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Howard K, Barratt A, Mann GJ, Patel MI. A Model of Prostate-Specific Antigen Screening Outcomes for Low- to High-Risk Men: Information to Support Informed Choices. Arch Intern Med. 2009;169(17):1603–1610. doi:10.1001/archinternmed.2009.282
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Information is needed to aid individual decision making about prostate-specific antigen (PSA) screening.
We aimed to provide such information for men aged 40, 50, 60, and 70 years at low, moderate, and high risk for prostate cancer. A Markov model compared patients with vs without annual PSA screening using a 20% relative risk (RR) reduction (RR = 0.8) in prostate cancer mortality as a best-case scenario. The model estimated numbers of biopsies, prostate cancers, and deaths from prostate cancer per 1000 men over 10 years and cumulated to age 85 years.
Benefits and harms vary substantially with age and familial risk. Using 60-year-old men with low risk as an example, of 1000 men screened annually, we estimate that 115 men will undergo biopsy triggered by an abnormal PSA screen result and that 53 men will be diagnosed as having prostate cancer over 10 years compared with 23 men diagnosed as having prostate cancer among 1000 unscreened men. Among screened men, 3.5 will die of prostate cancer over 10 years compared with 4.4 deaths in unscreened men. For 1000 men screened from 40 to 69 years of age, there will be 27.9 prostate cancer deaths and 639.5 deaths overall by age 85 years compared with 29.9 prostate cancer deaths and 640.4 deaths overall in unscreened men. Higher-risk men have more prostate cancer deaths averted but also more prostate cancers diagnosed and related harms.
Men should be informed of the likely benefits and harms of PSA screening. These estimates can be used to support individual decision making.
Prostate-specific antigen (PSA) screening for prostate cancer causes uncertainty and concern for men and their physicians. Findings from 2 large randomized trials1,2 that were supposed to provide answers and clarity may have worsened the situation. The trials report evidence of benefit but also evidence of substantial harm. Adding to community uncertainty are conflicting recommendations from health authorities and clinical guidelines. For example, the American Cancer Society "believes that health care professionals should discuss the potential benefits and limitations . . . discussion should include an offer for testing with the PSA blood test and digital rectal exam (DRE) yearly, beginning at age 50, to men who are at average risk of prostate cancer and have at least a 10-year life expectancy."3 The American Urological Association likewise considers that the PSA test is a "valuable screening tool" that "should be appropriately offered to men" 40 years and older.4,5 In contrast, the US Preventive Services Task Force has assigned an "I" ("insufficient evidence") rating to PSA screening, noting that PSA screening is "associated with important harms, including frequent false-positive results and unnecessary anxiety, biopsies, and potential complications of treatment of some cancers that may never have affected a patient's health."6
Although these organizations, and the clinical guidelines they have released, do not endorse "population screening," they do recommend that men be informed about the pros and cons of screening. However, this may increase confusion as men and their physicians struggle to access balanced, evidence-based information for individual decision making. They may find competing claims about the likely benefits and the potential for harm7 and opposing information produced by individuals or groups that may have a vested interest in promoting screening.
Decision aids prepare patients for complex decisions by providing information about different options and by helping people clarify their personal values regarding different options and outcomes.8 Decision aids are effective in increasing knowledge, creating more realistic expectations about outcomes, and reducing decisional conflict.9 They present balanced, evidence-based information about outcomes in a way that meets standards for information to be used for informed decision making.10,11 For prostate cancer screening, decision aids should present the chances of all relevant outcomes occurring (biopsies, prostate cancer diagnoses, and prostate cancer deaths) for men who choose vs those who decline screening. Risks should be presented as event rates for specified populations (eg, men who choose vs those who decline screening), and these event rates should use consistent denominators (eg, per 1000 or per 10 000 men) over comparable time frames.8,10 Risk presentation should allow patients to view event rates specific to their own situation, for example, based on age or family history. Despite the obvious need, decision support materials for men regarding PSA screening do not include such information.12
To address this information gap, we developed a model of outcomes of annual PSA screening for men at varying prostate cancer risk defined by family history (low, moderate, and high risk) over time frames appropriate for informed decision making rather than simply per screening test. We used the same approach previously used for breast cancer screening,13 which meets information standards for patient decision aids.10,11 Outcomes of PSA screening are presented over 10 years per 1000 men aged 40, 50, 60, and 70 years at different risk levels. Thus, we have taken the best available evidence from population studies and translated it into information that is useful for individual decision making. Data presented herein can be readily incorporated into patient decision aids to prepare men to make choices about PSA screening or can be used to inform clinical consultations with men considering screening.
