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Opinion | Morgan Liddick: Cocaine, quail and sequestration
And On Your Right
White House tours are still off. That nasty 'ol Sequester monster wants to spoil the kiddies' spring trips to Washington, D.C., and the White House is moving heaven and earth to make sure Republicans get blamed. At least they didn't sink to the level of Harry Reid, who linked the deaths of seven Marines in a training accident to the Sequester – meaning, of course, Republicans. It's not a new low in the history of partisan slimeage, but it's close.
The president, who never met a tax hike he didn't love, will release a budget tomorrow calling for "revenue increases" so he can – among other things – reopen the White House to tourists. Apparently, he forgot he got a $600 billion tax increase three months ago. Such is life in Washington, where hundreds of billions of dollars evaporate in the course of everyday business.
According to the Department of Homeland Security, it costs about $77,000 a week to keep White House tours going. Simple multiplication gives us a bit over $4 million a year, total. Since the President is unable to find this sum in the current federal budget, in the interest of bipartisan helpfulness the following are a few possible sources for the money.
Consider Michelle vacationing in Aspen while the president golfed with Tiger. Yes, he probably paid his own greens fees and she bought her own lift tickets, but what about communications and security, not to mention transportation? The Tiger trip alone cost around a million dollars, including hotel rooms. It was one of three vacations so far this year.
We could question the Federal Highway Administration's spending $529,000 to install a fourth visitors' center on the 54-mile-long Taliamena Scenic Highway, spanning Oklahoma and Arkansas.
We could inquire why $500,000 in Federal redevelopment money went to "DC Pancakes LLC" to open an IHOP in Columbia Heights, Maryland – a trendy new shopping district, not an "underserved neighborhood," as the grant specified. This foolishness almost equals that of a $484,000 community block grant given by HUD to the "Mellow Mushroom," a drug-themed pizzeria in Arlington, Texas – perhaps to address the Lone Star State's acute shortage of pizza and beer.
See? We're more than halfway there. Should we spend $300,000 to "ensure formal workers' benefits in El Salvador, or $2,500,000 for Tibetan refugees in South Asia? Should we give the Muslim Brotherhood government of Egypt $4,000,000 for "global disease detection activities," to say nothing of the military equipment we're showering on them?
Interested in big boondoggles? The Department of Agriculture pays U.S. farmers an average of $2 billion a year not to farm. And according to the Government Accountability Office, the federal government spends about $25 billion a year on federally owned buildings that are unused or abandoned.
We're way past that $4 million mark, aren't we?
But in the world of stupid federal programs, there's always more – like the National Institutes of Health spending $400,000 to determine why gay Argentine men engage in risky sexual behavior when they're drunk. Or the $175,000 research program to determine if Japanese quail engage in "sexually risky behavior" while high on cocaine. No, really. Quail.
Nothing illustrates the Obama administration's cynicism like its checking of the "yes to all" box on federal spending, while excoriating the "evil rich" if they object to emptying their pockets to advance our knowledge of video games, growing mangoes in Pakistan, and whether politicians "gain or lose support by taking ambiguous positions." We spent more than $30 million on these three programs, and an additional $2.6 million to "teach Chinese prostitutes to drink responsibly."
We should all remind ourselves of the old aphorism: "To govern is to choose." Doing so should make abundantly clear which political party is really responsible for Washington's "inability to govern." Giving favor to supporters and promising more, while forcing the productive sectors of the population to surrender their gains to fund such giveaways is not governance, but its opposite.
Failing to determine what level of spending our economy can sustain is not good politics, it is the willful surrender of long-term prosperity for immediate advantage. Refusal to eliminate even the most egregious examples of waste, while choosing more of the same to further political objectives, is worse than incompetence. Unless you think that the sexual behavior of coked-out quail is a question of national security.
Summit County resident Morgan Liddick pens a Tuesday column. Email him at firstname.lastname@example.com.
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Greetings from Gorgeous and Sunny Mexico!
I'm taking a break from the German winter, and spending three months exploring and experiencing Mexico. I've been here twice before, but it's been years. This time I wanted to spend several months here to really get to know the people, the culture, the language, the places, and of course: THE FOOD!
I've already spent a few weeks researching the wide variety of Mexican cuisine in more than a half dozen locations including Mexico City, Tepoztlán, Guanajuato, San Pancho, Sayulita, Buceriás, and La Peñita de Jaltemba.
Since last month, I've been based in the sleepy village of Lo de Marcos, Nayarit. I've rented a house just a few blocks from the Pacific. There's an amazing kitchen, fantastic garden full of herbs, lots of little vegetable markets and even a truck that drives around town selling fruits and vegetables. It's a little mini paradise! Warm. Sunny. Friendly. Authentic. Down-to-Earth. I've been doing yoga every morning and I even got a surfboard and have been having fun in the ocean almost every day.
I've already developed over 40 new recipes which I'm planning for my next cookbook of vegan recipes inspired by my travels. This book will be about my travels in Mexico, life here, adventures in the kitchen and much more. It will be full of stories and original artwork, similar to my first cookbook: The Lotus and the Artichoke – Vegan Recipes from World Adventures.
Here are a few photos from the last few weeks. I hope to be posting more, soon!

subset: commoncrawl


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Orchestration: 2 Flutes (2nd db.Piccolo), 2 Oboes, 2 Clarinets in A, 2 Bassoons, 4 Horns in F, 2 Trumpets in C, 3 Trombones, Timpani, Percussion (2 players: Cymbals (clashed & suspended), Snare Drum, Tambourine, Bass Drum, Glockenspiel), Harp (or Piano)Strings (Violin 1, Violin 2, Viola, Cello, Bass)On 6th May 1935 King George V celebrated his Silver Jubilee. To mark the occasion the BBC commissioned Walter Leigh (1905-1942) to compose a festive overture (for a fee of 20 guineas), which would be broadcast in an hour-long concert of Music of the British Isles, conducted by Joseph Lewis. Originally entitled Jubilee Overture, Leigh later renamed it Overture (Agincourt) when it was broadcast two years later, on the occasion of the coronation of King George VI. The title page of the full score bears this inscription:"Now gracious God he save our KingHis people, and all his well willing.Give him good life, and good endingThat we with mirth may savely singDeo GraciasDeo gratias Anglia redde pro Victoria"Song of the Victory at AgincourtA PACK includes a full score, string parts 4/4/3/4/2 and all wind, brass and percussion parts.Duration 13 minutes
Click the play button below to hear a performance which has been computer-generated from the score.
Takin'Names & Where Shall I Be?
by Bryan Davies
Messiah (Bartlett) Violin 1
by George Frideric Handel
Carol Symphony Pack
by Victor Hely-Hutchinson


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Shop Window by Sushrutha Metikurke
Street Photo on UPSP
Urban Picnic Street Photography | Street Photographer Community
#upsp #streetphotography #streetphoto #streetphotographer
christchurch • people • Portrait • shop • window
Sushrutha Metikurke has published 43 street photos in UPSP.
Urban Picnic Street Photography
A place to find inspiration, upload your best photographic work and develop ideas based on the street theme. Urban Picnic strives to showcase the best street photography and feature the best contemporary street photographers.


