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Jake and Maggie Gyllenhaal
Maggie was born in 1977 to director Stephen Gyllenhaal ("Numb3rs") and writer-producer Naomi Foner ("Bee Season"). Little brother Jake came along in 1980. Jake broke out on the big screen playing Billy Crystal's character's son in "City Slickers" in 1991, soon followed by Maggie in 1992, in "Waterland," which their father directed. The A-list sibs racked up leading roles in successful films, including "Secretary," "SherryBaby" and "The Dark Knight" for Maggie and "Jarhead," "Brothers" and "Love and Other Drugs" for Jake. Both are Oscar-nominated actors, Maggie for "Crazy Heart" and Jake for "Brokeback Mountain." The pair have acted in three movies together: "A Dangerous Woman" and "Homegrown," both directed by their father, and "Donnie Darko," in which they were on-screen siblings as well. Jake is good friends with Maggie's husband of two years, fellow "Jarhead" actor Peter Sarsgaard.
Lucy Nicholson / Agence France-Presse
Copyright © 2018, Sun Sentinel


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When civilian or military situations demand a temporary airfield, often in remote areas, a mobile control tower is dispatched. As part of the mobile control tower package, Handling Specialty designed a trailer mounted scissor lift to support a fully equipped air traffic control center. The control tower module is supported on top of the lift's platform. Once in position, four outriggers are extended and lowered to provide vehicle stability. The control tower is then raised and locked into place.
The mobile control tower includes portable generators to power the lift as well as control tower and runway lights. If external power is not available, an internal battery power pack is sufficient for lowering the scissor lift. The complete trailer system was specifically designed by Handling Specialty to meet rigorous military specifications. The trailer includes a front deck power pack, communications port, tool chest and power jacks. Tubular scissors minimize the total vehicle weight.

subset: commoncrawl


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About Adeola Adeyemo
Adeola Adeyemo is a graduate of Industrial Relations and Personnel Management from University of Lagos. However, her passion is writing and she worked as a reporter with NEXT Newspaper. She believes that anything can be written about; anything can be a story depending on the angle it is seen from and the writer's imagination. When she is not writing news or feature articles, she slips into her fantasies and creates interesting fiction pieces. She blogs at www.deolascope.blogspot.com


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The average 4-year-old child asks 437 questions a day. Take that in a moment and process that number. Four hundred and thirty seven questions within the 12 to 14 hours they are awake. Their curiosity is astounding along with their �super jet backpack� of energy reserves and the desire to master the tiniest of tasks that adults take for granted.
But mom and dad, don�t buy the earplugs just yet! Parents thankfully have a variety of local preschools with qualified staff ready to field a few of those 437 questions and provide a loving school environment to grow those �big� boy and girl personalities.
With preschools opening in less than a month, Walton County preschool directors took a break from lesson planning to share a few pearls of wisdom to new preschool parents. Some offer a �trick of the trade� for making home life a tad easier while others provide tips for a smooth first day of school. All in all though, our community is fortunate to have a group of educators so passionate about the littlest of our clan.
R-E-S-P-E-C-T. �The most important skill to utilize in working with young children is the act of showing respect. This is the �Golden Rule� in teaching,� says Maureen Paine, the director of The Tree House Episcopal Montessori School. �Children appreciate being treated with respect and will respond accordingly. We find that it is best to treat children the way you would want to be treated, or even better, the way you would treat a personal friend.�
Practice saying �goodbye� before the first day. �It would be wonderful if every student could separate easily from their parents without any tears,� says Robin Vaughn, director of Santa Rosa Beach Community Church Preschool. �Of course, we know this is a normal part of development, but this learned skill would make the first day and week less stressful for the parents.�
Storytelling skills go a long way. �My own bag of tricks is usually telling stories and singing songs that only I know,� says Maria White, director of Creative Learning Center. �I'm famous for my version of �The Three Pigs.� I also have the ability to create great interaction with my off the wall open ended questions.�
Give Choices. �My biggest trick of the trade is giving the child choices. In Montessori, we give the children choices within reason, thus empowering the child. This allows them to see that they control their environment,� says Catherine Beall, Head of School at South Walton Montessori Academy. �Each of their choices has a consequence, whether positive or negative, and it is up to them to decide which choice to make and how to deal with the consequences of that choice.�
Positive Words. �I like to use positive reinforcement to lead wondering students in the right direction. If I see a student off task, I praise a student that is engaged in the appropriate behavior. It is not long before all the students want to be engaging in the behavior that is being praised, � shares Robin Vaughn, director of Santa Rosa Beach Community Church Preschool.
Teach Love and Kindness. Brenda Ousley, the Director at New Beginnings Preschool at Good News United Methodist Church, encourages parents to �work with their preschoolers on loving and respecting themselves, peers, and teachers� before school starts. As obvious as this advice sounds, it can be challenging to instill this lesson in young ones without the home consistently reinforcing the concept.
Foster Independence. �As educators, our goal is to help parents build a child�s confidence. We encourage parents to promote independence by allowing children to perform any task that they are able,� explains Paine. �We coach parents to take the time necessary to allow a preschooler to learn to do things for themselves. Children can dress themselves, set the table, fold laundry and even help make family decisions. The more children practice, the better they will be able to care for themselves with confidence.�
Maintain dialogue with teachers. �Keeping lines of communication open between the staff and families is a must do for all invested in the success of their child,� says Ousley.
Attendance matters. �My biggest piece of advice for preschool parents is to make sure their child attends school regularly. Every day is important because the child misses so much when absent,� says Kim Gillis, director of Early Head Start. �Children have to be ready to enter kindergarten and foster their life-long learning. The educational early years are extremely important.�
Kids see things differently. �Parents and teachers need to remember that children look at the world different from adults,� says Lisa Brooks, director of St. Rita Church Preschool. �While they are always learning, they may need to be picked up and helped along the way. That�s what preschool is all about.�
Never overdue a good thing. �Ages 2 to 4 years old have short attention spans. Keeping them moving, engaged, and active requires a well-prepared learning environment�, says the director of First Christian Preschool Karen Linder. �The classroom should allow for many types of learning experiences in short spans of time.�
Be a good role model. �I say it half joking but in all seriousness, all those things that go on at home that you think nobody knows�think again!� says Maria White, director of Creative Learning Center. �EVERYTHING is shared during circle time! Remember kids are always listening and watching and repeating.�


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Kids in the Hood, a new business downtown, 13 Oak St., (see article on A2) hosts an impromptu Scrabble game for First Friday, open to all comers, on the courtyard tiles in front of the shop.
Join the family-friendly game night and book swap at the Hood River Library from 5-7 p.m. on First Friday.
New games have been donated by G. Williker's Toy Shoppe of Hood River. Bring your books and DVDs to swap with your friends and neighbors. All ages are welcome.
This August, Columbia Center for the Arts forges into the world of glass. The show "A Glass Act" will feature glass objects created in various techniques including blown, lamp-worked, kiln-formed, enamel, stained, painted and cast. The show opens Friday, Aug. 2, at 6 p.m. and runs through Sept. 1.
In addition to the show, there will be free glass demos in the studio every Saturday and Sunday during the month. Chat with artists, learn about the process and get a new perspective on glass.
Every Friday, The Fruit Company sets aside fruit that doesn't make it into its gift boxes, as well as excess inventory of gourmet goodies. In most cases this fruit is of a higher quality than you would find in your local grocer, but because it doesn't meet gift grade, it's offered at a reduced cost on a first-come, first-served basis while supplies last (no phone or pre-orders).
These discounted items are only for pick-up and cannot be shipped. Hours are 8 a.m. to 3 p.m. at The Fruit Company, 2900 Van Horn Drive.
Rishell Graves will be playing music for First Friday at Cascade Cliffs Tasting room (211 Oak St.), with Terry Hill on the djembe. Come on in and listen to Rishell's "Music from the Heart," from 5:30-8 p.m.
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BANGUI, Central African Republic (AP) — Clashes in Central African Republic involving fighters believed to be loyal to ousted President Francois Bozize killed dozens of people and displaced tens of thousands over the weekend, officials said Monday.
The fighting occurred in the west of the country, a region that in recent months has been the site of multiple massacres allegedly carried out by the Seleka coalition of fighters who toppled Bozize in March. Seleka leader Michel Djotodia was sworn in as president last month and vowed to return the country to democracy by organizing elections within 18 months.
Guy Simplice Kodegue, a presidential spokesman, said 60 people had been killed in the latest fighting, which he said had been initiated by pro-Bozize fighters. He said a column of army soldiers supported by Seleka fighters had been dispatched to the region from Bangui, the capital, to stop the assailants, whom he accused of abusing civilians in the town of Bossangoa near Bozize's home village.
"The international community should keep a watchful eye on what is happening in this country, as we have just made a policy shift to pave the way for elections," he said.
Phone coverage is sparse in the region, located nearly 400 kilometers (248.56 miles) from Bangui. Orongaye Rigobert, a community leader in Bossangoa, said the pro-Bozize fighters had destroyed bridges used to access the town from Bangui in a bid to halt the army's advance.
He said about 30 people had been killed in Bossangoa, most of them civilians. Kodegue, the presidential spokesman, accused the assailants of targeting Muslim civilians, though Rigobert said the casualties may have included Christians as well.
Seleka is composed primarily of fighters from the country's predominantly Muslim north, and some observers have said the group only targets Christian villages. Because Djotodia and many of his supporters are Muslim while Bozize and many of his supporters are Christian, the politics fall along religious fault lines.
The clashes in Bossangoa prompted about 30,000 residents — around 80 percent of the town's population — to flee into the forest, said Amy Martin, head of the United Nations humanitarian mission in Central African Republic.
She said the clashes also coincided with violence in two other locations in the west. Fighting in the nearby town of Bouca on Monday morning prompted residents to flee, she said. It was not clear what sparked violence in that town. The northwest town of Paoua, meanwhile, had received thousands of people fleeing clashes between self-defense groups and Seleka in surrounding areas. Around 3,000 displaced people had been registered in Paoua, according to Martin.
Last week the U.N. refugee agency said seven villages near Paoua were burned to the ground. Melissa Fleming, the agency's chief spokesperson, said the north appeared to have descended into lawlessness.
"We are, in general, increasingly worried about the civilians caught in the middle of the fighting and who are at the mercy of anyone with a gun," she said.
Martin, the U.N. humanitarian official, noted that the fighters squaring off against Seleka had not identified themselves, making it impossible to establish their origins and motivation. But she said it appeared that groups that had previously been disarmed were involved in the fighting.
Aid groups have been warning for months that Central African Republic is on the verge of a humanitarian catastrophe if the security situation doesn't improve.
Corey-Boulet reported from Dakar, Senegal.