A Markov model was constructed for 2 hypothetical cohorts that either participate in or decline annual PSA screening. The model assumes 100% participation in the screening cohort and 0% participation in the nonscreening cohort, generating outcomes for men who were screened regularly vs those who were not screened. The model was constructed for men at low, moderate, and high risk, defined by family history, using published estimates of the numeric increase in risk for differing types and numbers of affected relatives.14-16 Low-risk men are those with no first-degree relatives affected by prostate cancer. Men with 1 affected first-degree relative are considered to be at moderate risk (relative risk [RR], 2.5 vs no family history), and men with 2 or more affected first-degree relatives are considered to be at high risk (RR, 5.0 vs men with no family history). Calculations were conducted separately for all 3 risk categories. The model is based on annual screening commencing at age 40 years, consistent with American Urological Association recommendations.4,5 It generates outcomes over 4 × 10-year time frames: from age 40 years, from age 50 years, from age 60 years, and from age 70 years (Table 1) for men who start screening at age 40 years and continue to be screened, compared with men who decline screening at all ages. Sensitivity analyses were conducted on the mortality benefit and by increasing the starting age of low-risk men to 50 years (American Cancer Society3). All rates were converted to annual probabilities. Modeling was conducted using a spreadsheet program (Microsoft Excel; Microsoft Corp, Redmond, Washington). Data sources and assumptions underlying the model are outlined in the following subsections and in Table 2.1,14-20
The incidence in unscreened men was based on Australian age-specific incidence rates from prescreening years 1982 to 1988.24 (In Australia, PSA screening began in 1989, when the test was publicly funded.) These rates were linearly extrapolated to 2005 based on the temporal trend observed from 1982 to 1988. Proportions of localized and nonlocalized cancers in unscreened men were taken from the European Randomized Study of Screening for Prostate Cancer (ERSPC), based on Dutch cancer registry data before commencement of the trial.18 These Dutch data provide comparability with other data from the ERSPC used in the model. Prostate cancer incidence and mortality rates were similar in Australia24 and the Netherlands in the 1990s21,25; thus, we assumed that the proportions of localized and nonlocalized cancer would be similar too.
Age-specific prostate cancer mortality rates in 2005 for Australian men were used.24 Because these data combine prostate cancer mortality for screened and unscreened men, we adjusted it using estimates of the age-specific proportion of men undergoing a PSA test (eSupplementhttp://www.archinternmed.com). The PSA screening practices have changed over time, and prostate cancer is a slow-growing cancer, so we used PSA test utilization data from 10 years earlier by obtaining estimates of the age-specific proportion of men who had a PSA test in 1995 from Medicare data. (Medicare is the Australian national health care insurer that covers all Australian permanent residents and citizens.)
The numbers of prostate cancers detected were based on the relative number of cancers in the screened vs unscreened trial arms of the ERSPC.22 These ERSPC data were applied to the incidence in unscreened Australian men to calculate the number of cancers detected in screened men. When the ERSPC commenced, the criteria for a prostate biopsy were a PSA level of 4.0 ng/mL or greater (to convert to micrograms per liter, multiply by 1.0) and/or an abnormal rectal examination or abnormal transrectal ultrasonographic findings. As of May 1997 (midway through screening round 1), the PSA cutoff value for recommending a biopsy was decreased to 3.0 ng/mL, and rectal examination and transrectal ultrasound were discontinued.26 Overall test positivity and the subsequent number of biopsies by age were estimated from the positive predictive value reported in the ERSPC.1 All men with a positive PSA screen were assumed to have a biopsy. We assumed that PSA testing has the same test characteristics for all 3 risk groups (in the absence of data providing sensitivity, specificity, and positive predictive value of PSA testing by risk group). Interval cancers were estimated in 2 ways, depending on age: (1) for ages 40 to 59 years, we used annual age-specific incidence rates for unscreened men and (2) for ages 60 to 79 years, we used the interval rate reported in the ERSPC.1
The model further assumes that men diagnosed as having prostate cancer will accept effective treatment. Because the aim of the model was to estimate the main outcomes, we have not explicitly modeled individual treatments because choice of treatment is likely to vary between individual men, depending on their physician and treatment center and on the men's personal preferences regarding potential benefits and adverse effects. In the base case, we assumed that screening and subsequent effective treatment confers a mortality benefit.
Data from the ERSPC1 suggest a 20% relative reduction in prostate cancer mortality in screened vs unscreened men (RR of prostate cancer death, 0.8; 95% confidence interval, 0.65-0.98). We use an RR of prostate cancer mortality of 0.8 as a best case and test, in sensitivity analyses, an RR of 1.0, consistent with ERSPC results1 and a recent Cochrane systematic review.19
Because prostate cancer is slow growing and because the mortality benefit of screening is not immediate, we assumed that the mortality benefit accumulates over time. Based on ERSPC results (Figure 2 in the study by Schröder et al1), we assumed that there is no mortality benefit in the first 7 years and that the 20% RR reduction is achieved by 9 years (median follow-up of the ERSPC). We assumed that mortality benefit declines linearly during the 10 years after screening ceases. The RR was applied to the age-specific prostate cancer mortality rate for unscreened men to derive the age-specific prostate cancer mortality rate for screened men for each risk group.
Australian Bureau of Statistics data were used to provide estimates of age-specific all-cause mortality rates.20 Age-specific all-cause mortality rates were split into prostate cancer–specific mortality and mortality due to causes other than prostate cancer and then were applied to screened and unscreened cohorts. The total number of deaths in each year was calculated by summing deaths due to prostate cancer and deaths due to causes other than prostate cancer.
Results for all age groups are provided in Table 3 (low familial risk) and in Table 4 (moderate and high familial risk) using an RR of prostate cancer mortality of 0.8.1 Results of sensitivity analyses on the mortality benefit using an RR of 1.0 are given in the eTablehttp://www.archinternmed.com.
Using 60-year-old men as an example, of 1000 men aged 60 years who are screened and who have annual screening with PSA during the next 10 years, 115 will have a prostate biopsy triggered by an abnormal PSA screen result, and, of these, 87 will not have prostate cancer. This represents an 11.5% chance of having a prostate biopsy due to PSA screening and an 8.7% chance of having a biopsy and not finding prostate cancer (experiencing a false alarm). Approximately 53 men will be diagnosed as having prostate cancer during the 10 years (28 detected by screening plus 25 interval [clinically diagnosed] cancers) compared with 23 men diagnosed as having prostate cancer among 1000 unscreened men. Of 1000 screened men, 3.5 will die of prostate cancer during the 10-year time frame compared with 4.4 unscreened men. This is in the context of 116 deaths from all causes in the screened group and 117 deaths from all causes in the unscreened group.
