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Diabetic Neuropathy (Nerve Damage) - An Update
Nerve damage or diabetic neuropathy resulting from chronically high blood glucose can be one of the most frustrating and debilitating complications of diabetes because of the pain, discomfort and disability it can cause, and because available treatments are not uniformly successful.
Some patients find some relief from this nerve damage or neuropathy by keeping blood sugars as closely controlled as possible, getting regular exercise and keeping their weight under control. Using non-narcotic pain relievers consistently throughout the day—rather than waiting until nighttime when symptoms can become more severe—also seems to help if pain is the major symptom. Surprisingly, clinicians have also found that certain antidepressants may be helpful and can take the edge off the pain of neuropathy.
Although pain or numbness in the legs or feet may be the most common complaint from people diagnosed with neuropathy, it is not the only symptom of this complication. Neuropathy can cause a host of different types of symptoms, depending on whether nerves in the legs, gastrointestinal tract, or elsewhere in the body are affected. If you have any of these symptoms, neuropathy may be the culprit:
- inability to adequately empty the bladder of its contents, resulting in frequent infections;
- nausea, vomiting, abdominal fullness or bloating, diarrhea, or constipation;
- low blood pressure upon standing that causes fainting or dizziness;
- inability to lift the foot or new deformities of the foot, or foot ulcers;
- trouble achieving or maintaining an erection.
Although physicians have found some medications and other treatments that help ease these symptoms in some people, prevention continues to be the key. "Hemoglobin A1C readings should ideally be at 7.0% or lower. Those that are consistently near or higher than 8% cause concern that any diabetes complication, including neuropathy, may develop," says John Hare, MD, Medical Director of Joslin Diabetes Center's Affiliated Center's program. "The good news is that the Diabetes Control and Complications Trial shows that people who keep their blood sugars consistently in this healthful range can decrease their risk of nerve damage by more than 50%. Getting diabetes under better control also may help limit the amount of damage caused by neuropathy once it's developed."
If your healthcare provider has told you that symptoms you have been experiencing are a result of neuropathy, you certainly have many questions. The following are some answers that may be helpful to you as you battle this complication.
What are the different types of neuropathy?
There are three broad types of neuropathy: sensory, autonomic and motor:
- Sensory neuropathy (or peripheral neuropathy, usually just called neuropathy) affects the nerves that carry information to the brain about sensations from various parts of the body. For example, how hot or cold something is, what the texture of something feels like, the pain caused by a sharp object or heat, etc. This is the most common form of diabetic neuropathy.
- Autonomic neuropathy affects the nerves that control involuntary activities of the body, such as the action of the stomach, intestine, bladder and even the heart.
- Motor neuropathy affects the nerves that carry signals to muscles to allow motions like walking and moving fingers. This form of neuropathy is very rare in diabetes.
Sensory neuropathy can lead to pain, numbness or tingling in the extremities and, ultimately, an inability to feel heat, cold, pain or any other sensation in affected areas. Autonomic neuropathy can lead to impotence in men, bladder neuropathy (which means the bladder is unable to empty completely), diabetic diarrhea, or bloated stomach. Motor neuropathy can lead to muscle weakness.
If you are diagnosed with neuropathy, your physician may use terms to describe the type that you have based on whether only one side of your body is affected (asymmetric) or both sides (symmetric). If only one kind of nerve is affected, your doctor may say you have mononeuropathy. If several nerves are affected, the term polyneuropathy may be used.
Other terms may be used based on what parts of the body are affected, including:
- Distal neuropathy is a form of sensory neuropathy that affects the hands or feet. It can be asymmetric but is usually symmetric, and is the most frequently diagnosed type of neuropathy.
- Femoral neuropathy is painful sensory neuropathy that centers in the thigh muscles. It can be asymmetric or symmetric.
- Diabetic amyotrophy is motor neuropathy that affects the thigh nerves, with resulting weakness often in addition to or instead of pain. It can be symmetric or asymmetric.
- Gastroparesis is autonomic neuropathy that affects the stomach, preventing it from emptying normally. It can result in ulcer-like symptoms, vomiting, bloating, and poor absorption of food resulting in malnutrition and hypoglycemic episodes as food fails to be absorbed at the anticipated rate. High blood glucose can later result when the meal finally makes its way through the system.
- Diabetic diarrhea is autonomic neuropathy that results in an erratic functioning of the small intestine. This can cause unformed stools to be passed. If the nerves which communicate with the sphincter muscles (which control passing a bowel movement) are not working properly, stool can pass without warning, and/or without the patient being able to control when it comes out, resulting in fecal incontinence. Constipation also can result when the large intestine is involved and the stool remains in the large intestine too long.
- Bladder neuropathy occurs when the bladder nerves no longer respond normally to pressure as the bladder fills with urine, and do not enable the bladder to empty completely. Some urine continually stays in the bladder, leading to urinary tract infections. Symptoms of this problem include cloudy urine, painful urination, low back pain and fever.
- Postural hypotension is autonomic neuropathy that results in low blood pressure when standing. In people with postural hypotension, the pulse does not go up to compensate for the change in blood pressure, so fainting and dizziness can result.
- Charcot joint is also called neuropathic arthropathy and occurs when the bones in the feet fracture or "powder" and the foot becomes misaligned. The foot becomes deformed as a result of the lack of nerve stimulation, which causes the muscles to lose the ability to support the foot properly. Walking makes it worse. People who already have neuropathy in their feet and have lost sensation are at a greater risk of developing this.
- Unilateral foot drop occurs when the foot can't be picked up because a nerve in the leg has been damaged either by blood vessel disease or compression.
- Impotence is caused by autonomic neuropathy and/or sensory neuropathy, and/or blood vessel disease that leads to an inability to have and maintain an erection in men.
What is peripheral neuropathy and what causes it?
Peripheral neuropathy (more commonly called neuropathy) is a general term for diseases that cause damage to the nerves outside of the brain and spinal cord. While diabetes is a frequent cause of neuropathy, it is not the only cause. Nutritional deficiencies (B-12 and folate), chemical exposures, pressure on nerves, or medications (such as some of those used for chemotherapy or to treat AIDS) can also cause neuropathy.
Theories abound as to why exactly neuropathy occurs in people with diabetes. In general, diabetic neuropathy is thought to be a result of chronic nerve damage caused by high blood glucose. "There are many possible ways this might happen," says Dr. King. "Nerves are surrounded by a covering of cells, just like an electric wire is surrounded by insulation. The cells surrounding a nerve are called Schwann cells. One theory suggests that excess sugar circulating throughout the body interacts with an enzyme in the Schwann cells, called aldose reductase. Aldose reductase transforms the sugar into sorbitol, which in turn draws water into the Schwann cells, causing them to swell. This in turn pinches the nerves themselves, causing damage and in many cases pain. Unless the process is stopped and reversed, both the Schwann cells and the nerves they surround die."
Another theory is that certain intracellular metabolites, such as myoinositol, become depleted, leading to nerve damage. Still other theories hold that pathways such as the protein kinase C pathway, being studied by George King, MD, Director of Research and Head of the Section on Vascular Cell Biology and his colleagues at Joslin, are triggered by chronic high blood glucose, resulting in several diabetes complications, which might include neuropathy.
"Recent studies have suggested that decreased blood flow to the nerves can also contribute to the development of diabetic nerve disease," says Dr. King. There are multiple studies ongoing which are designed to improve blood flow to the nerves in diabetic animals and in patients. Two new categories of drugs being examined are called antioxidants and PKC inhibitors. Preliminary studies using these drugs have shown encouraging results in animal models of diabetes. Clinical trials are being planned and some are already in progress.
How is neuropathy diagnosed?
People may seek their healthcare provider's help for treatment of pain, not knowing exactly what causes it. Men may come to the doctor concerned about a decreasing ability to have and maintain an erection. Increasingly frequent urinary tract infections may be another clue, as may be recurring diarrhea or constipation, or vomiting or symptoms resembling an ulcer. Fainting spells upon standing may indicate postural hypotension.
A physician may detect early signs of neuropathy. He or she may notice that knee and ankle jerk reflex tests show nerves aren't as responsive as normal, or may observe a dip in blood pressure when you go from a reclining to sitting position. These are signs that increased attention to blood glucose are warranted to try to limit further problems.
A variety of tests, including electromyography (a test that measures the response of muscles to electrical impulses) and nerve conduction studies (a study of the flow of electrical current through the nerves) combined with clinical observations may help a physician rule out other possible causes of pain and diagnose neuropathy. To diagnose Charcot foot fracture, the doctor may take an X-ray and possibly conduct a bone scan.
How is it treated?
Unfortunately, there are no miracle cures or treatments for neuropathy, although a variety of treatments are often helpful. There is no way to heal or replace nerves that have been damaged.
The most important thing someone who has neuropathy can do is keep their blood glucose levels as close to the target goal as possible, exercise regularly, and make sure his or her weight is as close to what it should be as possible. This will help keep blood glucose closer to normal and limit the damage high blood glucose can cause to nerves. Exercise will have the added benefit of keeping muscles that may be weakened by decreasing nerve activity to remain strong and toned. Christopher Gibbons, MD, of Joslin, says he finds that patients with painful neuropathy say the pain seems less severe if they get some simple exercise regularly.
Patients with painful neuropathy will try almost any kind of pain reliever their physicians will give them. "One can try a variety of non-narcotic pain killers," says Dr. Gibbons. "But one should stay away from the more powerful narcotics, which do not work very well for neuropathy, but will lead to addiction."
Dr. Gibbons recommends acetaminophen (Tylenol®), aspirin and ibuprofen (Motrin® Advil®, etc.) first. Pain medicines are best used regularly throughout the day, rather than waiting for pain to become severe. At that point, pain medicines are less able to stem the tide, says Dr. Gibbons. Some physicians recommend creams that contain capsaicin, an extract of the hot capsicum pepper (which includes red, cayenne and tabasco peppers) and can be rubbed on the skin over the pain. It is believed in some circumstances that these creams block pain signals, although they do not work for everyone—occasionally, they may even worsen the pain in some patients or cause other adverse effects, like eye or skin irritation. Be sure to check with your doctor before trying such products and follow application instructions carefully. Capsaicin, which has been approved by the Food and Drug Administration for treating pain, is available in over-the-counter topical salves that include ArthriCare® and Zostrix®.
Certain antidepressants also seem to be particularly helpful for pain, says Dr. Gibbons. Amitriptyline (Elavil®), desipramine (Norpramin®) or imipramine (Tofranil®) are members of the tricyclic antidepressant category of drugs. These medications are not prescribed because the patient is depressed, "although having constant pain for months can be depressing," notes Dr. Gibbons. "Rather, it seems that the medications block the pain. Patients take them at night, and they have the effect of helping patients tune the pain out. When I prescribe them to patients, I explain that it's kind of like having a full bladder. If you aren't doing anything, you notice the full bladder and you feel the need to go to the bathroom right away. But if you're engrossed in a TV show, you don't notice it as much and can go for quite a while before going to the bathroom. These anti-depressants have largely the same effect on pain, helping patients notice it less. Because the pain is usually worse at night, patients take the medication at night and it seems to help them sleep. It also helps them with the depression and insomnia they may be experiencing as a result of the neuropathy."
"Antidepressants can take several weeks to become effective, so I tell patients to give it a month before deciding whether it is helpful or not," says Dr. Gibbons. "These drugs can also cause dry mouth, which most patients find not to be much of a problem."
Other types of drugs that sometimes help are anti-convulsants such as phenytoin (Dilantin®), carbamazepine (Tegretol®) or gabapentin (Neurontin®). Drugs such as mexiletine (Mexitil®) normally used to treat irregular heart rhythm sometimes relieve neuropathy pain. Drugs like metaxalone (Skelaxin®) that generally depress the central nervous system can help reduce muscle pain. All of these drugs, however, can have unpleasant side effects such as dizziness or confusion when taken in large doses, especially by elderly patients.
Many patients will ask their physician about the value of nutritional supplements or vitamins to ease pain. "If the neuropathy is caused by a vitamin deficiency, such as a B vitamin deficiency, taking B6 or B12 will help," notes Dr. Gibbons. "But if you're body is not deficient in these B vitamins, the vitamins will just go down the drain in your urine. You'll notice that your urine is a very bright yellow . . . but the treatment probably won't do you any harm. As for other nutritional supplements or vitamin treatments, there isn't anything that is widely accepted as being useful, unfortunately. But other vitamins that are not so easily passed through the urine can lead to vitamin toxicity. So you need to be careful that you aren't taking too much of any vitamin supplement in the distant hope of easing the pain."
Some patients have experienced success will other forms of pain management, such as biofeedback, meditation, or acupuncture. "I don't discourage a person from trying any safe, non-drug approach to pain relief," says Dr. Gibbons. "What may not work for one person may work really well for someone else."
Some patients may remember a lot of talk in the late 1980s and early 1990s about a new class of drugs called aldose reductase inhibitors, which were thought to be a significant breakthrough in treating some types of neuropathy. "Unfortunately, to date none of these drugs has proven to be sufficiently effective and side-effects have been a concern. As a result none have come to market to treat neuropathy yet, although companies are still working to develop them," says Dr. Gibbons.
Treating gastroparesis
For gastroparesis, in which the stomach is not emptying properly, physicians at Joslin may prescribe metoclopramide (Reglan®), which will help the stomach push food and get it through the rest of the digestive process. These may be used in conjunction with sucralfate (Carafate®), which "helps to sop up extra acid that may be sitting in the stomach," Dr. Gibbons says.
Treating bladder neuropathy
For those experiencing bladder neuropathy, which results in the bladder never completely emptying, bethanechol (Urecholine®) may be prescribed. "This is a urine propellant that helps to keep the bladder clear," says Dr. Gibbons. "Because patients with this problem will be more likely to develop frequent urinary tract infections, the physician may also prescribe chronic antibiotic therapy to try and keep the bacterial count in the bladder and urinary tract at a manageable level."
Treating impotence
Impotence in men that is a result neuropathy or blood vessel damage (versus psychological causes or due to medications such as anti-depressants or blood pressure medication) can be treated using certain drugs that are either inserted into the end of the penis or injected to cause an erection before intercourse. Vacuum devices that enable an erection to be achieved or a surgically implanted prosthesis are also options to be explored with a physician.
There are other drugs, such as Cialis, Levitra®, and Viagra®, that may be an option, although patients should be sure to check closely with their physician before taking the drug. People with diabetes are more prone to heart and blood vessel disease than non-diabetics. The use of these drugs may lead to the resumption of sexual activity in individuals with underlying cardiovascular disease (diagnosed or undiagnosed), so such use should be reviewed and approved by a physician. Also, the use of these drugs in combination with nitroglycerine tablets (a treatment for acute heart problems such as angina or heart attack) has led to several reported deaths. Finally, there is an unproven suspicion that usage of these drugs may also affect retinal circulation (in addition to its known side effects).
Treating postural hypotension
Patients with postural hypotension may be prescribed certain blood pressure raising medications or may benefit from support stockings to prevent pooling of blood in the legs. For patients with diabetes who also have high blood pressure, the process of balancing blood pressure lowering medications with medications that will keep blood pressure from dipping too low when sitting up after reclining can be particularly tricky, and may require several adjustments to fine-tune.
Treating Charcot damage
Charcot damage is addressed by avoiding putting any weight on the foot while it heals. The foot is usually put into a cast for a period of weeks to limit damage. Later, the patient wears special shoes. Surgery may be needed to restore a more normal shape to the foot.
How can further problems be avoided?
One of the major issues with neuropathy, particularly sensory neuropathy, is that eventually the affected nerves die, and the patient experiences a complete loss of sensation in the area. For this reason, if you have developed neuropathy in your feet and legs, you need to check your feet every day for cuts and other problems that you may no longer feel. You need to make sure your shoes are in excellent condition and don't have pebbles or rough spots in them that could damage feet without your knowing. If you have neuropathy, you should not use heating pads or electric blankets because you could seriously burn yourself without knowing it. You should be especially careful when taking baths to ensure that the water is not too hot, as it would be relatively easy to scald your feet or legs if they have become desensitized to pain.
When will the pain end?
"There's no easy answer to the question, 'When will the pain end?'" notes Dr. Gibbons. "Maybe if a patient gets their blood sugars under good control, that will be enough to ease the pain. If it doesn't, perhaps a daily regimen of Tylenol every few hours plus an anti-depressant at night and regular exercise every day will make the pain manageable. It can take up to two years for the pain of neuropathy, which is caused by ongoing damage to the nerve, to be replaced by the numbness that occurs when the nerve cells are more severely damaged. Our goal in the meantime is to identify ways to help patients manage the pain and discomfort of neuropathy and to help patients lead as normal a life as possible despite the pain or other side-effects caused by this complication."
Page last updated: October 15, 2019


