text:
"The notion of love-starved widows has become so entrenched in American culture that it has been a sitcom staple and the subject of an endless succession of jokes." But it seems that's one stereotype women have outlived.
A piece in the Times claims that the newest generation of widows and widowers sees a dramatic shift from the dynamic they knew in married life: widows feel comfortable being independent, while a generation of men who rarely learned to cook or keep house finds itself lonely and dependent. Often responsible for organizing the family social lives, women generally have an easier time maintaining a circle of friends and contact with family and neighbors - in part because, perhaps, men of this generation might feel uncomfortable being dependent or seeking help. And perhaps partly as a result, a far higher percentage of widowers over 65 choose to remarry than do their female counterparts.
What's more,
Left to their own devices, older men don't eat as well as older women, are less likely to seek medical care when they are sick, and more likely to abuse drugs and alcohol. Older women have more chronic diseases, in part because they live longer, but older men are more likely to die suddenly from heart attacks and other catastrophic, stress-related diseases. Men over 65 are five times as likely as women to commit suicide. Divorced and widowed men have suicide rates three times higher than that of older men living with a spouse.
While it's delightful to hear that older women are increasingly happy and independent - and the truth of these assertions are certainly borne out anecdotally, I know in my own family - I don't like the tone of some of the comments in this piece. Especially this:
In a strange twist of fortune - some might call it poetic justice - age can bring with it something of a reversal in gender roles. The rise of an old girls' network, friends and family who see women through a lifetime of transitions, often contrasts sharply with the decline of the old boys' network, the professional associations that secure young men's places in the world but offer little support or solace in later life.
"Poetic justice?" Yuck. I get the point they're making - but I think this callousness belittles both these women's accomplishments and the sorrow of those men who have succumbed to loneliness. Certainly no one who's seen a grandfather struggling through learning basic housekeeping and eating poorly can take any larger satisfaction from the turn of events. Why can't we instead realize that the same rigidity of roles that we deplore could hurt not just women, but men, and find that not a source of satisfaction, but of sorrow? Nowadays, one hopes, the increased equality at both home and work will also serve to benefit men as well as women - that they, with some knowledge of cooking and caring for themselves, won't be left helpless.
The author also talks about the "liberation" some widows feel, and the plans for a new life, "none of which involved managing another man's domestic life." While this may be true for many, I rankle at dismissing decades of life according only to the modern terms that equate marriage of that generation only with domestic slavery. I'm thinking of my great-aunt here; after her husband's death, she took full advantage of her "freedom," traveling and enjoying friends, volunteer work and culture. She was happy, and yes, surely free of the need for security that may have bedeviled widows of earlier generations - but she'd also have loved a few more years with her husband. Maybe I'm thinking too of yesterday's "Modern Love" that painted a touching portrait of a long marriage and the joy of its companionship. Are men of this generation frequently troubled by a "loss of status?" Are women often happy to stay unmarried? Surely. But aging in our society is a lot more complicated than this - as are the individuals.
With Friends Aplenty, Many Widows Choose Singlehood [NY Times]
Yes, We Do. Even At Our Age. [NY Times]


text:
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subset: commoncrawl


text:
Paging Dr. Freud! The fiscal cliff has the country in need of some serious therapy—and maybe a Xanax or two.
Many economists are warning about the possible psychological scars left by the cliff, not the relatively straightforward cash flow issues that Democrats and Republicans must reconcile before the start of next year.
Beneath the debate about potential tax hikes and spending cuts, there lurks fear, paralysis, wild optimism and basic questions of trust. The country already views government leaders with skepticism, a feeling that could become even more pronounced if the fiscal cliff talks fail.
"Much like the finale in some kind of horror movie, you know something big is about to happen and are just waiting to see what," said Stanford University economics professor Nick Bloom.
The game inside the White House negotiations involves tough budgetary math. But for the investors and consumers without a seat at the table, it is a matter of debilitating suspense. Stocks rally on canned statements by congressional leaders that sound positive. Upper-income Americans spend less in anticipation of higher taxes. It's open speculated whether film legend George Lucas sold-off the Star Wars franchise to avoid higher taxes—and which other billionaires might follow suit.
Along with two other economists, Bloom developed the policy uncertainty index to gauge the financial impact of escalating political tensions. The daily index has steadily climbed over the previous three months—dipping only after House Speaker John Boehner, R-Ohio, and other congressional leaders emerged from the White House on Nov. 16 to call the initial discussions with President Obama "constructive."
The index currently stands at an elevated 180, its increase tracking with alarmist quotes from CEOs about the cliff and a slowdown in business investment. But that reading remains below the critical 230 level reached last year during the debt ceiling negotiations, when the government nearly defaulted and economists actively warned of an oncoming recession.
Surprisingly, Americans care more about federal spreadsheets than scandalous bed sheets. The fiscal cliff has generated more interest than the juicy extramarital affair involving former CIA director and retired Army Gen. David Petraeus, according to a survey by the Pew Research Center for the People & the Press.
As the details of any bargain get sorted out, some of the usual partisan bile will start pumping. Republicans have historically resisted the tax increases being pushed by Democrats, who in turn oppose the dramatic overhaul of entitlement spending that would likely be part of any deal. The celebrating over friendly tones will give way to sharp doubts, which should take stocks on a volatile ride.
"Despite last week's kumbaya moment, I'm still expecting to see brinksmanship, posturing, statements to keep the base intact, I expect to see some real conflict and the market is not going to like that," said Jerry Webman, chief economist for Oppenheimer Funds.
Administration and congressional officials are deeply aware about the role played by animal spirits in the economy. Alan Krueger, the president's top economics adviser, recently voiced his concerns about the breach of public trust if negotiations disappoint.
"What's to me much more worrisome is the psychological effects of falling off of the cliff in a number of respects," Krueger told the Economic Club of Washington. "It would mean to many people that the government is not there to solve the problems it was meant to solve."
The challenge is that these psychological responses approach the limits of data-driven economics. Consumer confidence is at a five-year high of 82.7 according to a University of Michigan index, despite all the understandable carping about uncertainty.
Swarthmore College professor Barry Schwartz recently proposed that Obama create his own "Council of Psychological Advisers." This group of PhDs would complement the existing council of economists led by Krueger, helping the president to think through how government policies impact behavior.
"The recent financial crisis and its persistent aftermath make it clear that ignoring the real psychology of 'irrational' enthusiasm (or pessimism) can be perilous," Schwartz wrote this month in The Atlantic. "This is not to say that macroeconomic variables don't matter and that the behavior of the economy is completely driven by the psychology of participants. Of course macroeconomic variables matter. But they are not, and never have been all that matters."
But a major part of the fiscal cliff is, in fact, the result of a psychological trick by policymakers. When the bipartisan super committee was unable to agree on spending reductions last year, they set into motion the budget sequestration that will slash $109 billion for Defense and domestic expenditures next year.
Because Congress has a short-term incentive to keep splurging, it created a cliff as a mechanism to curtail the growth of a national debt that now tops $16 trillion. Obama and lawmakers were lashing themselves to the mast just like the mythical character Ulyssess did in order to hear the mythical sirens.
"They've basically said, we're going to force ourselves to do the responsible and right thing by setting up a cliff," Shankar Vedantam, author of "The Hidden Brain," recently explained on NPR. "And the cliff is so bad, and its consequences are going to be so detrimental, that it's going to force us to get our house in order. So essentially, what the cliff does is it makes the long-term challenge salient in the short-term. It puts a looming catastrophe right in front of us and says, this is going to get everyone's attention to sit down and focus."
But even if the cliff succeeds in imposing discipline, any deal is unlikely to instantly produce much certainty—one of the most important psychological salves that the government could offer.
"Frankly, I think the markets have this wrong," said Greg Valliere, chief political strategist for Potomac Research. "A deal around Dec. 21 probably would be an agreement in principle, with a commitment to fill in the blanks during the first quarter. So there potentially will be another three months of uncertainty in 2013. So the good news may be that we won't plunge over the cliff in early January; the bad news may be still more months without clarity. If you believe, as most economists do, that businesses aren't spending or hiring because of all the uncertainty, this scenario is no prize."
In other words, politicians don't just have the mission of talking the government off the cliff. They also just might need to talk the nation off the ledge.


