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Knocking noise under dash
See Also
Chevy Blend Door Actuator Replacement
tschutz Member Posts: 4When it is damp outside, my 2007 Chevy Impala when you use the signal lights it has a buzzing sound under the dash each time the signal light flashes, it does it right or left.0
djf5 Member Posts: 1I have a 2007 Impala and after turning off a/c, knocking noise for about 30-45 seconds. I looked behind the glove box and saw this white box going up and down after turning off the a/c. Repair shop said it's an Actuator that's tied into the lend door that controls the air/heat. Got it repaired w/ parts/labor for $200. Hope this helps.0
pooadrid Member Posts: 1I have a 2007 Impala and after turning off or turning the a/c, knocking noise for about 30-45 seconds or more. i opened up the glove box and removed some papers that were blocking the air flow.
And of course this noise only happens every now and then but when it does. wow is it annoying.
so of course when i finished cleaning out that area it didnt make any noises. which i figured that fixed the problem....but it didnt.
it continues again. and this sound shifts from driver side to passenger side. sometimes though.
so what should i do?0
needcarfixed Member Posts: 1Hello, I was trying to find out where the acuator is located because my car is doing the same thing and I was told by the dealer that it sounds like an acuator but it would cost me 7 or 800 dollars to fix. Any suggestions0
rob771 Member Posts: 2Having the same thing going on with my 2008 Impala LS at 42,000 miles. If I turn the fan speed up (with the outside air option LED lit) and press the snowflake (to kick on the compressor) it doesn't make the knocking noise. Switch the air from outside air to recirculate and I hear the knocking noise from under the dash. Eventually the noise stops (after 30-45 seconds). When I turn the fan speed back to Lo, the knocking noise returns (probably because it's switching back to outside air). It's probably the actuator. Spoke with one of my neighbors who mentioned having that problem on a Chevy pickup.
Already had the steering issue/bumping noise when you accelerate/decelerate. Thankfully, that was fixed under warranty.
Last year I had the problem where I had no heat the first cool spell. That ended up being another trip to the shop.
Just today I ran into the alignment problem/premature tire wire.0
My 07 is doing the same thing. I was told it is the arm control valve. Though it is annoying it's not a major problem. If I am wrong please let me know, I hope to be able to wait a while to get mine repaired.0
My 07 Impala's trunk release inside the car and on my remote has stopped working. I did not realize that there is not a key spot on the outside of the car as a back up. Any ideas what is the problem?
ctaylor63801 Member Posts: 1:mad: Knock knock, tic tic, knock knock! Wow so you have heard this as well? So glad you did because you see I took my car my 2008 Impala back to the dealership I bought it from Sikeston Autry Morland, and the service manager told me i had a problem with my battery, that once that was replaced I wouldnt hear this noise...I argued with him till I was yelling and blue in the face! Telling him there is no way this was my battery! I purchased a new battery took the car back up to him and since I belittle and ashamed him I was kicked off the premises. Now my car is at a different location being fixed....0
Gosh, hated that you had to spend money on a battery. My only does it when I turn off the ac, my husband says it the control shutter door (something along those words lol) if I turn my ac back on it stops. I have used my heater a little and it does not do it at all. Unless you are using your ac all year, I would probaly wait to get it fixed.0
I got my trunk fixed, after I had several people it was going to cost quite a bit to fix it. My husband pulled the fuse out and replaced it with a new one. The trunk and remote are both working fine now.0
bobby80908 Member Posts: 1My Pontiac Vibe started making a clacking noise (about 2/sec.) but stops when I turn off the outside air. The A/C is off. When I stop 'Inside Air' so it brings in fresh outside air, it takes about 5 seconds and the clacking noise starts again.
elkparkerjmp Member Posts: 2My mechanic immediately diagnosed, "Actuator!" when I described the knocking noise under the dash of my 2006 Impala. He recommended waiting until the heat/air no longer works before springing for the repair, and explained it won't be a cheap fix -- about $500 "because the dash has to come out". Although the racket is annoying, it only occurs when I turn off the engine -- and not every trip -- and usually winds down by the time I've climbed out and locked up.1
daves95maxima Member Posts: 1In the Impala all the mechanic has to do is drop down the glove box door and the actuator is right there and held on by 3 6mm screws very easy fix!0
Thanks for the info! Definitely not spending several hundred $ to fix a 60 second noise and then it stops.0
My 07 Impala's message center keeps flashing that the trunk is open. It started several weeks ago & yes the trunk is closed lol. Could this be a fuse that needs replacing?0
You can find information on your vehicle's electrical system (including diagrams of fuse blocks) starting on page 397 in your owner's manual. If we can be of any assistance, please let us know!
GM Customer Service0
goldi1 Member Posts: 1I just recently discovered this knocking sound in my 2008 Chevy Impala, I was told by a friend that this is something she heard in a similar car. Is this something that I can fix or is it best to have a mechanic do it? its started to get louder and sounds like now its in the venting and the dashboard! Help!
Damsel (IN DISTRESS!!!)0
luckygirl7133 Member Posts: 1My 2006 does it, but it has gotten worse. Now it won't stop unless i turn the car off and it takes about 5 minutes before it does stop. And only HOT air blows out of my driver's side vents.0
Good evening luckygirl7133,
We're sorry to hear that you're having some troubles with your HVAC system; what are your plans for getting this looked into?
Sarah, GM Customer Service0
chandrab1 Member Posts: 1
I am into a month or so now. The knocking noise under my front passenger dash is scary especially traveling with young children. I spoke on the phone and via email with a GM customer service representative who recommended that I take the car for a diagnostic at Sport Chevy in Maryland-Bad Idea!. They diagnose the car as the REAR Actuator which I am unable to understand because the problem is when I switch from vent to AC that knocking sound gets louder. They wanted $405 to fix that problem but wouldn't discount it from the $113. diagnostic fee I had to pay. I am so frustrated because this is a very common problem with Chevys and for them to put it onto the power train warranty but not upheld their part of repairs is just ridiculous. An obvious problem. I took my car to a local shop and they will fix it for $200. And I found out that the car is leaking engine oil onto the transmission which I am told could caused a fire. GM would have plenty to worry about then. I am so disappointed and do not think I will every recommend or purchase another Chevy vehicle for that matter.
Disappointed at their customer service
Chevy Impala 2008 Owner0