Similar interpretations apply to the other age groups. In younger men, the numbers of prostate cancer diagnoses, deaths from prostate cancer, and deaths from all causes are lower. In older men, the numbers of these events are higher, with increasing age-specific prostate cancer incidence and mortality, but also in the context of increasing all-cause mortality.
We also examined the impact of screening to age 69 years on prostate cancer and all-cause mortality until age 85 years (the life expectancy of Australian men) (Table 3). For men aged 40 years who screen to age 69 years, deaths were cumulated for 45 years. For men aged 50 years who screen to age 69 years, deaths were cumulated for 35 years. For men aged 60 years screening to age 69 years, deaths were cumulated for 25 years. Men 70 years and older may continue to be screened, depending on life expectancy; so, for these men, we assumed that they continued to be screened until age 79 years and cumulated deaths over 15 years. Under the best case, for 1000 men who are screened from ages 40 to 69 years, with deaths cumulated to age 85 years, there were 27.9 prostate cancer deaths and 639.5 deaths overall in men who screen compared with 29.9 prostate cancer deaths and 640.4 deaths overall in men who do not screen.
Compared with low-risk men, the overall pattern of events is similar for moderate- and high-risk men, although the absolute chance of events is higher (Table 4). Men with a moderate or high familial risk had a higher chance of having cancer diagnosed, a higher chance of undergoing a prostate biopsy, and a higher chance of experiencing a false alarm. This is balanced against a greater absolute mortality benefit in terms of prostate cancer deaths over 10 years and up to age 85 years (Table 4).
The sensitivity analysis that varied the RR of prostate cancer mortality to the null (RR = 1.0)19 is given in the eTable. This sensitivity analysis highlights the relatively high chance of experiencing a false alarm or of having screen-detected prostate cancer for men who choose to be screened over several decades, which needs to be balanced against no improvement in mortality rates. If there is no mortality benefit of PSA screening, the detrimental impact of screening on quality of life would be substantial.
Changing the age at which low-risk men start screening from 40 to 50 years (and, therefore, delaying the mortality benefit) has little effect on the number of prostate cancer deaths. During the 10 years from ages 50 to 59 years, there are 0.45 deaths in men previously screened from age 40 years compared with 0.51 deaths in men who commenced screening at age 50 years. Accumulating prostate cancer deaths to age 85 years, there are 28.39 deaths in 1000 men who commence screening at age 40 years compared with 28.45 deaths in 1000 men who commence screening at age 50 years.
This article presents comprehensive risk- and age-specific estimates of the benefits and harms of PSA screening that can be used by men and their physicians for individual decision making about undergoing PSA screening. The estimates should help men and physicians achieve the goal of full discussion of the benefits and risks of PSA screening, as recommended in clinical practice guidelines and advice from health agencies.4,6
Although other models of PSA screening exist,27-29 this is the first use of a balance sheet approach comparing outcomes for men who choose to be screened with those for men who decline screening and is an approach consistent with best practice for individual decision making.10 This model is unique in modeling screening outcomes across time frames that support informed decision making, that is, cumulated over 10 years and accumulated during a lifetime of screening participation to age 85 years. We deliberately present the outcomes for men who choose to participate in screening regularly (ie, 100% participation in screening) and who, therefore, can expect to obtain the full mortality benefits of PSA screening. The comparator is men who do not participate at all. This is the comparison that is needed for decision making at an individual level. However, note that this is different from a policy-level approach if one wanted to estimate outcomes, including cost-effectiveness, for a population with less than 100% participation in screening.
Despite the recently published results of the ERSPC,1 there is still considerable uncertainty regarding the mortality rate reductions that may be attainable with population-based PSA screening, as demonstrated by the results of the recently published Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial.2 Participants in randomized trials may be more adherent, or the screening interval of the trials may not be clinically relevant. For example, the ERSPC reports on 2 screening rounds with a screening interval of 4 years, whereas the guidelines that advocate screening recommend annual screening. It is also possible that men who screen annually may be inherently different from men who do not screen, for example, in terms of cancer risk, comorbidities, or other risk factors, that, in a population screening context, may all mean that the mortality benefit from clinical trials may not be fully realized. We used an RR of 0.8 for prostate cancer mortality1 and tested an RR of 1.0 in sensitivity analysis. Even using the RR of 0.8, it is striking that the absolute mortality benefit is small even in men at the highest levels of familial risk and even when prostate cancer deaths are cumulated to 85 years of age. This reflects the relatively small proportion of overall deaths due to prostate cancer and the fact that deaths from other causes partly offset those averted by screening.
On the harm side of the balance sheet, the present estimates provide a sobering illustration of the frequency of harms men are likely to experience if they participate in PSA screening. The risk of having a false alarm rises strongly with age and with increasing familial risk. Up to 21.1% of low-risk men will experience a false-positive result during 10 years of screening. Prostate cancer biopsies carry risks such as hemorrhage and infection.
In moderate- and high-risk men, mortality reductions are more sizable. However, the increased risk of prostate cancer in these men means that harms are also more sizable, with very high proportions of men experiencing false-positive results and having screen-detected cancers.
