text:
HELLP syndrome is a life-threatening pregnancy complication usually considered to be a variant of preeclampsia. Both conditions usually occur during the later stages of pregnancy, or sometimes after childbirth.
HELLP syndrome was named by Dr. Louis Weinstein in 1982 after its characteristics:
H (hemolysis, which is the breaking down of red blood cells)
EL (elevated liver enzymes)
LP (low platelet count)
HELLP syndrome can be difficult to diagnose, especially when high blood pressure and protein in the urine aren't present. Its symptoms are sometimes mistaken for gastritis, flu, acute hepatitis, gall bladder disease, or other conditions.
The mortality rate of HELLP syndrome has been reported to be as high as 30%. That's why it's critical for expecting mothers to be aware of the condition and its symptoms so they can receive early diagnosis and treatment.
The physical symptoms of HELLP Syndrome may seem at first like preeclampsia. Pregnant women developing HELLP syndrome have reported experiencing one or more of these symptoms:
Signs to look for include:
The most common reasons for mothers to become critically ill or die are liver rupture or stroke (cerebral edema or cerebral hemorrhage). These can usually be prevented when caught in time. If you or someone you know has any of these symptoms, please see a healthcare provider immediately.
Most often, the definitive treatment for women with HELLP Syndrome is the delivery of their baby. During pregnancy, many women suffering from HELLP syndrome require a transfusion of some form of blood product (red cells, platelets, plasma). Corticosteroids can be used in early pregnancy to help the baby's lungs mature. Some healthcare providers may also use certain steroids to improve the mother's outcome, as well.
Among pregnant women in the United States, 5 to 8% develop preeclampsia. It's estimated that 15% of those women will develop evidence of HELLP syndrome. This mean as many as 48,000 women per year will develop HELLP syndrome in the US.
We can help lower the cases of HELLP syndrome by properly and quickly diagnosing and treating preeclampsia.
Unfortunately, there's currently no way to prevent this illness. The best thing to do is:
The severity of HELLP syndrome is measured according to the blood platelet count of the mother and divided into three categories, according to a system called "the Mississippi classification."
If a baby weighs at least 2 pounds (over 1000 grams) at birth, he or she has the same survival rate and health outcome of non-HELLP babies of the same size.
Unfortunately, babies under 2 pounds at delivery don't fare as well. Several studies have suggested these babies will need longer hospital stays and will have a higher chance of needing ventilator care. Unfortunately, right now doctors can't predict the scope of the medical problems that these small babies will encounter at birth and later in life.
In developed countries, the stillbirth rate (in utero death of the baby after 20 weeks) is 51 out of every 1,000 pregnancies. This rate is higher than both severe preeclampsia and eclampsia.
Overall perinatal mortality from HELLP Syndrome (stillbirth plus neonatal death) ranges from 7.7 to 60%. Most of these deaths are attributed to abruption of the placenta (placenta prematurely separating from the uterus), placental failure with intrauterine asphyxia (fetus not getting enough oxygen), and extreme prematurity.
Women with a history of HELLP syndrome are at increased risk of all forms of preeclampsia in subsequent pregnancies. The rate of preeclampsia in subsequent pregnancies ranges from 16 to 52%, with higher rates if the onset of HELLP syndrome was in the second trimester. The rate of recurrent HELLP syndrome ranges from 2 to 19% depending upon the patient population studied.
AWHONN Indiana
Indianapolis, Indiana
August 23, 2019
Invite Us to Speak at Your Event
Faces of Preeclampsia


text:
Mainstream groups such as the American Heart Association and the American Dietetic Association endorse a unified set of dietary guidelines for people who wish to lose weight—eat a low-fat diet and cut calories.
However, many popular diet books take a very different approach. The Atkins diet, the Zone diet, Protein Power , and numerous other dietary approaches turn thumbs down on low-fat. Instead, these methods recommend cutting down on carbohydrates. According to proponents of these theories, when you reduce the carbohydrates in your diet (and, correspondingly, increase protein and/or fat), you will find it much easier to reduce your calorie intake, and you may even lose weight without cutting calories.
The controversy over these contradictions has been heated. Proponents of the low-fat diet claim that low-carbohydrate diets are ineffective and even dangerous, while low-carb proponents say much the same about the low-fat approach. However, an article published in the Journal of the American Medical Association suggests that neither side has a strong case. Researchers concluded, essentially, that a calorie is a calorie, regardless of whether it comes from a low-carbohydrate or a low-fat diet. 1 They did not find any consistent evidence that the low-carb diet makes it easier to lose weight than the low-fat diet, but neither did they find any consistent evidence for the reverse. Furthermore, the authors of the JAMA review did not find any compelling reason to conclude that low-carb diets are unsafe, although they did point out that the long-term safety of such diets remains unknown.
Subsequent studies confirmed these findings for a variety of low-carb diets. 4-9,11-15,18,20-21,29 In some studies, one particular diet method may do better than others. But, in other studies, a different diet stands out.
For example, researchers reviewing 13 studies comparing low-carb against low-fat/low-calorie diets in overweight subjects for at least 6 months concluded that the low-carb diets tended to perform better at reducing weight and cardiovascular disease factors for up to 1 year. 31 But, in a subsequent trial involving 144 obese subjects with diabetes, researchers found that a low-carb diet did not result in greater weight loss when compared to a low-fat diet over a 2-year period, nor did it perform any better at improving blood cholesterol or glucose levels. 32
As research continues, a consensus has yet to emerge among nutrition scientists as to which diet performs better overall. Many of the studies cited above suggest that if a diet causes weight loss, cholesterol will improve regardless of the diet used to achieve that weight loss. However, the manner of change in cholesterol profile differs between the two approaches. Low-fat diets tend to improve total and LDL cholesterol levels, but worsen HDL and triglyceride levels, while low-carb, high fat diets have the opposite effect. 22
The Mediterranean diet, which is relatively high in fiber and monounsaturated fats (eg, olive oil) has also attracted the attention of nutrition researchers. There is good evidence that it is as effective as low-carb diets for weight reduction, and probably more effective than low-fat diets. 30 It also seems to have the added advantage of benefiting diabetic patients more than the other two diets.
However, if one undertakes a low-carb (or low-fat) diet that does not cause weight loss, cholesterol profile will probably not improve significantly. In addition, there is little to no evidence that the low-carb approach improves blood sugar control except insofar as it leads to weight loss. However, there is a bit of evidence that a low-carb, high-monounsaturated fat diet reduces blood pressure to a slightly greater extent than a high-carb, low-fat diet. 19 Contrary to claims by some low-carb proponents, low-fat, high-carb diets do not seem to metabolically backfire and promote weight gain. 16
Therefore, based on the current state of information, it seems that the most sensible course is as follows: If you need to lose weight, experiment with different diets, and see which one allows you to most easily cut calories (and keep them cut). If the low-carb diet approach works for you, stick with it. However, if it does not help you lose weight, you probably should not continue it indefinitely.
Note : Any form of extreme dieting can cause serious side effects or even death. We strongly recommend that all people who intend to adopt an unconventional diet should first seek medical advice. Furthermore, people with kidney failure should not use low-carb, high-protein diets, as high protein intake can easily overstress failing kidneys. (High-protein diets are probably not harmful for people with healthy kidneys. 2,3 )
In addition, people who take the blood thinner warfarin (Coumadin) may need to have their blood coagulation tested after beginning a high-protein, low-carbohydrate diet. Two case reports suggest that such diets may decrease the effectiveness of warfarin, requiring a higher dose. 10 Conversely, if you are already on warfarin and a high-protein, low-carbohydrate diet and go off the diet, you may need to reduce your warfarin dose.
Revision Information
- Reviewer: EBSCO CAM Review Board
- Review Date: 09/2014 -
- Update Date: 09/18/2014 -

subset: commoncrawl


text:
Sudden infant death syndrome (SIDS) refers to the unexpected, unexplained death of a child less than 1 year old. SIDS is rare during the first month of life. It peaks at 2-4 months of age, then gradually decreases.
Experts do not know the exact cause of SIDS. Many theories exist. Potential causes include:
- Abnormalities in a section of the brain that controls breathing during sleep and waking
- Abnormalities in the control of heart rhythm
- Changes in how serotonin, a neurotransmitter, functions in the brain
- Changes in some components of the immune system
- Inadequate arousal response to breathing obstruction or asphyxia—a lack of oxygen or excess carbon dioxide
Risk Factors
SIDS is more common in infants less than 6 months old. Other factors that increase your infant's chance of SIDS include:
- Low birth weight
- Delayed fetal growth
- History of SIDS death in a sibling
- History of an acute life-threatening event
- Previous incident of unexplained severe apnea—when breathing is repeatedly interrupted and requires resuscitation
- Sleeping on the stomach or side rather than back
- Co-sleeping in parents bed
- Loose covers and blankets
- Overheating
Other risk factors are more general and include:
- Smoking during pregnancy or in a house where the baby is sleeping
- Alcohol , excessive caffeine, opiate, or cocaine use during pregnancy
- Mother's age—younger than 20 during first pregnancy
- Poverty
- Black, Native American, and Alaskan Native families
- Sex: male
- History of anemia or a urinary tract infection while pregnant
- No or late prenatal care
- Premature birth
- Recent infection and/or fever
- Cold weather in late fall or winter
- Low socioeconomic status or low level of education
A baby that dies of SIDS typically appears healthy. The baby may have had a cold or gastrointestinal infection in the 2 weeks prior to death. There usually are no warning signs that a baby is about to have SIDS.
All possible illnesses and causes of death must be ruled out before a diagnosis of SIDS is made. A complete investigation will take place including:
- Autopsy
- Assessment of the death scene
- Review of the baby and family's medical histories
Emergency medical personnel should be called as soon as the infant is discovered not breathing. Infant CPR should be started right away. Seek medical care right away even if the baby starts breathing again. The cause of the incident should be fully evaluated. Families may need grief counseling after the death. Some parents find support groups helpful.
There is no way to predict which infants will die of SIDS. Several actions may help you lower your child's chance of SIDS:
During pregnancy:
- Get prenatal care early and regularly.
- Do not smoke, drink alcohol, or use drugs while pregnant.
After birth:
- Babies less than 1 year old should sleep on their back. Do not allow a young baby to sleep on their stomach or side. However, many babies roll over after 6 months of age and do not require constant monitoring of sleep position. Ask your doctor for more information about positioning your baby for sleep.
Other factors that may help reduce SIDS risk include:
- Provide a firm crib mattress.
- Breastfeed your baby.
- Do not place blankets, a comforter, pillow, or sheepskin under your baby.
- Do not let your baby sleep on a waterbed.
- Remove soft, stuffed toys and loose bedding from the sleep area.
- Do not cover your baby's head or face.
- Have your baby sleep in the same room as you do for at least the first 6 months, but ideally for the whole year. However, do not share your bed.
- Practice skin-to-skin contact with your baby as soon as possible after birth.
- Keep the bedroom at a comfortable temperature (68-72°F [20-22.2°C]).
- Avoid overheating. Do not overdress your baby.
- While your baby is awake, place him on his stomach so that he can move his body.
- If you smoke, do not smoke in the house or around your baby. Ask your doctor about ways you can quit.
- Be sure that your baby gets routine medical care, including the recommended vaccines.
- Do not use cardiorespiratory monitors or other commercial devices that claim to reduce the risk of SIDS. There is no evidence that these devices are useful.
- Learn infant CPR.
Make sure anyone else caring for your child is also aware of these recommendations.
Revision Information
- Reviewer: EBSCO Medical Review Board Kari Kassir, MD
- Review Date: 03/2018 -
- Update Date: 09/26/2017 -