text:
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Hackers have targeted Ukrainian state institutions about 6,500 times in the past two months, including incidents that showed Russian security services were waging a cyberwar against the country, President Petro Poroshenko said on Thursday.
According to Reuters, Ukraine suffered last December attacks on its finance and defense ministries and the State Treasury that allocates cash to government institutions. A suspected hack also wiped out part of Kiev's power grid, causing a blackout in part of the capital.
"Acts of terrorism and sabotage on critical infrastructure facilities remain possible today," Poroshenko said during a meeting of the National Security and Defense Council, according to a statement released by Poroshenko's office.
The statement said the president stressed that "the investigation of a number of incidents indicated the complicity directly or indirectly of Russian security services waging a cyberwar against our country".
Relations between Kiev and Moscow collapsed in 2014 following Russia's annexation of Crimea and support for pro-Russian separatists in eastern Ukraine, where fighting continues despite a ceasefire agreement.
Among the 6,500 attacks Poroshenko said the country had been hit by, the attack on the State Treasury halted its systems for several days, meaning state workers and pensioners had been unable to receive their salaries or payments on time.
Cyber security firm CrowdStrike said last week a hacking group linked to the Russian government likely used a malware implant on Android devices to track and target Ukrainian artillery units from late 2014 through 2016.
Its findings are the latest to support a growing view among Western security officials and cyber security researchers that Russian President Vladimir Putin has increasingly relied on hacking to exert influence and attack geopolitical foes.
Russia has repeatedly denied hacking accusations.
Poroshenko's comments come as the Obama administration plans to announce retaliatory measures against Russia for hacking into U.S. political institutions and individuals and leaking information in an effort to help Donald Trump win the presidency. Trump has dismissed the assessments of the U.S. intelligence community.
In December 2015, Ukrainian regional power company Prykarpattyaoblenergo reported an outage, saying the area affected included the regional capital Ivano-Frankivsk. Ukraine's state security service blamed Russia.
Experts widely described that incident as the first known power outage caused by a cyber attack. The U.S. cyber firm iSight Partners identified the perpetrator as a Russian hacking group known as "Sandworm".
As a result of the cyber attacks, Ukraine's security council agreed measures to protect state institutions, the statement said. It did not disclose what the measures were.


text:
|Perl: the Markov chain saw
Re^2: Breaking The Rulesby Limbic~Region (Chancellor)
|on May 30, 2006 at 19:07 UTC ( #552593=note: print w/replies, xml )
|Need Help??
The rest of that two line paragraph you omitted reads: Think for yourself and make sound judgements.
Let me make it clear that I am not suggesting these rules don't exist for good reason or that following them is not a good idea. My point was that the exceptions are not universal and that careful experimentation results in experience to know what to follow and when. Being careful requires the coupling of common sense and prudence.
Unless you're writing an e-mail address parser...
In my meditation, I state that while looking for the things that could go wrong (prudence), you will need to utilize your situation specific context to know how, if at all, to apply this information. So what are my existing wheels for parsing email addresses:
All but the last deal with RFC-822 and/or RFC-2822. These would be useless if the purpose I was parsing was to find addresses attempting to expliot an open-relay. This is because addressesses such as email@example.com%blah.net are valid by the RFC but result in the vulnerable MTA responsible for the blah.net MX record in stripping off the %blah.net and redirecting the message for email@example.com.
Ok, so I use Data::Validate::Email which supports RFC 822 addresses but has "real-world" flavor as well. This still we do me no good if my objective is to find addresses that fit a specific pattern. It is a case of the general purpose tool not working for the specific problem space.
I have updated the original meditation with a closing paragraph and provided a reply that I believe helps explain my position.
Cheers - L~R
In Section Meditations


text:
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If you are planning to submit a lot of sequence searches, we recommend installing Infernal locally.
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text:
Vecoplan LLC, a worldwide leader in size reduction technologies, has promoted Jason Schultz to the position of client support manager.
In his new position, Schultz is the go-to-guy for all things service. Responsibilities of his new position include providing troubleshooting service, to customers and service technicians in the field.
Schultz will also oversee the organization and scheduling of Vecoplan's network of certified service personnel throughout North America. Ensuring that the right service people are where they need to be, when they need to be, with the right parts, to get all maintenance and service issues handled in a timely and professional manner. Prior to his promotion, Schultz was the plant production supervisor at Vecoplan and before that a senior field service technician with Vecoplan.
Schultz holds a welding certification from Orleans Niagara Vocational School in Sanborn, NY, and has two decades of experience in the installation and maintenance of large industrial machinery and systems. Prior to joining Vecoplan, Schultz worked as a maintenance mechanic at Duracell, a welder at Thomas Built Buses, and a MTM 2 at Tyco Electronics.
"With our continued sales growth, the sheer number of customers, machines and systems that we have in the field has increased dramatically, and so has our need for senior level service support," states Bill Davison, VP of operations at Vecoplan. "Jason's background enables him to hit the ground running and that's exactly what we need right now. He brings extensive knowledge and expertise to this department, having been a Service Technician both in the factory and in the field for 20 years."


text:
Millennials Arrested for Doin' Middle Fingers at Taylor Swift's House
Three American heroes were arrested for speaking truth to power over the weekend, after allegedly hurling beer bottles and hurtful words at security guards stationed outside singer Taylor Swift's beachfront Rhode Island mansion.
The Westerly Sun reports that the individuals—two men and one woman, all in their twenties, all Nutmeggers bringing low-class Connecticut-style tomfoolery to Rhode Island's genteel shores—were charged with misdemeanor disorderly conduct.
Security guard Ryan Poirier—who probably became a securidy gahd because he wanted to protect people and keep them safe; who probably never envisioned himself weathering a barrage of beer bottles and rude gestures as he spent yet another Sunday patrolling the enormous perimeter of an empty mansion bought on a lark by a singing child—told police that, after throwing the bottles, the trio "extended their middle fingers," and, in the words of the Sun, "shouted the corresponding expletive" ("Take a hike!"). He snapped a photograph of the miscreants on his cell phone.
One of those arrested—Tristan Kading, 28—told TMZ they were flashing peace signs, not middle fingers. He and his associates have been ordered to appear in court on a later date.
Taylor Swift was not in Rhode Island at the time of the incident, because she is rich and can go anywhere.
[Image via Getty]


text:
Sea-Run Cutthroat Fly Patterns
These flies are just a small selection of attractor patterns for coastal cutthroat. It is about to expand in the very near future. Moreover, this whole section is about to undergo a major revision. The flies you see here are all in the process of being retied and photographed and many new flies will be added, including the popular Kinney's Reversed Spider mentioned in A Letter from Preston Singletary. The haggard examples you see here were old flies that were scanned before the advent of the modern digital camera. If you are you are really serious about tying flies and fishing for these excellent game fish, I suggest that you do some more research. There is an excellent book by Les Johnson, called Fly-Fishing Coastal Cutthroat, Flies, Techniques, Conservation which is chock-full of Sea-Run Cutthroat patterns and advice. I highly recommend it as a reference.
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text:
Did you know that Elvis had his own little private trailer village tucked away in the far reaches of his 163 acre Circle G Ranch in Mississippi? His foray into cowboy communal living is an interesting story, especially because spring 1967 may well have been the happiest period of his life.
I received an e-mail from a member of The Circle G Foundation who asked if I could write a story on ElvisBlog about their efforts to get the ranch purchased and save it from slow destruction. It sounded like something I could do, and it might help, so I said sure. Then, I realized I knew almost nothing about Elvis' Circle G Ranch in Mississippi.
After two weeks of research, I now know enough to write a three-part ElvisBlog series. I've found so much information on the web and in books I own, and Lesley Pilling of the Circle G Foundation has been very helpful.
But I need time to get it all together. So, this week, all you get is that first paragraph tease. Instead, we are going back in the archives again to find old stories that would improve the most with photos added. Here is one from 2007 that really improved.
The Women Who Loved Elvis
That enticing title graced the cover of the August 2007 issue of the Ladies Home Journal. As soon as I read the first line of the subtitle, "Very Private Confessions," I knew this was prime material for an Elvisblog article.
A good many Elvisblog readers probably missed the Ladies Home Journal article by leading Elvis writer Alanna Nash. It featured seven lovely ladies associated with Elvis in a variety of ways.
The subtitle "Very Private Confessions" turned out to be quite a stretch. I looked specifically for them and have listed below my best guess at each woman's "Confession."
June Jaunico: Elvis' girlfriend for over a year in 1955/56.
"We got so wrapped up in kissing on our very first date – nothing too sloppy, it was marvelous – a little pecking here and there, a little nibble here and there, then a serious bite." (This one is a very sweet confession, but wouldn't a real confession have been about what she and Elvis did on date number five or six, not on the first one?)
Wanda Jackson: sang in concerts on tour with Elvis and was his girlfriend in 1955/56.
"In the early part of '56, he gave me one of his rings… We stood by his car and he asked me to be his girl… I had a crush on him, and being able to know him and know his heart made me admire him a lot. So, I said I'd be his girl." (Good move, Wanda)
Raquel Welch: had a bit part in the 1964 movie Roustabout.
"One of his guys came over and said, "Elvis is having a little party at the house, and if you'd like to come up…" I had a very strict upbringing, and I didn't like the setup, so I didn't go." (Big mistake. Bet you wish you had that one to do over again, Raquel.)
Mary Ann Mobley: appeared in Girl Happy and Harum Scarum
"Elvis and I felt a common bond, coming from Mississippi. He thought I understood him… This is an odd thing to say about Elvis Presley, but it was like I was working with my brother. We never dated." (Sorry, but there is nothing else remotely approaching a confession in Mary Ann's section.)
Jo Smith: wife of Elvis' very close cousin Billy Smith
"He loved you to talk babytalk to him, and we had to take care of him and cater to him like a small child… He liked to be put in bed and be told good night." (You have to assume this took place in the time after Priscilla and before Linda Thompson. Can't see Jo Smith tucking Elvis in bed when either of them was around.)
Linda Thompson: Elvis' girlfriend from 1972-76.
"But I think it's wonderful if you can be all things to each other. And he and I were. He called me 'Mommy.' And he was like my father at times. And we were like brother and sister at times, and we were like lovers at times. (Looks like they played 'cowboys and Indians' at times, too.)
Kathy Westmoreland: recorded and toured with Elvis in the 70s.
"My last in-depth conversation with Elvis was just a few weeks before he died. I remember he said, 'Kathy, what's it all about?' And I said, "I think that is for you to find out for yourself.'" (Kathy's section in the article was very short and mostly about sad topics. This is about the most upbeat thing she said.)
Here is a selection of other interesting quotes by some of the ladies.
June Jaunico didn't hear from Elvis for a while after that first date. "It turned out he was calling and my older brother wasn't bothering to tell me. Finally, he said, 'Some guy with a hillbilly accent called.'"
Wanda Jackson and her dad were backstage on the first stop of a tour with Elvis in 1955. "All of a sudden my dad and I started hearing screaming. My daddy said, 'I wonder if there's a fire or something. Let me go look.' I started getting my things, and he came back and said, 'No, relax. But you've got to see this for yourself.' He took me to the wings, and there was Elvis singing and moving and gyrating, and all these girls standing at the foot of the stage, screaming and reaching for him."
Raquel Welch had a revelation about how sexy a guy could be when she saw Elvis in concert for the first time. "Like many adolescents of the 50s, I had been completely gaga over Elvis. I saw him live in San Diego in one of his early shows. It was my first rock 'n' roll concert ever."
A Linda Thompson quote seems to dispute reports that Elvis knew he would die young. "I think it's terrible for people to say they couldn't imagine Elvis growing old. Everybody has that right, even if they are a sex symbol. He wanted to live to be an old man."
And, we sure wish he had.
Remember, lots of good stuff coming up the next three week on the Circle G Ranch.


