text:
JAZZ table. 28 tablets
€ 21.00
Tablet-taking has to start on Day I-st of the natural menstrual cycle of women (ie the first day of her menstrual bleeding).
JAZZ table. 28 tablets
24 light pink tablets
Each tablet contains 0,020 mg ethinylestradiol [ethinilestradiol) (as betadeksov clathrate) (betadex clathrate) and 3 mg drospirenone (drospirenone).
Excipient: lactose 46 mg.
4 white coated placebo tablets: tablet contains no active substances.
Excipient: lactose 50 mg.
For a full list of excipients, see section 6.1.
/ Yaz tabl. film 0,02 mg / 3 mg - 1 x 28, 3 x 28, 6 x 28 /
Active tablet is a pale pink, round with convex faces, one side embossed with the letters "DS" in a regular hexagon.
Placebo tablet is white, round with convex faces, one side embossed with the letters "DP" in a regular hexagon.
Therapeutic indications
Oral contraception.
Posology and method of administration
Route of administration: Oral.
How to take JAZZ?
The tablets should be taken every day at the same time, if necessary with a little liquid under specified on the blister. Taking the tablets consistent. Take one tablet daily for 28 consecutive days. Each subsequent pack is started the day after taking the last tablet from the front pack. Bleeding stopped taking the active ingredient usually occurs 2-3 days after initiation of placebo tablets (last row, and may not have finished before the next pack.
How to start taking jazz?
No prior hormonal contraceptive use (last month)
Tablet-taking has to start on Day I-st of the natural menstrual cycle of women (ie the first day of her menstrual bleeding).
Changing from a combined hormonal contraceptive method (combined oral contraceptive, SMC) (combined oral contraceptive pill, vaginal ring or transdermal patch)
The woman should start taking Jazz preferably on the day after the last active tablet (the last tablet containing the active ingredient) of its preceding combined contraceptive method, but not later than the day after the usual interval preceding its combined contraceptive method in which not accept tablets or placebo tablets. If it has been used a vaginal ring or transdermal patch woman should start taking Jazz as possible on the day of removal, but no later than the day on which would be the next place.
Changing from a progestogen-only-method (progestogen-only pill, injection, implant) or progestogen-delivering intrauterine system (IUS)
The woman may switch on any day of the period of administration of progestogen-only pill (from an implant or the IUS on the day of its removal, from an injectable when you apply after injection), but in all these cases should be advised to apply a barrier method for the first 7 days of tablet-taking.
After a miscarriage in the first three months of pregnancy
The woman may start immediately. When doing this, it should not take additional contraceptive measures.
Following delivery or abortion in the second trimester of pregnancy
The woman should be advised to start the adoption in 21 to 28 days after delivery or abortion in the second trimester of pregnancy. When starting later, the woman should be advised to additionally use a barrier method for the first 7 days. In the meantime, if you have had sex, should be excluded pregnancy before the actual start of COC use or the woman has to wait for her first menstrual period.
For breastfeeding women, cf. Section 4.6.
Management of missed tablets
Placebo tablets from the last (fourth) row of the blister can be ignored. At the same time, they should be discarded to avoid inadvertently prolonging the placebo tablet. The following advice only applies to missed active tablets:
If the woman is overdue less than 12 hours in the making of any tablet, contraceptive protection is not reduced. The woman should take the tablet as soon as remembered and the next dose should be taken at the usual time.
If it is delayed more than 12 hours in taking any tablet, contraceptive protection may be reduced. Management of missed tablets can be guided by the following two basic rules:
1. tablet-taking must never be discontinued for longer than 4 days
2. it takes 7 uninterrupted tablet to achieve adequate suppression of the hypothalamic-pituitary-ovarian axis.
In daily practice, therefore, can give the following advice:
Day 1-7
The user should take the last missed tablet as soon as she remembers, even if this means taking two tablets at the same time. She then continues to take tablets at her usual time. Moreover, during the next seven days should apply a barrier method such as a condom. If you had intercourse in the preceding 7 days, it should be borne in mind that there is likely to be pregnant. The more tablets are missed and the closer they are to the placebo tablet phase, the greater is the risk of pregnancy.
Days 8-14
The user should take the last missed tablet as soon as she remembers, even if this means taking two tablets at the same time. She then continues to take tablets at her usual time. Provided that the woman has taken her tablets correctly in the 7 days preceding the first missed tablet, there is no need to take additional contraceptive measures. At the same time, if she has missed more than one pill a woman should be advised to use extra precautions 7 days.
Day 15-24
The risk of reduced reliability is imminent because of the forthcoming placebo tablet phase. At the same time, by adjusting the scheme taking the pill, reduced contraceptive protection can still be prevented. By observing one of these two options, there is no need to apply additional contraceptive protection, provided that in the 7 days preceding the first missed tablet the woman take the tablets correctly. However, if it is not, it should move to the first of two opportunities, apply extra precautions for the next 7 days.
1. The user should take the last missed tablet as soon as she remembers, even if this means taking two tablets at the same time. It will then continue to take your tablets at the usual time while using all the active tablets. 4 tablets from the last row should be ignored. Immediately to start the next blister pack. Less likely to receive bleeding stopped taking active part before the close of the active tablets of the second pack, but she may experience spotting or breakthrough bleeding on days when taking tablets.
2. The woman may also be advised to stop taking the active tablets from the current blister pack. Then she should take placebo tablets from the last row for no more than four days, including the days when she missed tablets, and then continue with the next blister pack.
If the woman missed tablets and subsequently has no withdrawal bleed adoption of active ingredient in the phase when placebo tablets should be kept in mind that there is a possibility of pregnancy.
Advice in case of gastro-intestinal disturbances
In case of severe gastro-intestinal disorders (eg, vomiting or diarrhea), absorption may not be complete and should take additional contraceptive measures. If vomiting occurs within 3-4 hours after taking the active tablet as soon as possible to take a new (replacement) tablet. The new tablet should be taken, if possible, within 12 hours after normal hours of taking the tablet. If you take more than 12 hours, should be given advice on missed tablet similar to that in section 4.2 "Management of missed tablets." If the woman is unwilling to change its normal schedule of making tablets, she should take extra tablet (s) from another blister pack.
How to delay the appearance of bleeding stopped taking the active ingredient
To delay the onset of bleeding, the woman should continue with another blister Jazz without taking placebo tablets from the current pack. The extension can continue as desired, up to end of the active tablets in the second pack. During the extension the woman may experience breakthrough bleeding or spotting. Therefore, regular intake of Jazz recovered after phase placebo tablets.