text:
Export 13 results:Author Title [ Type] Year
Filters: Author is Joseph H. Eto [Clear All Filters]
Integration of Distributed Energy Resources: The CERTS MicroGrid Concept. CERTS, 2003. LBNL-50829..
Journal Article
"Evaluation of Control Methods to Prevent Collapse of a Mixed Source Microgrid." IEEE Transactions on Industry Applications 52.6 (2016). LBNL-1006118..
"Design and Operation of Smart Loads to Prevent Stalling in a Microgrid." IEEE Transactions on Industry Applications 52.2 (2015) 1184-1192. LBNL-1005169..
"CERTS Microgrid Laboratory Test Bed." IEEE Transactions on Power Delivery 26.1 (2011). LBNL-3553E ..
Conference Paper
"Web-Based Economic and Environmental Optimization of Microgrids." 2012 IEEE PES Innovative Smart Grid Technologies Conference. Washington Marriott Wardman Park, Washington D.C., USA, 2012. LBNL-6354E..
"Validation of the CERTS Microgrid Concept: The CEC/CERTS Microgrid Testbed." IEEE Power and Energy Society General Meeting. Montreal, Canada, 2006. 3. LBNL-60326..
"An R&D agenda to enhance electricity system reliability by increasing customer participation in emerging competitive markets." IEEE Power Engineering Society Winter Meeting, 2001. 2001. 247-251 vol.1..
"Overview of the CERTS microgid laboratory test bed." Integration of Wide-Scale Renewable Resources into the Power Delivery System, CIGRE/IEEE PES Joint Symposium. Calgary, AB, Canada: IEEE, 2009..
"Modeling, Analysis and Evaluation of Smart Load Functionality in the CERTS Microgrid." 2014 IEEE Energy Conversion Congress and Exposition (ECCE). Pittsburgh, PA: IEEE, 2014. LBNL-1005173..
"Evaluation of control methods to prevent prime-mover stalling in a mixed source microgrid." IEEE Industrial & Commercial Power Systems Technical Conference. IEEE, 2016. LBNL-1006117..


text:
Western equine encephalitis (WEE) is a virus spread by a bite from an infected mosquito. While WEE is rare, an infection can be serious or fatal.
Risk Factors
Factors that may increase your chance of WEE include:
- Living in or visiting the plains regions of western and central US
- Doing activities outdoors and not using insect repellent
Most people with WEE do not have any symptoms.
If symptoms do occur, they appear within 5-10 days after infection and include:
- Headache
- Fever
- Nausea and vomiting
- Neck stiffness
- Chills
- Fatigue
- Joint and muscle pain
WEE can lead to more serious, life-threatening symptoms like inflammation of the brain (encephalitis), seizures, and coma . These serious symptoms are more common in infants and older adults.
In addition to taking your medical history and doing a physical exam, your doctor will ask you:
- What kind of symptoms you are experiencing
- Where you have been living or traveling
- Whether you have been exposed to mosquitoes
Your doctor may need to test your bodily fluids. This can be done with:
- Blood tests
- Lumbar puncture to evaluate the fluid that surrounds the brain and spinal cord
Imaging tests to evaluate the brain can be done with:
Because the infection is viral, there is no specific treatment for WEE. Treatment will focus on managing your symptoms and related complications through:
- IV fluids
- Antiseizure medications
- Medications to decrease brain swelling
- Mechanical ventilation
There is no vaccine for humans. There is a vaccine for horses. Prevention of WEE focuses on controlling mosquitoes and avoiding mosquito bites. Steps you can take to avoid mosquito bites:
- Stay inside between dusk and dark, when mosquitoes are most active.
- Wear long pants and long-sleeved shirts when outside.
- Use an insect repellent with DEET.
- Repair screens to prevent mosquitoes from entering the house.
- Use proper mosquito netting at night. Look for netting treated with insecticide.
- Remove standing water (such as birdbaths, clogged gutters) to prevent mosquito breeding.
Revision Information
- Reviewer: EBSCO Medical Review Board David L. Horn, MD, FACP
- Review Date: 11/2018 -
- Update Date: 12/20/2014 -


text:
Because prostate enlargement occurs naturally with advancing age, and because there are no known controllable risk factors, there are no guidelines for prevention. Prostate enlargement is more common in men with obesity and low HDL cholesterol levels. Some research shows that factors like a healthy diet, maintaining a healthy weight, regular exercise, and not smoking may help.
Revision Information
- Reviewer: EBSCO Medical Review Board Adrienne Carmack, MD
- Review Date: 09/2018 -
- Update Date: 09/17/2014 -