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Jan 08, 2013, 08:30 EST
SAN DIEGO, CA, January 8, 2013 /PRNewswire/ -- Senomyx, Inc. (NASDAQ: SNMX), a company using proprietary taste science technologies to discover and develop novel flavor ingredients for the food, beverage, and ingredient supply industries, announced today that Kent Snyder, the Company's Chief Executive Officer, and Tony Rogers, Senior Vice President and Chief Financial Officer, will present an overview of the Company's technology and programs on Tuesday, January 15 at 4:10 p.m. Eastern Time (1:10 p.m. Pacific Time) during the 15th Annual Needham Growth Conference. The conference is taking place at the New York Palace Hotel in New York, NY. During the presentation, Mr. Snyder and Mr. Rogers will discuss corporate developments including the Company's pipeline of novel flavor ingredients and its business strategy.
To access the live presentation or a subsequent archived recording, please log onto Senomyx's website at http://www.senomyx.com and click on the "Investor Relations" tab. The archived webcast will be available for 30 days following the presentation. Please connect to Senomyx's website prior to the start of the webcast to ensure adequate time to download any software that may be necessary.
About Senomyx, Inc. (www.senomyx.com)
Senomyx is using proprietary taste science technologies to discover and develop novel flavor ingredients. These include new flavors such as Savory Flavors and Cooling Flavors, as well as Bitter Blockers and modifiers of Sweet and Salt tastes. Senomyx is also engaged in a new effort to discover and develop natural high-potency sweeteners. The Company has collaborative agreements with global food, beverage, and ingredient supply companies, some of which are currently marketing products that contain Senomyx's flavor ingredients. Its corporate socially responsible activities are described on the Senomyx Cares blog at http://www.senomyx-csrblog.com/. For more information, please visit www.senomyx.com.
Gwen Rosenberg
Senomyx, Inc.
Vice President, Investor Relations & Corporate Communications
SOURCE Senomyx, Inc.


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Philosophy, Political Science, and EconomicsPage address: http://mnsu7700france.info.mnsu.edu/programs/philosophypolecon.html
|Arts & Humanities
|Program Website
|Undergraduate Degree Type(s)
|Program Description
|The PPE major integrates the historical, methodological, theoretical, and practical foci of Philosophy, Political Science, and Economics to form a single course of study. The focus of the major is on the dynamic relationships between the economic, political, and legal systems of our society, relationships that require the analytical methods of all three disciplines to be understood fully.
For example, the best way to understand our competitive market economy, certainly a fundamental institution of our society, is to explore its empirical, historical, political, and ethical dimensions. Indeed, if one considers the most influential historical figures in each of the three fields, e.g., John Locke, Adam Smith, David Hume, John Stuart Mill, G.W.F. Hegel, and Karl Marx, it is immediately clear that they recognized no rigid disciplinary boundaries between philosophy, political science, and economics, and that the strength of their views lies precisely in their grasp of the dynamic relationships between the systems that these disciplines study.
Admittedly, the coherence of the major is expressed at a fairly abstract and analytical level; the content of the major can be broad and diverse, but all students who work through the major's curriculum will develop an appreciation of the complexity of our society's central institutions and problems at the same time that they acquire the analytical facility to engage and critically evaluate them.
|Admission Requirements
|Admission to Major is granted by the department.
Minimum University admission requirements are:
|Other Requirements
|Students in the major take required core courses in Philosophy, Political Science, and Economics, (9 credits from each of the three departments, a total of 27 credits). Majors must also choose which department they will focus in, their "concentration." Students then take 5 more upper-level courses in the concentration (15 credits), and two more upper-level courses from each of the other two departments (12 credits). Majors must also take a statistics course (3 credits), and a senior thesis or independent study course (3 credits). The PPE major qualifies as a "broad major" that does not require a minor.
|Academic Bulletin
|A full description of the program including class listings and class descriptions are listed in the Academic Bulletin.
|Program Contact Information
|Craig Matarrese
Department of Philosophy
227 Armstrong Hall
Mankato, MN 56001
Phone: 507-389-2012
Email: email@example.com
|College Advising
|College of Arts & Humanities Advising
Student Relations Coordinator
226B Armstrong Hall
Note: This page may not print properly from Internet Explorer.


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Can you spot the performance problem with the two queries below? These queries both illustrate a common and nasty performance problem that robs CPU cycles and consumes I/O bandwidth.
CREATE TABLE dbo.Foo(
Bar varchar(10) NOT NULL
CONSTRAINT PK_Foo PRIMARY KEY CLUSTERED,
Data char(100) NOT NULL,
CreateDate datetime NULL
CREATE INDEX Foo_CreateDate ON dbo.Foo(CreateDate);
--select single row by key
SELECT Data FROM dbo.Foo
WHERE Bar = 1;
--select rows created within last week
WHERE DATEDIFF(day, CreateDate, GETDATE()) <= 7;
Both of these queries are examples of non-sargable conditions. The first SELECT statement shows the gotcha of data type precedence. The second query demonstrates the anti-pattern of applying a function to an indexed column instead of specifying the column alone on one side of the comparison operator.
The WHERE clause predicate of the first query isn't sargable because SQL Server must convert the varchar "Bar" column to integer before the comparison to the integer literal 1. SQL Server has well-defined rules which dictate that, when two expressions are compared, the side with the lower precedence data type is converted to that of the higher data type. A column's index cannot be used for a seek operation when the column is converted to a different data type. Implicit conversion due to precedence rules is especially insidious.
The order of data type precedence is listed in the Books Online (http://msdn.microsoft.com/en-us/library/ms190309.aspx). You don't need to memorize the entire data type precedence list to write efficient queries, though. Just pay attention to detail regarding literals and data types to ensure the data types match whenever possible. Be aware of column data types during query development.
The problem with the first query can be remedied simply enclosing the literal in quotes. The two quotes turn the clustered index scan into an efficient seek:
WHERE Bar = '1';
The WHERE clause predicate of the second SELECT statement is also non-sargable because "CreateDate" is only passed as an argument to the DATEDIFF function. Columns must stand alone on one side of the comparison operator in order for an index seek to occur. Remember that the indexed values are the actual column values, not the results of a function (with the exception of a indexed computed column, which is beyond the scope of this post).
The performance issue with the second query can be addressed by reformulating the predicate so that "CreateDate" is alone. The query version below allows a seek using the non-clustered index. Whether or not the index is actually used depends on whether SQL Server deems it advantageous to do so based on estimates of qualifying rows.
--select rows created within last 7 days
WHERE CreateDate >= DATEADD(day,-7,CAST(GETDATE() AS DATE));
Sargable conditions are low-hanging fruit that you should pay attention to during query development or when investigating a performance issue. Not only does one need indexes to provide an efficient data access path, queries need to be written so that they can take advantage of them.
posted @ Saturday, March 07, 2009 6:41 PM
© Dan Guzman
Theme by PiyoDesign. Valid XHTML & CSS.


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OK, it's a rally. I've been to a bunch of them. We always have a good time, no matter what happens. This year, the original plan was that I'd ride out on the RT and Tina would fly out to join me. I'd thrash it on home and she'd fly home.
And then we bought the /2.
So, instead of the ride/fly, we put the /2 in the truck and headed to WI.
We have busy lives. She works in the city, I work at home. During the week, we're both so whooped from our jobs that we don't really have a chance to talk - which is what you're supposed to do when you're married. We got to do lots of that in the truck. We spent three days getting to the rally and two days going home, so we had plenty of time to talk about our family, our house, our jobs, ourselves, bikes, going places, doing things.
It was pretty refreshing.
Utah was under seige, with a couple hundred square miles of it on fire. Despite the haze, the views were still wonderful.