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This Ovo floor lamp comes in a designer Baja Blue Metallic color and is paired with a glass tray table that's perfect for drinks, TV remotes, and more.More Details >
Add designer style to your home with this tray table floor lamp design from the Color + Plus™ collection. The clear glass tray table offers a handy spot to place a TV remote or your favorite beverage. Below the tray, the lamp base stands beautifully in our designer Baja Blue Metallic color. This high-quality color features small metal flakes, for a stunning look that sparkles beautifully - like a new car in the sunlight! A white fabric shade completes the look up top. Custom made to order lamp design. Lamp base U.S. Patent # 8,899,798


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This series presents an overview of Salvation History and the Eucharist. Students see clearly how the Eucharist is the center of God's plan of mercy and the center of our Catholic faith. This revised edition series is fully correlated with the Catechism of the Catholic Church and features increased use of scripture to complement the outstanding presentation of Catholic doctrine and practices.
The Ad Hoc Committee to Oversee the Use of the Catechism, United States Conference of Catholic Bishops, has found this catechetical text (The Faith and Life Series) to be in conformity with the Catechism of the Catholic Church.
The third edition is fully correlated with the Catechism of the Catholic Church and the revised translation of the Roman Missal. It also uses Sacred Scripture to enhance a systematic, dynamic presentation of the Catholic faith for young people.
The online version of the Faith & Life series includes all components of the student textbook and is supplemented with a full text voiceover for audio learners, which addresses readability level issues.Online Assessments
Each chapter has assessments for all chapters, for teachers and parents to see how students are doing before and after their learning. These assessments are scored instantly and a historical record can be reviewed by instructors.Rich Links and Multimedia
The online curriculum includes links to primary sources. Additionally, music and video are designed to help students pray. Each course includes excerpts of video from the Footprints of God series by Steve Ray.Engaging Games
Games are designed with content from the books and activity guides. Each game provides a break from reading and tests learning. Additionally, vocabulary flashcards help students review the material.
Click any of the links below to view a curriculum outline for the particular grade level.
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Betsy Wikes, or Wilkes, Howe was born on 26 January 1838 in England, probably Northamptonshire. Her parents were William Howe and Elizabeth (possibly Kilsby). Betsy married William A. Blincow in October 1860, in England.
Betsy and William had eight children, five born in England.
William Blincow (1861-1946)
Richard Blincow (1864-1872)
Frederick Howe Blincow (1867-1952)Mary Elizabeth "Polly" Blincow (1869-1951)
Eliza "Nellie" Helen Blincow (1870-1955)
After immigrating in 1872, William and Betsy had three more children, all born in Nebraska.
Frank Robert Blincow (1872-1945)
Ada Louise Blincow (1873-1957)
George Blincow (1877-1952)
The family was listed in the 1880 census in York County, Nebraska, but by 1900 they were in Thomas County, Kansas. Sometime after William died, Betsy moved in with her daughter Nellie and her family. Betsy died in 1915 at the home of J.A. and Nellie Horning and is buried in Beulah Cemetery, in Thomas County, Kansas.


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The Muslim Brotherhood defiantly called for a week of protests across Egypt starting on Saturday, a day after more than 100 people died in clashes between Islamists and the security forces that pushed the country ever closer to anarchy.
Undeterred by the bloodshed in which about 700 have been killed since Wednesday, the Brotherhood urged its supporters back onto the streets to denounce the overthrow of Islamist President Mohamed Morsi and a crackdown on his followers.
"Our rejection of the coup regime has become an Islamic, national and ethical obligation that we can never abandon," said the Brotherhood, which has accused Egypt's military of plotting the downfall of Morsi in July 2013 to regain the levers of power.
Muslim Brotherhood calls rallies across Egypt after a day of bloodshed
Security sources said that roughly 50 people died in Cairo and more than 20 in Alexandria.
Many Western allies have denounced the killings, including the United States, but Saudi Arabia threw its weight behind the army-backed government on Friday, accusing its old foe the Muslim Brotherhood of trying to destabilise Egypt.
Violence erupted across Egypt after the Brotherhood, which has deep roots in the provinces, called for a "Day of Rage". Roughly 50 people died in Cairo and more than 20 in the country's second city, Alexandria, security sources said.
Automatic gunfire echoed around the capital throughout Friday afternoon, army helicopters swooped over the roof tops and at least one office block was set ablaze, lighting up the night sky long after the violence had subsided.
The Brotherhood announced a series of daily rallies over the next six days, starting on Saturday.
"We will not leave the squares. And we will not be silent over our rights, ever," said Cairo resident Abdullah Abdul Fattah, adding that he was not a Brotherhood voter.
"We are here because of our brothers who died," he said.
An interim cabinet, installed by the army after it removed Morsi during rallies against his often chaotic rule, has refused to back down. It has authorised police to use live ammunition to defend themselves and state installations.
After weeks of futile, political mediation, police moved on Wednesday to clear two Brotherhood protest sit-ins in Cairo. Almost 600 people, most of them Islamists, were killed in the mayhem. With no compromise in sight, the most populous Arab nation - which is often seen as leading events in the entire region - looks increasingly polarised and angry.
"Egypt fighting terrorism," said a new logo plastered on state television, reflecting tougher language in the local media that was once reserved for militant groups such as al Qaeda.
The government said in a statement it was confronting the "Muslim Brotherhood's terrorist plan".
Undermining Brotherhood pledges of peaceful resistance, armed men were seen firing from the ranks of pro-Morsi supporters in Cairo on Friday. A security official said at least 24 policemen had died over the past 24 hours, and 15 police stations attacked.
The Brotherhood suggested the gunmen had been planted by the security forces, saying it remained committed to non-violence.
Witnesses also said Morsi backers had ransacked a Catholic church and set fire to an Anglican church in the city of Malawi. The Brotherhood, which has been accused of inciting anti-Christian sentiment, denies targeting churches.
Christians make up roughly 10 per cent of Egypt's 84-million population and the Coptic Church authority issued a statement on Friday saying it "strongly supports the Egyptian police and armed forces".
The streets of Cairo fell quiet after nightfall, with the government warning the dusk-to-dawn curfew would be vigorously enforced. Neighbourhood watch schemes sprouted up, and residents stopped and searched cars driving past their communities.
Egypt has lurched from one crisis to another since the downfall of the autocratic Hosni Mubarak in 2011, dealing repeated blows to the economy, particularly tourism.
A number of tour operators have suspended all holidays to Egypt until at least next month and the United States has urged its citizens to leave the country.
The European Union asked its states to consider "appropriate measures" to take in reaction to the violence, while Germany said it was reconsidering its ties.


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Sir Elton John staged an intervention for Donatella Versace at her daughter's 18th birthday party in 2004, according to an explosive new book due out Tuesday.
The legendary performer took action after seeing a high and paranoid Versace at one of his concerts, according to "House of Versace" by Wall Street Journal reporter Deborah Ball. He recruited the drugged-out designer's daughter, Allegra, using her party as a front.
The intervention didn't start out as planned -- Versace snorted a line of coke in the bathroom moments before the singer arrived. However, it ended well: Versace ultimately agreed to seek help and flew that night to The Meadows, a rehab center in Wickenberg, Ariz.
According to the book, Versace's drug problem grew considerably after the murder of her brother, Gianni, in 1997. At her worst, Versace snorted cocaine openly at fashion shows and parties.
The intervention wouldn't be the last time John stepped in to help a friend fight addiction. He told BBC Radio last month that he's been helping Eminem kick his drug habit over the past 18 months.


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Every other year, Carlow University sponsors the Carlow Roundtable in Ireland. This event is a dialog on teaching in Mercy mission-centered institutions and the role of Catholic Social Teaching. Although each Mercy institution has its own culture, every institution shares the same heritage. Inspired by that common Mercy heritage, we draw from our knowledge and experience to explore how our heritage and Catholic Social Teaching influences how and what we teach in these institutions of higher learning.