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So it appears the Delaware sports betting bill will be signed into law later this week. And, on cue, the NFL is making a big production of being outraged.
It should go without saying that, had it not been for the invention of the betting line, the NFL would occupy a place in the American consciousness roughly equivalent to that of Frisbee. Nevertheless, the league has filed a legal brief with the state supreme court, arguing that gambling threatens the integrity of the game, and that skill plays "an impermissible role" in sports betting, both of which no one but Roger Goodell pretends to believe anymore.
Hell, way back in 1977, a Delaware federal judge dismissed both arguments in upholding a short-lived state football lottery (essentially a parlay) called "Touchdown," delivering perhaps the only legal opinion to draw on the work of noted geneticist Jimmy "The Greek" Snyder. Wrote Judge Walter K. Stapleton:
The record shows that extensive gambling on NFL games has existed for many years and that this fact of common public knowledge has not injured plaintiffs or their reputation.
"Jimmy the Greek" is a widely recognized oddsmaker, syndicated columnist and television personality who earns his living in part by predicting the outcome of NFL games. The record shows that, although he correctly predicted the winner of 101 out of 126 NFL games from September 12 through November 8, if he had bet on both pools of games in Football Bonus each week, he would have won only three times. He would never have won the All-Game Bonus awarded to those who correctly choose the winners of all fourteen games in a single week. We cannot determine how he would have fared in Touchdown because we do not know which three, four or five games he would have placed wagers on each week. However, he successfully predicted the point spread in only 38 out of 126 games in nine weeks. This strongly suggests that expertise would not have carried the day in this game either.
That's my lock of the week!
The NCAA has also gotten in on the action, threatening to block Delaware schools from hosting bowl games. This is of real concern to precisely no one.
Senate OKs sports bets, table games [The News Journal]


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MSc in Animal Science
Agricultural & Marine Sciences
Program Type
Course Work and Thesis
Study Mode
Full-time or Part-time
2 Years for Full-time and 3 Years for Part-time
Instruction Language
Name: Dr. Waleed Al Marzooqi
Email: email@example.com
College Website
Program Overview
The student should complete the course work requirements specified in the degree plan with a minimum cumulative GPA of 3.00. For the thesis, the candidate is required to conduct the necessary literature review, undertake the research, analyse the results, write the report and communicate the results at an oral defense. This work need not necessarily be original research, but should be a new application of ideas. The student should identify the research problem in consultation with the supervisor, which normally takes place in the second semester. The student should register for the thesis in the third semester after having completed at least 12 credits of the course work.
Admission Requirements
- Two year's Work experience is a must for candidates with Cumulative Grade Point Average between 2.5 and 2.74 in the Bachelor degree, or
- Applicants who have bachelor degree from a recognized institution and a postgraduate diploma in a related specialization from a recognized institution of higher education with a minimum cumulative GPA of 3.00 on a 4-point scale or its equivalent.
English Proficiency
Before starting the program the admitted candidates should submit an English Proficiency Test Certificate band (6) or higher in academic International English Language Testing System (IELTS) Academic or a score of (79) or higher in the International TOEFL - IBT
Selection Criteria
There will be an interview for all applicants and it can be by phone for international applicants.