To replace regular bleeding in another day of the week other than that in which it is accustomed with the existing schedule of taking tablets, it can be advised to shorten the forthcoming placebo tablet phase by as much as desired. The shorter the interval, the greater the risk that it will not get breakthrough bleeding or spotting at the next pack (just as when delaying the onset of bleeding).
Contraindications / Yaz tabl. film 0,02 mg / 3 mg - 1 x 28, 3 x 28, 6 x 28 /
Combined oral contraceptives (COCs) should not be used in any of the following conditions. If any of these conditions appear for the first time in the application of SMC, taking the medicinal product should be stopped immediately.
Venous thrombosis present or in history (deep venous thrombosis, pulmonary embolism)
Arterial thrombosis present or in history (eg myocardial infarction) or prodromal conditions (eg angina pectoris and transient ischemic attack)
Cerebrovascular accident present or in history
Presence of heavy (s) or multiple (and) risk (s) factor (s) for arterial thrombosis:
Diabetes mellitus with vascular symptoms severe hypertension
severe dyslipoproteinemia
Hereditary or acquired predisposition for venous or arterial thrombosis, such as APC-resistance, antithrombin-III deficiency, protein C deficiency, protein S deficiency, hiperhomotsistei dumb and antiphospholipid antibodies (anticardiolipin antibodies, lupus anticoagulant)
Pancreatitis or a history of such, if associated with severe hypertriglyceridemia
Presence or history of severe hepatic disease as long as liver function values that are not returned to normal
Severe renal insufficiency or acute renal failure
Presence or history of liver tumors (benign or malignant)
Known or suspected malignancy influenced by hormones (such as the genitals or breasts)
Nediagiostitsirano vaginal bleeding
History migraine with focal neurological symptoms
Hypersensitivity to the active substance or to any of the ingredients in the film-coated tablet Jazz
Special warnings and precautions for use
If any of the conditions / risks mentioned below, the benefits of COC should be assessed by the possible risks for each individual woman and discussed with her before the woman to decide whether to start using the product. In aggravation, exacerbation or first appearance of any of these conditions or risk factors, the woman should consult a doctor. When the doctor should decide whether COC use should be discontinued.
Circulatory Disorders
The use of any combined oral contraceptive is associated with an increased risk of venous thromboembolism (VTE) compared with women who did not use such drugs. The increased risk of VTE is highest during the first year in which women used combined, oral contraceptive.
Epidemiological studies have shown that the incidence of VTE in women with known risk factors for VTE, used oral contraceptives with low estrogen (<0,05 mg ethinylestradiol) ranges from 20 cases per 100 000 women-years (for levonorgestrel containing a "second generation" COCs) to 40 cases per 100,000 women-years (desogestrel / gestodene-containing "third" generation COC). In comparison, female contraception such unused frequency is 5 to 10 cases per 100,000 women-years and 60 cases per 100,000 pregnancies. VTE ends fatal in 1-2% of cases.
Data from a large, prospective 3-branched group study showed that the incidence of VTE in women with or without other risk factors for VTE, who used ethinylestradiol / drospirenone 0,03 mg | / 3 mg is in the same range as in users of other COCs with low estrogen, including levonorgestrel-containing OC (so-called 'second' generation OS). Ute at risk of Jazz is unknown at present.
Epidemiological studies have also shown a relationship between use of combined COCs and an increased risk for arterial (myocardial infarction, transient ischemic attack) thromboembolism.
Extremely rarely, oral contraceptives, thrombosis occur in other blood vessels, eg. hepatic, mesenteric, renal, cerebral or retinal veins and arteries. There is no general agreement on the existence of a relationship between the occurrence of these events and the use of hormonal contraceptives.
Symptoms of venous or arterial thrombotic / thromboembolic or cerebrovascular accident can include:
unusual unilateral leg pain and / or swelling • sudden severe chest pain with or without radiation to the left arm
sudden shortness of breath
suddenly started coughing
any unusual, severe or prolonged headache
sudden partial or complete loss of vision
drawl or aphasia
collapse with or without focal seizure
weakness or marked numbness suddenly affecting one side or one part of the body
movement disorders
"acute" abdomen.
The risk of venous thromboembolic complications in applying SMC increased by
a positive family history (venous thromboembolism ever in a sibling or parent at a relatively early age). If a hereditary predisposition is suspected, the woman should be referred to a specialist for advice before deciding about any COC use.
prolonged immobilisation, major surgery, any surgery to the legs, or major trauma. In these situations it is appropriate to adopt the pill be stopped (in the case of elective surgery at least four weeks in advance) and not resume until two weeks after complete remobilisation. Consideration should be given antithrombotic treatment if pills have been discontinued in advance.
There is no consensus about the possible role of varicose veins and superficial thrombophlebitis in the onset or progression of venous thrombosis.
The risk of arterial thromboembolic complications or cerebrovascular accident in COC users increases with:
smoking (women over age 3 5 years should be strongly advised not to smoke if they want to apply SMC)
a positive family history (venous thromboembolism ever in a sibling or parent at a relatively early age). If a hereditary predisposition is suspected, the woman should be referred to a specialist for advice before deciding about any COC use.
disease of the heart valves
atrial fibrillation
The presence of major risk factors or multiple risk factors respectively for venous or arterial disease, may also constitute a contraindication. The possibility of anticoagulant therapy should also be taken into account. COC users should be specifically directed to consult with your doctor if you experience possible symptoms of thrombosis. In suspected or confirmed thrombosis, COC use should be discontinued. Should immediately begin an adequate alternative contraception because teratogenicity of anticoagulant therapy (coumarins).
In the postpartum period must be borne in mind the increased risk of thromboembolism
Other medical conditions that are associated with adverse effects on the cardiovascular system include diabetes mellitus, systemic lupus erythematosus, haemolytic uraemic syndrome and chronic intestinal inflammation (Crohn's disease or ulcerative colitis) and sickle cell anemia.
Increased incidence of severe migraine during COC use (which may be prodromal phenomenon cerebrovascular event) may be a reason for immediate discontinuation of the COC.
Some epidemiological studies have reported an increased risk of cervical cancer in long-term users of COCs (over 5 years), but there are still controversies about the degree to which these findings are the result of sexual behavior or other factors such as human papillomavirus (HPV ).
Meta-analysis of 54 epidemiological studies reported that there is a slightly increased relative risk (RR = 1,24) of breast cancer in women using COCs. The increased risk gradually decreased during the 10-year follow-up after discontinuation of COCs. Because breast cancer is rare in women under the age of 40 years, the increased number of diagnosed with breast cancer treated at the time or before a COC users is small in relation to the overall risk of breast cancer. These studies do not provide evidence for causation. The observed pattern of increased risk may be due to earlier diagnosis of breast cancer in COC users, the biological effects of COCs or a combination of both. Breast cancers diagnosed in ever-SMC is less advanced clinically than the cancers perspective diagnosed in never users SMC.