In March, 2012, Dr. Peter Gilmore spoke on the dynamic, ongoing impact of the mass migration of Irish on the economic, political and cultural development of the United States, where 45 million people today claim some ancestral connection to Ireland.The movement of millions from a small island nation in the North Atlantic to colonies and a new nation in North America represents a significant example of transnational migration in the modern world. This is simultaneously a dramatic and (for some) highly personal story of loss, leaving, labor, and conflicted memory; it is also a set of case studies which illuminate power relationships, the rise of empires and the development of a global economic system. Similarly, the construction of an Irish diasporic community in the United States is suggestive of the historic and ongoing formation of diasporas as a consequence of population movement.Dr. Peter Gilmore received a PhD in social and cultural history from Carnegie Mellon University in 2009, following completion of a study on Irish Presbyterians in western Pennsylvania, 1780-1830, and their attempts to recreate an ethno religious culture in the context of backcountry political transformation and market revolution.
Mr. Paul Hederman discussed the rise and fall of the Celtic Tiger, the impact on social services, and the parallels for the Pittsburgh economy at a lecture that launched the Graduate School Colloquium on April 5, 2011. Paul Hederman, an expert on economics and social policy in Ireland, received his BA in economics and sociology and his MA in economics from University College Cork. He taught courses in economics and social policies at the National College of Ireland for eight years and also served as the college's Director of Continuing and Professional Studies.In addition, Hederman has worked for various government agencies and initiatives, including the Strategic Innovation Fund, National Institute for Transport and Logistics, Irish Fisheries Board, and Irish Trade Board (now Enterprise Ireland).
Fil Campbell appeared in concert at Carlow in September 2010. She grew up in Belleek in Co. Fermanagh in the North of Ireland. She was brought up on the folk songs that we are popular in Fermanagh and Donegal and spent her childhood immersed in music.Fil returned to her roots for her most recent CD, Songbirds, which is the basis for her current touring show, the Irish Songbirds. A collection of charming Irish folk songs that formed the musical backdrop to Ireland of the 30s, 40s and 50s, Songbirds accompanies a TV show and DVD of the same name, which profiles the women singers of that period. Fil both performs and presents this documentary series which is already being seen as a valuable contribution to Irish traditional music archives.
This family-friendly performance featured Irish ballads and holiday carols, lively fiddle tunes and thrilling Irish dancing. Narration brought to life ancient customs and stories, while evocative photographic images provide a backdrop of rich historical context. A memorable glimpse into the enchanting spirit of Christmas, some of Ireland's finest traditional artists took us through a distinctively Irish journey during the holiday season of 2010.


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Soul legend Aretha Franklin has canceled her appearance at the New Orleans Jazz&Heritage Festival, but organizers and fans got lucky with a replacement.
Earth, Wind & Fire happens to be in the area and offered to play on the popular music festival's largest stage on Friday night.
Festival spokesman Louis Edwards says the "Queen of Soul" told organizers on Thursday that she wouldn't be able to perform. Edwards said she apologized to fans but wouldn't give a reason why.
But Earth, Wind & Fire were already scheduled to play Saturday in Biloxi, Miss., about 65 miles away. They played Jazz Fest last year to rave reviews.
Pearl Jam is scheduled to headline Saturday, and the setwill be broadcast live online to Louisiana National Guard soldiers serving in Iraq.


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For this week leading up to Halloween, I have a trio of spooky beverage reviews. First up is one whose name translates from the Italian as "The Beast", and the little script lower down reads Puro Sangue or "Pure Blood". Bonus points go to the classic werewolf woodcut on the label, though I can happily report that lycanthropy is not a side effect of drinking the 2005 Lachini La Bestia, a Cabernet Sauvignon from the Red Mountain AVA of Washington State. 14.9% abv, $45. And good luck finding it, because there were only 120 cases made. (This was a gift from my former boss, and thanks go out to the staff at Great Wines for picking it out.)
This is a really spectacular wine. Black currant, pepper, and cedar aromas, with a mild and smooth plum flavor and a touch of tannins on the start. One of those rich and complex wines you spend a lot of time sniffing and swirling over the course of a few hours. While I received it a few months ago, I just got around to trying it with a strip steak, asparagus in a sherry vinaigrette, and fresh pineapple. I'm anxious to try some of the other selections from Lachini, of which I've heard great things.
27 October 2008
2005 Lachini La Bestia
Labels: beef, cabernet sauvignon, washington
2 comments:
- Michael Hughes said...
I'm so glad you got to experience this wine. It is truly one of the few amazing bottles that I've had. Yes without a doubt you should try Lachini's other bottlings. While pricey, they do deliver exceptional quality. We have just a couple bottles left of the La Bestia at Joe's Wines if you ever want some more!
- 27 October, 2008 11:14
- Benito said...
Might take you up on that... I've been meaning to get out to Joe's.
I don't really do scores or top ten lists on this site, but the La Bestia would definitely be in the #1 position for wines I've tried 2008.
- 27 October, 2008 12:21
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SEASON THREE PREMIERE OF "RAISING HOPE" AVAILABLE NOW ON TWITTER @RaisingHopeFOX
RAISING HOPE is First Television Show Ever to be Made Available for Viewing on Twitter
RAISING HOPE Premieres Tuesday, October 2, on FOX
In an exclusive Twitter first, the series premiere of RAISING HOPE (@RaisingHopeFOX) is now available for viewing on the Tuesday-night comedy's Twitter page at www.twitter.com/raisinghopefox. Starring Martha Plimpton, Lucas Neff and Garret Dillahunt, RAISING HOPE is the first-ever TV series to offer a full episode on Twitter.
Now through Thursday, Sept. 27 at 11:59 P.M., fans may watch the season premiere in advance of its on-air debut by following @RaisingHopeFOX, which will tweet an exclusive link to the episode. Fans who share the commercial-free premiere with their followers on Twitter may also receive a special thank-you message from the RAISING HOPE cast. Join the discussion about the comedy's debut on Twitter by using #ShareHope.
The Season Three debut episode of RAISING HOPE is also available on FOX On Demand, FOX.com, Hulu.com and Facebook.com/RaisingHope, through Thursday, Sept. 27 at 11:59 P.M.
RAISING HOPE premieres Tuesday, Oct. 2 (8:00-8:30 PM ET/PT) on FOX.
"In the space of 140 characters on Twitter, FOX is introducing fans to some of the funniest characters on TV," said Fred Graver, Head of TV at Twitter. "FOX's innovative approach to Twitter will bring millions of fans closer to a hotly anticipated fall premiere."
"We're thrilled to partner with Twitter to offer this unprecedented and innovative advanced Twitter preview to all of our RAISING HOPE followers and fans," said Laurel Bernard, Executive Vice President, Marketing, Fox Broadcasting. "The Season Three premiere is hilarious and charming, and we know all of our fans are going to be compelled to #ShareHOPE with their followers and friends."
"Season Three is shaping up to be our best season yet, so we're excited about this opportunity for new viewers to sample the show, as well as giving a sneak peek to our loyal fans who know how to use Twitter," said Greg Garcia, executive producer and creator of RAISING HOPE. "My father, however, will have to wait to see the premiere episode on regular TV on Oct. 2, but that's what he gets for being old."
