text:
This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http://cancer.gov or call 1-800-4-CANCER.
Separate PDQ summaries on Endometrial Cancer Prevention; Endometrial Cancer Treatment; and Uterine Sarcoma Treatment are also available.
Transvaginal Ultrasound
There is no evidence that screening by ultrasonography (e.g., endovaginal ultrasound or transvaginal ultrasound) reduces mortality from endometrial cancer. Most cases of endometrial cancer (85%) are diagnosed at low stage because of symptoms, and survival rates are high.
Based on solid evidence, screening asymptomatic women will result in unnecessary additional biopsies because of false-positive test results. Risks associated with false-positive tests include anxiety and complications from biopsies.
Endometrial Sampling (Biopsy)
There is inadequate evidence that screening by endometrial sampling (i.e., biopsy) reduces mortality from endometrial cancer. Most cases of endometrial cancer (85%) are diagnosed at low stage because of symptoms, and survival rates are high.
Based on solid evidence, endometrial biopsy may result in discomfort, bleeding, infection, and rarely, uterine perforation.
Epidemiology of Endometrial Cancer
Incidence and mortality
Endometrial cancer is the most common invasive gynecologic cancer in U.S. women, with an estimated 46,470 new cases expected to occur in 2011 and an estimated 8,120 women expected to die of the disease.[1] Endometrial cancer is primarily a disease of postmenopausal women with a mean age at diagnosis of 60 years.[2] Age-adjusted endometrial cancer incidence in the United States has declined since 1975, with a transient increase in incidence occurring from 1973 to 1978, which was associated with estrogen therapy, also known as hormone therapy;[3] there was no associated increase in mortality. Since 1992, endometrial cancer incidence rates have been stable in white women but have been increasing by 1.7% per year in African American women.[1] The endometrial cancer mortality rate has been stable in white women, but has been increasing in African American women by 0.8% per year since 1998.[1] Most cases of endometrial cancer are diagnosed because of symptoms, which are nonetheless "early" stage and have high survival rates.
Risk Factors
Estrogen therapy unopposed by progesterone therapy is a cause of endometrial cancer in women with an intact uterus. However, women taking combination estrogen-progesterone therapy (hormone therapy) exhibit similar risk to women who do not take postmenopausal hormone therapy.[4,5,6,7,8] Tamoxifen therapy is also a cause of endometrial cancer. Results from the National Surgical Adjuvant Breast and Bowel Project P-1 trial, report a doubling of the risk of endometrial cancer associated with an annual rate of 2.30 per 1,000 for women taking tamoxifen compared with 0.91 per 1,000 for women receiving placebo; the increased risk was seen primarily in postmenopausal women.[9]
In addition to the increased risk of developing endometrial cancer that is observed in women who use unopposed estrogen therapy or tamoxifen, a number of additional risk factors have been identified, and most appear to be related to estrogenic effects. Among these factors are obesity, a high-fat diet, and reproductive factors such as nulliparity, polycystic ovarian syndrome, early menarche, and late menopause. Hereditary nonpolyposis colorectal cancer (HNPCC) syndrome is associated with a markedly increased risk of endometrial cancer compared with women in the general population. Among women who are HNPCC carriers, the estimated cumulative incidence of endometrial cancer ranges from 20% to 60% by age 70 years (refer to the PDQ summary on Genetics of Colorectal Cancer for more information).[10,11,12] This risk appears to differ slightly based on the germline mutation; for MLH1 carriers the lifetime risk at age 70 years is 25% while MSH2 mutation carriers have a 35% to 40% lifetime risk of endometrial cancer by age 70 years. The mean age of diagnosis for MLH1 or MSH2 carriers is 47 years compared with 60 years for noninherited forms of endometrial cancer.[13] The prognosis and survival are similar between HNPCC-related and noninherited forms of endometrial cancer.[14]
Major differences exist between black and white women in stages of endometrial cancer at detection and at subsequent survival. Although the incidence of endometrial cancer is lower among black women, mortality is higher. The National Cancer Institute initiated a Black/White Cancer Survival Study [15] and concluded that higher-grade and more aggressive histologies appear to be related to excess risk of advanced-stage disease in black women. It is difficult to disentangle the effects that biology and socioeconomic status may have on the lower survival rates of African American women with endometrial cancer. Evidence suggests that lower income is associated with advanced-stage disease, lower probability of undergoing a hysterectomy, and lower survival rates.[16] Others, however, assert that there is no black/white difference in the interval from patient-reported symptoms to initial medical consultation, making it unlikely that patient delay after onset of symptoms could explain much of the excess of advanced-stage disease found in black women.[17] Further research is necessary to understand why black women tend to be diagnosed with more aggressive disease and have a higher probability of dying than white women, despite their lower incidence of endometrial cancer.
|American Cancer Society.: Cancer Facts and Figures 2011. Atlanta, Ga: American Cancer Society, 2011. Also available online. Last accessed July 27, 2011.
|American Cancer Society.: Detailed Guide: Endometrial Cancer: What are the Risk Factors for Endometrial Cancer? Atlanta, Ga: American Cancer Society, 2005. Available online. Last accessed July 15, 2011.
|Jick H, Walker AM, Rothman KJ: The epidemic of endometrial cancer: a commentary. Am J Public Health 70 (3): 264-7, 1980.
|Pike MC, Peters RK, Cozen W, et al.: Estrogen-progestin replacement therapy and endometrial cancer. J Natl Cancer Inst 89 (15): 1110-6, 1997.
|Persson I, Weiderpass E, Bergkvist L, et al.: Risks of breast and endometrial cancer after estrogen and estrogen-progestin replacement. Cancer Causes Control 10 (4): 253-60, 1999.
|Heiss G, Wallace R, Anderson GL, et al.: Health risks and benefits 3 years after stopping randomized treatment with estrogen and progestin. JAMA 299 (9): 1036-45, 2008.
|Doherty JA, Cushing-Haugen KL, Saltzman BS, et al.: Long-term use of postmenopausal estrogen and progestin hormone therapies and the risk of endometrial cancer. Am J Obstet Gynecol 197 (2): 139.e1-7, 2007.
|Barakat RR, Bundy BN, Spirtos NM, et al.: Randomized double-blind trial of estrogen replacement therapy versus placebo in stage I or II endometrial cancer: a Gynecologic Oncology Group Study. J Clin Oncol 24 (4): 587-92, 2006.
|Cuzick J, Forbes JF, Sestak I, et al.: Long-term results of tamoxifen prophylaxis for breast cancer--96-month follow-up of the randomized IBIS-I trial. J Natl Cancer Inst 99 (4): 272-82, 2007.
|Watson P, Vasen HF, Mecklin JP, et al.: The risk of endometrial cancer in hereditary nonpolyposis colorectal cancer. Am J Med 96 (6): 516-20, 1994.
|Aarnio M, Mecklin JP, Aaltonen LA, et al.: Life-time risk of different cancers in hereditary non-polyposis colorectal cancer (HNPCC) syndrome. Int J Cancer 64 (6): 430-3, 1995.
|Aarnio M, Sankila R, Pukkala E, et al.: Cancer risk in mutation carriers of DNA-mismatch-repair genes. Int J Cancer 81 (2): 214-8, 1999.
|Berends MJ, Wu Y, Sijmons RH, et al.: Toward new strategies to select young endometrial cancer patients for mismatch repair gene mutation analysis. J Clin Oncol 21 (23): 4364-70, 2003.
|Boks DE, Trujillo AP, Voogd AC, et al.: Survival analysis of endometrial carcinoma associated with hereditary nonpolyposis colorectal cancer. Int J Cancer 102 (2): 198-200, 2002.
|Barrett RJ 2nd, Harlan LC, Wesley MN, et al.: Endometrial cancer: stage at diagnosis and associated factors in black and white patients. Am J Obstet Gynecol 173 (2): 414-22; discussion 422-3, 1995.
|Madison T, Schottenfeld D, James SA, et al.: Endometrial cancer: socioeconomic status and racial/ethnic differences in stage at diagnosis, treatment, and survival. Am J Public Health 94 (12): 2104-11, 2004.
|Coates RJ, Click LA, Harlan LC, et al.: Differences between black and white patients with cancer of the uterine corpus in interval from symptom recognition to initial medical consultation (United States). Cancer Causes Control 7 (3): 328-36, 1996.
Measuring endometrial thickness (ET) with transvaginal ultrasound (TVU) and endometrial sampling with cytological examination have been proposed as possible screening modalities for endometrial cancer. The Papanicolaou (Pap) test, used successfully for screening for cervical cancer, is too insensitive to be used as a screening technique for the detection of endometrial cancer,[1] although occasionally the Pap test may fortuitously identify endometrial abnormalities, such as endometrial cancer.
Routine screening of asymptomatic women for endometrial cancer has not been evaluated for its impact on endometrial cancer mortality.[2,3] Although high-risk groups can be identified, the benefit of screening in reducing endometrial cancer mortality in these high-risk groups has not been evaluated. Using the same cutoffs to define an abnormal ET in asymptomatic women [4] as used in symptomatic women [5] would result in large numbers of false-positive test results and larger numbers of unnecessary referrals for cytological evaluations. Published recommendations for screening certain groups of women at high risk for endometrial carcinoma are based on opinion regarding presumptive benefit.[6]
Modalities of Endometrial Cancer Screening
Ultrasonography in women with vaginal bleeding
TVU is used as a diagnostic tool to evaluate symptomatic women with vaginal bleeding. Among women with postmenopausal uterine bleeding and cancer, 96% will have an abnormal ET (>6 mm). The specificity varies by whether women used hormone therapy. Among nonusers, the specificity was 92%.[5] Much less work has been done to evaluate the accuracy of TVU among asymptomatic women. If the same endometrial thickness cutoff is used among asymptomatic women, the false positives will be extremely high, resulting in a very low positive predictive value.[4] No studies have evaluated the efficacy of screening with TVU in reducing mortality from endometrial cancer.
A group of researchers used dilation and curettage (D&C) as a gold standard, to evaluate TVU measurement of ET as a predictor of endometrial cancer in women reporting postmenopausal bleeding (estrogen-progestin therapy [hormone therapy] and nonhormone therapy users). Of the 339 participants, 39 (11.5%) were diagnosed with endometrial cancer (four had an ET of 5–7 mm and 35 had an ET > 8 mm) based on histopathology from curettage. No cancers were detected in women with an ET of less than 4 mm. Using a cutoff point of 4 mm, TVU has 100% sensitivity and 60% specificity.[7] In this population, 46% (156) of the women had an ET greater than 4 mm.
Ultrasonography in women without vaginal bleeding
A comparison of TVU and endometrial aspiration was conducted among asymptomatic postmenopausal women potentially eligible for an osteoporosis prevention trial [8] as part of determination of eligibility for randomization. TVU was performed on 1,926 women. Of these, 93 women had ET greater than 6 mm. Among the 93 women with abnormal ET, 42 had endometrial aspiration with one finding of abnormal pathology (defined as adenocarcinoma or atypical hyperplasia). Of the 1,833 women with ET measuring 6 mm or less, 1,750 women had endometrial aspiration and five of these women had an abnormal pathologic biopsy. Among this population of asymptomatic postmenopausal women, the estimated sensitivity for TVU with a threshold value of 6 mm was 17% and 33% for a threshold value of 5 mm.
One study assessed the usefulness of TVU among a cohort of postmenopausal, asymptomatic women receiving hormone therapy. Utilizing the Postmenopausal Estrogen and Progestin Interventions Trial participants who had undergone both TVU and endometrial biopsy, sensitivity, specificity, positive predictive value, and negative predictive value were determined for women who received placebo, estrogen alone, and estrogen-progestin therapy. At a threshold value of 5 mm for ET, TVU had 90% sensitivity and 48% specificity. Using this threshold, more than half the women would receive a biopsy while only 4% of them had serious disease.[9]
Another study obtained endometrial biopsy specimens from 801 asymptomatic perimenopausal and postmenopausal women prior to enrollment in a hormone therapy study. Of the specimens, 75% of the samples contained sufficient tissue for diagnosis. Among these women, one case of endometrial cancer was diagnosed, illustrating the low yield of screening among asymptomatic women and the difficulty with endometrial cavity access.[10]
Although TVU can be used to evaluate asymptomatic and occult endometrial pathology, the technique has not been evaluated as a screening method for reducing mortality in asymptomatic women.
Ultrasonography in women using tamoxifen
Tamoxifen is widely used as part of adjuvant therapy for breast cancer and as chemoprevention for women at increased risk of breast cancer. In addition to the protective effects for breast cancer, the biological and endocrine effects of tamoxifen increase patients' risk of developing endometrial pathology, including endometrial polyps, endometrial hyperplasia, and endometrial carcinoma.
There is interest in trying to reduce the morbidity from endometrial cancer through early detection, and there has been interest in using endovaginal ultrasound as a method to screen women to detect endometrial cancer.
In a prospective, observational study of 304 women using tamoxifen over 6 years, women underwent annual endovaginal ultrasound screening; women with abnormal ultrasound findings and women who were symptomatic with bleeding all underwent endometrial biopsy. Thirty-two percent of the ultrasound examinations had associated significant uterine abnormalities identified that required further medical or surgical investigation and treatment. However, most abnormalities (80%) represented benign polyps for which no treatment was needed. Six cases of primary endometrial cancer were detected, and all cases presented with irregular bleeding. The sensitivity of ultrasound was only 63.3%, with a specificity of 60.4%, and had a low positive predictive value for cancer of only 1%.[11]
Other reports have noted similar results. Routine ultrasound surveillance in asymptomatic women using tamoxifen is not useful because of its low specificity and low positive predictive value. Evaluation of the endometrium in women taking tamoxifen should be limited to women symptomatic with vaginal bleeding.
Sonohysterography (hydrosonography) is a diagnostic test among asymptomatic women, and is able to separate space occupying endometrial lesions from an abnormal endometrial-myometrial junction in order to help guide biopsies. There is no evidence that routine screening sonohysterography will confer clinical benefit.
