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47 thoughts on "TMI: The Mooncup"
First time I removed mine I got blood EVERYWHERE. Now, I just empty it when I shower. Gross perhaps? It all ends up in the same pipes…
I've been using the same mooncup for about 8 years now. I love it. Never have to worry about running out of pads or tampons, and to think of the money I have saved over the years. Weee.
I loved my moon cup rip off (the keeper – there are many different brands) right up until the moment my dog ate it… I think that grossed me out more than taking it in or out! They are good to measure how much blood is coming out, for those that like to monitor their periods it does help.
You do need to clean them properly once your period is over, but that can be as little as submerging in boiling water, easy peasy.
Anything that allows you to sleep naked in the summer, even with your period is amazing! I am going to buy a new one, and make sure the dog doesn't get this one!
I've been using a menstrual cup for 10 years, starting with the UK Mooncup – http://www.mooncup.co.uk/wc.php?u=1741 – I'd never go back to tampons or pads. No risk of TSS, vaginal infections, increased cramps, increased bleeding, irritation, allergic reaction, or any exposure to dioxin like with tampons – thus wear for 12 hours, with any flow, overnight, before your period, and no need to alternate with pads. Plus tampons aren't recommended to pre-teens or teens and shouldn't be worn from menarche – cups are fine from menarche and recommended to younger women.
Plus many other benefits…environmentally friendly (reducing harmful manufacturing CO2 emissions, and waste), companies are ethical and body-positive, cups can improve your body-literacy, companies are small usually women-run businesses, cups are becoming as popular as they are based on word-of-mouth alone which is a huge testimonial in itself, they are very comfortable, the cheapest sanitary product available, and best of all for those of us with super-heavy flow they hold a lot more plus have light suction so don't leak like tampons or pads.
Menstrual cups = awesome!
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I've been mooncupping for two years now as I love the eco-freedom of not having to buy so many tampons,and it seems more natural not to rely on a series of packaged and disposable sponges.
However, while I'm really pleased for you guys who find it the perfect seal and the only protection you need, I do have to wear pantyliners as back up – it seems like when I sit down, the cup/my vejay changes shape and breaks the seal, if its more than a quarter full. Does this seriously not happen to other people? I wonder why it does to me.
Also its awkward if there's no sink within reach when emptying it, not only to wash the cup but to rinse off the blood dripping down my fingers… the toilet paper option takes much longer and is more stressful than a tampon changeover – especially when people are waiting in line outside a cubicle. So while I do prefer to mooncup, tampons are still the simplest option unless I know I'll be near bathrooms with sinks, or that my flow's light enough not to change until I'm home.
PS a couple of tips someone told me about the seal:
- When its been folded and inserted, rotating it should pop the rim out if it wasn't already, and it should form the seal.
- When you want to bring the cup out, pinching the base of the cup will change the shape of the rim and break the seal.
I would love to hear some tips on avoiding overflow?!
Thanks for writing this! I have planning to change over to a cup for a little while… Any ladies in the US know where to purchase?
I bought a Mooncup and really really want to use it, but I just can't get the hang of taking it out – part of the problem I think is if I can't get it out first time I start to panic a bit and then clench more; last time I tried it took me nearly 20 mins to get it out – I started thinking about embarrassing A&E trips – and because of that I daren't cut the stem any shorter, but it's too long and rubs making it very uncomfortable.
It's not just you – I still have to wear a light pad most days along with the mooncup, and I've been using cups about ten years. The reason being that I have ridiculously heavy periods, so it fills quickly and I do get a little leakage. But I've gone from getting through about 6 pads and tampons a day to just one pad, so that's a massive improvement for me – I use cups for the heavy periodness, not environmental reasons tbh.
I haven't experienced overflow myself when using my moopcup, but perhaps you need a different size? I know currently there's only two sizes.
I totally had a panic trying to get it out the first couple of times and was convinced it would have to stay there forever! Sometimes it is still a bit tricky, but I find if you can pinch the base of the cup and give it a wiggle, rather than just pulling at the stem, it will release the seal and come out easier.
One of those weird things…I was telling the beau just last night how I'm considering changing over to the cup, but not too sure how it would work for me and if I'd be comfortable with it.
Thanks for the wonderfully informative article… off I go to purchase my first cup!
Yes, depending on which side of 30 you are and whether or not you've had kids. I don't intend to replace this one for a few years yet and I'll be in the over 30 camp then. It leaks because it fills so quickly, in my case, and it does with a couple of other cup loving friends I have. Don't get me wrong, this thing is amazing, I just think people should know it can and does happen and it isn't always due to human error when putting it in place.
There is another brand called The Diva Cup which is easier to find in the US: http://divacup.com/
I use a Diva Cup and love it.
Ladies, on the subject, anyone have suggestions on how to use a cup (or honestly tampons do the same thing to me) without it making cramps worse? I have a cup, and I love the idea of it, and I love how well it works when I can manage it, but I just can't seem to use anything internal without doubling my cramp-load. (And it doesn't make any damn sense because I have horrible cramps and an almost nonexistent flow, so it doesn't seem like they're endometriosis or any of the usual culprits…) I've had periods for hmmm wow 20 years now, and it's not getting better as I get older – it's getting worse (so it's not a "puberty ups and downs you'll straighten yourself out" thing).
So, any thoughts? I figured the Vagenda is the place where ladies who know cool stuff hang out, y'know?
I have one but as I've only used tampons a couple of times, I'm finding it very hard to insert which is depressing because I have to buy extra thick pads for a heavy flow and want to cut down on them. The prices for sanitary stuff is ridiculous. My period came early on a trip away and I had to spend over 10 euros for supplies of inadequate pads GRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR
I've been thinking of changing to a Mooncup for a while, mostly for environmental reasons, but whenever I read anything about objections to it, my main one is never mentioned. I just find the idea of rinsing all that blood out with just water before putting it back inside quite unhygienic. I especially dislike the idea of it sitting around for 3 weeks or so gathering bacteria before being needed again. I'm really susceptible to thrush and wary of anything that might provoke this. Anyone know anything about this?
Interesting: I've found that internal solutions also give me bad cramps, and have for, hmmm, 20 years now. I've been using a mooncup for the last year, and the cramps are bad on the heaviest two days of my cycle (when I have to empty every two hours, sometimes!). The solution I have worked out so far is (a) frequent emptying at peak flow, (b) pre-emptive painkillers, and (c) telling my body to Get Over It (the female equivalent of Jens Voigt: "Shut Up Uterus!", if you will).
You're not a fellow retroverted uterus, are you?
The vagina is pretty good at self-cleaning. It contains symbiotic bacteria which fight for you, and kill off nasty invading bacteria (which is why chemical/soapy cleaners can be bad, as they kill off the Good bacteria).
You can boil/Milton your mooncup each month to sterilise it if you feel the need, but I usually only bother every few months. I travelled around India with only extremely dodgy water to rinse my cup (I was worried that the water purification chemicals would damage the silicone), and was absolutely fine!
I've been using a mooncup on and off over the last couple of years and loved it mostly, but have had ongoing problems with leakage (not overflow, just a bit of blood sneaking out somehow) – so have gone back to using tampons for my first couple of days. I need to double check which size I have but I thought I'd bought the bigger one. Anyone got tips here? I've had very heavy periods lately and even super plus tampons aren't quite doing the trick so might just go back to my moonie with a pad to back it up.
Great article. I have been considering making the switch for a while now, and I think I have been convinced. In relation to this, I went to the cinema yesterday and on the back of the toilets was an advert for a 'Femme cup', which some person had scribbled 'yuck, disgusting' all over. But I was heartened to see others had responded with 'every girl gets them' , 'they're actually quite environmentally friendly' and even 'GO FEMME CUP, YOU DO YOUR THANG'.
I've always used tampons, for the last 10 years, but over the last two or three months I've found that they've become unbearably painful and I've had to resort to pads. I hate pads, and have considered migrating to the Mooncup. Can someone answer my two questions please:
-If tampons are causing me problems, will a Mooncup also be an issue?
-I find the thought of taking it out really disgusting – do your hands get covered, or is it not that bad? My flow is 'Super' in tampons.
Cheers ladies
I used to suffer from almost constant thrush (very unpleasant) but it's almost disappeared completely since using the mooncup! Only get about one bout a year now which is great!
Obviously I can only speak for myself, and I alone do not constitute a peer-reviewed medical study, but I think the mooncup helped.
you can just buy it online as well- ships from the UK but I'm in Australia and had no problems.
I tend to use a little hand soap and rinse extra well- I've had no problems!
I've only just switched to the mooncup (partly environmental reasons, partly sick of running out of tampons at inopportune times and then having to pay crazy prices for more!) and have had the same experience- freaking out at size of it, realising folding it is the way to go, freaking out at getting the damn thing out, but now loving it and extra loving never having to buy more sanitary products! (also the non-drying-out thing is awesome.) it took me ages to actually buy one because the logistics of removing and washing it seemed a bit tricky/gross- but I agree with someone above, doing it mid-shower is the easiest!
I have been using Mooncup for maybe 6 years. I recently went away without it and had to use tampons for the first time in aaages. They suck. I was surprised by how uncomfortable I found them, given that I used to use them all the time before Mooncup came into my life.
One of the problems with tampons is that they absorb everything, even the good stuff. Using a Mooncup is much more comfortable for me because it's smooth and non-absorbent, so there's less friction, more natural lubrication.