Rarely used in the SMC are benign liver tumors and even more rarely, malignant liver tumors. In isolated cases, these tumors have led to life-threatening abdominal bleeding. Hepatic tumor should be considered in the differential diagnosis when severe pain in the upper abdominal, liver enlargement or signs of abdominal bleeding in women taking COCs.
With the use of high-COC (50 ?g ethinylestradiol) the risk of endometrial cancer and ovarian cancer is reduced. Whether this applies to low-dose COCs remains to be confirmed.
Other Conditions
Progestin component of Jazz is an aldosterone antagonist with properties allowing retention of potassium. In most cases it is not expected to increase in the levels of potassium. In a clinical study, however, in some patients with mild to moderate renal impairment and concomitant use of potassium sparing medicinal products serum potassium levels slightly, but not significantly, increased when taking drospirenone. It is therefore advisable to check serum potassium during the first treatment cycle in patients with renal insufficiency and serum potassium before treatment to the upper limit of normal, especially when concomitant medicinal products, preservatives potassium.
When using SMC women with hypertriglyceridemia, or a family history thereof may be at increased risk for pancreatitis.
Although there are reports of small increases in blood pressure in many women taking COCs, clinically relevant increases cases are rare. Only in these rare cases is warranted immediate discontinuation of the COC. If using SMC and previous hypertension, permanent or significant increases in blood pressure is not adequately respond conducted by antihypertensive treatment, SMC must be stopped. If considered appropriate, COC use may be restored in achieving antihypertensive treatment with normal blood pressure.
Reported the emergence or worsening of these conditions during pregnancy and COC use, the data for the application of COC use is inconclusive: jaundice and / or pruritus related to cholestasis, gallstones, porphyria, systemic lupus erythematosus, haemolytic uraemic syndrome; Sydenham Sydenham's, herpes gestationis, otosclerosis-related hearing loss.
In women with hereditary angioedema exogenous estrogens may induce or exacerbate symptoms of angioedema.
Acute or chronic disturbances of liver function may necessitate the discontinuation of COC use until markers of normalization of liver function. The appearance again holestaichen: jaundice and / or pruritus related to cholestasis, which previously appeared during pregnancy or previous use of sex hormones require discontinuance of the COC.
Although COCs may affect peripheral insulin resistance and glucose tolerance, there is no evidence for a need to alter the therapeutic regimen in diabetics using low-dose COCs (containing <0,05 mg ethinylestradiol). However, diabetic women should be carefully monitored, especially at the start of COC use.
Worsening of endogenous depression, of epilepsy, of Crohn's disease and ulcerative colitis with the use of COCs.
Sometimes it can develop chloasma, especially in women with a history of chloasma gravidarum. Women with a tendency to chloasma should avoid exposure to the sun or ultraviolet radiation whilst taking COCs.
Each light pink tablet of this product contains 46 mg lactose per tablet, each white tablet contains 50 mg. Patients with rare hereditary problems of galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption who are lactose-free diet should have that kind of quantity.
Medical examination / consultation
Before starting the application again, the Jazz must be removed complete medical history (including
family) and to exclude pregnancy. You should measure your blood pressure and do a physical examination, taking into account contraindications (see section 4.3) and warnings
(See section 4.4). The woman should be instructed more carefully read the user leaflet and to adhere to the advice given. The frequency and nature of examinations should be based on established practice and are individually tailored to each individual
Women should be advised that oral contraceptives do not protect against HIV infection (AIDS) and other sexually transmitted diseases.
Reduced efficacy
The efficacy of COCs may be reduced in the case of so missed active tablets (see section 4.2), gastro-intestinal disturbances in taking active tablets (see section 4.2) or concomitant
Reduced control of the menstrual cycle
With all COCs may occur outside normal bleeding (spotting or breakthrough bleeding episodes), especially in the first months of use. The evaluation of any irregular bleeding is only meaningful after an adaptation interval of about three cycles.
If irregular bleeding persists or occurs after previously regular cycles, then you should look for non-hormonal causes and adequate diagnostic measures are indicated to exclude malignancy or pregnancy. These may include curettage.
Some women may not appear bleeding stopped taking the active ingredient in the placebo tablet phase. If the COC has been taken according to the guidelines provided in Section 4.2, it is unlikely that the woman is pregnant. However, if the COC has not been taken according to these directions prior to the first missing bleeding stopped taking the active ingredient or if this happens twice, to exclude pregnancy before continuing use of COCs.
Interaction with other medicinal products and other forms of interaction
Note: You need to read the accompanying prescribing information for treatment and to identify potential interactions.
Effects of other medicinal products on Jazz
Interactions between oral contraceptives and other medicines can cause bleeding stopped taking the active ingredient and / or contraceptive failure. In the literature, the following interactions.
Hepatic metabolism
Interactions can occur with drugs that induce liver enzymes, which may have consequently increased clearance of sex hormones (eg phenytoin, barbiturates, primidone, carbamazepine, rifampicin, bosentan and HIV-medication (eg ritonavir, nevirapine), and and oxcarbazepine, topiramate, felbamate, griseofulvin and products containing the herb St. John's Wort (hypericum perforatum)). Maximum enzyme induction is generally observed for about 10 days, but may last at least 4 weeks after cessation of treatment.
Interaction with enterohepatic circulation
Contraceptive failure is observed during treatment with antibiotics, such as penicillins and tetracyclines. The mechanism of this effect is not understood.
Women on short-term treatment (up to one week) with any of the above classes of drugs or individual active substances (drugs that induce liver enzyme) than rifampicin should temporarily use a barrier method in addition to the COC, ie the period of concurrent product and 7 days after their discontinuation.
Women of rifampicin should be used a barrier method in addition to SMC, while taking rifampicin and 28 days after discontinuation of it.
Women-term treatment with hepatic enzyme-inducing active compounds, it is advisable to administer another reliable, non-hormonal contraceptive method.
Women on treatment with antibiotics (besides rifampicin, see above) should use the barrier method until 7 days after discontinuation.
If concomitant use of medicinal products continue after the end of the active tablets in your current pack SMC placebo tablets should be skipped and immediately begin next COC pack.
The main metabolites of drospirenone in human plasma are generated without involvement of the cytochrome P450 system. Inhibitors of this enzyme system are therefore unlikely to affect the metabolism of drospirenone.
Influence of Jazz on other medicinal products
Oral contraceptives may affect the metabolism of other active ingredients. Can therefore increase (eg ciclosporin) or decrease (eg lamotrigine) plasma and tissue concentrations.