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A short and intense action track with nervous staccato strings and synth chords. The tight drums are accompanied by a continuous low string hit. Suspense until the last second.
Of course VIDEOHIVE AUTHORS can use all my preview tracks in their video items. Please set a link and send me an email. Then I can complete my item descriptions. Thanks.
I'm very interested how my music was used. If it is possible, please let me know (on my profile page right side bottom).


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CINCINNATI (AP) — A Cincinnati man jailed in the accidental shooting death of his 11-year-old daughter lost his request Thursday to attend the girl's funeral, with a judge saying that public safety trumps his grief.
In an emotional hearing in Hamilton County court, Judge Nadine Allen said that too many members of the public and some relatives are angry to allow Deandre Kelley, 34, to attend the funeral Saturday of young Shanti Lanza.
Allen said the neighborhood where the funeral will be held is not particularly safe and that Kelley will have to "grieve symbolically."
Kelley's attorney, Hugh McCloskey Jr., had argued that Kelley's presence at the funeral would help the whole family begin healing and suggested the possibility of allowing Kelley a private viewing away from the public "to say goodbye to his daughter."
Prosecutor Mark Piepmeier said allowing that would be wrong.
"He's a horrible person for what he did," he said. "He shouldn't go to the funeral, he should go to prison."
Allen's decision prompted Shanti's mother, Kristina Lanza, to sob loudly in court and appear to nearly faint. She had wanted Kelley to attend Shanti's funeral, saying the shooting was an accident.
Kelley had previously pleaded not guilty to reckless homicide and pleaded not guilty during the hearing to three new charges, including involuntary manslaughter, endangering children and having a weapon under disability.
If convicted on all counts, Kelley could face up to 17 years in prison.
According to Hamilton County prosecutor Joe Deters, Shanti was having a slumber party with several friends Sunday when her mother, Kristina Lanza, began arguing with Kelley about him bringing a gun into the home. Lanza ordered Kelley out of the house, but he returned drunk around 3 a.m., prosecutors said.
The children, who were downstairs watching TV while Lanza slept upstairs, opened the door for Kelley, who walked in, turned and fired a gunshot out the front door, prosecutors say.
Shanti then ran upstairs for her mother, who again ordered Kelley to leave. That's when Kelley walked out and fired two shots into the air. One of them hit Shanti's lung, who was hiding in an upstairs bedroom. She later died at a hospital.
Deters said Kelley had previously been charged three times with domestic violence but was never prosecuted because Lanza refused to testify.
"This is the end of the road for this enabling," Deters said in a statement. "He needs to be in jail, and the rest of them (Shanti's family) should be looking in the mirror for the reason this little girl is dead."
Relatives have described Shanti as a happy, beautiful child who loved her father. She was a ballet dancer who enjoyed rapping with her father and was set attend the School for Creative and Performing Arts next year, they said.
Kelley's brother, Antwon Kelley, described his brother as a family man and loving father of seven children who lost his teenage son a year ago in a still-unsolved shooting.
Follow Amanda Lee Myers on Twitter at https://twitter.com/AmandaLeeAP


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Nationwide Homeowners Insurance in Belton, South Carolina From RENEA S ROWLAND
Protect your house and personal property by choosing the right insurance coverage from Nationwide.
Need help understanding what's required by your home lender? Or how you can best protect your home's property value including the dwelling, other property structures, and the belongings inside the home? Let RENEA S ROWLAND make sure you don't miss that crucial detail about your homeowner's policy. Along with their general expertise of Belton home insurance, our agents will listen carefully to your questions and concerns. From there, it's a straightforward process to find the policy coverage that makes the most sense for your home and your loved ones.
Everything from the age of the home to the age of the homeowner can mean new ways to save on your Belton home insurance. There are also exclusive Nationwide benefits programs, like Brand New Belonging® and Better Roof Replacement®. These programs will make it easier to move forward should a covered damage occur. In the meantime, they offer extra peace of mind.
You probably didn't build the house on your own, and nor should you have to wade through the details of a home insurance policy by yourself either. Let RENEA S ROWLAND demystify the process and help you understand how a policy protects you from covered damages. When it comes to something this important, you don't want to stay in the dark. Give us a call at (864) 338-1600 to discuss your policy. Or schedule an appointment with our office at 703 Anderson St, Belton, South Carolina, 29627-2101 to talk about your concerns in person with Renea S Rowland and our staff today.


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Office of Student Affairs & Wellness:
Academic Performance Standards
What are Academic Performance Standards?
This program was designed to recognize, inform, and reward the academic achievements of our CCSF students by offering certificates, recommendations, and even scholarships to students who are maintaining high academic standards for themselves. It is also designed to help and support students who are not meeting academic standards.
Why is it important?
CCSF promotes a higher standard of academic achievement for all students. We strive to remind students of the importance of education and what a pivotol role it can play in their future. We strive so by helping students who need more support and also recognizing those that are making excellent academic progress.
Student Learning Outcome (SLO)
To find out more about the outcome for this or any other one of our programs, please click here.