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America's President-elect Donald Trump is setting the tone already with the media as he's already changing things letting the public know that they won't be getting full access to him.
He's already said he'll be doing things differently, so America is getting an idea of what to and not expect.
His response to the protestors is also showing which version of Donald Trump we will be getting in the White House.
Just had a very open and successful presidential election. Now professional protesters, incited by the media, are protesting. Very unfair!
— Donald J. Trump (@realDonaldTrump) November 11, 2016
Donald Trump is keeping Americans in the dark about his earliest conversations and decisions as president-elect, bucking a long-standing practice intended to ensure the public has a watchful eye on its new leader.
Trump on Thursday refused to allow journalists to travel with him to Washington for his historic first meetings with President Barack Obama and congressional leaders. The Republican's top advisers rebuffed news organizations' requests for a small "pool" of journalists to trail him as he attended the meetings.
The decision was part of an opaque pattern in Trump's moves since his victory Tuesday. He was entirely out of sight on Wednesday. His aides said he was huddled with advisers at his offices in New York. His team has not put out a daily schedule or offered any detailed updates on how he has spent his time. They have not acknowledged phone calls or other contact with world leaders.
When Russian President Vladimir Putin sent a congratulatory telegram to Trump on Wednesday, Moscow spread the word. A phone call with British Prime Minster Theresa May was announced in London. The pattern was repeated for calls with leaders of Israel, Egypt, South Korea and Australia.
The White House typically releases statements on the president's phone calls with foreign leaders, providing some details about the conversation. Past presidents-elect have had early briefings with journalists, even in confusing first hours after Election Day.
But early signs suggest Trump is willing to break protocol when it comes to press access and transparency.
As a candidate, Trump railed against the press as "disgusting" and "dishonest." He refused to allow a pool of campaign reporters and photographers to fly on his plane to events, sometimes starting his rallies before his press corps had arrived. The practice did not extend to his running mate, Mike Pence, who was followed by a traditional pool of journalists.
News organizations had tried for weeks to coordinate a pool of journalists to travel with Trump immediately after Election Day if he won.
Trump spokeswoman Hope Hicks said the president-elect's team expects "to operate a traditional pool and look forward to implementing our plans in the near future."
The White House Correspondents' Association, which coordinates press pools and advocates for transparency at the White House, urged Trump to allow journalists to cover his meetings and other movements.
"This decision could leave Americans blind about his whereabouts and well-being in the event of a national crisis," said Jeff Mason, White House correspondent for Reuters and the group's president. "Not allowing a pool of journalists to travel with and cover the next president of the United States is unacceptable."
Trump's meeting with Obama in the Oval Office was recorded by the pool of White House reporters, photographers and TV journalists who cover the president.
Every president and president-elect in recent memory has traveled with a pool of journalists when leaving the White House grounds.
A pool of reporters and photographers was in the motorcade when President John F. Kennedy was shot and killed in Dallas. The pool was just steps away from President Ronald Reagan when he was shot outside a hotel in the District of Columbia and was stationed outside his hospital as he recovered. The pool also travels on vacation and foreign trips and at times captures personal, historic moments of the presidency.
The practice makes journalists eyewitnesses to how the president conducts business, rather than relying on secondhand accounts. They often capture more intimate moments between the president and people he greets. The White House, meanwhile, depends on having journalists nearby at all times to relay the president's first comments on breaking news.
News organizations take turns serving in the small group, paying their way and sharing the material collected in the pool with the larger press corps. The pool also covers official events at the White House when space doesn't allow for the full press corps.
Because of safety concerns, presidents and presidents-elect travel in a bubble of security, with the exact timing of their travel kept secret and streets often blocked off around their events. That leaves news organizations dependent on the White House to facilitate the pool coverage by arranging security clearances and transportation.
Obama also has looked for new ways to limit White House press access.
On Thursday, photographers were not allowed to shoot a meeting between first lady Michelle Obama and Melania Trump, who joined her husband on the White House visit.
The White House released a photo taken by a staff photographer and circulated it on social media. This does lead one to wonder if this is how the new Trump White House will work by sending out approved images only.
White House photographers were allowed to shoot a similar meeting between Mrs. Obama and then-first lady Laura Bush eight years ago.

subset: commoncrawl


text: Red ?hristmas Ball on white background. Zip file contains fully editable vector file eps10. Scalable: to any size without quality loss. Vector objects separated and grouped. I recommend a vector editing in Adobe Illustrator from a CS and above. Layers can easily be edited in Adobe Photoshop as a smart object, for this you just need to transfer them from Adobe Illustrator.


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The Dragon Waiting is a fantasy, an alternate history, a tragedy, and a game of stories. John M. Ford juggles his works -- historians' views, Shakespeare's plays, legends, mysteries, secrets -- in a way that looks effortless; until you look up, and see all the other pieces flying through the air, sparkling and reflecting off each other.
Lest it all go over our heads, I assemble this concordance.
My goal is to document everything that I thought a reader might miss.
This means a lot of documentation. Much of it will be, for any given reader, unnecessary. If you find that many (or most) of the topics here explain the obvious, I hope you'll forgive them for the sake of the shiny bits around the edges.
Like any discussion of art, this documentation constitutes an opinion. That opinion, and the interpretations herein, are my own. I have gathered as many as I could in forming them; if I have disregarded yours, please write and tell me.
Documentation also means spoilers. I make no attempt to preserve the narrative tension or pacing of revelation that John M. Ford intended. If you haven't read The Dragon Waiting, for the gods' sakes, put this aside and go read it first.
Draco Concordans has two parts: a set of page-by-page notes, and an index of topics which appear in the text. I have tried to cross-link and cross-reference everything fluidly.
Page notes, by chapter:
All page numbers are from the 1985 Avon paperback edition, because that's what I have. Names are in the most commonly-used form.
Have I missed things in The Dragon Waiting?
Yes; yes, I have. (Some
things I missed.)
Do you know what they are? Please let me know!
Corrections, emendations, redactions, connections, historical
references, bad jokes, and trivia are all welcome. Email to
All quotations from The Dragon Waiting are copyright 1983 by John M. Ford. I reproduce them for scholarship. The rest of Draco Concordans is copyright 2007 by Andrew Plotkin.
These pages were designed and edited by Andrew Plotkin. The information within was contributed by many, starting with the aforementioned Plotkin guy, and also including: Gunther Schmidl (German), Emily Short (Latin and Greek), Paul Mazaitis (Italian), Christopher Tate, Elise Matthesen, Charlene Ahn, TexAnne.
Thanks to the Shakespeare Collection at MIT, for being a clean and linkable repository.
For primary sources on Richard's era, the collection of the Richard III Society, including the Croyland Chronicle, Fabyan's Chronicle (p512-520), Thomas More's History of King Richard the Third, Polydore Vergil's Anglica Historia (bk 23-25).
Secondary sources that helped orient me: Luminarium Encyclopedia; Internet Medieval Sourcebook; Richard III (Charles Ross, 1981); Bosworth Field & the Wars of the Roses (A. L. Rowse, 1966). The Rowse, I admit, I picked up because I saw a copy for cheap.
Despite everything, Wikipedia was invaluable -- irreplaceable -- in preparing this work. Wikipedia: you'll want to check everything you find, but you'll find out what you want to check.
I never had a conversation with John M. Ford. I am grateful to him, nonetheless, for the joy and brilliance that he invested in his every word. (And he wrote plenty of them.) (Albeit not half as many as I would have liked.) Mike Ford died on September 24, 2006.