In the season premiere episode, "Not Indecent, But Not Quite Decent Enough Proposal," SABRINA (Shannon Woodward; @shannonwoodward) introduces the Chance family to her mother, TAMARA (guest star Melanie Griffith; @MelanieGriffith), at the funeral of her grandmother, NANA (guest star Tippi Hedren). Nana's last will and testament, revealed in a video she recorded before she died, has a big impact on JIMMY (Lucas Neff; @reallucasneff) and Sabrina's relationship that leaves Jimmy on bended knee. Upcoming guest stars include Chris Klein (@iamchrisklein), Wilmer Valderrama (@WValderamma), Jenny Slate (@jennyslate25), Leslie Jordan (@lesliejordan) and David Ury (@DavidUry).
RAISING HOPE is produced by Amigos de Garcia Productions in association with 20th Century Fox Television. Garcia serves as executive producer on the series.


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In the 1680s antiquarian John Aubrey was the first Englishman to mention the observance of April Fool's Day. He stated that it was celebrated all over Germany, but folklorists assume that the holiday was imported from France, where seems to have been well-established by the 1650s. They also speculate that this mock-holiday arose to fill the gap as the tradition of sanctioning all kinds of misrule during the Christmas holiday season waned (think the cruel jokes perpetrated on Shakespeare's Malvolio during Twelfth Night). In comparison, April Fool's was a more civilized occasion for mischief-making, being confined to one day and the only kind of horseplay authorized was to trick others into making public spectacles of themselves.
In the eighteenth-century England, perpetrating hoaxes upon the unwary was ubiquitous on April 1, if we can believe contemporary writers. Age and class came into play because children were allowed to try and deceive adults and members of a higher class could impose on someone of a lower class. Making an April fool of someone was not below the likes of Jonathan Swift, who in 1713 sat up late with some friends cooking up a prank. Convincing someone to go on a wild goose chase (or sleeveless errand as it was also called) for things that didn't exist, like pigeon's milk or the biography of Eve's mother, was a favorite ploy.
The first description of an April Fool's sleeveless errand was described in a notice in the April 2nd 1698 issue of Dawk's News-Letter: "Several persons were sent to the Tower Ditch [i.e. the Tower of London's moat] to see the Lions washed." One of the city's great tourist destinations, visitors since the reign of Elizabeth I went the royal menagerie to gawk at caged lions, tigers, bears, elephants, etc. The lions were kept in the barbican called the Bulwark, which was renamed the Lion Tower. The fast-talking trickster would convince his gullible victim that every year on April 1 the lions were taken down to the moat for a bath. All someone had to do to enjoy the spectacle was enter by the White Gate. Of course, there was no such gate or any wet lions… In the nineteenth century, the merry sometimes distributed fake admission tickets.
In honor of the day, here are two accounts of washing the lions from two eighteenth-century children's books, which may be unknown in the literature on the holiday. (They are reproduced from the British Library copies on Eighteenth-Century Collections On-Line but Cotsen has copies of both.) The first account comes from the last chapter of Travels of Tom Thumb Over England and Wales (1746), where the intrepid little narrator confesses to being taken in by the story of the lions' public grooming. He also mentions that the most common visitors to the Tower lions are pregnant women, who want to know the sex of their babies!
The second, longer description of washing the Tower lions comes from chapter 8 of Richard Johnson's The Picture Exhibition (1783). The narrator is a school boy, telling about a picture he drew of an April Fool's prank in progress. He clearly disapproves of the incident and there is something unpleasant about the watermen's gratuitous cruelty towards the poor country bumpkin. While the tone of the narrator's lecture about appropriate behaviour is too prosy for modern tastes, he was expressing quite enlightened views at a time when blood sports were tolerated and jokes based on highly offensive gender and class stereotypes perfectly acceptable.
P.S. Princeton has a pride of lions to wash, if anyone on campus wants to revive the tradition…


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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.
National surveys consistently support the idea that religion and spirituality are important to most individuals in the general population. More than 90% of adults express a belief in God, and slightly more than 70% of individuals surveyed identified religion as one of the most important influences in their lives.[1] Yet even widely held beliefs, such as survival of the soul after death or a belief in miracles, vary substantially by gender, education, and ethnicity.[2]
Research indicates that both patients and family caregivers [3,4] commonly rely on spirituality and religion to help them deal with serious physical illnesses, expressing a desire to have specific spiritual and religious needs and concerns acknowledged or addressed by medical staff; these needs, although widespread, may take different forms between and within cultural and religious traditions.[5,6,7]
A survey of hospital inpatients found that 77% of patients reported that physicians should take patients' spiritual needs into consideration, and 37% wanted physicians to address religious beliefs more frequently.[8] A large survey of cancer outpatients in New York City found that a slight majority felt it was appropriate for a physician to inquire about their religious beliefs and spiritual needs, although only 1% reported that this had occurred. Those who reported that spiritual needs were not being met gave lower ratings to quality of care (P < .01) and reported lower satisfaction with care (P < .01).[7] A pilot study of 14 African American men with a history of prostate cancer found that most had discussed spirituality and religious beliefs with their physicians; they expressed a desire for their doctors and clergy to be in contact with each other.[9]
Sixty-one percent of 57 inpatients with advanced cancer receiving end-of-life care in a hospital supported by the Catholic archdiocese reported spiritual distress when interviewed by hospital chaplains. Intensity of spiritual distress correlated with self-reports of depression but not with physical pain or with perceived severity of illness.[10] Another study [11] of advanced cancer patients (N = 230) in New England and Texas assessed their spiritual needs. Almost half (47%) reported that their spiritual needs were not being met by a religious community, and 72% reported that these needs were not supported by the medical system. When such support existed, it was positively related to improved quality of life. Furthermore, having spiritual issues addressed by the medical care team had more impact on increasing the use of hospice and decreasing aggressive end-of-life measures than did pastoral counseling.[12]
This summary will review the following topics:
Paying attention to the religious or spiritual beliefs of seriously ill patients has a long tradition within inpatient medical environments. Addressing such issues has been viewed as the domain of hospital chaplains or a patient's own religious leader. In this context, systematic assessment has usually been limited to identifying a patient's religious preference; responsibility for management of apparent spiritual distress has been focused on referring patients to the chaplain service.[13,14,15] Although health care providers may address such concerns themselves, they are generally very ambivalent about doing so,[16] and there has been relatively little systematic investigation addressing the physician's role. These issues, however, are being increasingly addressed in medical training.[17] Acknowledging the role of all health care professionals in spirituality, a multidisciplinary group from one cancer center developed a four-stage model that allows health care professionals to deliver spiritual care consistent with their knowledge, skills, and actions at one of four skill levels.[18]
Interest in and recognition of the function of religious and spiritual coping in adjustment to serious illness, including cancer, has been growing.[19,20,21,22,23] New ways to assess and address religious and spiritual concerns as part of overall quality of life are being developed and tested. Limited data support the possibility that spiritual coping is one of the most powerful means by which patients draw on their own resources to deal with a serious illness such as cancer; however, patients and their family-member caregivers may be reluctant to raise religious and spiritual concerns with their professional health care providers.[24,25,26] Increased spiritual well-being in a seriously ill population may be linked with lower anxiety about death,[27] but greater religious involvement may also be linked to an increased likelihood of desire for extreme measures at the end of life.[28] Given the importance of religion and spirituality to patients, integrating systematic assessment of such needs into medical care, including outpatient care, is crucial. The development of better assessment tools will make it easier to discern which aspects of religious and spiritual coping may be important in a particular patient's adjustment to illness.
