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Dig Lounge along with Saarloos & Sons is very pleased to announce the launch of our new crowd funding campaign #CraftWineLA. The project came about by a chance meeting between Matt and Keith several years ago at his Los Olivos tasting room. Through some creative collaboration they curated a few wine tasting events together in Downtown LA and Orange County.
Keith, who's also from the Bellflower/Long Beach area mentioned how great it would be to create a wine specifically for Dig Lounge and Los Angeles. We started to think about the craft beer movement and wonder why we don't have "craft" wine in LA. It's about time the craft wine movement came together in Los Angeles.
#CraftWineLA is a crowd funding campaign to bring the craft wine movement to Los Angeles. With the hopes to bring together others in LA who love to drink and/or create craft wines. The first project is to create a limited edition, unique wine with Saarloos & Sons winery. Future plans to promote craft wine awareness will include wine dinners and events, along with additional wine collaborations with small, independent and family owned wineries.
We hope you'll join us and be a part of the #CraftWineLA movement!


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Delaney pledges support to help Woodview find a place called home
FAI chief executive John Delaney was in Dundalk on Wednesday evening to pledge his full support behind Woodview Celtic's bid to find a place they can call home.
Delaney, along with local TD, Peter Fitzpatrick, Dundalk FC chairman, Ciaran Bond, NEFL secretary Gerry Gorman and Dundalk Schoolboys League chairman, Gerry Gover all addressed a packed crowd at The Ballymascanlon Hotel.
Woodview have been in existence for 25-years but still don't have a home ground of their own. However Delaney, who gave the club a donation of €2,500 as well as offering 150 kids tickets for the upcoming European Championship Qualifier between the Republic of Ireland and Georgia in September, said the FAI would do everything in their power to change that.
"Ultimately, I will help Woodview in whatever way I can," he told The Dundalk Democrat.
"It's easy giving out tickets and small funding but we must now deliver the pitch. There is work to be done now."
"If you build a house you have to build the foundations first," he continued
"Grassroots football is the foundation of the game and I genuinely love meeting clubs and trying to help them with the problems that they face."
Delaney met with the club's committee members before the presentation and he said he was impressed by what he saw.
"There's an incredible energy from the committee, they're young, vibrant, enthusiastic lads. They're all doing it on a voluntary basis and they're all giving back to their community. They have ten underage teams and a senior side and effectively what they are doing is keeping kids away from things like Playstations and getting them onto the football pitch.
"It's quite remarkable that the club has stayed alive for 25-years," he added.
"I gather that it was formed after the Italia 90 World Cup so to go that long and have the amount of teams they do is tremendous but they need to look at the next 25 years now and for that they will need their own home and dressing rooms and committee rooms. "Peter Fitzpatrick asked me to come up and meet the club and I'm delighted to do that. "We'll all work together to help find them a home of their own."
His comments were echoed by Fitzpatrick. The former Louth GAA boss has been working with Woodview committee members Paul McArdle and Eamonn O'Hagan in trying to secure Woodview a home and he said no stone would be unturned until that is resolved.
"Eamonn and Paul have been knocking at my door for the last six months," he said.
"We're in negotiations with a few people at the minute and my commitment over the next six months is to help Woodview Celtic. Even if we have to beg, borrow or steal, we will get them a pitch."
Woodview secretary Kevin Magee also paid tribute to Delaney and said the club were thrilled to have him on board.
"The FAI have given us their full backing in trying to find a piece of land for ourselves. They will send an FAI representative down to the meeting that will hopefully secure us a home. When we secure this land, John has given us his full support that the FAI will help us out in any way to help with facilities for the children.
"It's great to have him here. It's a long time since a club from Dundalk has had John down to see them and I would really like to thank him for that."
Magee also thanked the sponsors of the event, Fyffes, Peter Fitzpatrick, Café 37, Dundalk Schoolboys League, Balon Sports, NEFL, Black Wok, Young's, Oxy Arc, Slimming World (Fiona Pepper), Lally's Electrical, O'Hare Tyres, Smack Dry Cleaners, Johnny Kirk, Gary Hoey, Laverty Motors, Micro Clean Environmental, National Time, The Strong Room, McCreesh's Avenue Deli, Black & White Construction, Gem Embroidery, and Priority Printing.

subset: commoncrawl


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DuPont™ Sorona® Awarded Oeko-Tex® Standard 100 Certification
"Receiving Oeko-Tex® Standard 100 Class 1 certification for Sorona® provides third-party validation of the safety of Sorona® for use in all fiber applications."
- Walter L. Fields, III, Global Business Director
Receipt of the Oeko-Tex® Standard 100 Class 1 Certification means DuPont™ Sorona® has passed the most stringent third-party safety test in the textiles industry. Awarded by Oeko-Tex® and the Hohenstein Textile Testing Institute, the Oeko-Tex® Standard 100 Certification means Sorona® is approved for use in apparel, home, office, automotive interiors, and commercial and residential carpeting. The "Class 1" designation means Sorona® is so safe it has been certified for carpeting and textile applications intended for infants and toddlers.
Look for the Oeko-Tex® Label
The Oeko-Tex® Standard 100 is an international testing and certification system restricting the use of unsafe chemicals in textiles. Headquartered in Zurich, the Oeko-Tex Association has offices in over 40 countries and responsibility for the standard is shared by 15 test institutes. The testing methods and criteria are standardized at the international level providing a global safety benchmark for consumers, and for apparel brands and carpeting mills seeking optimal safety in textile products. Oeko-Tex® safety protocols have become an indispensable component of textile manufacturing quality assurance, checking for harmful substances at every step in the production chain.
Safe Enough for a Baby's Skin, Easy on the Environment
Sorona® polymer is raising the bar for safety in textiles. But it's also an environmentally-responsible material. Sorona® contains 37% renewably-sourced, plant-based material by weight, so Sorona® has a smaller ecological footprint than petroleum-based nylon. The production of Sorona® also consumes less energy and results in fewer greenhouse gas emissions than the production of an equal amount of nylon. And unlike some other materials, Sorona® is entirely free of heavy metals.
"This certification is further assurance of the desirability of this fiber for many textile designers concerned about long-term sustainability and technical superiority."
- Sam Moore Ph.D, Oeko-Tex®, North America
Sorona® contains 37% annually renewable plant based ingredients by weight (28% biobased carbon)


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The mission of both the Certified Home Health Care Program and the Long Term Home Health Care Program is to improve the health of our community by providing caring, high quality, accessible professional home care services to patients of all ages.
Good Samaritan Hospital Home Care Agency programs can provide for a quicker discharge from the hospital and prevent future inpatient stays while maintaining quality care.
A comprehensive assessment is performed to identify the patient's needs and an individualized treatment plan is established in consultation with the patient's physician.
The following services are available under the Certified Home Health Care Program:
Services may be provided seven days per week, with 24-hour on-call services available.
For more information, please contact us:


text: We already know you're a savvy globe trotter who knows the ins and outs of air travel. However acquainted a flyer may be, one item remains elusive to many travelers and that is how to sleep on the plane. Here, you will find a few steps that may facilitate the sleeping affair and help with jet lag. Consider this your 'How to sleep on a plane 101'.


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Park Quadrant Residences presents a rare opportunity to become part of an exciting and dramatic development of high-end residential living in an area renowned for its quality of historical architecture and townscape.
In 1851, architect Charles Wilson developed proposals for a public park, which was to become Kelvingrove Park, along with a masterplan for a concentric pattern of streets at Woodland Hill. In 1854, this plan was changed to include the inner ring of terraces, Park Circus, along with the outer ring of Park Terrace and Park Quadrant.
However, construction of the concentric ringed Park Circus area halted in the mid 1850s and the final quadrant lay undeveloped, until now. This legacy has resulted in Park Quadrant Residences taking its place as 'the missing piece' of the historic Park Circus area.
Architects, Holmes Miller have created a subtle re-interpretation of the original masterplan designs with stunning, contemporary detailing.