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What is a marketing strategy anyway?
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What's the difference between big business and small business marketing strategies?
Frankly, not a whole lot. The strategy starts the same but differs in the conversion. In a small business, the ratio of marketing dollars spent and conversion to business needs to have a lower margin. The other area that differs is there isn't a dedicated marketing department equipped with a big budget.
In a smaller business, the hat of "marketer" often falls on the shoulders of the business owner. A difficult task when you are managing the day-to-day business, production, as well as marketing. To control it effectively you need to develop targeted goals to balance and meet attainable outcomes.
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text:
Article by Ray Duffill
By daytime in World War II, Charlie Mason was an aircraft engineer at Brough, but this just provided cover for his covert membership of Britain's secret resistance organisation. Charlie's role, in an invasion by foreign enemy troops, would be to fight the invaders from behind their own lines with a campaign of espionage, sabotage and disruption.
Charles Arthur Mason was a member of the South Cave Patrol of the secretive Auxiliary Units set up on the orders of Prime Minister Winston Churchill in 1940. This secret army was established with two key roles during an invasion by forces of Nazi Germany; to collect intelligence on invading enemy forces and to organise a guerilla offensive behind enemy lines. Nominally part of the Home Guard, this was certainly no 'Dad's Army'.
An exhibition at Hedon Museum, which opened on Saturday, reveals much about the secret life of Charlie Mason who along with his comrades trained and prepared to resist the invaders. Because of the secret nature of its organisation, the story of this 'underground' resistance army remains largely untold, and for most of his life Charlie, bound by the Official Secrets Act, kept his wartime role secret.
"He didn't tell us much at all about his secret activities," said Charlie's daughter Jo Mulhearn at the Hedon Museum on Saturday. "He'd told us that he worked for a section of the Home Guard, and during the war, he said to Mother 'if the invasion starts, let the chickens out of the coop, then go to the church and make sure the bells are rung to warn people. I'll then be going away… and may not be back for some time.'"
During an invasion, Charlie would have made his way to his operational base, a hide-out in the countryside stocked with knives, guns and explosives from which his unit would conduct operations against the enemy. Some of those items, safely decommissioned, are on display in the exhibition.
Maggie Sumner from the Hedon & District Local History Society was particularly interested in one commando knife in the exhibition which she believes was the one that Charlie brought with him when he gave a talk to a meeting of the Society, perhaps 20 years ago. "The presentation stands out, even after all this time because of the interesting subject matter, but also because of Charlie holding this big lethal looking dagger!" Apparently, in peacetime, the knife was used for nothing sinister but merely as a gardening trowel by Charlie!
Jo Mulhearn opened the exhibition on Saturday, but introducing her was Alan Williamson who has spent 22 years researching the local Auxilary Units – work which he says is ongoing. Alan has written a book, East Ridings Secret Resistance, which was published in 2003. Much of the research for that book was undertaken by both Alan and Charlie – "Charlie was always keen to re-discover the sites of the former Operational Bases," said Alan "he would be the first one down into any forgotten underground bunker."
There was a real threat of invasion in the early part of the war, and whilst that did not take place, the Auxilary Units were kept in active service until finally 'stood down' in November 1944.
The "Secret No More" exhibition currently showing at the Hedon Museum reveals much about the membership and wartime activities of this secret army and draws heavily upon the experiences of Charles Mason (1914 – 2008) and other veterans of this most secret army.
The story of East Riding's secret resistance army 1940-44 at Hedon Museum is open every Wednesday and Saturday, 10 am – 4 pm until Wednesday 4th May 2016. Refreshments are available. Please seek out the signs and notices in Hedon town centre to find your way to the museum which is behind the town hall complex.
A 'must-see' exhibition!