text:
This extremely long page contains emails I've received recently about my books, poems, my writing tips, requests to borrow poems and much more.
Thank you so much Andrea for writing the How to Write a Children's Picture Book and get it Published. It's wonderful ,and I can see how it will save me time and otherwise wasted efforts. I didn't realise the importance of word count. I have quite a
few stories completed. All around 1000 words. I can now see for the first time how slap dash I have been using sentences that add nothing to the story. Keeping it simple, it really is quite exciting, thanks again for sharing your experience.
Carl Bromwich
Firstly thank you for your 'How to Write a Children's Picture and get
it Published'. It is really going to be great help. Have read it twice through already
Kind regards
Black Holes for my homework. I need a Space poem. My homework is to
write a poem neatly and decorate it for a good presentation. Could i
use your poem please it will only stay in my homeworkbook.
I have begun writing children's picture books and read your, 'how to
write a children's book'. I have found it amazing and is by my side to
check questions as I go. I am however still a little confused in
sending manuscripts. Can I send my manuscript to more than one
publisher at a time or do I need to give them a chance to reply?
Also I'd like to say thank you for your insight and sharing your
experience, knowledge and encouragement. Alix Moore
My daughter is doing a project on Medieval Castles. She
needed a poem that related to her topic of protection against enemies.
She is making a powerpoint and wanted to post your poem 10 ways to
attack a castle. She will post your name with it Stacey Carpenito
Dear Andrea,
I hope you are super well! My name is marina and I have just finished to read your "How to write
a children picture book and get it published". I really enjoyed it and
your writing style too.
Dear Andrea
Thank you for letting me use your poem. I told everyone about your website
and they thought your poem was really great. I got a distinction for
reciting it. Thanks again, I really liked my Aunt the extra-terrestrial as
Dear Andrea
I have to learn a poem about space and I would like to use your amazing
poem, The Advent Horizon to recite it to the class
Thank you Sam
Hello Andrea,
Having read your 'How to write a children's picture book' I wanted to
say a big thankyou for opening a window into this challenging field.
All I have to do now is bang on a few (publisher's) doors and hope they
open them! You have been an inspiration.
Thank you, Penny Pedlar
I was wondering if I could use the poem "moving on" for a
school speech? Summer
Hello Summer. I'm afraid I cannot give you permission to use anyone else's work, only my own. This is an important copyright issue. Maybe you can find one of mine you like.
Hello, I am called Odoki David living in Uganda. I work as an
information officer for a childcare organisation and produce a
childrens magazine called childlink magazine. It is a magazine
we produce and give to children in Ugandan schools for free, I
would love to publish some of your poetry in an upcoming issue
as they are informative, educative and entertainig and very
relevant toschool children Please allow me to do this,the
organisation i work for is on the web at www.anppcanug.org
Hi Andrea
thank you for your book, 'How to write a children's picture
book and get it published.' I found it so helpful. I have
always worried about the covering letter and your template was
just what i needed.
best wishes
Hello Andrea,
I have just finished working through your 'How to write picture
books' and have now sent off one of my picture books to two
publishers. thank you for giving me the confidence to do it.
Mrs C.Richardson,York,UK
I have just bought & read your How to Write Children's Picture Book.
I really enjoyed reading it. Now to put it into practice!
Jean Webster
Hi Andrea. I recently purchased your 'How to Write a
Children's Picture Book' and devoured it in a single evening.
Great read! Mark Smith
Thank you for sharing with us, I think this website
genuinely stands out : D. 13 November 2011
I loved the description about you dropping the glass of water on
the head teacher's foot in front of the whole school. Francesca C
Dear Andrea
I need to choose poems for a school project and I like the
poem Advent Horizen please allow me to use it.
From Robert Bruce at Wetpups.Cape Town South Africa
Love your web site and very user friendly - well done!
Hope it's a great success... Paula Mitchell
Greetings everyone - I'm a fresh participant on this message
board therefore I believe I would do best to say a few things
about myself. Here goes, I'm 23 years of age, female, and I
read politics in my school. I for sure can't wait talking
with you folks. Au revoir! Deetta
Dear Andrea,
My teacher asked our class - Std V to learn a short funny poem. I really loved your poem about Black Holes. May I narrate it in my classroom? Regards, Shloka Mariwala.
NAME: Sue Wicks
Having searched long and hard for a simple and easy to understand guide to publishng a children's book I was relieved to discover you website.
Thank you.
(I don't think I've been put off yet.)
NAME: NAvjat
The poem that i liked thre besy was miss picky !!!!!GREAT POEM!!!!!
NAME: *~*Baby Gigglez*~*
NAME: Lucy Wetton
Dear Andrea,
Thank you for an amusing and really informative read. It feels like you have just provided me with an insight to the secret 'Authors world' with a pinch of blunt, yet realistic advice thrown in for good measure.
I have found your advice really helpful and I look forward to my first attempt at getting published!
Thanks once again!
Lucy (Cambridge)
NAME: Linda Clode
I am an absolute neophyte who really appreciates your witty information.
However, now that I am overwhelmed, I will put my 8 stories back in their box and wait awhile before I again consider getting them published.
I do love golfing.
Thanks, Linda
Hello Andrea,
I'm sure you get emails like this all the time but I really need some help. I have an interview / assessment centre this Friday and as part of the process I have to do an Fastrack test, which I believe is part of the SHL groups testing portfolio. The only problem is I can't find any examples of these type of test so I can practice.
Can you help. I'm just out to buy your book now
Good idea, lots of genuine SHL tests in my books
NAME: liam
my skool is swalloowdale im in melton mowbray and England i love all of your work it isd the best ever
Hi Andrea,
what u been up to i really like the poems their aswome for realz i really like reading poems.
Hilaria Ochoa 13 years old
ok thank you so much but its time to be honest my real name is caroline i go to school in tampa I would love it if you could come and do a school visit. i love and enjoy all of your poems excpecially my old mummy write back soon i really didnt want to mencian my name at first because i didnt want to get blackmailed
Goodness well if somebody woudl pay my expenses I'd love to do a school visit in Tampa!
NAME: Cora
In: Bushey
Hi. You visited my school a couple of weeks ago and I just wanted to say i really enjoyed hearing about your books. Also I'd like to buy a book of yours but im not sure which one. What would you reccomend?
NAME: Talia
Hi andrea do u remember when u came 2 Highwood primary school 2 open our libary? I was dressed up as tinkerbell if u saw me i love your books and poems i think there great!!! xxxxxx Talia
NAME: Marc Mitchard
Hi Andrea
My friend and I are in the process of producing a childrens story/picture book (there is a second in the pipe line too) . My friend has written the story and I have illustrated. I know in your get published page you suggest not sending art work but the idea for us was to do something creative together. So my first question is will this hold us back if we want to stick with original art work and why?
You can send the story and the artwork, just make it clear you don't mind if they reject one half of the duo. Otherwise if they hate the artwork, the whole proposal will be rejected.
NAME: Chrissy-T
Dear Andrea,
I am working on a presentation, and i was just reading your poems. WOWEEE!!! they're really nice!
I would like to use one of them from my visual project (a poster). Don't worry. I'll write it's by you.But what is your last name?
Do you know, Chrissy T, I believe it begins with an S.
I just love the poem called "Miss Picky!" It relates to my LA teacher and I just HAVE to share it with her.
Keep writing!
NAME: Leigh Kemp
i have read the whole of you 'how to get published' and im now scared!
i'm 19 and i'm just finishing my first fantasy story. i have now learnt that i should send it everywhere and not hope for much, and even if someone does take an interest i will need other stories in the bank for them to invest in me. i am planing other things, but when i feel pressured to write nothing comes out.
Thank you for your time!
Leigh Kemp
Hi Andrea,
I think your poem "Predictable" is great and would like my Year 1 class at Altrincham Preparatory School to recite it at our end-of-year prize giving event. Please could you let me know if this will be ok and how much we will have to pay. Thanks very much.
Liz Atkinson
On the other hand, I think I've been more than compensated by receiving this one.
PS I never charge anything, just quote me as author.
NAME: Phillipa Bayliss
Dear Andrea,
This 'page' has been bookmarked in my 'cheer-me-up' folder (I also write notes to myself with inspiring quotes for the much needed 'cheer-me-up' moments). It's so encouraging to read your words, and laugh over rejections - really! We all know we mustn't give up, it's not personal, etc, but they do eat away at your confidence and hope. I mean, what if my work IS rubbish? What if it NEVER attracks an agent or editor's interest? How many times is it 'normal' to be told "no thanks" (Yikes! Have I had more "no's" than normal?)... and so it goes.
I'm going to try to get hold of your books - I think you've made a fan of me, just by being approachable and encouraging! Thank you so much! I do apologise for rambling on (there's nothing better than a consoling fellow writer to open up to).
I wish you every success,
Phillipa, Canada
NAME: Paula McBride
Great site, I really enjoyed reading and giggling through "Get Published".
NAME: Hillary vasuqez
Andrea You chose some good poems and I always go this poetry page and I always find good poems and the poems you write are really nice too god bless your taste for poems and you are a real poet sincerely ,Hillary v
NAME: Kalp Pat
Hi my name is kalp from london, i am apply for a finance graduate posiition and i will be reqired to do a SHL verbal reasoning and Numerical reasoning test. I was hoping you could advise me on possible resources of help and the best way to pass these tests with high marks. I have done one SHL test before and i didnt do so well in it.
NAME: Maeve O'Mahony
I would like permission to use the wonderful poem 'Advent Horizon' as part of my English classes this term.
Thank you
Maeve O'Mahony, Concordia Lutheran College, Toowoomba Australia
NAME: Mary
Hi! I want to use the poem that talked about how to persuade your parents to give you more pocket money for poem in the pocket day. I loved that poem. Plus really I am am a natrual persuader.... I persuaded my sister to dump out the ice cream she hates.....
Dear Ms. Shavick:
My fourth grade class is studing poets. My teacher assigned me you. I really like your poetry, especially the nasty, grusome bloodthirsty ones :) . Please come visit if you are ever in Florida!
Thanks, Jake Pinckney, Gorrie Elementary School, Florida USA
NAME: Allison Kelly
I was looking for poems to use on my screen saver for my home computer. nothin big! just a really cool poem and i really liked yours... can i copy it and use it on my screen saver?
NAME: Alastair Bishop
Just a quick note to say thank you very much for your article on getting published. I found it really useful.
Cheers Alastair
NAME: miss nits
I really like the poem miss nits it is a very funny poem!!!!!!!!!!!!!!!1
NAME: Jacqueline
Hi! I used to work for Mills & Boon (oh, yes, I did). I was a production editor so I didn't have to read the slush pile, thank god (I'm afraid romantic fiction was never my cup of tea. Anyway, I'm thinking of writing a novel and I find your advice absolutely great.
Best wishes, Jacqueline
NAME: Mr Robert Scott
Hi first of all I found just about everything here interesting and a few things use full. I am in the process of writting my first book.
NAME: zainab
Hi Andrea I haven't read any of your poems but by what I saw here many love your work and you won't believe I loved your work before reading any
I hope I'll read soon and I was so impressed with the feedback here and your title were amazing.
I also do write poems and which oneday I wish to publish them in book. I post most of my poems in poetry forum
And thanks to God I get lot of feedback , that's like a part of my life
I told you I'll be back
And yes here I am d:
You are an amazing writer. And I really loved your poems in Grandma was eaten by a shark
My best of the best poem is Poor Daniel
Very good poem is Grandma was eaten by a shark and Grandma gone
And the poems which were good
Auntie Betty thinks she is bat girl
Auntie janet
Miss Nits
And the remain were not bad there were fine
I just loved your work d:
NAME: Krystle Appiah
Dear Ms Shavick, My name is Krystle and I love to write. I live in Romford, Essex. I am currently writing 2 books which are about 2 sisters that are very close. The books are filled with love, loss and tragedy. Could you please give me some advice on finding an agent and publisher.
Dear Andrea,
Hi i am 11 years old. I live in Hong Kong(Where there may be King Kong, just kidding).
I am very imaginative, creative, patient, brave and cocparating girl(or alien!) What I mostly do at home is reading, drawing, doing expriences, making up poems and stories and tidying my room.
I want to ask you a question: Where did you get your ideas from? I got mine from all over the world!!! I am always writing about aliens!
From Janice Alien
NAME: Michael Taylor
Hi, my name's Michael and I live in the Scottish Borders. I have currently written a fantasy book which is the first part of a trilogy. Could you tell me what my chances are of getting the book published whilst I am writing the second story? The title of the book is 'Twins' and the next two are to be called 'Betrayal' and 'War'. Thanks!
NAME: Sarah Emmott
I am a 35 year old graduate and have an interview with an investment bank. I have been told that as part of the process I will be asked to sit a psychometric test. I wanted to buy one of your books for practice but am not sure which of Psychometric tests for graduates or Management level psychometric tests would be the higher level of tests?
thanks Sarah
the Management Level book has more advanced tests and is more suitable for the type of job you're after
NAME: Jason John Whitehouse-Strudwick
Where do I begin I have read your site top to bottom and I have absorbed a lot of valuable information.
I have written 12 picture book stories but they are all in ryhme it looks like I may have to self publish having read your site. JJW-S
NAME: Gail Jones
I would like your permission to use some of your poems with my class. After discovering your website I think my year 4s would love your poems, they would appeal to their humour.
I would like to print off the people and school poems so that they could use them to write poems in a similar style. I would like to use them on World Book Day.
Kewaigue School is a primary school on the Isle of Man, I've been teaching year 4 at the school for the last 10 years. I've found that some of the most memorable and enjoyable lessons for the children and myself have involved poetry.
NAME: Charlotte Wakefield
Hello Andrea,
I am a primary school teacher at St Peter's School in Chippenham, England I'm about to do a class assembly and would like my children to perform some of your poems. We have been learning about Space and have just starter a literacy unit on performance poetry so it seems natural to combine the two.
I particularly like "Auntie Ethel the Extraterrestrial", "Black Holes" amd "Watch out". I am sure the children will enjoy performing them - with your permission!
Thanks, and best wishes,
Charlotte Wakefield.
Hi Andrea,
I have just read your Get Published Page, and was wondering if the format you listed for picture books applies to ABC and 123 books as well. The book I have comprised is written in verse. (oh well!) Any advice would be greatly appreciated.
J. Ellis
Hi, ABC and Board books are normally written in-house by publishers, not commissioned from outside authors. Stick to actual picture book stories.
NAME: Fiona Neil
Great tips! Thanks.
Fiona, West Wales
NAME: Ami Humphreys
Can i please use your poem miss picky to read out to my class tomorrow?
I go to Hall Mead in upminster but i live in harold wood england essex.
I prommis that i will write that you wrote it at the bottom of the poem.
NAME: Audrey c Bartholomew
Thank you for all the great info and wish me luck in fallowing my dream!
NAME: Ms Hobby
My son, George aged 6, is taking part in a school poetry recital competition nest week and he really likes your poem 'Predictable'. It sums up perfectly the kind of conversation we have with each other. Please may he have your permission to use it. Thank you.
NAME: sally-mum of twins-also a teacher!
Thanks for the great advice-
I have found writing a fantastic release from the struggle of raisng my gorgeous but demanding twins and am determined to share my writing. I would love to write as a freelance writer and am aiming to get a book on my first year with the twins published. Youtr tips have been so helpful and have me all fired up to get somewhere!!
NAME: Julie
I appreciated your practical and witty article on getting published!
NAME: Gill Clemens
Thanks for the advice on getting published - very comprehensive and realistic. I've thought about it for so long and have decided it's time I just got on with it, so it's helpful to be able to find guidance like yours on the Internet.
NAME: Kelly Williams
Hi Andrea,
I am completing a PGCE primary course in Bangor University in Wales and would like to ask if it would be possible to include your 'Advent Horizon' poem and 'Auntie Ethel the Extraterrestrial' poem in a poetry anthology for my english assignment. We are creating a teaching pack, which can be used to improve boy's reading abilities. I am basing my pack on science fiction and space and we have to include a number of poems on our theme in the pack as well as a fiction/non-fiction book, video and website. I really enjoyed reading the poems and would like to include the poems in my pack because they are humorous and I think boy's would enjoy reading them.
NAME: Ranita
Fairview International School, Malaysia
Hey Andrea! I loved all your school poems... They are really fun to read... Even I write poems and its nice and fun to read yours... :) Bye!
PS: I only read the school poems... :)
NAME: Lesley-Ann Jones Shine
Dear Andrea
Your poems are fantastic!
My daughter Bridie, 7 yrs old, has to read a poem in class about school ... she has chosen your 'Predictable' poem. Would it be ok with you for us to print the poem so that she can take it in to school?
Lesley-Ann Jones Shine
NAME: Cross Country
i really liked it! It was very funny! My favorite above all!
NAME: K Glessinger
Dear Andrea
I thought the info on getting published was really helpful.
NAME: kayla Laux
I just love this site. I think this is a great thing to see all these young kids and teenagers writting poems and for everyone to see how good they are i also write poems I have a 75 right now and hope to have many more as time goes on. I am 15 years old and i think this poems on here form other teenagers are so really and show how they feel.
NAME: Sophie Lloyd
I luv da poem called unstable auntie i think it is gr8 k cya
NAME: kayla Laux
I just love this site i am 15 years old and i love poems i enjoy writing them as well!
NAME: Scarlet Stapleton
Good evening Andrea, I have been asked to find a funny poem for my school homework and I really like your 'School Poems'. Would you mind if i copied them and used them for my School work?
Thank you in anticipation
Scarlet Stapleton (aged 10)
NAME: Elizabeth Saldana
Hi my name is Elizabeth Saldana and i attend Natalia High School. I was woundering if we (students) can use one of your poems for our next year planner. We are located at Natalia, TX
NAME: Ethan Cook
Hi Andrea
My name is Ethan and I am 12. I would like to use your poem Miss Nits for a project at school. We have to say what our favourite poem is and then write one of our own.
NAME: Hope Jensen
Hello Andrea,
I would like to use your "Things I did for luck" poem on my superstition report for my Boise State University Psychology learning class. It is an APA paper that will just be viewed by my teacher for grading. Thanks, Hope
NAME: Aaliyah
To Andrea,
The poem that i liked best is Miss nits because i don't want nits because thier really nasty but if they were infected then nobody woul want nits because thier friends will say"err.....she nasty stay away from that Nit's girl/boy."
NAME: kathy otto
Thanks for all your tips - certainly food for thought. I have a range of ms I have written and smiled to myself at your NO GOOD IN A FILING CABINET comment. I have three children's books and four scripts as well as too many unfinished pieces to mention.
NAME: Antonio
Hello Andrea. My name´s Antonio. Congratulations for your exquisite web.
There are really good poems.
NAME: Reeta Sood
Hello Andrea,
I have just finished your "Management Level Psychometric & Assessment Tests". I think its brilliant! I'd highly recommend it to anyone trying to appear in Psychometric tests at any level.
I look forward to another book with more practice questions similar to these.
NAME: Maria Calderon
With your permission, I would like to use your space poems as a sample to teach a language arts 4th grade pretend classroom, in connection to a thematic unit that I have to put together for a SXU professor.
I promis to make sure, they always display your copyright!
They are wonderful!
NAME: Bex
First off may I say how helpful your website was! No, really I know what your thinking... "Yeah yeah, heard it all before!" but I mean it.
Bex, age 13 from Frome.
Hi Andrea,I really like your poems. there all nice, am always so interested to read poems about school! and the best poems I ever red are the ones you made!they are really nice. I want to know about you and like to be your friend.
Am 11 years old and am in grade six. and am from Muscat the capital of Oman
NAME: James
I've found this page realy helpfull, and somewhat insperatinal. Thank you!
althgough i am only about half way through my first ms, i've got a realy good felling about it. (don't worry i'm not going to get my hopes up to high)
The biggest heardle i have to overcome is that i suffer quite seaverly from Dyslexia! (as i'm shaw you can tell)
So if i were ever to be published... well lets just say that would be one hell of an acheavmet for me! and something i allways will strive to acheve.
once again thank you for your advice!