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PENSACOLA, Fla. (NNS) -- Naval Education and Training Command announced 16 Navy College Offices (NCO) in the continental United States will close Oct. 1, as part of a restructuring effort to increase virtual and self-service options to Sailors.
"We are continuously looking to make changes and improvements that will enhance education opportunities to our Sailors," said Rear Adm. Mike White, commander, NETC. "Our young Sailors today are more technologically advanced and adaptive to change. Our goal is to provide them the access to tools and information when and where they need it."
The following NCOs will close Oct. 1: Bethesda, Maryland; New London, Connecticut; Little Creek, Virginia; Pensacola; Charleston, South Carolina; Gulfport, Mississippi; Kings Bay, Georgia; Ventura County, California; Coronado, California; Lemoore, California; Fallon, Nevada; Whidbey Island, Washington; Everett, Washington; Great Lakes; Millington, Tennessee; Corpus Christi, Texas.
To help with this transition, the Navy will keep four NCOs open for an additional year in the fleet concentration areas of Norfolk, San Diego, Jacksonville, Florida, and Kitsap, Washington. They will be open until Sept. 30, 2017.
There will be no effect on the 11 overseas NCOs in Atsugi, Japan; Guam; Misawa, Japan; Sasebo, Japan; Yokosuka, Japan; Bahrain; Guantanamo Bay, Cuba; Rota, Spain; Sigonella, Sicily; Naples, Italy; and Pearl Harbor.
This new structure will make counseling and tuition assistance accessible for all Sailors in the continental U.S. through a combination of virtual services that they can access at times and places of their choosing that is most convenient to them.
Additionally, Navy regional advisors will be established at four Navy regions to support and advise installation commanding officers, and facilitate access for academic institutions to operate on base.
"We are committed to providing the right resources for our Sailors," said White. "This will not impact Tuition Assistance or impact any Sailor who wishes to advance their education."
For more information on the Naval Education and Training Command, visit http://www.netc.navy.mil.
For more news from Naval Education and Training Command, visit www.navy.mil/local/cnet/.


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An alleged HBO cover-up has the network in trouble and facing a lawsuit over the treatment of animals on the set of Luck.
A former director of production in the American Humane Association's film and television unit, Barbara Casey, is suing over the alleged HBO cover-up. She claims that she was wrongfully terminated in January 2012 and is also suing Luck producer Stewart Productions for aiding and abetting the alleged HBO cover-up for months after the series ended.
Casey says the AHA was coerced by HBO to approve the production and keep from contacting law enforcement officials.
"AHA bowed to political and financial pressure and refused to report the Production Defendants' conduct to the authorities," Casey alleges in the suit. "AHA instructed Plaintiff not to report such conduct. AHA engaged in efforts to conceal and cover up the production defendants' criminal activities."
Several horses died during the series, and the series was canceled after PETA protested the show.
Casey filed the lawsuit in Los Angeles Superior Court, claiming that the AHA observed horses being drugged, underweight and/or sick horses being used for the show, and misidentification of horses by producers so animal safety representatives couldn't track their medical histories, The Hollywood Reporter notes.
HBO denies the alleged cover-up.
"We took every precaution to ensure that our horses were treated humanely and with the utmost care, exceeding every safeguard of all protocols and guidelines required of the production," an HBO representative said in a statement to The Hollywood Reporter. "Barbara Casey was not an employee of HBO, and any questions regarding her employment should be directed to the AHA."
Casey has a different story, TV Guide noted. She says the alleged HBO cover-up whitewashed the animal abuse. In once case, a horse that was killed during a summer hiatus was not documented because it happened during a break in production, she claimed.


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Most of us are on social media for fun and entertainment. But did you know that people make money with posting pictures? And lots of it too!
Who of us would have thought five years ago that "instagrammer" would become an actual job. Especially in the fashion industry is where the most of the money is being made. The amounts vary a lot, but I can tell you that there are so-called instagrammers that ask 50.000 dollars for just posting one picture. And, who would pay that kind of money? Well, brands do pay it.
Social media is a great way to get to your potential clients, and we all know that the internet is a fast way of spreading out information. This is why companies pay so much money, because with one post, in a time frame of minutes, thousands of people have seen the post. There's not a faster way in the world to get to your costumers.
An important fashion blogger is Chiara Ferragni, an Italian girl that started this just as a hobby. She's got 6,8 million followers from all around the world. This has turned out to be some big business!


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Your wedding will be among the most joyful and important days that you ever experience. You will remember this day forever. Because the wedding day is so important, planning the perfect one can be stressful and may be difficult. After reading this article you will find many suggestions that will make your wedding day as good as it possibly can!
You save large amounts of money by purchasing your wedding dress online. However, it is crucial that you do it far in advance, should it need any alterations. For example, you may purchase your dress for $100, but you need to spend an additional $200 on alterations. Make sure to allow for additional expenses in your total budget.
Personalize your wedding by including unique touches that express the essence and interests of you and your new spouse. Pick a theme that symbolizes the time you two have had together.
Your wedding photographs will perhaps be the most important photographs that you ever own. Be certain to hire the best photographer you can to get a clear and touching record of your special day.
Never go on a strenuous weight loss diet in order to look your best. Starving yourself will just dehydrate you and make you feel sick. Passing out at the altar in the middle of exchanging vows? Not a pleasant thought. Buy a dress that has a corset back instead for more flexibility.
Instead of one large, expensive wedding cake, consider serving cupcakes or several small cakes. Some bakeries will even ship fresh cupcakes with fewer than 100 calories per serving as well as healthy options like gluten-free ingredients, fruit-filling instead of frosting, no-calorie sweeteners, or even tart meringue toppings.
As mentioned, your wedding day is a day you will not soon forget. Organizing the wedding of your dreams can easily become a nightmare if it gets out of control. Following the suggestions from this article provides a good way to ensure that you are going to have your dream wedding.
Weddings are usually a tricky combination of planning, preparation and compromise. The way you can be sure you are prepared is to learn everything you can about what goes into creating the wedding of your dreams. The tips below will help.
When planning your wedding, think about what type of alcohol serving you want, and what type will be the most cost efficient. An open bar that is available all evening can quickly become a very costly endeavor. With only a quick question, your venue should be able to provide you with their alcohol serving options.
If you plan on doing the catering yourself, then you need to visit wholesale food stores. Wholesale prices are generally lower. Think about asking people you know to assist with the food costs.
The photographs of your wedding will build your book of memories to look back on for years to come. See to it that you hire professional photographers and pay a little bit more for this if needed in order to document this wonderful experience.
Have your wedding at a friend's home. If someone you know owns a large piece of property, like a farm or a place with a large backyard, you can cut down a major cost. The only real cost would be to hire someone to clean beforehand and afterwards.
One way to add glamour to your look on wedding day is to research the possibility of renting diamonds to add to your ensemble. At a mere fraction of the cost, you can add that perfect touch of glamour to your wardrobe for the big day.
Brides should de-stress their skin before walking down the aisle. Find products with oatmeal proteins and sea salts, for example.
Be sure to browse around for experienced and skilled photographers, before you commit to one for your wedding. You don't want to end up with a photographer that you're not going to be happy with. If you would like good tips on finding the best local photographers, make sure you read all the reviews online, and solicit advice from family and friends.
Place a full length mirror at that head of the aisle and practice walking toward it. This will help insure a trip-free wedding day. Flats may be a better choice if you think you may hurt your feet. Comfortable footwear is a wonderful trade off to protect you from falling.
Now that you know all these tips, you are ready to start planning for your wedding. Stay positive and joyous for your wedding day.


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I was really intrigued by this glitter topcoat. I love stars, and the colors seemed bright and interesting. This one is called Hollywood Walk of Fame, and it is a clear base filled with holographic and iridescent purple, blue, red, silver, and gold stars.
There are also some small flecks of iridescent glitter suspended in the base along with some tiny bar glitter. Not a lot of those transitioned onto the nails, but they added a bit more sparkle without taking away from the stars too much.
The stars are certainly interesting. They shine green, blue, and other colors. Unfortunately they're a little sparse. I suppose this happens in a lot of polishes that have pieces of glitter this large though. So instead of applying this carefully like a normal polish or glitter topcoat, I would apply quite a bit and try to get a lot of stars out of the bottle at once.
The overall look is alright though. The stars are placed pretty randomly, which I like, though you could easily try to control where they go. You could probably also fish the stars out of the bottle with a toothpick to try and place them more carefully.
Hollywood Walk of Fame and other Wet n Wild Fergie polishes sell for $3.49 each and can be found where most Wet n Wild products are sold.
Product purchased by me. All opinions are my own.