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OVERVIEW: What every clinician needs to know
Pathogen name and classification
Listeria monocytogenes is a short, nonbranching, nonsporeforming, gram-positive rod. There are several species of Listeria, but only L. monocytogenes is an important cause of human disease. Rarely, L. ivanovii and L. gravi have caused human illness in severely immunosuppresssed persons.
What is the best treatment?
Ampicillin or penicillin is generally considered the drug of choice based on in vitro data, treatment in animal models, and clinical experience. There have been no controlled trials to firmly establish a drug of choice or compare efficacies of alternative agents. Based on in vitro synergy and animal model studies, most authorities recommend adding gentamicin to ampicillin for patients with central nervous system (CNS) infection or endocarditis along with any infection in a neonate or immunosuppressed patient. For adults, the ampicillin dose should be 2g every 4 hours. For synergy, gentamicin should be administered as 3mg/kg per day in three divided doses.
Although continued vigilance is warranted, resistance of L. monocytogenes to the most commonly used agents has been very rare; there is no evidence that resistance is increasing.
Treating physicians should check with the laboratory about routine sensitivity testing results to be sure the isolate is susceptible.
Those with life-threatening allergies to penicillin should be treated with trimethoprim-sulfamethoxazole (TMP-SMX) with a dose of 20mg/kg intravenously (IV) per day in two divided doses. In occasional cases with rapid clinical response and a mechanism to ensure reliable dosing, early transition to oral therapy with TMP-SMX may be considered at a dose of three single-strength tablets every 6 hours.Related Content
Vancomycin is an alternative, but both successes and failures have been reported.
Meropenem is active in vitro and is approved for the treatment of bacterial meningitis. Ertapenem is considerably less active than meropenem and should not be used.
Cephalosporins are ineffective and should be avoided. Because of this, ampicillin or TMP-SMX should be added to the initial therapy for bacterial meningitis in those aged more than 60 years or those with impaired cell-mediated immunity due to disease or immunosuppressive treatment.
Linezolid is active, and efficacy has been demonstrated in case reports.
Tetracyclines, erythromycin, and chloramphenicol lack efficacy and should be avoided.
Quinolones are active in vitro, but clinical experience to this point is minimal.
Daptomycin is variably active in vitro; clinical experience is lacking, but MICs would indicate that daptomycin cannot be recommended to treat listeriosis.
Iron is a virulence factor for Listeria. In patients who are iron deficient, it is prudent to withhold iron replacement until the infection is cured or under excellent control.
How do patients contract this infection, and how do I prevent spread to other patients?
Listeriosis is a foodborne illness in humans that occurs year round. Human epidemics and case clusters occur, and there is evidence that seemingly sporadic cases may, in fact, be part of a larger outbreak occurring over a widespread area. Food vehicles of infection have included delicatessen style ready-to-eat meats, particularly poultry products, soft cheeses, hot dogs, milk, and smoked fish. In recent outbreaks, vehicles have included fresh fruits (cantaloupes) and vegetables (sprouts). In some studies, there is an increased frequency of disease in temperate climates during the summer months; other studies do not support this association.
There are no apparent environmental conditions that predispose to listeriosis. Listeriosis is a zoonotic disease, particularly in herd animals. Humans typically acquire infection through ingestion of contaminated food containing viable bacteria. Unlike most foodborne diseases that result in gastrointestinal (GI) distress, human infection following ingestion of Listeria often manifests as invasive disease with bacteremia or meningitis carrying significant morbidity and mortality. Listeriosis is a relatively rare foodborne illness (~1% of US cases) but is associated with a case-fatality rate of 16-20% (second only to Vibrio vulnificus at 35-39%) and causes 19-28% of all foodborne disease-related deaths.
Listeriosis is quite uncommon in the general population, but it is a major cause of bacteremia and CNS infection in those with impaired cell-mediated immunity, such as those with hematopoietic cell or organ transplantation, those with hematological malignancies, and those receiving corticosteroids or anti-tumor necrosis factor agents. There are approximately 1,600 cases in the United States each year with approximately 260 deaths. It occurs worldwide, but prevalence appears to be increased in those countries and communities in which ingestion of unpasteurized cheeses is commonplace (e.g., France, Spain, and the Mexican-American community).
In the early 1990s, food industry regulations were instituted to minimize the risk of foodborne listeriosis through routine surveillance of food processing sites. Within a few years, the incidence of human listeriosis had fallen to almost one-half previous levels and has remained relatively constant ever since.
Other than transmission from an infected mother to her fetus or newborn at birth, human-to-human transmission does not occur, so no special isolation other than standard precautions is necessary.
There is no vaccine.
Anti-infective prophylaxis is not generally recommended. In the event of a foodborne outbreak of febrile gastroenteritis, it might be prudent to give those individuals with underlying immunosuppression who ingested contaminated food a short course of oral ampicillin or TMP-SMX in an attempt to eradicate GI colonization and prevent invasive disease. TMP-SMX given as Pneumocystis prophylaxis has been shown to decrease the frequency of listeriosis in human immunodeficiency virus (HIV)-infected patients and transplantation recipients. Prophylaxis for Group B streptococcal infections given to pregnant women appears to have decreased the incidence of neonatal listeriosis.
At-risk patients should be advised to thoroughly cook raw food from animal sources; keep uncooked meats separate from vegetables, cooked food, and ready-to-eat foods; avoid consumption of unpasteurized milk; and wash hands, knives, and cutting boards after handling uncooked foods. In addition, they should be advised to avoid soft cheeses and delicatessen counter foods, such as prepared salads, meats, and cheeses; and keep cooked perishable foods only short-term in the refrigerator.
What host factors protect against this infection?
Protection against listerial infection is mediated by both innate and adaptive immunity; the adaptive response is primarily mediated by the cellular arm of the immune system. The role of humoral immunity is unknown, but the frequency of listeriosis is not increased in those with immunoglobulin disorders, nor is there any increased frequency in those with deficiencies in neutrophil numbers or function, splenectomy, or complement deficiency.
Those with impaired cell-mediated immunity, whether due to underlying conditions (e.g., pregnancy) or diseases (e.g., lymphoma, acquired immunodeficiency syndrome [AIDS]) or due to therapy (e.g., corticosteroids, anti-tumor necrosis factor [TNF] alpha agents), are at the greatest risk for infection. Those at the extremes of age are also at risk, with the highest infection rates being seen in those aged less than 1 month and aged more than 60 years. In each of these age groups, L. monocytogenes accounts for approximately 20% of bacterial meningitis cases. Pregnant women account for approximately 30% of all cases and 60% of cases in the 20 to 40 years of age group. Iron overload and diabetes are less important risk factors. Invasive infection may occasionally be seen in apparently healthy individuals.
Invaded tissues show inflammation with both acute and chronic inflammatory cells; microabscesses and ill-formed granulomas may be seen in solid organs. When infection occurs in utero, bacteria proliferate in the placenta; the histopathology of the infected placenta with severe inflammation and microabscess formation, even in the absence of visible bacteria, may suggest the possibility of listeriosis to a pathologist.
What are the clinical manifestations of infection with this organism?
The species name comes from the fact that an extract of the L. monocytogenes cell membrane has potent monocytosis-producing activity in rabbits, but monocytosis is almost never seen in human infection.
Infection in pregnancy: During gestation, mild impairment of cell-mediated immunity occurs, and pregnant women are prone to developing listerial bacteremia with an estimated 17-fold increase in risk. The organisms proliferate in the placenta, and cell-to-cell spread facilitates maternal-fetal transmission. For unknown reasons, CNS infection, the most commonly recognized form of listeriosis in other groups, is extremely rare during pregnancy in the absence of other risk factors. Bacteremia manifests clinically as an acute febrile illness, often accompanied by myalgia, arthralgia, headache, and backache. Illness usually occurs in the third trimester, probably related to the major decline in cell-mediated immunity seen at 26 to 30 weeks of gestation. About one-fourth of perinatal infections result in stillbirth or neonatal deaths; premature labor and spontaneous abortion are common. Untreated bacteremia is generally self-limited, although if there is a complicating amnionitis, fever can persist in the mother until the fetus is aborted. Antimicrobial therapy for infection diagnosed during pregnancy may prevent fetal or perinatal infection and its consequences (fetal viability 29% in second trimester; 95% in third trimester).
Neonatal infection: When in utero infection occurs, it may precipitate spontaneous abortion. The fetus may be stillborn or die within hours of a disseminated form of listerial infection known as granulomatosis infantiseptica, which is characterized by widespread microabscesses and granulomas particularly prevalent in the liver and spleen. In this entity, abundant bacteria are often visible on Gram stain of meconium.
More commonly, neonatal infection manifests similar to that noted with group B streptococcal disease in which one of two forms can occur: early-onset sepsis syndrome, usually associated with prematurity and probably acquired in utero; and late-onset meningitis, occurring at approximately 2 weeks of age in term infants, who most likely acquired organisms from the maternal vagina at parturition. Purulent conjunctivitis and a disseminated papular rash have been described rarely in neonates with early onset disease, but clinical infection is otherwise similar to that due to other bacterial pathogens.
Bacteremia: Bacteremia without an evident focus is the most common manifestation of listeriosis after the neonatal period. Clinical manifestations typically include fever and myalgias; a prodromal illness with nausea and diarrhea can occur.
CNS: Organisms that cause bacterial meningitis most frequently (Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae) rarely cause parenchymal brain infections, such as cerebritis and brain abscess. By contrast, L. monocytogenes has tropism for the brain itself (particularly the brainstem), as well as for the meninges. Many patients with meningitis experience altered consciousness, seizures, or movement disorders and truly have meningoencephalitis.
Meningitis: L. monocytogenes accounts for 20% of bacterial meningitis cases in neonates and 20% in those aged more than 60 years. Worldwide, L. monocytogenes is one of the three major causes of neonatal meningitis, is second only to pneumococcus as a cause of bacterial meningitis in adults aged more than 50 years, and is the most common cause of bacterial meningitis in patients with lymphoma, patients with organ transplants, or those receiving corticosteroid immunosuppressive therapy for any reason.
Clinically, meningitis due to L. monocytogenes is usually similar to that due to more common causes, but the presentation may be subacute. The first prospective study of meningitis due to L. monocytogenes was reported in 2006.
Notable clinical features of listerial meningitis included headache in 88%, nausea in 83%, and fever in 90%; but only 75% of patients had a stiff neck at the time of presentation. A focal neurologic deficit was present in 37%. Only 43% had the classic meningitis triad of fever, neck stiffness, and change in mental status. At the time of presentation, 19 out of 30 patients had symptoms persisting for more than 24 hours, and eight had symptoms for 4 days or more.
Remarkable cerebrospinal fluid (CSF) findings included a median white blood cell count of 620 (range 24-16,003) and protein of 2.52g/L. Spinal fluid Gram stain revealed a gram-positive rod in only 28% of patients while blood cultures were positive for L. monocytogenes in 46% of patients. Sequelae in survivors included hemiparesis in two patients and cranial nerve palsies in two others; mortality was 15%.
Brainstem encephalitis (rhombencephalitis): An unusual form of listerial encephalitis involves the brainstem. In contrast to other listerial CNS infections, this illness usually occurs in healthy older children and adults.
The usual clinical picture is one of a biphasic illness with a prodrome of fever, headache, nausea, and vomiting lasting approximately 4 days, followed by the abrupt onset of asymmetric cranial nerve deficits, cerebellar signs, and hemiparesis or hemisensory deficits, or both. Respiratory failure develops in approximately 40% of cases.
Nuchal rigidity is present in approximately 50%, CSF is only mildly abnormal, and CSF culture is positive in approximately one-third; almost two-thirds are bacteremic. Magnetic resonance imaging is superior to computed tomography (CT) scan for demonstrating rhombencephalitis.