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A Study of Axitinib in Advanced Carcinoid Tumors
|The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
|ClinicalTrials.gov Identifier: NCT01435122
Recruitment Status : Completed
First Posted : September 15, 2011
Results First Posted : May 25, 2017
Last Update Posted : October 2, 2018
- Study Details
- Tabular View
- Study Results
- Disclaimer
- How to Read a Study Record
|Condition or disease
|Carcinoid Tumor
|Drug: Axitinib
|Phase 2
|Study Type :
|Interventional (Clinical Trial)
|Actual Enrollment :
|30 participants
|Intervention Model:
|Single Group Assignment
|None (Open Label)
|Primary Purpose:
|Official Title:
|A Phase II Study of Axitinib in Advanced Carcinoid Tumors
|Actual Study Start Date :
|October 25, 2011
|Actual Primary Completion Date :
|January 11, 2017
|Actual Study Completion Date :
|February 13, 2018
Experimental: Axitinib Administration
The investigational drug used in this study is axitinib, and is available as tablets.
You will take the tablet orally with food. Doses should be taken around 12 hours apart continuously, without scheduled breaks. If you vomit anytime after taking a dose do not take another tablet to "make up the dose" but instead continue taking your next dose as planned.
Any missed dose may be taken late (up to 3 hours before the next scheduled dose); otherwise it should be skipped. If doses are missed or vomited, please keep track of this and report at your next visit.
Drug: Axitinib
Axitinib Administration as outlined in Arm description
Other Names:
- Rate of Progression Free Survival (PFS) [ Time Frame: 12 Months ]Progression-free survival rate at 12 months. PFS: determined as the time from administration of the initial dose of axitinib until objective tumor progression using Response Evaluation Criteria In Solid Tumors (RECIST), or death. Progressive Disease (PD) Appearance of one or more new lesions and/or unequivocal progression of existing non-target lesions. Unequivocal progression should not normally trump target lesion status. It must be representative of overall disease status change, not a single lesion increase. Stable Disease (SD): Neither sufficient shrinkage to qualify for Partial Response (PR) nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study.
- Median Progression Free Survival [ Time Frame: Up to 36 Months ]Post follow-up progression free survival at time of analysis.
- Tumor Response Rate [ Time Frame: 12 Months ]Tumor response rate using RECIST. Complete Response (CR): Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to <10 mm. Partial Response (PR): At least a 30% decrease in the sum of the diameters of target lesions, taking as reference the baseline sum diameters.
- 24 Month Overall Survival (OS) Rate [ Time Frame: 24 months ]Overall survival by Kaplan Meier, determined from the time of drug administration to death from any cause. The effect of an intervention is assessed by measuring the number of subjects survived or saved after that intervention over a period of time. The time starting from a defined point to the occurrence of a given event, for example death is called as survival time and the analysis of group data as survival analysis.
- Time to Treatment Failure [ Time Frame: 12 Months ]Time to Treatment Failure: Time from administration of the initial dose of axitinib until study discontinuation for any reason (e.g., disease progression, toxicity, death, withdrawal of consent).
- Occurrence of Possibly Related Adverse Events (AEs) [ Time Frame: 12 Months ]Grade 2 through 4 toxicities considered at least possibly related to treatment. Percentage of participants affected per category. Safety assessments will consist of monitoring and recording all adverse events and serious adverse events, the regular monitoring of hematology and blood chemistry parameters and regular physical examinations. Adverse events will be evaluated continuously throughout the study. Safety and tolerability will be assessed according to the National Institute of Health/National Cancer Institute (NIH/NCI) Common Terminology Criteria for Adverse Events version 4 (CTCAE v4) available at: http://ctep.cancer.gov/protocolDevelopment/electronic_applications/ctc.htm.
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.
|Ages Eligible for Study:
|18 Years and older (Adult, Older Adult)
|Sexes Eligible for Study:
|Accepts Healthy Volunteers:
Inclusion Criteria:
- Locally unresectable or metastatic well-and moderately-differentiated (low- or intermediate- grade) neuroendocrine tumors of the aerodigestive tract (e.g. foregut, midgut, and hindgut) and unknown primary site as well as rare primary sites (renal, ovarian, thymic, hepatic); Otherwise known as typical or atypical carcinoid tumors
- Measurable disease by Response Evaluation Criteria In Solid Tumors (RECIST) Criteria
- Functional or nonfunctional tumors allowed
- Evidence of progressive disease within 12 months of study entry
- Adequate hepatic function: total bilirubin ≤1.5 x upper limit of normal (ULN)mg/dl; aspartic transaminase (AST) ≤2.5 x ULN (≤5 x ULN if attributable to liver metastases)
- Adequate renal function: serum creatinine ≤ 1.5 x ULN
- Adequate bone marrow function: absolute neutrophil count ≥ 1,500/mm³; platelets ≥75,000/mm³
- Prothrombin time (PT) and activated partial thromboplastin time (aPTT) levels ≤1.5 x ULN (unless patients receiving coumadin anticoagulation in which case a stable international normalization ration (INR) of 2-3 is required).
- Urine protein <2+proteinuria (or <2 g proteinuria /24 hr)
- Prior somatostatin-analog therapy required in patients with midgut carcinoid tumors
- Minimum 4 weeks since completion of prior treatment (investigational or other). Prior treatment with chemotherapy, radiotherapy, hepatic artery embolization, surgery or other therapeutic agents is allowed.
- Treatment related toxicity should have returned to baseline and/or ≤grade 1 prior to study treatment.
- Prior or concurrent therapy with somatostatin analogs is permitted for the control of hormone-mediated symptoms, provided patient has been on a stable dose for at least 2 months and progressive disease on somatostatin analogs (SSTa) has been documented
- Eastern Cooperative Oncology Group (ECOG) performance status 0-2
- Women of childbearing potential must have a negative serum pregnancy test within 14 days prior to treatment.
- Ability to sign informed consent
- Willingness and ability to comply with scheduled visits, laboratory tests and other study procedures
Exclusion Criteria:
- Poorly differentiated, high-grade (e.g. small cell or large cell) neuroendocrine carcinomas are excluded.
- Pancreatic neuroendocrine tumors (NETs), paragangliomas, pheochromocytomas and medullary thyroid cancers are excluded.
- Adenocarcinoid tumors and goblet cell carcinoid tumors are excluded.
- Prior antiangiogenic therapy with a dedicated vascular endothelial growth factor (VEGF) pathway inhibitor
- Clinically apparent central nervous system metastases
- Any of the following within 12 months prior to study: myocardial infarction, uncontrolled angina, coronary/peripheral artery bypass graft, symptomatic congestive heart failure, cerebrovascular accident, or transient ischemic attack
- Deep venous thrombosis or pulmonary embolism within 6 months of study
- Major surgery 4 weeks prior to enrollment
- Inability to take oral medication or prior surgical procedures affecting absorption (including total gastric resection)
- Active gastrointestinal bleeding, if transfusion dependent
- History of abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within the past 28 days
- History of pulmonary hemorrhage or evidence of significant hemoptysis
- History of serious non-healing wound, ulcer, or bone fracture within the past 28 days
- Pre-existing thyroid abnormality allowed provided thyroid function can be controlled with medication.
- Current use or anticipated need for treatment with drugs that are known potent CYP3A4 inhibitors (i.e. grapefruit juice, verapamil, ketoconazole, miconazole, itraconazole, erythromycin, clarithromycin, indinavir, saquinavir, ritonavir, nelfinavir, etc.)
- Current use or anticipated need for treatment with drugs that are known inducers of CYP3AR or CYP1A2 (i.e carbamazepine, dexamethasone, omeprazole, phenobarbital, phenytoin, rifampin, St. John's Wart, etc.)
- Uncontrolled serious medical or psychiatric illness. Patients with a "currently active" second malignancy other than non-melanoma skin cancers, carcinoma in situ of the cervix, resected incidental prostate cancer (staged pathological tumor-2 (pT2) with Gleason Score ≤ 6 and postoperative prostatic specific antigen (PSA) < 0.5 ng/mL), or other adequately treated carcinoma-in-situ are ineligible. Patients are not considered to have a "currently active" malignancy if they have completed therapy and are free of disease for ≥3 years.
- Pregnant or lactating women, or adults of reproductive potential who are not using effective birth-control methods.
- Prior antitumor therapy within 4 weeks of enrollment (with exception of somatostatin analogs)
- Liver-directed therapy within 2 months of enrollment. Prior treatment with radiotherapy (including radio-labeled spheres and/or cyberknife, hepatic arterial embolization (with or without chemotherapy) or cryotherapy/ablation is allowed if these therapies did not affect the areas of measurable disease being used for this protocol or if progressive disease can be documented in the previously treated area.
- Recent infection requiring systemic anti-infective treatment that was completed ≤14 days prior to enrollment (with the exception of uncomplicated urinary tract infection or upper respiratory tract infection)
- Uncontrolled hypertension (blood-pressure >140/90). Patient with baseline hypertension may be eligible after initiation of antihypertensive therapy.
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01435122
|United States, California
|University of California San Francisco (UCSF)
|San Francisco, California, United States, 94115
|United States, Florida
|H. Lee Moffitt Cancer Center and Research Institute
|Tampa, Florida, United States, 33612
|Principal Investigator:
|Jonathan Strosberg, M.D.
|H. Lee Moffitt Cancer Center and Research Institute
Additional Information:
|Responsible Party:
|H. Lee Moffitt Cancer Center and Research Institute
|ClinicalTrials.gov Identifier:
|NCT01435122 History of Changes
|Other Study ID Numbers:
|First Posted:
|September 15, 2011 Key Record Dates
|Results First Posted:
|May 25, 2017
|Last Update Posted:
|October 2, 2018
|Last Verified:
|August 2018
|Studies a U.S. FDA-regulated Drug Product:
|Studies a U.S. FDA-regulated Device Product:
Keywords provided by H. Lee Moffitt Cancer Center and Research Institute:
progressive advanced carcinoid tumors
cancerous tumors
digestive tract
Additional relevant MeSH terms:
Carcinoid Tumor
Neuroendocrine Tumors
Neuroectodermal Tumors
Neoplasms, Germ Cell and Embryonal
Neoplasms by Histologic Type
Neoplasms, Glandular and Epithelial
Neoplasms, Nerve Tissue
Protein Kinase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action


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PATTANI, Thailand (AP) — Suspected insurgents have detonated a motorcycle bomb in Thailand's violence-plagued south, killing one person and wounding 20, one day ahead of President Barack Obama's visit to the country.
Police say the explosion Saturday morning in Yala province also set five buildings on fire in the city center.
Police Col. Narin Busaman says the suspected militants set off the remote-controlled bomb, which was hidden in a motorcycle, when a group of patrolling soldiers passed by the city's commercial area.
He says five soldiers and 15 civilians were injured. Police have not identified the dead victim.
More than 5,000 people have been killed in Thailand's Muslim-dominated southernmost provinces since an Islamist insurgency erupted in 2004.
Obama arrives in Thailand on Sunday. He'll also visit Myanmar and Cambodia on his trip.


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Nashua man charged with lewdness for August incidentBy PAUL FEELY
New Hampshire Union Leader
October 16. 2017 10:02PM
NASHUA — A Gate City man was arrested Friday on lewdness charges, after two women say he exposed himself to them behind a Nashua business in August.
According to Nashua Police Lt. Kerry Baxter, at 7:56 p.m. Friday police arrested Nicholas Savoia, 24, of 16 Poliquin Dr. in Nashua and charged him with indecent exposure and lewdness, following an investigation into a report of indecent exposure officers received in August.
According to Baxter, on Aug. 16 around 2:13 p.m. officers responded to the rear parking lot of the Southern New Hampshire Health Immediate Care center at 112 Spit Brook Road, Nashua, for a report of an indecent exposure. Upon arrival, officers spoke with two adult females who reported that while they were in the parking lot a male exposed his genitals to them while he committed a lewd act.
Police identified Savoia as a suspect, and officers applied for and received an arrest warrant for him.
Savoia was released on $2,000 personal recognizance and will be arraigned at the 9th Circuit-District Division-Nashua Court on Nov. 30.
Nashua police request anyone with information regarding this or any similar incident to contact them at 594-3500 or the Crime Line at 589-1665.


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100mg, 200mgCelebrex is a brand name for the generic drug celecoxib. It is a non-steroidal anti-inflammatory drug, or NSAID, used in the treatment of several different serious conditions, including the relief of symptoms of osteoarthritis and rheumatoid arthritis in adults and children over two years of age. It is also used for the relief of ankylosing spondylitis, which is a type of arthritis characterized by pain in and around the spine. Celebrex is given to adults for the management of general pain and for the treatment of severe menstrual cramps, as well as to reduce the number of colorectal polyps for those suffering from familial adenomatous polyposis. It is prescribed in capsules.