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You've just moved in—and you want your house to become a home…inside and OUT. With Spring here, now is the perfect time to get the outside of your home looking the way you want it to. Adding grass, flowers, mulch, and a deck may be on your checklist for this Spring. What is the best deck to put in your backyard? There are two good options: composite and natural wood decks. This article will discuss the pro's and con's to each type of deck.
Composite decks are initially more expensive than a natural deck but have less maintenance in the long run. Composite decking is made up of a combination of plastic and wood particles. There are two types of composite decks that you can buy. One is hollow and the other is solid. The hollow composite decks are on the lower-end of the price scale. These types of decks can hold water that can warp the boards, but the boards will expand and contract less than the solid boards. The solid boards are stronger than the hollow and have a more realistic appearance. A con to the solid composite decks are that they have a greater tendency to expand and contract compared to the hollow. When it comes to composite decks you can buy scratch resistant boards, and UV protected decking to keep maintenance cost down.
Natural wood decks are the original deck. This type of deck requires more maintenance overall and needs more care in the long-run. The initial investment will determine the needed upkeep for the lifetime of your deck. Depending on the type of wood you choose for your natural wood deck determines how much money you spend initially, how soon you will need a new wood for you deck, and how much upkeep you will need to do throughout its life. The less expensive woods will be more prone to warping and rotting, while more expensive woods will be less prone to rotting and more durable.
Living in Oklahoma and in Tornado Alley, the weather can get bad in the summertime with thunderstorms, so it is good to keep that in mind when making your decision for the type of deck you choose. A more durable deck in the Oklahoma area will last much longer, so whatever you choose between a composite deck or a natural wood deck make sure it's lifetime and durability is one you approve.
By Green Haven Homes 4-3-2017


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Volkwagen / Audi Track Day at Castle Combe Report
The rain managed to hold out to make the Volkswagen and Audi track day held at Castle Combe race circuit in Wiltshire another great success and a thoroughly enjoyable day out.
Organised by Autometrix, the publishers of Volkswagen Driver and Audi Driver magazines, this years' track day enjoyed a good turnout of over 60 track cars, plus many spectators, clubs and traders.
Read the Full Report including video footage of the new Audi RS4 V8 on the circuit


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POLICE in Madrid are baffled at the discovery of a dead dolphin in the grounds of a stately home in the city – which is a three-hour drive from the nearest sea and has no water parks close by.
The sea creature was seen in the land belonging to what used to be a country house, or casa de campo, wound up in a wire netting which it appeared to have become trapped in.
Its body is in an advanced state of decomposition, says the Municipal Police force.
Officers cannot work out how the animal got there.
It was found by a local man who was out walking his dog in the casa de campo area, Madrid's main green area along with the Retiro Park and the site for the city zoo.
According to the man who found it, his dogs detected the smell and traced it to an area of the park close to the Boadilla del Monte road, and he contacted the current owner of the casa del campo who, in turn, rang the police.
Despite the zoo being nearby, police do not believe the dolphin could have escaped from there, since staff say none of their animals are missing.
Read more at thinkSPAIN.com
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var sid = 454; var aid = 3;
Minnesota State Fair Turkey Marinade
1 lb. turkey tenderloins
1/4 cup vegetable oil
1/4 cup soy sauce
1/4 cup cooking sherry
2 T. lemon juice
Dash of pepper
Dash of garlic salt
2 T. chopped onion
1/4 tsp. ground ginger
Combine ingredients and pour over turkey tenderloins in glass or plastic container. Marinate 6-8 hours in refrigerator. Grill 3 to 4 minutes per side over hot coals or 8-10 minutes over medium fire.
Note: Pounding the thickest part of the tenderloin muscle will prevent curling or pulling during cooking.
Recipes: Back to Main Dishes | Back to Main Menu
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The Eklipes Cobra Motorcycle Hardwire USB Charging System is an excellent addition for most motorcycles. It includes everything needed to enable a power outlet onto your bike.
This hardwire solution is one of the most cost-effective and functional that I have seen. If you are looking to power your device on your bike, this is what you need. Most hardwire kits have a pair of bare wires, a fuse in the middle then either a 12-volt DC outlet or a mini-USB at the end without an on/off switch. This power outlet includes not only a DC outlet but also a USB port and an on/off switch. This means you can potentially plug your GPS charging or traffic cable as well as charge your cell phone at the same time.
This power kit includes a handlebar mount and has a chrome finish. Most hardwires I have seen do not come with the ability to mount to a handlebar. The Eklipes Cobra Charging System kit comes with the ability to mount to most handlebars and fits bars up to 1.25 inches diameter. There is a 5 1/2 foot cable to attach the adapter to your battery and that should be long enough to make the trip from the battery to the handlebar.
The cable is in two parts. The part that connects to your battery has two round leads attached to the red and black cables. There is a connection at the end that will attach to the handlebar attachment. The handlebar attachment has a short cable and the 12-volt DC outlet, USB port and on/off switch. The ports have a waterproof cap that is another unique and very useful feature of this hardwire kit. There is a 15 AMP fuse integrated into the kit. The handlebar mount also has a locking plate mechanism which is a theft deterrent feature which I haven't seen before in other hardwires. Another nice feature.
The Eklipes Cobra cable includes the ability to attach to a standard motorcycle battery charger. The included EZ Jump-Start battery harness is a 12 gauge female BMW jumper plug capable of handling over 2000 cranking AMPS. Using the cable that connect to the battery enables the addition of the Eklipes Bike to Bike Charging Kit to enable battery charging from another motorcycle. You can also attach the cable to a standard battery charger. Just be sure this is a battery charger made to handle smaller motorcycle batteries, not one that's made for a large car battery unless it has a step down feature.
I have been used to using the small hardwire kits that have a fuse box in the middle and a dangling cable at the end which is typically a mini-USB that fits a GPS like a Garmin Nuvi. The Eklipes Cobra gives me the same functionality as my SUV. I can charge an Apple iPhone directly using my Lightning Cable plugged into the USB port. If I want to use a Garmin GPS with the traffic cable built into the charger, I can use that cable and plug it into the DC port that's now mounted right on the handlebar.
The Eklipes Cobra Motorcycle Hardwire USB Charging System is a great addition for a motorcycle that doesn't have any utility power sources already built-in at the factory. This chrome kit is also available in a black finish.


