braidwood, Illinois. The piano became a part of him at a very young age, and his love for film scores inspired him to begin composing. Fantasies For Piano is a six-movement dissection of favorites by artists such as Andrew Bird, St. Vincent Sufjan Stevens and Fiona Apple. After earning a degree in Film Scoring and Composition from Berklee College and studying briefly in Greece, Oldham continues to create beautiful and passionate music as well as looking for all kinds of creative opportunities.
Disclaimer: Many websites either sell music or provide free music streaming with advertisements. There are also sites that share music illegally. And then there are the artists who give their music away for free. PPcorn prepares a list of free music downloads you can enjoy anytime, anywhere. With a list of the best links that take you to a safe site or an artist's site, PPcorn provides legal music with high-quality files and high-speed downloading. You have the ability to obtain your favorite songs with just one click. PPcorn's sources contain no viruses, malware, or spyware that will harm your PC. Our team of music experts at PPcorn hand-select trending songs, old school tunes, and fan favorites ranging from good ol' country to hip-hop on a daily basis. Today's featured genre is Classical. It's easy, it's safe and it's free. Now you can enjoy free access to music from your favorite artists, build a playlist, and take it with you wherever you go. Visit our website to find out what tomorrow's list will contain. It's a surprise every time.


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KICKOFF: Saturday, 7 ET
SITE: Heinz Field, Pittsburgh, Pa.
SURFACE: Grass
SERIES: Pitt leads 8-2 (last meeting, 2010, Pitt 28-10)
RECORDS: Cincinnati 6-1, 2-0 Big East; Pitt 4-4, 2-1 Big East
POLLS: Cincinnati (No. 23 AP, No. 22 USA Today)
PREDICTION: Pittsburgh 24-21
-- For Cincinnati: Win the line of scrimmage. This game likely will be decided by how well the Bearcats control the Panthers' formidable defensive front. The Bearcats want to avoid a slow start coming off the bye week.
-- For Pittsburgh: Avoid negative plays and don't give up big plays on defense. Cincinnati will pass the ball and do it often with QB Zach Collaros, but the big weapon is Isaiah Pead in the running game. The Panthers must protect the QB Tino Sunseri.
Cincinnati's offense is anything but one-dimensional. It has shown uncanny balance with 200 yards rushing and just under 234 yards passing per game. The Bearcats have the ability to pound the ball with Isaiah Pead, who has 703 yards and eight TDs, but when the opportunities have presented themselves, they have unveiled its signature big-play passing game behind QB Zach Collaros. Collaros has passed for 1,576 yards and 14 TDs to a deep receiving corps that has five players with two or more TD catches. When pressured, or by design, Collaros has rushed for 225 yards and six TDs. The offensive line has been a pleasant surprise with redshirt freshman Eric Lefeld earning two starts.
If you're looking for a reason why Cincinnati is the Big East Conference's first bowl-eligible team, look no further than the Bearcats' defense. Since being a big question mark in the preseason, UC is plus-13 in turnover margin, with nine interceptions and 12 fumble recoveries. A revamped defensive line has produced 23 sacks led by DT Derek Wolfe with five and DE Dan Giordano and DE Brandon Mills with four each. LB J.K. Schaffer and CB Deven Drane have three interceptions apiece.
Pitt's offense will have to change with RB Ray Graham out for the year due a knee injury. He was ranked second in the nation in rushing when injured against Connecticut. He finished with 958 yards. Zach Brown is Graham's replacement and is a capable runner, but Graham is out of the mode of LeSean McCoy and Dion Lewis, the two men who preceded him and went to the NFL. A big question this week is the offensive line, which has been decimated by injury. Senior G Chris Jacobsen was lost for the year in the Iowa game, Lucas Nix has been out three games with an injury against South Florida and against UConn freshman OL Matt Rotheram suffered a season-ending ankle fracture.