Yours thankfully
James (Birmingham UK)
NAME: Michelle Marroquin
Your poems are really cool and very interisting to me and my parents like them to so I hope you write some more NEW poems soon Well good bye!!!
NAME: Jackie
My name is Jackie and I would like to use your poem advent horizon for one of my lesson that i will be teaching. I go to the Unviersity of texas at san antonio and i am in the process of getting certified as a teacher. I need to teach lessons and I would like to use your poem to accompany my lesson. Thanks Jackie
Hello Andrea,
I have just finished your "Management Level Psychometric & Assessment Tests". I think its brilliant! I'd highly recommend it to anyone trying to appear in Psychometric tests at any level.
I look forward to another book with more practice questions similar to these.
Reeta Sood
Hi Andrea
I have never written before but love reading and have some ideas about a screenplay script and a non-fiction book both aimed at adults. I found your practical tips and honest advice very helpful in getting me thinking seriously about what steps I need to take if I am going to take this seriously.
Sabrina Aries, Milton Keynes
I've just read through these gems on getting published and I all I can think of is it was pretty deflating and can't think how anyone got a book published ever. Not exactly encouraging. Would there really be no positives to pass on? Karen Renshaw, Chesterfield
As I've mentioned before, I'm not trying to put people off writing, just being honest. To succeed you need to be really determined.
Good Morning Andrea,
Thank you for this web site, and all the wonderful points you mentioned. I feel I have learned a great deal already.
Best regards, Robin Berlanti
NAME: jessica vickery
i think the best poem was miss picky!
NAME: wendy
i don't wanna put it in anything i just wanna show my friends!lol those poems ROCK!!
Hello Andrea,
My name is Pandora and I would like to read one of your poems out to my class. I am in Year 5 at Manly State School (Brisbane, Australia) and my teacher, Mr Smith, has set an assignment where we have to learn a poem by heart and recite it to our class. We can use props or costumes as well. Can you please tell me if I am allowed to use your poem about "Miss Picky". I think this one is funny. Thankyou Pandora
NAME: Nel
I found your Get Published page very useful
NAME: amira
ur peoms r funny ! i don't like them
I am teaching a summer music camp in which we are exploring the composition process. I would like to use your poem "DISGUSTING (BUT LUCKY)" with my class of 12 high school students. They will be putting the poem to music as a part of this lesson.Thank you for your kind consideration.
Dr. Matthew P. Fritz
Assistant Professor of Music
Elizabethtown College
dear andrea,
my name is almas khan and i live in pakistan islamabad.i study in grade 5.i love u and ur poems.i love the poem which is called miss picky.its very funny.when ever i m depressed or sad i read that poem and become happy again
hi i'm a primary school teacher and mother of 2 tiny children. I found your article extremely helpful and enjoyable to read. Now i have had my babies, my ambition is to have a young children's book published as i have been writing since i was 10. I would also like to write a book about practical tips for helping children to foster an interest in reading.
Thank-you for your advice gillian
hey, im laura
i wold just like to say that your poems are great.
my favourite is "Miss Picky" from the school section. i was realkly moved be it. it had a fantastic sense of humour.
School: Grace Lutheran College
Location: Brisbane,
I really identify with the "Predicatable" poem on your website, these are exactly the words my 6 year old daughter uses when I ask her the exact same questions. Thank you. I wish to pass this particular poem on to some female colleagues who are all suffering with 'return to schoolitis' from their varied aged children.
Many thanks for making me smile! Ann J Merritt
Hi Andrea -
I was bouncing around Roger Stevens' web site this afternoon which eventually led me to yours. Wonderful work and resources! You're one busy and very talented writer. And I very much enjoyed "What's in a Name?" in Paul Cookson's recent Dinosaur Poems anthology. (My own two in that collection are my first to be published on your side of the pond.)
Eric Ode - See Eric's site here for poems and lesson plans www.ericode.com
Hi Andrea,
May I first say how impressed I was reading through the different sections on your site and I especially liked your poems. I have written a few for children aged between 7 and 12 (at a guess). Sometimes younger children understand more than we credit them for!
Chris Radford
Dear Ms. Shavick,
I would like to use your poem "Dumbo" in a lesson on scansion. I am a future teacher and this lesson is to be "taught" to my peers for my Direct Instruction practice lesson. I wanted a funny poem about teachers because I am trying to tie the lesson into "real life" and since we are going to (hopefully) be teachers, I thought it was perfect! My school is Gonzaga University and it is in Spokane, Washington.
Thank you for your funny limerick! Stacci McIntyre
NAME: amy louise jarvis
i think that the one with the lice in the teachers hair is the best because i think it is funny so i think that is the best, i also like the one with the girl who saves the world then gets in to detention because it is funny how she gets into detention so i also like that one to !!!!!
NAME: merry mahary
hi first i would like to say that your poems are really wondrefull and i really like them very much and i read them always. to tell you my name is merry mahary i am years old .i am the student of finnish mission school and i an grade nine . my country name is ERITREA with it's capital city ASMARA. and as my wish i wanna to be a famus poem and book writer
Hi! For my English homework I have to write a poem anthology(I go to Hayes Secondary school, that's in Bromley), I have to put some of my favourite poems in it, and I really like: Grandma was eaten by a Shark! and predictable, so please may I use them in my anthology, yours sincerely, Katie Wells
NAME: Ann
My teacher always tells us to bring in a poem on friday, and tomorrow is friday the thirteenth, so she said we should bring in a poem about superstitions. Can i use yours??
NAME: Nicola Webb
Please can I use "School Report" Poem in my newsletter which goes out to children in Singapore?
NAME: Michelle Marroquin
Yuor poems are really cool and very interisting to me and my parents like them to so I hope you write some more NEW poems soon Well good bye!!!
NAME: Brianna Gentile
I would like to copy this in my one only book for ace. There will only be one book made. My book is called "My Favorite Poems" I go to West Carroll Elementary School. Jackson US
My name is Jackie and I would like to use your poem advent horizon for one of my lesson that i will be teaching. I go to the Unviersity of texas at san antonio and i am in the process of getting certified as a teacher. I need to teach lessons and I would like to use your poem to accompany my lesson. Thanks Jackie
NAME: pete
Ive just read your tips for getting published. They're excellent! Thanks very much. Thanks for doing that for people like me.
NAME: Tasha
What the hell are the publisher's problem? They sound like their on a total power trip? who the hell do they think they are? (unless your exagerating) do they actually accept any book? or are you trying to put people off writing?
I'm not trying to put people off writing, just being honest. No publisher is on a power trip - they just want to make money, like all businesses. And why not - if there were no publishers there would be no books.
NAME: Scott Chambers
Dear Andrea, I have just finished reading your "get published" page, and just thought I would drop you a little note to let you know that somebody out there appreciates the time that you have taken to help others. I have found myself with some spare time on my hands at the moment and have always wanted to write. Just never managed to get around to it. I am now considering finally buckling down and having a go during my new found freedom. I found your comments useful given my complete and utter inexperience!
Thanks again for helping us all. Scott
NAME: ruzeb
I liked the poem "PREDICTABLE" because it says alot of funny things my school is P.S.149 THE CHRISTA MACAULLIFFE SCHOOL in NEW YORK CITY
sincerly, RUZEB CHOWDHURY
I did - I always do!
Dear Andrea
Thank you for your very practical guide to publishing. There is one thing I need to know but cannot find any information on and that is: does one have to put the name of the printer on the verso page?
Yours sincerely
Alison Orchard
only if you are self-publishing, otherwise it will be done for you
NAME: Heidi Norweg
Thanks, Andrea. Your page was very helpful. I am just at the stage of trying to find someone who can make a book dummy for me. I haven't even gotten to the rejections part of the cycle, yet.
hi my name is katrina,
I live in Adelaide,South Australia,Australia. I go to Stradbroke Primary School and I am 12 and in year 7.
I am envolved with a Speech and Drama group at my school. I am working on grade 5 advanced Speech and Drama and I like ur poem:Advent Horizon and I am asking for ur permission to possibly use this poem for an Estedford and an exam. Iam looking forward to your reply thanks
NAME: TA-Nisha
Whats up i like the poems alot they mad me feel alot better about alot of everything in my life thank you so much.......... Love,Ta-nisha
NAME: Christina Pratt
Hi, im currently doing my teacher training at Edge Hill in Ormskirk, UK. Our current subject in school is poetry on certain themes, our first theme is school. If possible i would like the pupils to look on your website and find their favourite poem about school. They would then copy the poem, write their own sentence about why they liked the poem and then decorate it to go in our class anthology. We will hopefully be taking poems from a variety of different sources, using your website would allow the children to use I.T aswell. The anthology would not be getting published, it would just be a resource we would use in our classroom. Would this be ok for us to use one or more of your poems?
Thank you very much Christina
NAME: Kelsea
I go to a middle school in Ohio, and was wondering if I can use a couple of your poems called: School Report, Predictable, and Miss Picky for my poetry book in my class. I will put that you wrote them.If you do let me thanks and if you don't it is ok because i no how it feels to write poems and you don't want anybody else to no it.
sincerely Kelsea
NAME: Mariss Cooper
hi andera,
i love your poems they are really cool, i really like that one about the boy and his brother, who punch each other trhen play thoses funny games after wooooooooo so cool keep up the good work tatata luv from rissa-aged 12-sydeny nsw
NAME: dani climpson
hey, i really love the poems about school replort and miss picky they are funny, from dani P.s good luck 4 the furture
NAME: ellie ward
hi, my name is Ellie and i live in harrogate. I am auditioning for a school play and i thought that your poems are suitable for this matter. I was hoping on using 'predictable' or 'dumbo' thanks
Hello. My name is Joany Mc Donald and I'm from Ballinrobe Community school Co Mayo Ireland.My class are doing a school magazine and we would really like to use your poem "School Report" in our magazine as we really enjoyed reading it and would really like to share it with all the students and parents that will hopefully buy our magazine.
please reply, and thankyou for your time, Joany & Classmates.
NAME: Saachi Sharma
Hi Andrea how are you I am from West Lodge F&M I just wanted to say thatwhen you came to my school I think you did really well and I really love your poems especially Miss Picky.
NAME: Eileen
Dear Andrea,
I would like permission to use two of your poems, "Predictable" and "Miss Picky" for a parent's meeting at our school next week, in Athenry, Co. Galway, Ireland.
Our Book Club for First and Second Graders is thinking about growing up! Next month, we'll be reading One Morning in Maine (McCloskey) and You'll Grow Soon, Alex.
Do you have any advice you can share on the topic or, even memories you have of being 6 or 7?Thanks in advance! We love your books!
First and Second Grade Book Club
Walpole Public Library MA USA
I just wanted to say that I found your article inspirational. I have lots of ideas for childrens books and more recently picture books (mostly while daydreaming at my desk) but have lacked direction for these ideas. I now have a plan:
1) Start writing ALL of my ideas down
2) Buy the Year book
3) Start sending out my ideas
Thanks for writing your guide, I really like the honesty and brief step-by-step approach that you have adopted. There is a lot of good karma coming your way!
Sarah - in Upnor, Kent
Hi Andrea,
I have been thinking about trying to write for children for a wee while now. My own children are 7,5 and 3 and like me love their stories. They've all endured mummy's made-up characters and tall tales. I'm also a librarian and so am very familiar with what's on offer to children just now. I would love to issue one of my own books to our young readers! I guess I just need the push to sit down and put pen to paper and I found your advice on getting published refreshingly honest and indeed inspiring.
Thanks again for the no-nonsense info.
Nicola. P.S. 'You'll soon grow Alex' is sitting in my son's bookcase and has been enjoyed many times!
Dear Andrea,
I came across your publishing advice whilst looking for websites relating to my daughter's reading scheme. Thanks so much for down to earth advice and humour...we live in South Africa (where thankfully most people appreciate the British sense of humour)and I'm looking to send a first manuscript off (it is in the filing cabinet!!!) P.S. I love the bit about birthday candles,my daughter's friend went up in flames, thankfully no serious injury thanks to a quick thinking teacher and they DO still allow birthday candles in schools here!!
Katherine Dodd
NAME: anna Dawson
I love your poems on amazing people, superstitions and gruesome and grizzly poems and would like to read some to the children I teach at Mount House School Tavistock.
Hi Andrea,
A great site, well done. I will be coming back to your site for tips again. Kind regards.
Gareth Thomas
Your advice is great and you are a terrific writer! Thank you for the information. I am considering writing teaching-related materials, not for children. More for other teachers and for parents. Good luck to you in your future endeavors!
Sherry Brown, Oxford
Dear Andrea
Please may I use either Advent Horizon or How to Successfully Persuade Your Parents to Give You More Pocket Money to learn for my speech and drama exam? I hope I may because they are very funny.
Thank you Jacob Newton
Dear Andrea
Many thanks for your fabulous advice, I greatly appreciated everything you said. Debbie Barton
Hello there, thank you so much ive really learned alot from reading all the advice and ideas you've given on this site. I'm at the moment TRYING to continue with an idea fo a childrens book. Anyway thank you again for an interesting afternoon , and i really mean that too!! Kindest regards Jacky King
Dear Andrea.
I thoroughly enjoyed your information on tips getting published. Andrew Reid
Dear Andrea
What a great website.
I recently had an idea for a picture book and I couldn't shake it off. With my job I spend long lonely hours in the car and this little story just kept popping up on a regular basis. I decided to write it down - if only to stop it rattling around my brain! I then thought about having it published so that other people could enjoy it. However, I have never done anything remotely like this before and looked to the internet for some guidance.
Your website has been so informative. I bought the book you suggested from Amazon and I am currently reading through that. Shortly, I am going to start sending my manuscript off. It may come to nothing but then again it may be taken up.......... who knows, you can but try.
You have given me very useful information on how to go about sending the manuscript off to publishers. So thank you and I will let you know if anything happens.
Regards, Sarah Phillips, Swansea
My 10 year old son Matthew has been given a poetry reading assignment at school. He chose your "Advent Horizon" poem to read to his class. I would therefore like to ask for permission for him to read this poem. Matthew is an avid Stargate and Star Trek (when it was on the past couple of years) viewer so this poem is very near and dear to his heart. Thanks, Becky Tutto, Indiana
Hey Andrea
Thanks so much for your tips on getting published, I have a few pieces sitting in my computer that i will be sending in!!
TO ANDREA;thank you for allowing teens from all over the world to express themselves the way they do. THANK you for allowing others to have their dreams of becoming a poet come true! I wish YOU a happy year and a GOD bless you! MAY you continue doing so and beyond! I for one am eternally grateful! Ashley
NAME: michelle chamberlain
All these poems on here are fab . they portray the feeling of millions of teen feelings across the worls wickedly. I write poems my self an u would be surprised how similar but uniqe we all are .
big up's to u all .
Keep writig!!! xxx
Dear Andrea,
I have just found 'Psychometric Tests for Graduates' to be very useful, thank you. Am off to by the practice book now! Many thanks,
Thomas Kingston
Dear Andrea,
Very enlightening article on how to get published. I read it out loud to my 13-year-old. She is an avid writer and illustrator. These were great tips. Thanks so much.
Ann Wilber
Lawrenceville, NJ USA
NAME: Nicole M
I like your poems very much, and would like you to continue writing these poems. I've always wanted to be a poet. Merry Christmas Andrea.
Hi, I just want to say that this site has inspired me in many ways. I'm just a teenager but I've been writing poems and short stories for quite a while and this site has helped me to discover the deeper meaning of what I'm writing or reading. Anne Fiore's poem "Sqeeze My Hand Twice" is my favorite because I can relate to it. Thanks Andrea for creating this site.
-Hailee, Houston, TX
I have to read poems that have been published for UIL Poetry reading - I would like to use Lucky Escape, Things I did for Luck and HOW TO SUCCESSFULLY PERSUADE YOUR PARENTS TO GIVE YOU MORE POCKET MONEY. They cannot be read straight from the book, but just from a plain sheet of paper. Sorry for the late notice, but the reading is tomorrow. Will it be alright to use them? Thanks - Bailey Jones
NAME: Katelyn
I would like to use Miss Picky for poem reading contest on Thursday, Dec. 1st. I am in the 5th grade. My school is Valley Mills Elementary tx. USA
NAME: Mia Angelique F.
I really liked Miss Picky and Miss Nits they made me laugh. You're a fabuous writer
NAME: shelly
i think think that henrita the bat is realy funny and my friend matt told me that poem on the bus and i forgot to ask him what website did he get it from and i was looking at heaps of sites then i got to this and found the poem henrita the bat and i was very happy. i think your poems are great.
NAME: Lynne Holden
Time to Get Out
Please could my 7 year old daughter use this poem for her literacy homework at St. Patrick's RC School in Birmingham England. The class is just starting to learn about poems. Thank you very much
NAME: Claire Waghorn
Dear Andrea,
I'm a drama teacher looking for a few space poems as stimuli. May i use yours in my lesson please
Thanks Claire
I thought Miss Nits was funny and also School Report Channing London
Please can i read your poem "predictable" to my class next week as my home work is to find a poem to share with my friends. My school is Stone Cross Primary in east sussex. I really like this poem because it is like my mum. Thank you!
Hi Andrea, my name is Liz and I go to Eastwood Public School in NSW Australia.I am in year 6, and for homework we have to find a poem about school or homework, and copy it into our spelling books. I was wondering whether I could use one of your school poems.
NAME: Hannah Thorne
I would like to use the poem "Miss Nits" for my homework. I attend Emmbrook Junior School, Wokingham, Berkshire and I am in year 5. For my homework I have to copy the poem into my homework book and answer questions on it like, What it is about, does it rhyme and did I enjoy it. I hope very much too use your poem as it was very good.
NAME: piglet
TO all the awsome poets,i sincerely wish you good luck to your bright future! KEEP your head up, continue to bless GOD!
NAME: Lucy Brooker
Hi Andrea
I've just read all your tips on writing children's books and now feel quite deflated. As a complete amateur I never realised it there was so much to think about. I am a young(ish) mother of two (3 year old and 14 months). My husband and I made up a character to teach our 3 year old son about the consequences of being naughty, not brushing teeth, running out into the road etc which proved very effective and fun at the same time. He does love them and so do cousins, friends etc. I am a Graphic designer and work closely with an illustrator and I am seriously thinking about developing this idea into picture books for 3 - 5 year olds. However, since reading your tips, I am thinking Oh my goodness! Am I just another unrealistic parent who think they can get a book published or is it worth putting in some real effort. I would appreciate your view. Kind regards
lots of tips for writers on the Get Published page. I wish there was an easy answer to your question but if you never try you will never know.
NAME: Jasmine
At school i need to read out a poem for homework and i really liked Miss Picky and i think that my teacher would find it funny to. Please may i read it out in class.
Hi I'm Catherine
I was just wondering if I could use the Poem'Miss Picky' and ' Miss Nits' for some english work at Rugby School. We have to find a poem about schools and I thought these ones were great.
Please may I use your poem Watch Out as part of my school project on Mars and Jupiter for this halfterm. My school is St. Margaret Clitherow Kent, England
Thank you Alice
NAME: Amanda
My daughter has been asked to take a poem into school as her class are putting together a class anthology of poems,linked to the curent work unit on poetry. She would like to take in Grandma was eaten by a Shark and Predictable. She really enjoyed them. The children will be sharing their poems and discussing what they particularly enjoy about them.
School- Sprowston First School, Norwich, England.
NAME: Silla
Hello Andrea, really loved your space poems and wanted to ask if it was ok for my children to take them into school to buddy read with the younger children. We are celebrating Nat Poetry Day, actually we are having a whole week of activities and buddy reading is one of them. We are a little behind the UK as school is closed on Thursday and Friday (its our weekend!). We are based in Dubai, our school is called Dubai English Speaking School and I am sure the children will really enjoy your poems. Hope it's ok, kind regards, Silla