More important, participation in screening considerably increases the likelihood of having prostate cancer diagnosed; there is approximately a 2- to 4-fold increase in the risk of having prostate cancer diagnosed compared with men who do not participate in screening. Yet, few of these men die of prostate cancer, and death rates (from prostate cancer and from all causes) are similar in screened and unscreened men. The only interpretation is that many men with screen-detected prostate cancer are having cancer therapies for clinically insignificant cancers. Because we cannot predict accurately which screen-detected prostate cancers will progress to life-threatening disease, all these men will most likely be offered cancer treatment, which may include surgery, radiotherapy, and endocrine therapy.
Hospital admissions for a principal diagnosis of prostate cancer doubled between 2000-2001 and 2005-2006, and prostatectomies in men with a principal diagnosis of prostate cancer increased by 56% during the same period.30 The risks of these treatments in terms of adverse effects on quality of life are substantial.23 Twenty percent to 70% of men experience erectile dysfunction or impotence after treatment, and 15% to 50% experience long-lasting urinary incontinence. Although the risks are less after radiotherapy compared with prostatectomy, the mortality benefits may not be as great, the risks of reduced potency and incontinence are still considerable, and up to 25% of patients experience bowel problems.23 An undebated consequence of guidelines that recommend informed decision making and consumer choice is the potentially substantial financial implications of those choices that will be borne by the health system.
A variety of areas of uncertainty exist in the available data, and, therefore, a range of assumptions were made. First, there is no organized PSA screening program in Australia, and so we had to rely on data from multiple sources to estimate screening outcomes such as test positivity rates, positive predictive values, and interval cancer rates. By assuming that every positive PSA screening result is investigated by means of biopsy, we may have overestimated the number of biopsies; it is possible that, once a man has had an abnormal PSA test result and a subsequently negative biopsy result, the next positive PSA test result may not be investigated using another biopsy. Second, because data are simply not available, we had to model the incidence for unscreened men by extrapolation of prescreening incidence, assuming that incidence has not been greatly affected by changes in prostate cancer risk factors during the past 20 years; we also assumed that the proportional increase in incidence in screened compared with unscreened men and the mortality benefit attributed to screening are consistent across men who are at low, moderate, and high risk. We believe that these assumptions are reasonable in the absence of data to the contrary. This means that, although there is clearly some uncertainty regarding each estimate (in Tables 3 and 4 and the eTable), the general picture of the results is likely to be correct, and the relative frequency of benefits to harms is broadly representative of what could be expected with participation in PSA screening. We modeled annual screening because that reflects most guidelines and common clinical practice; however, the balance of harms to benefits may change with a longer screening interval. Estimation of interval cancers was difficult in the absence of data from a population screening program. We applied the best and most applicable data by using ERSPC results for older men (≥60 years) and the estimated incidence in unscreened men for younger men. It is possible this may have led to overestimation of interval cancers; however, the effect of this on the overall picture of benefits vs harms of PSA screening is small.
In addition, we limited this analysis to consideration of mortality rather than explicitly considering the effect on quality of life. The aim of this study was to provide men and their physicians with enough information about the broad potential outcomes to help inform a choice about prostate cancer screening. As yet, data on quality of life in screened and unscreened men are unavailable; prostate cancer treatment may lead to improvements in quality of life because of a reduction in local recurrence or metastatic disease; however, just as likely, it may lead to decreases in quality of life as a result of long-term adverse effects, such as impotence and incontinence. Thus, the overall effect on an individual's quality of life is likely to depend on how that individual views the trade-off between potential benefits and harms; only each individual can decide what an acceptable level of benefit to harm trade-off is.
The information in Tables 3 and 4 translates the results of the latest evidence from population studies into information for individual men and their physicians to use when considering the pros and cons of PSA screening. Physicians who want to support their patients in this decision can use the information to provide estimates of the likely outcomes (particularly the risk of a screen-detected cancer and the risk of death from prostate cancer) if the man chooses to screen or not to screen. These data are tailored by age and by risk status based on family history. The information presented herein is suitable for inclusion in patient decision aids for men considering PSA screening. Australian patient decision aids using these data are currently under evaluation. For researchers who would like to test decision aids in their setting, the model is available on request.
In conclusion, before undergoing PSA screening, men should be aware of the possible benefits and harms and of their chances of these benefits and harms occurring. Even under optimistic assumptions, the net mortality benefit is small, even when prostate cancer deaths are cumulated to 85 years of age. These quantitative estimates can be used to support the goal of individual informed choices about PSA screening.
Correspondence: Kirsten Howard, BSc(Hons), MAppSc, MPH, MHealthEcon, PhD, Health Economics, Screening and Test Evaluation Program, School of Public Health, University of Sydney, Edward Ford Bldg (A27), Sydney, New South Wales, Australia.
Accepted for Publication: June 16, 2009.
Author Contributions: Dr Howard had full access to all of the data in the study and takes full responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: Howard, Barratt, Mann, and Patel. Acquisition of data: Howard, Barratt, Mann, and Patel. Analysis and interpretation of data: Howard, Barratt, and Mann. Drafting of the manuscript: Howard and Barratt. Critical revision of the manuscript for important intellectual content: Howard, Barratt, Mann, and Patel. Statistical analysis: Howard. Administrative, technical, and material support: Howard and Barratt. Study supervision: Howard and Barratt.
Financial Disclosure: None reported.
Funding/Support: This work was undertaken as part of the Screening and Test Evaluation Program funded by the National Health and Medical Research Council of Australia under program grant 402764.
Role of the Sponsor: The funding agency had no role in the design and conduct of the study; in the collection, analysis, and interpretation of the data; or in the preparation, review, or approval of the manuscript.