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The United States will be stepping up its so-called pivot toward Australia's region in President Barack Obama's second term, America's man in Canberra says.
Ambassador Jeffrey Bleich also sought to reassure Australians that the US will not topple over the so-called fiscal cliff and drag the rest of the world back towards recession.
In his first major public address since President Obama won re-election last month, Mr Bleich moved to combat claims the US doesn't have the will or resources to carry through its plan to boost its presence across the Asia-Pacific region.
He says the Obama administration has a big "meaty" agenda for the region over the next four years.
"Let me be absolutely clear about this: we are not leaving, we are not receding," he told reporters at the National Press Club in Canberra on Wednesday.
"The only reason that we would retreat from this region now is this: if we had completely lost our minds.
"To use a blackjack term, we are doubling down on the success of this region," he said, alluding to the gambling practice of doubling a bet.
Mr Bleich said he was confident Democrats and Republicans would soon agree on a way to avoid the fiscal cliff.
If no deal is agreed before the end of the year, taxes will go up for all Americans and savage cuts to government spending will begin, prompting fears of a new recession. Treasurer Wayne Swan has warned Australia would not be immune from the effects of such a failure.
"There is every reason to hope and every reason to believe this grand bargain is going to happen," Mr Bleich said.
The ambassador also took time to lament the negativity of the US election campaign, saying both sides of politics are training people to think all politicians are inept and corrupt.
Mr Bleich is keeping mum on how long he will be staying in his job, amid speculation Mr Obama wants him back in Washington DC.
"I will do whatever the president says will be in the best interests of my country," he said.
"At the same time, I have told him I absolutely love this job. If he wants me to leave he's going to have to pry me out of the embassy first.
"And now we have more marines, so it'll be harder for him," he quipped, referring to the US marines on training rotation through Darwin.
He denied his speech was intended to coincide with this week's visit of senior Chinese official Liu Yandong, who is meeting with Prime Minister Julia Gillard but not speaking with the media.


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The fastest XC Race Lady-Rocket the World has ever seen! From its asymmetrically offset rear triangle and drivetrain to its new-school geometry and custom offset Lefty, every part of the new F-Si was designed as a System, fully Integrated in the pure pursuit of speed. The new F-Si is the most integrated, most advanced and fastest XC race bike ever made and these bikes are lighter, stiffer, better handling and simply faster than anything else out there. Shimano XTR/XT 1x11-speed shifting components underline the standard of this bike, provide high transmission bandwidth and guarantee highest precision and durability. The extremely stiff Cannondale Si crankset in connection with the PF3 bottom bracket does not waste a single watt. Hydraulic Magura MT-Race disc brakes enable a powerful and save brake performance in all conditions. A lightweight wheelset with CZero carbon rims can be easily prepared for tubeless setup. Well thought technologies, great components and one of the lightest and stiffest forks available unified in one 29'er race hardtail. The lightweight frameset is a mark all other competitors have to beat. Fantastic stiffness to weight values underline the know how of Cannondale and let it be a perfect choice for hardest competitions. Cannondale reached that target by implementing several innovative technologies and materials in their concept. F29 Carbon achieves unheard of levels of light weight and efficiency by System Integration design. Cannondale designs components to work together, like the new Lefty Hybrid fork and the Stem/Steerer, or the crankset with the PF3 system. Lighter and stiffer than aluminum, more shockproof than steel. Ballistec carbon can shake off rock strikes and impacts that would destroy F-Si's flimsy competition. Tube2Tube Construction is a time intensive and expensive construction procedure which is used by Cannondale to create every tube individually and to arange the unidirectional fibers exactly. This results in increased stiffness and further reduced weight. The Speed Save System with its optimized chain- and seat stay shaping offers lateral rigidity, while providing vertical compliance for bump absorption and comfort with no loss in power transfer. Ai Drivetrain Asymmetric Integration - The heart of the F-Si's System Integration is the all-new, Ai, asymmetrically offset rear triangle and drivetrain. The offset shifts the rear hub and drivetrain 6 mm to the right, delivering super short chainstays without any of the usual compromises, and a rear wheel that is dramatically stiffer and stronger because the spoke tension and angles are equal on both sides. Cannondale then integrate this with their new Ai HollowGram spider, which moves the chainrings an equal 6 mm to the right, balancing the system and maintaining perfect chain-line, shifting performance and Q-factor. This elegantly simple approach - Ai - enables them to have their cake and eat it too. The extra space created by shifting the drivetrain outboard enables the F-Si to have: - The shortest chainstays on the market, for incredible traction, stiffness and agility. - Up to 6% increase in rear wheel stiffness. - Dual chainring compatibility with super short stays. - Tons of mud clearance. - Ample tire clearance with the chain and front derailleur. System Geometry When it comes to the way a bike handles, geometry is everything. The difference of just a few millimeters here or a half a degree there can significantly impact handling. Cannondale developed a winning 29er geometry for the F29 but World Cup competition is changing. With courses becoming ever more technical, steep and brutal, they knew that they have to rethink XC geometry completely. The result is F-Si - a bike that defines new-school XC handling and speed. Super Short Chainstays: Category leading, super short chain stays, which were extremely agile in tight and technical terrain, especially when navigating switchbacks. That also puts more of the rider weight over the rear wheel, dramatically increasing rear wheel traction on steep climbs. Slack Head Angle with 5 mm Offset Lefty: Progressively slack 69.5° head angle mated to the Lefty's proprietary 55 mm fork offset, the nimble rear end is complemented by equally agile and capable steering. At high speeds, the added stability of the slack head angle enables the rider to attack rough terrain with confidence. In slower, tight, technical sections, the extra fork offset and resulting lack of "trail keep the steering quick and nimble. Lefty 2. A bike as radically new and boundary-pushing as the F-Si demands an equally radical fork to complement its freakish handling and stiffness. For the uninitiated, Lefty has always been the lightest, stiffest, smoothest, and most durable front suspension on the start line: XC+ Damper Who says an XC rocket can't borrow technology from the enduro world? The new Lefty gets the same new smooth and supple damper technology found in the new SuperMax forks, but tuned for XC. Dual Integrated Crowns Stiffer and stronger than single crown setups. The Lefty 2. has multiple clamp widths, lowering the front end heights of Cannondales small, medium and large sizes. Inverted Design Inverted design is not just stiffer and stronger, it's also better lubricated. Gravity holds lube against the seals and bearings for longer life and smoother action. Oversized Clamp Area The Lefty gets an updated structure which grows to 44 mm in diameter at the clamp areas. This keeps the fork svelte, but adds even more stiffness and strength. Hybrid Needle Bearing System For maximum control, SuperMax's proprietary needle bearing assembly keeps the suspension smooth, no matter how hard you brake, corner, or land. For 217 it comes with a new air spring assembly, called 2Spring. This internal update decreases the strut's activation force by 7 lbs and makes for longer service intervals. Overall it offers 1 mm air suspension, a hydraulic lockout and adjustable rebound damping.


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Truck Cartoon
Here are the best of the October 2009 YES! cartoon caption submissions.
- "Even if you could've reached the clutch, where were you going to drive it?"
Jim Fox
- Next time let's use the valet parking.
Jeff Nawrocki
- A Float In the Global Warming Parade
Deborah Marchant
- "...and the ice for clunkers program expired last month"
Aubrey Enoch
"Moving gets harder every year."
Jim Wheeler
- That species is threatened!
Monty Williams
- Yeah, I hear Detroit's had to put a lot of projects on ice
Renee Moog
- Think they'll listen now?
Mr. W
Rob Pendragon
|Add your caption to our latest
See other reader submitted captions for YES! cartoons:


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Obama urges cooperation as government reopensBy LORI MONTGOMERY, ROSALIND S. HELDERMAN and WILLIAM BRANIGIN
The Washington Post
October 17. 2013 8:55PM
WASHINGTON — Federal agencies, parks, museums and monuments began to reopen Thursday morning, after a chastened Congress ended a bitter funding standoff that triggered a 16-day government closure and drove the nation toward the brink of default.
The agreement struck by Senate Majority Leader Harry Reid, D-Nev., and Minority Leader Mitch McConnell, R-Ky., funds agencies through mid-January, calls hundreds of thousands of civil servants back to work and raises the $16.7 trillion debt limit.
"There are no winners here," President Barack Obama said Thursday at the White House. "These last few weeks have inflicted completely unnecessary damage on our economy."
Obama called on Congress to resist "pressure from the extremes" and "understand that how business is done in this town has to change." He urged lawmakers to pursue a "balanced approach to a responsible budget" and to pass comprehensive immigration reform and a new farm bill.
And he offered thanks and encouragement to federal workers as they returned to their jobs. "What you do is important, and don't let anybody else tell you different," he said.
Top officials in his administration conveyed the same message.
"Good morning folks, thank you for your service," called out Agriculture Secretary Tom Vilsack, as no-longer-furloughed civil servants streamed from the nearby Smithsonian Metro station through the doors of agency headquarters.
Vice President Joe Biden greeted employees at the Environmental Protection Agency, and White House Chief of Staff Denis McDonough shook hands with returning workers at the guarded gate outside 1600 Pennsylvania Avenue.
At the National Zoo, officials turned the popular panda cam back on, revealing an older, fatter and more robust black and white cub than was last seen more than two weeks earlier. The cub, now nearly two months old, gained two pounds during the shutdown, the zoo announced Thursday.
The Department of Veteran Affairs said it would issue benefit payments to about 5 million veterans, survivors and their families on Nov. 1 as scheduled now that funding has been restored. The VA had warned that if the shutdown continued to the end of the month, it would run out of funds and be unable to issue checks, a disclosure that caused major consternation among lawmakers and veterans.
The bill passed late Wednesday ended a stalemate created last month, when hard-line conservatives pushed Republican leaders to use the threat of shutdown to block a landmark expansion of federally funded health coverage.
That campaign, however, succeeded mainly in undermining popular support for the Republican Party. By the end, dozens of anxious GOP lawmakers were ready to give Obama almost exactly what he requested months ago: a bill to fund the government and increase the Treasury Department's borrowing power with no strings attached.
The Senate overwhelmingly ratified the deal Wednesday evening, 81 to 18, with more than half of Senate Republicans voting yes. A few hours later, the House followed suit, approving the measure 285 to 144. Eighty-seven Republicans joined a united Democratic caucus in approving the measure, allowing Congress to meet a critical Treasury Department deadline with one day to spare.
Obama signed the measure into law shortly after midnight, reopening parks and monuments across the nation, restoring government services and putting furloughed federal employees back on the job.
In his remarks Thursday, Obama said the shutdown and the threat of a U.S. default probably slowed economic growth, set back hiring and increased borrowing costs, adding to deficit that has been shrinking.
"That's not a surprise that the American people are completely fed up with Washington," Obama said. "At a moment when our economic recovery demands more jobs, more momentum, we've got yet another self-inflicted crisis that set our economy back. And for what? There was no economic rationale for all of this."
He added: "Probably nothing has done more damage to America's credibility in the world, our standing with other countries, than the spectacle that we've seen these past several weeks. It's encouraged our enemies, it's emboldened our competitors, and it's depressed our friends, who look to us for steady leadership."
Obama predicted that "we'll bounce back from this," but he cautioned that it "won't be easy." He said, "There's a lot of noise out there, and the pressure from the extremes affect how lot of members of Congress see the day-to-day work that's supposed to be done here."