According to the results of studies of the effects of inhibition in vitro and in vivo interactions in female volunteers using omeprazole, simvastatin and midazolam as marker substrate are unlikely effects of drospirenone 3 mg with the metabolism of other compounds.
Other interactions
In patients without renal failure, concomitant administration of drospirenone and ACE inhibitors or NSAIDs had no significant effect on serum potassium. However, concomitant administration of Jazz and aldosterone antagonist or potassium-sparing diuretics has not been studied. In this case, during the first treatment cycle should be examined serum potassium.
Laboratory tests
The use of contraceptive steroids may influence the results of certain laboratory tests, including biochemical parameters of liver, thyroid, adrenal and renal function, plasma levels of (carrier) proteins, eg. corticosteroid-binding globulin and lipid / lipoprotein fractions, parameters of carbohydrate metabolism and parameters of coagulation and fibrinolysis. Changes generally remain within the normal laboratory range. Drospirenone causes increased plasma renin activity and plasma aldosterone induced by its low antimineralocorticoid activity.
Pregnancy and lactation
Jazz is not indicated during pregnancy.
If using Jazz pregnancy develops, the product should be stopped immediately. Epidemiological studies indicate no increased risk of the existence or risk of birth defects in children born to mothers who have taken SMC prior to pregnancy, nor a teratogenic effect when adopting a mistake SMC child.
Animal studies have demonstrated the existence of side effects during pregnancy and lactation (see section 5.3). The results of these animal studies can not exclude adverse effects caused by hormonal action of the active ingredient. At the same time, the experience as a whole SMC in pregnancy indicates the practice of side effects in humans.
Existing data regarding the use of Jazz in pregnancy are too limited to allow to draw conclusions about the Jazz negative effect on pregnancy, health of the fetus or newborn. So far, no relevant epidemiological data.
Lactation may be influenced by COCs as they may reduce the quantity and change the composition of breast milk. The use of COCs should generally not recommended for nursing mothers until they stop breastfeeding completely. Small amounts of the contraceptive steroids and / or their metabolites may be excreted in breast milk when using COCs. These amounts may affect the child.
Effects on ability to drive and use machines
No studies on the effects on ability to drive and use machines. Not affect the ability to drive and use machines using SMC
Adverse reactions / Yaz tabl. film 0,02 mg / 3 mg - 1 x 28, 3 x 28, 6 x 28 /
For serious adverse reactions in COC users
The following adverse reactions have been reported with the use of Jazz:
The table below reports adverse reactions by MedDRA database system (MedDRA SOC). Frequencies are based on clinical trials. Use
appropriate MedDRA term to describe a certain reaction and its symptoms and related conditions.
Adverse reactions associated with the use of jazz as an oral contraceptive or to treat moderate acne in skin accordance with snstemo organ classification and terminology MedDRA MedDRA
Mr. infestations Infections
Blood and lymphatic system
rare-Anemia Thrombocythaemia
Immune System
rare, allergic reaction
Endocrine disorders
rare-Endocrine Disorders
Metabolism and nutrition
Rare, increased appetite, anorexia, Hyperkalaemia, Hyponatraemia
Psychiatric Disorders
common - Emotional lability
uncommon, depression, decreased libido, nervousness, drowsiness
Rare, anorgasmia, Insomnia
Nervous System
Headache frequency
uncommon, Dizziness, Peresteziya
rare - Vertigo, Tremor
Eye Disorders
rare-conjunctivitis, dry eyes, eye disorders
Cardiac disorders
Vascular Disorders
uncommon, migraine, varicose veins, hypertension
rare-Phlebitis, vascular disorder, epistaxis, syncope
Gastrointestinal Disorders
uncommon, abdominal pain, vomiting, Dyspepsia Bloating Diarrhea Gastritis
rare - Enlarged abdomen, Gastrointestinal disturbance, Gastrointestinal sensation filling Hiatusova hernia Oral candidiasis, constipation, dry mouth
Hepatobiliary disorders
rare - Biliary pain Cholecystitis
Skin and subcutaneous tissue disorders
uncommon acne, pruritus, rash
Rare, chloasma, Eczema, Alopecia, Acne and forms dermatitis, dry skin, erythema nodosum, hypertrichosis, Skin disorder, skin striae, Contact dermatitis, photosensitivity dermatitis
Skin nodule
Disorders Musculoskeletal and connective tissue disorders
uncommon, Back Pain, Pain in extremity, muscle cramps
Reproductive system and breast disorders
common - chest pain, metrorrhagia * Amenorrhea
uncommon - Vaginal candidiasis, pelvic pain, breast enlargement, fibrocystic breasts, uterine / vaginal bleeding * genital secretions, hot flushes, vaginitis, menstrual disorder Dizmenoreya, Hipomenoreya, Menorrhagia dry vagina, suspicious Pap
rare - Dizpareuniya, vulvovaginitis, bleeding after intercourse bleeding stopped taking the active ingredient Cystic breast hyperplasia, breast, Breast Neoplasm Cervical polyp, endometrial atrophy, ovarian cysts, uterine enlargement
General disorders and administration site conditions
uncommon, asthenia, increased sweating, edema
(Generalized edema, peripheral edema, Swelling of the face)
rare - Malaise
uncommon - Increased body weight
rare - Reduced body weight
Bleeding abnormalities ... usually resolve with continued treatment
The following serious adverse reactions were reported in women taking COCs
Special warnings and precautions for use:
Venous thromboembolism violation;
Arterial thromboembolic disorders;
Liver tumors;
Occurrence or deterioration of conditions for which association with COC use is not conclusive: Crohn's disease, ulcerative colitis, epilepsy, migraine, endometriosis, uterine fibroids porfiririya system
lupus erythematosus, herpes gestationis, Sydenham chorea of, haemolytic uraemic syndrome, cholestatic jaundice;
Acute or chronic disturbances of liver function may necessitate the discontinuation of COC use until markers of normalization of liver function.
In women with hereditary angioedema exogenous estrogens may induce or exacerbate symptoms of angioedema.
The frequency of diagnosis of breast cancer is very slightly increased among COC users. Because breast cancer is rare in women under 40 years, the excess number is small relative to the overall risk of breast cancer. Causation with COC use is unknown.
€ 21.00


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Curriculum > 2020 Spring Term - Lower School
School Curriculum Advice for Parents
Welcome back to the Summer Term! We hope that this grid will give you helpful details of planned work for this term. Please assist your son/daughter in exploring and discussing these areas. We trust you continue to find the homework diary useful and intend to continue to suggest activities in it.
All year groups will be having English and Mathematics lessons every day. The most important way to help your children is to read with them on a daily basis. The more you read together the better they will do in school and in life!