text: Reducing Postpartum Depressive Symptoms Among Black and Latina Mothers A Randomized Controlled TrialHowell, Elizabeth A., MD, MPP; Balbierz, Amy, MPH; Wang, Jason, PhD; Parides, Michael, PhD; Zlotnick, Caron, PhD; Leventhal, Howard, PhDObstetrics & Gynecology: May 2012 - Volume 119 - Issue 5 - p 942–949 doi: 10.1097/AOG.0b013e318250ba48 Original Research Free Abstract In Brief Author InformationAuthors Article OutlineOutline Article MetricsMetrics OBJECTIVE: To estimate the effectiveness of a behavioral educational intervention to reduce postpartum depressive symptoms among minority mothers. METHODS: We recruited 540 self-identified black and Latina mothers during their postpartum hospital stay and randomized them to receive a behavioral educational intervention or enhanced usual care. Those in the intervention arm received a two-step behavioral educational intervention that prepares and educates mothers about modifiable factors associated with symptoms of postpartum depression (physical symptoms, low social support, low self-efficacy, and infant factors), bolsters social support, enhances management skills, and increases participants' access to resources. Enhanced usual care participants received a list of community resources and received a 2-week control call. Participants were surveyed before randomization and, 3 weeks, 3 months, and 6 months later to assess depressive symptoms. The primary outcome, depression, was assessed using the Edinburgh Postnatal Depression Scale (score of 10 or greater). RESULTS: Positive depression screens were less common among intervention compared with enhanced usual care posthospitalization: 3 weeks (8.8% compared with 15.3%, P=.03), 3 months (8.4% compared with 13.24%, P=.09), and 6 months (8.9% compared with 13.7%, P=.11). An intention-to-treat repeated-measures analysis for up to 6 months of follow-up demonstrated that mothers in the intervention group were less likely to screen positive for depression compared with enhanced usual care (odds ratio 0.67, 95% confidence interval [CI] 0.47–0.97; number needed to treat 16, 95% CI 9–112). CONCLUSION: An action-oriented behavioral educational intervention reduced positive depression screens among black and Latina postpartum mothers. CLINICAL TRIAL REGISTRATION: Clinicaltrials.gov, www.clinicaltrials.gov, NCT01312883. LEVEL OF EVIDENCE: I A behavioral educational intervention reduces positive depression screens for up to 6 months of postpartum follow-up among black and Latina mothers. From the Departments of Health Evidence & Policy, Obstetrics, Gynecology, and Reproductive Science, and Psychiatry, Mount Sinai School of Medicine, New York, New York; the Department of Psychiatry and Human Behavior, Warren Alpert Brown Medical School, and Women and Infants Hospital, Providence, Rhode Island; and the Institute for Health, Health Care Policy and Aging Research and Department of Psychology, Rutgers, the State University of New Jersey, New Brunswick, New Jersey. Supported by the National Institute on Minority Health and Health Disparities (5P60MD000270-10) and the National Institute of Mental Health (5R01MH77683-2). Presented at Society of General Internal Medicine 34th Annual Meeting, May 4–7, 2011, Phoenix, Arizona. Corresponding author: Elizabeth A. Howell, MD, MPP, Department of Health Evidence & Policy, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1077, New York, NY 10029-6574; e-mail: firstname.lastname@example.com. Financial Disclosure Pfizer supplies medication for an National Institutes of Health-funded study on the treatment of postpartum depression, which is led by Dr. Zlotnick. The other authors did not report any potential conflicts of interest. Abstract PATIENTS AND METHODS RESULTS DISCUSSION REFERENCES Cited By Symptoms of depression postpartum are a major health problem and affect hundreds of thousands of American mothers annually.1–4 Experiencing these symptoms after childbirth has a negative effect on maternal quality of life and ability to function.5,6 In addition, untreated postpartum depression has an adverse effect on maternal–infant interaction that negatively affects infants' cognitive, social, and emotional development.7–10 The burden of postpartum depressive symptoms is especially high in low-income black and Latina women.3,11,12 Prior research by us and others suggests that a range of situational factors such as postpartum physical symptoms, overload from daily demands, and poor social support play a major role in the generation of depressive symptoms.3,13–15 Based on these findings, we created a behavioral educational intervention aimed at reducing the frequency of depressive symptoms in postpartum mothers by preparing women about specific situational triggers of depressive symptoms, bolstering their personal and social resources, and suggesting specific actions to enhance their self-management skills to buffer postpartum demands. The intervention was aimed at prevention of depressive symptoms, not treatment of major depression. The primary outcome was the reduction of positive postpartum depression screens among black and Latina mothers randomized to the intervention arm. Back to Top | Article Outline PATIENTS AND METHODS Participants included 540 self-identified black and Latina postpartum mothers who delivered between April 2009 and March 2010 at a large tertiary inner-city hospital located in East Harlem in New York City. The Program for the Protection of Human Subjects (the institutional review board) at Mount Sinai School of Medicine approved this study. The patient sample was identified through an electronic documentation system for the labor and delivery unit. Eligible participants were black or Latina, aged 18 years or older, and had neonates with birth weights of 2,500 g or higher and 5-minute Apgar scores of 7 or greater. Maternal race, ethnicity, and age and neonatal Apgar scores and birth weight are contained in the electronic system. To ensure eligibility, two bilingual clinical research coordinators asked additional questions of mothers who met initial requirements from the electronic record. Final eligible mothers self-identified as black (or African American) or Latina (or Hispanic), spoke English or Spanish, and had a working telephone. The clinical research coordinators approached mothers between their delivery day and postpartum day 2 (recruitment was done Mondays through Fridays). Patients were assigned a number between 1 and 20 in order of delivery date and time and then approached in the order set by that day's list of random numbers generated by the project statistician. Our study team recruited between 12 and 14 patients per week. After obtaining informed written consent, enrolled participants completed a 20-minute baseline in-hospital survey. Patients were randomized to conditions in four stages. The statistician carried out randomization using a computerized procedure that used a random number generator to assign participants to intervention or enhanced usual care. At the end of each stage, the randomization allocation could be potentially adjusted based on important covariates (eg, race or ethnicity, Edinburgh Postnatal Depression Scale score). No adjustment to randomization was initiated at any time. The research clinical coordinators were blinded to study arm assignment. Patients randomized to the intervention arm were given a two-step behavioral educational intervention. The in-hospital component of the intervention involved a 15-minute, in-hospital review of a patient education pamphlet and partner summary sheet by the mother with a Masters-trained bilingual social worker. The pamphlet represented each potential trigger of depressive symptoms as a "normal" aspect of the postpartum experience and provided specific suggestions for management. For example, the prevalence of moderate or heavy vaginal bleeding immediately postpartum was depicted by eight of 10 female silhouettes colored red; only one of 10 was red 3 months postdelivery. Simple "to do" statements (rest; use pads) were listed between the two rows of figures. Postpartum and 3-month rates and intermediate "to do" lists also were provided for cesarean delivery site pain, episiotomy site pain, urinary incontinence, breast pain, back pain, headaches, hair loss, hemorrhoids, feeling sad and blue or depressive symptoms, and infant colic. A separate page was dedicated to social support and "helpful organizations" were listed. The partner summary sheet spelled out the typical pattern of experience for mothers postpartum, ie, it was designed to "normalize" the feelings and behaviors experienced and enacted by most mothers postpartum and stressed the importance of social support for the patient. The social worker reviewed the patient education pamphlet and partner summary sheet with the patient during her postpartum hospital stay and answered questions. The second and final component of the intervention was a 2-week postdelivery call in which the social worker assessed patients' symptoms, skills in symptom management, and other needs. The "to do" lists to help alleviate symptoms were reviewed when needed and the patient and social worker created action plans to address current needs including accessing community resources. Fidelity of the intervention was maintained by repeated training and review of scripts for both the in-person in-hospital and telephone components of the intervention. Approximately 5% of both in-hospital sessions and 2-week telephone needs assessments were observed by a physician or project manager on the team. The content of the intervention was based on responses from our prior studies, focus groups with postpartum mothers, obstetricians, psychiatrists, social workers, and our community action board. The intervention was pilot-tested with 50 diverse postpartum mothers and revised based on feedback from pilot study participants, the results from two focus groups conducted with black and Latina postpartum mothers, and feedback from community action board members (community representatives from Harlem). Content, pictures, wording, and length were revised according to input from these sources. Materials were translated to Spanish and back-translated for accuracy and consistency of meaning. Enhanced usual care patients received routine postpartum hospital education (ie, discharge materials, television educational programs on infant care, breastfeeding, and peripartum care). To ensure equivalent contact, patients assigned to enhanced usual care control received a 2-week postdelivery call to inform them of future surveys and a list of health-related and community resources was mailed to them. Interviewers were blinded to study arm assignment. All study participants were interviewed by phone at 3 weeks (mean 27.6 days, standard deviation [SD] 5.8; median 27 days, range 20–52 days), 3 months (mean 83.5 days, SD 7.8; median 81 days, range 76–124 days), and at 6 months (mean 175.6 days, SD 8.9; median 174 days, range 165–218 days) to assess depressive symptoms and contributing and buffering factors. Postnatal depressive symptoms were assessed using the 10-item Edinburgh Postnatal Depression Scale. The Edinburgh Postnatal Depression Scale is a common measure used in research to assess symptoms of postpartum depression in both treatment and prevention trials and has been validated in many postpartum populations and different languages.16–29 The recommended cutoff score of 10 or greater has sensitivities of 0.59–0.81 and specificities ranging from 0.77 to 0.88 for major and minor depression.2 The Patient Health Questionnaire-9 was also administered and a comparison was made between the Edinburgh Postnatal Depression Scale and the Patient Health Questionnaire-9 scores over time in a secondary analysis. Survey items also included questions on sociodemographics, clinical characteristics such as antepartum complications, comorbid conditions (eg, diabetes, hypertension, asthma, thyroid disease, heart disease), depression history, anxiety, social support, and health care factors. Medical charts were reviewed for parity, delivery type, insurance, medical history, maternal complications, delivery complications, and infant outcomes. After patients were consented and completed the baseline survey, women reporting high levels of depressive symptoms (Edinburgh Postnatal Depression Scale of 13 or greater, Patient Health Questionnaire-9 of 20 or greater, or suicidal ideation) were referred for inpatient psychiatric assessment and possible treatment. To address risk over time, all mothers, including those referred for inpatient assessment at baseline, were retained in the study, and mothers who reported high levels of depressive or suicidal symptoms at any time point were referred for psychiatric assessment and treatment. Analyses excluding mothers referred for baseline psychiatric intervention during hospitalization were planned a priori. Sample size was powered to detect a clinically meaningful difference in reduction of symptoms of postpartum depression 3 weeks postrandomization for women in the intervention arm in comparison with women in enhanced usual care. Assuming that 46% of black and Latina women would report depressive symptoms (Edinburgh Postnatal Depression Scale of 10 or greater) in enhanced usual care (based on published literature and our studies of postpartum depressive symptoms among inner-city black and Latina mothers3,4), our recruitment target of 460 patients (230 per arm) met 90% power based on a two-sided .05 level χ2 test to detect a clinically meaningful 15% reduction in depressive symptoms (from 46% to 31%, a relative risk reduction of approximately 33%). To allow for decreased power resulting from patient loss at follow-up, we planned to enroll 540 participants. Data were collected in person at baseline and by telephone during follow-up interviews by bilingual clinical research coordinators blinded to intervention status. All data were entered directly into a laptop computerized instrument linked to a Microsoft Access database. Participants in the intervention arm (n=270) and enhanced usual care (n=270) were compared at baseline on demographic and clinical characteristics using t tests and their nonparametric equivalents, χ2 tests, as appropriate. Group differences were summarized by 95% confidence interval estimates. Overall study attrition rate was low and equivalent across treatment groups. The amount of missing data for our primary outcome measure, Edinburgh Postnatal Depression Scale, was low at 3 weeks (13% [71 of 540]), 3 months (12% [62 of 540]), and 6 months (22% [117 of 540]) and similar between groups at each time point. The primary analysis examined the efficacy of the intervention in reducing the likelihood of positive postpartum depression screens. Planned subgroup analyses examined whether the intervention reduced the likelihood of a positive depression screen among mothers who scored below 13 on the Edinburgh Postnatal Depression Scale and were therefore not referred for baseline psychiatric intervention. Before conducting these analyses, missing data were imputed, ie, estimated using a multiple imputation approach.30 Data were assumed to be missing at random because baseline characteristics for those missing outcomes at 3 weeks were very similar to those for whom outcomes were available at 3 weeks with the only significant differences (P<.05) being that those with missing outcomes were more likely to be born in the United States, to speak English, and have a history of depression. The regression models used baseline Edinburgh Postnatal Depression Scale scores and depression history. Five complete data sets were created using multiple imputations and analyzed and combined using the MIANALYZE procedure in SAS. The final parameter estimate and the associated standard errors account for both within- and between-imputation variance. Because imputation yielded similar results to the observed trial results both for the total sample and the subgroup analysis including the mothers not referred for intervention (92% of the sample), we present observed results, the more conservative estimate of effect, for both. The logistic regression analyses tested the effect of the intervention on positive depression screens at 3 weeks, 3 months, and 6 months postpartum. We conducted adjusted analyses for the subgroup of mothers not referred for treatment at baseline. We included independent variables that were associated with a positive depression screen at baseline. To assess change over time across groups for the primary outcome, mixed-effects models using maximum likelihood procedures were used. A significance level of .05 was used for the primary outcome of postpartum depression and the final model was adjusted for baseline depression screen. Back to Top | Article Outline RESULTS Of the 5,968 women who delivered over the study period, 1,528 (25.6%) met the initial eligibility criteria (eg, were black or Latina, 18 years old or older). A total of 668 (43.7%) of the 1,528 eligible mothers were approached in the hospital and reviewed the study consent form. Of the 668 mothers, 540 (80.8%) completed the consent process and were enrolled in the trial and 128 (19.2%) mothers declined to participate (Fig. 1). There were no significant differences between those who consented or declined in mean age, insurance status, primary language, or delivery route. Latina mothers were more likely to decline (P<.05) than black mothers. Of the 270 mothers randomized to the intervention arm, 261 received the intervention in the hospital, although nine mothers were discharged before the social worker could meet with them. Those nine patients were sent the education materials and the social worker reviewed the educational materials over the phone. Ninety-three percent (250 of 270) of the intervention group and 93% (251 of 270) of the control group were successfully reached for the 2-week calls. Of the 540 enrolled patients, nine patients withdrew over the 6-month study period. Completion rates for the follow-up interviews were 87% (468 of 540) at 3 weeks, 89% (478 of 540) at 3 months, and 78% (423 of 540) at 6 months. Follow-up was equivalent for intervention and control at 3 weeks (84.4% compared with 88.9%, P=.09), 3 months (87.8% compared with 89.3%, P=.59), and 6 months postpartum (79.3% compared with 77.4%, P=.06). There were no baseline differences in rates of positive depression screens between women lost to follow-up compared with those included in the analyses at 3 weeks (19% compared with 15%, P=.28), at 3 months (18% compared with 15%, P=.55), or at 6 months (18% compared with 14%, P=.35). Fig. 1 The overall mean age of enrolled participants was 28 years (range 18–46 years); 62% were Latina and 38% were black, 63% had Medicaid insurance, 56% earned $30,000 or less annually, 35% were foreign-born, and 21% spoke Spanish as their primary language. Baseline characteristics of the intervention and control groups are described in Table 1. There were no clinically important differences between the two groups at baseline except that comorbid conditions were more prevalent among the controls than the intervention group (27% compared with 20%, P=.05). The mean Edinburgh Postnatal Depression Scale scores at baseline were 4.2 (SD 4.6) in the intervention group and 4.5 (SD 4.9) in the control group. Forty-five mothers (20 in the intervention group and 25 in the control group) had high levels of depressive symptoms at baseline and were referred for psychiatric assessment or possible treatment while in the hospital. Table 1 In the intention-to-treat analysis (n=540), mothers in the intervention arm were less likely to screen positive for depression than mothers in the control arm: at 3 weeks, 8.8% (20 of 227) compared with 15.3% (37 of 242; P=.03), respectively; at 3 months, 8.4% (20 of 237) compared with 13.2% (32 of 242; P=.09), respectively; and at 6 months, 8.9% (19 of 214) compared with 13.7% (29 of 211; P=.11), respectively. Repeated-measure analysis showed that the intervention was protective against a positive depression screen for up to 6 months of follow-up (odds ratio [OR] 0.67, 95% confidence interval [CI] 0.47–0.97; number needed to treat 16, 95% CI 9–112). Subgroup analyses were planned to estimate the effect of the intervention on mothers not referred for baseline psychiatric assessment and treatment because this intervention was aimed at prevention, not treatment of mothers with severe depressive symptoms. Analyses of the 495 mothers who did not receive an additional psychiatric intervention at baseline showed that mothers in the intervention arm were less likely to screen positive for depression than mothers in the control arm at 3 weeks (7.1% compared with 14.4%, P=.01), 3 months (6.3% compared with 11.4%, P=.058), and 6 months (7.5% compared with 13.1%, P=.068) (Table 2). In multivariable analyses controlling for baseline depression scores, history of depression, country of birth, language, social support, and presence of comorbid clinical condition, mothers in the intervention arm compared with. controls were less likely to screen positive for depression at 3 weeks (adjusted OR 0.37, 95% CI 0.17–0.79), at 3 months (adjusted OR 0.45, 0.21–0.92), and at 6 months (adjusted OR 0.51, 0.24–1.07). Repeated-measure analysis showed that the intervention was protective against a positive depression screen score for up to 6 months of follow-up (OR 0.57, 95% CI 0.37–0.88) among mothers not referred for psychiatric intervention at baseline. Among the 45 mothers referred for psychiatric assessment and treatment at baseline, there was no significant difference between intervention and control in rates of positive depression screens at 3 weeks, 3 months, and 6 months postpartum. Table 2 Back to Top | Article Outline DISCUSSION The results of this trial suggest that a behaviorally focused, educational intervention, delivered in the obstetric setting has the potential to reduce the likelihood of a positive depression screen among black and Latina mothers. Our intervention, designed to address modifiable, situational factors for the prevention of postpartum depression, was successful in buffering the occurrence of such symptoms; both intent-to-treat analysis and subgroup analysis of mothers not referred for psychiatric intervention at baseline demonstrated that mothers randomly assigned to the intervention were less likely to screen positive for depression during the 6-month follow-up period than mothers in enhanced usual care. We believe the significantly lower odds of reporting symptoms indicating a positive screen for depression during the 6 months of follow-up as compared with controls is clinically important because many of the detrimental effects of postpartum depression affect mothers, infants, and families during this crucial period. Given our success in recruiting 540 black and Latina mothers with only a 19% refusal rate, our results are likely representative for mothers from similar racial and socioeconomic backgrounds. The effect of our intervention appeared somewhat stronger among the 495 mothers not referred for psychiatric assessment and possible treatment at baseline. Because the intervention was designed to prevent and not to treat depressive symptoms and those referred were given a potentially stronger personalized assessment and treatment, a behavioral education intervention was unlikely to provide added benefit. For ethical reasons, we decided to continue to include, assess, and refer for formal assessment and treatment any mother who exceeded the highest cut point (Edinburgh Postnatal Depression Scale score of 13 or higher, a Patient Health Questionnaire-9 score of 20 or higher, or suicidal ideation) at any point in time. However, our data do suggest that in settings where mothers are not screened before hospital discharge, the evidence suggests that this intervention shows promise for reducing positive depression screens in the early postpartum period. Our results suggest that one can address and modify the factors that have been reported to be correlated with and hypothesized to elicit postpartum depressive symptoms.3,15 Our intervention aimed to increase mothers ' knowledge about specific triggers of postpartum depressive symptoms by presenting visual displays of the number of mothers likely to experience each symptom, providing simple "to do's" to manage each symptom, and was followed by a visual display of the number of mothers likely to still experience these factors at 3 months. The visual representations made clear that these factors were "normal," manageable with behavioral strategies and tactics, and likely remediated in a defined timeframe. It also emphasized the importance of social support. Finally, specific instructions specified to call one's physician in the event that symptoms did not resolve or worsened and provided a list of existing health-related community services. Although our study is one of few trials that have successfully reduced postpartum depressive symptoms among black and Latina mothers, our results are consistent with a large Cochrane review, which demonstrated that psychosocial interventions to prevent postpartum depression are more likely to be successful if they are individually based, initiated postnatally, and conducted by a health professional.31 Psychoeducational interventions may be especially helpful in the setting of prevention because they avoid some of the stigma associated with mental illness, which is of particular importance for many black and Latina communities. There were limitations with this trial. First, the rate of positive depressive symptom screens was much lower than rates previously published in the literature on perinatal women of color.3,32 Previous studies have rates as high as 50% depending on the screening instrument used and population studied.3,4 Given that the prevalence of depressive symptoms was much lower than expected, our power to detect a meaningful difference was extremely limited in this study. Despite the low prevalence of depressive symptoms in this patient sample, the intervention was found to be effective. Second, we used a depression screening instrument rather than a formal structured interview to diagnose depression. Our intervention was implemented in an obstetrics setting where formal assessments are often too burdensome to perform. Furthermore, positive screens for depression, whether or not they are associated with a diagnosis of major depressive disorder, are associated with multiple negative outcomes for mothers and infants.3,5,13,32 Finally, our trial was implemented in one institution, which limits the generalizability of our results. However, the institution serves a very racially, ethnically, and socioeconomically diverse population in a large urban city. Future research should examine the effect of this intervention more broadly (in multiple settings) and this intervention has the potential to be adapted to an outpatient setting. A behavioral educational intervention, reviewed and modified by mothers and community members, delivered to black and Latina postpartum mothers successfully reduced the likelihood of a positive depression screen in a large urban hospital setting. This first-step intervention focuses on educating and preparing mothers for postpartum experiences and increasing their ability to cope with postpartum demands. Although this intervention does not replace treatment for major depression and may be of limited benefit for those with major depression, it successfully reduced positive postpartum depression screens among low-income mothers of color in this study. It is important to note that the effect during the first 6 months postpartum would likely benefit the infant, mother, and family.Back to Top | Article Outline REFERENCES 1. Martin JA, Hamilton BE, Sutton PD, Ventura SJ, Menacker F, Kirmeyer S. Births: final data for 2004. Natl Vital Stat Rep 2006;55:1–101. Cited Here... | PubMed 2. Gaynes BN, Gavin N, Meltzer-Brody S, Lohr KN, Swinson T, Gartlehner G, et al.. Perinatal depression: prevalence, screening accuracy, and screening outcomes. AHRQ Publication No. 05-E006-2; February 2005. Rockville (MD): Agency for Healthcare Research and Quality; 2005. Cited Here... 3. Howell EA, Mora PA, Horowitz CR, Leventhal H. Racial and ethnic differences in factors associated with early postpartum depressive symptoms. Obstet Gynecol 2005;105:1442–50. Cited Here... | View Full Text | PubMed | CrossRef 4. Zayas LH, Cunningham M, McKee MD, Jankowski KR. Depression and negative life events among pregnant African-American and Hispanic women. Womens Health Issues 2002;12:16–22. Cited Here... | PubMed | CrossRef 5. McKee MD, Cunningham M, Jankowski KR, Zayas L. Health-related functional status in pregnancy: relationship to depression and social support in a multi-ethnic population. Obstet Gynecol 2001;97:988–93. Cited Here... | View Full Text | PubMed | CrossRef 6. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 2001;16:606–13. Cited Here... | View Full Text | PubMed | CrossRef 7. Cogill SR, Caplan HL, Alexandra H, Robson KM, Kumar R. Impact of maternal postnatal depression on cognitive development of young children. Br Med J (Clin Res Ed) 1986;292:1165–7. Cited Here... | PubMed | CrossRef 8. Field T, Healy B, Goldstein S, Perry S, Bendell D, Schanberg S, et al.. Infants of depressed mothers show 'depressed' behavior even with nondepressed adults. Child Dev 1988;59:1569–79. Cited Here... | PubMed | CrossRef 9. Field T. Maternal depression effects on infants and early interventions. Prev Med 1998;27:200–3. Cited Here... | PubMed | CrossRef 10. Righetti-Veltema M, Bousquet A, Manzano J. Impact of postpartum depressive symptoms on mother and her 18-month-old infant. Eur Child Adolesc Psychiatry 2003;12:75–83. Cited Here... | View Full Text | PubMed | CrossRef 11. Lewis-Fernandez R, Das AK, Alfonso C, Weissman MM, Olfson M. Depression in US Hispanics: diagnostic and management considerations in family practice. J Am Board Fam Pract 2005;18:282–96. Cited Here... | View Full Text | PubMed 12. Das AK, Olfson M, McCurtis HL, Weissman MM. Depression in African Americans: breaking barriers to detection and treatment. J Fam Pract 2006;55:30–9. Cited Here... | View Full Text | PubMed 13. Howell EA, Mora PA, DiBonaventura MD, Leventhal H. Modifiable factors associated with changes in postpartum depressive symptoms. Arch Womens Ment Health 2009;12:113–20. Cited Here... | View Full Text | PubMed | CrossRef 14. Howell EA, Mora PA, Chassin MR, Leventhal H. Lack of preparation, physical health after childbirth, and early postpartum depressive symptoms. J Womens Health (Larchmt) 2010;19:703–8. Cited Here... | PubMed | CrossRef 15. Howell EA, Mora P, Leventhal H. Correlates of early postpartum depressive symptoms. Matern Child Health J 2006;10:149–57. Cited Here... | View Full Text | PubMed | CrossRef 16. Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry 1987;150:782–6. Cited Here... | PubMed | CrossRef 17. Eberhard-Gran M, Eskild A, Tambs K, Opjordsmoen S, Samuelsen SO. Review of validation studies of the Edinburgh Postnatal Depression Scale. Acta Psychiatr Scand 2001;104:243–9. Cited Here... | View Full Text | PubMed | CrossRef 18. Eberhard-Gran M, Eskild A, Tambs K, Schei B, Opjordsmoen S. The Edinburgh Postnatal Depression Scale: validation in a Norwegian community sample. Nord J Psychiatry 2001;55:113–7. Cited Here... | PubMed | CrossRef 19. Harris B, Huckle P, Thomas R, Johns S, Fung H. The use of rating scales to identify post-natal depression. Br J Psychiatry 1989;154:813–7. Cited Here... | PubMed | CrossRef 20. Murray L, Carothers AD. The validation of the Edinburgh Post-natal Depression Scale on a community sample. Br J Psychiatry 1990;157:288–90. Cited Here... | PubMed | CrossRef 21. Boyce P, Stubbs J, Todd A. The Edinburgh Postnatal Depression Scale: validation for an Australian sample. Aust N Z J Psychiatry 1993;27:472–6. Cited Here... | PubMed | CrossRef 22. Lundh W, Gyllang C. Use of the Edinburgh Postnatal Depression Scale in some Swedish child health care centres. Scand J Caring Sci 1993;7:149–54. Cited Here... | PubMed | CrossRef 23. Jadresic E, Araya R, Jara C. Validation of the Edinburgh Postnatal Depression Scale (EPDS) in Chilean postpartum women. J Psychosom Obstet Gynaecol 1995;16:187–91. Cited Here... | PubMed | CrossRef 24. Zelkowitz P, Milet TH. Screening for post-partum depression in a community sample. Can J Psychiatry 1995;40:80–6. Cited Here... | PubMed | CrossRef 25. Wickberg B, Hwang CP. The Edinburgh Postnatal Depression Scale: validation on a Swedish community sample. Acta Psychiatr Scand 1996;94:181–4. Cited Here... | View Full Text | PubMed | CrossRef 26. Areias ME, Kumar R, Barros H, Figueiredo E. Comparative incidence of depression in women and men, during pregnancy and after childbirth. Validation of the Edinburgh Postnatal Depression Scale in Portuguese mothers. Br J Psychiatry 1996;169:30–5. Cited Here... | View Full Text | PubMed | CrossRef 27. Ghubash R, Abou-Saleh MT, Daradkeh TK. The validity of the Arabic Edinburgh Postnatal Depression Scale. Soc Psychiatry Psychiatr Epidemiol 1997;32:474–6. Cited Here... | PubMed 28. Carpiniello B, Pariante CM, Serri F, Costa G, Carta MG. Validation of the Edinburgh Postnatal Depression Scale in Italy. J Psychosom Obstet Gynaecol 1997;18:280–5. Cited Here... | PubMed | CrossRef 29. Lawrie TA, Hofmeyr GJ, de Jager M, Berk M. Validation of the Edinburgh Postnatal Depression Scale on a cohort of South African women. S Afr Med J 1998;88:1340–4. Cited Here... | PubMed 30. Rubin DB. Multiple imputation for nonresponse in surveys. New York (NY): John Wiley & Sons; 1987. Cited Here... 31. Dennis CL, Creedy D. Psychosocial and psychological interventions for preventing postpartum depression. The Cochrane Database of Systematic Reviews 2004, Issue 4. Art. No.: CD001134. DOI: 10.1002/14651858.CD001134.pub2. Cited Here... 32. Seguin L, Potvin L, St-Denis M, Loiselle J. Depressive symptoms in the late postpartum among low socioeconomic status women. Birth 1999;26:157–63. Cited Here... | View Full Text | PubMed | CrossRef © 2012 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.