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PACE's ThermoFlo Systems (TF 1700 & TF 2700) are the next generation in semi-automated, cost effective solutions for area array package (BGA) rework. No other systems on the market have the advanced features found on these systems or is easier to use, ensuring operator acceptance and success! Designed for today"s PCBs, ThermoFlo Rework Systems can safely install and remove a wide variety of CSPs, FCs, PBGAs, CBGAs, MLFs, LCCs, and other SMDs. The PC based software is so advanced that creating profiles has never been easier! The PC software guides the operator through an intuitive interface that virtually automates the process.
All operations: component pick-up, alignment, placement, and reflow are completed in a single axis, eliminating the risk of component movement after placement. The PCB holders features fine micrometer adjustment for the most delicate X and Y axis alignments. Precise and accurate, within 25 "m (.001"), Z axis movement is ensured through a twin rail, linear bearing motion control assembly that is similar to those used on automated pick and place equipment. The optic systems utilize advanced digital, color cameras and the highest quality prism available for amazing image clarity. ThermoFlo systems combine convective top-side heating with remarkably stable and powerful IR bottom-side heating for the most effective, repeatable heating process available today. Both systems are self-contained and do not require an external air supply or vacuum connections. Upgrade your area rework capabilities and throughput with ThermoFlo!
230 V Part #: 8007-0466
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- Heater (top side)Convective (air or N2), 1200 Watts
- Bottom Heater w/ adjustable heightIR, 400 Watts x 1 220mm (8.6") x 155mm (6.1")
- Temperature setting rangeTop Heater: 100˚ to 400˚ C (212˚ - 750˚ F)
Bottom Heater: 100˚ to 221˚ C (212˚ - 430˚ F)
- Max Component size65mm (2.5") x 65mm (2.5")
- Max PCB size305mm x 305mm (12" x 12")
- Airflow maximumSelf contained,PC controlled, 20 SLPM
- N2 OptionStandard
- Positioning Accuracy (Z axis)± 25 µmeters (0.001")
- Vacuum450 mm Hg
- OpticsHigh resolution, Vision Overlay System
- Video Inputs2 Composite Video, 1 "S" Video (for alignment optics)
- Dimensions737mm (29") H x 686mm (27") W x 737mm (29") D
- Weight (Without Computer)45kg (100lbs)
- Video Monitor Viewable Area482mm (19") Wide Screen LCD
- Board SupportsIncluded
- Optical Alignment KitIncluded