As for your other question, the short answer is: it's not that bad. When I first started using a cup I was surprised by how little blood there seemed to be most of the time. It looks like much more when it's spread all over sanitary products. (Traditional products seem really gross to me these days). Sure there are times when it doesn't go to plan but usually the blood stays in the cup, I empty it in the sink, rise, replace. I pretty much only empty my cup in a bathroom where there is a sink so I can wash up in private.
I probably have a 'super' flow too, but there is usually only one day (the first or second) where I need to monitor closely and empty every 4 hours or so, and may need a liner in case of leakage. Charming. At the tail end it's super easy because you can just empty twice a day, am and pm, until there's nothing left.
I love my Mooncup and would never voluntarily go back. Other than PMS and still feeling the cramps, it's much like not having periods at all. Which I am totally in favour of!
Be brave and good luck!
I love my mooncup, been using it for years now and I would never go back to tampons or pads. I would say though in terms of leaking, if you're using the smaller cup then try the bigger one. I originally bought the smaller but found it moved too much and leaked quite a bit no matter how I positioned it, so swapped to the bigger one and that was much much better. I know it says that the bigger one is for those over 30 who have had kids but this is only a guide, I was worried getting the bigger one and being under thirty and without kids meant my vagina was abnormally big or something but I got over that and have loved my mooncup ever since!
I've been interested in the idea of the mooncup for a while – no more embarrassing tampon falling out of pocket moments would be a bonus! However l have the copper coil fitted and worry about the suction pulling it out. It was painful enough to be fitted in the first place, I don't want to go through that again too soon.
What I'm asking from the Vagenda community, is whether anyone has experience (good and bad) or the mooncup and coil?
Push! My mooncup had a delightful tendency to move out of reach, especially after exercise, which caused more than a slight panic the first time. So I took to pushing down to move it closer to the exit before I even tried to reach it. You use the same muscles to push a baby (or mooncup) out as you do to poo. I found lots of small pushes was more successful than one big one and it'll probably take a couple of attempts to get the hang of it, but on a couple of occasions I've managed to nearly completely remove it without touching it :).
Though I feel like I should point out that after 9 months of pregnancy and 7 months of breast feeding, I haven't had a period for a while so am out of practice and maybe looking though rose tinted spectacles.
Ive used a mooncup with a copper coil for the past two years (maybe for similar reasons as each other actually – both reduce our dependency on big pharma/ disposable gumph). I've never noticed any interaction, even after I had a new coil fitted a few months ago. Also, the only time Ive felt any suction is when Ive tried pulling the cup down with the stem instead of pinching the base to break the seal – normally i can already reach the base, and sometimes I have to PUSH it down a bit as suggested above by Lizzie!
Go for it, if the coil was moving Im sure you'd feel it (*also remembering the pain of its arrival in my life!*). The mooncup FAQs support us, saying we have the same risk of expulsion when using a cup or not – one in twenty apparently, i didnt realise that til now…
Hmm, being 2 weeks into my 30s Im gonna go for it and sign up my membership to the wider vagina camp!
I also have a copper coil and use a mooncup.
I have found since I got my coil that my mooncup doesn't seem to be as effective but to be honest I think a lot of it might be to do with the increase in blood flow. This is another thing that has been useful, I knew from using my mooncup and monitoring my blood flow that I had period which averaged about 40mls, which is fairly low; after I got my copper coil I could visibly see how much the blood flow had increased and it was really high on a couple of periods, about 90-100mls and that confirmed to me why I was feeling so shit and tired and I discussed it with my doctor.
It's also been comforting to know that the blood flow has been decreasing again after a while and I can continue to monitor it.
in terms of suction, I worried about this too, especially when I tried to change to the bigger cup because I was leaking. The bigger cup is too big for me and the suction is too strong and I really did worry I'd pull the coil out so I stopped using it (that and the fact that I really struggled to get it out at all, producing the same feeling of panic you get when you're stuck in clothes in a dressing room!)
I really love my mooncup though, even though it does leak sometimes. I usually just put a bit of toilet roll in my pants to make sure I'm not all leaky on them.
Also I am almost certain it's reduced my thrush as well, I used to have really bad problems with thrush even when following a low sugar/yeast diet and I don't have as many problems now.
And it's cheap
And you don't have that awkward thing of having to go to your bag to take more tampons out or whatever if you're going to the toilet, because you just have the mooncup nestled in your vag already and you just need to clean it off.
I LOVE MY MOONCUP. I'd honestly recommend it to anyone and I used to be so averse to the idea of it, I thought it'd be gross, It's totally fine
Not that I know of – I assume a gyno would have mentioned it, right? I've seen several over the years due to relocations.
In between the time I posted and now, I've been diagnosed (finally, the mystery illness is identified) with fibromyalgia, and it occurs to me that it's related to the "oversensitization of pain-sensing nerves" thing. Hmmm. That doesn't help you any though…
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I am another fellow thrush sufferer but haven't found any increase from using my mooncup. I boil it in water with vanish powder in it every few months but that is mainly to get the discoloration off as I do find it a bit gross after it has gone brown. I have found however that since getting my new implant fitted my periods are low to nearly non-existent and when I tried using my mooncup this time it did cause a bit of irritation. I think that is because the flow was so low. I ended up taking it out and didn't need anything more than my knickers int the end. The flow was basically just brown discharge.
I have had heavier periods in the past when using my mooncup but luckily never too heavy and have usually been able to put it in in the morning and take it out and replaced in the evening before bed. I leave it in for about 12 hours which is a bit longer than recommended but it hasn't overflowed and hasn't caused any trouble.
I do love my mooncup and heartily recommend it. Great to for camping and travelling in developing countries as you only need a bottle of water and don't need to worry about where to throw away your dirty tampon.
I've found that the Jade & Pearl Sea Pearls sponges are the only internal solution that doesn't cause cramping, for me! You may want to try them!
I haven't tried a mooncup yet, but after this article I just might.
I bought mine from Me Luna, they do 4 sizes. I use medium and its hasn't been over a third full yet (only used for one month!)I also struggle with no sinks nearby so use bottled (tap) water which I usually have on me anyway.
I've been using my brown Keeper (the original, not the knock off by the way) since around 2003 and think it's the best. For real, if you can take ten mins or so to figure it out, you'll feel liberated. I too love to be a scientist with my menstrual blood, noting the color, thickness and quantity makes me feel, you know, connected to my body!
I have a totally TMI question, but if someone can help that'd be great: so yknow how if you can't reach it, you push? Well for me that means I have to pre-emptively take out my cup every time I go for a poo to avoid it falling in the loo, which can get kinda inconvenient. Is that just a fact of life or am I inserting wrong? Thanks x
I've been using a mooncup for around a year and it's great, but I feel as though it might have widened my vagina walls because of where it sits. Am I wearing it too low? Or just being paranoid? It just feels as though 'it' isn't as tight as before.
Hi Libby don't worry I'm exactly the same. I have to remove my cup (a Cuplee) when I need a poo. i had to do it with tampons as well. You just have some pretty good muscles that (if and when) you want kids are going to be great! Its the only annoying thing about using a cup for me but as it happens with tampons as well I'm stick with my cup.
As an extra, all need for lubricants for sex has also ended since using the cup, I'm now back to my teenage slightly damp self!
Hey Katie, I am day one in to the first period where im using a moon cup so longer time members may have other things to say on the subject. My line of thinking is if you can squeeze a baby out of you vag and it goes back to 'roughly' the same size I don't think a wee moon cup is going to have any lasting effect. I have mine very low but I did read that it's less effective if its inserted to high up and should sit lower than tampons.
My concern is that if I overflow (at night) does everything in the cup spill out of just the excess. I am happy to wear even a mega pad at night in case I don't wake up & the cup overflows but if it all goes south then I will be in trouble lol! If anyone has any insight/advice that would be great. On my heaviest night I have to change super plus tampons 2 maybe 3 times
Hi All, so after the first night ever of wearing my mooncup I am somewhat disappointed. One of the reasons for getting my mooncup was to give me more confidence when sleeping over at others houses during my period as I thought the mooncup would mean I wouldn't be up every few hours and less chance of major leakage. This did not transpire, in fact everytime I got up the cup lost suction, I could feel it 'bubbling'! Not sure if anyone else had experienced this and can give me some advice, maybe I'm wearing it too low? I also find it quite painful to remove (the lip of the cup is thick and not very flexible). Any advice would be appreciated because I am already losing confidence in the cup and as you know confidence in your menstrual protection is paramount
It can definitely take some getting used to, so try not to lose heart. I adore menstrual cups, but even I'll admit they're more work (at first) than other methods and they're not normally a "quick fix".
Did you actually leak with it in? because even after several years of use I sometimes feel a "bubbling" sensation and the odd movement, but I never actually leak so I'm inclined to think it's normal.
As for the pain thing on insertion/removal, it's all about being properly relaxed. You're probably a bit tense since you're still getting used to it and finding it a bit difficult. Again, I can only speak from personal experience but I remember struggling a bit at first but now I don't even think about it and I certainly never feel pain with it. I guess it's also possible that the cup becomes more flexible with use, but I'm not sure.
Hope some of that's reassuring, anyway. Good luck, but obviously don't panic if it just turns out not to be for you either
I am very interested in the moon cup.