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Saturday, May 15, 2010
Modern Tropical House | Jakarta, Indonesia | Djuhara + Djuhara Architects
In the Indonesian capital of Jakarta, Ahmad Djuhara is on a one-man crusade to blow away the conservative cobwebs of the city's dowdy suburban architecture.
Combine the eight and a half million people living in Jakarta, Indonesia's humid capital, with those dwelling in its nearby satellite conurbations of Bogor, Tangerang, and Bekasi (together known by the portmanteau "Jabotabek") and you've got a combined population that approaches 20 million. Amidst the largely planless urban sprawl, you'll find gleaming modern skyscrapers jostling with mounting ruins of the city's crumbling colonial heritage.
Bekasi, just down a highly accessible toll road, isn't as densely packed as Jakarta proper, but with a population of more than two million, it's hardly a garden suburb. Nonetheless, the prospect of a little more space, cheaper housing, and the work of architect Ahmad Djuhara got Nugroho Wisnu and his family thinking about a new home outside of town.
Wisnu and his wife, Tri Sundari, both come from Indonesia's rather conservative Javanese culture; however, the couple, who both trained in the petroleum industry—Wisnu now works for BP and travels around the country—clearly have a sense of architectural adventure. And considering that the first house they bought in Bekasi proved better for insects than humans—it was uncomfortable, badly designed, and infested with termites—they thought it was time to shop around.
"We thought that an all-steel house like the one that Mr. Djuhara had built just down the road would be termite resistant," Wisnu explains. "However, he proved difficult to pin down as he is a very busy man. We also feared that an in-demand architect would be prohibitively expensive."
Djuhara + Djuhara, the firm Ahmad runs with his wife, Wendy, designed several high-profile bars and restaurants in central Jakarta, and as chair of the Jakarta chapter of the Indonesian Institute of Architects, Djuhara helped to modernize the city's rather draconian planning regulations. His first attempt at a suburban house—the one that caught Wisnu's eye—was startlingly original and cocked a snook at critics who claim that young Indonesian architects only work on luxury hotels.
Labels: Djuhara + Djuhara Architects, Indonesia
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When your significant other presents you with a blinding, four-carat emerald-cut engagement ring and asks that critical question, it can be incredibly simple to lose sight of exactly what the proposal signifies in the excitement of the moment. But how will you know when you're ready to take the plunge and make an everlasting promise to your hubby? Four top relationship therapists offer their expertise on the signs you're ready to say "I do" to getting married.
1. You accept imperfection
New York City therapist Jean Fitzpatrick stresses that marriage requires a couple to accept one another's weakness and imperfections. "You're ready for marriage if you can accept that sometimes your partner is incredibly annoying and that doesn't mean he's not The One," Fitzpatrick explains. "It takes years to turn a guy into The One, years of growing to understand how to talk about tough subjects without blowing up or giving up."
2. You take "for better or worse" seriously
You relationship will have speed bumps — and you have to understand that. "Certain periods in a couple's life — like having kids — are especially stressful on a relationship. Partners who make it a point to spend time together, to be kind to each other, and to say thank you for everyday chores can make it through those tough times stronger than ever," Fitzpatrick maintains.
See More: How Your Wedding Planning Stress Is Hurting Your Fiancé
3. You know your future spouse better than anyone else
Whether it occurs over five years or five months, a profound knowledge of your hubby-to-be is integral to taking the next step in your relationship. New York City-based therapist Irina Firstein encourages couples to foster their familiarity before jumping into marriage, insisting, "[It Is] really important to know your future spouse for some time, like their family of origin, discuss and agree of finances, kids, etc."
4. You and your partner are supportive of each other
Dr. Bonnie Eaker Weil, Ph. D and author of Make Up, Don't Break Up asserts that couples who pay each other compliments, maintain mutual support, and avoid unnecessary criticism are bound to go the distance in their marriages. "Work on that now," Weil states.
5. You fight fair
"Most couples don't know how to fight fair, with respect. Respect always breeds love," Weil reminds couples.