Endometrial sampling in women with uterine bleeding
In the setting of abnormal uterine bleeding, endometrial sampling has gained favor largely as an alternative to more invasive procedures such as fractional D&C. Several methods of biopsy exist (e.g., Pipelle, Tao Brush, and Uterine Explora Curette) to identify endometrial pathology. Although endometrial sampling has largely replaced D&C as the first choice in the evaluation of women with bleeding, issues of access to the endometrial cavity and sampling error limit the clinical significance of a negative result. In the Arimidex, Tamoxifen, Alone or in Combination trial, 36% of biopsies had insufficient tissue for diagnosis.[12]
No studies have evaluated the use of endometrial sampling as routine screening in reducing endometrial cancer mortality.
Hysteroscopy is used in the office setting to directly visualize the uterine cavity. A group of researchers noted that hysteroscopy is not as useful in detecting endometrial cancer as biopsy or D&C.[13] It has not been evaluated as a screening tool.[14]
|Burk JR, Lehman HF, Wolf FS: Inadequacy of papanicolaou smears in the detection of endometrial cancer. N Engl J Med 291 (4): 191-2, 1974.
|Pritchard KI: Screening for endometrial cancer: is it effective? Ann Intern Med 110 (3): 177-9, 1989.
|Eddy D: ACS report on the cancer-related health checkup. CA Cancer J Clin 30 (4): 193-240, 1980 Jul-Aug.
|Smith-Bindman R, Weiss E, Feldstein V: How thick is too thick? When endometrial thickness should prompt biopsy in postmenopausal women without vaginal bleeding. Ultrasound Obstet Gynecol 24 (5): 558-65, 2004.
|Smith-Bindman R, Kerlikowske K, Feldstein VA, et al.: Endovaginal ultrasound to exclude endometrial cancer and other endometrial abnormalities. JAMA 280 (17): 1510-7, 1998.
|Burke W, Petersen G, Lynch P, et al.: Recommendations for follow-up care of individuals with an inherited predisposition to cancer. I. Hereditary nonpolyposis colon cancer. Cancer Genetics Studies Consortium. JAMA 277 (11): 915-9, 1997.
|Gull B, Karlsson B, Milsom I, et al.: Can ultrasound replace dilation and curettage? A longitudinal evaluation of postmenopausal bleeding and transvaginal sonographic measurement of the endometrium as predictors of endometrial cancer. Am J Obstet Gynecol 188 (2): 401-8, 2003.
|Fleischer AC, Wheeler JE, Lindsay I, et al.: An assessment of the value of ultrasonographic screening for endometrial disease in postmenopausal women without symptoms. Am J Obstet Gynecol 184 (2): 70-5, 2001.
|Langer RD, Pierce JJ, O'Hanlan KA, et al.: Transvaginal ultrasonography compared with endometrial biopsy for the detection of endometrial disease. Postmenopausal Estrogen/Progestin Interventions Trial. N Engl J Med 337 (25): 1792-8, 1997.
|Archer DF, McIntyre-Seltman K, Wilborn WW Jr, et al.: Endometrial morphology in asymptomatic postmenopausal women. Am J Obstet Gynecol 165 (2): 317-20; discussion 320-2, 1991.
|Fung MF, Reid A, Faught W, et al.: Prospective longitudinal study of ultrasound screening for endometrial abnormalities in women with breast cancer receiving tamoxifen. Gynecol Oncol 91 (1): 154-9, 2003.
|Duffy S, Jackson TL, Lansdown M, et al.: The ATAC adjuvant breast cancer trial in postmenopausal women: baseline endometrial subprotocol data. BJOG 110 (12): 1099-106, 2003.
|Bradley WH, Boente MP, Brooker D, et al.: Hysteroscopy and cytology in endometrial cancer. Obstet Gynecol 104 (5 Pt 1): 1030-3, 2004.
|Gumus II, Keskin EA, Kiliç E, et al.: Diagnostic value of hysteroscopy and hysterosonography in endometrial abnormalities in asymptomatic postmenopausal women. Arch Gynecol Obstet 278 (3): 241-4, 2008.
Hormone Therapy
There is no evidence to suggest that screening women prior to or during estrogen-progestin therapy, also known as hormone therapy, would decrease endometrial cancer mortality.[1,2] Thus women on hormone therapy should have a prompt diagnostic work-up for abnormal bleeding. Although women using certain hormone regimens have an increased risk of endometrial cancer, most women who develop cancer will have vaginal bleeding. There is no evidence that screening these women would decrease mortality from endometrial cancer.
Hereditary Nonpolyposis Colorectal Cancer
The lifetime risk of endometrial cancer for women with hereditary nonpolyposis colorectal cancer (HNPCC) and for women who are at high risk for HNPCC is as high as 60%. These cases are often diagnosed in the fifth decade, 10 to 20 years earlier than sporadic cases. [3,4,5,6,7] Based on limited evidence, it appears that 5-year survival among HNPCC women diagnosed with endometrial cancer is similar to that of nonhereditary cases in the general population.[8] Because the risk of endometrial cancer is so high among these women, international guidelines suggest gynecologic surveillance including annual transvaginal ultrasound with endometrial biopsy for women aged 25 to 35 years.[9,10] The most recent American Cancer Society Cancer Detection Guidelines (updated January 2005) recommend annual screening with endometrial biopsy beginning at age 35 years.[11]
Tamoxifen-Treated Women
The risk of endometrial cancer is increased in women who are treated with tamoxifen and is even greater in the subset of women who have a history of prior estrogen therapy.[12] Beyond a routine gynecologic examination eliciting any history of abnormal bleeding, it has been recommended that screening studies and procedures for detecting endometrial pathology in women taking tamoxifen should be left to the discretion of the individual gynecologist.[13] Commonly, there are endometrial abnormalities in women taking tamoxifen, especially in false-positive endovaginal ultrasound screening tests. More importantly, any abnormal uterine bleeding should be completely evaluated.
Endometrial cancers that occur in tamoxifen-treated women are very similar to those cancers occurring in the general population, with respect to stage, grade, and histology.[14,15,16] Prognosis is good and not affected by early detection.[17]
To date, there have been no published studies evaluating the effect of endometrial cancer-screening modalities on mortality among women taking tamoxifen for breast cancer treatment or prevention.
|ACOG committee opinion. Routine cancer screening. Number 185, September 1997 (replaces no. 128, October 1993). Committee on Gynecologic Practice. American College of Obstetricians and Gynecologists. Int J Gynaecol Obstet 59 (2): 157-61, 1997.
|Korhonen MO, Symons JP, Hyde BM, et al.: Histologic classification and pathologic findings for endometrial biopsy specimens obtained from 2964 perimenopausal and postmenopausal women undergoing screening for continuous hormones as replacement therapy (CHART 2 Study). Am J Obstet Gynecol 176 (2): 377-80, 1997.
|Watson P, Vasen HF, Mecklin JP, et al.: The risk of endometrial cancer in hereditary nonpolyposis colorectal cancer. Am J Med 96 (6): 516-20, 1994.
|Aarnio M, Sankila R, Pukkala E, et al.: Cancer risk in mutation carriers of DNA-mismatch-repair genes. Int J Cancer 81 (2): 214-8, 1999.
|Vasen HF, Wijnen JT, Menko FH, et al.: Cancer risk in families with hereditary nonpolyposis colorectal cancer diagnosed by mutation analysis. Gastroenterology 110 (4): 1020-7, 1996.
|Dunlop MG, Farrington SM, Carothers AD, et al.: Cancer risk associated with germline DNA mismatch repair gene mutations. Hum Mol Genet 6 (1): 105-10, 1997.
|Lancaster JM, Powell CB, Kauff ND, et al.: Society of Gynecologic Oncologists Education Committee statement on risk assessment for inherited gynecologic cancer predispositions. Gynecol Oncol 107 (2): 159-62, 2007.
|Boks DE, Trujillo AP, Voogd AC, et al.: Survival analysis of endometrial carcinoma associated with hereditary nonpolyposis colorectal cancer. Int J Cancer 102 (2): 198-200, 2002.
|Burke W, Petersen G, Lynch P, et al.: Recommendations for follow-up care of individuals with an inherited predisposition to cancer. I. Hereditary nonpolyposis colon cancer. Cancer Genetics Studies Consortium. JAMA 277 (11): 915-9, 1997.
|Vasen HF, Mecklin JP, Khan PM, et al.: The International Collaborative Group on Hereditary Non-Polyposis Colorectal Cancer (ICG-HNPCC). Dis Colon Rectum 34 (5): 424-5, 1991.
|Smith RA, Cokkinides V, Eyre HJ: American Cancer Society Guidelines for the Early Detection of Cancer, 2005. CA Cancer J Clin 55 (1): 31-44; quiz 55-6, 2005 Jan-Feb.
|Barakat RR: Tamoxifen and endometrial neoplasia. Clin Obstet Gynecol 39 (3): 629-40, 1996.
|ACOG committee opinion. Tamoxifen and endometrial cancer. Number 169, February 1996. Committee on Gynecologic Practice. American College of Obstetricians and Gynecologists. Int J Gynaecol Obstet 53 (2): 197-9, 1996.
|Fisher B, Costantino JP, Wickerham DL, et al.: Tamoxifen for prevention of breast cancer: report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study. J Natl Cancer Inst 90 (18): 1371-88, 1998.
|Barakat RR, Wong G, Curtin JP, et al.: Tamoxifen use in breast cancer patients who subsequently develop corpus cancer is not associated with a higher incidence of adverse histologic features. Gynecol Oncol 55 (2): 164-8, 1994.
|Fornander T, Hellström AC, Moberger B: Descriptive clinicopathologic study of 17 patients with endometrial cancer during or after adjuvant tamoxifen in early breast cancer. J Natl Cancer Inst 85 (22): 1850-5, 1993.
|Barakat RR, Gilewski TA, Almadrones L, et al.: Effect of adjuvant tamoxifen on the endometrium in women with breast cancer: a prospective study using office endometrial biopsy. J Clin Oncol 18 (20): 3459-63, 2000.
Abnormal ultrasound typically requires further investigation including endometrial biopsy (sampling). The evidence is solid that endometrial sampling may result in discomfort, bleeding, infection, and rarely uterine perforation. A study designed to evaluate performance, patient acceptance, and cost-effectiveness of blind biopsy, hysteroscopy with biopsy, and ultrasound, in 683 women with vaginal bleeding, reported that minor events, including discomfort and distress, occurred in 16% of women who had hysteroscopy with biopsy, and in 10% of the women who had a blind biopsy.[1] A group of researchers studied 13,600 diagnostic and operative hysteroscopic procedures and found a lower complication rate among diagnostic procedures (0.13%) compared with operative procedures (0.28%).[2] Risks associated with false-positive test results include anxiety and additional diagnostic testing and surgery. Endometrial cancers may be missed on endometrial sampling and ultrasound.
|Critchley HO, Warner P, Lee AJ, et al.: Evaluation of abnormal uterine bleeding: comparison of three outpatient procedures within cohorts defined by age and menopausal status. Health Technol Assess 8 (34): iii-iv, 1-139, 2004.
|Jansen FW, Vredevoogd CB, van Ulzen K, et al.: Complications of hysteroscopy: a prospective, multicenter study. Obstet Gynecol 96 (2): 266-70, 2000.
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Added text to state that since 1992, endometrial cancer incidence rates have been stable in white women but have been increasing by 1.7% per year in African American women (cited American Cancer Society as reference 1).
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Azarenka ignoring favourite tag
Serena Williams is very much regarded as the woman to beat at the Australian Open but it is Victoria Azarenka who is bidding for a third successive title at Melbourne Park.
The last of Williams' five titles at the year's opening grand slam came four years ago, with ankle problems contributing to shock exits in both 2012 and 2013.
But the 32-year-old's quarter-final defeat by Sloane Stephens was one of only four she suffered in the whole of last season.
Williams began this year by beating Azarenka to win another title in Brisbane and heads into the Australian Open on a 22-match winning streak.
It is no wonder she is the clear favourite, and Azarenka has no complaints.
The Belarusian said: "I don't really care about it, honestly. I never cared about it. For us, it's a matter of playing tennis and giving your best on the court.
"Comparing to her last season, of course, everybody will be motivated to beat her."
Fifty per cent of Williams' defeats last year came against Azarenka and the rivalry is the closest the women's game has got to the competition at the top of the men's game.
But Azarenka has managed only three victories against Williams from 17 matches, while third seed Maria Sharapova has lost 14 straight times against the world number one dating back to 2004.
Despite her final defeat, Azarenka was happy with the way things went in Brisbane.
She said: "I think it was a great preparation, the whole week in Brisbane, to play actually so many different types of players.
"That's what you want to get at the beginning of the season and in preparation for an event like this. It was a great week for me."
Azarenka's final opponent last year was Li Na, who is the fourth seed this time around after the most consistent season of her career in 2013.
Li's main ambition is simply to stay on her feet after twice taking medical time-outs during the final 12 months ago, once for a twisted ankle and then when she fell and hit her head.
The Chinese star also made the quarter-finals at Wimbledon and the semi-finals at the US Open, and she had no doubt what her target is for 2014
"I really wish I can win another grand slam," said the 2011 French Open champion. "This is the goal for me. I will keep going for that."
Home hopes will once again fall on the shoulders of 2011 US Open winner Sam Stosur, who is seeded only 17th this year.
The 29-year-old has always struggled under the glare of home pressure and has never been past the fourth round in Melbourne.
Asked if there was still a great weight of expectation on her shoulders, Stosur said: "I guess there is because I'm the top female player from this country. We've got a huge grand slam tournament.
"But I don't think that's really bothered me this time around so far. At the end of the day it's always been a really positive thing. Anyone that has ever come up to me just wants me to do well.
"I want to try to play well and play my best tennis here in Australia and give them all something to cheer about."
Stosur is now coached by former British Davis Cup player Miles Maclagan, who has previously worked with Andy Murray and Laura Robson.
She said: "I'm really pleased with the way it's gone so far with Miles. I feel like we're on the same wavelength. I'm looking forward to hopefully spending a lot of time with him in the future."
Stosur opens her campaign on Monday on Rod Laver Arena against Czech Klara Zakopalova.
Bizarrely, it is the third time they have met in the opening round here, with Stosur winning both times, but Zakopalova was an easy winner when they met in Hobart on Friday.
The stand-out match sees Williams take on 17-year-old Australian wild card Ashleigh Barty in the night session on Laver while Li meets 16-year-old Ana Konjuh.
The Croatian, who won the junior title here last year, is considered one of the game's brightest talents and breezed through qualifying.
Ana Ivanovic, Venus Williams and Petra Kvitova are also in action.