Mortality is high, and serious sequelae are common in survivors.
Brain abscess: Macroscopic brain abscesses account for approximately 10% of CNS listerial infections.
Bacteremia is almost always present, and concomitant meningitis with isolation of L. monocytogenes from the CSF is found in 25%; both of these features are rare in other forms of bacterial brain abscess.
Approximately 50% of cases occur in known risk groups for listerial infection.
Subcortical abscesses located in the thalamus, pons, and medulla are common; these sites are exceedingly rare when abscesses are due to other bacteria.
Mortality is high, and survivors usually have serious sequelae.
Endocarditis: Listerial endocarditis is rare. It affects the population at risk for viridans streptococcal endocarditis, produces both native valve and prosthetic valve disease, and has a high rate of septic complications and a mortality of almost 50%.
Febrile gastroenteritis: Many patients with listeria meningitis or bacteremia give a history of antecedent GI illness, often accompanied by fever. Although isolated cases of GI illness due to L. monocytogenes appear to be quite rare, at least seven outbreaks of foodborne gastroenteritis due to L. monocytogenes have been documented. Illness typically occurs 24 hours (range 6 hours to 10 days) after ingestion of a large inoculum of bacteria and usually lasts 1 to 3 days (range 1-7 days); attack rates have been quite high (52-100%). Common symptoms include fever, watery diarrhea, nausea, headache, and pains in joints and muscles. Vehicles of infection have included chocolate milk, cold corn and tuna salad, cold smoked trout, and delicatessen meat. L. monocytogenes should be considered a possible etiology in outbreaks of febrile gastroenteritis when routine cultures fail to yield a pathogen.
Localized infection: Rare reports of focal infections from which L. monocytogenes have been isolated include direct inoculation resulting in conjunctivitis, skin infection, and lymphadenitis. Bacteremia can lead to hepatic infection, cholecystitis, peritonitis, splenic abscess, pleuropulmonary infection, pyogenic arthritis, osteomyelitis, pericarditis, myocarditis, arteritis, and endophthalmitis. There is nothing clinically unique about these localized infections; many, but not all, have occurred in those known to be at risk for listeriosis.
What common complications are associated with infection with this pathogen?
Listeria meningitis may lead to obstructive hydrocephalus. Patients surviving encephalitis or brain abscess often have focal neurological deficits or a seizure disorder. Bacteremia during pregnancy may lead to premature labor, spontaneous abortion, stillbirth, or neonatal sepsis. Other reported complications of invasive disease include disseminated intravascular coagulation, adult respiratory distress syndrome, and rhabdomyolysis with acute renal failure.
How should I identify the organism?
Listeria is most often isolated from blood culture and CSF culture. Febrile patients with impaired cell-mediated immunity should have blood cultures obtained. Those with a clinical picture of meningoencephalitis should have blood and CSF cultures taken. Listeria may be grown from aspirates of localized abscesses (liver, brain, etc.) when present.
Listeria are readily stained by standard Gram stain and appear as short, nonbranching, gram-positive rods resembling diphtheroids. Occasionally, the organisms may be gram-variable, particularly on direct stain from CSF. Also, on occasion, the stained organisms may resemble cocci or diplococci.
Listeria are easily cultured by routine microbiological techniques. Molecular techniques, such as pulsed-field gel electrophoresis, can be used to separate isolates into distinct groups and are useful in identifying and tracking epidemics.
Blood agar is the preferred media for culture of normally sterile specimens, such as blood, CSF, pleural fluid, and joint fluid. In patients with suspected febrile gastroenteritis, the stool should be cultured, but media used to identify typical GI pathogens will inhibit the growth of Listeria. If culturing stool, the lab should be informed. Selective media are available to isolate Listeria from specimens, such as stool or food, that contain many organisms.
On blood agar, colonies appear small and white-gray. When grown on blood-free agar and viewed with light transmitted at a 45° angle (Henry's illumination), colonies of L. monocytogenes appear blue-gray, whereas other bacteria appear yellow-orange. Under the microscope, a characteristic tumbling motility can be demonstrated at room temperature.
Listeria are catalase-positive and oxidase-negative and produce incomplete beta-hemolysis on blood agar. Unlike most bacteria, Listeria grow well at refrigerator temperature (4-10°C) and, by so-called cold enrichment, can be separated from other contaminating bacteria by long incubation in this temperature range.
Listeria grow within 24 hours routinely.
CSF cultures in those with meningitis are almost always positive, unless the patient received antimicrobials prior to obtaining the specimen. Blood cultures are often positive in patients with meningitis or brain abscess (>75%).
Polymerase chain reaction (PCR) for listerial infection is not commercially available and, to date, has not been helpful in the early diagnosis of meningitis due to this organism.
In one outbreak of febrile gastroenteritis, measurement of antibodies to listeriolysin O, a major virulence factor, was useful in implicating Listeria as the cause and identifying those who had been infected weeks after all clinical evidence of infection had resolved.
How does this organism cause disease?
Listeria enters the human host through contaminated food. In the intestine, it crosses the mucosal barrier by active endocytosis of organisms by endothelial cells. Once in the bloodstream, hematogenous dissemination can bring the organism to any site; Listeria has a particular predilection for the CNS. There is evidence that in ruminants Listeria may invade the oral or perioral mucosa or skin and travel directly up cranial nerves to invade the CNS; this may be how rhombencephalitis is acquired in humans.
Listeria are intracellular organisms. Several virulence factors enable L. monocytogenes to function as an intracellular organism. A specific surface protein, LPXTG, helps L. monocytogenes adhere to mucosal surfaces. The bacterium possesses the cell surface protein, internalin, that interacts with E-cadherin, a receptor on macrophages and intestinal lining cells, to induce its own ingestion. The major virulence factor, listeriolysin O, along with phospholipases, enables Listeria to escape from the phagosome and avoid intracellular killing.
Once free in the cytoplasm, the bacterium can divide and, by inducing host cell actin polymerization, propel itself to the cell membrane. Subsequently, by means of pseudopod-like projections, it can invade adjacent macrophages. The bacterial surface protein Act A is necessary for the induction of actin filament assembly and cell-to-cell spread and, therefore, is a major virulence factor. The adjacent cell can "take a bite" of the pseudopod containing the Listeria and internalize the organism in a new vacuole. Again, listeriolysin O aided by phospholipases, destroys the phagosome, leaving Listeria free in the cytoplasm of a new cell. Thus, through this novel life cycle, L. monocytogenes moves from cell to cell, evading exposure to antibodies, complement, or neutrophils.
Ability to scavenge iron, essential for the life of most microorganisms, appears to be an important virulence factor of L. monocytogenes. Siderophores of the organism enable it to take iron from transferrin. In vitro, iron enhances organism growth, and, in animal models of listerial infection, iron overload is associated with enhanced susceptibility to infection and iron supplementation with enhanced lethality, whereas iron depletion results in prolonged survival. The clinical associations of sporadic listerial infection with hemochromatosis and of outbreaks with transfusion-induced iron overload in patients receiving dialysis attest to the importance of iron acquisition as a virulence factor in humans.
These virulence factors enable Listeria to be a successful intracellular parasite. Since cell-mediated immunity is the major mechanism by which we deal with intracellular organisms, it is no surprise that those with impaired cellular immune systems, whether from illness or therapy, are those most often affected.
WHAT'S THE EVIDENCE for specific management and treatment recommendations?
Fortunately, listeriosis remains an uncommon human infection. Largely due to its infrequency, there are no studies available to provide significant data on specific management and treatment. Below are some references that may be useful to the practitioner.
Aureli, P, Fiorucci, GC, Caroli, D. "An outbreak of febrile gastroenteritis associated with corn contaminated by ". N Engl J Med. vol. 342. 2000. pp. 1235-41. (This is a report of the largest foodborne outbreak due to Listeria.)
Brouwer, MC, van de Beek, D, Heckenberg, SG. "Community-acquired meningitis in adults". Clin Infect Dis. vol. 43. 2006. pp. 1233-8. (This is the only prospective study of meningitis due to Listeria.)
Clauss, HE, Lorber, B. "CNS infection with ". Curr Infect Dis Rep. vol. 10. 2008. pp. 300-6. (This is a succinct review of CNS listeriosis.)
Drevets, DA, Bronze, MS. ": epidemiology, human disease, and mechanisms of brain invasion". FEMS Immunol Med Microbiol. vol. 53. 2008. pp. 151-65.
Elinav, H, Hershko-Klement, A, Valinsky, L. "Pregnancy-associated listeriosis: clinical characteristics and geospatial analysis of a 10-year period in Israel". Clin Infect Dis. vol. 59. 2014. pp. 953-61. (This paper demonstrates that treatment of a pregnant woman with listeriosis can result in a healthy birth and that the likelihood of a good outcome increases later in pregnancy).
Godshall, CE, Suh, G, Lorber, B. " Cutaneous listeriosis". J Clin Microbiol. vol. 51. 2013. pp. 3591-3596. (This is the most complete review of skin infection due to Listeria).(This is a description of the pathogenesis of listeriosis with particular attention to CNS invasion.)
Goulet, V. "What can we do to prevent listeriosis in 2006?". Clin Infect Dis. vol. 44. 2007. pp. 529-30. (The title says it all.)
Grant, MH, Ravreby, H, Lorber, B. "Cure of meningitis after early transition to oral therapy". Antimcrobial Agents Chemother. vol. 54. 2010. pp. 2276-7. (This source provides evidence that in certain cases CNS listeriosis can be treated with oral therapy.)
Jacob, J, Lorber, B. " Listeriosis after transient infectious or mechanical disturbance of the gastrointestinal tract". Infect Dis Clin Pract. vol. 23. 2015. pp. 13-15. (Interesting reports of invasive listeriosis following procedures on the GI tract (colonoscopy) or infections of the GI tract (shigellosis; C. difficile).
MacDonald, PDM, Whitwam, RE, Boggs, JD. "Outbreak of listeriosis among Mexican immigrants as a result of consumption of illicitly produced Mexican-style cheese". Clin Infect Dis. vol. 40. 2005. pp. 677-82. (This is a description of listeriosis outbreak in a US community related to specific dietary habits.)
McCollum, JT, Cronquist, AB, Silk, BJ. "Multistate outbreak of listeriosis associated with cantaloupe.". N Engl J Med. vol. 369. 2013. pp. 944-53. (Report of an unusual outbreak due to fresh fruit demonstrating the potential for previously undescribed food vehicles to cause human listeriosis and reminding us of the importance of carefully washing vegetables and fruits before eating.)
Mylonakis, E, Hohmann, EL, Calderwood, SB. "Central nervous system infection with 33 years' experience at a general hospital and review of 776 episodes from the literature". Medicine. vol. 77. 1998. pp. 313(This is a comprehensive, detailed review of CNS listeriosis.)
Mylonakis, E, Paliou, M, Hohmann, EL. "Listeriosis during pregnancy: a case series and review of 222 cases". Medicine. vol. 81. 2002. pp. 260-9. (This is an excellent clinical review of listeriosis during pregnancy.)
Ooi, ST, Lorber, B. "Gastroenteritis due to ". Clin Infect Dis. vol. 40. 2005. pp. 1327-32. (This is a review of the recently described entity of febrile gastroenteritis due to Listeria.)
Schett, G, Herak, P, Graninger, W. "-associated arthritis in a patient undergoing etanercept therapy: case report and review of the literature". J Clin Microbiol. vol. 43. 2005. pp. 2537-41. (This is a review of new association of listeriosis complicating anti-TNF therapies.)
Swaminathan, B, Gerner-Smidt, P. "The epidemiology of human listeriosis". Microbes Infect. vol. 9. 2007. pp. 1236-43. (This is a comprehensive review of epidemiology.)
Voetsch, AC, Angulo, FJ, Jones, TF. "Reduction in the incidence of invasive listeriosis in foodborne diseases active surveillance network sites, 1996-2003". Clin Infect Dis. vol. 44. 2007. pp. 513-20. (This is documentation of reduction in incidence of listeriosis following new regulations governing food safety.)
Copyright © 2017, 2013 Decision Support in Medicine, LLC. All rights reserved.
No sponsor or advertiser has participated in, approved or paid for the content provided by Decision Support in Medicine LLC. The Licensed Content is the property of and copyrighted by DSM.
- OVERVIEW: What every clinician needs to know
- Pathogen name and classification
- What is the best treatment?
- How do patients contract this infection, and how do I prevent spread to other patients?
- What host factors protect against this infection?
- What are the clinical manifestations of infection with this organism?
- What common complications are associated with infection with this pathogen?
- How should I identify the organism?
- How does this organism cause disease?
- WHAT'S THE EVIDENCE for specific management and treatment recommendations?