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This afternoon I participated in CNN's annual World Report International Conference for its overseas affiliates. I was part of a panel on blogging that included Harry McDougald, the famous "Buckhead" of 60 Minutes fame, Rebecca McKinnon, John Aravosis, Chris Nolan, Christopher Allbright, who self-financed a trip to Iraq as a free-lance journalist through a blog, Howard Kaushansky of Umbria Software, and someone I'm forgetting. Our moderator was Michael Holmes, an Australian who works for CNN and did a great job of keeping our segment on track. The presentations were done in the round; I took the photo below during a break between sessions:
From my perspective, it didn't seem like we were breaking a lot of new ground, but I suppose much of it was new to many of the international affiliates, and the CNN people seemed happy with the panel. I tend to view these events mostly through a personal prism, so for me, the biggest kick was meeting McDougald. The other thing that blew me away was how cordial the CNN people were. Every one of the CNN people we dealt with, including the producer who made our arrangements and rode herd over the program, Michael Holmes, Jon Klein, Chris Cramer, who succeeded Eason Jordan as head of CNN International, and hauled a couple of us bloggers out into the corridor between sessions because he was excited about the possibilities of our medium, Christiane Amanpour, who quoted our between-sessions conversation in the segment she moderated, and everyone else we met from CNN was friendlier than we had any right to expect.
I don't suppose that CNN invited us bloggers with a view toward raising our opinion of their operation, but, speaking for myself, it certainly had that effect.
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Place any town on the shores of Lake Champlain and surround it with mountains and you'd have a special place to go to college.
Add the shops, businesses, restaurants and energy that you find in downtown Burlington and you have a place that Travel & Leisure Magazine just named the top college town in America. Burlington is known as one of the healthiest, happiest and most appealing cities in the whole country (one that draws 14,000 college students a year).
Live music, great food from around the world, the beaches of Lake Champlain, the Community Boathouse, the seven-mile bike path, internship-friendly companies like IBM, GE Medical, Burton Snowboards, Dealer.com and Ben and Jerry's, and quick access to top ski areas like Sugarbush and Stowe are just part of our location's appeal.
Vermont is green, in more ways than one. The Green Mountains surround campus, providing spectacular views of Camel's Hump and Vermont's highest peak, Mount Mansfield. The Adirondacks of New York are just across the lake.
We care about the environment. On campus, we recycle, we compost, we refill our water bottles, we eat local and shop local. We're a Fair Trade institution and we have our own organic garden and farm stand during the growing season.
Right outside of campus are sites for hiking, rock climbing, river and lake kayaking, and fly fishing. Our Adventure Sports Center will get you into the great outdoors in ways you might never have imagined (ice climbing, perhaps?).
People come from around the world to visit our part of Vermont. St. Mike's students are lucky enough to make this place their college home.


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During the University's academic year, tuition is charged at the rate of $5,475 per course (2015-16 academic year). One course credit equals four credit hours. The maximum number of course credits for which a graduate student may register in a semester is four. During the summer session students may enroll for a total of two full course credits or the equivalent.
Financial assistance is available to well-qualified graduate degree candidates who assist departmental faculty, or who qualify for tuition scholarships granted by the University. Financial aid is awarded on a yearly basis and is normally limited to two years. Preference is given to full-time students.
- Graduate Assistantship - includes a stipend and tuition remission and is available in all department programs.
Continuation of financial aid in the form of a graduate assistantship into the second year of enrollment is contingent upon satisfactory performance of duties expected of a graduate assistant, including the maintenance of an acceptable GPA (3.0), progress on the thesis project, and satisfactory performance as a teaching assistant.
Educator Tuition Discount
A 40% discount may be available to graduate students in the education program. Applicants must be teachers or other professionals (counselors, psychologists, supervisors, administrators, etc.) employed in public, private not for-profit, or parochial elementary or secondary schools or programs and must be enrolled at Bucknell University in an approved program of courses leading to a master's degree or state certification in an area of specialization. Other educational objectives may be considered at the discretion of the University. Complete an Educators Scholarship Program Application (pdf) to apply.
Loans and Federal Funding
Federal direct loans are available to help cover graduate school costs and are available to full-time degree seeking students.
Information concerning loans and other federal support can be obtained from the Financial Aid Office.
Graduate students are responsible for arranging their own housing.


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SOCHI, Russia, Feb. 5 (UPI) -- Citing the risk of injury, U.S. snowboarder Shaun White said he was withdrawing from the slopestyle competition at the Winter Olympics in Sochi, Russia.
"After much deliberation with my team, I have made the decision to focus solely on trying to bring home the third straight gold medal in halfpipe for Team USA," White told NBC News' "Today" Wednesday in a statement. "The difficult decision to forgo slopestyle is not one I take lightly as I know how much effort everyone has put into holding the slopestyle event for the first time in Olympic history, a history I had planned on being a part of."
White's announcement follows a fall he took Tuesday, jamming his left wrist on a practice run on the Rosa Khutor Extreme Park course.
"With the practice runs I have taken, even after course modifications and watching fellow athletes get hurt, the potential risk of injury is a bit too much for me to gamble my other Olympics goals on," White said.
While danger is inherent in an extreme snow sport such as slopestyle -- in which competitors are judged on a variety of tricks performed on rails, boxes and jumps -- White and other snowboarders have expressed concerns about the Rosa Khutor Extreme Park, NBC News said. Criticism grew after Torstein Horgmo of Norway, considered a medal contender, fell off a rail Monday and broke his collarbone, knocking him out of the Sochi Games.