text:
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SAMJ: South African Medical Journal
On-line version ISSN 2078-5135
Print version ISSN 0256-9574
SAMJ, S. Afr. med. j. vol.100 n.1 Pretoria Jan. 2010
Utilisation and outcomes of cervical cancer prevention services among HIV-infected women in Cape Town
Priya BatraI,*; Louise KuhnII; Lynette DennyIII
IBA, College of Physicians and Surgeons, Columbia University, New York
IIPhD, Mailman School of Public Health, Columbia University
IIIMB ChB, MMed, PhD, FCOG (SA), Department of Obstetrics and Gynaecology, University of Cape Town and Groote Schuur Hospital, Cape Town
OBJECTIVE: An audit of outcomes of cervical cancer screening and prevention services for HIV-positive women in Cape Town, South Africa.
DESIGN: Retrospective review of clinic registers, patient records and pathology databases at three HIV primary health clinics and a tertiary colposcopy referral centre.
SUBJECTS: Women recently diagnosed with HIV at three primary health clinics between 2006 and 2008 (N=2 240); new patients seen for colposcopy at a tertiary referral centre between 2006 and 2009 (N=2 031).
OUTCOME MEASURES: The proportion of women undergoing cervical cancer screening after HIV diagnosis at primary health clinics, demographic characteristics of women referred for colposcopy at a tertiary centre, and outcomes of therapy for precancerous lesions of the cervix.
RESULTS: The proportion of women undergoing at least one Pap smear at HIV primary health clinics after HIV diagnosis was low (13.1%). Women referred for colposcopy tended to be HIV-positive and over the age of 30 years, and in most (70.2%) cytological examination revealed high-grade cervical dysplasia. HIV-positive women treated with excision for precancerous lesions of the cervix were significantly more likely than their HIV-negative counterparts to undergo incomplete excision, experience persistent cervical disease after treatment, and be lost to follow-up.
CONCLUSION: Cervical cancer screening efforts must be scaled up for women with HIV. Treatment and surveillance guidelines for cervical intraepithelial neoplasia in HIV-positive women may need to be revised and new interventions developed to reduce incomplete treatment and patient default.
Cervical cancer is the most common cancer among South African women. The age-standardised mortality rate from cervical cancer is 21.0% in South Africa but only 8.9% worldwide.1,2 This differential highlights inequality in the availability of screening for easily treated precursor lesions. South Africa's cervical cancer burden severity is compounded by its HIV epidemic (2008 adult prevalence rate 18.1%).3 In HIV-infected women, the risk of developing squamous intraepithelial lesions (SIL) is increased, and the annual incidence of human papillomavirus (HPV)-associated cervical intraepithelial neoplasia (CIN) is 4 - 5 times greater than in the general population.4,5 CIN appears in younger women and progresses to cancer more quickly in the presence of HIV.6
Cancer screening rates in South Africa are low, regardless of HIV status. Papanicolaou (Pap) screening rates are as low as 4% among women 15 - 65 years of age, with most performed in antenatal or family planning clinics.7 In 2000, the South African Department of Health published guidelines for a comprehensive national cervical cancer screening programme. All asymptomatic women of at least 30 years of age should be offered three free lifetime Pap smears, up to 10 years apart.8 This policy did not take HIV status into account, and there are few evidence-based guidelines for cervical cancer screening in HIV-positive women.
We aimed to evaluate the provision of cervical cancer prevention services to HIV-positive women in Cape Town. First, we attempted to define the proportion of HIV-positive women undergoing Pap smears at HIV primary health clinics (PHCs) in the community. Second, we audited the Groote Schuur Hospital (GSH) colposcopy clinic to describe the impact of HIV status on diagnosis and management of precursors to cervical cancer.
Study design and subjects
We conducted a retrospective review of clinic registers, patient medical records and pathology databases at three HIV PHCs in Cape Town and the GSH colposcopy clinic, which is a tertiary referral site for a large proportion of women undergoing cervical screening in Cape Town.
PHCs serving HIV-positive women
The PHC sample included all women at three selected HIV clinics who were aged at least 16 years, had been tested for HIV between 1 August 2006 and 31 July 2008, and were receiving care for HIV. Western Cape Department of Health policy specifies that HIV-positive women should undergo annual cervical screening by Pap smear, the first performed just after HIV diagnosis. The three HIV PHC sites selected were known to refer patients with abnormal smears to GSH for colposcopy. Data captured included PHC location, age, whether the woman underwent a Pap smear, cytology results and any details regarding referral for colposcopy. For the subject to be included, Pap smears had to have been performed after HIV diagnosis and before 1 December 2008.
GSH colposcopy clinic
This sample included all women at least 16 years of age referred between 1 January 2006 and 31 December 2008 as new patients for colposcopy from family planning clinics, community health centres and workplace clinics in Cape Town. Indications for referral to colposcopy were an abnormal glandular lesion on Pap smear, a single result of high-grade SIL or cancer, or two or more low-grade SIL or atypical squamous results on Pap smears taken at least 6 months apart. Patient encounters occurring before 1 January 2009 were reviewed.
The final sample included 2 045 women, of whom 2 031 had records available for review (99.3% completion). Data were collected for the first colposcopy visit for all subjects. For subjects undergoing large loop excision of the transformation zone (LLETZ) for treatment of CIN, data were also collected for the treatment visit and for the 4-month post-procedure visit. Indicators captured from colposcopy charts and pathology databases included demographics (age, gravidity/parity, co-morbid genital warts/herpes, co-morbid pulmonary tuberculosis, contraceptive use), self-reported HIV status, self-reported use of highly active antiretroviral therapy (HAART), smoking status, Pap smear results, colposcopy findings, histological diagnoses and compliance with follow-up visits. Laboratory results (cytology, histology) were recorded as reported by the National Health Laboratory Service (NHLS), which serves all PHC sites and GSH.
Statistical analysis
Data were entered into an anonymous database using Access 2000 software (Microsoft, Seattle, WA), and exported into SAS 9.1.3 (SAS Institute, Cary, NC) for analysis. Proportions of subjects undergoing Pap tests were calculated for PHC sites. Descriptive statistics were generated for demographic data in the GSH sample. We used the chi-square (χ2) statistic to test for differences in outcomes by categorical variables, with statistical significance defined at alpha = 0.05 (p=0.050). Outcome variables included whether a Pap smear was performed, colposcopy findings and cytology/histology pre- and post-treatment. Hypothesised determinant variables included age, contraceptive method, self-reported HIV status and HAART use.
Ethics considerations
Ethics approval was obtained from the Research Ethics Committee of the University of Cape Town Health Sciences Faculty and from the Columbia University Institutional Review Board (New York, USA).
Pap smears performed among HIV-positive women at PHCs
The final PHC sample included 2 240 HIV-positive women at three clinic sites (Table I); 52.4% were 30 years of age or older, and only 293 (13.1%) had had at least one Pap smear between HIV diagnosis and the end of the data collection period. Older women were significantly more likely to have had at least one Pap smear (p=0.0021). The proportion of women having at least one Pap smear was stratified by clinic site (A, B or C). At site A, 688 women tested HIV positive, of whom 72 (10.5%) had a Pap smear, compared with 92 of 1 346 patients (6.8%) at site B. At Site C, with a sample of only 206 HIV-positive women, 129 (62.6%) had Pap smears. Table I lists the PHC Pap smear results. Cytology results are reported as classified by the NHLS: normal, atypical squamous cells of undetermined significance (ASCUS), atypical squamous cells cannot exclude high-grade SIL (ASC-H), low-grade SIL (LSIL), high-grade SIL (HSIL), atypical glandular cells of undetermined significance (AGUS), adenocarcinoma in situ, or cancer. Most women were found to have normal, ASCUS or LSIL Pap smears. Referrals for colposcopy at GSH were indicated for 12 (4.1%) of the patients undergoing at least one Pap test, only 5 of whom had colposcopy (58.3% lost to follow-up after Pap smear).
GSH colposcopy clinic data descriptive analysis
The final GSH sample included 2 031 women (Table II); 70.0% were between 30 and 49 years of age. Over half of all new patients were HIV positive by self-report. No contraception was used by 633 (31.2%), while just over one-third were using long-acting injectable progestins (LAIP). Condom use was reported by 210 (10.3%), with only 175 (17.1%) of HIV-positive patients reporting regular condom use. HAART was utilised by 524 (51.3%) of HIV-positive women at the time of their index colposcopy visits (self-reported). Co-morbid pulmonary tuberculosis, genital herpes and genital warts were significantly more likely to be reported in HIV-positive patients (p<0.0001, p=0.0026 and p<0.0001, respectively).
Table II presents referring Pap smear and colposcopy findings. An HSIL Pap smear was the reason for referral in 1 187 (58.4%) women. Consistent with referring Pap smear results, most women were considered to have CIN 2 or 3 (high-grade dysplasia) by the colposcopist. LSIL Pap smears were seen in 555 (27.3%) of women referred to GSH; 364 (65.6%) of them were HIV positive by self-report, and 335 (60.4%) were also found to have low-grade dysplasia on colposcopy.
LLETZ outcomes
LLETZ was performed in 778 patients for treatment of CIN (Table III), of whom 360 (46.3%) were HIV positive and 186 (51.7%) reported using HAART. The loss to follow-up rate after LLETZ (patient did not attend 4-month post-procedure visit) was 21.9% for patients seen in 2006 and 2007 (LLETZ cases from 2008 were excluded, as patients may have been scheduled for follow-up after the close of data collection). HIV-positive women were significantly more likely than HIV-negative women to be lost to follow-up after LLETZ (p=0.0280). Descriptive statistics were calculated for the presence of residual CIN at LLETZ ecto- and endocervical excision margins. Both margins were negative in 349 (44.9%) of LLETZ cases, and one or both margins were positive for residual CIN in 429 cases (55.1%). HIV-positive women undergoing LLETZ were significantly more likely to have one or more margins positive for residual CIN (p<0.0001).
Post-LLETZ Pap smear results were available for 494 women (Table IV). LSIL or a more severe lesion on Pap smear (defined as 'incomplete treatment') was seen in 149 women (30.2%) 4 months after LLETZ. HIV-positive women were significantly more likely than HIV-negative women to be incompletely treated by LLETZ (p<0.0001). The 'incomplete treatment' group was also significantly more likely to have both excision margins positive for residual CIN (p<0.0001). Use of LAIP contraceptives, histological grade and self-reported HAART use (in HIV-positive subjects) were not significantly associated with LLETZ treatment success.
Positive predictive value of colposcopy
Positive predictive value (PPV) describes the proportion of patients with a positive diagnostic test result subsequently found to have true disease on confirmatory testing. We examined the subgroup of women classified as having CIN 1 or more severe lesion on colposcopy and identified the proportion in this subgroup who had CIN 1 or more severe lesion confirmed by histological sampling (biopsy or LLETZ) to calculate PPV. The PPV of colposcopy in predicting a histological diagnosis of CIN 1 or more severe lesion was 82.6% among women who had diagnostic tissue sampling and for whom adequate colposcopy results were available (1 787 of the sample of 2 031 women). PPV remained robust when stratified by self-reported HIV status. In HIV-positive women with colposcopy findings and histological results available (N=897) the PPV was 83.0%, and in HIV-negative women (N=537) it was 81.1%.
Primary health centre data on recently diagnosed HIV-positive women revealed that the proportion of patients undergoing at least one Pap smear was low (13.1%). HIV-positive women over the age of 30 years were preferentially screened at HIV clinics. It is possible (though unlikely) that HIV-positive women undergo cervical screening at other primary health care sites. PHC site C, which served the fewest patients and offered primary care and HIV services in a single setting, provided almost two-thirds of newly diagnosed HIV-positive women with at least one Pap test. Larger HIV clinic sites with greater patient volumes and more fragmented service provision were less successful in linking cervical cancer prevention to HIV care.
Over 80% of women referred to GSH for colposcopy were at least 30 years old. It appears that primary health care providers are systematically offering Pap smears in accordance with national cervical screening guidelines, and are shifting away from opportunistic screening provided in the context of antenatal or family planning care. HIV-positive women were over-represented in the colposcopy sample. When combined with our data from primary care clinics, this finding suggests that while Pap rates among HIV-positive women may be low, the proportion of HIV-negative women undergoing Pap smears may be even lower. HIV-positive women in Cape Town may have more frequent contacts with the health care system. Many women referred for colposcopy also utilised contraceptive methods requiring regular health care encounters (i.e. LAIP, tubal ligation). Cape Town women with regular health system interactions of any type may have more lifetime Pap smear opportunities.
Colposcopy had a PPV of 82.6%, which was not surprising given that PPV is directly proportional to disease prevalence (known to be high in our sample). It is important to note that PPV was not altered by self-reported HIV status. Colposcopy has previously been demonstrated to correlate as well with histological diagnosis in HIV-positive women as in uninfected controls.9 While colposcopy is useful in estimating lesion grade, management decisions may still require histological confirmation.
A substantial proportion of women referred for colposcopy (27.3%) had low-grade SIL according to cytology, and most of these were HIV positive. Although the relative risk of progression of low-grade lesions to high-grade CIN/cancer is increased in HIV-positive women, the absolute risk of progression remains low.10 In a study of HIV-positive women from Cape Town, Denny et al. demonstrated that while 35% of women had LSIL on Pap smear at entry, only 4% of them progressed to high-grade SIL over a 36-month follow-up period.4 However, referrals of low-grade dysplasia to GSH probably represent a small fraction of the true number of women requiring colposcopy, given the low Pap smear rates reported at PHC sites, and the requirement of two low-grade Pap smear abnormalities for colposcopy referral. As cervical screening increases, the number of cases of low-grade cervical disease requiring follow-up is likely to outpace growth in colposcopy services.
We found a post-LLETZ patient default rate of over 20%. This is concerning, as HIV-positive women were most often lost to follow-up. Those HIV-positive women who did follow up were significantly more likely to present with Pap smear abnormalities after LLETZ. Our suboptimal LLETZ treatment outcomes mirror studies in South Africa, Brazil and the USA.11-13 HIV-positive women may require more intensive surveillance for persistent cervical abnormalities after LLETZ. HAART therapy was not associated with improved excision outcomes in HIV-positive women in our sample. Studies on HAART and CIN excision are mixed; while some suggest that HAART promotes regression of CIN/SIL after excision,14 others have not shown any clear cervix-specific treatment benefit.15 However, HAART use was self-reported in our sample, and we had no data on duration of therapy.
Limitations and further directions
A retrospective design limited this study's findings, as research questions were restricted to data recorded in clinic folders and registers. Data on severity of HIV-related disease (i.e. CD4 count, viral load) were unavailable, and the impact of these factors on study outcomes could not be assessed. HIV status was self-reported in the GSH sample many women who reported 'negative' HIV status had last been tested more than 12 months before index colposcopy encounters. The large proportion of HIV-positive women in our sample may be an underestimate.
Our study illustrates the realities of Cape Town's cervical cancer prevention programme for women living with HIV. The proportion of HIV-positive women undergoing Pap smears at HIV care sites is low, and varies highly by clinic site. In spite of low Pap test rates, many HIV-positive women are being referred for colposcopy. Poor follow-up after excision coupled with suboptimal CIN treatment outcomes in HIV-positive women means that cervical surveillance efforts must be scaled up for these patients. New recommendations for follow-up in these women will impact on the allocation of health resources for cervical cancer prevention. Cervical cancer prevention must be linked to basic HIV care for health outcomes to improve.
Dr R Soeters assisted in the design of data collection instruments, and ensured institutional support. Drs N Mbatani, P van Greunen, R Boa, B Howard, K Dehaeck and J Robinson of Groote Schuur Hospital provided assistance. Dr M Sobieszczyk of Columbia University provided guidance during study development. The investigators thank the Western Cape Department of Health for its support.
Conflict of interest. The authors have nothing to disclose.
Funding support. The Doris Duke Charitable Foundation.
1. World Health Organization/Institut Catala d'Oncologia. Human Papillomavirus and Cervical Cancer Summary Report: South Africa [document on the Internet]. Barcelona: WHO/ICO, 2007 (updated 2007). http://www.who.int/hpvcentre/en/ (accessed 10 May 2009). [ Links ]
2. Denny L. Prevention of cervical cancer. Reprod Health Matters 2008; 16: 18-31. [ Links ]
3. Joint United Nations Programme on HIV/AIDS and the World Health Organization Working Group on Global HIV/AIDS and STI Surveillance. Epidemiological Fact Sheet on HIV and AIDS: South Africa [document on the Internet]. Geneva: UNAIDS/WHO, 2008 (updated September 2008). http://data.unaids.org/ Publications/Fact-Sheets01/southafrica_EN.pdf (accessed 10 May 2009). [ Links ]
4. Denny L, Boa R, Williamson AL, et al. Human papillomavirus infection and cervical disease in human immunodeficiency virus-1-infected women. Obstet Gynecol 2008; 111: 1380-1387. [ Links ]
5. Ellerbrock TV, Chiasson MA, Bush TJ, et al. Incidence of cervical squamous intraepithelial lesions in HIV-infected women. JAMA 2000; 283: 1031-1037. [ Links ]
6. Danso D, Lyons F, Bradbeer C. Cervical screening and management of cervical intraepithelial neoplasia in HIV-positive women. Int J STD AIDS 2006; 17: 579-584. [ Links ]
7. Cronje HS, Beyer E. Screening for cervical cancer in an African setting. Int J Gynaecol Obstet 2007; 98: 168-171. [ Links ]
8. South African Department of Health. National Guideline On: Cervical Cancer Screening Programme [document on the Internet]. Pretoria: SA DOH, 2000 (updated 2000). http://www.doh.gov.za/docs/index.html (accessed 10 May 2009). [ Links ]
9. Massad LS, Schneider M, Watts H, et al. Correlating Papanicolaou smear, colposcopic impression, and biopsy: Results from the Women's Interagency HIV Study. J Low Genit Tract Dis 2001; 5: 212-218. [ Links ]
10. Massad LS, Evans CT, Minkhoff H, et al. Natural history of grade I cervical intraepithelial neoplasia in women with human immunodeficiency virus. Obstet Gynecol 2004; 104: 1077-1085. [ Links ]
11. Adam Y, van Gelderen CJ, de Bruyn G, McIntyre JA, Turton DA, Martinson NA. Predictors of persistent cytologic abnormalities after treatment of cervical intraepithelial neoplasia in Soweto, South Africa: a cohort study in a HIV high prevalence population. BMC Cancer 2008; 8: 211-221. [ Links ]
12. Lima MI, Tafuri A, Araujo AC, de Miranda Lima L, Melo VH. Cervical intraepithelial neoplasia recurrence after conization in HIV-positive and HIV-negative women. Int J Gynaecol Obstet 2009; 104: 100-104. [ Links ]
13. Massad LS, Fazzari MJ, Anastos K, et al. Outcomes after treatment of cervical intraepithelial neoplasia among women with HIV. J Low Genit Tract Dis 2007; 11: 90-97. [ Links ]
14. Ahdieh-Grant L, Li R, Levine AM, et al. Highly active antiretroviral therapy and cervical squamous intraepithelial lesions in human immunodeficiency virus-positive women. J Natl Cancer Inst 2004; 96: 1070-1076. [ Links ]
15. Soncini E, Zoncada A, Condemi V, Antoni AD, Bocchialini E, Soregotti P. Reduction of the risk of cervical intraepithelial neoplasia in HIV-infected women treated with highly active antiretroviral therapy. Acta Biomed 2007; 78: 36-40. [ Links ]
Accepted 24 August 2009.
* Corresponding author: P Batra (email@example.com)