Families that read together succeed together!
We will also continue to suggest spellings and times tables to learn in the homework diary too as this type of work is also considered beneficial. Please continue to refer to the homework diary for general reminders about expectations, such as those relating to uniform. Thank you!
Examples of areas we plan to cover
Art & Design
In the first half of the term we will find out about the cave paintings discovered within the Stone Age. We will use our research to make our own cave paintings.
In the first part of the half term, we will be doing an e-safety unit, looking at cyber bullying. Following on from this, we will be exploring how we communicate in the digital world, including blogging, social media and emailing.
In DT this term we aim to research different types of bread, find out where it comes from, how bread is made and how it fits into our healthy, daily diet. We will taste and evaluate different types of breads. We will plan, design, make and evaluate our own twist on homemade bread.
Throughout the term we will be exploring the history of Britain from the Stone Age to the Iron Age, examining how life changed over the course of these periods.
This term we will be: learning about the orchestra and the different instruments; listening and analysing Prokofievs Peter and the Wolf and composing pieces of our own, inspired by art and the artist Kandinsky.
In P.E. the children will be having lessons in: dance learning a group routine with a Stone Age theme; gymnastics floor and apparatus work; athletics running, jumping & throwing; cricket striking and fielding. The last swimming session will take place on Friday 19 July 2019.
The first half terms unit of work gives a range of opportunities for children to explore their values in relation to finding money (or property); the rights and wrongs of keeping such items and the law. In the final part of the year we will look at changes that have taken place in their lives, change can be good as well as bad, draw a journey of their life and add feelings about each event. Then conclude with thinking about changes for next year.
Over the course of this term, we will be covering topics including: The Circle of the Christian Year; Islam: The Mosque, Muhammad and The Quran; Gods Transforming Power.
This term we will be learning about rocks and soils. We will find out how rocks are made as well as sorting them according to their properties. After half term, we will explore materials and how some solids turn into liquids when they are heated.
This term, we will be looking at a story called, The Four Friends, food and The Carnival of Animals.
You may like to talk to your child about these topics. The prospectus (which details how the different subjects are taught) is available for download by clicking here. In addition, you may also wish to:

subset: commoncrawl


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The effects of the resistance resources of personality hardiness, exercise, and social support, taken singly and in combination, on concurrent and prospective levels, and probability of illness were studied. In 1980, 85 male business executives identified as high in stressful events were tested for the three resistance resources. Predicting their illness scores in 1980 formed the concurrent aspect of the study. For the prospective aspect, illness scores in 1981 were available on 70 of the subjects. With regard to resistance resources, when there are none, one, two or three, the level and probability of both concurrent and prospective illness drop in a regular and marked fashion. These results highlight the importance of multiple resistance resources. Estimates of relative effectiveness indicate that hardiness is the most important of the resistance resources studied.
Recently, a shift has occurred in research on the relationship between stressful events and illness symptoms toward identifying moderating variables. The list of moderators, called resistance resources by Antonovsky [1], is growing. Now that research has suggested the importance of various individual resistance resources, it is time to consider their joint effects on the stress-illness relationship. The present study makes a start on this endeavor. The three resistance resources considered here are personality hardiness [2], exercise [3], and social support [4]. All three have received considerable attention lately.
Introduced by Kobasa [2], hardiness is considered a personality style consisting of the interrelated orientations of commitment (vs alienation), control (vs powerlessness), and challenge (vs threat). Persons high in commitment find it easy to involve themselves actively in whatever they are doing, being generally curious about and interested in activities, things and people [5]. Persons high in control believe and act as if they can influence the events taking place around them through what they imagine, say and do [6]. Challenge involves the expectation that life will change and that the changes will be a stimulus to personal development.
These various beliefs and tendencies are considered very useful in coping with stressful events [7]. Optimistic cognitive appraisals are likely, in which the events will tend to be perceived as natural changes, meaningful and interesting despite their stressfulness. In that sense, the stressful events will be held in perspective.
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The New York Times bestselling novel that continues the passionate story of Rush and Blaire from Fallen Too Far.
Our relationship had been short. Intense and brief. I wondered what it would have felt like to curl up in Rush's arms anytime I wanted. To know I was safe and that he loved me. We'd never had that chance.
Just when Blaire allowed herself to fall for her stepbrother, Rush, he revealed a life-altering secret so devastating that she couldn't forgive him.… (more)
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Publisher: Atria Books (January 20, 2014)
Collection: Atria Books
Parent ISBN: 9781476776019
Page count: 272 pages
File size: 1.6 MB
Language: English


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Dance Gavin Dance - Dance Gavin Dance (Instrumental) (2019)
bunkyyunky replied to dewey duck's topic in Post-Hardcore
Royal Coda - Compassion (2019)
bunkyyunky replied to Michael's topic in Post-Hardcore
Dayshell - Mr. Pain (2019)
bunkyyunky replied to Cosmic Reaper's topic in Post-HardcoreThe first half of the album was great, and I loved most of the songs there. The second half was okay, but nothing really stood out to me with most of the songs there. Feel like it definitely would benefitted from being a shorter album, but it took so long to get out that I guess he just decided to throw everything in.
Dance Gavin Dance - Blood Wolf (Single) (2019)
bunkyyunky replied to Michael's topic in Singles
The Devil Wears Prada - The Act (2019)
bunkyyunky replied to Michael's topic in MetalcoreOnly had the chance to listen to it once so far, but it was pretty great. Lots of variety, much more than Transit Blues had IMO, and I personally feel like that's far more important when it comes to how good/memorable an album is, rather than just how heavy it is. Also The Thread is just fucking insane. It was great hearing Mike's lows again after so long.
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Dance Gavin Dance - Acceptance Speech 2.0 (2019)
bunkyyunky replied to xcblackdiamond's topic in Post-HardcoreIt sounds like a few minor parts might've been re-recorded? For example, the vocals in the beginning of Doom & Gloom and Strawberry Swisher Pt. 3 sound a bit different beyond just the mix, but maybe that's just how much the mixing was affecting it before, IDK. Also the vocal intro at the very beginning of Death of the Robot with Human Hair is just completely gone lol. Honestly, I'm really not sure I *needed* this, but it's nice I guess? Maybe I just can't pick up on the improvements as much since my ears are still overloaded from the ERRA/Northlane show last night, but I never had much of a problem with AS in the first place.