Canada's Sebastian Toutant said maneuvering the course felt like "jumping out of a building" while Finland's Roope Tonteri called the course "pretty sketchy," NBC News said.
"I just don't want to get injured," Tonteri said. "It's not a really fun course to ride."
Changes were made to the course -- including reducing the combined height of its three jumps about 6 feet -- after the Olympians' feedback, NBC News said. Snowboarders said the changes were an improvement.


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The co-founder of Apple, Steve Wozniak was interviewed at TEDx Brussels by TechCrunch, where the technological genius was asked how he felt about the advances Microsoft is making in both the PC and smartphone markets. So how does Wozniak view the new Microsoft? He's worried for Apple, and for good reason.
The Apple guru has previously picked up a Lumia 900, choosing the Windows Phone over Android and stating that the operating system is "intuitive and beautiful". Wozniak also was recorded in revealing he's excited about Microsoft and sees a new company re-entering the PC and mobile markets. This is all leading up to him being concerned for Apple.
Apple has continuously been viewed as the innovative technology giant that surpassed Microsoft in many ways, including public interaction (the Apple stores) and presentation (Steve Jobs and his famous keynotes). The advertisement campaign that Apple launched attacking PC as a boring platform was true in a way - it's how consumers viewed Microsoft. Office, spreadsheets and Vista.
Microsoft has since changed. In more ways than one. The launch of Windows Phone brought something new to the table. Everyone wondered what the then software giant was planning for the future. Then Windows 8 was unveiled with multiple public previews. This is when the game changed, when Microsoft fought back against Apple.
Windows 8, Windows Phone 8, Skype, SkyDrive, Xbox (with Xbox Live, Music, Video and more) and the new Office. It's quite a product line-up. It's also worth noting that Microsoft is also investing in expanding its reach with new apps and services launching on competing platforms, including Mac, iOS and Android. It's making massive, bold risks that look likely to pay off.
Wozniak is impressed by how Microsoft is making one think "woah!" at what's being announced and the strides taken in research. He feels as though Apple is "cracking out the newest iPhone" instead of innovating and advancing technologies. He's worried that the company could lose ground due to merely "improving" already available products and services. It's not Apple's style and why he's worried the company will lose the recognition of being the lead in innovation.
Check out the video interview below, it's well worth the watch.
Source: TechCrunch


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House GOP won't follow their leaders
The whip count on Syria has become like the war itself: No one in Washington wants to own it alone.
While most top congressional leaders have vowed to back President Barack Obama in seeking authority to launch missile strikes, there's little evidence that they can — or even want to — help him round up the rank-and file-Republicans he'll need to win a vote in the House.
Story Continued Below
Speaker John Boehner's spokesman said that he "expects the White House to provide answers to members' questions and take the lead on any whipping effort." Majority Whip Kevin McCarthy (R-Calif.), whose aides and allies run the whip process, isn't yet in favor of Obama's request for military authority in Syria.
Several lawmakers and aides who have been canvassing support say that nearly 80 percent of the House Republican Conference is, to some degree, opposed to launching strikes in Syria. Informal counts by Obama allies show that support in Congress for Obama's plans is in the low dozens.
( PHOTOS: Senate hearing on Syria)
While a handful of lawmakers pledged support for striking Syria inside a White House meeting with Obama Tuesday, the hell-no caucus in the House gathered steam outside, portending a vicious, multi-factional fight over the most somber issue that ever faces Washington — whether to deploy military force. In the House, neither Republican nor Democratic leaders are in a position to speak for their rank-and-file. Several lawmakers and senior aides interviewed by POLITICO Tuesday wondered about the fallout for leadership if the resolution is resoundingly defeated.
Of course, there's time, and classified briefings and arm-twisting from committee chairmen can help change lawmakers' moods and opinions. But at this point, the overwhelming narrative is that authorizing military action in Syria will be one of the toughest sells of Obama's time in the White House.
The biggest problem for Obama — and now Boehner — is that the opposition is coming from precisely the places where many expected the president to find support. The thought throughout top levels of the House Republican Conference is that Obama needs to garner backing from Republicans on the Foreign Affairs, Armed Services and Intelligence committees, and the Appropriations subcommittees on Defense and Foreign Operations. He should also look in and around leadership, these sources say.
( Also on POLITICO: Senators craft Syria compromise)
But it is in those places where loud opposition is bubbling up.
Rep. Tom Rooney (R-Fla.) — a member of the GOP whip team and a natural ally of Boehner's as a former Army attorney who sits on the Intelligence committee — told POLITICO leadership's approval of the mission didn't move him at all. He said that the U.S. has "the keys to escalate [the conflict] unilaterally."
"I really do believe when you have an engagement confined within the boarders of Syria as bad as it could imaginably be to engage, you're really really asking for it to spill outside the borders," Rooney said in an interview Tuesday. "If I'm Assad and I get attacked, Tel Aviv is in my scopes."
The clash of titanic interests, from national to political security, makes this vote the toughest for Obama since he narrowly won enactment of his health care law in 2010. It cuts so many different ways — across parties, philosophies, and parochial political considerations — that win or lose, its reverberations are sure to be felt well into the second term of Obama's presidency.
( Also on POLITICO: Pelosi's test)
Division within each party and the matter-of-conscience nature of a war vote make it uncomfortable for party leaders to whip the votes. Republican leaders have said they won't do it, and Democratic leaders aren't likely to run a formal whip effort. That doesn't mean, though, that they won't keep tabs on where members are to make sure the White House knows whether it's winning or losing.