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EPA Awards Projects to Improve Onondaga Lake Water Quality (USA)
The U.S. Environmental Protection Agency has awarded a total of $260,000 to two organizations for work that will improve water quality in Onondaga Lake and the Onondaga Lake watershed.
The New England Interstate Water Pollution Control Commission (NEIWPCC) has used a $200,000 EPA grant to hire an Onondaga Lake Watershed Coordinator for a two-year period. The Onondaga Environmental Institute will use a $60,000 EPA grant to train people in Syracuse to develop, build, install and maintain controls on stormwater using green infrastructure. Green infrastructure is an approach to water management that protects, restores, or mimics the natural water cycle and enhances quality of life for communities.
"Because of the tremendous work of concerned citizens, community leaders and government agencies, Onondaga Lake becomes healthier each year," said EPA Regional Administrator Judith A. Enck. "These EPA grants will further these efforts, creating a cleaner lake and watershed for generations to come."
"The Onondaga Environmental Institute is grateful to the U.S. Environmental Protection Agency, is excited about the opportunity to work with our partners, and looks forward to fulfilling this grant," said Onondaga Environmental Institute President Edward Michalenko.
"We at the New England Interstate Water Pollution Control Commission are pleased to be able to assist with the ongoing restoration efforts for Onondaga Lake and its watershed," said NEIWPCC Executive Director Ron Poltak. "The many dedicated partners engaged in this initiative have accomplished much to date and we intend to take advantage of the momentum established and build off their strong work."
NEIWPCC's Onondaga Lake Watershed Coordinator will work with community groups, businesses and local governments and the Onondaga Nation to develop strategies for the restoration of the physical, chemical and biological health of the Onondaga Lake Watershed. The Watershed Coordinator will also initiate outreach awareness efforts with groups to explain or promote restoration of and access to Onondaga Lake and other natural areas within the watershed. In addition, the Watershed Coordinator will support local governments in assessing the impacts of proposed projects, land use planning and other local decisions on the integrity of Onondaga Lake. The coordinator is Aimee Clinkhammer.
The Onondaga Environmental Institute will sponsor two green Infrastructure training workshops for low-income, unemployed adults at the L&M Training Center in Syracuse's southside. Participants will be taught to create and maintain green infrastructure, including rain gardens, bioretention basins, rain barrels and green roofs. In addition, the program will include training on life skills, job readiness, workplace safety and exposure to a variety of "green" careers. The Onondaga Environmental Institute will also use its EPA grant to host two month-long afterschool programs to train young people ages 15 – 21 about green infrastructure, job readiness, life skills, workplace safety, community outreach and environmental justice. This grant is part of the EPA's National Urban Waters program, which supports communities in their efforts to access, improve and benefit from their urban waters and the surrounding land.
Press Release, August 9, 2013