Of equal importance is the consideration of how and when to address religion and spirituality with patients and the best ways to do so in different medical environments.[29,30,31] Although addressing spiritual concerns is often considered an end-of-life issue, such concerns may arise at any time after diagnosis.[24] Acknowledging the importance of these concerns and addressing them, even briefly, at diagnosis may facilitate better adjustment throughout the course of treatment and create a context for richer dialogue later in the illness. One study of 118 patients seen in follow-up by one of four oncologists suggests that a semistructured inquiry into spiritual concerns related to coping with cancer is well accepted by patients and oncologists and is associated with positive perceptions of care and well-being.[32]
In this summary, unless otherwise stated, evidence and practice issues as they relate to adults are discussed. The evidence and application to practice related to children may differ significantly from information related to adults. When specific information about the care of children is available, it is summarized under its own heading.
Specific religious beliefs and practices should be distinguished from the idea of a universal capacity for spiritual and religious experiences. Although this distinction may not be salient or important on a personal basis, it is important conceptually for understanding various aspects of evaluation and the role of different beliefs, practices, and experiences in coping with cancer.
The most useful general distinction to make in this context is between religion and spirituality. There is no general agreement on definitions of either term, but there is general agreement on the usefulness of this distinction. A number of reviews address matters of definition.[1,2,3] Religion can be viewed as a specific set of beliefs and practices associated with a recognized religion or denomination. Spirituality is generally recognized as encompassing experiential aspects, whether related to engaging in religious practices or to acknowledging a general sense of peace and connectedness. The concept of spirituality is found in all cultures and is often considered to encompass a search for ultimate meaning through religion or other paths.[4] Within health care, concerns about spiritual or religious well-being have sometimes been viewed as an aspect of complementary and alternative medicine (CAM), but this perception may be more characteristic of providers than of patients. In one study,[5] virtually no patients but about 20% of providers said that CAM services were sought to assist with spiritual or religious issues. Religion is highly culturally determined; spirituality is considered a universal human capacity, usually—but not necessarily—associated with and expressed in religious practice. Most individuals consider themselves both spiritual and religious; some may consider themselves religious but not spiritual. Others, including some atheists (people who do not believe in the existence of God) or agnostics (people who believe that God cannot be shown to exist), may consider themselves spiritual but not religious. In a sample of 369 representative cancer outpatients in New York City (33% minority), while only 6% identified themselves as agnostic or atheist, only 29% attended religious services weekly; 66% represented themselves as spiritual but not religious.[6]
One effort to characterize individuals by types of spiritual and religious experience [7] identified the following three groups, using cluster analytic techniques:
Individuals in the third group were far more distressed about their illness and were experiencing worse adjustment. There is as yet no consensus on the number or types of underlying dimensions of spirituality or religious engagement.
From the prospective of both the research and clinical literature on the relationships between religion, spirituality, and health, it is important to consider how these concepts are defined and used by investigators and authors. Much of the epidemiological literature that has indicated a relationship between religion and health has been based on definitions of religious involvement such as membership in a religious group or frequency of church attendance. Somewhat more complex is assessing specific beliefs or religious practices such as belief in God, frequency of prayer, or reading religious material. Individuals may engage in such practices or believe in God without necessarily attending church services. Terminology also carries certain connotations; the term religiosity, for example, has a history of implying fervor and perhaps undue investment in particular religious practices or beliefs. Religiousness may be a more neutral way to refer to the dimension of religious practice.
Spirituality and spiritual well-being are more challenging to define. Some definitions limit spirituality to mean profound mystical experiences; however, in considerations of effects on health and psychological well-being, the more helpful definitions focus on accessible feelings, such as a sense of inner peace, existential meaning, and purpose in life, or awe when walking in nature. For the purposes of this discussion, it is assumed that there is a continuum of meaningful spiritual experiences, from the common and accessible to the extraordinary and transformative. Both type and intensity of experience may vary. Other aspects of spirituality that have been identified by those working with medical patients include a sense of meaning and peace, a sense of faith, and a sense of connectedness to others or to God. Low levels of these experiences may be associated with poorer coping (refer to the Relation of Religion and Spirituality to Adjustment, Quality of Life, and Health Indices section).[3]
The definition of acute spiritual distress must be considered separately. Spiritual distress may result from the belief that cancer reflects punishment by God or may accompany a preoccupation with the question "Why me?" A cancer patient may also suffer a loss of faith.[8] Although many individuals may have such thoughts at some time following diagnosis, only a few individuals become obsessed with these thoughts or score high on a general measure of religious and spiritual distress (such as the Negative subscale of the Religious Coping Scale [the R-Cope–Negative]).[8] High levels of spiritual distress may contribute to poorer health and psychosocial outcomes.[9,10] The tools for measuring these dimensions are described in the Screening and Assessment of Spiritual Concerns section.
Religion and spirituality have been shown to be significantly associated with measures of adjustment and with the management of symptoms in cancer patients. Religious and spiritual coping have been associated with lower levels of patient discomfort as well as reduced hostility, anxiety, and social isolation in cancer patients [1,2,3,4] and in family caregivers.[5] Specific characteristics of strong religious beliefs, including hope, optimism, freedom from regret, and life satisfaction, have also been associated with improved adjustment in individuals diagnosed with cancer.[6,7]
Type of religious coping may influence quality of life. In a multi-institutional cross-sectional study of 170 patients with advanced cancer, more use of positive religious coping methods (such as benevolent religious appraisals) was associated with better overall quality of life and higher scores on the existential and support domains of the McGill Quality of Life Questionnaire. In contrast, more use of negative religious coping methods (such as anger at God) was related to poorer overall quality of life and lower scores on the existential and psychological domains.[8,9] A study of 95 cancer patients diagnosed within the past 5 years found that spirituality was associated with less distress and better quality of life regardless of perceived life threat, with existential well-being but not religious well-being as the major contributor.[10]
Spiritual well-being, particularly a sense of meaning and peace,[11] is significantly associated with an ability of cancer patients to continue to enjoy life despite high levels of pain or fatigue. Spiritual well-being and depression are inversely related.[12,13] Higher levels of a sense of inner meaning and peace have also been associated with lower levels of depression, whereas measures of religiousness were unrelated to depression.[14]
This relationship has been specifically demonstrated in the cancer setting. In a cross-sectional survey of 85 hospice patients with cancer, there was a negative correlation between anxiety and depression (as measured by the Hospital Anxiety and Depression Scale) and overall spiritual well-being (as measured by the Spiritual Well-Being Scale) (P < .0001). There was also a negative correlation between the existential well-being scores and the anxiety and depression scores but not with the religious well-being score (P < .001).[15] These patterns were also found in a large study of indigent prostate cancer survivors; the patterns were consistent across ethnicity and metastatic status.[16]
In a large (N = 418) study of breast cancer patients, a higher level of meaning and peace was associated with a decline in depression over 12 months, whereas higher religiousness predicted an increase in depression, particularly if meaning/peace was lower.[17][Level of evidence: II] A second study with mixed gender/mixed cancer survivors (N = 165) found similar patterns. In both studies, high levels of religiousness were linked to increases in perceived cancer-related growth.[17][Level of evidence: II] In a convenience sample, 222 low-income men with prostate cancer were surveyed about spirituality and health-related quality of life. Low scores in spirituality, as measured by the peace/meaning and faith subscale of the Functional Assessment of Chronic Illness Therapy—Spiritual Well-Being (FACIT-Sp), were associated with significantly worse physical and mental health than were high scores in spirituality.[18]
A large national survey of 361 paired U.S. survivors and caregivers (caregivers included spouses and adult children) found that for both survivors and caregivers, the peace factor of the FACIT-Sp was strongly related to mental health but negligibly or not at all related to physical well-being. The faith factor ("religiousness") was unrelated to physical or mental well-being. Fifty-two percent of the survivors in this survey were women.[19] These findings support the value of the FACIT-Sp in separating people's religious involvement from their sense of spiritual well-being and that it is this sense of spiritual well-being that seems to be most related to psychological adjustment.