subset: commoncrawl


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Inspired by conversations on the FOOD52 Hotline, we're sharing tips and tricks that make navigating all of our kitchens easier and more fun.
Today: It's Ice Cream Week -- from broken custard to brain freeze, here our top 5 tips for better ice cream.
You'd think ice cream would be so simple: it's just frozen dessert, right? But from too-soft ice cream to icy leftovers, there are plenty of ways that everyone's favorite dessert can go awry. Whether you're making ice cream from scratch, dealing with the storebought stuff, or just eating it way too fast, we've compiled our top 5 unexpectedly helpful tips for better ice cream. Happy freezing!
1. Blend Away: We'll be seeing more of Bi-Rite Creamery here on the site later this week, but for now here's a lifesaving tip from them for when you overcook or "break" your ice cream base on the stovetop: blend it! Using an immersion blender or just a regular one, whizz your custard until it's smooth again and strain the mixture to get out any final lumps -- that's it. You can continue as directed.
2. Melt and Refreeze: You know how ice cream is always the best just after it's been spun in the ice cream maker? Ever wondered how to avoid the icy, too-hard texture that it takes on the next day after a stint in the freezer? Become an "ice cream snob in all the right ways" with this tip from the Momofuku Milk Bar cookbook: every time you want ice cream, just melt and re-spin it. It's that simple -- your post-picnic melted peach gelato, your too-icy vanilla custard leftovers, your intermezzo cucumber sorbet, all of them: after serving, just melt the leftovers and spin them again when you want more. The texture of a just-frozen ice cream will always be softer and smoother than what you can get by leaving a rock-hard pint out to thaw between dinner and dessert, and the melting and refreezing process does no harm to the ice cream base.
3. Cut It Down to Size: Ice cream left in the freezer can develop unwanted ice crystals and a freezer-y taste. Sidestep those problems entirely with this tip from America's Test Kitchen: cut the carton down to the level of the ice cream so the lid is flush with it. Minimal exposure to the freezer's frosty air means minimal smell absorption and crystal formation.
4. Freeze in the Freezer: This one comes from our very own Peter Steinberg: "If you're using one of those basic $50 Krups or Cuisinart ice cream makers -- the ones with the tub you freeze in advance -- I find that sometimes the ice cream never really sets up as much as I'd like. So I've been known to run the entire machine INSIDE the freezer. I just close the door on the cord, let it run for however long, and voila! Really, truly frozen ice cream. Hey, when it comes to ice cream, a guy's gotta do what a guy's gotta do." Peter, we salute you.
5. How to Cure Brain Freeze: All the ice cream-making pointers in the world won't cure a bad case of brain freeze, brought on when you indulge in frozen treats a little too fast. Enter these four quick cures from Ice Creams, Sorbets, and Gelati: The Definitive Guide.
• Try pressing your tongue against the roof of your mouth. This warms up the blood vessels in the areas that have constricted in response to the cold.• Press your hands over your nose and mouth and breathe rapidly, trapping the warm air of your breath and raising the temperature around your poor frozen face.• Drink a glass of warm water to thaw out your mouth and throat.• Finally -- and this one is admittedly hard to follow -- try eating your ice cream slowly, and in smaller bites!
See what other Food52 readers are saying.


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FAIRFIELD, CT (April 6, 2012) - The Sacred Heart men's and women's tennis teams posted matching wins over the University of Hartford Friday afternoon on the SHU Tennis Courts. The Pioneer men posted a 4-3 win while the women cruised to a 6-1 win over the Hawks.
The SHU women swept all three doubles matches and won at #2 though #6 singles for their second-straight victory. Freshman Nicole Rydzewski (Maspeth, NY) posted a 6-1, 6-0 win over Ashley Harel at #2 to lead the singles charge. Rydzewski teamed with Kritin Legenza (Berlin, CT) to win at #3 doubles, 8-1. Legenza won her #5 singles match against Jessica Galik, 6-1, 6-3.
Seniors Kate Donnelly (Centerville, MA) and Kristina Chao (Needham, MA) teamed up for a win at #1 singles and also won their singles match-ups as well. Donnelly and Chao posted an 8-2 win over Abby Liu and Ashley Harel. Donnelly beat Katina Zampas at #3, in straight-sets, 6-0, 6-0. Chao won at #4 of Haley Gileau, 6-1, 6-1.
Sophomore Gabi Kaldan (New Brunswick, NJ) and senior Delaney Downing (Englewood, CO) took the other doubles match at #2, beating Zampas and Jessica Glik. Sophomore Maggie Tooley (Cheshire, CT) won the other singles point for SHU, beating Christie Greenberg, 6-2, 6-2.
The SHU men opened by winning the doubles point and split the six singles matches to end a six-match losing streak. The senior/freshman combo of Chadd Sullo (Orange, CT) and Justin Pagan (Flushing, NY) teamed for an 8-5 win over Marco Neves and Mike Kennelly at #2 doubles.
Junior John Lopresti (Syosset, NY) and sophomore Luka Bagi (Branford, CT) teamed up to seal the point with an 8-3 win at #3 doubles over Alex Holdstein and Bogden Nedelcu. Sullo along with classmate Jacob Miller (West Chesterfield, NH) and junior Logan Mohering (Naples, FL) pulled in singles wins at #1, #5 and #6.
Sullo beat Neves, 6-3 and 6-2 to set the pace. Mohring and Miller both posted 6-2 and 6-2 wins. Mohring defeated Nedelcu at #5 and Miller beat Ed Ureta at #6.
The SHU men close out the week hosting Monmouth in a Northeast Conference match-up Saturday afternoon.


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Woodstock is in Bibb County, in the Birmingham-Hoover metro area. [NOTE: This is not the only community in Alabama named Woodstock. For links to other places called Woodstock, AL, see the Duplicate Names box at right.]
The latitude of Woodstock is 33.206N. The longitude is -87.15W.It is in the Central Standard time zone. Elevation is 554 feet.
Sections below provide additional information and links about Woodstock travel and tourism, nearby airports, cemeteries, the Bibb County economy, education, environment, genealogy, government, historic sites, libraries, maps, museums, newspapers and other media, nonprofit groups, real estate, recreation, religion, transportation, and weather.
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KC makes money selling sewage sludge
Profits top $2M over past 6 years
A Kansas City farm that uses sewer sludge to fertilize crops for the production of biofuel has generated revenue for the city while providing a way to get rid of tons of sewage produced each year, city officials said.
The city uses the waste as fertilizer on 1,340 acres it owns along the Missouri River near a wastewater treatment plant. The farm grows mostly corn and soybeans that are sold to make biofuel - meaning none of the crops are meant for human consumption, The Kansas City Star reported Monday.
The program has brought in $2.1 million in profit since the city took over farming on the land in 2006.
"That is fantastic," said Tammy Zborel, who works with a sustainability program for the National League of Cities. "That is not a common practice for cities to engage in that level of farming."
The city used to burn its waste in incinerators, an expensive process that requires lots of water, gas and electricity, said Kurt Bordewick, manager of the Water Services' wastewater treatment division.
In the mid-1970s, the city bought 300 acres of Missouri River bottomland and dug two lagoons to store waste from the Birmingham wastewater plant. Every two years, the lagoons were cleaned and some of the waste was applied to the ground.
In the 1980s, the city bought digesters to remove the water from the waste, creating biosolids, which tenant farmers used on crops grown for the city. An elaborate system of pipes was built underground to distribute the fertilizer. The city was producing more biosolids than the farm could handle, Bordewick said, so it kept buying more ground in anticipation of continued growth in population and waste.
The city took over most of the farming in 2006 after Timothy Walters, an agronomist and farm manager for the water department, decided the land could produce more and better crops.
"We do all the tillage, and we plant the crops," Walters said. "We don't do the harvest because we can't afford a $300,000 combine."
The water department conducts extensive testing and monitoring to ensure the biosolids do not contain harmful contaminants.
The effort has paid off, both in increased revenue and reducing the amount of waste that the city needs to burn.
From 2000 to 2005, average yearly gross from the land was $52,373. From 2006 to 2011, after the city took over farming, average yearly gross was $455,451.
And 2007 was the last year when more biosolids were incinerated at the Birmingham plant than were used as fertilizer. Last year, 9,982 tons of fertilizer were spread on the farm, and 2,044 tons were incinerated.
"It's my goal to get out of the incinerator business," Bordewick said.


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SACRAMENTO — Lawmakers are sending Gov. Jerry Brown legislation allowing the state to pay nearly $21 million in settlements for two vehicle crashes involving state employees while they were on the job.
In one, a CalFire chief rear-ended a vehicle on Interstate 210 in San Bernardino in August 2012, killing Gregory Kirwin. The state Department of Justice agreed to pay $15 million to settle a wrongful death claim filed on behalf of Kirwin's children, who were 4 and 7 at the time.
The state also will pay $5.7 million to a man who is paralyzed from the chest down after a motorcycle crash with a Department of Public Health employee in San Leandro in December 2011. Both men were found equally at fault for the crash.
The Senate approved AB234 Wednesday, 35-1.


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Apply for degree
If you plan to graduate for the next graduation date (August, December, May), you need to apply for your degree on the registrar's website. If you applied previously but now expect to graduate later, you need to apply for your degree again, setting a new estimated date. Scroll down, and fill out the form. If your plans change again, and your graduation date will be delayed further, you can out the form again.
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Monday, August 26, 2019
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Exams will only be offered on the scheduled dates. Please plan ahead. All requests for alternate dates will be refused.
Meet in Room 2330; In January, April and July, History
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Sight-singing exams must be arranged by appointment: email@example.com The material for the prepared portion of the sight singing exam is at the end of the the Theory and Sight Singing Comprehensive Exam Study Guide (click link below).
Thesis Guidelines for Composition Students
Your thesis must be submitted to the library in electronic format. Save your score as a PDF file. Be sure to include a title page at the beginning of the work. A sample title page can be found on the "Graduate Comprehensive Exam Study Guides and Comp Thesis Materials" link above this section. If you wish, you may include a page listing instrumentation, performance instructions, and a description of the work after the title page. Please include the title page, and any other printed pages along with the score in a single PDF document. Also required is a Signature Page. A blank signature page also can be found at the link above. Download the blank page and type in your name. Then print out the page and submit the document to your thesis advisor. Once all the signatures are collected, the document will be returned to you. Scan the signed copy and then submit it to the library as a separate PDF. Thus, you will submit two PDFs to the library: the signature page, and your score (including title page and other information).
The link below will take you to the library webpage where you will upload your thesis and signature page. On the right side of the page is a box entitled "Theses at IC." Click the link on the sentence "Students can upload their thesis and signature page with signatures" to access the form and gateway for the upload. Fill in the information and upload your thesis and signature page.