The president's informal whip team consists of most, but not all, of the top House Democratic leadership, several top lawmakers on national security committees, his Cabinet, France, and the pro-Israel lobby. The French Embassy sent members of Congress a nine-page intelligence report Tuesday afternoon to help persuade them to vote for military action. And the American Israel Public Affairs Committee, the top pro-Israel advocacy group in Washington, released a statement encouraging lawmakers to back Obama.
The French embassy went as far to send members of Congress a nine-page French intelligence report Tuesday afternoon. The country offered up its Middle East political hand to lawmakers if they had questions. National Security Adviser Susan Rice will brief the Congressional Black Caucus Sept. 9. The House Armed Services Committee will also have a members' only briefing that same day.
( Also on POLITICO: Senate all over the map on Syria)
The CBC is asking its members to stay mum for now.
"We ask that you limit any public comment on the subject of Syria until after the meeting," a caucus official wrote in an e-mail to member offices.


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Fantasy and Science Fiction
February 2018
Recent Releases
Iron Gold: A Red Rising Novel
Pierce Brown
slave-turned-statesman Darrow, a lowly Red whose uprising against Mars' Gold elite led to the establishment of the Solar Republic -- and an endless war.
Series alert:
This spinoff of the Red Rising trilogy takes place ten years after the events of
Morning Star.
ewcomers should start at the beginning with
Red Rising
Read it for:
a dystopian outer space setting, a unique color-coded caste system, and an action-packed plot rife with warfare and political intrigue.
A War in Crimson Embers
Alex Marshall
What it's about:
Once a hero, now a pariah, warrior Zosia rounds up her far-flung former comrades-in-arms in an attempt to right past wrongs and redeem herself.
For fans of:
the potent mix of extreme violence and sardonic humor found in Joe Abercrombie's First Law books.
Series alert:
A War in Crimson Embers
concludes the Crimson Empire trilogy, which begins with
A Crown for Cold Silver
, followed by
A Blade of Black Steel
The Night Market
Jonathan Moore
What it's about:
Responding to a late-night call, San Francisco homicide detectives arrive at the scene of the crime to find it crawling with FBI agents in hazmat suits. Then things get really weird.
Is it for you?
Equal parts dystopian SF, noir, and conspiracy thriller, this genre-bending novel boasts a menacing atmosphere and a twisty plot. Think Philip K. Dick meets the
X Files
Should you start here?
You can! The 3rd installment of a loose trilogy,
The Night Market
stands on its own.
The Will to Battle
Ada Palmer
What it's about:
Ex-convict Mycroft Canner discovers the high cost of peace as his world -- a 25th-century utopian society in which philosophical Hives have replaced nation-states -- begins to collapse.
Series alert:
Due to the complexity of this 3rd Terra Ignota novel, readers should begin at the beginning with
Too Like the Lightning
Try this next:
For another thought-provoking blend of Western philosophy and science fiction, try Jo Walton's Just City novels, which envision a society based on the principles of Plato's
The Sky Is Yours
Chandler Klang Smith
In a world...
where dragons soar above the burned-out ruins of Empire Island (think New York in the year
301970), a reality-TV star, a baroness, and a feral girl must survive the mean streets of their own city.
Want a taste?
"This is the story of what it is to be young in a very old world."
For fans of:
the inventive and freewheeling apocalyptic fiction of Nick Harkaway.
It's Complicated (Romantic Relationships)
Burn For Me: A Hidden Legacy Novel
Ilona Andrews
What it's about:
A pyrokinetic "Prime" is on the loose, using powerful magic to incinerate anyone or anything that stands in his way. As private investigator Nevada Baylor tries to stop him, she finds an unlikely ally in Connor "Mad" Rogan, a billionaire with dark powers of his own.
Why you might like it:
Straddling the line between urban fantasy and paranormal romantic suspense, this steamy series starter asks: can your enemy's enemy be your friend-with-benefits (and more)?
You might also like:
Although they feature a lighter tone and a snarkier heroine, Darynda Jones' Charley Davidson novels also pair a tough private eye and a hot but dangerous alpha male.
The Heart Goes Last: A Novel
Margaret Atwood
What it's about:
In exchange for a secure middle-class existence, downwardly mobile couple
Charmaine and Stan become subjects in an unusual social experiment that will put their relationship to the test.
Why you might like it:
No one does chilling yet slyly satirical literary dystopia like
Handmaid's Tale
author Margaret Atwood.
For fans of:
sardonic, keenly observed novels of formerly middle-class individuals adjusting to the harsh realities of late capitalism, such as Karl Taro Greenfeld's
The Subprimes
or Lionel Shriver's
The Mandibles
The Cold Between: A Central Corps Novel
Elizabeth Bonesteel
Commander Elena Shaw, chief engineer of the Central Corps ship
, and retired starship captain Treiko "Trey" Zajec, whose
hookup on the colony planet of Volhynia gets complicated
when Trey is accused of murdering one of Elena's crewmates.
You might also like:
Blending mystery, political intrigue, action, and romance, this opening installment of the Central Corps novels may appeal to fans of Ann Aguirre's Sirantha Jax novels.
Captain Vorpatril's Alliance: A Vorkosigan Saga Novel
Lois McMaster Bujold
Captain Ivan Vorpatril, who (unlike his adventurous cousin, Miles Vorkosigan) is content
with his quiet, uncomplicated existence... Then he receives orders to protect Tej Arqua, a young woman targeted by a criminal syndicate.