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Babies and toddlers get overtired easily. When they do, they find it harder to get to sleep. Once you can spot the telltale signs of tiredness, you'll be able to settle your child to sleep before he gets overtired, grumpy and harder to settle.
You can read this article in a selection of languages other than English.
Children show they're tired through changes in behaviour. For example, your child might be suddenly irritable, overactive or demanding.
It's important to look for your child's 'tired signs'. These signs let you know when it's time to reduce stimulation and start settling your child for sleep. If you wait until your child is overtired, it'll be harder to settle her.
Newborn babies will probably get tired if they've been awake for 1-1½ hours.
If your newborn is tired, you might see some of the following tired signs:
At 3-6 months, your baby might be tired after 1½-3 hours awake.
At 6-12 months, your baby might be tired after 2-3 hours awake.
At 12-18 months, your baby might be overtired if he misses out on his morning or afternoon sleep.
If your baby or toddler is tired, you might see some of the following tired signs:
Grizzling and crying can mean your child is tired, but it can sometimes be hard to tell the difference between tired grizzling and hungry grizzling.
If your baby has had a feed within the last two hours and is grizzling and cranky, she's probably tired. If you're not sure, offer a feed. If she takes only a little milk and is still grizzly, she needs a sleep.
If your child is showing signs of tiredness, it's a good idea to get him ready for sleep by reducing stimulation. You can do this by:
Some quiet time before bed in the place where your child usually sleeps will help her settle to sleep.
Quiet time with your child might include a gentle cuddle, a story or a quiet song.
Your child might need only a few minutes of quiet time before he's relaxed and ready to be put in bed. If your household is noisy and active, your child might need some extra quiet time before it's time for sleep.
When it comes to sleep, every baby is different, as the parents in this video note. But it can really help to get to know your own baby's tired signs.
These mums and dads also talk about encouraging baby sleep. In particular, they share tips on:
You might need to experiment to find out what works for your baby.
Hiscock, H., Cook, F., Bayer, J., Le, H.N., Mensah, F., Cann, W., Symon, B., & St James-Roberts, I. (2014). Preventing early infant sleep and crying problems and postnatal depression: A randomized trial. Pediatrics, 133(2), 346-354. doi: 10.1542/peds.2013-1886.
Ngala (2004). Secrets of good sleepers: A guide to sleep for families of children 0-5 years. Perth, WA: Ngala Family Resource Centre.