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As a member of the Bureau of Erotic Discourse I've been following this thread with a good deal of trepidation. I haven't waded in and said why I think informing the Rangers would have been a good idea, because I wanted to be sure of what might have happened if they had been involved. I've even wondered if I should try to find Black Swan or Dirtwitch to ask them what they might have done. I can certainly understand why you're angry, but at this point I think the discussion needs light more than heat.
Based on my experiences the advantages of bringing the BR Rangers in would have included the following:
- The option of coming down in a calm space with experienced and knowledgeable persons supervising.
The addition of this camp and this bartender to rangers' radar, reducing the chances of there being further attempts.
Possible expulsion from the event. That might well depend on someone's filing a complaint, and since WHEELCHAIR's friend did not remember the event it might be difficult finding someone who was eligible to file one.
Prevention of WHEELCHAIR's being convicted of a violent felony.
- I do think this is a nasty piece of business, and I would like to stop the asshole doing it, as well as discourage other assholes from trying the same. I don't know what the best approach is. I do think not including the rangers is depriving yourself of a weapon in a nasty fight.


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If you grow winter-weary and long for spring experience shopping for early bloomers to enliven the garden with showy color. Early bloomers come alive in the landscape with a fantastic show of beautiful flowers and lush new foliage. Choose the size and shape perfect for your garden and enjoy the textures these early bloomers deliver.
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text: A friend and I have been trying to get together to fish for a few months. Finally we made arrangements to meet at the pond. The pond is about halfway between each of our homes. Unfortunately some other things came up so that I could not meet him at the time we planned so I arrived at the pond a few hours later than I had hoped. I knew that he might not still be there, but he was waiting for me. I apologized for being late and he laughed. He had been there for about an hour since he had something come up that made him late.


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On July 25, an editorial in The New York Times lambasted the Republican Party for walking out on President Obama's meeting concerning the nation's financial future. Politics aside, the piece pointed out something interesting: a lack of compromise. According to the article, the walkout stemmed from an unwillingness by both parties to reach an consensus.
On August 2, a bill to raise the nation's debt ceiling was finally signed into a law. CNN spoke with Fareed Zakaria of Time Magazine on about how the lack of compromise from Tea Party hardliners nearly held the country hostage.
Compromise is a fact of life. As children, we were taught to share. We cannot always have our way, but we can reach an agreement by which we and another party can both be relatively satisfied. Many of us learned compromise by simply sharing our toys and reaping the rewards of community. The same lessons apply when we broker business deals or negotiate decisions with friends and loved ones.
We all have to protect our own interests, and sometimes it's difficult to find the middle ground. Here are some executive coaching tips for learning how to compromise effectively.
- Know what the other party wants. Likewise, decide what exactly you want out of an agreement. By knowing exactly what all parties want out of a deal, it will make negotiation smoother.
- Know when to make concessions. Along with knowing what you want, know what you can let go. It can help if you're willing to give the other party something they want for something you want.
- Refrain from a stubborn "my way or the highway" attitude. Listen to others who weigh in on the matter. Ignoring or cutting them off is a sign of disrespect and can put everyone on the defensive.
- Conversely, don't tolerate disrespectful behavior from others. Let them know that, if they're not willing to at least listen to you, you're not willing to talk.
- Focus on the situation and resist the urge to judge the people involved. Nothing breaks down communication as badly as throwing around accusations that someone else is being "difficult" or "stubborn" if things aren't going your way.
If employed from a position of strength and awareness, compromise will prove a much more powerful tool than stubbornness.


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Released on
Dec 21, 2007
Oak Brook, Ill. – December 21, 2007 – The American Society for Gastrointestinal Endoscopy (ASGE) has issued guidelines for the role of endoscopy in treating dyspepsia, discomfort thought to arise from the upper-gastrointestinal tract, which affects a fourth of the population in Western countries. An upper endoscopy is a procedure which uses an instrument to evaluate the inside of the esophagus, stomach and small intestine. The guidelines, prepared by ASGE's Standards of Practice Committee, appear in the December issue of Gastrointestinal Endoscopy, the monthly peer-reviewed scientific journal of the American Society for Gastrointestinal Endoscopy.
Dyspepsia may encompass a variety of more specific symptoms, including epigastric discomfort, bloating, anorexia, and heartburn. These nonspecific symptoms can be indicative of an underlying diagnosis such as peptic ulcer disease, GERD, functional disorders (nonulcer dyspepsia), and malignancy. The appropriate role of endoscopy in the evaluation of dyspepsia is both a pragmatic concern for the gastroenterologist and an important determinant in healthcare costs.
"Since dyspepsia affects large numbers of people across a broad spectrum of symptoms, it is not practical to perform endoscopy in all patients with dyspepsia," said Todd Baron, MD, chair of the ASGE Standards of Practice Committee. "In review of the medical data available, we concluded in these guidelines that age and alarm features offer the best guidance for the physician in managing patients and in determining if an endoscopy is appropriate treatment."
Patients With Alarm Features (Symptoms)
Dyspepsia is not only a convenient descriptor for upper-gastrointestinal (GI) symptoms, but also a marker for the risk of structural disease: malignancy is present in 1 to 3 percent of patients with dyspepsia, and peptic ulcer disease in another 5 to 15 percent. Endoscopy offers the potential for early diagnosis of structural disease.
Age and alarm features have been used in an attempt to identify those patients with dyspepsia who harbor structural disease. Alarm features include new onset of symptoms in someone over 50, family history of upper-GI malignancy, unintended weight loss, GI bleeding or iron deficiency anemia, progressive trouble swallowing, pain with swallowing, persistent vomiting, palpable mass or lymphadenopathy, and jaundice.
The guidelines recommend that patients older than 50 years of age with recent onset of dyspepsia or patients of any age with alarm features should undergo an endoscopy. An endoscopy should also be considered for patients in whom there is a clinical suspicion of malignancy even in the absence of alarm features.
Patients Without Alarm Features
Patients with dyspepsia who are younger than age 50 and without alarm features are commonly evaluated by one of three methods: noninvasive testing for Helicobacter pylori (H. pylori), with subsequent treatment if positive (the "test-and-treat" approach), a trial of acid suppression or an initial endoscopy.
In many patients with dyspepsia who have peptic ulcer disease, H. pylori infection will be present. Noninvasive testing options for this infection include a blood test, urea breath testing (UBT), and stool antigen. There is growing evidence that patients who are managed with the test-and-treat approach have similar outcomes when compared with those undergoing initial endoscopy. In addition, the test-and-treat approach is more cost effective. Results from a meta-analysis of five randomized studies of test-and-treat versus an initial endoscopy showed a negligible improvement of symptoms in the endoscopy group, but a savings of $389 per patient in the test-and-treat group.
Many investigators and societies advocate acid-suppressive therapy as the initial strategy for patients with dyspepsia. Proton pump inhibitors (PPI) are more effective than H2 blockers in this approach. Initiation of empiric acid suppression will not address underlying H. pylori in those patients with H. pylori–associated peptic ulcer disease, risking recurrent symptoms when acid suppression is withdrawn. This may prompt long-term acid suppression if no further investigation is performed.
One advantage of early endoscopy is the possibility of establishing a specific diagnosis, such as peptic ulcer disease or erosive esophagitis. The risk of malignancy is quite low in young patients without alarm features. Many patients, however, with early stage malignancy do not have alarm symptoms. Another advantage of a negative endoscopy in the evaluation of patients with dyspepsia is a reduction in anxiety and an increase in patient satisfaction. Yet, there is little evidence to suggest significant improvement in outcomes by the initial endoscopy approach. Most studies demonstrate an increased cost with the initial endoscopic approach compared with the test-and-treat method.
About the American Society for Gastrointestinal Endoscopy
Founded in 1941, the mission of the American Society for Gastrointestinal Endoscopy is to be the leader in advancing patient care and digestive health by promoting excellence in gastrointestinal endoscopy. ASGE, with more than 10,000 physician members worldwide, promotes the highest standards for endoscopic training and practice, fosters endoscopic research, recognizes distinguished contributions to endoscopy, and is the foremost resource for endoscopic education. Visit www.asge.org and www.screen4coloncancer.org for more information.
About Endoscopy
Endoscopy is performed by specially-trained physicians called endoscopists using the most current technology to diagnose and treat diseases of the gastrointestinal tract. Using flexible, thin tubes called endoscopes, endoscopists are able to access the human digestive tract without incisions via natural orifices. Endoscopes are designed with high-intensity lighting and fitted with precision devices that allow viewing and treatment of the gastrointestinal system. In many cases, screening or treatment of conditions can be delivered via the endoscope without the need for further sedation, treatment or hospital stay.


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The Registrar's Office (RO) has undergone a bit of reorganization since the July departure of Chris Hart, the previous Registration & Records manager. We spent some time evaluating the office needs and took the opportunity to strategically realign some functions and adjust staff responsibilities in order to more effectively serve the needs of our student, faculty and staff customers.
Nicolle Nixon DuPont (right) has a new title of Associate Registrar, Registration & Operations. She has responsibility for the broad areas of Registration & Records and also oversees the Residency area and the RO office-wide website and communication work. Nicolle has worked in our unit for over 10 years serving in a variety of leadership roles, giving her broad and deep experience, knowledge and expertise relevant to her new role.
Rossella De Leon (left) will now serve as the official Residency Officer for PSU and will be replacing Nicolle as the representative to the OUS Residency Council. Rosella will have a variety of additional responsibilities, which include managing legal requests for records and providing onboarding support for new employees within the unit. Her new title is Residency Officer & Records Administrator.
In addition to their experience/expertise, both women are dedicated to delivering high quality service to students, faculty and staff. Please join me in congratulating and welcoming them to their new roles.
Thanks to all for your patience as we worked through this transition. As always, please let me or Nicolle know if you have any questions or if you want to discuss any service needs with us.