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E-mu MP-7 Command Station
The cool looking MP-7 is a desktop sequencer module version of E-mu's Mo'Phatt HipHop and R&B sound module. You may recall that the Mo'Phatt module itself was a new and improved Urban Dance and Hip Hop synth based on the popular Planet Phatt module. Like the Mo'Phatt, the MP-7 uses the same sample-playback synthesis engine as E-mu's Proteus 2000 sound module. The MP-7 and all its Urban sounds and beats can also been found in a sleek keyboard version called the MK-6 Mo'Phatt Keys.
Sharing its sounds and specs with the Mo'Phatt, the MP-7 has 128 voices of polyphony like the Turbo Phatt. It ships with one 32 MB ROM soundset, called "Pure Phatt" and it is full of brand new and classic Hip Hop type sounds, from basses and synths to drum kits, scratches, vinyl effects and more! The MP-7 has 3 additional slots for adding more, up to 128 MB, of E-mu's 32 MB ROM soundsets from E-mu's family of genre based sound modules, keyboards, and desktop groove machines.
What sets the MP-7 (and the XL-7 Techno/Dance version as well) apart from its sound-module and keyboard versions is its built-in MPC-style sequencer. If you find the rack-mount sound modules too constricting to work with, and don't have room for another 61-note keyboard, the desktop sequencing all-in-one Command Station may be what you need. There are 13 large velocity and aftertouch sensitive pads which can be used to play notes, chords or drop in drum sounds. Sequences can be recorded in real-time, step input, or grid-styled classic TR drum-machine style programming. Patterns can be up to 32 bars long each, there is quantization, overdubbing features, and synth parameters can be automated in pattern and song modes.
There are 16 front panel real-time controllers for automating parameters in your tracks, or just for easy hands-on access to programming your sounds. Mute/Enable Track buttons allow you to add or remove patterns on the fly. The sequencer has full-blown MIDI implementation as well, supporting up to 32 MIDI channels. Use the MP-7 as a sound module or sync it up to other MIDI equipment. You can control its built-in sounds and external devices simultaneously! Many rhythmic synth parameters (LFO, envelopes) are Tempo/MIDI syncable too. There's even a cool real-time assignable touch strip ribbon controller. Unfortunately, the sequencer stores up to 1024 patterns and 512 songs.
Other great features it shares with its sister sound modules and keyboard versions include 32 simultaneously available arpeggiators with all the basic patterns plus up to 300 preset and user patterns! Two effects processors offer up the standard batch of reverb, delay, chorus, flange and distortion, and there are also digital 12 pole resonant filters. There are six outputs and a digital S/PDIF output, USB port, and a new BNC 12V lamp socket for lighting up the unit while using it on stage or alongside the DJ's turntables! On the stage or in the studio, Mo'Phatt has been the professional's choice for Hip Hop sounds and beats. Now the MP-7 gives musicians and DJs alike an MPC-style take on working with the proven sounds of E-mu's genre based Urban synths!
Current E-mu sound modules ship with one 32 MB sound-set each, but are expandable up to 128 MB via three additional slots for 32 MB expansion cards. These cards include (ranging from $249 to $395):
- 9061: Siedlaczek Orchestra 32 MB ROM.
- 9062: Pure Phatt 32 MB ROM - standard in Mo'Phatt, MP-7 and MK-6.
- 9063: Beat Garden 32 MB ROM - standard in Orbit 3.
- 9082: Protozoa 16 MB ROM - standard in Proteus 1, 2, 3.
- 9083: Definitive B-3 32 MB ROM - standard in B-3.
- 9084: Techno Synth Construction Yard 32 MB ROM - standard in Orbit 3.
- 9085: Orchestral Session Vol. 1 32 MB ROM - standard in Virtuoso 2000.
- 9086: Orchestral Session Vol. 2 32 MB ROM - standard in Virtuoso 2000.
- 9087: World Expedition 32 MB ROM - standard in Planet Earth.
- 9088: Sounds of the ZR featuring the Perfect Piano 32 MB ROM - standard in Ensoniq Halo.
- 9089: X-Lead 32 MB ROM - standard in Xtreme Lead-1, XL-7 and XK-6.
With these expansion options, you could buy a PK-6, then add the sounds of the Orbit 3, XK-6, and the MP-7... or any other combinations you may want. If you like desktop synths, you can start with an MP-7 or XL-7, and then add these same expansion card options to add Proteus, Orchestral, or the new Halo sounds to them. E-mu/Ensoniq's interchangeable sound cards and a variety of keyboard/sound-module options means that there's a model out there for everybody now.
Demos & Media
Arpeggiator: 32 Simultaneously available arpeggiators with up, down, up/down, forward assignable, backward assignable, forward/backward, random, 200 preset patterns, 100 user patterns
Images from Perfect Circuit Audio.


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Orioles closer Jim Johnson can be depended on to always be at his locker to answer questions anytime he becomes a focal point of a game following a blown save.
Those times have been rare, until recently, as Johnson has blown three consecutive ninth-inning leads that all ended in losses.Following the Orioles' 6-4 loss to the New York Yankees in the 10th inning on Monday at Camden Yards, Johnson put the team's season-high six-game losing streak in perspective.
"Well, three of them are my fault," Johnson said. "The other guys do their job and I do mine, then we're not standing here. I think everybody's doing a great job. I'm just not pulling my weight. And I'll figure it out.
"I'm not getting the ball to where I need to be. We've watched a lot of tape, and working on certain things, staying tall a little bit longer. We will figure it out. I'll figure it out, there's no other option."
Johnson had been a model of consistency, recording a remarkable streak of 35 straight converted save opportunities dating back to last July, serving as the crescendo of an Orioles bullpen that has been the team's strength since the beginning of last year.
But on Monday night, Johnson couldn't preserve a one-run lead, yielding a gut-punch, game-tying homer to Travis Hafner in the top of the ninth. The Yankees went on to plate two runs in the 10th inning for a 6-4 win.
The Orioles chased Yankees ace CC Sabathia — who has long dominated the Orioles at Camden Yards — from the game in the seventh inning and received a gritty quality start from right-hander Freddy Garcia, only for a win unravel with a bullpen implosion.
But Orioles manager Buck Showalter said he remains confident in Johnson.
"Jimmy's a very consistent human being," Showalter said. "We didn't do enough to win tonight. We're all human beings. He's solid as they come. The want-to is over the top and he made a lot of good pitches tonight. It's frustrating for him, but he wasn't the only one who could come out of this game a little frustrated tonight."
Since he unofficially took over the team's closer job on Sept. 7, 2011, Johnson leads all of baseball with 72 saves, and given that, Johnson's sudden slump is startling.
Now the Orioles (23-21) have lost six straight games for the first time since last May 26 through June 1, the team's only losing streak of more than three games in 2012. This is also the first time they are two or fewer games above .500 since April 20.
The Yankees hit four homers off Orioles pitching, none more important than Hafner's game-tying shot off Johnson. The blow came on a 3-1 sinker that didn't sink and instead hung over the outside half of the plate, allowing Hafner to take it the opposite way into the left-field stands for the game-tying homer.
"Tonight [Johnson] just got that 3-1 count and had to come in there and threw a sinker that ran more than sank and Hafner put a good swing on it," catcher Matt Wieters said. "It's not easy to hit home runs in this game especially off a guy that throws as hard as Jim. They put four solo homers together to keep them in the game."
In the 10th, Pedro Strop — who had allowed just one run over his last 13 games — yielded back-to-back doubles to Ichiro Suzuki and Vernon Wells, the latter of which scored the eventual game-winning run. Hafner then hit a two-out RBI single off Brian Matusz to score Wells and make it a 6-4 game.
Hot-hitting shortstop J.J. Hardy, hitting in the three hole for the first time this season, chased Sabathia from the game in the seventh inning by slapping an opposite-field double to right, scoring Nick Markakis with the go-ahead run. Hardy's hit was his 10th in 31 at bats against Sabathia.
The inning, which began with the Orioles trailing 3-2, was fueled by second baseman Alexi Casilla, who singled to open the inning for his 15th hit in 27 career at bats against the Yankees ace. The speedy Casilla scored the tying run from first base one batter later on Markakis' double into left-center.
Instead, Sabathia allowed a season-high 11 hits and four runs and lasted 6 1/3 innings, striking out two and walking none.
Garcia, despite pitching to a 7.45 ERA in his previous two starts, rebounded nicely against the team he played for the previous two seasons.
Garcia held the Yankees to two runs over six innings after falling behind 2-0 early on a pair of solo homers by Robinson Cano and David Adams. But following Adams' homer in the second inning, Garcia went on to face just one batter over the minimum, giving the Orioles back-to-back quality starts following a stretch in which Orioles starters went five innings or less in six of seven games.
"I was able to throw strikes and make good pitches when I needed," Garcia said. "We made a couple for good [defensive] plays and that was good for me. Too bad we lost but its part of the game. And hopefully we can turn it around."
Casilla also made a huge impact with his glove, making a pair of outstanding diving plays in critical situations.
He dove to his left on a ball hit by Curtis Granderson in the fourth and despite struggling to get to his feet, he threw a one-hopper first to get Granderson. And with Garcia in trouble with two on and one out in the sixth, Casilla snagged an in-between hop off the bat of Hafner and started an inning-ending 4-6-3 double play.
"Alexi put on a show at second base," Showalter said. "What a game he had. My gosh, he was impressive."
Reliever Troy Patton yieled a solo homer to Lyle Overbay in the seventh to give the Yankees a 3-2 lead.
Trailing 2-0, Orioles first baseman Chris Davis cut the gap to a run with his 13th homer of the season, a blast to center field on a full-count slider over the outside half of the plate. Davis' homer tied him with Cano for the AL lead in home runs.
Orioles closer Jim Johnson can be depended on to always be at his locker to answer questions anytime he becomes a focal point of a game following a blown save.