The Devil Wears Prada - Lines of Your Hands [Single] (2019)
bunkyyunky replied to NieR:Automata™'s topic in Singles
Enter Shikari - Stop the Clocks (Single Edit) (2019)
bunkyyunky replied to mR12's topic in Singles
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bunkyyunky replied to mR12's topic in Singles
HAWK - Counter Ops [Single] (2019)
bunkyyunky replied to Rorschach's topic in Singles
Dance Gavin Dance - People You Knew / Perfect (Single) (2019)
bunkyyunky replied to mR12's topic in SinglesThe art is the same as the vinyl release: https://www.discogs.com/Dance-Gavin-Dance-People-You-Knew-Perfect/release/3073592 Probably just for a digital release since they were originally Hot Topic exclusive. The fact that they were just added to Spotify seems to confirm that (https://www.reddit.com/r/dancegavindance/comments/c310x2/people_you_knew_perfect_were_just_added_to_spotify/)
I can understand getting tired of the sound, since they *do* get a bit formulaic at times, but wanting a new singer for the sake of "changing things up" is just weird, and kind of disrespectful. I guess some diehard fans might find it charming with how many times they've changed their lineup, but it's not like it was ever done for a good reason. They already said that they'd likely just break up if Tilian ever left, and he doesn't seem to be leaving anytime soon. I'm sure it sucks for him to see people say that they don't want him anymore even though he's still an amazing singer, and infinitely more stable of a person than any of their past singers have been.
Dayshell - Kombat (feat. Dropout Kings) (2019)
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Wolf & Bear - Deleto (Single) (2019)
bunkyyunky replied to Rorschach's topic in Singles


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VITORIA-GASTEIZ— The loss of Real Madrid to CSKA Moscow in Friday's (17/5) EuroLeague semifinal was a huge blow for Sergio Llull.
"We feel fu–ked," Llull told Eurohoops when asked how he feels the day after his team's defeat. "It is clear that we wanted to play tomorrow at 20:30. We must try to finish this Euroleague year winning against a great team like Fenerbahce."
Instead of the Final, Llull and his teammates will play for the third place in the Final Four.
"This game doesn't make much sense," Llull said. "The calendar is long and demanding enough to put one more game. It's a game where you don't play for anything, but that's the competition. Let's play it, try to make a great game and win."
Last night, Llull's lackluster performance in the semifinal became a trending topic in Spain. Former Real Madrid player Luka Doncic tweeted a message of support towards Llull, writing: "I see many people criticizing LLULL … He, who has given everything for this club and has worked like an animal to return! Remember everything that has brought to Madrid! He should be an example for every player who plays this beautiful sport! Sergi, I love you and we love you "
"Yes, it is always nice that a teammate defends you in some way," Llull said. "With Luka we have a very good relationship. He's a phenomenon both on and off the court and I appreciate it."


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1. Biography
On October 8th 1980, in San Diego California, Nicholas Scott Cannon was born. His parents, James Cannon and Beth Hackett, did not realize what a star they had just created, but soon found out. Before Nick was a teen, he fearlessly did stand-up for his father's evangelical public-access show, and was singing by the age of 8.


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Club Tobacco reviews
County Cork Review
Having had several bowls, my overall impression is that Sutliff County Cork is an enjoyable aromatic tobacco that burns well and smells great with a pleasant taste. Aromatic smokers should delight in it while those who predominantly smoke non-aromatics will find it worth a try.
Dunhill Elizabethan Mixture - Houston Pipe Club
Dunhill - Elizabethan Mixture
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Sunday Sept 29
Today was originally scheduled to be a day without much too, but since the weather forecast for Monday is rain, the Amalfi company I had booked a Capri cruise with emailed and wanted to know if we could change the cruise from Monday to today. We agreed, sounded like a great idea! So at 9:45 we were at the pier in Amalfi for the cruise. Limited to 12 people, on a nice boat, with…
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Sting in Tail Race
Posted by lee james on 06th May 2019 in Blogging |Brianplant Supporting the Local 10K Sting in Tail Race at Caistor. A fantastic turn out supported by many of the team - a fair few of the team successfully ran the race too!...
Sting in the Tail 2019
Posted by Isobel Salsbury on 30th September 2019 in Blogging | Sting in the Tail,Running Club,Supporting Local,CaistorWell…. what can we say! The Brianplant team were proud to take part in what is well renowned Locally as being one of the most, if not THE MOST fun races in the running calendar-The Caistor Sting in the Tail 10k 2019. Those that know Caistor will know that is is FAR from flat. And after a relatively flat first 8 kilometres, the STING comes in the form a final gruelling 2 kilometres of relentless hills which are more suited to a mountain goat than a human! But it is the phenomenal support at the heart of this race which is what inspired and encouraged every runner up all up those hills and what makes this race so unique and special. The Caistor c...
The Three Kubotaeers
Posted by Isobel Salsbury on 02nd December 2019 in Blogging | Kubota,9T Excavator,Excavator,Machinery,Digger,Plant Hire,Experienced Operators,Local hireDue to the increasing popularity of our 9T excavators we've added a third Kubota KX080 to our fleet, hence the creation of... The Three Kubotaeers ... All for Brianplant and Brianplant for all! Delivering the same top quality machinery, always with experienced qualified operators, designed to give you peace of mind with your hire. ...
Bring your dog to work day
Posted by Isobel Salsbury on 11th December 2019 in Blogging | #Charity,#Giving back,St Andrews Hospice,Festive Cheer,Donation,Every Little Helps,Santas Little Helper,Lighthouse Club,Charity AuctionAt Brianplant we strongly believe in giving back to the community - especially at this time of year - so we are proud to say that our donation not only helps one, but two charities, in their mission. Every year we donate a giant stuffed animal to St Andrews Hospice (a Local hospice that not only caters for adults but has a specialist Childrens branch) in an effort to raise vital funds for an amazing cause. The cuddly toy is obtained through an auction at another charity event dedicated to people injured within the construction industry. This year we bid on this adorable Harley the Husky (who joined us for a day at the office) - and we are sure he will m...


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Posted: Feb 20, 2019
|Youngstown State at Northern Kentucky
|Date & Time
|Thursday, Feb. 21 | 7 p.m.
|BB&T Arena | Highland Heights, Ky.
|570 WKBN | iHeartRadio
|ESPN+ | WatchESPN
|Game Notes
|YSU Notes | NKU Notes
|Live Stats
|Live Tweets
|@YSUMensHoops | @YSUSports
|Hash Tags
|#GoGuins | #HLWBB
|Mobile App
|YSU Front Row
Opening Tip
• Youngstown State plays its final two road games of the regular season at Northern Kentucky, Feb. 21, at 7 p.m. and at Wright State, Feb. 23, at 3 p.m. Both games will be broadcast on 570 WKBN while the NKU game is on ESPN+ and the Wright State contest is on ESPN3.