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posted by Thom Holwerda on Mon 18th Aug 2008 22:29 UTC, submitted by rlem6983
Linux project lead Linus Torvalds has said it is not easy to become a major contributor to the Linux kernel. In an email interview with ZDNet.com.au sister site ZDNet.co.uk last week, Torvalds said that, while it was relatively easy for coders and organisations to contribute small patches, the contribution of large patches, developed in isolation, could lead to both new and established contributors becoming frustrated. "The kernel is about pretty harsh technical issues, and mistakes are really frowned upon," wrote Torvalds. "In an OS kernel, there are simply more security and stability requirements, and the bar is really higher in some respects. That will inevitably also reflect in the response to patches."


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thk u for e advice ladies.
a few qns =)
i am scared of rolling over her if I zzz with her.
and I've tried nursing her lying down...but she falls asleep so quickly and wakes up so much faster. Its a constant feed wake cycle.. it got me so tired.
I cant do anything when I feed her. If she unlatches, she cant find her way back to the nipple....so I'm basically just watching her when she feeds to check if she has unlatched. In a sling, I cant see if she has unlatched so I'm afraid to use one.
hmmm....how come I cant feel it when baby unlatches off the breast?


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Sharing information about Louis Armstrong New Orleans International Airport with our community is vitally important to MSY. This airport is a place of hope and possibilities and must be in touch with the community it serves. Two-way communication is a priority at Armstrong International Airport. Tearing down communication barriers between our passengers, our customers and the airport is vital. The airport utilizes a number of different tools for communicating. The most visible and probably the timeliest is our website, On the website is a wealth of information for not only checking on a flight but for business opportunities, airport construction updates, historical data and airport news. It is also one of the best ways for our passengers to communicate with us. We welcome both compliments and complaints. If we are not aware of issues at the airport, we cannot address them. We have recently initiated changes in the way the airport responds to comments. We now have a target time for a response and the individuals answering comments and inquiries are Airport Managers. Also, now there is direct access through two e-mail in-boxes on the website. To leave a statement, click on "contact us" and send us your message. We will respond to you within 72 hours because we want to resolve any issues for our passengers in a timely manner. We aspire to answer in 24 hours. Please utilize this vital tool. At the time of this writing, we are redesigning the website to update the look and improve its function in an attempt to make it even more user friendly than it is now. Watch for the debut coming soon, but the existing website is fully functional until that time.
Another vehicle for communication is our 30 minute television program, entitled "Airport Alive". This program, previously titled "Air Trends" showcases the latest news at Armstrong International Airport. The program is hosted by Orleans broadcast personality and Voice of the Saints, Jerry Romig. The quarterly program airs on most of the major Government Access stations in parishes surrounding the airport as well as on public and commercial television stations throughout southern Louisiana. Airport Alive may also be viewed on our website by clicking on "Airport Alive Now Available on Line". The television program concentrates on major issues impacting our public. From construction updates to the latest airline announcements, the program is designed to inform through an entertaining format so that the viewers know what is happening at their airport. To see the show, check your local listings for the time and day the program is airing in your area. You may also access the list on the airport website.
A third communication tool is this article. Each month, I report to you on aviation subjects that have an affect on our passengers. With this article, I am able to update you on what is new at Louis Armstrong New Orleans International Airport or what may be planned for the future. This article is published in local newspapers with a circulation of subscribers in the thousands. It is one way for me to speak directly to you. At the end of each article is my e-mail address in case you wish to correspond with me. I have an open door policy with our employees at the airport and I hope you will view this contact address as my open door to you.
It is a goal of the New Orleans Aviation Board and their staff to keep a line of communication open to the publics we serve. We are trying to not only modernize Armstrong International Airport with various capital improvement projects and increased air service, but we are also focusing on improving the way we keep you informed. Communication works for those who work at it. We are striving to do our best.
Iftikhar Ahmad may be reached by clicking here.
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08/22/2010 in Email Lists | Tags: eletter, email, newsletter | Leave a comment
In the same way you might want to send your friends and family a letter for the holidays giving them an update on your life during the past year, you should develop a list of fans (including your friends and family) to receive your book-related newsletter by email. Always ask them first!
Now, email may be going out of style what with the faster, more convenient connections made through Facebook and Twitter, but don't think for a second that those services can replace a message that is sent directly to their inboxes, rather than a public message that they will have to visit your Facebook Fan Page to read. According to Lyrislab.com, for every dollar you spend on e-mail campaigns, you make back an average of $44.25.
How often do you send one?
I suggest no more often than once a month. If you find you don't have much to say in one month and nothing is urgent, don't worry about waiting until next month. It isn't like a blog where they will stop visiting it if you don't post often–it goes right to their email. And you don't want to flood their inboxes with daily or weekly updates because it will move fans to unsubscribe.
What to include
- A Table of Contents at the top, especially if you have more than five things you want to say
- Give away something for free, especially if your letter is only every couple months. Drive them to your website to pick up their coupon code or free excerpt or enter a contest for a free book or getting a character named after them. Be creative!
- Tour dates, both live and digital dates, times, and locations.
- All of your book-related news and major site updates.
- Lots of links. Drive people to your website, your social media pages. Don't let them remain passive readers!
- Contact information
Instead of writing long paragraphs and full sentences, let the page breathe with paragraph breaks and bullet points. Get down to the gist of it. They can read your blog if they want to hear your writing voice. This is informational (not that you can't make it fun too, of course).
Remember to include a Subscribe to my e-letter button on your website
Remember to include an Unsubscribe link at the bottom of your emails.
If you don't know how to write or format your newsletter, why not subscribe to some people's newsletters and see what they're like. You can always unsubscribe later. One good example of well written and good frequency of e-letters are those of Jonathan Rundman. Try it out and see what you do and don't like about it.
Useful links:
Social Media Now More Popular Than Email
Your Email Newsletter (Music 3.0)
8 Best Email Practices (Music 3.0)
Why Social Supports Email in the Interactive Marketing Hub (Convince and Convert)


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The Village of Four Seasons Board of Trustees continues to make improvements to its recently expanded Village Hall.
The Village of Four Seasons Board of Trustees continues to make improvements to its recently expanded Village Hall.
Trustees Wednesday night voted to spend up to $1,300 to cover costs of building an office wall partition just outside of the trustees' meeting chambers. The open area is used by several people to conduct office business, but some semblance of privacy is needed. Cost for materials will be $577 with labor of $450. Painting is estimated at $200.
Trustees voted two years ago to expand the Village Hall, and have since tweaked the project as funds have become available. Window treatments are the next order of business for the meeting room.
Evers & Company, LLC, recently conducted a routine audit of the city's finances.
The only significant recommendation, which has been completed, involved how Municipal Court fines are recorded. Evers suggested that when fines don't meet the standards of the fine schedule that the amount to be documented in the files verify the amount the judge set.
The audit also noted that because the city's small size, adequate administrative and accounting staff is not available to conduct certain financial reporting. The city uses independent auditors to draft the financial statements.
This situation is typical of small communities such as the Village, Lake Ozark and Osage Beach.
Other business
•The board learned that building permits and permit revenue are up about 10 percent from a year ago.
•The board learned that repair of several Waters Edge Condominium units damaged by fire last year is in limbo until project managers and the Waters Edge Condo Association work out several issue.
•There will be a meeting with lake-area contractors at 9 a.m. Tuesday, June 19, at the Village Hall to review changes in building codes since 2009. Ameren Missouri officials are expected to discuss dock regulations, and the Four Seasons Property Owners Association (POA) is expected to discuss several issues as well.
•Ranita Jones, who with her husband coordinates flag placements in the Horseshoe Bend area during holidays, said thieves continue to steel two or three flags each holiday. She hopes to use donated money to expand the flag effort, but uses the funds for replacement instead.