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text: We also offer a price match guarantee on our large selection of C-Line Products Inc. items, so you don't have to worry about overpaying for brand name and quality products. We also believe that the satisfaction of our customers comes first and foremost. We strive to provide the kind of customer service that will make Unbeatablesale.com your only on-line store for online retail products. You can check the status of your order anytime on our order status page so you know exactly where your package is. Shop Unbeatablesale.com today for a great experience!


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If you don't need to buy, just rent. Over 100 laser systems are ready for immediate transfer to you and your spectacular show.
From laser shows and displays to laser mapping, 3D video and holographic projections, right up to fireworks and water shows. You name it, we can do it.
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Warlord Miniatures (Dwarf Warrior 14353)
This Warlord model by Reaper Miniatures comes unpainted and unassembled. Assembly and painting required. Any photos of painted miniatures are for demonstration and inspirational purposes only. Click here for assembly instructions.
- 25mm heroic scale fantasy miniature
- Metal tabbed figures on plastic slotted bases (assembly and painting required)
- Suitable for fantasy RPG games and collections
- Perfect for hobbyists and gamers alike
- Not a toy. Contains small components and should be considered a choking hazard.
- Made in USA
Only 1 left in stock.
- Questions?
- Delivery
Dark Elf Dice ships fast!
- US customers usually receive delivery in 2-3 business days from the time a package is mailed (Priority Mail) or 4-5 business days (First Class Mail).
- Customers outside the US will usually receive delivery within 14-21 days.
- Delivery times are based on US Postal Service estimates. Although we ship fast, we unfortunately cannot guarantee an actual delivery date.