Another large national survey study of female family caregivers (N = 252; 89% white) identified that higher levels of spirituality, as measured by the FACIT-Sp, were associated with much less psychological distress (measured by the Pearlin Stress Scale). Participants with higher levels of spirituality actually had improved well-being even as caregiving stress increased, while those with lower levels of spirituality showed the opposite pattern, suggesting a strong stress-buffering effect of spiritual well-being. This finding reinforces the need to identify low spiritual well-being when assessing the coping capacity of family caregivers as well as patients.[5]
One author [20] found that cancer survivors who had drawn on spiritual resources reported substantial personal growth as a function of dealing with the trauma of cancer. This was also found in a survey study of 100 well-educated, mostly married/partnered white women with early-stage breast cancer, recruited for the study from an Internet Web site, in which increasing levels of spiritual struggle were related to poorer emotional adjustment, though not to other aspects of cancer-related quality of life.[21] Using path analytic techniques, a study of women with breast cancer found that at both prediagnosis and 6 months postsurgery, holding negative images of God was the strongest predictor of emotional distress and lower social well-being.[22] However, longitudinal analyses failed to find sustained effects for baseline positive or negative attitudes toward God at either 6 or 12 months. One possible explanation for these findings is that such attitudes are somewhat unstable during a period of uncertainty (e.g., at prediagnosis).[22]
Engaging in prayer is often cited as an adaptive tool,[23] but qualitative research [24] found that for about one third of cancer patients interviewed, concerns about how to pray effectively or the questions raised about the effectiveness of prayer also caused inner conflict and mild distress. A useful discussion of how prayer is used by cancer patients and how clinicians might conceptualize prayer has been published.[25]
Ethnicity and spirituality were investigated in a qualitative study of 161 breast cancer survivors. In individual interviews, most participants (83%) spoke about some aspect of their spirituality. Seven themes were identified: "God as a Comforting Presence," "Questioning Faith," "Anger at God," "Spiritual Transformation of Self and Attitude Towards Others/Recognition of Own Mortality," "Deepening of Faith," "Acceptance," and "Prayer by Self." A higher percentage of African Americans, Latinas, and persons identified as Christians were more likely to feel comforted by God than were other groups.[26]
Positive religious involvement and spirituality appear to be associated with better health and longer life expectancy, even after controlling for other variables such as health behaviors and social support, as shown in one meta-analysis.[27] Although little of this research is specific to cancer patients, one study of 230 patients with advanced cancer (expected prognosis <1 year) investigated a variety of associations between religiousness and spiritual support.[28] Most study participants (88%) considered religion either very important (68%) or somewhat important (20%); more African Americans and Hispanics than whites reported religion to be very important. Spiritual support by religious communities or the medical system was associated with better patient quality of life. Age was not associated with religiousness. At the time of recruitment to participate in the study, increasing self-reported distress was associated with increasing religiousness, and private religious or spiritual activities were performed by a larger percentage of patients after their diagnosis (61%) than before (47%). Regarding spiritual support, 38% reported that their spiritual needs were supported by a religious community "to a large extent or completely," while 47% reported receiving support from a religious community "to a small extent or not at all." Finally, religiousness was also associated with the end-of-life treatment preference of "wanting all measures taken to extend life." Another study [29] found that helper and cytotoxic T-cell counts were higher among women with metastatic breast cancer who reported greater importance of spirituality. Other investigators [30] found that attendance at religious services was associated with better immune system functioning. Other research [31,32] suggests that religious distress negatively affects health status. These associations, however, have been criticized as weak and inconsistent.[33]
Several randomized trials with cancer patients have suggested that group support interventions benefit survival.[34,35] These studies must be interpreted cautiously, however. First, the treatments focused on general psychotherapeutic issues and psychosocial support. Although spiritually relevant issues undoubtedly arose in these settings, they were not the focus of the groups. Second, there has been difficulty replicating these effects.[36]
Raising spiritual concerns with patients can be accomplished by the following approaches:[1,2]
These approaches have different potential value and limitations. Patients may express reluctance to bring up spiritual issues, noting that they would prefer to wait for the provider to broach the subject. Standardized assessment tools vary, have generally been designed for research purposes, and need to be reviewed and utilized appropriately by the provider. Physicians, unless trained specifically to address such issues, may feel uncomfortable raising spiritual concerns with patients.[3] However, an increasing number of models are becoming available for physician use and training.[4]
Numerous assessment tools are pertinent to performing a religious and spiritual assessment. Table 1 summarizes a selection of assessment tools. Several factors should be considered before choosing an assessment tool:
The line between assessment and intervention is blurred, and simply inquiring about an area such as religious or spiritual coping may be experienced by the patient as an opening for further exploration and validation of the importance of this experience. Evidence suggests that such an inquiry will be experienced as intrusive and distressing by only a very small proportion of patients. Key assessment approaches are briefly reviewed below; pertinent characteristics are summarized in Table 1.
Standardized Assessment Measures
One of several paper-and-pencil measures can be given to patients to assess religious and spiritual needs. These measures have the advantage of being self-administered; however, they were mostly designed as research tools, and their role for clinical assessment purposes is not as well understood. These measures may be helpful in opening up the area for exploration and for ascertaining basic levels of religious engagement or spiritual well-being (or spiritual distress). Most also assume a belief in God and therefore may seem inappropriate for an atheist or agnostic patient, who may still be spiritually oriented. All of the measures have undergone varying degrees of psychometric development, and most are being used in investigations of the relationship between religion or spirituality, health indices, and adjustment to illness.
The questions are worded well and may provide a good initiation for further discussion and exploration.
Interviewing Tools
The following are semistructured interviewing tools designed to facilitate an exploration, by the physician or other health care provider, of religious beliefs and spiritual experiences or issues. The tools take the spiritual history approach and have the advantage of engaging the patient in dialogue, identifying possible areas of concern, and indicating the need for provision of further resources such as referral to a chaplain or support group. These approaches, however, have not been systematically investigated as empirical measures or indices of religiousness or of spiritual well-being or distress.
Various modes of intervention or assistance might be considered to address the spiritual concerns of patients. These include the following:
Two survey studies [1,2] found that physicians consistently underestimate the degree to which patients want spiritual concerns addressed. An Israeli study found that patients expressed the desire that 18% of a hypothetical 10-minute visit be spent addressing such concerns, while their providers estimated that 12% of the time should be spent in this way.[2] This study also found that while providers perceived that a patient's desire for addressing spiritual concerns related to a broader interest in complementary and alternative medicine (CAM) modalities, patients viewed CAM-related issues and spiritual/religious concerns as quite separate.
A task force [3] of physicians and end-of-life specialists suggested several guidelines for physicians who wish to respond to patients' spiritual concerns:
Inquiring about religious or spiritual concerns by physicians or other health care professionals may provide valuable and appreciated support to patients. Most cancer patients appear to welcome a dialogue about such concerns, regardless of diagnosis or prognosis. In a large survey of cancer outpatients, between 20% and 35% expressed a desire for religious and spiritual resources, help with talking about finding meaning in life, help with finding hope, talking about death and dying, and finding peace of mind.[4][Level of evidence: II] It is appropriate to initiate such an inquiry once initial diagnosis and treatment issues have been discussed and considered by the patient (approximately a month after diagnosis or later). In a large, multisite, longitudinal study of patients with advanced cancer,[5][Level of evidence: II] there was considerable variation in whether spiritual concerns were addressed by medical staff, with about 50% reporting at least some support at three of the settings, in contrast to fewer than 15% reporting some support at the other four settings. Support received from the medical team predicted greater quality of life, greater likelihood of receiving hospice care at the end of life, and for patients who have high levels of religious coping, less aggressive care.