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Civil Procedure: Cases and Materials
Jack H. Friedenthal
Thomson/West, 2005 - Law - 1241 pages
Updated to include a contemporary perspective, this popular classic casebook covers important developments in several areas of civil procedure and incorporates student and professor comments on previous editions. While it retains a focus on procedural evolution, the new ninth edition also discusses cutting-edge issues, such as transnational litigation and technology's effect on jurisdictional doctrine. To make way for new material, this edition abbreviates a few older cases and commentaries and streamlines some notes.
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adjudicate affirmed alleged Amendment apply arising assert attorney California cause of action Circuit citizen Civil Procedure claimants claims class action class members common law complaint Congress constitutional contract Corp corporation counterclaim Court of Appeals damages decision defendant defendant's denied determine discovery dispute District Court diversity jurisdiction doctrine Due Process Clause equity Erie evidence exercise F.Supp fact federal court federal law Federal Practice Federal Rule filed forum non conveniens Helicol injury interest interpleader involved issue joinder judge judgment judicial jury Justice L.Ed lawsuit liability litigation matter minimum contacts negligence nonresident Notes and Questions notice opinion parties permitted personal jurisdiction petitioner plaintiff pleading proceedings reason relevant relief remand respondent Rules of Civil S.Ct Section service of process settlement statute of limitations subject-matter jurisdiction substantial suit supplemental jurisdiction Supreme Court tion tort trial United venue verdict writ York


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Lady Panthers stay alive with 51-37 win over Bear Lake
POCATELLO - Jocelyn Harper banged home 18 points and snagged 9 rebounds as the Snake River Lady Panthers kept their season alive with a 51-37 victory over Bear Lake on Thursday evening at Highland High School.
"Jocelyn put us on her back, especially in the third quarter," Snake River head coach Rich Dunn said. "I just can't stress enough just how happy and proud of the effort and desire that my team showed tonight."
Coming off of the heart breaking one point loss in the district title game less than twenty four hours earlier the Lady Panthers came out with their trademark steely defensive effort as they shut down the Bears with just 11 first half points.
Despite that, Snake River led by just 7 at the break before Harper and company took the game over with a 19-4 third quarter that witnessed Harper convert a pair of three point plays on the low block for 12 points in the quarter.
"Both teams played last night and both teams were tired and that showed in the first half," Coach Dunn said. "Our kids decided that the pain of regret was far worse than the pain of being tired and they just came out and left it all on the floor."
The name of the game was defense as the Lady Panthers forced 18 turnovers and picked up 10 steals led by Shayla Christiansen with 4.
"We had better execution in the third quarter but the difference tonight was our heart on the defensive end," Coach Dunn said.
Snake River (13-4) will play on Saturday at 1:00 when they face off with Salmon at Century High School. The winner will punch their ticket to the state tournament the following weekend.
Bear Lake 3 8 4 22 - 37
Snake River 9 9 19 14 - 51
Bear Lake (37) - Shayna Cochran 5, Meg Wilkes 3, Jessica Passey 7, Shania Bateman 5, Tiffany Wallentine 6, Chaylie Hulme 11. FG: 13. FT: 9-12. 3-pointers 2 (Cochran, Hulme). Fouls: 16. Fouled out: (Cochran, Hulme).
Snake River (51) - Shayla Christensen 6, Laurel Rigby 2, Billie Gibson 2, Madison Pilster 8, Macy Martin 3, Max Shelly 3, Scout Baldwin 4, Jocelyn Harper 18, Brylie Bair 5. FG: 17. FT: 17-25. 3-pointers (none). Fouls: 16. Fouled out: (none).


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Jenny McNulty
Faculty Profile
Wade Davies
Professor, Guitar/VocalsEmail: firstname.lastname@example.com
Office: NAC 203A
- National Institue for Staff and Organization Development Award for Teaching Excellence, for teaching services at San Juan College, New Mexico
- New Mexico Region of Phi Theta Kappa, Dr. Jimmy Miller Advisor Hall of Honor Award
- Past Appointments:
- Instructor of History, San Juan College
- Visiting Assistant Professor, Arizona State University
- Instructor of American Studies, Phoenix College
Research Interests
History of American Indian sporting traditions, Indian basketball in particular Past: Navajo efforts to utilize traditional and Western healing ways.
Field of Study
Navajo health and healing, Native American sports and games
Selected Publications
Co-edited with Rich Clow and Submitted to Scarecrow Press, American Indian Sovereignty and Law: An Annotated Bibliography
Co-authored with Rich Clow, "The St. Francis Mission Indians and the National Interscholastic Catholic Basketball Tournament, 1924-1941." The International Journal of the History of Sport,23 (March 2006): 213-31.
Entries on professional basketball, college basketball and college sports for an encyclopedia of the 1940's.
"Western Medicine and Navajo Healing: Conflict and Compromise" in ed. Robert Johnston, The Politics of Healing. New York: Routledge Press, pp. 83-94.
"Clyde James"; "Egbert Ward"; "Wilson Charles" in ed. C.Richard King, Encyclopedia of Native Americans and Sports. Armonk, NY: M.E. Sharp Inc.
Healing Ways: Navajo Health Care in the Twentieth Century. Albuquerque: University of New Mexico Press.
"Cornell's Field Seminar in Applied Anthropology: Social Scientists and American Indians in the Post-war Southwest." Journal of the Southwest, 43 (Autumn 2001): 317-41.
Co-Author with Peter Iverson. "American-Indian Identities in the Twentieth Century." Organization of American Historians, Magazine of History, 9 (Summer 1995): 15-21.
Academic journal reviews of the following books: Colleen O'Neill, Working the Navajo Way: Labor and Culture in the Twentieth Century; Betty Basien, Blackfoot Ways of Knowing; E. Richard Hart, Pedro Pine: Governor of Zuni Pueblo, 1830-1878; Warren Metcalf, Termination's Legacy: The Utah Indian Experience; Robert S. McPherson, Navajo Land, Navajo Culture: The Spirit of Pestilence; William Hass Moore, Chiefs, Agents & Soldiers: Conflict on the Navajo Frontier; Garrick Bailey and Roberta Glenn Bailey, A History of the Navajos: The Reservation Years; Laura Graves, Thomas Varker Keam, Indian Trader; Kathleen P. Chamberlain, Under Sacred Ground: A History of Navajo Oil, 1922-1982; Jere' Bishop Franco, Crossing the Pond: Tha Native American Effort in World War II; and Robert H. Keller and Michael F. Turek, American Indians and National Parks.
"Fred Begay," in Notable Native Americans, ed. Sharon Malinowski. Detroit: Gale Research, 27-28.
(Work in Progress) Book project on the history of American Indian basketball from 1891 to 1950.
Chair Director Departments
Native American Studies
- Native American sports and games presentations to local schools, connected to the Indian Education for All
- Montana representative for the Membership Committee of the Organization of American Historians
- Peer reviewer for academic journals and publishers
- Advisory Board Member for the Project Literacy Education and Teacher Training for Excellent Reservation Schools (LETTERS)
- Co-Advisor to WaYaWa, Native American Education Society
- Co-Advisor to Kyi-Yo, Native American Student Organization


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All News Releases By Date
EPA to Hold an Availability Session Regarding the Huntsville Gas Company Site, Huntsville, Alabama
Release Date: 01/21/2011
Contact Information: Dawn Harris-Young, (404) 562-8421, email@example.com
Representatives from EPA, the Agency for Toxic Substances and Disease Registry, the Alabama Department of Environmental Management, the Huntsville Housing Authority and Alagasco will be available to provide information and answer questions about upcoming site activities.
The Huntsville Gas Company site is comprised of approximately three acres and is located at 414-424 Dallas Avenue, Northwest in Huntsville. Historical information indicates that a corporation at the facility, originally known as Huntsville Gas Light Company, manufactured gas, primarily from coal, using a process known as coal gasification. In 1902, after an asset transfer to the Huntsville Gas Company (HGC), the facility continued to operate using the same process. After a series of mergers HGC became the Alabama Gas Corporation, commonly known as Alagasco. The Huntsville MGP was in operation from approximately 1872 to approximately 1946.
Community members interested in obtaining additional information are encouraged to contact Sherryl A. Carbonaro, EPA Community Involvement Coordinator, at (678) 575-7355.
For more information about the Site, please visit http://www.epaosc.org/hgc.
ATTENTION: A media availability session will be held prior to the public availability session on Thursday, January 27, 2011 to allow officials to answer questions from the media. The media session is scheduled from 6:00 until 6:30 p.m. at the Searcy Homes Office Building, 426 Dallas Ave., NW, Huntsville, Ala. Site representatives will be available to answer media questions concerning the upcoming site activities. This arrangement will allow for the public to use the entire availability session to get information and have their questions answered.
Search this collection of releases | or search all news releases
View selected historical press releases from 1970 to 1998 in the EPA History website.