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Portfolio Murray Velvet Flocked Faux Silk Duvet Cover Set, Oyster - King
Murray King Oyster Duvet Cover & Pillowcase Set boasts a soft to the touch fabric adorned with glamorous two-tone flocked panels of velvet with a contemporary geometric design. Pair the duvet cover set with the matching cushion and runner for a coordinating look. Duvet set includes quilt cover and two pillowcases.
Availability: In stock Free UK Delivery!
Portfolio offer a wide range of bed linen to suit everyone, whatever their style. From clean, simple checks to stunning geometric designs, from charming patchworks to elegant florals, whatever you desire, Portfolio offer something to compliment or to contrast.
Exuding luxury and elegance, the Murray Bed Linen Range from Portfolio is ideal for transforming your bedroom for the new season. Featuring a soft to the touch faux silk feel, Murray is decorated with a glamorous flocked panel of two-tone velvet complete with a contemporary geometric design to bring a touch of Manhattan styling to your bedroom. Available in on-trend oyster or stone, coordinating boudoir cushions and bed runners are available separately to complete the sophisticated look.
Available in single, double, king or super king sizes, Murray comes with matching pillowcase(s), one with single and two with double, king and super king sizes, that are also adorned with flocked velvet panels. Combining the look of luxury with sumptuous patterned fabrics, Murray has been delicately crafted from a mixture of Polyester Velvet, Polyester Bamboo and Cotton for a quilt cover set that washes well and requires minimal ironing.
|King - Duvet Cover W230cm x L220cm, Pillow Case W50cm x L75cm
|Face: 100% Polyester Velvet, Reverse: 50% Polyester Bamboo 50% Cotton
|Duvet Cover and Two Pillow Cases
|Washing Instructions:
|Machine washable at 30°C, can be tumble dried, warm iron
|Delivery Information
Delivery available worldwide.
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|Polyester / Cotton
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Rules on site:
Technical rock climbing is inherently dangerous. All climbers must understand and accept the risks involved. Any person using any gear in any manner is personally responsible for learning the proper techniques and exercising good judgment. We strongly recommend that every climber seek instruction by a qualified professional. You are responsible for inspecting all pieces of fixed anchor points and intermediate bolts for safety on each climb and you are responsible for knowing and respecting your own capabilities and limitations as well as the limitations of all the climbing equipment you are using. Be aware that loose rocks are a constant hazard. Climbers must be vigilant and always "test before you trust" the stability of a rock hold. We strongly advise everyone to wear proper rock climbing helmets at all times near the rock wall. Furthermore, always know the maintenance and use history of your equipment and destroy retired gear to prevent future use. The use of secondhand equipment is strongly discouraged. You are responsible for your own actions and decisions. Failure to follow these warnings can result in severe injury or death. MCU is not liable for any injuries.
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Day 3
One in a Billion
Today Chris is traveling to a new part of India - on a train!
He will show you what life is like for over 700 million people in India who live in rural villages. You'll meet more kids who are attending Children's Bible Clubs.
And one little boy has a very special invitation for Chris...