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Minnesota Vikings general manager Rick Spielman insists his team has no plans to shop wide receiver Percy Harvin, but teams will continue to come calling about a possible trade for the electric playmaker.
One logical landing spot for Harvin: The New England Patriots.
With Wes Welker and Brandon Lloyd potentially on their way out the door, Harvin would fill an immediate need on offense. Not to mention coach Bill Belichick's documented fascination with the wideout, dating back to Harvin's days at the University of Florida.
Karen Guregian of the Boston Herald recently pointed to a conversation she had with Harvin back in 2010, when the receiver acknowledged he thought the Patriots would draft him.
"I'm real familiar with (Belichick)," Harvin said. "He came down a bunch of times to talk to me, talk to the (Gators) team, talk to (quarterback Tim) Tebow. I've heard a lot of things (about the 2009 draft). I think if Minnesota had passed, they would have taken me."
Harvin continued: "(The Patriots) looked at me for special teams play. They thought I could make an impact there right away. They thought I could play slot receiver. We just kind of got to know each other."
The Patriots had the 23rd pick in 2009 NFL Draft, but Harvin didn't get past the Vikings at No. 22. Four years later -- with Belichick and friends in the market for a difference-maker at receiver -- the Patriots loom as a candidate to make a run at Harvin.
Follow Marc Sessler on Twitter @MarcSesslerNFL.


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Obama, Romney and Lagarde to Speak at Newspaper Industry's Annual Conference
By: Press Release | Newspaper Association of America (NAA)
WASHINGTON, March 29, 2012 —
WASHINGTON, March 29, 2012 /PRNewswire/ — President Barack Obama, Gov. Mitt Romney and International Monetary Fund Managing Director Christine Lagarde have joined the impressive schedule of speakers at the nation's largest annual gathering of newspaper media leadership during the Newspaper Association of America's mediaXchange 2012 conference in Washington, D.C., April 2-5.
This event offers an unparalleled opportunity to huddle with industry leaders as they share insights and successes with new business models and new platforms. It has already attracted dozens of major national advertisers for one-on-one sessions with newspaper executives.
Held in conjunction with meetings of the American Society of Newspaper Editors and The Associated Press, NAA mediaXchange 2012 features keynotes and panels that address the pressing issues of newspaper journalism, advertising, digital transformation and more.
President Obama and Lagarde are scheduled to appear at The Associated Press Annual Meeting on April 3, while Romney is speaking at the NAA/ASNE Luncheon on April 4. In addition to these distinguished guests, NAA also has lined up several dynamic sessions and keynotes throughout the three-day event. One featured panel promises to deliver an engaging discussion on the disruptive changes in news consumption, delivery and business models. Participants include:
- Emily Bell, former director of digital content for Guardian News & Media and current director of the Tow Center for Digital Journalism at Columbia University's Graduate School of Journalism;
- Betsy Morgan, former CEO of Huffington Post and current president of Glenn Beck's The Blaze;
- Josh Quittner, former editor-at-large of Time Inc. and now editorial director of Flipboard;
- David Westin, former head of ABC News and current CEO of NewsRight;
- Michael Wolff, author, columnist and founder of news curator Newser.
NAA mediaXchange 2012 is designed to provide valuable ideas and insights to help newspaper professionals continue to grow audiences and revenue for their print and digital products. With 100 confirmed speakers, sessions highlight cutting-edge media strategies, successes in product and revenue development, new ideas and innovations in newspapers, and the latest tactics and techniques being deployed in print and digital. Topics range from paid content, social media tools and mobile product development to political advertising, the "digital first" strategy and the latest research on multiplatform audiences. In addition, more than 70 industry suppliers are expected to showcase their products and resources for newspaper media.
A complete list of keynoters and other sessions is available at http://mediaxchange.naa.org/.
WHEN: April 2-5
WHERE: Marriott Wardman Park | Washington, D.C.
SOURCE Newspaper Association of America (NAA)


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Find Builders in Chauvin, Louisiana
Find Chauvin, Louisiana LA local builder, building companies, and building contractors near you for residential and commercial building repair or new building. Get free estimates, bids, and quotes.
Use the builder directory below as a guide to compare, shop, and find a commercial or residential builder to build your house, business, or home improvement project. Use the Nearby Cities links to find additional builders near you in your area.
Use the Submit Project button above for the fastest, most efficient way to get free estimates. Instead of wasting time contacting building contractors individually, take 2 minutes to fill out our simple form, and anonymously email it to multiple building contractors simultaneously. Then you will start receiving free quotes from multiple building contractors in your area. You can also click on Login to edit your project(s), and manage the bids you receive. There is no better way to do your comparison shopping.
Builders in Chauvin, Louisiana
The below information is public information which was obtained in April, 2011 from the Louisiana State Licensing Board for Contractors. Click on the "Get current license status" links below to go to the State of Louisiana website where you will be able to lookup the current status of the contractors licenses.
You will also want to verify the contractor you choose has the necessary insurance/bonding.
Never use unlicensed or uninsured contractors.
Additional Builders in Chauvin, Louisiana
Qualifying Party: Eschete, Allen J.
204 South Central Boulevard
Chauvin, LA 70344 Parish:Terrebonne
Phone: (504) 594-3103
License Description: RESIDENTIAL BUILDING CONTRACTOR
License Number: 80941 Get current license status
Qualifying Party: Edward Jack James
P.O. Box 609
Chauvin, LA 70344 Parish:OUT-OF-STATE
Phone: (985)594-7777
License Description: RESIDENTIAL BUILDING CONTRACTOR
License Number: 880599 Get current license status
5516 Bayouside Drive
Chauvin, LA 70344 Parish:Terrebonne
Phone: (985) 594-2592
License Number: 554245 Get current license status
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Tim Tebow is expected to ask the New York Jets for a trade or a release in the offseason. We suspect the Jets won't be averse to a divorce.
"We'll see what happens," Jets coach Rex Ryan said Wednesday about Tebow's future. "My focus has to be with those two games, and that's it."
Greg McElroy will start the next two games and get virtually every first-team snap in practice. Ryan's decision to decline saying that Tebow will be on the team next year is a sure sign he's likely on his way out.
Ryan answered questions Wednesday about why he brought Tebow to New York in the first place. In one breath, Ryan defended the move.
"(The Wildcat) hasn't been totally ineffective," Ryan said.
Then again ...
"It hasn't panned out to my expectations and maybe to Tim's either," Ryan said.
Yep, that about sums about the Tebow experience in New York.Follow Gregg Rosenthal on Twitter @greggrosenthal.


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Free shipping over € 149
Free shipping over € 149
Designed by Josef Hoffmann in 1906, the Rundes Modell cutlery fully respected the design guidelines of the Wiener Werkstätte, of which the designer was one of the founders: functionality and practicality together with the refined processing of the materials. In 2000 Alessi reissued a version of this historic service in 18/10 stainless steel. In 2015 Alessi unveils a new version with a reduced assortment compared with the original service: fork, knife and spoon for place settings; fork and knife for fruit; tea and mocha spoons; fish knife and fork. The place setting spoon comes in two versions: the original one with the side-on bowl, and the version with the bowl coaxial to the handle.VIEW THE COMPLETE RANGE
Prominent member of the Viennese Secession, he was born in Pirnitz-Mähren in 1870. At the Academy of Fine Arts in Vienna, he studied under Karl Hasenauer and Otto Wagner and until 1937 he held a course in architecture at the Kunstgewerbeschule of the Österreichisches Museum für Kunst und Industrie. In 1903, together with Kolo Moser he founded the Wiener Werkstätte. He developed his simple geometric shapes starting from the curvilinear language of the European Art Nouveau. One of his most important works was the Stoclet Palace in Brussels (1905-1911). He developed the principles of the total work of art. He died in 1956.


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The U.S. Postal Service reported on Friday that it managed to slow the hemorrhaging of cash in its latest fiscal year, but said a legislative fix is still needed to put it on a sound financial footing.
The mail agency, which does not rely on taxpayer funds, said its loss for the 2013 fiscal year narrowed to $5 billion from nearly $16 billion in the prior year.
The U.S. Postal Service (USPS) said it benefited from growth in its shipping and packages business as well as aggressive cost-cutting that included a drastic reduction in employee hours. But the agency is still struggling under the weight of heavy mandatory payments into its future retirees' health fund, which was mandated by Congress in 2006, as well as the continued slide in first-class mail, its most profitable product.
(Read more: How technology is changing the shopping experience)
"We've achieved some excellent results for the year in terms of innovations, revenue gains and cost reductions, but without major legislative changes we cannot overcome the limitations of our inflexible business model,'' Postmaster General Patrick Donahoe said in a statement.
The U.S. Postal Service has sought legislation that would relieve the pressure of the retiree payments, shift to a five-day mail delivery service, close some rural post offices and allow it to modernize its business service offerings.
Lawmakers for years have failed to reach agreement, partly because they are reluctant to see postal services rolled back in their districts.
(read more: Holiday shopping: Discount stores trail on Web)
House Oversight and Government Reform Committee Chairman Darrell Issa, a California Republican, and postal subcommittee Chairman Blake Farenthold, a Texas Republican, said in a joint statement that USPS losses will continue unless Congress steps in soon.
"Based on briefings the Committee has received from USPS, this is likely the last year that ongoing cost-cutting measures will generate significant savings,'' the lawmakers said. "There is no doubt that mail delivery will be affected in the near future without Congressional action to cut costs and restructure USPS finances.''
With few days left on the U.S. congressional calendar, it was seen as unlikely that any bills addressing these issues will pass by year-end.
Revenue Growth
In the meantime, package services have remained a promising business as more people shop online and need carriers to deliver their goods. Package volumes grew by 210 million pieces this year.
Earlier this week, the USPS announced a potentially lucrative partnership with online retail giant Amazon.com to deliver packages on Sundays in some large cities, including New York and San Francisco. Financial terms of the deal were not disclosed.
The U.S. Postal Service has also entered an arrangement to sell its services out of Staples Inc office supplies retail stores.
The agency's operating revenues rose to $66 billion from $65.2 billion last year, the first growth in revenue since 2008.
To cut costs, the agency reduced work hours by 12 million and consolidated mail processing centers this year.
A plan to cut Saturday delivery of first-class mail was defeated by Congress earlier this year.
Fredric Rolando, president of the National Association of Letter Carriers, said he was encouraged by the improvement in the U.S. Postal Service's finances.
"With the economy gradually recovering from the recession, the Postal Service has returned to operational profitability—with an operating profit of $600 million delivering the mail this fiscal year,'' he said.
Still, this was the USPS's seventh consecutive year of losses as first-class mail volumes continued to tumble, with more Americans communicating and paying bills electronically.
(Read more: Amazon offers Sunday deliveries with US Postal Service)
First-class mail, or stamped mail, fell by 2.8 billion pieces in 2013.
—By Reuters