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A reader emailed me a question about chambering the fist and I thought it wold be good to address the subject generally.
"Chambering the fist" refers to bringing the fist back to the side of your body when you punch, block, or strike. When you punch with your right fist, for example, you generally bring your left fist back to your left side.
I must admit that I never heard the word "chambering" when I started learning Karate. We just brought the fist back. There was no term for it. I do not know the Japanese term. It probably is some form of hikeru.
Where you bring the fist back differs greatly from one school or style to another. When I started learning Shorin-Ryu, we brought our fist back pretty high -- the idea was for the forearm and fist to be parallel to the ground. With such a high (parallel) alignment, it was thought that a punch would be more direct -- on a straight line. This alignment was stressed by Choki Motobu.
Today I chamber my fist much lower, about the height of my lowest (or floating) rib. The idea is for the fist to move along the arc of a natural pendulum for the beginning of the punch and then to thrust forward.
I must say that with the parallel alignment, you must make numerous small adustments as you punch to keep the arm parallel to the ground. With the lower chamber, I find punching to be much easier and natural. I also found that I raised my shoulders with the high chamber. This caused many problems, including shoulder and neck strain.
I met a gentleman who lives here in Hawaii. He learned from Chotoku Kyan in Okinawa. When he showed me his punch, he used the low chamber (at the floating rib). However, he hid his fist behind his back. When you looked at him from the front, you could not see his fist because it was tucked behind his side/back. He also used a hanmi body alignment.
He explained that hiding the fist made it harder for the attacker to see it and to react to it. It thought this was very interesting. I also thought that it would work better with the old style of clothes in Okinawa and Japan.
Thus, it is possible to chamber high (like Motobu), low (like Kyan), and all points in between. I believe it to be a matter of personal preference.
Now, that said, I believe that chambering is overused and not that practical in real self-defense. We must be able to punch wherever our hand may be. It is not natural to bring it back to our side. That is simply callistenics.
The only reason to bring the hand back is because you are pulling, tearing or blocking something. If you are not doing something, it would be better to keep your fist and arm in front of you. This makes it harder for the attacker to hit you and also reduces the distance you must punch. I like the idea of a "one inch punch." If you can generate power in a short distance, your Karate will be incredibly efficient -- no wasted time due to long movements.
The chambering approach also has a certain assumption -- that you would hit with one hand and bring back the other. Perhaps you would block with your left hand, and then hit with your right, at which time you would bring back your left hand.
However, some styles of Karate teach that it is better to block with the left and then hit with the left. The right would be kept as a guard. Again, block with a hand and then hit with it. The idea is not to alternate between hands. Using this approach, there is no chambering.
I personally follow this last approach. I do not believe in chambering the fist except for basics, as done in kata, or to pull back something -- like hair, an arm, to twist a joint, etc.
What about the rationale that bringing back the left arm transfers power to the right? My answer is that that are better ways to generate power using the core of your body/koshi. I do not like zig-zag Karate (alternating between right and left). I prefer to keep one side forward and to change orientation seldom and with great care.
I should add a caveat about the Motobu high chamber. If he brought his fist back high to the side of his chest with his elbow parallel to the ground, then I see problems. But if his fist was high with his elbow low (about the level of the floating rib), then this alignment makes much more sense. In this way, the arm covers the side very effectively and the shoulders will not be raised. It is a more natural position.
I think that the problem occurs when people interpret Motobu as requiring a high chamber with a high elbow. A high fist with a low elbow works very well. In fact, I would do that with my fist extending a few inches in front of my body (almost like the beginning of Tensho).
This alignment is also like the back hand of a chudan shuto uke. The idea is to protect your side and have your hand in front of you, ready to block or attack. Your elbow is also in position to block kicks.
Lastly, watch a boxer punch. They never bring their hand back to the side. It is kept in front of them for a good reason. And remember, boxers can't pull body parts -- thus there is no reason to bring the hand back to the side.
Ok, one more thing. It is possible to bring the hand all the way back to the side in order to strike to the back with the elbow. This is a good technique but would be used only when necessary, not with every punch. Since the attacker is generally in front of you, it is better to keep your returning hand in front of you too.
To the reader who submitted the questions, thank you!
Charles C. Goodin
Chambering the Fist
A reader emailed me a question about chambering the fist and I thought it wold be good to address the subject generally.
Posted by Charles C. Goodin on Friday, January 19, 2007


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Enjoy fantastic discounts and savings on top Irish and international brands on www.kilkennyshop.com, with up to 50% off all products* in Kilkenny's biggest ever pre-Christmas sale event. Running for four days only (November 15th to 18th) get your Christmas shopping in hand with great savings on your favourite labels.
Home to Ireland's largest collection of Irish designers, Kilkenny.com has all you need to make this Christmas magical, with a fantastic selection of gifts for all the family as well as an array of stunning Christmas displays and decorations – there has never been a better time to 'buy Irish'! Free Shipping also available.
Fashion accessories and jewellery
Fashionistas can enjoy incredible discounts off their favourite fashion and accessory labels, with up to 30% off Orla Kiely's stylish accessory range and up to 40% off products by Mischa Barton, Fossil and Marla. The Orla Kiely Midi Sling Bag, was €165 now €115.50 is sure to bring a smile on Christmas morning. And designer arm candy doesn't come any better than the stunning Modalu Pippa Bag, was €255 now €204, with 20% off the immensely popular Modalu collection.
Prepare to sparkle this Christmas with 10-50% off all jewellery* in store. With 15% off, the Alan Ardiff Heart of Gold Neckpiece, was €116 now €98.60 is a great value timeless keepsake. The funky watch range Ice boasts reductions of up to 50%, while customers can enjoy 20% off the Pilgrim, Swarovski and Coeur de Lion collections.
Introduce a touch of the 'traditional' to your home with a fabulous selection of Waterford Crystal products reduced by up to 50%, including creations by top designers John Rocha, Vera Wang and Jasper Conran. The stunning Waterford Crystal-John Rocha Signature Shot Glass (4 Set), was €98 now €55 and Waterford Crystal-Vera Wang Lace Boutique 8x10 frame, was €82.50 now €41.50 are both stunning accessories and also make for excellent gifts this Christmas. Entertain in style with the Waterford Crystal-Jasper Conran Champagne Flute Pair, was €110 now €55 and Jasper Conran Wine Glass Pair, was €100 now €55.
The Culinary Concepts collection boasts an array of exquisite tableware and home accessories and with 40% off products, decking out your home in the finest pieces couldn't be easier. Our top pick has to be the Culinary Concepts Station Lantern, was €24.95 now €14.97, an ideal feature piece for any room.
Christmas décor
Spread the festive cheer throughout your home with some quirky accessories and pretty decorations, with 20% off all Christmas decorations. The Belleek range has everything you need to bring the magic of Christmas to the home, from classic nativity pieces like the Belleek Living Nativity Set, was €49 now €39.20 to cute Christmas characters like the Belleek Ice Skating Snowman, was €17 now €13.60.
The Ulster Weavers Christmas Tea Towel, was €7.95 now €3.98 and the Ulster Weavers Christmas Reindeer Gauntlet, was €12.95 now €6.48 are the perfect Christmas additions for the kitchen.
To avail of these fantastic limited pre-Christmas savings, simply go online to www.kilkennyshop.com


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Below you will find a compilation of the photos we have displayed on our site broken down by season. Click on the thumbnail to enlarge the photo and see a brief description of the landscapes.
All photographs and images on the Kansas Secretary of State's website are copyrighted. To obtain permission to use the photos from our website, contact the Public Affairs Department at (785) 368-8095.


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New Real-Estate Power Symbol: Water
As water features from giant man-made lakes to artificial waterfalls become larger and more elaborate, homeowners are encountering some unexpected headaches. Lauren Schuker Blum has details on Lunch Break. Photo: Everett Fenton Gidley.
This transcript has been automatically generated and may not be 100% accurate.
... ay ay ay ay ... the beest lunch break is the new real estate power symbol water water everywhere but ... wasn't do your bills and resale value of your home Large shaker she's one of our man to reporters and she joins us now from Beverly Hills with the D tells Laura Tyson we're ... not talking about a fancied laptop for hero ... I couldn't get the odd that when they ... were looking at you know mode for high-tech Reedy River people are building ... a new water amount and with no water from the modern high end hundred foot water on the ... edge Dreamliners teachers today ... now cost wise it was the kid that will let ... you talking to somebody about bellwether because I have on the around your house and I thought that upkeep must be ... unimaginable will get to the economic cost wise where we talking ... fiscally ... depends where you live in the know how I found to have to move to ratify the term moat around it ... if it rains in Miami and Florida ... so the guy who built it into a deep dive into the limestone County water right away and Tenneco beatdown ... most income in California were Watters more hot commodity made it bit ... trickier proposition and or Hawaii or was it a great week and that ... it depends where you live ... in this case I think you know he ... added that the yet the guide to get the mind and gave it to him and I was that ... of course not to say that that the construction of a costing quite a bit now I picked up steam ... I can imagine for something like this mean it with water comes problems often tells about that but to do ... so again independent feature but I mean are people of the time my doctor family who has ... been kind of mounting in their backyard have waterfall ... fountain water five and brought it finished ... higher in scuba diver ... to clean the did water American every single week actual scuba diver to ... the cake green lighted tennis court and the amount and not cleaned it did he know that the ... issue of ... the people you'll have to clean house and a pot that often are taking it to cool off their water feature ... I don't really know the actual liability ... can you really spend it if you have ... here are ten or fifteen hundred pumping water through your property and I kept above ninety seven thousand dollars a month Peter Batchelor ... you can have the ... electricity and water to get water and appropriate ... ended a lot of those still high but that life into a department water power ... actually showed up there haven't ... we first moved into the kit the radio came together in a water bill that I ... didn't get quite outrageous cyclically and I had trouble resale value and we just be selling these loans ... yet well I mean ... yes I meant ... to give the firm but the home in Palm Beach County beautiful ... you can get ... their feet ... and he took in about two years to sell it for Hourican Telecom has been picking up your mind ... because a lot of people reacted badly to having too many water features and will they think ... that comfortable there was a wall of water and I love ... it that way for contentment ... for over a pool ... a lot of people into the house you love the feeling of water daily lock and leave it there thank you so much more in the arena


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The LuBar and Bistro
Wine trail featuring several wineries throughout the Carlyle Lake region. More details coming soon.
WAREHOUSE 300 is a new vintage marketplace opening soon in Trenton, IL Our retail will include home decor, rustic, shabby chic, and more!
New "Formula Blue" Design with indoor pool, exercise room, ExpressStart Breakfast.
The McKendree MetroRecPlex is a new, full-service, state-of-the-art sports complex. The complex offers two NHL-sized ice rinks, an aquatic center fit with a 10 lane championship swimming pool, a contemporary fitness area and many other amenities. Memberships and daily passes can be purchased for use of the facility and all its features.
Located the corner of Scott Troy Rd and Hwy 50, our address is 205 Rec Plex Drive, O'Fallon, IL 62269.
The trail runs from the Carlyle Lake Visitor's Center (Trailhead) east for 10 miles across the Carlyle Lake/Kaskaskia River Dam and the saddle dams. The surface is black top and concrete with some crushed rock surface on the eastern end.
Indoor archery range, hunting and fishing supplies.
Built in 1859, the bridge is named in honor of William F. Dean, a Korean War hero.
Year-round facility on the southwest end of Carlyle Lake; safe, clean facilities, ideally situated for water sports, sailing, fishing and lounging.
Pontoon rental available from Dam West Pontoon Rentals (618) 332-2319.
Located on pristine Lake Carlyle, the hotel offers daily complimentary breakfast, outdoor pool , 24-hour coffee in the lobby and Banquet/Conference Center.
Held in September at Bretz's Wildlife Lodge and Winery in Carlyle, this pairing of Illinois wines and local artisans is a great way to spend a weekend.
Located next to Carlyle Lake, the orchard is open in the summer for peaches that are hand-picked at maturity for ultimate sweetness.
The reserve wines humbly wear the label of the variety of grapes grown in this vineyard. Customers are invited to enjoy the fruit flavors in the wines and relax in a country setting with family and friends.
The only pecan grove/orchard in Illinois. Open in season on weekends in November and December.
The park is currently closed for renovation. Call for 2017 reopening dates.
Located in Eldon Hazlet State Park, the marina offers launching facilities, a clubhouse, and other amenities. Open to the Sailing Public, the association organizes several sailing regattas from May through October. The harbor accommodates more than 280 boats in 'dry sail' plus 100 beach cats. There are three electric hoists, two ramps,
and a 300-foot beach area. CSA offers club activities from May through October including a 25-weekend racing program, learn-to-sail programs for kids and adults, sailboat/kayak rentals, training programs, and numerous social events.
Visit the farm for Fall Festival Fun Thursdays through Saturdays or by appointment in late September through October. Activities include a barrel train, corn maze, corn bin, horse swings, and more.
3 bedrooms – sleeps 8
Hickory Shores has been active for more than 25 years! Make Hickory Shores Resort a yearly destination for your family fun! There is so much to do in so little time, so book your stay, today!! Carlyle offers hunting, fishing, golf, swimming, and much more! Did we mention it is also extremely kid-friendly? We have mini golf, playgrounds, and a swimming pool on our campgrounds!
Tent Camping, RV Camping, Full Hook-Up Sites and Cabin Rentals
We offer full hook-up sites, camping sites, and cabins that sleep up to 10 people! No matter what type of camping experience that you are looking for, we can accommodate to what you are looking for.
2 Cabins – 1 sleeps 4, 1 sleeps 7
2 Large Cottages – 1 sleeps 8, 1 sleeps 10