One trial,[6][Level of evidence: II] with a sample of 115 mixed-diagnosis patients (54% under active treatment), evaluated a 5-minute semistructured inquiry into spiritual and religious concerns. The four physicians' personal religious backgrounds included two Christians, one Hindu, and one Sikh; 81% of patients were Christian. Unlike the history-oriented interviews noted above, this inquiry was informed by brief patient-centered counseling approaches that view the physician as an important source of empowerment to help patients identify and address personal concerns (see Table 2 below for the content). After 3 weeks, the intervention group had larger reductions in depression, had more improvement in quality of life, and rated their relationship with the physician more favorably. Effects for quality of life remained after statistically adjusting for change in other variables. More improvement was also seen in patients who scored lower in spiritual well-being, as measured by the Functional Assessment of Chronic Illness Therapy—Spiritual Well-Being (FACIT-Sp) at baseline. Acceptability was high, with physicians rating themselves as "comfortable" in providing the intervention during 85% of encounters. Seventy-six percent of patients characterized the inquiry as "somewhat" to "very" useful. Physicians were twice as likely to underestimate the usefulness of the inquiry to patients rather than to overestimate it, in relation to the patient ratings.
The statements in Table 2 may be used to initiate a dialogue between health care provider and patient.
A common concern is whether to offer to pray with patients. Although one study [7] found that more than one-half of the patients surveyed expressed a desire to have physicians pray with them, a large proportion does not express this preference. A qualitative study of cancer patients [8] found that patients were concerned that physicians are too busy, not interested, or even prohibited from discussing religion. At the same time, they generally wanted their physician to acknowledge the value of spiritual and religious issues. A suggestion was made that physicians might raise the question of prayer by asking, "Would that comfort you?" The most important guideline is to remain sensitive to the patient's preference; therefore, asking patients about their beliefs or spiritual concerns in the context of exploring how they are coping in general is a viable approach in exploring these issues.
Hospital Chaplains
Traditional means of providing assistance to patients has generally been through the services of hospital chaplains.[9,10] Hospital chaplains can play a key role in addressing spiritual and religious issues; chaplains are trained to work with a wide range of issues as they arise for medical patients and to be sensitive to the diverse beliefs and concerns that patients may have.[11] Chaplains are generally available in large medical centers, but they may not be available in smaller hospitals on a reliable basis. Chaplains are rarely available in the outpatient settings where most care is now delivered (especially early in the course of cancer treatment, when these issues may first arise). In a large, multisite, longitudinal study of patients with advanced cancer,[5][Level of evidence: II] only 46% of patients reported receiving pastoral care visits. While these visits were not associated with receipt of end-of-life care (either hospice or aggressive measures), they were associated with better quality of life near death.
Another traditional approach in outpatient settings is having spiritual/religious resources available in waiting rooms. This is relatively easy to do, and many such resources exist; however, a breadth of resources covering all faith backgrounds of patients is highly desirable (refer to the Additional Resources section).
Support Groups
Support groups may provide a setting in which patients may explore spiritual concerns. If spiritual concerns are important to a patient, the health care provider may need to identify whether a locally available group addresses these issues. The published data on the specific effects of support groups on assisting with spiritual concerns is relatively sparse, partly because this aspect of adjustment has not been systematically evaluated. A randomized trial [12][Level of evidence: I] compared the effects of a mind-body-spirit group to a standard group support program for women with breast cancer. Both groups showed improvement in spiritual well-being, although there were appreciably more differential effects for the mind-body-spirit group in the area of spiritual integration.
A study of 97 lower-income women with breast cancer who were participating in an online support group examined the relationship between a variety of psychosocial outcomes and religious expression (as indicated by the use of religious words such as faith, God, pray, holy, or spirit). Results showed that women who communicated a deeper religiousness in their online writing to others were found to have lower levels of negative emotions, higher levels of perceived health self-efficacy, and higher functional well-being.[13] An exploratory study of a monthly spirituality-based support group program for African American women with breast cancer suggested high levels of satisfaction in a sample that already had high levels of engagement in the religious and spiritual aspects of their lives.[14][Level of evidence: III]
One author [15] presents a well-developed model of adjuvant psychological therapy that uses a large group format and addresses both basic coping issues and spiritual concerns and healing, using a combination of group exploration, meditation, prayer, and other spiritually oriented exercises. In a carefully conducted longitudinal qualitative study of 22 patients enrolled in this type of intervention,[16] researchers found that patients who were more psychologically engaged with the issues presented were more likely to survive longer. Other approaches are available but have yet to be systematically evaluated,[17,18] have not explicitly addressed religious and spiritual issues, or have failed to evaluate the effects of the intervention on spiritual well-being.[19]
Other therapies may also support spiritual growth and post-traumatic benefit finding. For example, in a nonrandomized comparison of mindfulness-based stress reduction (n = 60) and a healing arts program (n = 44) in cancer outpatients with a variety of diagnoses, both programs significantly improved facilitation of positive growth in participants, although improvement in spirituality, stress, depression, and anger was significantly larger for the mindfulness-based stress reduction group.[20][Level of evidence: II]
Spirituality, religion, death, and dying may be experienced by many providers as a taboo subject. The meaning of illness and the possibility of death are often difficult to address. The assessment resources noted above may be of value in introducing the topic of spiritual concerns, death, and dying to a patient in a supportive manner. In addition, reading clinical accounts by other health care providers can be very helpful. One such example is a qualitative study utilizing an autoethnographic approach to explore spirituality in members of an interdisciplinary palliative care team. Findings from this work yielded a collective spirituality that emerged from the common goals, values, and belonging shared by team members. Reflections of the participants offer insights into patient care for other health care professionals.[1]
Although a considerable number of anecdotal accounts suggest that prayer, meditation, imagery, or other religious activity can have healing power, the empirical evidence is extremely limited and by no means consistent.[1] On the basis of current evidence, it is questionable whether any patient with cancer should be encouraged to seek such resources as a means to healing or to limiting the physical effects of disease. However, the psychological value of support and spiritual well-being is increasingly well documented, and evidence that spiritual distress can have a negative impact on health is growing. Therefore, in exploring these issues with patients or encouraging the use of such resources, health care providers need to frame these resources in terms of self-understanding, clarifying questions of beliefs with an appropriate spiritual or religious leader, or seeking a sense of inner peace or awareness.
Web sites:
These reference citations are included for informational purposes only. Their inclusion should not be viewed as an endorsement of the content of the Web sites by the PDQ Cancer Supportive Care Editorial Board or the National Cancer Institute.
Check NCI's list of cancer clinical trials for U.S. supportive and palliative care trials about spiritual concerns and spiritual therapy that are now accepting participants. The list of trials can be further narrowed by location, drug, intervention, and other criteria.
General information about clinical trials is also available from the NCI Web site.
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.
Relation of Religion and Spirituality to Adjustment, Quality of Life, and Health Indices
Added text about relationships between spiritual well-being and quality of life among paired survivors and caregivers (cited Kim et al. as reference 19).
Screening and Assessment of Spiritual Concerns
Added Borneman et al. as reference 20.
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Purpose of This Summary
This PDQ cancer information summary for health professionals provides comprehensive, peer-reviewed, evidence-based information about religious and spiritual coping in cancer care. It is intended as a resource to inform and assist clinicians who care for cancer patients. It does not provide formal guidelines or recommendations for making health care decisions.