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Fr. Frank Pavone, Co-Founder of the International Pro-life organization, Priests for Life, has been chosen by The Franciscan University of Steubenville, to receive the honorary degree, "Doctor of Christian Letters," at a ceremony to take place at the university on Saturday, May 11, 2002.
Among others being honored at Steubenville that day will be Avery Cardinal Dulles, S.J., who will receive an honorary Doctorate of Sacred Theology.
Anthony DeStefano, Executive Director of Priests for Life, said, "It is very significant that one of the foremost Catholic Universities in the United States is honoring one of the foremost pro-life leaders in the country. This stands in significant contrast so some Catholic educational institutions which have demonstrated very poor judgment in the past by allowing well-known pro-abortion politicians to speak on their campuses. Fr. Frank is one of the greatest defenders of innocent human life that America has ever known; we are extremely grateful to Steubenville for honoring him, and by extension, the entire pro-life movement."
Fr. Pavone's remarks at the ceremony are expected to contain an urgent nationwide call for graduates and other professionals to devote themselves full-time to ending the abortion tragedy.
WHO: Fr. Frank Pavone, Co-Founder, Priests for Life


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The restart-on-exit argument is treated in the same way as for spawn-node-with-dynamic-place-at .
The one-sided-place? argument is an internal use argument for launching remote places from within a place using the old design pattern.
The place-exec argument describes how the remote place should be launched in the same way as for launch-place in remote-node% .
However, the final word on the overall cultural competence of a counselor rests in the perspective of each specific client. In other words, "Does this client experience me as culturally competent?" As found repeatedly in the counseling research, the client's perspective on a number of important elements of counseling is often more strongly associated with counseling outcomes than is the counselor's perspective. This holds true for core predictors of outcome such as empathy, the therapeutic alliance and multicultural competence/responsiveness. Thus, putting MCO into practice involves establishing an interpersonal stance of cultural humility and a willingness to explore cultural opportunities that are relevant to the client.
With this in mind, some in-session recommendations follow.
MCO cannot be scripted or manualized, but its central features include communicating respect, practicing humility, being receptive to acknowledging one's own biases when they occur and practicing culturally inclusive engagement that resonates with clients. An essential element of cultural humility is nondefensiveness around one's own lack of awareness or demonstrations of incompetence. Thus, before encouraging client feedback, counselors need to be clear about how willing and able they are to receive this feedback with humility.
Cultural competence is not adequately defined by counselors' self-perceptions of competence. Rather, it is determined by how their clients — especially marginalized clients — view the counselors' capacity and willingness to understand the cultural forces that influence clients' lives. Comprehending clients' subjective cultural experiences and acknowledging our own cultural blind spots in the process are central to cultural humility. This interpersonal stance can help counselors improve client outcomes, honor the cultural experiences of clients and clarify the effects of counselors' own privilege.
Knowledge Share articles are developed from sessions presented at American Counseling Association conferences.
Sidney Shaw
is a core faculty member in the clinical mental health counseling program at Walden University, a certified trainer for the International Center for Clinical Excellence and a workshop presenter. Additional information on multicultural counseling and other counseling topics is available at
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. Contact him at firstname.lastname@example.com .
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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.
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We are all socialized into systems that oppress.Our parents and teachers, grandparents and loved ones intentionally or unintentionally pass on theirbeliefs, norms, rules and expectations.
We learn to accept oppression as normal.
We do this through day- to -day interaction in schools, in temples, in churches, during doctors appointments, working with mortgage officers, via cab drivers, and police officers.
We may not see how deeply embeddedthese rules, regulations, and values help continue business as usual in this country, but they do.
We are born into a social system which teaches us to accept things as they are.
We are rewarded for accepting things as they are. We are congratulated for accepting things as they are. We become "model members of society" when we accept things as they are.
We gain comfort, money, connections and power when we accept things as they are. People who go against the grain, pay the price
I know as you read this a tiny voice deep in your heart issaying " I do notoppress people"
That might be true, you may not actively oppress others- but here is the reality- oppression is still happening because this cycle and the systems they support continue to run uninterrupted.
Oppression is thenorm, notthe exception. Justice is the exception, not the norm.
Institutions influence individuals and individuals influence institutions.
This process is pervasive, consistent, circular, self-perpetuating, and invisible.
The simplest thing to do is nothing.
But we have failed to realize that we have become participants in our own oppression by doing nothing.
The Institutions/ systems of this country are not broken, they are doing exactly what they were meant to be doing.
They don't need to be fixed. They need to be dismantled.
Will you take responsibility for the oppression that continues? Will you stand up and confront the systems, rules, and norms?
How, where, and when you confront injustice is irrelevant, as long as you do it.
You and I are responsible for interrupting oppression. We are responsible for dismantling it. We are responsible for creating new systems and ways to share social power.
Society will not transform itself. We have to break the chains.
We all have to pay the price so that can happen.
Let's get to work y'all because freedom ain't free.
Comments on this entry are closed.
Comments are closed.
Brilliant article – appreciated every word and I thank you for bringing to light something which I'm sure has been on a lot of our minds and also for use in the brilliant quote by Dr. Cornell West
Thank you for this profound and insightful article. I think it is spot on and is very clearly articulate and something that is present it in a clear and very powerful way. And I really appreciate the stance that you are taking an active stance in changing dysfunctional ingrained archaic systems, institutions and people.
Brilliant article – appreciated every word and I thank you for bringing to light something which I'm sure has been on a lot of our minds and also for use in the brilliant quote by Dr. Cornell West
Thank you for this profound and insightful article. I think it is spot on and is very clearly articulate and something that is present it in a clear and very powerful way. And I really appreciate the stance that you are taking an active stance in changing dysfunctional ingrained archaic systems, institutions and people.
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Affectionately known as "The Paris of the Piedmont," Carrboro, North Carolina is a vibrant, forward-thinking community that prides itself on its cultural and economic diversity. While the parking meters commonly found in larger cities are thankfully absent, more importantly, a focus on sustainability and responsible growth management (sometimes lacking in smaller communities) is in full effect in Carrboro.
This town of just under 20,000 people is located west of the University of North Carolina's main campus at Chapel Hill. Locals here appreciate the town's rich history, its close proximity to the University, and its wealth of locally owned small businesses.
Carrboro is also a regional Mecca for foodies. The town's eclectic culinary scene has earned national attention for its culinary delights, as well as its emphasis on farm-to-plate eating. Carrboro's Farmers Market receives excellent marks for its high quality, locally grown food and flowers, its support of local artisans, and its contribution to the overall spirit of the community.
The town of Carrboro's active, youthful population enjoys a wide variety of recreational facilities and community parks. The Adams Tract, a 27-acre urban forest area, provides extensive hiking trails. Neighborhood parks, baseball diamonds, and basketball courts also add to Carrboro's appeal as a great place for healthy living.
Luxurious townhomes, spacious new custom homes, and historical southern charmers are just a sampling of the homes for sale in Carrboro, NC. Sometimes called the Paris of the Piedmont, Carrboro offers the convenience and culture of urban living, within a closely connected community typically found only in smaller towns.
If the lively community spirit, charm, diversity, and progressive politics of Carrboro are just what you're looking for in a new hometown, let us help you find your perfect Carrboro home. Our intuitive home search makes it easy to find real estate in Carrboro and the home you've been dreaming of. Our trained real estate experts are here to help answer all of your buying, selling and moving questions.