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Schools are under increasing strain to provide fast, reliable Internet access for teachers and students, and federal officials insist that help is coming. But will it arrive quickly enough?
Those familiar with the E-rate program predict that proposed changes to its funding—expected to pump an extra $2 billion into high-speed broadband over the next two years—are likely to produce significant benefits for the nation's schools over time, thanks in part to a new focus on supporting the use of new technologies.
Yet they also say it will take time for the bulk of the new money to reach districts—probably not until calendar year 2015—where it can help cover the costs of new Wi-Fi connections and other needs.
The pressure on school districts to upgrade their technology is growing, as the financial support to make those changes is limited. States are scheduled to begin giving online tests aligned to the Common Core State Standards in a year—exams that many district officials say will greatly tax their bandwidth and their ability to give tests with their current stock of laptops, desktops, and other devices.
Demand Rising
Meanwhile, schools' demand for bandwidth is also rising because of the growth of technology-enhanced lessons in classrooms, as well as students' increasing reliance on mobile devices and other new technologies.
The Federal Communications Commission, the agency that oversees the E-rate, announced a series of steps last month that officials said would not only put more broadband funding into the program over the next two years, but also redirect the funding to pay for the most in-demand technologies, such as broadband.
Yet most of the tangible benefits of the new money for broadband will not be felt in districts for a while, a number of observers predict. They cite a variety of reasons, including the fact that the E-rate application process for 2014 is already far along, as well as the limits on how quickly districts can arrange to make technology upgrades.
In the long term, the picture "is very optimistic" for E-rate funding to help meet schools' growing technology needs, said John Harrington, the CEO of Funds for Learning, a company in Edmond, Okla., that consults with school districts on how to apply for money through the program.
From the FCC and many policymakers, "there's a good vision for the program," he said. "There's a real commitment, up and down the line."
Prioritizing the Money
Yet the FCC's blueprint is less likely to help schools with more-immediate needs, particularly in areas such as strengthening connections between buildings and classrooms, he said.
"For many schools, the bottleneck is inside the schools themselves," Mr. Harrington said, adding that "for the internal connections, the short term is pretty bleak."
FCC Chairman Tom Wheeler recently announced plans to bring changes to the federal E-rate program, which supports K-12 schools and libraries and has an annual budget of $2.4 billion. Among the newly proposed policies:
• A $2 billion increase for broadband funding over the next two years;
• Applications in the current 2014 funding cycle that "get the most students the most broadband," without favoring urban school systems, will be prioritized;
• Opportunities for greater productivity in use of funding in the program will be prioritized after an ongoing, internal review;
• The release of a public notice soon that emphasizes phasing out outdated "legacy services" and focuses on broadband; and
• Prioritizing rather than penalizing, applications from groups of schools.
SOURCE: Federal Communications Commission
E-rate applications to secure money to pay for improvements to internal connections are typically deemed "Priority 2" requests within the federal program. Historically, little money has been left for those E-rate projects after "Priority 1" requests, which usually bring basic Internet connectivity to a school campus, have been met.
"Only in Washington, D.C., do those priorities matter," Mr. Harrington said. "If you're a superintendent, your priority is connecting students."
In a statement to Education Week, FCC officials confirmed that they expect that the bulk of the new $2 billion in broadband money will flow during 2015.
During 2014, the agency "will be taking a range of steps to free up the additional funds, as well as modernize the program," the FCC said. Also in 2014, the agency will focus on Priority 1, and wait to see how much demand there is for Priority 2 services before acting on those requests, it said. Decisions about Priority 2 requests typically aren't made until later in the calendar year, and FCC officials said they expect to stick to that schedule this year, too.
School and technology advocates have for years been calling for foundational changes to the E-rate program, which provides discounted telecommunications services to schools and libraries and has a $2.4 billion annual budget. President Barack Obama was one of those making that argument. Last year, the White House called for more money to go to the program and to refocus it on relevant technologies.
Earlier this month, the FCC announced plans to act. In a Feb. 5 speech, FCC Chairman Tom Wheeler, an Obama administration appointee, promised that the agency would spend $1 billion more a year over the next two years on broadband. Mr. Wheeler also said the agency would prioritize requests for broadband support in the current E-rate funding cycle, for which applications from schools are coming in now; and phase out support for outdated services, a change that would be spelled out in a public notice to be released by the agency.
Some backers of the E-rate program say the overall money devoted to the program needs to increase dramatically—perhaps doubling in size—to meet demand.
But Mr. Wheeler said in his speech that the FCC needs to scour the existing program for savings, and for money that can be redirected, before it considers taking that broader step.
"[T]he biggest immediate opportunities are unlocked by first looking carefully at how to do better with what you already have," Mr. Wheeler said. He called for "an assessment of the use of current funds, along with a fact-based analysis of the needs of the program."
Evan Marwell, the CEO of EducationSuperHighway, a nonprofit group in San Francisco that seeks to improve school Internet access, said it made sense that the bulk of the new broadband money would not reach districts until 2015, partly because the 2014 funding cycle is too far along for the agency to make major shifts in the kinds of projects that receive money.
In some respects, that's not a bad thing: The FCC will be able to ensure that new broadband funding is awarded as part of a restructured, improved E-rate program, rather than sending it to schools under the existing model, Mr. Marwell argued.
The process of using E-rate money for tech upgrades gets slowed down for other reasons, he noted. It takes time for districts to put out bids for technology to companies, including Internet service providers, and to select them, he said.
Other scheduling barriers persist. For instance, districts often try to limit ambitious tech upgrades so they occur during summer months, rather than during the school year, when they fear the work will derail instruction, Mr. Marwell added.
Crafting Future Plans
But even if the money doesn't course through the pipeline as quickly as schools want, Mr. Marwell said the delay should give districts the opportunity to assess their needs for bandwidth and devices, so that when a substantial pool of money for broadband does become available, they'll be ready.
"Start getting your ducks in a row," Mr. Marwell said he would advise K-12 systems. "Take a hard look at what [you] have for wired and Wi-Fi. Every school in the country should have a plan."
Schools wondering about their digital readiness will soon be asked to take their technology systems for an important, and potentially arduous, test lap around the track.Later this year, the two main state consortia designing online common-core exams, the Partnership for Assessment of Readiness for College and Careers and the Smarter Balanced Assessment Consortium, will begin administering field tests in districts across the country.
The field tests "will reveal a lot," said Lillian Kellogg, the vice president for client services at Education Networks of America, a Nashville, Tenn.-based company that is a managed-network-service provider.
"What schools find out this year is that they're going to need a lot more bandwidth," she said. "I believe we will see a huge surge in demand in next year's cycle because schools will better understand the limit of their existing infrastructure."
Ms. Kellogg's company, which serves 550 school districts, recently joined two other organizations—the nonprofit Consortium for School Networking, a Washington-based professional association, and the eLearn Institute, a Wyomissing, Pa.-based nonprofit—in releasing a series of resources to help schools prepare to administer online common-core exams.
In the meantime, it's possible that the FCC could use its authority to redirect some funding for pressing school district needs in 2014, rather than waiting until next year, said her colleague Bob Collie, a senior vice president at the company. The agency could redirect money that was approved to go to various school systems but has not been spent, he said.
Regardless of when funding arrives, schools' needs are broad, Ms. Kellogg said. And while it is an oversimplification to say that districts' technology needs are being driven by online testing, the relationship between digital needs for testing and for classroom instruction is becoming clearer, she said.
"If you're going to be testing digitally, you have to be instructing digitally," she said. "And you have to have the infrastructure in place all year long."
Coverage of entrepreneurship and innovation in education and school design is supported in part by a grant from the Carnegie Corporation of New York. Education Week retains sole editorial control over the content of this coverage.
A version of this article appeared in the February 26, 2014 edition of Education Week as New E-Rate Funding to Address K-12 Technology Needs


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When Subscription Isn't an Option
Thank goodness someone explained to everyone why tweeting how much you'd pay for HBO Go is a useless exercise:
Think about it: Every time someone signs up for cable or satellite service, one of the inevitable perks is a free six- or 12-month subscription to HBO. And those free subscriptions are rarely, if ever, cancelled once the trial period ends.
What would happen if HBO no longer had the pay TV industry's marketing team propping it up all the time? The results would be disastrous, and there's no way that HBO could make up in online volume the number of subscribers it would lose from cable. Which is why, even though some users would actually pay more for access to HBO GO without all the other cable channels, you won't see it show up as a standalone service anytime soon.
What's more, I find the whole attitude that HBO must be stupid to not offer this to be the most obnoxious part. Are we really to believe that no one inside HBO has considered this? There are a lot of complexities to any market and the reason a company isn't doing something that seems obvious is hardly ever because they haven't thought of it. Or, if you don't believe me, listen to what Dan Frommer has to say.
And actually, whenever I read anything about this topic I think back to this piece from 2007 by Joe Nocera about a la carte cable.