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lace and denim japanese knot purse
Added Feb 15, 2013
by liliv-1
Athens, Greece
Romantic japanese knot purse made of two old pairs of pants (denim and plaid).
I love knot purses! They are very easy to carry, very easy to open and close.
I made horizontal seams (which I covered with lace) beacause the fabric pieces were not wide enough. I also a made seperate handle for the same reason and decorated it with lace as well, to acheive some kind of optical balance.
I made other knot purses after this one, but this was the most functional and pretty, mostly because of the seperated piece for the handle (the third picture shows it clearly). So if you like knot purses I recommend trying this and your wrilet will not slip on your wrist.
Material Notes
recycled denim and lace for the exterior, plaid fabric from old pants for the lining
- For
- Women
- Garment Type
- Accessories
1 Comment Sign in to add a post
Feb 15, 2013, 07.10 PMby Mary Athey
Great re.cycling project. This.looks so lovely.x
1 Reply
Feb 15, 2013, 11.29 PMby liliv-1
thank you so much:)
Add to Favorites 1 person added it


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Qatar - best betting odds
On this page you will find the best betting odds on the final result for matches from this country. The list of leagues is displayed in the right hand menu.
None of the serviced bookmakers have provided odds for the matches in this country. Odds will be shown immediately after their will be available.
If you want to check the archive betting odds please visit Archive Qatar section.


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Kids need a durable and safe place to work on classroom projects and Correll's Rectangular Activity Table answers the call. This activity table has a 1 1/4" high-pressure laminate work surface that resists stains and scratches, so your table looks good year after year. The durable leg mounting system keeps joints in place and reduces the risks caused by unsteady tables. Every Correll Activity Table comes with a free wrench for easy height adjustments; choose standard or short legs. Select from a rainbow of great colors for the high-pressure laminate and the T-mold edge band. This Correll Rectangular Activity Table has a 36" wide x 72" long top and is backed by a five-year warranty.
Key Features
- Sturdy particleboard top with high-pressure laminate finish
- 36" x 72" rectangular work surface
- Tubular steel legs are adjustable
- Available in a variety of colors
- Backed by a five-year warranty
- Table Material: Particleboard
- Top Finish: High-pressure laminate
- Frame Material: Tubular steel w/ chrome leg inserts
- Edge Band Material: T-mold
- Warranty: 5 years
- Tabletop Dimensions: 36"W x 72"L
- Height: 21" – 30" (with standard legs); 16" – 25" (with short legs); tables adjust in 1" increments


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- "Come in, my dear, and rest your soul."
- ―Auntie Poulet
Auntie Poulet is a character in the Grand Theft Auto series who appears as a main character in Grand Theft Auto: Vice City.
Poulet is an elderly Haitian matriarch and the leader of the Haitian gang (which she also uses as her own protection).
Auntie Poulet was voiced by Youree Dell Cleomili Harris, better known as infamous "psychic hotline" spokeswoman Miss Cleo.
Life up to 1986
Most of Auntie Poulet's life before the late 1980s is unknown. Poulet was born in Port-au-Prince in Haiti. Poulet started both tea and drugs business during her youth. Poulet also founded a small Haitian gang.
From 1984, shortly after the Cubans defeated the Cholos, Poulet and her Haitians gang came to Vice City and took over the Little Haiti district, starting a gang war with Umberto Robina and his Cuban gang.
Poulet gives Tommy Vercetti mind-altering voodoo potions to get him to cooperate in the missions she wants him to undertake. This includes acting against the Cubans, with whom he has friendly relations. However, when the potion's effects wear off, Tommy shows no memory of what he has done for the Haitians.
Ultimately, she cuts her ties with him and wishes that he not return to Little Haiti, but if Tommy does do so, he receives a final phone call from Auntie Poulet ("Why you coming here fee? Me tell you we don't want to see you around here no more"). Following Poulet's final mission, Tommy destroys the Haitians' main drug operations plant.
VCPD Crime Tree Record
- Elderly Haitian matriarch.
- Believed to be involved in long term feud with Cuban crime families for control of eastern and downtown Vice City.
- Heavily protected by Haitian thugs at all times.
Mission Appearances
- GTA Vice City
- Stunt Boat Challenge (Post-mission phone call)
- Juju Scramble (Boss)
- Bombs Away! (Boss)
- Dirty Lickin's (Boss)
- Trojan Voodoo (Post-mission phone call)
- In the original PS2 version of the game and Xbox version, Auntie Poulet wears a purple dress with matching head wrap. However, in all other releases of the game, she wears a yellow dress with matching head wrap similar to her box-art rendition (except 10th Anniversary Edition for iOS and Android).[1][2]
- Poulet is French for "chicken".
- Auntie Poulet is the only female gang boss in 3D Universe; Asuka Kasen, and Catalina were only co-bosses.
- At the age of 86, she is one of the oldest living characters in the 3D Universe.
- Auntie Poulet's house interior can be seen and entered via trainers. This can be done by entering the VCPD HQ, then leaving the building without using the actual door (e.g. flying outside through the wall) and finally going to her location on the map.


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The Catch: Things things to hate about Miami's no. 6
Wondering what topic to write about this week, I found myself sitting around a campfire at a friend's lake cabin Friday night. As the twelve of us visited and bounced from topic to topic, the mood was very laid back, as you would expect from a weekend at the cabin. And then one person's name was brought up, causing the calm, laid back chatter to suddenly turn serious and defensive.
That name was LeBron James.
Instantly, I knew what my column would be about this week. As points were made to defend LeBron, I offered one simple reason to back my distaste for him. One was enough for that discussion, but there were many more in my arsenal. Here are six things I hate about No. 6, LeBron James.
1. LeBron James is the type of athlete that you either love or you hate. There truly is no in between. Just a few years ago, he was one of the most beloved athletes in the country. That is no longer even remotely the case. A decision that he so eloquently named "The Decision" changed all of that. Now, we all know what happened with "The Decision," so let's not get into that. For me, that was not the turning point of when I went from a casual LeBron James fan to somebody who cheers against him the same way I cheered against Michael Jordan and Kobe Bryant. My cheering against Jordan stemmed from a childhood in which my older brother was a huge Michael Jordan fan and I was a huge Magic Johnson fan. Jordan winning also meant my brother was winning and rubbing it in, so naturally I could not cheer for Jordan. Magic won his five titles, but the cheering against Jordan did not work out so well for me, as he captured six rings. With Kobe, it was a bit of jealously, because he came into the league around the same time as Kevin Garnett and enjoyed much more success. The peak was the 2004 Western Conference Finals in which Kobe, Shaq, and the Los Angeles Lakers ended KG and the Timberwolves' run at the NBA Finals. There's not much more to it than this; I got sick of watching Michael Jordan and Kobe Bryant win. They were/are both amazing basketball players, but the constant winning got to be too much. Here's the difference. As of today, LeBron James has not won anything. He is two wins away from his first NBA Championship, but has failed to get there as of yet. The "pre-championship" celebration that the Miami Heat held after LeBron, Dwyane Wade, and Chris Bosh aligned in South Beach was absolutely disgusting. A press conference wouldn't have sufficed to introduce the new players? It was a classless move and an overwhelming majority of my dislike for not only LeBron James, but also the Miami Heat stems from that celebration.
2. Since joining the Heat, it seems millions of fans have turned their backs on LeBron James. It is widely stated that James has the type of personality where he just wants to be liked by everybody and it bothers him when he is disliked. If this is true, he doesn't do a very good job of getting fans to like him. Hey LeBron, here's an idea; how about you actually compete in the Slam Dunk Contest, for once, during All-Star weekend?! If you want to be liked so much, there can't possibly be a better way, than to put on an electric show Saturday night of All-Star weekend. Not only do the fans want it, but also the league needs it badly. LeBron is clearly one of the most athletically gifted dunkers in the league and for him to consistently skip out on the dunk contest; he is doing a disservice to the NBA, himself, and what fans he has left.
3. The way LeBron James teamed up with Dwyane Wade and Chris Bosh tells me a couple of things. First of all, it tells me he does not have the desire to be the best basketball player in the world, because to be the best, you must beat, not join, the best. When the Big Three joined forces, Wade was arguably one of the top five players in the league and Bosh was already a five time All-Star. Do you think Michael Jordan, Magic Johnson, or Larry Bird ever would have left their team to join forces with another top ten player? Not a chance…that never would have happened in any situation because those guys wanted to be the best in the world and they knew they needed to beat the best to become the best. Michael Jordan didn't win an NBA title until his seventh season in the league, but that didn't mean he was going to up and leave the Bulls to go play with the likes of Patrick Ewing or Charles Barkley.
4. This brings me to my fourth point, which is similar to No. 3, but has a different spin. LeBron lacks that intense competitiveness that Jordan, Magic, Bird and so many other greats had. It was there every time Jordan or Magic Johnson took the floor. Larry Bird was one of the most competitive players I ever saw. Kobe Bryant has it, even Kevin Garnett. I just don't see it enough with LeBron. The one time he showed this quality was Game 6 of this season's Eastern Conference Finals against the Boston Celtics. The Heat were facing elimination, LeBron had a focus and determination we hadn't seen from him before and look what happened. He dominated the game to the tune of 45 points, 15 rebounds, 5 assists, and went 19-26 from the field.
5. LeBron's unprofessionalism bothers me. Last season in the NBA Finals, Dirk Nowitzki was sick during Game 4. Dirk went on to lead the Mavericks to victory, tying the series at two games apiece. Before Game 5, LeBron and Dwyane Wade were shown, walking down the tunnel to the arena, fake coughing, as if they were sick. Another classless move and disrespectful toward Nowitzki. Three games earlier, with a 1-0 series lead, the Heat took an 88-73 lead in Game 2 after a huge Wade three-point shot, right in front of the Mavs bench. With 7:14 left in the game, LeBron ran over and mobbed Wade in front of the whole Mavs team, as if they had just won the game. Not a good move LeBron. This angered the Mavs and they ended the game on a 22-5 run, stealing Game 2.
6. LeBron gets every call and rarely gets called for a foul. As a kid, I remember complaining about how Jordan would seem to get every single call to go his way, but to the best of my knowledge, a majority of those were actually fouls. Some of the calls that have gone LeBron's way in the Eastern Conference Finals and so far in the NBA Finals have been just absurd. LeBron is a very good defender, but to only foul 1.7 times per 36 minutes played is astonishing. In his career, Jordan, a nine time NBA All-Defensive First Team selection, averaged at least two fouls or more (per 36 minutes) every season except two, Magic Johnson averaged 2.2 fouls per 36 minutes, and Larry Bird, 2.4. In this same stat, Kobe Bryant (nine time NBA All-Defensive First Team) is also at 2.4. So, while LeBron seems to get every call, he's also getting away with plenty of fouls on the other end as well.
Plattner is a Minnesota-based columnist. Catch "The Catch" every Tuesday in the Times-Record