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Most of the time, skiing is a fun, leisurely pursuit enjoyed my millions of people around the world. Occasionally things can take a turn for the worst, like last weekend when an avalanche took the lives of three highly experienced skiers in the Cascade Mountains in Washington.
Of the four skiers caught in the avalanche, only one survived. Speaking after the incident, Elyse Saugstad put her incredibly lucky escape down to her airbag backpack which she managed to trigger just in time.
"Ultimately I think you don't have much time to react," she said in an interview with ABC News. "The first thing that came to my mind was to use my airbag device."
As she and her fellow skiers were swept 3,000 feet down the mountain, her inflated airbag helped to keep her on top of the snow. The airbag is also designed to create space around the skiers face and body so that should they become buried, they'll still be able to breathe while they wait to be rescued.
The device has been available in Europe for some time, though has only recently come to North America.
Speaking of her experience, Saugstad said it was like being tossed and turned in a washing machine. "You don't know which way is up, but the [airbag] system keeps you up above so you have a very good chance of survival," she said.
The airbag backpack, which costs around $1000, is activated by pulling on a handle, causing it to inflate with nitrogen. It's been designed so that it doesn't obstruct the view of its wearer or hinder their movement.
The latest design actually comprises two, not one, 85-liter airbags, which inflate on each side of the user's body, helping to keep them as flat as possible on top, or close to the top, of the avalanche.
The maker of the airbag, a German company called ABS, has been researching ways to survive avalanches for more than 30 years.
[Source: BBC, ABS] [Top image: Prochasson Frederic / Shutterstock]
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Hooksett pantry counting on a successful food drive on Saturday
HOOKSETT - Hooksett residents wishing to do their part need do no more than leave non-perishable goods out by their mailboxes today, as the U.S. Postal Service's 21st annual "Stamp Out Hunger" food drive comes again to town, in collaboration with the Hooksett Community Food Pantry.
The "Stamp Out Hunger" food drive is a nationwide collaboration of U.S. Postal Service letter carriers, local post offices, and communities.
Residents are asked to leave non-perishables outside for mail pickup or at the post office. Foods stored in glass are discouraged, and the pantry cannot take any food past its expiration date.
The collected food will be brought to the post office in Hooksett, where it will be sorted by volunteers from the pantry, the Knights of Columbus, and Scout Troop 292, and distributed to residents in Hooksett through the Hooksett Community Food Pantry over the next several months, with some of it being immediately available to the pantry's patrons.
"There's food that we'll be able to use right away, so that goes right out on shelves," said the Food Pantry chairwoman, and recently named Hooksett Citizen of the Year, Barbara Brennan.
The collected food is also weighed and counted in order to track for the nationwide goal.
The drive collected over 70 million pounds of food across the country last year, 2,227 pounds of it collected in Hooksett.
The drive is also key for the Hooksett pantry's shelves, keeping them stocked over the summer months.
"It's a great food drive for us because it really helps us get through the summer months before our food drive in November," said Brennan. "Be generous this time of year. People tend to be over-generous during the holidays, and it's always appreciated but this food drive is really helpful to us. Everybody kind of goes away during the summer months and forgets about us, but this is a very important food drive for us."
The Hooksett Pantry has participated in the drive since moving to its current location in 2009.
Previously, food from the drive collected in Hooksett would go to a collection area in Manchester, but Brennan lobbied to have the food stay in town.
"I went and talked to the post office and said 'hey, we've got a food pantry here. We can use the food here,'" said Brennan. "It's been staying in Hooksett since then. We have a great need for food in our community, so it really helps out."
The pantry will also hold an on-site food drive in the gym of the town offices today from 1 to 5 p.m.
The Hooksett Community Food Pantry is located at 35 Main Street, at the back of the town offices.


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When I moved into my college dorm room, my mother's gift to me was a jade plant. She said that they were notoriously hardy, and that I would only need to water it every once in a while, when its leaves looked parched.Read More
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Gartner Auditorium
Event is in the past.
Directed by Josh Aronson. With Itzhak Perlman, Zubin Mehta, Joshua Bell, et al. A sold-out hit at last fall's Cleveland Jewish FilmFest, this new documentary chronicles how violinist Bronislaw Huberman (see The Return of the Violin) saved some of Europe's foremost musicians from the Nazis and founded an extraordinary orchestra in Palestine that would later become the Israeli Philharmonic. "Humane and inspiring." –The Forward. (USA/Israel, 2012, color/b&w, video, 84 min.)
Admission is $9; CMA members, seniors 65 & over, and students $7; or one CMA Film Series voucher. Vouchers, in books of ten, can be purchased at the Ticket Center for $70 (CMA members $60).
[1] http://www.clevelandart.org/file/6020


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Last night we made it to Dakota Jazz Club and Restaurant in downtown Minneapolis for the first of Peter Asher's two nights at the club performing his show A Musical Memoir of the 60s and Beyond. The show returns tonight at 7:00 p.m. and tickets are still available.
Last year we went to the show on a lark and were blown away by Peter's incredibly entertaining musical review of times past. This year we brought along friends including John and Loree Hinderaker for the ride.
I do believe a good time was had by all. John declared himself satisfied after Peter opened the show with "I Go To Pieces," the early 1965 Peter and Gordon hit written by Del Shannon. This year's edition of the show included Peter's recently discovered tape of Paul McCartney teaching him how to sing "World Without Love" and a surprise appearance by Denny Laine, formerly of the Moody Blues and Wings, who came out of the audience to sing his old Moody Blues hit "Go Now." I don't know if he'll be back for tonight's show, but I wouldn't be surprised.
We stayed around after the show as Asher graciously took a spot at a table to sign posters and discs for fans. My wife Sally took the opportunity to get a picture with him. He graciously indulged all comers and stayed until the room emptied.
The band members came out and talked to audience members as well. I reconnected with bass player Bill Cinque, who is a real gentleman. As I chatted with Bill after the show last year he ran back to the dressing room to present me with a copy of The Amazing Adventures of a Marginally Successful Musician, his humorous memoir cum self-help book. This year I told him how much I had enjoyed it. Please check it out at the Amazon link or at Bill's Web site.
We asked Bill if we could take a picture with him. John took the photo of Loree, me and Sally with Bill. We were slightly happy.
Last year I chatted with Bill about the Buddy Holly tribute show that Asher produced for PBS in connection with the tribute album recorded in honor of what would have been Holly's seventy-fifth birthday. (Peter also talks about it as part of the show. It is occasionally rebroadcast during PBS fundraising weeks.)
When Peter recruited Leland Sklar — "the world's best bass player," according to Bill — to play for the PBS show, he found a place for Bill by enlisting him to vocalize with the beautiful young backup singers. Bill suggested that those into pattern recognition would realize he didn't quite fit. "That's just the kind of generous man he is," Bill said, and I think that's the quality that shines through Asher's terrific show. Highly recommended.


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The Rancics are in the house! The stars of Style Network's hit reality series Giuliana & Bill (and pop culture's most famous new parents) have joined the Parenting team to bring you amazing real-life stories and the latest celebrity-parent dish. This issue, Giuliana, the host of E! News, and Bill, entrepreneur and season-one winner of The Apprentice, chat with Alison Sweeney, host of The Biggest Loser.
G&B: What's been your wackiest parenting moment?
AS: I'll never forget changing a majorly dirty diaper during a radio tour one morning. Radio tours are when you call in to a bunch of different local stations. It's nice 'cause you can do it from home, but sometimes they start at 6 a.m. and go until 10 a.m. So when Ben woke up really early, I had to deal with it while juggling the phone on my shoulder and ear, and trying to not get distracted from the interview. I totally had the bubble over my head, like in US Weekly, "real stars, they're just like us…" LOL. If they could see me now!
G&B: Who's the softie and who's the disciplinarian?
AS: We try to stick to the same plan so the kids know they can't "parent-shop" for the answer they want. That being said, I'm more the disciplinarian and Dave is the pushover.
G&B: The Biggest Loser is about to tackle childhood obesity. Does that have special meaning to you?
AS: I'm so proud of The Biggest Loser for creating a forum for dialogue about this epidemic. People sugarcoat this issue (pardon the pun).Everyone is so busy trying to be politically correct that we aren't getting the word out about how unhealthy kids are.
G&B: You publicly dealt with your weight in the past. How are you encouraging your kids to be healthy?
AS: I use simple terms—lots of Lightning McQueen analogies here—to explain that their body needs fuel, good fuel, to help them grow strong. When Ben's out there sweating, playing sports in the sun, he can have a sports drink, but he cannot when we're sitting down to dinner. They can have treats, but not every night, and I have really worked to keep their portions small. The only hard-and-fast rule I have is no fast food. They do get sweets, mac and cheese, stuff like that…but again, in small portions and along with mandatory healthy veggies!
G&B: How do you explain being famous to your kids?
AS: I don't know…that is such a weird thing!!! I think it's different for me because, to an 8-year-old boy, the fact that Daddy is a police officer is way cooler than me being on TV.
G&B: What's the biggest thing you've screwed up?
AS: Jeez…well, I've cursed in front of my kids. I know, it's terrible, and I try really hard not to. It was a big awakening for me when Ben, at 2, repeated a word I'd said.
G&B: We're obviously new at this parenting thing—what's your best advice?
AS: Parent your first child as if you already had one. New parents are quick to jump when their baby cries. Imagine that you were already holding a toddler in your arms. You would have to put that child down, give them a toy, then go see about the baby. It gives you a moment to breathe and realize it will all be OK. Also, go with your gut—and call me anytime with questions!
When she's not chasing Ben, 8, or Megan, 4, Sweeney is planning date nights with her patrol-officer hubby, Dave.