Reading comments saying you can leave it in for 8 hours, does that mean you can go to the loo with it in place like you can with a tampon?
There is a reason why the keeper has it's name. I really appreciate mine.


text:
How To Buy A Used Explorer
Everything You Need To Know About Ford's Most Popular SUV
For years the Ford Explorer was the bestselling SUV in the country, yet you rarely see them on the trails in numbers comparable to Jeep Cherokees or Toyota 4Runners. With production spanning two decades and high sales numbers, you can pick up a used Explorer for cheap and be out on the trails tomorrow... well, exploring. Cheesy puns aside, these Blue Oval SUVs offer good dimensions for wheeling along with potent engines and capable suspensions. There are a few pitfalls though, and you need to know what you are looking for.
First Gen ('91-'94)
The Explorer was designed as a replacement for the Bronco II, and it is a vast improvement in drivetrain strength over the BII. All first-gen Explorers came with a 4.0L OHV V-6 that made 155-160 hp and was backed by either a A4LD four-speed automatic or a Mazda-sourced M50D five-speed manual. Neither transmission is particularly strong, so plan to swap them out if you are shoehorning a V-8 in your Explorer. If you are looking at an Explorer with an A4LD, pull the dipstick and smell if the fluid is burnt. They get hot and can benefit from an auxiliary cooler like those offered by Flex-a-lite and B&M.
The transfer case is a BorgWarner 1354 chain-driven case with either a traditional lever or the electronically shifted "Touch Drive." Both use fixed yokes and can be shifted from 2-Hi to 4-Hi on the fly. The electronically shifted case can easily be swapped with the more desirable manually shifted case with just a few parts from a donor Explorer. The floor plate with shifter boot will bolt right in with no transmission tunnel modifications.
The Explorer was available in two-door or four-door models, with wheelbases of 102 and 112 inches, respectively. Note that they were also available in 2WD, so make sure there is a transfer case when you go on a test drive!
The front suspension on first-gen Explorers uses Twin-Traction Beams (TTB) with a high-pinion aluminum Dana 35 front differential. The radius arms, coil springs, and traditional steering box all lend themselves to relatively easy solid axle swaps. If you want to stick with the TTB there are suspension offerings from James Duff, Skyjacker, Superlift, and more. Out back the 31-spline, drum-braked Ford 8.8 axle is plenty strong and uses simple leaf springs under the axle. 235/75R15 tires came stock, and 31s will fit with just a small suspension or body lift.
Explorer Quick Facts
First Gen ('91-'94)
• 4-speed auto or 5-speed manual
• TTB front suspension with high-pinion Dana 35 diff
• Leaf spring rear with Ford 8.8 diff
• 32.6˚ approach angle (4-door)
• 22.3 ˚ departure angle (4-door)
• 15/19 mpg (automatic transmission)
• 19.3-gal fuel capacity (4-door)
• 34.2-ft turning radius (4-door)
Second Gen ('95-'01)
The second generation of Explorer saw the TTB front suspension replaced with more conventional IFS with torsion bars, but there are still plenty of reasons to consider this model. They did not grow in size at all and still fit on most trails, plus you can get one from the factory with a 5.0L V-8. Basically every speed part available for Mustangs fits the 5.0L in Explorers.
The 5.0L was an option starting in the '96 and came backed by a 4R70W four-speed automatic transmission and an all-wheel-drive BorgWarner 4405 transfer case. The AWD transfer case does not have a low range; however, a common swap is to a manually shifted BW4406 case from a '97-'03 Ford F-150. That not only gives you a low range but also drops the AWD function to potentially increase your mileage. The forum Serious Explorations (www.explorerforum.com) has step-by-step instructions on how to perform this swap.
In the '97 model a SOHC 4.0L V-6 was introduced that makes 205 hp and is mated to a 5R55E five-speed automatic. Both the V-6 and V-8 engines return similar mileage.
Wheelbases are unchanged from the first-gen Explorer. The rear end still uses leaf springs and a sturdy 8.8 differential. Disc brakes became standard in the '95 model year. The IFS does limit lift options, but Superlift makes a 4-inch lift specifically for this model and most Ranger front suspension kits will fit the Explorer. Longer shackles and cranked front torsion bars are popular and inexpensive to gain 1-2 inches of extra height. If you want to make the most of that 5.0L V-8 and go fast, Dixon Brothers make a long-travel IFS kit with 14-inches of wheel travel.
Second Gen ('95-'01)
• 4.0L OHV V-6, 4.0L SOHC V-6, or 5.0L V-8
• 4-speed auto, 5-speed auto, or 5-speed manual
• Torsion bar IFS with high-pinion Dana 35 diff
• Leaf spring rear with Ford 8.8 diff
• 32.1˚ approach angle (4-door)
• 23.9˚ departure Angle (4-door)
• 14/18 mpg (V-8 with automatic)
• 21-gal fuel capacity (4-door)
• 38.4-ft turning radius (4-door)
Third and Fourth Gens ('02-'10)
For 2002 the Explorer lost all commonality with the Ranger pickup and went to fully independent suspension front and rear, though it was still body-on-chassis construction with a true frame. While the SUV market in general has been sacrificing capability for comfort, the Explorer in particular received bad publicity related to the rollovers of the previous models. This influenced the switch to independent suspension and also had a large influence on the tire pressure monitoring systems (TPMS) that are standard on all new vehicles. The third and fourth generations of Explorers are difficult to modify for trail duty and have limited aftermarket support. Rancho does make a 2-inch QuickLift that allows fitment of 31-inch-tall tires.
Third Gen ('02-'05)
• 4.0L SOHC V-6 or 4.6L V-8
• 5-speed automatic or 5-speed manual
• Coilover IFS with Dana 30 diff
• Coilover IRS with Ford 8.8 diff
• 31˚ approach angle (4-door)
• 24.5˚ departure angle (4-door)
• 14/19 mpg (V-8 with automatic)
• 22.5-gal fuel capacity (4-door)
• 36.7-ft turning radius (4-door)
Fifth Gen ('11 and later)
The fifth-gen Explorers use unibody construction and are available in either front-wheel drive or AWD, with no low-range offered. A sad end to a vehicle that originally possessed so much off-road capabilities.
Aftermarket Support
The aftermarket support for Explorers is sparse compared to Cherokees and Wranglers, but it does exist. The Explorer uses the same 5-on-41⁄2 bolt pattern as YJs and XJs, so aftermarket wheels for these vehicles will fit on Explorers. For lower gears and lockers you have plenty of options, and D&D Machine even makes a doubler kit to put the reduction box from a BW1350 in front of the factory BW1354 transfer case. RLC Fabrication has the widest selection of armor with skidplates, front winch bumpers, and rear bumpers with tire carriers for Explorers, but James Duff makes Explorer front bumpers as well.
• Powerful engine choices
• Body-on-frame construction
• Plentiful
• Reasonably priced
• Strong rear axle
• Limited aftermarket support
• Lack of solid front axle
• Cooling issues
• V-6 timing chain issues
• Problematic automatic transmissions
Check Before You Buy
• Coolant in oil or overheating (cracked heads are common on 4.0L OHV engines)
• Timing chain rattle on SOHC V-6 engines
• Coolant leaking from timing chain cover on OHV V-6 engines
• Cracks in plastic engine fan
• Check transmission fluid for burnt smell or low level
• Sloppy manual transmission shifter
• Electric transfer case is functioning
• Automatic front hubs are functioning
• Wheel bearing play and/or noise
• Worn radius arm bushings
• Blend doors (HVAC) functioning

subset: commoncrawl


text:
Gov. Pat Quinn responds to tragic Connecticut elementary school
Send a link to a friend
[December 15, 2012]
CHICAGO -- Gov. Pat Quinn issued the
following statement Friday regarding the tragic massacre in
"All of Illinois prays for the victims of this senseless
violence and their families. May God bless the immortal souls of all
those who lost their lives. In their remembrance, I have ordered all
flags across Illinois to be flown at half-staff beginning today.
"We know firsthand from the tragedy that took place on Feb. 14,
2008, in a classroom at Northern Illinois University that guns have
no place in any school, at any time, anywhere in Illinois or
"It is the foremost duty of government to protect public safety,
especially the safety of children and students.
"As governor and as a parent, I intend to spearhead passage of
strict laws that will protect our children and the people of
Illinois from gun violence."
[to top of second column]
The governor ordered that all people or entities covered by the
Illinois Flag Display Act immediately fly flags at half-staff
honoring victims of the tragedy in Newtown.
[Text from
news release from the Illinois Government News Network; LDN]
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JPA1 provides a way for users to specify that a field will be persisted serialised . This is of use, for example, to collections/maps/arrays which typically are stored using join tables or foreign-keys to other records. By specifying that a field is serialised a column will be added to store that field and the field will be serialised into it.
JPA's definition of serialising applies to any field and all in the same way, unlike the situation with JDO which provides much more flexibility. Perhaps the most important thing to bear in mind when deciding to serialise a field is that that object in the field being serialised must implement java.io.Serializable .
If you wish to serialise a particular field into a single column (in the table of the class), you need to simply mark the field as a "lob" (large object). Let's take an example. We have the following classes
and we want the animals collection to be serialised into a single column in the table storing the Farm class, so we define our MetaData like this
<entity class="Farm"> <table name="FARM"/> <attributes> ... <basic name="animals"> <column name="ANIMALS"/> <lob/> </basic> ... </attributes> </entity>
So we make use of the lob element (or @Lob annotation). This specification results in a table like this
Provisos to bear in mind are
If the field that we want to serialise is of type String, byte[], char[], Byte[] or Character[] then the field will be serialised into a CLOB column rather than BLOB.