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Hello, new here:D
I am thinking of planning a backpacking trip to these areas at around early to mid june. I know we have a relatively big snow year.
Will the lakes be frozen? Will there be 100 percent snow cover at the elevation of the lakes?
I am thinking crampons might be a good idea but not necessarily ice axe.
What do you think?


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Recently Kaiser Health News published a story about the concerns some people living with HIV/AIDS have about Obamacare. As the Affordable Care Act is implemented, many have questions about how current insurance coverage may be affected and whether funding streams like the Ryan White Care Act will survive.
These are all very appropriate concerns as the nation rolls out the most dramatic change in healthcare delivery since the 1980s' introduction of a Medicare payment system that based reimbursement on algorithms by patient's principal diagnosis, ICD diagnoses, gender, age, treatment procedure, discharge status and the presence of complications or co-morbidities. While the "Diagnostically Related Groups," as this system was called, resulted in many positive outcomes, there were also cases where seriously ill stroke patients were sent home a day after admission, sometimes before they fully recovered, because the hospital could no longer get paid for a typical 4-5 day stay. Unintended kinks in new systems are not all that uncommon.
Since we have 31 years of experience working with low-income people living with HIV/AIDS, we have our own views on all of this. We strongly believe that as this revolution in healthcare unfolds, people living with HIV/AIDS and all other chronic illnesses need safety net services and advocacy that will ensure continued care access and positive health outcomes. As one man interviewed in the Kaiser article stated: ""My medical is very well-managed," said Land, an insurance adjuster before he retired in 1993 because of his illness. "But I also need that wrap-around care that helps me live every day. In my 15 minutes with the doctor…I am not going to get that."" We couldn't agree more.
Comprehensive care including stable housing, mental health services, food and healthcare coordination are the foundation for surviving and thriving. Bailey House built this model in the early epidemic because it made sense. Now after 31 years we have lots of data to prove it. Let's make sure that as the nation seeks to cut costs, it doesn't disassemble what makes the rest work.
To read the full Kaiser News article, click here.
Comments Off on When seeing a doctor is not enough


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Power Pac Weekend
Top HeadlinesDate: October 12, 2009
Contact: email@example.com
Phone: 269-471-3211
César González, Young Adult Initiatives coordinator for the North American Division of Seventh-day Adventists, will speak for Power Pac chapel on Thursday, Oct. 15, 2009. The chapel will be held at Pioneer Memorial Church at 11:30 a.m. Co-curricular credit is offered.
The topic for González' message will be "A Message for the Hard of Hearing." Other Power Pac meetings will include Thursday night's co-ed worship in Lamson Hall Chapel, Friday night vespers in the PMC Youth Chapel, Higher Ground Sabbath School in Dining Services, and New Life Fellowship in the Seminary Chapel. González will speak and/or answer questions at each event.
González has worked with the NAD for over a decade, specializing in discipleship and young adult issues. He spearheaded the Genesis 2000 and Seven Signs initiatives that worked to foster young adult inclusion and discipleship in North America and around the world. He also led the His Hands initiative in North America, which continues to promote volunteering at local churches.
In 2007, González was awarded the Adventist Ministries Award for Excellence in Young Adult Ministries. He has been invited to speak at eight colleges, presented at every NAD ministries convention since 1999, six Campus Ministries conventions and two NAD Youth Ministry conventions. His first book, The God I Saw, will be released in 2010. González lives with his wife, Grace, in Cambridge, Md.


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Question: I am looking for some information on the seriousness of the apparent increase in mountain lion attacks in the news lately. There have been several incidents of bears attacking humans, and we have a bear season. I'm wondering if it might not be time to reconsider having a mountain lion season? I understand that more mountain lions are killed each year now with depredation permits than were ever killed with a mountain lion season.
What can you tell me about the population increase in mountain lions in California in the past 10 years or so? Would it require legislation to overturn the existing law? Would Department of Fish and Game (DFG) data support the need for such a reversal? (Bill T.)
Answer: It's important to note that mountain lion (puma) attacks on humans are very rare. In the last decade, there have been only four confirmed attacks in California, three of which were nonfatal. Though you may be seeing more media coverage of mountain lion attacks on domestic animals, there's no evidence that the number of these incidents is increasing. While DFG does not formally track the number of domestic animals killed by pumas, we do keep track of the number of depredation permits issued for problem mountain lions. The numbers of depredation permits issued and resulting pumas killed have actually been fewer in recent years, though (www.dfg.ca.gov/news/issues/lion/depredation.html).
According to Marc Kenyon, DFG's Statewide Coordinator for Bear, Mountain Lion and Wild Pig Programs, keeping track of those permits is key. Since the original moratorium was placed on mountain lion hunting in California in 1972, DFG has been unable to assess the statewide puma population size in the traditional way (by inputting harvest numbers and age and gender ratios into statistical models). Researchers have attempted to develop indirect count methods over the years, but none have proven to be cost-effective with widespread applicability.
Hence, Kenyon relies on the annual number of depredation permits as an index to the statewide population size. It's a logical assumption that as the number of permits decreases, so too does the puma population. He believes the puma population is following this index, and the population size is, in fact, smaller than it was 10 years ago. This trend in the puma population closely follows the trend in the statewide deer population, as depicted on DFG's website (www.dfg.ca.gov/wildlife/hunting/deer/population.html). When viewing this website, note the similarity in the curves depicted on the graphs from the years 1972-2000, understanding that predator and prey populations traditionally cycle with a three to four year lag (the predators lag behind the prey).
The California Wildlife Protection Act of 1990 (Proposition 117) placed the current ban on puma hunting in California. According to the language in the Act, a four-fifths vote by both houses of the Legislature is required to approve any amendment to the Act. The Act further states (in Section 8): "Any amendment of this act shall be consistent with, and further the purposes of, this act…" which essentially means that no amendment shall reverse the Act's intent. A 1996 ballot measure, Proposition 197, asked voters whether the specially protected status of the mountain lion afforded by Proposition 117 should be repealed and the species managed by the Fish and Game Commission like all other mammals. This measure failed with a vote of 58 percent opposed, 42 percent support.
It is difficult to answer your last question regarding the data supporting a need to reverse the legislation. We have data that documents puma densities in a few University-sponsored study locations throughout the state. We have puma depredation and public safety incident data. We have deer (prey) numbers throughout the years. We have habitat availability models. However, the amount of data needed to adequately support this type of legislative action is subjective. Kenyon says that he suspects any such proposal would be highly controversial.
Spearfishing rockfish and lingcod after dark?
Question: Can rockfish and lingcod be taken by spearfishing after dark? (Brian S.)
Answer: Yes, you may spearfish for rockfish and lingcod at night, except in San Francisco Bay (California Code of Regulations Title 14, section 27.56).
Is it legal to keep live wild pigs on private property?
Question: Are there circumstances under which a California resident can keep live wild pigs on their property? Where can I find a regulation that addresses this? (Mike A.)
Answer: It is not lawful for a California resident to possess wild pigs (Sus scrofa) (CCR Title 14, section 671(c)(2)(Q)). However, there is an exception for Sus scrofa domestica, also known as the domesticated pig one commonly sees on a farm (CCR Title 14, section 671(c)(2)(Q)(1)).
# # #
Carrie Wilson is a marine biologist with the California Department of Fish and Game. While she cannot personally answer everyone's questions, she will select a few to answer each week. Please contact her at firstname.lastname@example.com.