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Welcome to the BMW Motorcycle Owners of America online community. Although most of the site is open to anyone, some areas are protected and require a username and password to access. If you are not a member of the site yet, please consider joining - - we'd love you to be part of our online community.
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0.25 CT. Diamond Wedding Band Ring in White Gold
Many in stock
Wedding Bands
White Carat Team
Diamond Total Weight: 0.25 CT. Diamonds
Metal Type: 14 KT
Diamond Color: F-H
Diamond Clarity: SI1-SI2
Diamond Certificate: Included with Purchase
Standard Ring Size: 7
Comes with Diamond Certificate.
All our diamonds are hand picked and are of high-quality clarity...
Diamond Total Weight: 0.25 CT. Diamonds
Metal Type: 14 KT
Diamond Color: F-H
Diamond Clarity: SI1-SI2
Diamond Certificate: Included with Purchase
Standard Ring Size: 7
Comes with Diamond Certificate.
All our diamonds are hand picked and are of high-quality clarity and color. Quality matters to us. Please indicate your preferences in special instructions and one of our diamond consultants will contact you. We recommend indicating any preference you may have regarding diamond certificates.
Diamond carat weights represents approximate of all the diamonds in each of its setting. Gold Karat weights represents approximate of all gold weight in grams. Errors are subject to correction. Merchandise enlarged to show detail may not always be exactly as pictured.
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White Carat Co. purchases come elegantly wrapped in our signature box.
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Normal processing may take 1-2 days before it ships and it will ship via your chosen ship method after the processing time is complete. Guaranteed to arrive securely to right your door. Signature required for orders over $100.
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You may return most new, unopened items within 30 days of delivery for a full refund. We'll also pay the return shipping costs if the return is a result of our error (you received an incorrect or defective item, etc.).
You should expect to receive your refund within four weeks of giving your package to the return shipper, however, in many cases you will receive a refund more quickly. This time period includes the transit time for us to receive your return from the shipper (5 to 10 business days), the time it takes us to process your return once we receive it (3 to 5 business days), and the time it takes your bank to process our refund request (5 to 10 business days).
If you need to return an item, simply login to your account, view the order using the 'Complete Orders' link under the My Account menu and click the Return Item(s) button. We'll notify you via e-mail of your refund once we've received and processed the returned item.
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Please also note that the shipping rates for many items we sell are weight-based. The weight of any such item can be found on its detail page. To reflect the policies of the shipping companies we use, all weights will be rounded up to the next full pound.