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Browse by Medical Category
Friday, September 16, 2011
"This is why we do transplants in children," says Nephrologist Avi Traum, MD, nodding toward the energetic 2-year-old who had just affectionately catapulted himself into Dr. Traum's arms. A recent recipient of a kidney transplant, Andrew Johnson looks every bit a typical, energy-rich toddler as he sprints up and down a hallway in the Yawkey Center for Outpatient Care at MassGeneral Hospital for Children.
"What we tell parents-- and they don't believe us until after-- is that you'll see increased energy," Traum says.
Andrew Johnson (left) with MassGeneral Hospital for Children Nephrologist Avi Traum, MD.
Just five months before, Andrew received his mother's kidney in a transplant surgery expected from the time of his birth.
Critical Condition
At 19 weeks of pregnancy, Tara Johnson and her husband Kevin learned their baby had a blockage in the urethra, the path urine takes from the bladder to exit the body. The kidneys filter waste from the bloodstream, which is stored in the bladder until it leaves the body as urine. That urine is an important part of the amniotic fluid that surrounds and protects an unborn baby and helps it develop. Andrew's blockage put him at risk for abnormal lung development, a condition his specialists didn't think he would survive. The Johnsons considered having him undergo an operation while in the womb, but at that time the levels of amniotic fluid surrounding him were too high to allow for surgery.
Fortunately, Andrew's condition improved, but the Johnsons awaited their baby's arrival and a definitive answer to the amount of damage the blockage and buildup of waste had done to his kidneys.
Tara Johnson gave birth to Andrew just six minutes after arriving at Massachusetts General Hospital, where the Johnsons had long been receiving care. "It's a world-class hospital, why not take advantage?" Tara Johnson says of the family's decision to seek care in Boston rather than closer to their Gloucester, MA, home.
Within the first day of Andrew's life, the Johnsons met Nephrologist Avi Traum, MD in the Neonatal Intensive Care Unit at MassGeneral Hospital for Children, where Andrew remained for 11 days.
A few days after Andrew's birth, Chief of Pediatric Urology Rafael V. Pieretti, MD, operated on him to remove excess tissue, also known as posterior urethral valves, from his urethra, the passage through which urine exits the body from the bladder.
Despite the surgery, an ultrasound revealed that Andrew's kidneys were failing due to earlier damage. Dr. Traum prescribed Andrew medications to assist in some of the functions of Andrew's failing kidneys. The medications helped as expected, but at 10 months the Johnsons began at-home peritoneal dialysis for their son, which involves a solution being pumped into the stomach to filter waste from the blood into an external bag. The Johnsons also began exploring their options for a kidney transplant.
Andrew Johnson (left) with his Nephrologist Avi Traum, MD, and his parents, Tara and Kevin.
Preparing for a Transplant
Andrew's parents were both a match based on their blood types, but they decided his mother would be a better fit because she is petite and her kidneys are smaller.
"I felt blessed to be able to be the one," Tara Johnson says.
The next hurdle was Andrew's size. He needed to be 22 lbs in order to undergo the transplant and at that time was just 14 lbs. Children with end-stage kidney disease need more calories to grow, but they suffer from altered taste. Dr. Traum recommended a nasogastric feeding tube, which connects through Andrew's nose to his stomach, and growth hormone shots.
"Those two things really helped," Tara Johnson says.
Andrew's surgery was originally scheduled for December 2010, but a setback with his blood tests required the family to wait until the following March. The Johnsons prepared for the surgeries and childcare for their older daughter Kathryn, who would be at home while Tara Johnson was in the hospital for two nights.
Transplant surgeon Tatsuo Kawai, MD, operated on Tara Johnson and Dicken Ko, MD, surgical director of pediatric renal transplantation at MGHfC, operated on Andrew.
"They were both incredible," Tara Johnson says. "These guys are great, so caring. Dr. Ko would show up at midnight, show up once or twice a day. They were just incredible, and very personable."
Of the care team, including Dr. Traum, the surgical and Pediatric Intensive Care Unit (PICU) staff, Tara Johnson says, "They all worked together beautifully," communicating with the family daily.
"Phoebe Yager, MD, in the PICU, she was phenomenal, she was incredible, she really made you feel part of the process, and with Dr. Traum, your opinion as the parent matters, you feel respected," Tara Johnson says. "It's about the people and MassGeneral Hospital for Children is just great-- it's smaller, you get to know the practitioners. You feel like they have a real stake in Andrew's [well-being]. They care about him."
Tara Johnson stayed down the hall from her son in the PICU's parents' room, which she calls a "godsend," because she didn't have to drive back and forth while her son was still hospitalized. "It's so nice, it was like a little respite," she says of the room, which overlooks the courtyard at Mass General.
Andrew Johnson
Beautiful Recovery
Both Andrew and Tara have recovered well, as evidenced by their energy and liveliness. Andrew sees Dr. Traum regularly for follow-up appointments and together the Johnsons and Dr. Traum are working to wean Andrew off his feeding tube, through which he still receives some of his nutrition and medication.
"Every parent worries about their children. When you have a child with a serious health issue, your worries increase tenfold," Tara Johnson says. "Dr. Traum's compassion, empathy and responsiveness have made the past three years so much easier than if he had not been involved.
"Andrew actually looks forward to going to doctors' appointments, which I'm sure is not the norm. It has really been a joy to work with Dr. Traum," she adds.
Though transplants from living donors typically last 15 years before they need to be replaced, Dr. Traum has high hopes for Andrew, particularly because he received the kidney from his mother and has adapted to it well. Andrew continues to grow, physically and developmentally. This summer he enjoyed trips to the beach and swimming lessons and he began preschool this fall.
"He's developing beautifully," Tara Johnson says.
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Rigi, 1798m
The Hotel Rigi Kulm has been welcoming guests for almost 200 years.
Media gallery
Media gallery
Remarkable for its unique location on the summit of the queen of the peaks, this hotel has 70 beds for hikers, individualists, walkers and nature-lovers. It is also the perfect place for a short break. Having been extensively renovated, the hotel is to reopen at the end of April 2007.
For nearly 200 years all guests have been enchanted by the sunset and sunrise rising over Mt. Rigi. Guests, who don't stay overnight on the Rigi, can ride the cogwheel train up to Vitznau during the summer months.
By public transport:
From Lucerne to Goldau or Küssnacht and then by local bus to Weggis or Vitznau
From Zürich Airport / Main Station to Lucerne and then by boat to Weggis / Vitznau, or from Zürich Airport / Main Station to Goldau.
By car:
From Berne: take the A1 / A2 motorway, from Basel the A2, from Zürich the A4, all of them in the direction of the Gotthard. Exit: Küssnacht (for Vitznau / Weggis) or Goldau (for Goldau)
By boat:
- From Lucerne Bahnhofplatz to Weggis or Vitznau
- By train to Arth and then by local bus to Goldau
Mt. Rigi is serviced by two railways and a cable car and hence is easy to reach:
- cog railway Vitznau - Rigi Kulm
- cog railway Goldau - Rigi Kulm
- cable car Weggis - Rigi Kaltbad
Rigi Kulm-Hotel
6410 Rigi Kulm
Phone +41 (0)41 880 18 88
Fax +41 (0)41 855 00 55