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Andrew Torrance and Bill Tomlinson have a paper out that challenges "assumption that innovation will be spurred by the prospect of patent protection, leading to the accrual of greater societal benefits than would be possible under non-patent systems." The paper, Patents and the Regress of Useful Arts, "employ[s] a multi-user interactive simulation of patent and non-patent (commons and open source) systems ("The Patent Game"), this study compares rates of innovation, productivity, and societal utility." In other words, the two have taken the idea of a Sim and created PatentSim "to simulate the innovation process in one of three scenarios: a patent system, a "commons†system with no patents, or a system with both patents and open source protection." In the words of Johnny Carson wild, weird stuff, and quite fascinating too. Under their model and testing system it appears "that there is no statistical difference in innovation, productivity, or societal utility between a pure patent system and a system combining patent and open source protection."
This post at Against Monopoly has a nice summary of some of the major articles on the topic of patents and innovation. Which reminds me, folks interested in empirical research should take a read of the paper too as it is trying to fill a gap by testing the innovation assumption in patent theory.
Image: World's first patent for a golf tee; British patent #12941 of 1889, by Bloxsom & Douglas
Source: WikiCommons
The image size is reduced for our site, but go to the original to see/read the patent.


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Saturday, February 6, 2010
Smacksy Saturday Photo: The Effort
Labels: saturday photo
6 comments:
a bob zinger. i can't wait to hear more.ReplyDelete
Have I ever told you how much I love little bums?ReplyDelete
{Cyber pinch}
- KnadeleFebruary 6, 2010 at 2:11 PM
I'm so happy!ReplyDelete
We need a plumber in the family.
Knadele (yummy and funny too; who knew?). What a teeny little tushy and what a great comment. So have you been practicing?ReplyDelete
They just think they are funny don't they?! :-)ReplyDelete
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This symposium will serve as a forum for the exchange of ideas among community members, researchers, public health practitioners, policymakers, students, and advocates on environmental justice and health issues. The goal of this symposium to establish and sustain a community engaged research enterprise on critical environmental health disparities and environmental justice issues, to raise the visibility of racial and ethnic environmental health disparities and feasible solutions with Marylanders, DC residents, and regional stakeholders, and facilitate action for change. Workshop topics include:
- Environmental justice and water issues in the Chesapeake Bay;
- Air pollution, traffic, asthma;
- Food injustice and health disparities in the region;
- Regional need for community capacity-building and creation of a community-based EJ network, among other diverse topics.
Please share the save the date announcement with your colleagues, networks, and community stakeholders who would like to attend or may be interested in speaking at the event. To register. There are scholarships available to community advocates and residents.
Sacoby Wilson, PhD, MS
Assistant Professor
Director, Program on Community Engagement, Environmental Justice, and Health (CEEJH)
Maryland Institute for Applied Environmental Health
School of Public Health
University of Maryland-College Park
Phone Number: 301-405-3136
or Laura Delamarre, CEEJH program associate.