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Tinea nigra is an infection of the skin. It affects the outermost layer of skin. The infection will cause a black or brown patch on the skin. Except for the dark patch, tinea nigra is a harmless condition.
Tinea nigra usually affect the palms of the hands or soles of the feet. It may also appear on the neck or trunk.
Tinea nigra is caused by a fungus. The type of fungus that causes this infection is most often found in rotting wood, soil, compost, or sewage. The fungus may enter your body through a break in your skin.
Risk Factors
You are more likely to develop tinea nigra if you have been living or traveling in tropical or subtropical areas, such as:
- South Africa
- Brazil
- Panama
- Cuba
- Puerto Rico
- Coastal areas along the southeastern United States
Tinea nigra causes a brownish-black patch on the skin that:
- Has an irregular shape with a darker border
- May be itchy or scaly
- Tends to expand over time
A tinea nigra patch may be mistaken for a type of skin cancer. Talk to your doctor about any skin growth or changes.
Your doctor will ask about your symptoms and medical history. A physical exam will be done. You may need to see a skin specialist for tests, diagnosis, and treatment.
Tinea nigra is diagnosed by scraping a small sample of the affected skin. The sample is examined under a microscope.
Tinea nigra is usually treated with an antifungal medication. The medication is placed on the skin as creams or ointments.
To help reduce your chance of tinea nigra:
- Use care when traveling in high-risk areas.
- Avoid contact with potentially infected material, such as rotting wood, dirt, sewage, or compost.
- If you must work with any of the materials listed above, take the proper safety steps. Wear gloves and other protective gear.
Revision Information
- Reviewer: EBSCO Medical Review Board David L. Horn, MD, FACP
- Review Date: 11/2018 -
- Update Date: 12/20/2014 -


text: USStorage Quote Results Southwest Mobile Storage Mini Mobile Storage & Portable Storage Containers Cathedral City, CA This Cathedral City storage facility offers the following storage spaces: Amenities vary by size. Not all amenities are available for each size. Size Monthly Rate Choose Your Unit This facility is not currently reporting unit sizes. This Cathedral City storage facility offers the following features: Container Sales Mobile Storage Custom Size Spaces Available Moving Supplies Available


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We make sure you understand exactly what to anticipate
To make the best decisions for Gas Leaks in Fort Riley, KS, you must be well informed. We make sure you know exactly what should be expected. That's the reason we make every attempt to ensure you are familiar with the procedure and aren't confronted with any surprises. Step one is to contact us by dialing 888-263-7702 to set up your project. Within this call, you'll get all your questions resolved, and we're going to establish a time to start the work. We consistently get there at the appointed hour, all set to work closely with you.
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Did you smell my text? Device sends scented alerts
Scentee plugs into the headphone socket of iPhone, Android smartphones
Move over, ring tone alerts.
Scentee, a new device you can attach to your smartphone, releases a burst of fragrance of your choice whenever you receive a text, email or other notification, Engadget reported.
Made in Japan, the plug-in accessory attaches to the headphone socket of your iPhones or Android smartphone.
An LED light also glows when you have an incoming notification.
In no particular order, the aromas you can choose from include bacon, rose, mint, cinnamon roll, coffee, curry, jasmine, ylang-ylang, lavender, apple, coconut, strawberry and even...corn soup?
The Scentee also has a timer that can release the fragrance of your choice however often you want to smell it, according to The Huffington Post.
The gadget costs about $35 on Amazon and each cartridge goes for $5, according to Engadget.
It's currently only available in Japan, but the company said it plans on making Scentee available to Americans at some point.
Distributed by Internet Broadcasting. This material may not be published, broadcast, rewritten or redistributed.


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Joyce shares about God's love from 1 John 4:7-21 for the Nazarene Church in Greve, Denmark, just outside of Copenhagen. Joyce was in...


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text: Thursday, December 06, 2012 Patients With RA Have More Complications After TJA Patients with rheumatoid arthritis (RA) have more complications after total joint arthroplasty (TJA) than patients with osteoarthritis (OA) and are at notably higher risk for dislocation of replaced hip joints, according to a Medscape Medical News article based on a systematic review published online November 28 in Arthritis & Rheumatism. The analysis included 40 reports published between 1990 and 2011 that describe primary TJA of the hip or knee in patients with RA (n = 2,842) or OA (n = 61,861). Outcomes included revision, hip dislocation, infection, 90-day mortality, and venous thromboembolic events. The researchers found that patients with RA had double the risk for hip dislocation after total hip arthroplasty compared with patients with OA. Adjustments were made for age, sex, surgical approach, and surgeon's volume. Infection risk was up to a 10-fold increase in patients with RA after total knee arthroplasty, particularly in patients with prior infection in the replaced joint, prior infection in any joint, or longer duration of operating. There was no association between infection risk and perioperative systemic corticosteroid use or withdrawal of biologic treatment before surgery. However, meta-analysis was not completed due to variable definitions of infection and preoperative antibiotic protocols, the article says. Johannes Cornelis Schrama, MD, who was not involved in the study, told Medscape Medical News that that the researchers do not appear to have overlooked any major factors in their analysis, but he was cautious about possible clinical application. "It is difficult to define clinical implications other than possible preventive measures [against infection] in patients undergoing [total knee arthroplasty]," he said.


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Content Amount: I was impressed with the numbers I found when I started to go through, I was expecting just a handful of horniness, but as it turns out there were 169 sets, all offering videos and images alike. Over 30 bonus sites are offered as well, so you'll be busy.


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Women are obviously less willing to take investment risks than men, right?
A seminal study by professors Brad Barber and Terrance Odean famously found that men trade more aggressively than women within brokerage accounts. Other early studies found that women prefer safer portfolios in their defined contribution plans. The perception of the fairer sex as less willing to suffer the cruel volatility of a stock-laden portfolio fits well with common beliefs about the differences between men and women.
But there's more to this story. Women and men are different, but not just biologically different. Women in older cohorts were less likely to go to college, many interrupted their working lives to raise children, and others chose not to assume responsibility for managing household investments. It's important to understand why these differences exist because an overly conservative portfolio can be just as inappropriate as an overly risky one.
Risky Reluctance
How harmful are risk-averse portfolios? Federal Reserve Bank economist Urvi Neelakantan estimates that the more conservative retirement investments of women can explain about 10% of the gender difference observed in sheltered retirement account balances. Since women live longer than men on average, they will need more money to fund the same level of retirement income. Maintaining some risk in a retirement portfolio is especially important given stocks' more favorable risk/return characteristics when held for a long period of time. Gender differences in risk tolerance can have important social implications if women are less prepared for retirement than men.
If women are less willing to take risks than men because they are wired differently, then this difference should show up in other decisions that involve taking chances. The evidence is mixed. Perhaps no scholar has spent more time studying the question than Stockholm School of Economics professor Anna Dreber. She finds no difference in risk taking between male and female professional bridge players, but these same players exhibited differences in financial risk aversion on a questionnaire. She also finds few differences in competitiveness between school-age girls and boys in various tasks.
Ohio State professor Sherman Hanna has studied gender differences in the Federal Reserve's Survey of Consumer Finances and finds more evidence that women and men may not be that different. Hanna compared portfolio allocation and responses to risk tolerance questions among same-sex couples and opposite-sex married couples. Married (opposite sex) women who responded to the survey were indeed less willing to take financial risks than men. But women within a same-sex couple were just as willing to take financial risk as married men. In fact, women in a same-sex couple were slightly more willing to take investment risks than men in a same-sex couple. This throws a wrench in the biology theory.
Hanna's most interesting finding may be that while women in same-sex couples are more willing to take financial risks, they actually hold less stock in their portfolios than married heterosexual couples. In the article, Hanna and his co-author Suzanne Lindamood wonder whether these less risky portfolios may reflect a bias on the part of financial service providers who assume that women aren't as interested in a risky portfolio.
This is one of the dangers of placing too much weight on an early piece of research that fits our own preconceived ideas. We tend to be much more receptive to information that is consistent with what we already believe, also known as the confirmation bias. The popularity of the Barber and Odean study may have been enhanced by how well it fit conventional wisdom about gender differences—it was even titled "Boys will be boys."
Digging Deeper
La Salle University professor Michael Roszkowski and University of Georgia professor John Grable find that the intuition of financial advisors about gender differences isn't very accurate. The correlation between the advisor estimate of risk tolerance and actual risk tolerance (measured using a common risk tolerance assessment tool) was only 0.41. The reason advisors were not able to consistently assess the risk tolerance of their clients was that they overestimated the risk tolerance of male clients and underestimated the risk tolerance of female clients. This bad intuition is a problem that can lead to making the wrong portfolio recommendations.
According to Texas Tech professor (and neuroscience expert) Russell James, most of us prefer relying on stereotypes because they save us time and effort. It takes less time to make assumptions than it does to dig a little deeper. "Bottom line, knowing about differences in the average behavior of men and women tells you absolutely nothing about the client sitting in front of you," notes James. "It is easy to think of yourself as being scientific by using a rule of thumb based on population averages, but it's really just being lazy. Don't assume."
Hanna is cautious about placing too much weight on biological explanations of risk tolerance. "My intuition is that there are some genetic differences that tend to make women more risk-averse than men," he says. "But to me this may to some extent reflect an illusion that can be corrected by education."
A recent paper by Dreber goes a long way toward explaining why the risk tolerance gap exists despite little evidence of gender differences in risk taking. Women tend to be less financially knowledgeable than men. Previous studies linked financial literacy with stock market participation. It makes sense that if you know about the risk and return characteristics of equities, you'll likely invest some of your portfolio in stocks. Those who aren't as aware of the potential benefits of stocks are less likely to buy them. Dreber shows that when you control for financial literacy, differences in stock market participation almost disappear.
The question remains: Why aren't women as financially knowledgeable as men? Economics provides an answer. When a man and woman get married, they tend to delegate household tasks to the person best suited for the job. Women often cede financial decisions to their husbands, although there is evidence that this is changing. Using data from the Texas Tech Financial Literacy Assessment Project, we calculated the gap between financial literacy scores for men and women by age group. For baby boomers and younger age cohorts, the difference was about 10%. For those aged 65 and older, the gap widened up to 25% among women age 75-79.
Going to college gives women more than exposure to business coursework—it gives them more earning power. And more earning power means more decision-making power over investments. One of the reasons women are increasingly responsible for financial decisions is that the higher-earning spouse often takes the role of primary financial decision maker. As the gender imbalance in higher education has shifted in favor of women, so has the size of their paycheck and their control over the household's finances. But in more traditional and older households, the primary financial decision-maker is often the man. So it makes sense that he will spend more time and effort learning about finance than will his wife.
Hanna also does not believe that previous studies have done a good enough job controlling for family characteristics that influence how much risk women are willing to take. Financial planner and Texas Tech Ph.D. Kim Bridges decided to look more closely at whether gender differences can be explained by these family characteristics. She explores the extent to which a woman's education and work experience contribute to a greater aversion to investment risk.
Bridges suggests that one way to think of an individual's earning ability is as a bond throwing off regular income. This bond has a value known as human capital. A man invests in education in order to increase the value of his income-generating ability. The investment for women is a little different. Many women choose to give up part of their careers to provide childcare. Some women leave the workforce for a period of time, and others take on less demanding careers.
This sacrifice early in life has two effects. First, it reduces the value of their future earning ability. Since risk tolerance increases with both financial wealth and human capital, this can explain a preference for less risky investments. Having less money generally means you can take fewer risks. Second, the wife is more reliant on the income of the husband since his human wealth was not reduced by career sacrifices. Since a large percentage of marriages result in divorce, the wife must consider this possibility when making investment decisions.
In her dissertation, Bridges calculated human capital for men and women. She then recycled a question from a national survey conducted during the debate over Social Security privatization that asked how respondents would invest money in private accounts. She found that women did prefer a retirement portfolio with a greater share of bonds. But when she included human capital as a variable, the preference disappeared.
So are women more risk-averse than men? Yes, but these differences probably aren't based on biology. Research indicates that women with the same financial knowledge and work history as men are going to want the same risk in their investment portfolios. Thinking otherwise may say more about the advisor than about the client.
Michael Finke, Ph.D., is a professor and coordinator of the doctoral program in personal financial planning at Texas Tech University.