See also :-


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October 18, 2012, 7:30 pm
Daniel Suelo: living in a Moab cave without money for over 10 years
Check out these two short videos about Daniel Suelo, who has lived without money in a cave near Moab, Utah for over 10 years. It's an interesting study in economics, homelessness and personal philosophy.
The first one's above; the second one's here.


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The week of Grand Theft Auto V's launch could have been a controversy cash-in for the publicity lovers at Rockstar Games. The game's checklist of features reads like Tipper Gore's personal hell: savage murders, psychotic heroes, strip clubs, an interactive torture sequence, and enough swears and offensive terms to do George Carlin proud.
And, the day before the game's launch, a man shot up a Navy yard in Washington DC. Shortly afterward, reporters dug up comments from acquaintances about the shooter's predilection for "violent video games." We've seen where that combination can lead.
Yet largely, GTA V has been denied its relatively worthy spot on the pop-culture controversy throne. Its most unsavory bits didn't budge Miley Cyrus' twerking off of any trending lists, even as the game raked in billions.
What gives? Has the American public given up on condemning video games? Has the games industry made enough mainstream headway to lump GTA into the general R-rated slew of entertainment options? Has the ghost of Jack Thompson finally evaporated into a fine mist?
Hard to say, considering how subjective gaming's reputation really is. Instead, it's worth considering that Rockstar, in spite of some uneven and troubling writing decisions, also took some responsible ideas to heart over the five years since the previous GTA release, and that the press, in general and in kind, has advanced just as much over those years to change the tenor of the resulting conversation.
Warning: The rest of this article contains significant spoilers for some plot and character points in Grand Theft Auto V.
GTA V is not shy about walking the line between outrage and satire, though it's admittedly a line the game walks in an inebriated state. The worst example comes from GTA V's navel-gazing obsession with gaming culture. Bratty son Jimmy is overheard in one sequence playing an online video game and shouting piles of triggering garbage over his headset: "If there was a rape button, I'd press that, unless you're a faggot and you like that, in which case I'd just rape your mom, instead!"
Jimmy's father, protagonist Michael, walks in soon after to awkwardly admonish his son—"threatening to molest your online buddies is bullshit!"—providing a pretty direct commentary from Rockstar on one strain of modern gamer in the process. Very little about Jimmy is projected in a positive or even likeable way; the guy's a scummy cipher meant to send up some of the more annoying traits of many gamers. Not that there's anything wrong with that, but there has to be a better way to mock the violent homophobia of stereotypical online shooter fans than to whack the topic over the head with a baseball bat.
Even worse is the game's "anti-torture" segment, which has players revel in painfully applying battery cables and pliers on a poor, tied-up man. The sequence ends by dismissing the whole affair with the flippant summary of "torture is only for the torturer," as if that turns such twisted exploitation into a noble statement. It's not.
Yet in many ways, GTA V exercises a notable mix of restraint and silliness in chiding pop culture. Facebook is spoofed in "Lifefinder," a social network company that loathes its customers, has no actual business plan, and revels in absorbing as much user data as possible (Subtle!). Radio broadcasts repeatedly mention government overreach and NSA-level spying with a dry shrug of the shoulders.
A billboard advertising perfume tells people to "smell like a bitch," but it's more of a spoof of shock-value advertising and companies using French words to seem fancier than they are (the perfume in question is called "Le Chien," or "The Dog"). Another billboard mocks the desperation of cash-for-gold schemes, begging people to rob their grandmothers and take their teeth to sell to "Cash For Dead Dreams."
Women's issues
On a subtler scale—not that Grand Theft Auto is incredibly subtle—there's the gray-area disappointment of how GTA V handles women. The game's three protagonists are men, and the few notable women aren't particularly strong-willed: a mobster's wife who shrugs her shoulders at being kidnapped; a protagonist's wife and daughter who are largely defined in the game by shallow sexual behavior; and another protagonist's old flame, hobbled by drugs and eager to offer sexual favors.
Series co-writer and co-creator Dan Houser recently explained to UK's The Guardian that GTA V's exclusion of playable women was not intentional from the outset, but rather the result of an "organic" plot that developed over time, and furthermore, that "the concept of being masculine was so key to this story."
The thing is, it doesn't take long in Los Santos to realize that the "masculine" concepts of GTA V's plot come across mostly as pathetic. Trevor's ongoing issues with trust and friendship, though hyperbolized by way of crime sprees and murders, mirror the kinds of faltering friendships that many men may face as they grow older. Same can be said for Michael losing touch with his own family or Franklin finding that his strides toward a bigger, better life end with him feeling like a broken record, repeating the same shit no matter how hard he tries.
These men put on as much bravado as possible, but they all inevitably descend into childish, petulant behavior. There's no truth in saying women "dodged a bullet" by avoiding such cynical headline roles in GTA V—there's room for at least one Sons of Anarchy-caliber Gemma in this wild world—but the game is at least consistent about painting "masculinity" in depressing tones.
While none of the game's women are playable, they are, in the biggest turn for the series, raised to something beyond object status, at least in interactive terms. I touched upon this notion in my review, when I pointed out the inability to hire a call girl as you drive through Los Santos' streets. The game also removes dating and sex mini-games as a means of earning either currency or bravado; there's no required mission in which you press buttons to mechanically turn a woman on.
The same can be said for how the game treats cultural stereotypes. At its worst, GTA V revels in the fake-macho nonsense of mainstream 90s gangsta rap. Still, it does so in a way that's authentic to South Cali slang and doesn't stand out starkly compared to treatments of meth-heavy hillbillies or Chinese gangbangers. The game's fake Los Angeles puts every ethnicity in the crosshairs of both plot and violence without resorting to kneejerk slurs or stereotypes (with the exception of white men reacting awkwardly to Franklin a little too often).
The biggest issue that I've found in my 30+ hours of play is the private dances at strip clubs, in which players can convince a dancer to go home with them by holding down a button to "touch" the dancer when a bouncer isn't looking. Get away with enough touches, and a meter fills up so much that the girl says, "Wanna go home with me?" Accept the offer, and you can drive the stripper home, hear some moaning sounds, and leave the apartment. Two steps forward, one giant lap dance back.
This highlights that GTA V is first and foremost a game that depends on how it is played. The enormity of the open-world structure means that players can forgo the plot to focus instead on utter chaos. Yet Rockstar still asserts direction and commentary within even the most chaotic GTA V playthroughs.
Rockstar keeps tabs on players mainly through random encounters—blips that pop up on the nearby map, when appropriate, to ask for errands, rides, or even "stop that thief!" moments. In these, everybody's a despicable dog; if anything, the Houser brothers that wrote the game have a real hangup with relationships. This is evidenced by many random pick-ups in which my passengers—men and women alike—whined about cheating partners before confessing their own poor decisions. In another encounter, recounted particularly well by Kotaku's Stephen Totilo, players pick up a woman on the wrong end of a robbery who ends up being one of the most poignant and troubled female characters in the game.
Totilo goes on to talk about his desire for a female-first GTA, ignoring the fact that for years, most similar open-world series—Red Dead, Red Faction, Infamous, Far Cry, Just Cause—have stuck with leading men. (To its credit, Saint's Row at least lets players create a female lead and battle alongside lady protagonists, and Assassin's Creed had a woman star in its PlayStation Vita spin-off.)
It's a fair enough request, echoed by more than a few writers over the past week, and it's an elevated perspective as opposed to the default "this game is offensive" tack. That line of thought sees men and women alike coming out and saying, "It's not the evil that we detest; it's the pronouns."
And other writers have gone for even higher-level critiques. The Guardian's Helen Lewis had plenty to say about the game's takes on gender roles, but her editorial was invested in balancing that topic with just as many mentions of exploitative violence. Leigh Alexander stared the game dead in the eyes and accused it of not being "open" at all, but rather stuck to the rails and limits of a 16-year-old series and its expectations.
In the end, this Grand Theft Auto doesn't get away with murder by avoiding the pop culture boiling point. Instead, it has attracted more accomplices and bigger dreamers, cresting with a pop culture now defined by scumbags on all sides of the gender and ethnicity aisle. Women and outsiders may not always be full players on GTA V's side of the screen, but they're responding on the other, and with guns blazing, at that.


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With the rights to Daredevil set to revert to Marvel on October 10th, 20th Century Fox is anxious to start production on a reboot. With director David Slade having exited, Fox is now looking at Joe Carnahan (The Grey) to helm. While solidifying a director is a step in the right direction, the deadline still looms. Luckily, Fox has been in talks with Marvel for a character swap of sorts, an arrangement that, if both studios agree, could keep the "Frank Miller-esque, hardcore 70s thriller" version of Daredevil at Fox while bringing some big players back to Marvel. Hit the jump to find out who.
News of Fox's interest in Carnahan to helm Daredevil comes via Variety. No official offer has been extended as of this writing, but their sources say that Carnahan is the man. The report also mentions a property swap that would allow the blind superhero, Matt Murdock, to take the screen for Fox. Think of it as a really expensive version of you and your friend exchanging prized comic books:
Marvel: "Okay, you can keep Daredevil a little longer. But what will you give me in return?"