The Penguins close out the regular season and will celebrate Senior Night against Cleveland State, Saturday, March 2. Tipoff is slated for 6 p.m. at the Beeghly Center. The game will be broadcast on 570 WKBN and ESPN3.
The Coaches
• Jerrod Calhoun is in his second year at Youngstown State and his seventh season overall as a head coach. The 13th head coach in program history, Calhoun owns a career mark of 144-78 overall and is 20-40 at Youngstown State. The Cleveland, Ohio, native came to YSU after spending five years at Fairmont State, where he led the Fighting Falcons to the 2017 NCAA Division II National Championship game and a 34-3 overall record. Calhoun was named the 2017 Mountain East Conference Coach of the Year and the Mountain East Conference Men's Sports Coach of the Year.
• John Brannen is in his fourth season on Northern Kentucky's sidelines, boasting a 75-48 record with the Norse. Brannen, who was 1-1 as interim head coach at Alabama, was named the 2017 Horizon League Coach of the Year and led the Norse to
the 2017 NCAA Tournament.
Quick Hitters
• For the third straight week, freshman Darius Quisenberry was named the Horizon League Freshman of the Week on Feb. 18. Quisenberry averaged 27 points, two rebounds, six assists and 2.5 steals per game while shooting 45.5 percent from the floor, 42.9 percent from 3-point range and 85.7 percent from the free-throw line. He also averaged three made 3-pointers per game. Quisenberry scored a career-high 37 points on 10-of-19 shooting from the floor, including three 3s, and 14-of-16 from the free-throw line in the win over UIC.
• Youngstown State's current six-game winning streak is the program's longest wining streak since joining the Horizon League in 2001-02 and the longest since 1997-98. The last time Youngstown State won six games in a row was in 1997-98 when it won seven straight. That year, the Penguins had a seven-game winning streak from Jan. 14 to Feb. 7, and an earlier six-game streak from Dec. 6 to Dec. 26. The Penguins finished with a record of 20-9, their last 20-win season.
Up Next
• Youngstown State plays its final regular-season road game when it visits Wright State, Saturday, Feb. 23.
• Tipoff is set for 3 p.m. ET and will be broadcast on 570 WKBN and ESPN3.
About Northern Kentucky
• Northern Kentucky enters the game with an overall record of 20-7 and a 10-4 mark in the Horizon League.
• The Norse are led by Drew McDonald with 19.2 points and 9.9 rebounds per game.
• Tyler Sharpe (14.3 ppg), Jalen Tate (13.0 ppg) and Dantez Walton (11.4 ppg) are also averaging in double figures for the Norse.
Last Time Against NKU
• In the first meeting this season, Northern Kentucky used a 19-6 run over a six-minute span to come away with an 82-74 win over the Youngstown State men's basketball on Jan. 19 at the Beeghly Center.
• Junior Donel Cathcart II led the Penguins with 16 points while Antwan Maxwell, Jr., scored 13 points and Garrett Covington and Darius Quisenberry added 11 and 10 points, respectively.
The NKU Series
• This is the 19th meeting between Youngstown State and Northern Kentucky in a series that dates back to 1976.
• The Penguins own a 10-8 advantage in the all-time series, but NKU has won the last four games.
• The Norse won the first meeting this season, 82-74, at the Beeghly Center.
• The last time the Penguins defeated the Norse was an 81-77 victory at the Beeghly Center on Feb. 28, 2017.
Last time Out
• Freshman Darius Quisenberry scored a career-high 37 points to lead the Penguins to their sixth straight victory in an 81-73 win over UIC on Feb. 16.
• Quisenberry went 10-of-19 from the field, including three 3s, and made 14-of-16 from the free-throw line.
• Junior Devin Morgan scored 15 points off the bench and freshman Jelani Simmons added 10 points.
A Win Would
• Give Youngstown State its 11th win over Northern Kentucky.
• Mark YSU's first seven-game winning streak since 1997-98.
• Snap a four-game losing streak to the Norse.
• Mark Jerrod Calhoun's 145th career win and his 21st at Youngstown State.
• Mark the 1,097th victory in program history.
• Give the Penguins an 13-16 overall record and a 9-7 mark in Horizon League play.
• Mark YSU's second-most Horizon League wins in a season with nine.
• Mark YSU's sixth road win of the season.
• Mark YSU's fifth Horizon League road victory of the season.
Quisenberry Set D-I Frosh Scoring Mark
• After scoring a career-high 37 points against UIC, freshman Darius Quisenberry set Youngstown State Division I freshman scoring record.
• Quisenberry has 388 points this season and broke the old mark of 358 set by Tim Jackson in 1987-88.
• He also ranks tied for sixth all-time with Bruce Alexander (1978-79) for most points by a YSU freshman.
YSU Freshman Scoring Leaders
1. Dave Zeigler (623, 1978-79)
2. Jeff Covington (543, 1974-75)
3. Mickey Yugovich (507, 1956-57)
4. Anthony Mitchell (453, 1973-74)
5. Herb Lake (430, 1955-56)
6. Darius Quisenberry (388, 2018-19)
7. Bruce Alexander (388, 1978-79)
YSU Freshmen Scoring 30+
• Darius Quisenberry's 37 points against UIC on Feb. 16 are the most by a freshman in YSU's Division I era.
• The last freshman to score at least 30 points in a game was Tim Jackson with 32 against Morehead State on Feb. 29, 1988.
• Jackson is the last freshman to post back-to-back 30 point games and had 31 against Eastern Kentucky on Feb. 27, 1988.
• Quisenberry is just the second freshman to score at least 30 points in YSU's Division I era (since 1981-82).
Penguins Set School 3-Point Record
• With nine 3-pointers against UIC, the Penguins set the school record for most 3-pointers made in a season with 271.
• The old school mark of 270 was set in 2011-12.
• Last season, the Penguins made 235 baskets from beyond the arc.
• Youngstown State has made at least 200 3s in a season for nine straight years.
• The Penguins also rank 14th nationally with 271 made 3-pointers.
Akuchie In Doubles = Success
• Sophomore Michael Akuchie scored a season-high 14 points on 6-of-7 shooting against IUPUI on Feb. 14.
• It marked the fourth time this season, Akuchie has reached double figures.
• The Penguins own a record of 3-1 this season when he scores at least 10 points.


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Negligence, Employer's liability. Evidence, Inference of fact.
In an action by a painter against a contractor employing him, for personal injuries from a fall caused by the breaking of a ladder used as a staging, it is not evidence of negligence on the part of the defendant, that the defendant's superintendent in charge of the work left the plaintiff and two of his fellow workmen, of an average weight of one hundred and sixty pounds each, to paint a house
Page 86
using as a staging an extension ladder, which was safe for such use when not extended, without telling the plaintiff, who was a painter of twenty years' experience and was conversant with the use of extension ladders as stagings, that it would be dangerous to extend the ladder so as to make it six feet longer if all three of the men were to use it as a staging at the same time.