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Sony Playstation Rewinds To 1995 in Nostalgic New Spot
Brand Was Inspired By User Memories Of Video Games
Published on Oct 21, 2013
Editor's Pick
There's incredible attention to detail in this European ad for Sony Playstation 4, which takes us back to 1995 and shows us the history of Playstations 1, 2, 3 and 4 right up to the present day. The action centers on a London flat (and its occupants), with the changing London skyline outside only just one hint of the four different eras depicted. From the posters on the walls to the fashion, hairstyles, products lying around and of course the style of TV, the spot is a huge nostalgia-fest and will no doubt delight die-hard fans of the brand who remember Playstation 1. (We're also glad to see that the flat's occupants have finally tidied up in 2013).
The campaign, by specialist branded content agency Drum, also includes a competition on the Sony Europe website. Viewers can guess the correct order in which the four Playstation symbols appear in order to win a PS4.
On its blog, Sony says it was inspired by the hashtag #PlayStationMemories which trended worldwide earlier this year. "We read a lot of your tweets and messages and wanted to make a film to represent what PlayStation has meant to all of us since 1995," says the brand. It also explains how other brands including Domino's helped, by supplying authentic products from the different dates. Watch the Making Of video to see more.
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- Date
- Oct 21, 2013
- Agency:
- Drum
- Client:
- Sony Playstation
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I have more pleasant things to focus my attention, time, and resources on than Gamergate or the Gamergate thread, such as pouring hot sauce in my eyes, lemon juice enemas, and imagining being eaten alive by fire ants.
A painting of a sailing ship being towed by steam tugs.
Guys, this is getting creepy. Can we talk about cannibalism instead?
"I don't give a fuck about race...I'm white, I'm American, but that shit don't matter. I'm human."
Yeah, gays cause hurricanes, tits cause earthquakes, and lack of prayer causes tornadoes. Learn to science, people.
Porn peddlers peddling pedal porn? My life is complete.
That may be the single gayest thing I have ever read on this board. Or the old one.
Life for the sake of life means nothing.
You get the "yo dawg" guy (whatever the fuck his name is).
Ok seriously, is nobody even going to try and avenge my man-burrito?