Fox: "How about…Fantastic Four? You can have Galactus and maybe even the Silver Surfer."
Basically, Daredevil could stay at Fox past the October 10th deadline in exchange for Marvel's use of Fantastic Four characters (like Galactus and Silver Surfer) in future films. Currently, the Surfer is locked up in Fox's reboot of Fantastic Four with director Josh Trank (Chronicle). The decision lies with Fox as to whether to take Marvel's offer or to let Daredevil swing off the lot. Keep an eye out for more as this story develops.
Update: As of the posting of this article, Carnahan himself wrote a cryptic Tweet that said only:
While it may mean less than nothing, I did a search for Daredevil #73 and came up with this quote:
I'm not a pawn — You can't make me fight against my will!
— Matthew Murdock (Earth-616)
And this cover image:
Let's keep in mind that current reports have yet to confirm an official offer to Carnahan and a simple Tweet doesn't change that. However, it's always fun to speculate on what it could mean. Maybe Carnahan pulled from this issue to drum up his vision/treatment of the Daredevil script? Maybe the Zodiac group will appear to challenge the masked vigilante?
Or maybe, now stick with me, there's more to the Marvel/Fox character swap talks than meets the eye. Could we actually see a studio crossover that features a cameo from Iron Man and/or Nick Fury at the end of the Daredevil reboot in order to recruit the Man Without Fear into his proper place on the Avengers?! The Zodiac group did appear as antagonists to the Avengers, so perhaps some version of that storyline is in the works. Or perhaps Carnahan just likes to yank our chain and watch us squirm. What do you think, fans?


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Wage and Hour Division (WHD)
WHD Information Related to the American Recovery and Reinvestment Act of 2009
The American Recovery and Reinvestment Act of 2009 (ARRA) was signed into law by President Obama on February 17, 2009. Division A of ARRA appropriates substantial funding for construction, alteration and repair of federal buildings and for infrastructure projects, such as roads, bridges, public transit, water systems, and housing. In accordance with existing Davis-Bacon Act (DBA) requirements, federal agencies directly contracting for construction work using ARRA funds must ensure that bid solicitations and resulting covered contracts contain Davis-Bacon labor standards and wage determinations in accordance with the Federal Acquisition Regulations.
Also, generally, Federal agencies must ensure that recipients of assistance funded by ARRA appropriations require contractors and subcontractors to pay laborers and mechanics employed on ARRA-assisted construction at least the Davis-Bacon prevailing wages. In addition, Division B of ARRA requires application of Davis-Bacon prevailing wage requirements to projects financed with certain tax-favored bonds.
This portal contains information on prevailing wage labor standards applicable to construction projects funded under ARRA. The Copeland "Anti-Kickback Act" and overtime pay requirements under the Contract Work Hours and Safety Standards Act also apply to ARRA funded construction. In addition, ARRA appropriations will fund federal service contracts subject to the Service Contract Act (SCA), and federal contracts subject to coverage under the Walsh-Healey Public Contracts Act (PCA). Links to information regarding application of these laws and the Davis-Bacon Act are provided on this site.
- Press Releases - American Recovery and Reinvestment Act press releases.
- All Agency Memorandum No. 207 - Applicability of Davis-Bacon to Federal and federally-assisted construction work funded by the American Recovery and Reinvestment Act of 2009.
- All Agency Memorandum No. 208 - Applicability of Davis-Bacon labor standards to construction financed with the proceeds of certain tax-favored bonds under section 1601 of Division B of the American Recovery and Reinvestment Act of 2009.
- Project-specific or agency-specific advisory letters issued in response to ARRA-related questions are posted here. Advisory letters provide initial recommendations and guidance on Davis-Bacon Act and Service Contract Act issues.
- Advisory Letter to Mr. Chris Henderson, Sr. Advisor, Office of Secretary, US Department of the Interior.
- Advisory Letter to Mr. Mathew Rogers, Sr. Advisor, Office of Secretary, US Department of Energy.
- Advisory Letter to Mr. Scott Harris, General Counsel, U.S. Department of Energy.
- Advisory Letter to Ms. Janet Barsy, General Counsel, U.S. Department of Energy.
- Advisory Letter to Ms. Farwa Naqvi, Chief, Engineering Branch, Broadband Division, USDA Rural Development/Rural Utilities Service.
- Advisory Letter to Mr. Terry Yellig, Partner, Sherman, Dunn, Cohen, Leifer & Yellig, P.C.
- Advisory Letter to Mr. Terry Yellig, Partner, Sherman, Dunn, Cohen, Leifer & Yellig, P.C.
Prevailing Wage Conferences
Davis-Bacon Act and Service Contract Act Online Training For Government Contracting Officials
The Wage and Hour Division (WHD) is pleased to announce that online training is now available to assist all federal, state and local contracting agencies with information on federal rules concerning prevailing wages and other labor law requirements. The training modules, presented by WHD staff and its federal agency partners, provide contracting officials with information on the process of obtaining wage determinations; adding classifications to wage determinations (conformances); compliance principles, and enforcement process under both the Davis-Bacon Act (DBA) and the McNamara Service Contract Act (SCA).
Specifically, two training modules are currently being offered on line. A four hour session for the DBA and a second four hour session on the SCA. These training modules and accompanying power points presentations are available in their entirety at the following links:
- Prevailing Wage Conference Videos and Transcripts
- McNamara - O'Hara Service Contract Act PowerPoint
- SCA Price Adjustment (Air Force Perspective) PowerPoint
- Davis-Bacon Act PowerPoint
- Davis Bacon Compliance Principles
- Certified Payroll Exercise
Prevailing Wage Conferences – 2012
- Fort Bliss, Texas
- Philadelphia, Pennsylvania
- Los Angeles, California
- Miami, Florida
- Chicago, Illinois
- Seattle, Washington
Previous Prevailing Wage Conferences
Prevailing Wage Conference Comments
- Prevailing Wage Conference Videos
- Overview of Government Contract Laws
- The Fair Labor Standards Act (FLSA)
- WHD's Enforcement of the SCA and its Interaction with DBA
- The SCA Wage Determination Process
- DBA Surveys, Wage Decision, and Conformance Process
- Overview of DBA Definitions and the Contract Work Hours and Safety Act (CWHSSA)
- Overview of DBA and CWHSSA Investigation Procedures
- Interaction Among Various Government Contract Laws and Federal Agencies
- Prevailing Wage Conference Highlights, WHD Video, (2009), 2 minutes
This video has been optimized for use with Windows Media Player ™
- DBA and ARRA Video (YouTube® Video)
- Davis-Bacon Act for USDA-RUS & Commerce-NTIA, Broadband Grantees, and Stakeholders, WHD Video (2011), Total Time: 1:53:59
This video has been optimized for use with Windows Media Player ™
- Prevailing Wage Resource Book
- Field Operations Handbook: Chapter 15 — Davis-Bacon and Related Acts and Contract Work Hours and Safety Standards Act (PDF)
- Davis-Bacon Poster (PDF)
- Davis-Bacon Poster Spanish Version
- SCA/PCA Poster (PDF)
- SCA/PCA Poster Spanish Version
- FLSA Minimum Wage Poster
- Contract clause — see 29 CFR 5.5(a)(3)
- Revised WH-347 Form and Instructions Applicable to Contracts Entered into Pursuant to Invitations for Bids Issued or Negotiations Concluded On or After January 18, 2009. (This form has been submitted for renewal to the Office of Management and Budget (OMB). According to law [5 CFR 1320.10(e)(2)], the agency may continue to use the form while its renewal is pending at OMB.)
Davis-Bacon Survey Information
Following a Department of Energy (DOE) request for project wage determinations applicable to the DOE Weatherization Assistance Program, the Wage Hour Division (WHD) of the U.S. Department of Labor (DOL) completed an expedited prevailing wage survey of weatherization construction on residential projects in the United States. Data was solicited from interested parties specific to weatherization construction performed on residential structures in the United States from April 1, 2008 - March 31, 2009. The nationwide survey was conducted in two stages.
The first stage of the survey included the states of California, Connecticut, Iowa, Illinois, Maine, Massachusetts, Minnesota, Michigan, Missouri, New Hampshire, New Jersey, New York, Ohio, Pennsylvania, and Wisconsin. Interested parties were notified on July 6, 2009 of this survey. Initially, the cut-off date for submission of data for this survey was July 15, 2009 but extended to July 31, 2009.
The second stage of the survey included the remaining 35 states of Alaska, Alabama, Arizona, Arkansas, Colorado, Delaware, Florida, Georgia, Hawaii, Idaho, Indiana, Kansas, Kentucky, Louisiana, Maryland, Mississippi, Montana, Nebraska, Nevada, New Mexico, North Carolina, North Dakota, Oklahoma, Oregon, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, and Wyoming as well as the District of Columbia. The survey start date of this survey was July 20, 2009 with a survey cut-off date of August 14, 2009.
WHD has published these rates in the form of project wage determinations at the following site: Davis-Bacon Weatherization Wage Rates. Following the narrative on the project wage determination is a listing of each county in the state. The heading of such listing contains two main columns separated by a bold line with the left column labeled Weatherization Survey and the right column labeled Existing Residential Wage Determination. The following links provide information on the appropriate use of each main column.