In an action by a painter against a contractor employing him, for personal injuries from a fall caused by the breaking of an extension ladder used as a staging, where it appeared that the accident would not have happened if the ladder had not been extended when used as a staging by three heavy men at the same time, the plaintiff had testified "We had used this ladder painting on other jobs in this same way," and his counsel argued that from this statement the jury could have inferred that the same three men had used the ladder extended and that this was known by the defendant. Held, that from the statement as an isolated piece of evidence the jury would not be warranted in drawing those inferences; and moreover an examination of the evidence showed that the statement referred merely to the use of the ladder as a staging and not to its use as such a staging by three heavy men when it had been drawn out.
TORT by a painter against a contractor and builder erecting a house on Logan Street in the town of Gardner for personal injuries received on August 13, 1903, from a fall caused by the breaking of a ladder used as a staging, with a count under the employer's liability act alleging negligence on the part of one Jeremiah O'Brien as superintendent of the defendant, and with other counts at common law alleging negligence of the defendant in furnishing an improper and defective staging, and in failing to maintain the ladder used as a staging in a safe and proper condition. Writ dated November 4, 1903.
At the trial in the Superior Court before Pierce, J. it appeared that on the day of the accident the plaintiff with two other workmen was employed under the direction of O'Brien in painting a barn and house, that O'Brien helped the three men to rig the staging on the barn, which consisted of the extension ladder doubled up suspended from the roof by two ropes. On the ladder was a long board on which to place the pots of paint. Having rigged the staging, O'Brien told the three men to paint the barn which was about twenty-four feet wide, and went away. The plaintiff painted in the middle and the other two painters at either end. Having painted the barn with one drop of the ladder the men, without the assistance of O'Brien, proceeded to rig the ladder in the same way on one end of the house, also about twenty-four feet wide. O'Brien came by and examined the hooks to see that they were properly fastened to the roof
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and proceeded to another job. Having finished this end of the house with one drop of the doubled up ladder, the three men proceeded to move the staging to the back of the house, which was wider, being twenty-eight feet wide. They decided to paint the back with one drop, and in order to do this extended the ladder by pulling it out. O'Brien was not there at the time. The plaintiff was painting in the middle, and according to his testimony the other two men "were right near the ropes." Suddenly the ladder gave way and the plaintiff fell and was injured.
A part of the plaintiffs testimony was as follows: "There were three men on the ladder when we painted the barn, and also when we painted the house. We had painted the four sides of the barn and had painted one end of the house and were painting the back of the house when the ladder broke. There were three men on the ladder. I worked in the middle and a man on either side. The ladder was rigged in the same way when it broke as it was when we were painting before on the house and barn, except that the side of the house where we were painting when the ladder broke was wider, and the ladder had to be pulled out more. When we began to paint the house, O'Brien was there and helped to tie the ropes, and he said when we finished painting that end, we could move onto the side of the house and paint, but O'Brien was not there when the ladder was put on the side where it broke, and took no part in putting up the staging at the place where it fell, because he had gone away, as soon as we began to paint the end of the house. We had used this ladder painting on other jobs in this same way. When the ladder is pulled way out, it is thirty-four feet long, and when it is not it is twenty feet long. It was stretched out to a length of twenty-six feet so that the ends of the ladder overlapped each other, when we were painting on the side of the house when it broke. The ropes were attached to the ladder about three or four feet from either end."
Other material facts, including the previous experience of the plaintiff and the weight of the three painters on the ladder, are stated in the opinion.
At the close of the evidence the defendant asked the judge to rule that upon all the evidence in the case the plaintiff was not
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entitled to recover, and that the verdict must be for the defendant. The judge refused to rule as requested, and submitted the case to the jury. The jury returned a verdict for the plaintiff in the sum of $3,000; and the defendant alleged exceptions.
C. C. Milton, for the defendant.
C. H. Blood, for the plaintiff.
LORING, J. We do not find it necessary to consider whether one of the defences set up by the defendant is made out as matter of law, namely, that a stronger ladder or ladders were furnished by him and were accessible for use by the plaintiff, for we are of opinion that if the ladder in question had been the only ladder furnished there is no evidence that the defendant was negligent.
It is not pretended that the ladder made an insecure staging when used as it was used while O'Brien was present, that is to say, without its being extended at all. We say while O'Brien was present for we assume that he might have been found to be a superintendent so far as liability on that ground under the statute goes, and to be the person to whom the defendant left the matter of stagings so far as liability at common law and under the statute as to safe appliances and safe ways, works and machinery are concerned.
What caused the accident here complained of was drawing the ladder out to a length of twenty-six feet at least, and putting on it three painters, whose aggregate weight was assumed to have been four hundred and ninety pounds, in order to paint the side of the house in one "drop" in place of keeping the ladder doubled up, as it was when O'Brien was present, and painting the side of the house in two "drops."
The plaintiff, to use his own words, was a painter of twenty years' experience, who had painted on stages all that time, had constantly used stages of all kinds on the outside of buildings, and had used extension ladders "lots of times." The ladder was of spruce, with side pieces approximately two by three inches.
The case therefore comes to this: Was it negligence on the defendant's part to leave the plaintiff and his fellow workmen to paint the house with this ladder as a staging, without telling them not to extend the ladder if all three of them, with an
Page 89
average weight of over one hundred and sixty pounds each were to use it as a staging? That it would be dangerous to do so is in our opinion a fact within the knowledge of a painter of twenty years' experience, who was conversant with the use of extension ladders as stagings.
The case belongs to the same class as Arnold v. Eastman Freight Car Heater Co. 176 Mass. 135. See also Adasken v. Gilbert, 165 Mass. 443; McKay v. Hand, 168 Mass. 270.
The plaintiff has asked us to hold that he had a right to go to the jury because in the course of his testimony he said "We had used this ladder painting on other jobs in this same way." His argument is that from this isolated statement the jury could have inferred that the same three men had used the ladder extended and that this was known by the defendant. We are of opinion that taken as an isolated piece of testimony the jury would not be warranted in drawing those inferences. Moreover, as the evidence went in, this statement is shown by the testimony preceding and following it to refer to the use of the ladder as a staging, not to its use as a staging when drawn out, with three men upon it weighing on an average one hundred and sixty pounds apiece. If the plaintiff intended to go to the jury on this theory he should have developed it more in evidence than he did by eliciting this statement in the connection in which it was given.
Exceptions sustained.


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