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BEIRUT (AP) — International military action against Syria's government over its alleged use of chemical weapons would run up against one of the Middle East's most formidable air defenses, a system bolstered in recent years by top-of-the-line Russian hardware.
The U.S. said last week that intelligence indicates the Syrian regime has likely used the deadly nerve agent sarin on at least two occasions in the civil war. That assessment has increased pressure for a forceful response from President Barack Obama, who has said the use of chemical weapons would cross a "red line" and carry "enormous consequences."
Obama has tried to temper expectations of quick action against Syria, saying he needs "hard, effective evidence" before making a decision. But he has also said that if it is determined that the regime of President Bashar Assad has used such weapons, then "we would have to rethink the range of options that are available to us."
Defense Secretary Chuck Hagel told a news conference Thursday the administration is rethinking its opposition to arming the rebels, saying it is one of the options being considered along with its allies in the more than 2-year-old conflict.
In 2011, the U.S. and its NATO allies imposed a no-fly zone in Libya after Moammar Gadhafi's brutal crackdown on its uprising. The allied air campaign, which received U.N. backing, played a major role in the rebels' victory in Libya's eight-month civil war.
While NATO quickly knocked out Libya's air defenses, experts warn that Syria's capabilities are far more sophisticated and its system is far more extensive than Gadhafi's was.
"In the case of Libya, the system had deteriorated completely already before the outbreak of the conflict due to the fact that Gadhafi had not invested so much in his air defense," said Pieter Wezeman, a senior researcher at the Stockholm International Peace Research Institute. "In the case of Syria, it's quite different."
Syria, experts say, possesses one of the most robust air defense networks in the region, with multiple surface-to-air missiles providing overlapping coverage of key areas in combination with thousands of anti-aircraft guns capable of engaging attacking aircraft at lower levels.
Six years ago, the system was showing signs of neglect.
In 2007, Syria's aging Soviet-supplied air defense system received a shock when Israeli jets bombed a suspected nuclear reactor site along the Euphrates River in northeastern Syria. The attack proved deeply embarrassing and provided a jolt to the Assad regime, which responded by making a concerted push to upgrade its air defenses, and turned to the country's traditional arms provider, Russia, for help.
Moscow, which has been the source of most of Syria's military hardware since Assad's father and predecessor, Hafez, courted the Kremlin decades ago, was more than happy to oblige.
It provided Syria with new systems, such as 36 Pantsyr mobile surface-to-air missile systems and at least eight Buk-M2E mobile SAMs. The Pantsyrs, considered particularly effective against attacking aircraft, feature a combination of 30mm cannons paired with a radar and anti-aircraft missiles all on the same vehicle.
At the same time, old SA-3s were upgraded to Pechora-2Ms — essentially a new and much more capable system.
There have also been persistent rumors that Syria acquired the advanced, Russian-built S-300 anti-aircraft missiles, considered to be the cutting edge in aircraft interception technology, although there are doubts about whether Damascus actually has them.
Moscow had refused to deliver the systems, but there have been unconfirmed reports that other nations may have sent Syria the missiles, which could make any aerial intervention very costly for the attackers.
"It's certainly the kind of system that if delivered would increase the risks for Israel, the USA or anyone else would they want to intervene militarily," Wezeman said.
Separately, Syria also has obtained from Russia the mobile Bastion-P land-based coastal defense systems, including Yakhont anti-ship missiles capable of sinking large warships, including aircraft carriers.
Russia has stood by Damascus since the uprising against Assad began in March 2011, shielding it from U.N. sanctions and continuing to supply the Syrian military with air defense components. Its support has not faded, even as the death toll in the conflict passed 70,000.
In February, Anatoly Isaikin, the head of the state arms trading agency Rosoboronexport, said that since there are no sanctions against shipping weapons to Syria, Russia was still fulfilling its contract obligations.
"These aren't offensive weapons," he said. "We are mostly shipping air defense systems and repair equipment for various branches of the military."
Like all of the Syrian military, the country's air defense system undoubtedly has suffered damage since the conflict became a civil war. Rebels have captured large swaths of northern Syria and have made a bridgehead in the south along the border with Jordan. Hydroelectric dams, cities and military bases have fallen into rebel hands.
But the extent of the fighting's toll on Syria's air defenses is, like many things in the country, hard to gauge.
"There is plenty of evidence that the rebels have been able to capture or destroy such air defense systems, and that included also new equipment," Wezeman said, citing videos posted on the Internet. "There must be major holes in there in the system."
Israel appeared to find one in January when it hit an apparent convoy purportedly carrying anti-aircraft missiles to the Lebanese militant group Hezbollah.
After that airstrike, Syrian Defense Minister Gen. Fahd Jassem al-Freij said rebels had made Syrian air defenses across the country a focus of their attacks, hitting some with mortar fire while trying to seize others in order to incapacitate them.
In response, he said the Syrian leadership decided to station them all in one safe place, leading to "gaps in radar coverage in some areas."
"These gaps became known to the armed gangs and the Israelis who undoubtedly coordinated together to target the research center," he said.
Despite al-Freij's uncommonly frank remarks, Elias Hanna, a retired Lebanese general and a senior lecturer at the American University of Beirut, said Syria's air defenses were still in good shape and would provide a stiff challenge to any foreign intervention.
Most of the country's air defense weapons, radar and other equipment have been positioned along Lebanon's border and in the Syrian-controlled part of the Golan Heights because Israel, which captured part of the territory in the 1967 war, was long perceived as the biggest threat, he said.
Some defense systems are also deployed along the Syrian Mediterranean coast and substantial air defense system have always been stationed in and around the capital Damascus.
"If there was an attack now," Hanna said, "Syria would have an upper hand."
Associated Press writer Jim Heintz in Moscow and Lolita C. Baldor in Washington contributed to this report.


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Udall pushes for national horse racing standards
U.S. Sen. Tom Udall on Monday revived his push for uniform
federal standards aimed at making the horse racing industry safer
following a New York Times investigation into a deadly and
debilitating year – for both horses and jockeys – at tracks in New
Mexico and elsewhere around the country.
Udall, D-N.M., said the newspaper's findings paint a "very
disturbing" picture of the industry in the United States and New
Mexico in particular.
"The sport of horse racing which, at its best, showcases the
majestic beauty of this animal and the athleticism of jockeys, has
reached an alarming level of corruption and exploitation," Udall
said in a statement.
The senator pointed to the need for a federal role in a sport
where problems of doping and countless euthanizations have been
exacerbated by inconsistent regulations at the state level.
The Times' analysis showed that on average, 24 horses die each
week at racetracks across America. A computer analysis of data from
more than 150,000 races, along with injury reports, drug test
results and interviews, showed an industry mired in a culture of
drugs and lax regulation and a fatal breakdown rate that remains
far worse than in most of the world.
The Times' analysis also found that five of the six tracks with
the highest rate of incidents per 1,000 starts last year were in
New Mexico – Ruidoso Downs, Sunland Park, Zia Park, The Downs in
Albuquerque and SunRay Park.
"The Times expose has shined a glaring light on the need for
national standards in a sport that reaps gambling profits, but has
lacked proper oversight for decades," Udall said.
Udall and Republican Congressman Ed Whitfield of Kentucky
introduced legislation last spring seeking to impose a national ban
on performance-enhancing drugs in horse racing.
Despite voluntary reforms offered by the industry over the
years, Udall said legislation is the "only viable way" to address
doping problems within the sport.
Under the legislation, any person with three doping violations
would be permanently banned from horse racing. A horse that tests
positive for performance-enhancing drugs three times would receive
a ban of at least two years.
The legislation was first introduced last April. It came three
years after some in the industry urged the federal government to
get involved, following the death of Eight Belles at the 2008
Kentucky Derby.
A drug test proved that the horse was clear of steroids, but the
incident helped shine a light on safety problems and the lack of a
single governing body. Rick Dutrow, trainer of the Derby winner Big
Brown, acknowledged he regularly injected the horse with the
then-legal steroid stanozolol.
Most states have banned steroids, but enforcement has been
In New Mexico, the state Racing Commission recently imposed a
yearlong ban on clenbuterol for thoroughbreds and quarter horses.
Clenbuterol's use picked up as a means to help horses build muscle
after the industry did away with anabolic steroids in 2008. High
doses can have adverse effects and even cause death.
But there are plenty of other medications and concoctions that
are used, and the Times' investigation accused New Mexico's tracks
and regulators of being unusually slow in responding to safety
Vince Mares, the director of the commission, did tell The Times
that the previous leadership at the commission had cut back on
tests for one pain medication due to financial reasons and that his
agency needs more uniform penalties to avoid charges of favoritism
among trainers.
"There is an issue of consistency – you can quote me on this,"
Mares said. "It is being addressed."
New Mexico's 2012 season begins April 20 at SunRay Park and
Casino in Farmington.
Thousands of races are held each season in New Mexico, where
tracks operate anywhere from 42 days to more than two months. Blood
and urine samples are taken from the winner and a randomly chosen
horse from each race to ensure the state's doping rules are being