Existing Residential Wage Determination Column
Any questions regarding this survey can be sent to the following email address - email@example.com.
Additional information:
- The Secretaries of Labor and Energy interim guidance to Weatherization grantees
- Major Survey Schedules
- Requesting Additional/Unlisted Classifications (Conformance) Procedures
- SF Form 1444 (PDF)
- American Recovery and Reinvestment Act of 2009 — Public Law 111-5
- The Davis Bacon Act - 40 U.S.C. 3141 et seq.
- Copeland Anti-Kickback Act - 40 U.S.C 3145
- Contract Work Hours and Safety Standards Act, as Amended (PDF) - 40 U.S.C. 3701 et seq.
- McNamara-O'Hara Service Contract Act of 1965, as Amended (PDF) - 41 U.S.C. 351 et seq.
- Walsh-Healey Public Contracts Act - 41 U.S.C. 35 et seq.
- Fair Labor Standards Act of 1938, as Amended (PDF) - 29 U.S.C. 201 et seq.
- Federal Agency Use of Davis-Bacon Wage Determinations —29 CFR 1.6
- Davis-Bacon and CWHSSA Contract Clauses—29 CFR 5.5
- Davis-Bacon Regulatory Definitions—29 CFR 5.2
- Permissible Payroll Deductions —29 CFR Part 3 (see sections 3.5 and 3.6)
- Federal Acquisition Regulations (FAR)
- Webinar on the Davis-Bacon Act (YouTube® Video)
- Prevailing Wage Conference Coverage Overview (Microsoft® PowerPoint®)
- Davis-Bacon Act Compliance Principles (Microsoft® PowerPoint®)
- Davis-Bacon Act Investigative Procedures (Microsoft® PowerPoint®)
- Service Contract Act Compliance Principles (Microsoft® PowerPoint®)
- Davis-Bacon Requirements for Certain Tax-Favored Bonds (Microsoft® PowerPoint®)
- Davis-Bacon Wage Determinations (Microsoft® PowerPoint®)
- Fair Labor Standards Act (Microsoft® PowerPoint®)
- Interaction of Labor Standards Statutes on Federal Government Contracts (Microsoft® PowerPoint®)
- Introduction to SCA Wage Determinations (Microsoft® PowerPoint®)
- Investigation Procedures Under SCA/FLSA/CWHSSA (Microsoft® PowerPoint®)
- SCA Coverage & Exemptions (Microsoft® PowerPoint®)
- Survey Process under the Davis Bacon Act and Related Acts
- Davis-Bacon and Related Acts (DBRA) Frequently Asked Questions
- Davis-Bacon Act Compliance Information
- Construction Survey Information
- Service Contract Act Compliance Information
- Walsh-Healey Public Contracts Act Compliance Information
- Department of Labor's Recovery Web page
- DOL Inspector General
- Recovery.gov
- Grants.gov
- FedbizzOpps.gov


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I don't know about you but there's nothing that I'd like to see floating in my drink less than a set of teeth. Unless they're these wonderful ice cubes that pop out of a rubbery bubblegum pink gums-colored tray right into the refreshment of your choice. I've even made them specifically for Bloody Mary's where I put some crushed peppercorns in the water so it looks like the teeth have cavities while slowly seasoning your drink as they melt.
It's a gorgeous day here in LA today, perfect for sitting back with a nice, cold drink showing off a beautiful extra set of choppers. I'm mixing the Kool-Aid right now.
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Categories: Bar accessory, Drink, Kitchen, Kitsch, Kitsch O' The Day
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Breast Cancer: 16 Questions to Ask
Your mind is likely swirling with questions. That's perfectly understandable. You may also have trouble listening to, understanding, or remembering what people tell you as you attempt to digest all the information you are hearing and reading. That's why it's a good idea to bring someone to your doctor appointments to help you remember important information. Here are some of the questions you may want to ask:
- What type of breast cancer do I have?
- How advanced is my disease?
- What types of additional testing will I need?
- What are my treatment options?
- Will I need a mastectomy?
- Should my lymph nodes be removed?
- What side effects can I expect from treatment?
- How soon can I undergo breast reconstruction (If mastectomy is warranted?)
- How will my breast cancer impact my level of physical activity going forward?
- What about follow-up care?
- Will I need to stop taking hormone replacement therapy?
- What is my risk of the breast cancer returning in my breast or elsewhere in my body?
- Will I still be able to work while having my treatments?
- How long will each phase of treatment take?
- Are my children now at higher risk of getting this disease?
- What can I do to best prepare myself for each phase of treatment?


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What Is Kidney Disease?
Learn more about the types, symptoms, and risk factors
Acute kidney injury (AKI) is a sudden, temporary, and sometimes irreversible loss of kidney function.1
In recent years, AKI has gained increasing recognition as a major risk factor for the development of chronic kidney disease (CKD). The clearest example of this relationship comes in cases of severe dialysis requiring AKI where patients fail to recover renal function. Indeed, acute tubular necrosis without recovery is the primary diagnosis for 2 to 3 percent of incident end‐stage renal disease (ESRD) cases annually. Yet this represents a small fraction of the renal disease burden resulting from AKI, as studies have demonstrated significantly increased long‐term risk of CKD and ESRD following AKI, even after initial recovery of renal function. Furthermore, this relationship is bidirectional and CKD patients are at substantially greater risk of suffering an episode of AKI. As a result, AKI is frequently superimposed on CKD and therefore plays a key role in CKD progression.2
There are a variety of symptoms that may include urinary hemorrhage, fever, weakness, fatigue, rash, diarrhea or bloody diarrhea, poor appetite, severe vomiting, abdominal pain, back pain, muscle cramps, no urine output or high urine output, pale skin, nosebleeds, swelling of the tissues, inflammation of the eye, and detectable abdominal mass.3 The symptom onset can sometimes be correlated to events like contrast application.
Causes and Risk Factors
Conditions that may lead to acute kidney failure3:
- Myocardial infarction
- Rhabdomyolysis (muscle breakdown)
- Severe dehydration
- Infection
- Iodinated contrast agent
- Administration or ingestion of certain medications that may cause toxicity to the kidneys
- Renal artery stenosis
- Conditions that may impair the flow of oxygen and blood to the kidneys, such as cardiac arrest
Diabetes mellitus and pre‐existing CKD are recognized as two major risk factors for AKI.2
Share this page:
1. U.S. Department of Health and Human Services ‐ National Institute of Diabetes and Digestive and Kidney Disease: https://www.niddk.nih.gov/health‐information/kidneydisease
2. https://www.usrds.org/2014/view/v1_05.aspx
3. Johns Hopkins Medicine: http://www.hopkinsmedicine.org/healthlibrary/conditions/kidney_and_urinary_system_disorders/end_stage_renal_disease_esrd_85,P01474/
4. Chronic Kidney Disease: www.diseaseinfosearch.org/result/3996
5. U.S. Department of Health and Human Services – Centers of Disease Control and Prevention: http://www.cdc.gov/diabetes/pubs/pdf/kidney_factsheet.pdf
6. National Health Services UK: https://www.nhs.uk/conditions/kidney‐disease/symptoms/
7. Recreated from: http://guidelines.diabetes.ca/App_Themes/CDACPG/images/Ch29_Tbl4_Stages_of_CKD.jpg
8. https://www.ukaachen.de/fileadmin/files/global/user_upload/Autosomal_dominante_polyzystische_Nierenerkrankung.pdf
9. https://www.orpha.net/data/patho/GB/uk‐CNF.pdf
10. https://ghr.nlm.nih.gov/condition/alport‐syndrome#synonyms
11. https://ercpa.eu/index.php/2017/03/09/discover‐our‐new‐infographic‐on‐ckd/
12. http://www.thelancet.com/campaigns/kidney/
13. National Kidney Foundation (U.S.) Republished with permission.: https://www.kidney.org/atoz/content/about‐chronic‐kidney‐disease
14. https://www.klinikum.uni‐heidelberg.de/Nierenerkrankungen.119146.0.html
This material does not constitute medical advice. It is intended for informational purposes only. Please consult a physician for specific treatment recommendations.


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12 November 2013 at 10.51am | 5 Comments
Composers often face significant challenges when composing for the ballet: what instruments might denote a flock of swans? How do you evoke a forest at midnight? Choreographer Marius Petipa set the bar particularly high when he created the scenario for The Nutcracker. Petipa wanted Tchaikovsky to write music for a Sugar Plum Fairy, but how might she sound? And what exactly is a sugar plum?
A sugar plum is not, as you might think, the kind of candied fruit that you can buy on the ground floor of Fortnum and Mason. In fact a sugar plum is nothing to do with fruit at all and is a hard sweet made up of several layers of sugar, not dissimilar to a sugared almond or the shell on Smarties. The process used to make that coating is called dragée in French, which is how Petipa refers to the Fairy who commands the Kingdom of Sweets and like her namesake, she glitters with sugar.
The second act of The Nutcracker is full of such delicacies, specified by various flavoured national dances. There at least Tchaikovsky had musical tropes he could turn to, but there was little musical guidance when it came to La Fée dragée. Tchaikovsky's solution was simple but radical: he would use an entirely new instrument, the céleste (or celesta).