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Anti-Aging Benefits of Creatine
By Will BrinkApril 2005
By Will Brink
Creatine is a nutrient with a long list of potential medical, exercise-enhancing, and anti-aging applications. As discussed in the March 2003 issue of Life Extension, creatine may play a role in preventing and treating diseases such as muscular dystrophy that affect the neuromuscular system.1 Creatine has potential therapeutic applications in aging populations and against disorders such as wasting syndromes, muscle atrophy, fatigue, Parkinson's disease, and Huntington's disease, as well as mitochondrial disorders and brain pathologies. Another article in the September 2003 issue of Life Extension examined creatine's potential role in increasing growth hormone levels, reducing homocysteine levels, and improving the symptoms of chronic fatigue syndrome.2
In this article, we will examine exciting new research on the use of creatine by older adults to fight age-related muscle loss (sarcopenia), improve function in both healthy and damaged brains, and perhaps modulate inflammation. Creatine is proving to be one of the most promising, well-researched, and safest supplements ever discovered for an exceptionally wide range of uses.
What is creatine? In a nutshell, creatine helps the body generate energy. Adenosine triphosphate (ATP), formed in the mitochondria, is often referred to as the body's "universal energy molecule." When ATP loses a high-energy phosphate molecule to become adenosine diphosphate (ADP), it must be converted back to ATP before it can be used again to produce energy. Creatine, stored in the body as creatine phosphate, can donate a phosphate group to ADP, thus recharging it to energy-producing ATP. By promoting faster and more efficient recycling of ATP, creatine helps provide the fuel our bodies need to accomplish physical and metabolic tasks.1
The Scourge of Aging: Sarcopenia
In literally dozens of studies, creatine has been shown to increase strength and muscle mass in young adults and to aid in rehabilitative strength training.3-13 Until recently, data concerning creatine's effects on older adults was very limited. One of the greatest threats faced by aging adults is the steady loss of lean body mass (muscle) needed to maintain a healthy, functional lifestyle. The medical term for this loss of muscle tissue is sarcopenia, a condition that is only now getting the recognition it deserves by the medical and scientific community.
Sarcopenia can be defined as the age-related loss of muscle mass, strength, and function. For decades, the medical community has focused on the loss of bone mass (osteoporosis) in aging adults, but has paid little attention to the loss of muscle mass that occurs with aging. This loss of muscle mass can affect a person's ability to be functional, perhaps even more so than a loss of bone mass. As with most medical conditions, it is easier, less expensive, and more effective to prevent or slow the progression of this condition than it is to treat it later in life. Sarcopenia generally appears in adults after the age of 40 and accelerates after the age of approximately 75.
Although sarcopenia is mostly seen in physically inactive adults, it is not uncommon in people who remain physically active throughout their lives. Thus, while remaining physically active is essential to avoiding sarcopenia, physical inactivity is not the only contributing factor to its development. Like osteoporosis, sarcopenia is a multifactorial process whose contributing factors may include decreased hormone levels (particularly of growth hormone, insulin-like growth factor 1, and testosterone), lack of adequate protein and calories in the diet, oxidative stress, inflammatory processes, and loss of motor nerve cells.14-33
How Creatine Affects Older Adults
With aging and inactivity, muscle wasting or atrophy most often occurs in fast-twitch muscle fiber. These fibers, which are recruited during high-intensity, low-endurance movements such as weight lifting and sprinting, are the most profoundly affected by creatine.
In a study examining creatine's effect on isometric strength and body composition, 28 healthy men and women over the age of 65 received either five grams of creatine daily or a placebo.34 In this random, double-blind study, both the creatine and placebo groups were put on a resistance (weight) training regimen. Fourteen weeks of training resulted in significant increases in all measurements of strength, functional tasks, and muscle fiber area in both groups. However, the creatine group experienced significantly greater increases in fat-free muscle mass, isometric knee extension strength, isometric dorsiflexion (ankle) strength, and intramuscular creatine levels. The researchers concluded, "the addition of creatine supplementation to the exercise stimulus enhanced the increase in total and fat-free mass and gains in several indices of isometric muscle strength."34
An abundance of recent studies has found creatine to have beneficial effects in older adults, especially when combined with a resistance training protocol. One study examined the effects of creatine supplementation on muscular performance in older men over a brief time period.35 The study authors concluded, ". . . seven days of creatine supplementation is effective at increasing several indices of muscle performance, including functional tests in older men without adverse side effects. Creatine supplementation may be a useful therapeutic strategy for older adults to attenuate loss in muscle strength and performance of functional living tasks."
One especially noteworthy study found that creatine's positive effects on strength and lean tissue in older adults continued for at least 12 weeks after they stopped using it.36 According to the study authors, "withdrawal from creatine had no effect on the rate of strength, endurance, and loss of lean tissue mass with 12 weeks of reduced-volume training." For most creatine users, however, optimal benefits occur with continuous use of creatine, which is both safe and well tolerated.
The Secret to Aging: Cellular Energy
What is one important difference between an older and a younger adult? The answer is cellular energy: each cell's ability to produce energy, detoxify harmful compounds, and defend itself against free radical damage and other assaults. An increase in oxidative stress, coupled with a cell's inability to produce essential energy molecules such as ATP, is a hallmark of aging and is present in many disease states.37-40 While a younger person's cells can efficiently meet these challenges, an older person's cells are poorly equipped to do so. Over time, damage accumulates in older cells, and cell death can occur. In younger healthy adults, healthy new cells rapidly repair or replace older cells, but this process slows with age.
A decline in muscle mass with aging, or sarcopenia, may be related to a decline in mitochondrial function. Without optimal functioning of these energy generators that are found in every human cell, both the cell and the entire body experience a decline in function. Research has established that older adults tend to have lower tissue levels of creatine phosphate, ATP, and other essential high-energy molecules. Older adults are also less adept at replenishing these essential molecules after exercise.
One study examined skeletal muscle mitochondrial function and lean body mass in healthy, exercising elderly adults.41 The study measured mitochondrial function and recovery time in 45 older adults (with an average age of 73) and 20 younger subjects (average age of 25) who were matched for body mass. The investigators then had the two groups exercise at different intensity levels. As other studies have found, the older adults had lower baseline creatine phosphate and ATP levels than did their younger counterparts, and they were slower to replenish tissue levels after exercise. As the researchers reported, "Our data suggest that mitochondrial function declines with age in healthy, exercising elderly adults and that the decline appears to be influenced by the level of physical activity." Thus, the older subjects not only had lower levels of essential high-energy compounds to begin with, but those levels were further diminished with more intense exercise.
As studies in older adults show, creatine in supplemental form can ameliorate some of the physiological decline that occurs with aging. Creatine may be one of the safest, most effective non-prescription compounds currently available to improve cellular energy.
Creatine's Anti-Inflammatory Effects
Creatine may also help to modulate inflammation, at least after exercise. One study examined creatine's effect on inflammation and muscle soreness in experienced runners after a 30-kilometer race.42 The researchers looked at inflammatory and muscle soreness markers—creatine kinase, lactate dehydrogenase, prostaglandin E2, and tumor necrosis factor-alpha—in runners before and after the race. One group of runners supplemented for five days before the race with 20 grams of creatine and 15 grams of maltodextrine daily, while the control group received only the maltodextrine. Blood samples were collected before the race, immediately afterwards, and 24 hours after the race.
As one would expect, the control group had large increases in all four markers: a fourfold increase in creatine kinase concentration, a 43% increase in lactate dehydrogenase, more than a sixfold increase in prostaglandin E2, and a doubling of tumor necrosis factor-alpha. All these markers indicate a high level of cell injury and inflammation in these athletes. In the creatine group, however, supplementation attenuated the exercise-induced changes observed for creatine kinase by 19%, for prostaglandin E2 by 61%, and for tumor necrosis factor-alpha by 34%, while entirely negating the increase in lactate dehydrogenase plasma concentration observed in the control group. Participants supplementing with creatine reported no side effects. The researchers concluded, "These results indicate that creatine supplementation reduced cell damage and inflammation after an exhaustive, intense race."
These findings underscore an important point. Regular exercise is an essential component of wellness for people who want to improve their health, minimize body fat, and retain essential muscle mass. Exercise, however, also has potentially negative effects that the body must manage, including increased free radical production. Creatine thus may be beneficial in helping to modulate the inflammatory stress generated by exercise.


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NEW YORK, April 4 (UPI) -- James Franco has spoken out and confirmed that he recently asked out a teenage girl.
The 35-year-old actor caused controversy on Thursday when screenshots of an apparent conversation between himself and 17-year-old Lucy Clode appeared online. Clode and her mother were visiting from Scotland, and the girl met Franco after his Of Mice & Men Broadway show.
The actor allegedly asked Clode to meet up with him after the two snapped pictures and photos together outside of the venue. He apparently later asked the girl on Instagram for her age and birthdate after she posted and tagged him in the pictures they took. She truthfully answered 17, and he went on to ask her for her phone number and hotel location.
Franco posted a picture of himself on Instagram that read "Why are you thirsty for underage ones?" after the screenshots of his and Clode's conversation leaked. The photo has since been removed, but his Twitter response to his own self remains -- "I'm not! I hope parents keep their teens away from me. Thank you."
I'M NOT! I HOPE PARENTS KEEP THEIR TEENS AWAY FROM ME. Thank you http://t.co/I1d4n3yVe0— James Franco (@JamesFrancoTV) April 2, 2014
The actor spoke out about the controversy on Friday during his appearance on Live with Kelly and Michael. The actor expresses his embarrassment and says, "I used bad judgement and I learned my lesson."
"I was feeling awkward," Franco says. "I guess I'm just a model of how social media is tricky. It's a way people meet each other today."
The actor says that many people experience the "embarrassing" ritual of trying to meet someone, but "it gets published for the world" to see in cases like his.
Despite the actor's admission, some believe the incident is all part of an elaborate hoax to promote Franco's new movie, Palo Alto. The film is based on the actor's short story collection of the same name, and follows a group of teenagers as they experiment with sex and drugs. Franco stars as Mr. B in the movie, a character who romances an underage girl.