Pitt has been turning up the pressure defending the passing game all season through the rush and leads the Big East in sacks with an average of 3.38 per game. That ranks fifth nationally. Sophomore DT Aaron Donald is leading the way with seven. Donald, DT Chas Alecxih and DE Brandon Lindsey rank among the Big East's top five in sacks. Pitt's attacking defense is tied for 12th nationally in tackles for a loss but that statistic is skewered somewhat because against Utah the Panthers managed a stunning 17 tackles for losses, including seven sacks. Pitt does need to do more work in forcing turnovers, having created only seven with four fumbles and three interceptions.
Bearcats: Before last year's loss to Pitt, Cincinnati had won two straight in the series during their back-to-back Big East Conference championship seasons in 2008 and '09, breaking a streak of seven straight Pitt victories. ... The last time Cincinnati played Pitt at Heinz Field was in 2009 when UC won a 45-44 thriller earning the Bearcats the Big East Conference title and a berth in the Sugar Bowl. ... With six wins already, the Bearcats have surpassed their win total for 2010 (four) and were the first Big East team to reach bowl eligibility by winning at South Florida on Oct. 22. ... Cincinnati ranks fifth in the FBS with 23 turnovers forced, including 11 interceptions and 12 fumble recoveries. Last season the Bearcats had just 13 total turnovers gained. ... Junior Danny Milligan took over as UC's starting punt returner after D.J. Woods fumbled twice fielding punts on Oct. 15 vs. Louisville. ... Freshman OL Eric Lefeld made his second career start in the win at USF. He has appeared in all seven games this season.
Panthers: The Pitt-Cincinnati game matches up two of the three teams in the Big East who hold their own fate in their hands. The other team that could win the conference outright by going unbeaten the rest of the way is West Virginia. ... The Panthers have won five of six meetings with the Bearcats in Pittsburgh. ... The one loss was in a classic matchup in 2009 when the Bearcats overcame a 21-point deficit to win 45-44. ... QB Tino Sunseri's 419 yards passing against Connecticut were the most thrown for by a Pitt QB in eight years and were a collegiate record for Heinz Field. ... OL Chris Jacobson will seek a medical hardship waiver and a sixth year of eligibility after suffering the second season-ending injury of his career. In 2007 Jacobson suffered a right knee injury in the preseason. He had surgery on his left knee after the Iowa game. ... Redshirt freshman OL Matt Rotheram sustained a season-ending left angle fracture against UConn. He had played in all eight games, starting the last two at tackle and guard, respectively.
RB Isaiah Pead -- Pead provides the spark for the Bearcats offense. He has rushed for 703 yards and 8 touchdowns in seven games. He ranks fourth among active career leaders with a 6.47 yards per carry.
QB Zach Collaros -- Collaros has 14 touchdown passes but also has six interceptions, a few of which have occurred in the red zone. Collaros is a dual threat with six rushing TDs but is still improving on his decision making.
LB J.K. Schaffer -- He leads the team with 54 tackles and three interceptions. He is the captain of a vastly improved Bearcats defense which ranks second nationally in rush defense and eighth in sacks.
QB Tino Sunseri -- Sunseri comes off the best game of his career, passing for 419 yards against Connecticut and all eyes -- including the defense's -- will be on him from here on out. Without running back Ray Graham, the nation's second leading rusher, the offense is forced to feature its air game. Sunseri has shown an ability to hit open receivers and spread the ball around.
RB Zach Brown -- With Graham out, Brown will pick up the bulk of the carries. Brown is averaging only 3.1 yards on 41 rushes, but when entering in place of Graham he has shown he can catch the football, possessing 16 catches on the year, nine in the UConn game when he saw extensive action.
WR Mike Shanahan -- Pitt's leading pass catcher among receivers, Shanahan broke out of a slump with four catches against Connecticut. He had caught only one pass in the previous two games and was coming off a game against Utah in which he was held without a catch. While Pitt's offense likes to spread the ball around, Shanahan is a big play player who needs a chance to make those plays.
Bearcats: DB Dominique Battle (knee, out), D Malcolm Murray (knee, out).
Panthers: RB Ray Graham (knee, out), OL Matt Rotheram (ankle, out), Q Trey Anderson (wrist, out).


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AValive has been renting and selling the finest brands of professional studio mics since 1992. We carry a huge line of Neumann -AKG-Blue-Telefunken Peluso Lawson-Royer-Scheops Studio Microphones.
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