Reviewers and Updates
This summary is reviewed regularly and updated as necessary by the PDQ Supportive and Palliative Care Editorial Board, which is editorially independent of the National Cancer Institute (NCI). The summary reflects an independent review of the literature and does not represent a policy statement of NCI or the National Institutes of Health (NIH).
Board members review recently published articles each month to determine whether an article should:
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Levels of Evidence
Some of the reference citations in this summary are accompanied by a level-of-evidence designation. These designations are intended to help readers assess the strength of the evidence supporting the use of specific interventions or approaches. The PDQ Supportive and Palliative Care Editorial Board uses a formal evidence ranking system in developing its level-of-evidence designations.
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National Cancer Institute: PDQ® Spirituality in Cancer Care. Bethesda, MD: National Cancer Institute. Date last modified <MM/DD/YYYY>. Available at: http://cancer.gov/cancertopics/pdq/supportivecare/spirituality/HealthProfessional. Accessed <MM/DD/YYYY>.
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Wendy Davis Has a Problem With the Truth
Perhaps the slogan of the Wendy Davis campaign should be that behind every successful woman is a good man.
It turns out that the Texas gubernatorial candidate has been telling a version of her life story that glosses over key facts, an article by Wayne Slater in the Dallas Morning News reveals—especially the contribution to her success made by her second husband, Jeff Davis.
Story Continued Below
Wendy Davis, of course, needs no introduction. Her filibuster of a bill to ban abortion in Texas after 20 weeks—a measure that would be uncontroversial even in Belgium or France—made her an instant star for progressives and much of the media. For them, few things are as stirring as a lonely, principled stand in favor of near-infanticide.
Her personal story was also catnip for TV producers and profile writers, who were thrilled by the trajectory of the former teen mom who lived in a mobile home and eventually earned a law degree at Harvard on the way to becoming the nation's foremost defender of late-term abortion. It's as if the protagonist of a Horatio Alger novel pulled himself up by his bootstraps and onto the board of Planned Parenthood. What's not to like?
Given her enormous wave of positive free media, its remarkable that Wendy Davis still felt the need to gild the lily, but so she did.
"By 19," her website said, "Wendy was a single mother." Actually, as Slater reported, she didn't get divorced from her first husband until age 21. She lived in a mobile home alone for a few months after the two separated, before moving back in with her mom and then into her own apartment.
According to her website, she got through school "with the help of academic scholarships and student loans." This is true, but elides the fact that after she married Jeff Davis, a successful lawyer 13 years her senior, he paid for her last two years at Texas Christian University and cashed in his 401(k) and took out a loan to put her through Harvard.
The marriage eventually hit the rocks. She and Jeff split in 2003. He tells Slater, "It was ironic. I made the last payment, and it was the next day she left." When they divorced, Jeff Davis was awarded parental custody of the kids, rare in Texas, because by his account Wendy thought, "While I've been a good mother, it's not a good time for me right now."
None of this need necessarily be damning—Davis still worked hard to make the most of herself; even the best marriages are complicated; and in any case, it's not unusual for ambitious politicians to take advantage of supportive spouses — but it wasn't the story Davis told about herself.
In part, she exaggerated simply to make her story more dramatic and telegenic. In a profile just last week, the Today Show accompanied her back to the mobile home as if it were taking Abraham Lincoln back to the log cabin where he was raised in Spencer County, Ind. Of course, there was no visit to, let alone mention of the "historic home in the Mistletoe Heights neighborhood of Fort Worth" (in the words of the Dallas Morning News), where she was living with Jeff Davis by age 24.


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More than 70% of current and prospective buyers see you as a necessary evil. Some, such as those in HR and procurement, use stronger language, calling recruiters "scum sucking pig dogs" or admitting they engage staffing firms only for "problematic use" (yes, these are real quotes from buyers).
How is it that an industry that impacts the most important asset of companies, their people, and one of the most important aspects of people's lives, their jobs and careers, isn't held in higher regard? Given this impact, why aren't staffing and recruiting professionals viewed as the heroes they really, on par with other heroic professions like firefighters, astronauts, and police officers?
The why doesn't matter.
While the problem always defines the solution, pondering the issue, in this case, only keeps the industry stuck where it is. Gaining or increasing respect requires action, not further analysis or pontification.
The problem is clear—the true value of staffing isn't being fully understood, appreciated, and acknowledged by the entire public.
For those reading this who have been awarded industry honors, such as the Best of Staffing, you may think this doesn't apply to you. While it's possible that's true in regards to your raving fans who give you high marks, what about those who aren't buying at all or as often as they could? Why are so many of the Best of Staffing winners facing similar struggles as everyone else when it comes to opening doors, hearts, and minds? If the best of the best are that good at what they do, why is it that more than 95% of companies buy staffing at some point in time over a decade yet only 25% do so each year?
If you want something different, you must do something different. Even if you want what you've got you still must change and adapt in relation to how the market is evolving. One surefire way to go from great to good or good to fair is to keep doing things the way they've always been done.
To do something different and be seen by more people as the ally you are, here are four steps:
Whether the staffing and recruiting industry remains a necessary evil or becomes more of a trusted ally is up to those of us in the industry. I hope you'll join me in making this happen, whether that's as a client, or on your own as a colleague on the same mission. Together, we can contribute to a dramatic shift in perception that is long overdue.
Views: 235
Great line " Do great work, then make the work greater" - thank you Scott.
@Scott: IMHO, clients can be valuable allies and good "friends" when
Clients need work that can be done best or only by skilled, professional, experienced 3PRs who are worth paying 30% fees for, and when clients feel comfortable paying that. When these conditions AREN'T met (clients want quality on the cheap, or recruiters are trying to get 20% fees for selling board-scraped candidates presented by newbies to clients too ignorant to know there're'much more cost-effective alternatives) ,then they can't be "friends""
You didn't finish the phrase:
"More than 70% of current and prospective buyers see you as a necessary evil...and the remaining nearly 30% don't regard you as necessary, just evil."


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How to Upload Your Website with Dreamweaver
Dreamweaver features a sophisticated set of commands that enable you to connect to a web server and upload files to that server — in Dreamweaver-speak, "put the files on the server" — or download files from the server — "get the files from the server." To upload pages using Dreamweaver, follow these steps:
1If the Files panel isn't visible, choose Window→Files to open the Files panel. Alternatively, press F8.
The Files panel shows the local files associated with the site on which you're working. For your convenience and ease of viewing, The figure shows the panel undocked.
2Click the Connects to Remote Host button.
Dreamweaver connects to the remote server using the credentials you supplied when you set up the site.
3Click the Expand/Collapse button.
Dreamweaver increases the size of the panel and splits the panel into two panes. The pane on the left shows the files on the remote server, and the pane on the right shows the files on the local machine.
4Select the files you want to upload to the server from the Local Files window.
If you're uploading edited pages on which you haven't changed any associated files, you don't need to select files (such as images) that are associated with the files you're uploading unless they've changed.
5Click the Put Files button.
Dreamweaver opens the Dependent Files dialog box, from which you can upload files associated with the page, such as images and so on.
6Click Yes.
Dreamweaver uploads the selected files, along with all files associated with the selected file.
Alternatively, click No if you know that the files associated with the file you're uploading have not been changed, and no new files have been linked to the file.
You can also upload a page you're editing by clicking the File Management icon (looks like two arrows, one pointing up and one pointing down) and then clicking Put. Alternatively, you can press Ctrl+Shift+U (Windows) or Apple+Shift+U (Mac).