Auguste Mustel invented this keyboard instrument in 1886, six years before The Nutcracker had its premiere. Mustel had built harmoniums for a number of years, but his father had meanwhile pioneered the dulcitone, in which hammers strike a series of tuning forks. The glockenspiel-like metal plates that his son Auguste used in the new version of the instrument allowed its delicate sound to carry within an orchestral context (aided by a system of wooden resonators). Its high, bell-like sonority was doubtless what led Mustel to dub his new invention the céleste (heavenly).
Having heard the instrument in Paris in summer 1891, Tchaikovsky asked his publisher Pyotr Jurgenson to acquire one for The Nutcracker. Keen not to let this innovative detail of orchestra out of the bag, he asked Jurgenson to keep it a secret; otherwise colourful colleagues such as Rimsky-Korsakov and Glazunov might use the instrument first.
Sadly Parisian composer Ernest Chausson had already pipped Tchaikovsky to the post by using the celesta in his 1888 incidental music to The Tempest. But what Tchaikovsky has over Chausson (and many composers since) is the clear link he created between the sound and a specific character. When the Sugar Plum Fairy first appears in Act 2, among the transparent columns and fountains of Petipa's synopsis, the celesta plays in combination with two harps, high woodwind and shimmering string harmonics. The effect is magical.
Later on in the act, as part of the Grand pas de deux, the Sugar Plum Fairy has an equally beguiling solo variation. Here Petipa wanted the music to sound like droplets of water falling from a fountain. Tchaikovsky's combination of pizzicato strings, celesta and a descending bass clarinet offers the perfect musical representation, to which Lev Ivanov (who continued the choreography of The Nutcracker due to Petipa's illness) added difficult but delicate steps.
But as well as the glittering sound of the celesta, its heavenly name may have also caught the composer's attention; Tchaikovsky had certainly been thinking of the afterlife during the completion of The Nutcracker. The death of his sister Sasha in the spring of 1891 had affected him deeply, but it also provided the inspiration for a project he had previously struggled to complete. Clara and her candied counterpart, the otherworldly Sugar Plum Fairy, were to be Tchaikovsky's tribute to his late sister. He now had the perfect instrument to describe her.
The Nutcracker runs from 3 December 2018—15 January 2019.
Find out more about the Orchestra of the Royal Opera House and how you can support them.


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Community Corrections Program
Closing the Loop: Community Corrections Program
The Community Corrections Program was formed in January 2010 by the Administrative Office of the Courts to manage three recent court-related initiatives. All three initiatives are designed to promote public safety by reducing recidivism among felony probationers and parolees and reducing the number of adult felony probationers and parolees sent to prison.
From 2006 to 2008, an average of 7.9 percent of the convicted felons on probation were sent to state prison each year. About 1.2 percent of these had committed a new felony, while 6.6 percent had violated the terms of their probation. In other words, of a statewide population of approximately 330,000 adult felons on probation, approximately 26,000 entered prison each year for violating probation or committing a new crime, accounting for approximately 40 percent of California's new admissions to state prisons.
It's evident from these figures that reducing the number of probation failures would benefit all parties involved: the probationers themselves, the criminal courts, and the state taxpayers who must pay the costs of incarcerating inmates. The present cost of incarcerating an inmate in a California prison is about $47,000 per year, and this cost is rising. Since fiscal year 2000–2001, the average annual cost per inmate has increased by about $19,500.
Each of the three initiatives managed by the Community Corrections Program focuses on reducing probation or parole failure in a specific manner. The first, established by the California Community Corrections Performance Incentives Act of 2009 (SB 678), creates a system of performance-based funding for county probation departments to support evidence-based practice in supervising adult felons on probation.
Evidence-based practice is currently one of the most promising reforms in state sentencing and corrections practice. For decades, conventional wisdom held that there was nothing the courts could do to reduce the rate of recidivism among probationers and parolees. Since 2000, however, new research has demonstrated that certain approaches can effectively change the behavior of offenders and significantly reduce recidivism rates. As defined in SB 678, evidence-based practices consist of "supervision policies, procedures, programs, and practices demonstrated by scientific research to reduce recidivism among individuals under probation, parole, or post-release supervision."
SB 678 created a state fund—the State Corrections Performance Incentives Fund (SCPIF)—and authorized the state to allocate money each year from the SCPIF to a Community Corrections Performance Incentives Fund (CCPIF) established in each county. Each county must establish a local community corrections program directed by the county's chief probation officer and based on evidence-based practices. These local programs then track the success of their evidence-based programs and report the outcomes to the AOC.
If the local programs succeed in reducing the number of felony probationers sent to prison, the state saves the cost of incarcerating those offenders. The state will then share a portion of these savings with the jurisdictions that generated the savings. Using a baseline average probation failure rate from the years 2006 through 2008 for comparison, the California Department of Finance calculates the change in the annual failure rate for each county to determine which counties are eligible to receive a portion of the state savings.
Preliminary results for this incentive-based program are very encouraging. In 2010, the first year that the local community corrections programs began using evidence-based practices, 6,182 fewer adult felony probationers were sent to state prison, compared to the baseline years of 2006 through 2008. This represents a 23 percent reduction in the rate of probation failure, for a savings to the state of $179 million.
The AOC's Community Corrections Program also manages another initiative designed to reduce recidivism—this one for offenders aged 18 to 25 placed on felony probation. The California Risk Assessment Pilot Project (CalRAPP) is a joint project of the AOC and the Chief Probation Officers of California, and is funded by the National Institute of Corrections and the State Justice Institute. CalRAPP has pilot projects in four counties: Napa, San Francisco, Santa Cruz, and Yolo.
These pilot projects employ risk/needs assessments of probationers, a key part of evidence-based practice, in the sentencing of 18- to 25-year-old offenders. First, a needs assessment is conducted to determine the likelihood that an offender will reoffend or violate the terms of his or her probation. Certain types of needs, or risk factors, have been demonstrated to predict future criminal behavior; these needs include antisocial attitudes and associates, family dysfunction, substance abuse, and lack of employment skills. Using the needs assessment, the project then assesses the risk that the individual will revert to criminal behavior and matches the level of supervision or services that the offender receives to his or her risk level. Those offenders determined to have a higher risk of recidivism will receive more intensive supervision and services. For example, an offender with a history of substance abuse might be ordered into a closely supervised treatment program and receive frequent drug tests. The offender might also receive encouragement and other positive reinforcements for staying in the program.
The CalRAPP projects will track the rates of recidivism and revocation of probation for participating offenders for up to three years and compare them to the rates of similar offenders not participating in the project.
With an additional grant from the Public Welfare Foundation, the Community Corrections Program has organized three regional trainings for judges and probation officers to learn more about evidence-based practices and discuss implementation programs for their respective counties. The grant funds are also being used to provide trainings at individual courts.
The final initiative managed by the AOC's Community Corrections Program is the Parolee Reentry Court Pilot Program. As part of the Corrections Reform package (SB18 3X) and the Budget Act of 2009, the Legislature provided $9.5 million in federal Edward Byrne Memorial Justice Assistance Grant funds to be distributed over a period of three years for the establishment of up to seven reentry pilot courts in California. To date, six reentry pilot courts have been established—in Alameda, Los Angeles, San Diego, San Francisco, San Joaquin, and Santa Clara Counties.
With a goal of reducing recidivism and parole revocation, the pilot courts employ a collaborative model that integrates treatment and social services with enhanced judicial monitoring of parolees. Parolees with a history of mental illness or substance abuse who have broken their parole agreements may be referred to a reentry court instead of being returned to prison.
The project will be evaluated over a period of three years by comparing the revocation and reoffense rates of participants to those of similar parolees who are not participants in the program. The evaluation, conducted by the Community Corrections Program of the AOC, will also consider different models of reentry courts.
In addition to evaluating the reentry court program and organizing educational programs about evidence-based practice, the Community Corrections Program works to ensure the accuracy of the data used to determine the funding for county probation departments as authorized by SB 678. Data accuracy is critical to a fair apportionment of state funds to counties that have lowered their rate of probation failure.
The Community Corrections Program will evaluate the three initiatives and report to the Legislature and other funders regarding the effectiveness of each program approximately three years after its inception. While results for the two pilot programs are not yet available, preliminary data for the California Community Corrections Performance Incentives Act (SB 678) shows a positive impact, as mentioned earlier. Evidence-based practices, after proving effective in numerous studies nationwide, are now beginning to demonstrate positive results in California.
The results in the first year in which SB 678 was implemented coincide with systemic downward trends in crime nationally and statewide. Compared to 2009, California's 2010 arrests for violent and property crime in urban areas declined by 7 percent and 3 percent, respectively. This is in line with a 6 percent reduction in violent crimes and a 3 percent reduction in property crimes at the national level over the same period. Crime rates in both California and the nation have been steadily declining since the mid-1990s, with a decrease of approximately 5 percent each year.
Source: Administrative Office of the Courts, Community Corrections Program, SB 678 Year 1 Report: Implementation of the California Community Corrections Performance Incentive (June 8, 2011).
Contact Info
Administrative Office of the Courts
Criminal Justice Court Services Office


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Table of Contents
Research and general acceptance
The South Beach diet is a popular short-term fast-weight-loss diet combined with a long-term calorie-controlled diet. The South Beach diet sets itself apart form several other popular diets by differentiating between ''good carbohydrates'' and ''bad carbohydrates'' based on their glycemic index and ''good fats'' and ''bad fats'' based on their degree of saturation.