text: Tuesday, September 04, 2012 HHS Amendment Excludes DACA Non-US Citizens From PCIP Coverage Non-US citizens under age 31 who have resided in the US and have been granted temporary relief under the Department of Homeland Security's June 15 Deferred Action for Childhood Arrivals (DACA) process will not be eligible for Pre-Existing Condition Insurance Plan (PCIP) coverage pending their removal determination. Last week, the Department of Health and Human Services (HHS) released a clarifying amendment to the interim final rule on the PCIP program. This amendment, effective immediately, revises the definition of "lawfully present" that was codified in the interim final regulation on PCIPs (published July 30, 2010) to exclude this group from PCIP participation. The Affordable Care Act (ACA) prohibits non-grandfathered health insurance coverage issuers from denying health care coverage or inflating health insurance rates based on preexisting conditions. This section of the ACA takes effect in 2014, at which time coverage will be made available through the Affordable Health Insurance Exchanges. In the interim, ACA directs states or nonprofit entities to establish temporary high-risk health insurance pool programs to cover eligible US citizens with preexisting conditions.


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Red Abstract Check Textile Seamless PatternThe sleek matte black exterior gives this USB flash drive a look that the recipient will surely desire. Small in size and can be attached to your key chain, this convenient computer accessory could be the ideal for kids! Design images are covered in a clear enamel coating to prolong its longevity.Hi-speed USB 2.0 certified.No installation required. Compatible with major operating systems such as Windows ME/2000/XP, Mac 9.x and above.No external power required.Data retention minimum 10 years.Measures approximately 2"(w) x 0.75"(h) x 0.25"(d).
If you order more than 50 pcs items (can be combined), please click here to contact us for whole price quotation, please include the SKU# and the quantity you want for each of them. For order less than 50 pcs, please order directly from our website.


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Popluation Change in the Wilderness
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Let us know what you would like to see that could make the site better and don't be afraid to share your ideas. This blog is meant to be a collaborative effort to teach Torah while bolstering our students' math skills. Our goal is to have thousands of new TorahMATH problems so we need your help! Submit a Torah question that requires math to answer. Make sure to include the solution and steps you took to get there.


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The purpose of screening is early diagnosis and treatment. Screening tests are usually administered to people without symptoms, but who may be at high risk for certain diseases or conditions.
There are no screening tests for colds and influenza. Diagnosis and treatment begin with the onset of symptoms.
Revision Information
- Reviewer: David L. Horn, MD, FACP
- Review Date: 09/2018 -
- Update Date: 09/17/2014 -


text: Wednesday, September 19, 2012 APTA Participates in 2012 Warrior-Family Symposium Caregivers, National Guard, reserve support, and sports are top Defense Department priorities for wounded warriors and their families, said top officials last week at the 2012 Warrior-Family Symposium. APTA has participated in each of the 6 annual Warrior-Family Symposiums. This year the association sponsored the event's breakfast. The September 12 symposium, titled Saluting Their Sacrifice: A Decade of Challenges and Triumphs for Our Wounded Heroes and Their Families, expanded on previous forums and efforts over the last 5 years to improve the physical, psychological, and well being of service members and their families. Programming focused on addressing the concerns and challenges facing wounded warriors and families/caregivers and helping those in attendance prepare to retire or transition to their new life, as veterans and citizens outside the military. Lunch keynote speaker VA Secretary Eric Shinseki spoke about issues facing returning service members, such as substance abuse, homelessness, and posttraumatic stress disorder, and explained what the VA is doing about these issues. Reception keynote speaker Lt Gen Patricia D. Horoho, USA, surgeon general and commanding general, US Army Medical Command, spoke about role of the command in meeting wounded warriors' needs. The day culminated in a Recognition-Transition Ceremony, honoring and celebrating the service and sacrifice of all service members wounded and disabled over the last decade.


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Gastroesophageal reflux disease (GERD) results in food and stomach acid backing up into the esophagus from the stomach. GERD requires treatment to avoid complications like esophageal damage.
The lower esophageal sphincter (LES) is a muscular ring between the esophagus and the stomach. It relaxes to let food pass into the stomach, then closes shut to prevent it from backing up. With GERD, the ring does not close as tightly as it normally should. This causes acid reflux, a burning sensation that can be felt below the breastbone.
The following factors contribute to GERD:
- Problems with the nerves that control the LES
- Problems with LES muscle tone
- Impaired peristalsis—muscular contractions that propel food toward the stomach
- Abnormal pressure on the LES
- Increased relaxation of the LES
- Increased pressure within the abdomen
Risk Factors
Factors that may increase your teen's chance of GERD include:
GERD may cause:
- Chronic heartburn—most common symptom
- Regurgitation
- Abdominal or chest pain
- Vomiting
- Difficulty swallowing
- Dry cough
- Hoarseness
- Sore throat
- Recurrent aspiration pneumonia or worsening asthma
- Weight loss, lack of appetite
Your doctor will ask about your teen's symptoms and medical history. A physical exam will be done.
Tests may include:
- 24-hour pH monitoring—a probe is placed in the esophagus to keep track of the acid in the lower esophagus
- Short trial of medications—success or failure of medication may help your doctor understand the cause
Imaging tests can assess LES function and surrounding structures. These may include:
- Upper GI series —x-rays using contrast material that is swallowed
- Upper endoscopy with biopsy
Treatment options vary based on the severity of the GERD. Options may include one or more of the following:
Lifestyle Changes
This may be all that is needed to relieve GERD symptoms. In some cases, these may be recommended before medication is prescribed. These changes can be tailored to an individual person based on their habits. Lifestyle changes include:
- Eating smaller, more frequent meals.
- Avoiding overeating.
- Avoiding late night meals.
- Sleeping with the head of the bed elevated.
- Avoiding lying down within 2-3 hours after eating.
- Wearing looser clothing that doesn't bind the stomach area.
- Losing weight if needed.
- Quitting smoking.
Foods and drinks to avoid may include:
- Chocolate
- Fried foods
- Peppermint
- Spicy foods
- Caffeine products
- Carbonated drinks
- Foods high in fat and acid
- Alcohol
Medication may be needed to relieve symptoms and heal any damage to the esophagus. Many medications for GERD are available over-the-counter and by prescription. Your teen's doctor may recommend the following:
- Antacids
- H2 blockers
- Proton pump inhibitors
In more severe cases, the doctor may recommend surgery or endoscopy.
The most common surgery is called fundoplication . During this procedure, the surgeon wraps part of the stomach around the LES. This makes the LES stronger and prevents stomach acid from backing up into the esophagus.
Revision Information
- Reviewer: EBSCO Medical Review Board Daus Mahnke, MD
- Review Date: 03/2018 -
- Update Date: 01/20/2015 -


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