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WP Mail Booster Backend Demos
We have made it very simple for the end user to take advantage of these Backend Demos.
Each step and the modules has been explained very clearly and with the help of adequate screenshots.
This will help the customer become easily familiar with the platform.
Happy Reading!


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Facebook users can now announce when they're expecting a baby, using a special "Life Event" description in their Timelines.
Life Events let users denote major happenings on their Facebook profile pages. For example, users can announce when they have moved, gotten a new job, picked up a new hobby or had a baby.
Until now, there has been no way to announce a pregnancy other than to create a generic Life Event. A new "expecting a baby" category lets Facebook users specify a gender (if known) and a due date, along with the usual categories for people involved, location, photos and the story of how it happened. (For pregnancies, that last category should perhaps be left blank.)
Pregnancy announcements will show up on users' Timeline pages, and they'll also appear under "Celebrations" on users' home pages, along with birthdays and other joyous news.
Although it's nice to see new ways to liven up your Facebook Timeline, the downside with major events like this is that they can lead to bad etiquette. We'll no doubt see instances where people announce their pregnancies on Facebook before calling their loved ones. Or worse, the lure of positive comments and "Likes" may compel some people to make the announcement too soon, which could create a tough situation if the pregnancy doesn't work out.
But it's an optional feature, and a useful one since people are already taking to Facebook to announce their babies anyway. Just keep in mind standard Facebook logic: Don't share anything on the network that you wouldn't want the entire world to know about.
Follow Jared on Twitter, Facebook or Google+ for even more tech news and commentary.


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Ford Reverses Stupid Decision, Brings Back Taurus Brand
In a reversal of one of the most idiotic brand decisions in decades, two un-named Ford execs said the Taurus name will return and be affixed to the two year old, poorly named Five Hundred. In 1992, 410,000 vehicles were sold. The Taurus brand resurrected Ford and outsold all other cars old in America for five years straight. The name as retired last October after 21 years. New Ford Chief Executive Alan Malally has been high on the name since he joined Ford last year. Most assuredly, the ad campaign supporting this launch will be large and far-reaching. Whether or not the renamed Five Hundred will be remotely as popular as the original Taurus is an entirely different discussion.
Topic: Brands, Good


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Six of the best… unknown carols
We ask six top choirmasters to name their favourite little-known festive treats
Graham Ross: I Sing of a Maiden
A favourite and currently little-known carol is Graham Ross's I sing of a Maiden. The text, written in the late Middle Ages, is of supreme beauty and Ross has captured the essence of the poem at least as well as Britten and Hadley. The music depicts the demure and almost mystical figure of the Virgin, through a harmonic palette of gentle but permanent unresolved dissonance and a daring refusal to submit to traditional soprano-alto-tenor-bass texture. The melodies are achingly beautiful and this carol is something new, fresh, stimulating.
Adrian Partington, Gloucester Cathedral
Arr. Richard Allain: Coventry Carol
I've chosen an arrangement of the Coventry Carol by Richard Allain. It's a piece I've known for a few years now, and it's just stunning. Richard's harmonies are special and quite intense at times, but it's a dramatic reading of the text, very beautiful. It's got this haunting, pulsating quaver movement running most of the way through it and it's an expansive arrangement – the scoring is quite wide. At one point in the piece there are five soprano parts as well as double alto, tenor and bass. It's big rich scoring of what's a great melody to start with, and he gives it a wintery haunting feel.
Matthew Owens, Wells Cathedral
Dr FW Wadely: O whither would ye go?
One of my predecessors at Carlisle Cathedral, Dr FW Wadely, composed a lovely carol, O whither would ye go? Set for unaccompanied four-part choir, each of the five verses takes the form of a dialogue between the upper voices who ask the shepherds where they are going and the lower voices who provide the answers. The simplicity and beauty of the music reflect the underlying the message of the carol, which is that we are all called 'In love and humility to fall/At the feet of the monarch of us all.'
Jeremy Suter, Carlisle Cathedral
Arr. Richard Lloyd: I wonder as I wander
I wonder as I wander, an American traditional spiritual, in an arrangement by Richard Lloyd, is my nomination. Having been a chorister in Durham when Richard was Organist and Master of the Choristers, I confess there is a lot of nostalgia in my choice. However this is a beautiful melody, which is treated very simply for choristers alone, but with great care. Lloyd sets it in the rich warm key of B flat minor, within a lilting 6/8, with some lovely descant writing in the right hand of the organ part and a few unexpected harmonic twists. The whole piece finishes ethereally on a single top B flat.
Aric Prentice, Lincoln Cathedral
Arr. Lionel Pike: I wonder as I wander
Arthur Wills: Carol of the Foal
There is a beautiful arrangement of the original Appalachian tune I wonder as I wander arranged by my old college professor, Lionel Pike. He wrote it while I was his organ scholar at Royal Holloway University of London. It's stunningly atmospheric with an opening and closing solo verse which just leaves you hanging… literally 'out under the sky', but it's unpublished. Of published pieces, there's a stunning little carol by Arthur Wills called Carol of the Foal. It's another atmospheric piece with gorgeous, sensuous harmonies that Morten Lauridsen would drool over.
Scott Farrell, Rochester Cathedral
Geraint Lewis: A Little Hymn to Mary
Lewis sets this medieval text for high voices and organ in a spare style. The harmony is slow-moving and there is considerable use of echo and rhetorical silence in the accompaniment. Each line of the text is set discretely in a rhythmically simple and serene style, separated by passages for organ alone. The climax of the piece is a repetition of the first line 'Hail! Quene of Heven' halfway through, where the voices, divided into two, enter forcefully and high in the range. The whole piece is extremely effective in performance and has always made an immediate impression when we've included it in carol services, both at St Davids Cathedral in Pembrokeshire, where it was first performed, and in Hereford Cathedral.
Geraint Bowen, Hereford Cathedral