Arthur Agatston, the originator of the South Beach diet, is a medical doctor. He is has a cardiology practice that emphasizes disease prevention and is an associate professor at the University of Miami Miller School of Medicine in Miami, Florida.
Agatston first developed the South Beach diet for his obese cardiac patients who were having trouble staying on the standard low-fat diet recommended by the American Heart Association. After these patients had success with his diet, Agatston began promoting the diet to the public, shifting the emphasis away from heart health and toward rapid weight loss. In 2003, he published The South Beach Diet: The Delicious, Doctor-designed, Foolproof Plan for Fast and Healthy Weight Loss.. Television coverage boosted the popularity of the South Beach diet, and in 2004, Kraft Foods entered into an agreement that allowed it to use the South Beach diet name on line of foods that were nutritionally compatible with the diet.
The South Beach diet is part a fast-weight-loss diet and part a calorie-restricted, portion-controlled long-term diet. Agatston says that the South Beach
(Illustration by GGS Information Services/Thomson Gale.)
diet is neither a low-carbohydrate nor a low-fat diet, although it restricts both these food groups.
The South Beach diet is divided into three phases. Phase 1 lasts the first two weeks of the diet. During this time Agatston claims that people can lose up to 13 lb (6 kg) on the diet, and that they will lose mainly belly fat. Phase 1 eliminates all carbohydrates, both ''good'' and ''bad'' from the diet. This means that the dieter eats no bread, pasta, rice, potatoes, fruit, milk, baked goods, ice cream, alcohol, anything containing sugar or flour, and any fatty meats. Portion size is not strictly controlled. The total calorie intake during phase 1 is usually between 1,200 and 1,400 per day spread out over three meals and two or three snacks.
Some permitted foods in phase 1 include:
- meat: veal and lean cuts of beef; low fat or fat-free lunchmeat
- poultry: skinless chicken and turkey breast and Cornish hen
- seafood: any kind of fish or shellfish
- cheese: many types, low-fat and fat-free only, excluding any type of cream cheese except dairy-free cream cheese substitute
- tofu: soft low-fat or calorie-reduced types only
- eggs: whole eggs, egg substitute, egg whites
- vegetables: non-starchy such as salad vegetables excluding tomato, artichokes, asparagus, broccoli, cauliflower, collard greens, eggplant, mushrooms, turnips, and zucchini
- fats: olive oil and canola oil
- spices: any seasoning that does not contain sugar
- artificial sweetened treats and artificial sweetener: sugar free only and limited in amount
After two weeks on the very rigorous phase 1 diet, the dieter is permitted to start adding back a limited amount of ''good'' carbohydrates that have a low
glycemic index. Weight loss in phase 2 is expected to be 1–2 lb (0.6–1 kg) per week. The permitted foods are the same as in phase one with the addition of whole grain cereals, oatmeal, whole-grain bread and whole-grain pasta, barley, low-fat milk, nuts, beans, starchy vegetables, wine, and most fruits. These items are portion-controlled. Watermelon, bananas, raisins, white bread, baked goods, and sugary foods are not allowed. Saturated fats and trans fats (animal fats, butter, cream, fatty meats, some solid-type margarines) are forbidden.
Dieters stay on the phase 2 diet until they have achieved their desired weight, at which time they move to phase 3, a maintenance phase. The list of restricted foods in phase 3 is quite similar to phase 2. Foods made with white flour and high levels of refined sugar are sill off limits. Individuals who get off track and violate the diet in phases 2 or 3 are instructed to go back to phase 1 and start again.
For a fee, the South Beach diet Website offers tools to help the dieter stay on track. These include as recipes, advice from dietitians, food journals, and meal planners. Daily moderate aerobic exercise and strength training are recommended for people on this diet.
The South Beach diet is based on the idea that to lose weight, the dieter must replace ''bad carbohydrates'' with ''good carbohydrates'' and ''bad fats'' and ''good fats''. Good carbohydrates are defined as those that have a low glycemic index, while bad carbohydrates have a high glycemic index in order to reduce insulin resistance.
The glycemic index compares foods on a scale of 1–100 for how much they increase the level of glucose (sugar) in the blood. When people eat, the level of glucose in their blood increases. How much it increases depends on the foods they eat. ''Good'' foods witha low glycemic index (below 50) raise blood sugar less than ''bad'' foods with a high glycemic index (above 50 or above 65 depending on which authority is consulted). When blood glucose levels increase, cells in the pancreas release the hormone insulin. This signals cells in the body to convert some of the glucose into a compound called glycogen that is stored in the liver and muscles and some into fat, stored in fat cells. When blood glucose levels go down, different cells in the pancreas release the hormone glucagon. Glucagon signals cells in the liver and muscle to release glycogen, which is converted back into glucose and is burned by the body. If glucose levels continue to be low, fat is also burned for energy.
When people eat foods that contain a lot of sugar or carbohydrates that break down rapidly in the body into glucose (the ''bad'' carbohydrates of the South Beach diet) their insulin level spikes. When people eat carbohydrates that break down more slowly into glucose (the ''good'' carbohydrates of the South Beach diet), their insulin level rises more slowly and does not reach as high a level. When someone eats too many sugary foods too often, they secrete a lot of insulin, and eventually cells in the body may become insulin resistant. Insulin resistance is a factor in type 2 diabetes. By removing all carbohydrates from the diet for two weeks, the South Beach diet is claims to eliminate insulin resistance.
The fats that the South Beach diet calls ''good'' fats are unsaturated fats. Unsaturated refers to a certain part of their chemical structure. ''Bad'' fats are saturated fats that have a slightly different chemical structure. Saturated fats are thought to promote atherosclerosis or ''hardening of the arteries.'' In this condition, cholesterol and other materials build up on the walls of the arteries (blood vessels) blocking blood flow and causing the arteries to lose their elasticity.
According to Agatston, benefits of the South Beach diet include:
- rapid weight loss followed by lifetime weight control
- loss of weight from the belly region
- fewer hunger pangs because of slower carbohydrate breakdown and frequent small meals
- a heart-healthy approach to fats
- decreased risk of developing cardiovascular disease.
The South Beach diet is unlikely to meet the nutritional needs of growing children.
Many nutritionists question whether this diet provides long-term balanced nutrition. Specific objections are that limiting milk may lead to calcium deficiency and limiting and whole grains even in the maintenance phase may lead to deficiencies in dietary fiber and B-complex vitamins. The initial rapid weight loss also is of concern to many weight-loss experts.
Research and general acceptance
The South Beach diet is relatively new, and no independent scholarly research has been done on it. A few small studies that report decreased blood fats and similar heart-protective effects have been sponsored by organizations with South Beach diet affiliations. However, nutritionists are in general agreement that replacing saturated fats with unsaturated fats in the diet is a healthy choice. Nutritionists also agree that whole grains tend to be more healthful than refined grains, but express concern about the small quantity of whole grains permitted on the diet.?
Of more concern is the rapid weight loss of phase 1. This rate of weight loss is not in line with generally accepted practices for healthy dieting and long-term weight control, and obesity experts find highly questionable the claim that dieters can control weight loss so that they preferentially lose belly fat. The public has
enthusiastically embraced the South Beach Diet, but how many people can stay on this fairly rigorous diet and maintain long term weight-loss remains to be seen.
Agatston, Arthur. The South Beach Diet: The Delicious, Doctor-designed, Foolproof Plan for Fast and Healthy Weight Loss. Emmaus, PA: Rodale, 2003.
Agatston, Arthur. The South Beach Diet Quick & Easy Cookbook: 200 Delicious Recipes Ready in 30Minutes or Less. Emmaus, PA: Rodale, 2005.
Agatston, Arthur. The South Beach Heart Program: The 4-Step Plan That Can Save Your Life. Emmaus, PA: Rodale, 2006.
Bijlefeld, Marjolijn and Sharon K. Zoumbaris. Encyclopedia of Diet Fads. Westport, CT: Greenwood Press, 2003.
Icon Health Publications. Fad Diets: A Bibliography, Medical Dictionary, and Annotated Research Guide to Internet References. San Diego, CA: Icon Health Publications, 2004.
Scales, Mary Josephine. Diets in a Nutshell: A Definitive Guide on Diets from A to Z. Clifton, VA: Apex Publishers, 2005.
American Dietetic Association. 120 South Riverside Plaza, Suite 2000, Chicago, Illinois 60606-6995. Telephone: (800) 877-1600. Website: <http://www.eatright.org>
The South Beach Diet Online. (Official Website of South Beach Diet) <http://www.southbeachdiet.com>
Harvard School of Public Health. ''Interpreting News on Diet.'' Harvard University, 2007. <http://www.hsph.harvard.edu/nutritionsource/media.html>
Kellow, Juliette. ''South Beach Diet Under the Spotlight.'' Weight Loss Resources, March 16, 2007. <http://www.weightlossresources.co.uk/diet/south_beach_review.htm>
Northwesternutrition ''Nutrition Fact Sheet: The South Beach Diet.'' Northwestern University. January 2007. <http://www.feinberg.northwestern.edu/nutrition/factsheets/southbeach.html> United States Department of Health and Human Services and the United States Department of Agriculture.
''Dietary Guidelines for Americans 2005.'' January 12,
2005. <http://www.healthierus.gov/dietaryguidelines>
WebMD. ''The South Beach Diet.'' June 2005. <http://www.webmd.com/content/pages/15/96038.htm>
Tish Davidson, A.M.