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Despite the prevalence of arachnophobia, and my own squeamishness about insects in general, I have absolutely no qualms with serving spiders for dessert. Yes, you heard me right, spiders!
…Of the purely chocolate-variety, perched on top of a chocolate web embedded in a vegan cheesecake, that is.
Striking that delicate balance between creepy and cute, this Halloween delight is sure to impress even your most finicky and easily frightened guests. Plus, it couldn't be easier to make; If you can assemble a cheesecake, this version takes only a little bit of extra effort.
Starting with my Mini Ice Box Cheesecake (sans fruit topping, of course) from My Sweet Vegan, I merely scooped some chocolate ganache into a piping bag with a tiny round tip, and piped it in a spiral over the top. Then, a toothpick is used to drag out the points of the web, starting at the center, and radiating out in equal spacing to the outer edges. For really clean lines, make sure you wipe off the tooth pick between each stroke!
While the cake is setting up in the freezer, take some plain melted chocolate, and pipe it out with that same tiny tip onto a silpat, drawing out simple spider shapes. As you can see, I'm no artist here, but all you need is to start with a medium blob, and then draw out eight lines along the sides for legs. Make many more than you think you'll need, as the legs can be a bit delicate and prone to breakage.
Let the chocolate rest until set, and then place them on the frozen cheesecake as desired. Hide any mistakes or imperfections with a plethora of little creepy crawlies, and make sure that each slice gets at least one spider when served.
Still don't have a copy of my book? Well, you're in luck, because you have another chance to win it over at Dinner at Christina's. Hurry, the drawing ends soon!


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RN, Registered Nurse - Respiratory Med/Surg (5N) -> Now offering a $10K sign-on bonus!
Company: CHRISTUS Health
Location: Corpus Christi
Posted on: September 20, 2023
Job Description:
Now offering a $10,000 sign-on bonus for RNs who qualify.
Provides professional nursing care for the comfort and well-being of patients. Prepares equipment and assists physician during examinations and treatments. Administers prescribed medications, changes dressings, cleans wounds, and monitors patient vital signs. Observes and maintains records on patient care, condition, reaction, and progress.
The Med/Surg Respiratory unit is a 36-bed unit that provides exceptional care for patients with chest tubes, tracheostomies, laryngectomies, post-op care for various conditions, infections, COPD, pneumonia and other respiratory disorders. We also care for general medical surgical patients. The mix of patients on this floor make it a great starting point for nurses in our Residency Program and for nurses who wish to become Certified in Medical Surgical Nursing and work at the top of their license with this population of rewarding and challenging patients. Our team has transitioned into our state of the art hospital where we have a brand new unit. Currently under development is our 5 North Tower (5NT) Unit Based Council. We value the voice of our team and encourage participation in Shared Governance. The patient to nurse ratio on this unit is 5:1 and on occasion 6:1. We look forward to welcoming you to the 5NT team, where you can practice your passion, establish excellent foundational skills together with the opportunity to specialize in Medical Surgical Nursing.
If you are looking to join a rapidly growing faith-based organization that encourages professional development, we want you to become a part of the CHRISTUS Spohn family!
Graduate of an accredited school of nursing. Able to assess, plan, implement and evaluate nursing care.
One-year experience in nursing preferred.
Current Texas State RN License
CPR (American Heart Association)
Work Type:
Full Time
Keywords: CHRISTUS Health, Corpus Christi , RN, Registered Nurse - Respiratory Med/Surg (5N) -> Now offering a $10K sign-on bonus!, Healthcare , Corpus Christi, Texas
here to apply!


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Software is going Reactive! Event-Driven, Scalable, Resilient, and Responsive are the new requirements weaving their way through HTML5, Mobile, NoSQL, and Big Data applications. With so much changing in how developers build software, developers need to get up to speed quickly and easily. This is why we created Typesafe Activator, and today we're excited to release version 1.0!
Activator gets Java and Scala developers started with the Typesafe Reactive Platform, Play Framework, and Akka. Watch a short demo of Activator:
Currently there are 29 templates in Activator! Many of these were contributed by the community. There is now a Reactive Mongo + Knockout template that does Reactive push of real-time updates in MongoDB. Also a new Play Framework + HBase template shows how to build a web app on top of Hadoop. The Reactive Stocks template is a good way to dive into Akka's actors and how they can be used with WebSockets in Play. There are also numerous standalone Akka templates like Akka Clustered PubSub with Scala.
We are really excited to see the applications that developers will create on the Typesafe Reactive Platform, so download Activator and take it for a spin! Check out the Activator docs to learn more.


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SolarUK: Glossary
A water storage vessel, which has the capability to increase the temperature of the water contained within it.
This is another name for a hot water cylinder/tank. A calorifier is different from a heat store; as the water within a calorifier is the same water which will come out of taps and showers. A heat store works in a similar way except the water in it merely stores the suns energy captured by the collector.
More information can be found here: Cylinders, Calorifiers & Heat Exchangers
Other Associated glossary terms : Commercial
Solar Thermal
The collection of the sun's energy as heat rather than converting it to electricity.
Vacuum Tube Solar Collector
This is a technology that uses a glass tube, think of a long thermos flask to insulate the solar collector and ensure that effectively all solar energy is retained.
Feed in Tariff
A method to reward the producer of renewable energy (electricity) by paying a fixed amount of money for each unit of electricity generated.
Recirculation - pumped secondary
Pipework carrying secondary hot water.
Sequential heating arrangement
The heating that occurs as the solar thermal system heats the water before the conventional heat source provides any necessary additional heating.
Heat store
Stores the suns energy as heat captured by the collector.
Refers to any period when the heat transfer fluid is not circulating, even though the solar panel is receiving the suns energy.
Primary and secondary systems
This refers to the water travelling round the boiler and the water in the cylinder which is heated by it.
Stratification / de-stratification
The layering of hot water on colder water.
Expansion vessel
A trapped volume of pressurised air or gas inside a steel vessel to allow for the expansion that accompanies temperature increases.
Buffer vessel
A tank storing heated water in anticipation of variable demand requirements.
Pre-feed cylinder
A cylinder placed between the cold water feed and the existing hot water cylinder.
Any pipe with several outlets to or from other pipes, or a junction of pipes.
A water storage vessel, which has the capability to increase the temperature of the water contained within it.
The controller compares the different temperatures at specific locations in the solar systems circuit.
Circulation module / Pump module
Operates the heat transfer system.


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The 2012 election should be about what's going on in America's boardrooms, but Republicans would rather it be about America's bedrooms.
Mitt Romney says he's against same-sex marriage; President Obama just announced his support. North Carolina voters have approved a Republican-proposed amendment to the state constitution banning same-sex marriage. Minnesota voters will be considering a similar amendment in November. Republicans in Maryland and Washington State are seeking to overturn legislative approval of same-sex marriage there.
Meanwhile, Republicans have introduced over four hundred bills in state legislatures aimed at limiting womens' reproductive rights – banning abortions, requiring women seeking abortions to have invasive ultra-sound tests beforehand, and limiting the use of contraceptives.
The Republican bedroom crowd doesn't want to talk about the nation's boardrooms because that's where most of their campaign money comes from. And their candidate for president has made a fortune playing board rooms like checkers.
Yet America's real problems have nothing to do with what we do in our bedrooms and everything to do with what top executives do in their boardrooms and executive suites.
We're not in trouble because gays want to marry or women want to have some control over when they have babies. We're in trouble because CEOs are collecting exorbitant pay while slicing the pay of average workers, because the titans of Wall Street demand short-term results over long-term jobs, and because of a boardroom culture that tolerates financial conflicts of interest, insider trading, and the outright bribery of public officials through unlimited campaign "donations."
Our crisis has nothing to do with private morality. It's a crisis of public morality – of abuses of public trust that undermine the integrity of our economy and democracy and have led millions of Americans to conclude the game is rigged.
What's truly immoral is not what adults choose to do with other consenting adults. It's what those with great power have chosen to do to the rest of us.
It is immoral that top executives are richly rewarded no matter how badly they screw up while most Americans are screwed no matter how hard they work.
Regressive Republicans have no problem intruding on the most personal and most intimate decisions any of us makes while railing against government intrusions on big business.
They don't hesitate to hurl the epithets "shameful," "disgraceful," and "contemptible" at private moral decisions they disagree with, while staying stone silent in the face of the most contemptible violations of public trust at the highest reaches of the economy.
We must protect and advance private rights of individuals over intimate bedroom decisions. We must also stop the abuses of economic power and privilege that are characterizing so many decisions in the nation's boardrooms and executive suites.
We need to update you on where Truthout stands.
To be brutally honest, Truthout is behind on our fundraising goals for the year. There are a lot of reasons why. We're dealing with broad trends in our industry, trends that have led publications like Vice, BuzzFeed, and National Geographic to make painful cuts. Everyone is feeling the squeeze of inflation. And despite its lasting importance, news readership is declining.
To ensure we stay out of the red by the end of the year, we have a long way to go. Our future is threatened.
We've stayed online over two decades thanks to the support of our readers. Because you believe in the power of our work, share our transformative stories, and give to keep us going strong, we know we can make it through this tough moment.
If you value what we do and what we stand for, please consider making a tax-deductible donation to support our work.


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No, we are not running out of IP addresses.
ARIN, the governing body that assigns IP addresses, has nearly depleted its range of IPs to assign using current IP technology (IPv4). However, we still have many IPv4 ranges assigned to us that are unused.
We are also working to implement support for the newest IP technology, IPv6.