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KCP573 necesitaba un nuevo diseño de página web y lanzó un concurso de diseño en 99designs.
Un ganador ha sido elegido entre 46 diseños de 6 diseñadores freelance.
Akida (products include: innGAUGE, wattGAUGE,eLOK, ePLUG, uMETER
Innovative technology startup is looking to redesign its corporate website to incorporate existing logo and branding into an interactive site that will allow prospective customers and partners to explore our solution and see how it works to accomplish their energy management and power consumption goals.
The company takes pride in developing forward thinking products and solutions. We prefer a crisp clean european bran and company image. We believe in making superior products that provide both functional and aesthetic value to our customers.
Design will be implemented in a content management system and will need to be structured to allow for programming into html and css for primary navigation and structure. We are open to using graphical animation and/or flash as part of the product demonstrations, designers showing these skills will be at an advantage since contest winner proficient in flash or graphical animation would have additional work as needs evolve.
Sites we Like
• http://econgroup.ca/
• http://www.biomal.com
• http://www.dwr.com/
• http://www.daversapartners.com
1) Business Owners
Energy Savings
Monitoring and Usage Reporting
2) Utility Companies
Smart Meters (Old News) Get the Last Mile into the House
3) Consumer
Green Energy Usage
Cost Management (Greater in markets with tiered/demand based pricing of energy)
4) Multi Occupancy Housing
University Housing
Regular Apt Buildings
We are looking for a home page and interior page for a website that will allow us to inform prospects about our products, demonstrate graphically how the products work, collect prospect contact information, and share event /demonstration information. (this site will be implemented in a content management system allowing marketing to update product information and content without requiring programming help.)
The key element for this design concept is to create a set of graphic elements that helps explain what Akida's technology does and how our products work. We see this as a graphical depiction of how the product or products will work. We have an old version of this for our innGAUGE product. Now that we have moved beyond a single product it is important for this design to support our product/solution families.
Must Have
• Websafe color palette must conform to the existing logo and product identities (these are not to be changed)
• Welcome Page – Animation of Akida Logo as part of the concept for our value.
• Interior Page – Describe secondary navigation and has to show all elements required for implementation in CSS. (tabs, higlight colors, breadcrumb location, header, footer etc)
• Icon library for use in future demo creation
Nice to Have
• Logo concept for ePLUG Logo consistent with the current logo family
• Logo concept for new uMETER virtual metering product


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Introducing a new engine, smoothing out the transmission, and adding desirable features including Apple CarPlay, the 2019 refresh has done a great job of sanding off the Cherokees rough edges and improving its mass-market appeal. - Motor Trend
Not only will you find RAM, Dodge, Jeep and Chrysler models at our dealership, serving the greater Fargo, Wahpeton, ND, Fergus Falls and Detroit Lakes, MN areas. You'll also find a friendly and accommodating staff eager to assist you.
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More than a week after some pro-Israel organizations moved to torpedo the possible nomination of former U.S. Sen. Chuck Hagel as defense secretary, Hagel supporters have pushed back.
Hagel is being slammed by groups including the Anti-Defamation League, the Zionist Organization of America and the Emergency Committee for Israel, which claim his record in support of Israel is weak.
An open letter in support of Hagel signed by eight former ambassadors was released Thursday, a day after a group of Hagel supporters began circulating a "Facts on Chuck Hagel" memo to rebut claims made by his detractors that he will not support Israel.
"We support, most strongly and without qualification, President Obama's reported intention to nominate Senator Chuck Hagel to be the next secretary of defense," the group wrote. The ambassadors praised Hagel for having the courage to do what is politically risky in the best interests of the United States.
"Each of us has had the opportunity to work with Senator Hagel at one time or another on the issues of the Middle East," the ambassadors wrote. "He has invariably demonstrated strong support for Israel and for a two state solution and has been opposed to those who would undermine or threaten Israel's security."
Hagel is said to be favored by the White House for the top Pentagon job, not only for his knowledge of defense and foreign policy but because his Republican credentials would appeal to conservatives. If he is nominated and appointed, Hagel – a decorated Vietnam War veteran – would be just the third Secretary of Defense to have first-hand experience in combat.
But not only have members of Congress, Democrats and Republicans alike, failed to rush to his defense in large numbers, some of those who have spoken say they are "concerned" with comments he made as a senator.
Neither the American Legion nor the Veterans of Foreign Wars would offer any comment when contacted by Military.com. Officials with Vietnam Veterans of America and Iraq and Afghanistan Veterans of America spoke highly of Hagel for his work on military and veterans' issues, but declined to talk about the ongoing attacks against him made by some major Jewish organizations and groups.
"We like Hagel. We think he's a great guy, and having a combat veteran in there would be a good thing," Vietnam Veterans of America President John Rowan said. "The Israeli thing? That's not our thing. I'm not an expert on foreign policy. If there's an issue, they'll dredge it up at the confirmation hearing."
Paul Rieckhoff, founder and Executive Director of IAVA, called Hagel "a balanced, thoughtful, honest, non-partisan guy, and I think for our community, especially, it would be really important to have a combat veteran in this job … I'll let the experts on Israel comment on those [other] things."
One exception was Jon Soltz, founder of VoteVets.org, who on Thursday called the anti-Hagel arguments and attacks "cheap political antics."
Soltz, who is Jewish, told Military.com he has known and worked with Hagel. Hagel is neither an anti-Semite nor anti-Israel, Soltz said, but a moderate who has acted in the best interest of Israel.
"There is anti-Semitism in the world," said Soltz. "There are people who are against Israel. [Hagel's critics] need to reserve those comments for when it matter. What they're saying hurts all Jews, it hurts their ability to understand when [anti-Semitism] does exist."
Retired military analyst Chuck Spinney said there are legitimate reasons to question whether Hagel is right for the job. Spinney doubts Hagel will be tough enough to fight the entrenched interests at the Pentagon.
But Hagel is not anti-Israel or an anti-Semite, Spinney said.
"I am ambivalent about whether Chuck Hagel has the managerial and bureaucratic skills to make the kind of [Secretary] of Defense we need to clean out the Pentagon's Augean Stables," he told Military.com in an email Thursday. "[B]ut the outrageous neo-con assault on him because he does not kowtow to the [right-wing Israeli] party line is over the top."
No sooner had Hagel's name emerged as a possible successor to Leon Panetta in late November than critics of his views and past votes dealing with the Middle East began taking shots at him. Conservative Washington Post blogger Jennifer Rubin accused him of wanting to negotiate with Hamas and not voting to label the Iranian Revolutionary Guard a terrorist organization.
For the most part the anti-Hagel campaign has been waged in ink and online, with scant television coverage. That changed on Thursday with a television commercial sponsored by the Emergency Committee for Israel urging President Obama not to nominate Hagel.
Hagel's one-time Senate colleagues have largely remained quiet. Sen. Carl Levin, chairman of the Senate Armed Services Committee, and Sen. Diane Feinstein, both say they support Hagel.


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Swimming Pool Blog
by John Galcius , March 28, 2009
For today's pool designers, the surrounding landscape can have as much of an impact on job design as the pool itself. Blending elements of wood, rock, plant and water may seem to be Feng Shui, and indeed the integration of these elements in a balanced way can result in an awe-inspiring pool setting. Plantings around a pool can soften architectural lines, provide privacy and prevent access or guide visitors along prepared pathways.
INGROUND POOLS - Your best chance to make your mark on your backyard pool area is with landscaping. Landscaping around a pool is different than a regular backyard without a swimming pool. In your pool area, use non deciduous trees and shrubs to keep leaves at a minimum. Hollys, Junipers and palms work great in a pool environment. The key here is to keep things like flower buds and petals, leaves and other plant debris away from the pool water.
Trees like Cherry, Poplar, Gum and Oak are beautiful in the spring, if not year round, but they will increase your workload and some of their debris can clog pump impellers. Evergreen trees, Palms or Cactus add dramatic landscape with less "shedding". I would avoid most conifers and pine trees because of the needles and the pollen. Avoid fruit bearing trees, which are a mess to clean up, and can attract bees and wasps.
For ground covers that are attractive and chlorine resistant, look at Trailing Rosemary or Gazanias. Good ol' iceplant is popular in the sunbelt. Hosta is popular in the north, as is pampas grass. Rock gardens are a good idea as a ground cover, much better than mulch, which tends to wash into a pool (!) during a strong summer storm. Certain types of clover can fill planter beds or surround strategically placed boulders. Generally speaking, pool water is harmless to plants. There are many jurisdictions that send water to your tap at home with a chlorine residual of 2-3 PPM - that's more than most pools!
While in your backyard pool landscaping dreams, consider fencing, hedges and retaining walls. Short walls and fences or even deck levels do a great job of keeping debris from blowing into the pool. All pools should have a deck of concrete or wood, surrounding the pool. Grass right next to the pool is a mess. It is almost impossible to mow, or trim the lawn without getting grass into the pool.
ABOVEGROUND POOLS - Above ground pools are easier to landscape, but more necessary. The sight of an aboveground pool wall is large and white, and well, unattractive. The best thing for this may be to install a deck around a portion of the pool, and a nice hedge of bushes around the rest. If you do plant bushes, remember to leave enough room for service on the pool and pool equipment. To keep roots from running under the pool, plant at least 18" from the pool wall and consider sinking a barrier wall underground, between pool wall and bushes.
Cyprus and holly are also a good choice around an aboveground pool. Most above ground pool owners put a 3'-4' rock border around the bottom edge of the pool. This is a great idea. If mulch, or even grass gets anywhere near the bottom of the pool wall, it will not allow for evaporation of any water or moisture, thus rusting the pool wall and bottom ring prematurely. As a rule, keep mulch and dirt away from the pool wall. Stones will allow for evaporation. A vapor barrier can also be installed against the pool wall to slow any effects of soil against the pool wall.
Planters can be a good choice for a seasonal pool in the northern climates. Large clay pots with tropical plants and small palms can be spaced around the edge can be a quick landscape fix, and can be brought into the house during the winter.
Creating a small wall around the base of the aboveground pool will help to keep the yard and planting areas separated. This will make it easier to keep plantings out of the yard, and vice versa, while preserving pleasing visual lines.Make sure plantings do not obstruct the view to the pool, for safety's sake!
Installing your own plants, shrubs and trees around above ground pools is no small task, but it can be fun! Providing shade and cooler breezes is the calling card of swimming pool landscaping. Your pool can be more attractive, more enjoyable and even safer, by limiting pool access to areas that are highly visible. Your local nursery can provide you with expert advice on the types of plants and trees that grow especially well in your climactic region. We hope you consult them, and enjoy your pool even more this year!


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Veteran's Oil, Inc. is a full line Shell and Peak Lubricants distributor providing prompt, friendly service.
Prompt delivery, accurate product recommendations, ShellcareShell, Lube Oil Analysis, Shell LubeVideo Check and DEF (Diesel Exhaust Fluid) are our main service offerings. We also maintain the inventory at several customer locations.
Nimble reaction to market conditions, niche marketing, a diversified customer base, as well as excellent service and customer relations are our formula for success.