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You are here: Social Security Administration > Research, Statistics & Policy Analysis > Research & Analysis by Author > Robert H. Mugge
Research & Analysis by Robert H. Mugge
Aid to Families With Dependent Children: Initial Findings of the 1961 Report on the Characteristics of Recipients
from Social Security Bulletin, Vol. 26, No. 3 (released March 1963)
Concurrent Receipt of Public Assistance and Old-Age, Survivors, and Disability Insurance
from Social Security Bulletin, Vol. 23, No. 12 (released December 1960)


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The Dots Wood Hook L - Taupe
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Rounded wooden coat hooks in four sizes and a vast range of colors that invites you to create your own graphic pattern on the wall.
LARS TORNØE ON THE DESIGN "The Dots are a characteristic family of hooks that make a friendly addition to any wall. With their smooth, round edges, they will treat your clothes with the greatest care. Designed in multiple sizes and colors, The Dots can be arranged in any pattern imaginable to express your personal taste. Oh, and feel free to add more as time."
- COUNTRY OF MANUFACTURER: Denmark
- DESIGNER: Lars Tornøe
- SIZES: Diameter Ø: 17 cm;
- MATERIAL: Oiled oak or walnut. Colored versions in painted ash wood
- COLORS: Black, Dark Grey, Grey, White, Oak, Ash, Walnut, Mustard, Petroleum, Dusty Green, Clay Brown, Dark Green, Taupe, Beige-Green, Pale Blue, Burgundy, Midnight Blue, Off- White, Dark Green
- ADDITIONAL INFO: Dots Wood are sold with a French screw with M5 metric thread
- BRAND: Muuto
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Mitchell Canyon Interpretive Trail, Mt Diablo State Park: Mitchell Canyon Trailhead, San Francisco: Marin Headlands - Mt Tamalpais - Point Reyes, California
Mitchell Canyon Interpretive Trail - 4.0 miles
Mt Diablo State Park: Mitchell Canyon Trailhead
|Round-Trip Length:
|4.0 miles
|Start-End Elevation:
|580 ' - 970' (970' max elevation at picnic area)
|Elevation Change:
|+390' net elevation change (+390' total roundtrip elevation gain)
|Skill Level:
|Dogs Allowed:
|Bikes Allowed:
|Horses Allowed:
|Related Trails:
Mitchell Canyon Interpretive Trail - 4.0 Miles Round-Trip
Mount Diablo State Park covers 20,000 acres of Central California oak, chaparral and grassland ecosystems with over 400 plant species across slopes ranging 300' - 3,849'. The Mitchell Canyon Visitor Center accesses the north section of MDSP with a network of trails and fire roads leading to high peaks and deep canyons.
Mitchell Canyon Road traces a short section of Mitchell Creek through a riparian zone that supports coulter pine, blue oak, willow, alder and cottonwoods.
Visitors will enjoy diverse vegetation, mild grades and travel extensions up White Canyon and Meridian Ridge. Mitchell Canyon is an interpretive area - be sure to grab a brochure explaining various markers along the way:
Mitchell Canyon Road arcs south to the Bicentennial Tree, a 200 year old coast live oak selected by Daughters of the American Revolution as a symbol for the Bicentennial of the US Constitution.
Coast Live Oak is named for its perennial leaves, in contrast to seasonal deciduous oak, which drop seasonally. Coast Live Oak leaves are dark green on top and white and hairy underneath. No other oak in California has leaves that curve backwards at its tip.
Like all oaks, coast live oak drop acorns in the fall. Coast Miwok boiled acorns and pounded them into meal. Scrub jays and California ground squirrels help the acorns out by burying them in winter caches, essentially planting the acorns in the ground.
The road-trail continues past Red Road (0.6 miles : 710') and up Mitchell Canyon for the next 1.4 miles to a second large coast live oak at a picnic area (2.0 miles : 970'). This is an ideal place to have lunch and explore the creek before turning back.
The road continues on much steeper grades to Meridian Ridge, which has loop options back to the trailhead and Mount Diablo summit access via Prospector's Gap.
Interactive GPS Topo MapKey GPS Coordinates - DATUM WGS84
- N37 55.195 W121 56.514 — 0.0 miles: Mitchell Canyon Trailhead
- N37 54.837 W121 56.914 — 0.6 miles: Red Road Trail junction - stay straight - 710'
- N37 54.549 W121 57.015 — 1.0 miles: Following Mitchell Creek through canyon
- N37 54.206 W121 56.966 — 1.5 miles: Continuing along Mitchell Canyon Fire Road - 850'
- N37 53.858 W121 56.769 — 2.0 miles: Massive coast live oak and picnic area - 970'
Worth Noting
- Be mindful of fast moving bikers coming down Mitchell Canyon Road.
- Western rattlesnakes inhabit this area. Stay on designated trails and never place your hands or feet where you can't see them.
Camping and Backpacking Information
There's no backcountry camping in Mt Diablo State Park, however three campgrounds are available for car camping. Campsite reservations can be made by phone up to seven months or as little as 48 hours in advance by calling 800.444.7275.
- Juniper Campground: (36 sites | 3,000'). Located approximately 2 miles below the summit on Summit Road, Juniper is known for its views.
- Live Oak Campground: (22 sites | 1,450'). Located one mile above the Southgate entrance Station, off Southgate Road. Live Oak is near Rock City. At Rock City one can explore interesting rock formations.
- Junction Campground: (6 sites | 2,200'). Located where Southgate and Northgate meet at the Ranger Station. This campground is situated in an open woodland area. *Available on a first come/first served basis only.
For more info, visit the Mt Diablo Interpretive Association page: http://www.mdia.org/site/park-information/camping
Fishing Information
- There is no fishing in Mount Diablo State Park.
Rules and Regulations
- There's a $6 self registration fee for entering Mitchell Canyon by car - cash and check only.
- Gates open 8am and close at sunset. Visitors should plan to be in their vehicles by sunset and headed out to avoid being locked in.
- Dogs are not allowed on any trails or fire roads. They are allowed in campground but must be on leash at all times and must be in tent at night.
- No alcohol, hunting or firearms allowed in the park. Violators are always prosecuted as per State policy.
- BICYCLES ARE ALLOWED only on paved roads, fire roads, and designated trails. Speed limit is between 15 - 25 MPH and strictly enforced by patrolling rangers.
Directions to Trailhead
The Mitchell Canyon Visitor Center is located at the end of Mitchell Canyon Road in Clayton, California - within Mt Diablo State Park.
From Highway I-680, take the exit for Ygnacio Valley Road and drive east on Ygnacio Valley Road for just 7.8 miles then turn right onto Clayton Road.
Drive on Clayton Road for .8 miles to Mitchell Canyon Road. Turn right onto MItchell Canyon Road and drive approx 1.5 miles to the Mt Diablo State Park gate. Pay the fee at the gate then proceed to the parking area directly ahead.
Contact Information
Mount Diablo State Park
96 Mitchell Canyon Road
Clayton, CA 94517


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