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Ahhh the details, the decorating, the cake, the flowers & other assorted fun things that kept me awake many a night with my brain going a million miles an hour over the past 12 months! Things that came from hours of wedding blog trawling, pages torn from magazines, random hair brained ideas & the 'art & craft' that took over our little apartment....twas fun... But i admit, i am slightly relieved i have my brain back now :) I wanted to share this post to show you the results of all my inspiration posts over the last year & to thank all the suppliers that helped me with my 'projects'!
Our invites were letterpressed by Love vs Design
The venue Terrara House Estate is decoration in itself!
Ok, so somehow this is the only photo i have seen so far of our paper bag programs?!
Speaks for itself really! Our programs were printed onto brown paper bags that were filled with petals for throwing.
Designed with help from & printed by Christina from Extravagant Exists via Etsy.
We filled french antique wire baskets (lent to me by a lovely client) with them & they were passed around before the ceremony.
The table was set up like a road side jam stall (the type i always make Ben stop at so i can buy jam!) Each jar had your name & table number on it. My grandmother & i made all the fabric covers.
Labels & tags designed with the help of Belletristics via Etsy
Image: The Simple things studio
Sally DIY sign! (one word - bunnings!)
Spent about 10 months collecting jars to hang filled with flowers from the tree's in the drinks area.
Thanks to all the friends & family who collected, washed & my awesome aunties who hung them on the day!
The amazing table at the entrance to the marquee was styled by Terrara House.
maybe a few to many emails from myself lol)
The big flower arrangement had dahlias, hydrangeas & yucca's!
Our beautiful bouquets were by The Shady Fig (check out the divine website!)
They had david austin roses, hydrangea, gardenia, tuberoses & smelt amazing!
Loved the thick black & white grossgrain ribbon too :)
The cake was by the divine Patricia at Yummy Cupcakes & Cakes.
I cant tell you how amazing it was in the flesh - the sugar peonies were a work of art.
Patricia is well on her way to becoming a superstar - if you are looking for a wedding cake call her right this second! The cakes stand is from Bountiful in Venice (Los Angeles - near Santa Monica!) supercool shop on Abbott Kinney Blvd (if your ever there check it out!)
Place cards were simple swing tags (also from Etsy) which i hand wrote & tied with twine!
For our guestbook we had a polaroid camera for guest to take snaps & then stick into the book with a note. I pre stuck photo corners (from Typo) into the book to make it easy for them! The guestbook was custom made by Lorgie & Me - by far the nicest one i ever came across! Signs designed by me (photoshop is fun!)
I made the box for the back of my bike with a cheese box & wooden letters from spotlight that i painted!
Another thing you may have noticed is that the 'bouff' on my dress came off!
Surprise! Underneath was a sleek sequin number :)
When we get the full set of photos from the photographer ill share a few more from the reception.
Ben made the most amazing speech i have ever heard (i cried my false eyelashes off!)
I am lucky to have such a caring & thoughtful husband who is so excited about the next part of our lives!
Thanks for all the well wishes, advice & nice words over the past year