Series alert:
Starring a popular supporting character from the long-running Vorkosigan saga, this
18th series entry, which takes place several years before the events of
, easily stands on its own.
Kushiel's Justice
Jacqueline Carey
What it is:
a lush, steamy tale of the forbidden love between Sidonie, dauphine of Terre d'Ange, and Imriel
de la Courcel
, son of the realm's most notorious traitor.
Is it for you?
Depicting a society whose motto is "love as thou wilt," this novel does not shy away from explicit depictions of erotic relationships.
Series alert:
Jacqueline Carey's popular Kushiel's Legacy series is comprised of three linked trilogies:
Kushiel's Justice
is book 2 of a trilogy that focuses on Imriel's journey to adulthood.
Love Minus Eighty
Will McIntosh
What it's about:
If you're a beautiful but uninsured young woman who's facing terminal illness, your best bet is to become a "bridesicle." Of course, you'll be cryogenically frozen until a wealthy man opts to pay for your treatment in exchange for becoming his wife.
You might also like:
Andri Snaer Magnason's
or Chris Adrian's
The New World
, both of which explore issues of economic inequality as they depict futuristic technologies that create more problems than they solve when applied to personal relationships.
Contact your librarian for more great books!


text:
Message Board
William Bayer Message Board
Talk about the novels, new and used books that Bayer has written!
Author Bayer's Book Reviews
The Dream Of The Broken Horses
Pocket, Feb 2001, 25.00, 354 pp. ISBN 0743403363 David Weis is a police sketch artist who draws pictures of suspects after he interviews the witness. He is very good at his job and his work has led to the capture of some of the deadliest serial killer of our time. He is now working as a court room artist in the Midwest town of Calista, the place of his birth and formative growing up years. When he has free time, he is trying to solve...


text:
motherhood, nature, outdoors, planting roots, plants, settling
The weather has been so absolutely beautiful the past few days that we have been enjoying a lot of time outside. Today, before supper our little family (Daddy, Mama, three girls, two cats, and a dog) headed out on a walk through our forest in search of our boundary lines that Dan has been marking out.As we walked, we enjoyed the sounds of squirrels calling to each other, the stream gurgling near by, and the branches cracking underfoot. At one point Aneliese stopped to say, "this is so nice, I am just taking a deep breath.". My thoughts exactly. We are so blessed by this little bit of land that we have been given to care for.
Near one of our boundaries is a bit of a clearing with small "Christmas Trees". It's delightful to discover a tree smaller than ones self. These trees are now the girls growing trees. They each chose one and we marked them so as to find them again. And each time we will see how they grow in comparison to their trees. (Kathleen will have to choose hers later!) This simple spontaneous activity today was meaningful to me because it spoke of setting down roots. I have no way of knowing where the future could lead to and we try to be open to anything, but this is the first place in which we have lived that we intend to remain indefinitely. It's the first place that we have put down roots that did something more than skimmed the surface.
And today we chose trees to grow with…


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James Spenceley, CEO at ASX-listed company Vocus Communications, says that fibre-to-the-node (FTTN) technology should make up part of the National Broadband Network (NBN).
Senator Stephen Conroy, Minister for Broadband, Communications and the Digital Environment, has dictated what customers need for the NBN, Spenceley says, instead of assessing whether different consumers around Australia need different things.
"That's my biggest criticism of NBN – it's never approached this to say, 'What does the customer require?' The customer in the bush requires something very different to someone in a mid-sized town to someone in a CBD," he says.
"They also have varying amounts as to how much they're willing to pay. I think that's the biggest folly … of Senator Conroy's is not looking at technology for the right application."
Spenceley says the correct technology for an NBN is dependent on location. For example, he says fibre-to-the-home (FTTH) is suitable in densely populated areas, whereas FTTN would work better in other locations.
"It really comes down to the technology that's right for the area and the requirements," he says.
Malcolm Turnbull, shadow minister for communications and broadband, has consistently stated FTTN would be cheaper and faster to roll out, and is a viewpoint which Spenceley agrees with.
"It just means that people get it earlier and you save a hell of a lot of money in what are probably semi-challenging economic conditions globally," he says.
While much of the debate on the NBN has centred on FTTH versus FTTN, Spenceley believes people in regional areas of Australia don't have a preference for how the NBN is delivered or what speed they receive. Instead, he says they want to any technology which is better than dial-up or satellite broadband.
"I think if you said to some people in the bush, 'Do you want wireless-style access today at 5Mbps or 100Mbps NBN but in five years' time and the price is double – which would you prefer?' I'm going to guess it's not quite as clear cut as probably the NBN assumes," he says.
Using FTTN would also allow Australia to prioritise the rollout to regional and remote areas of Australia, Spenceley says, which is in line with New Zealand's approach to roll out high-speed broadband to regional areas first.
"My concern as an industry participant is still about getting broadband to people who don't have it, necessarily, rather than rolling out fibre to every single house," he says.
"[That] has always been my greatest criticism of the NBN – it's fibre-to-the-home because that's what [communications minister Senator] Stephen Conroy said."
Spenceley has been an outspoken opponent of the NBN, telling the <i>Australian Financial Review</i> in February this year uncertainty over the network was stifling investment in it.
Seven months on and Spenceley says investment is now starting to filter through.
"I'm also starting to see, anecdotally, people rolling out more DLSAMs in areas. For such a long time it stifled investment – I think a lot of it is just creeping through now, but it's not a landslide of investment that's coming through by any means," he says.
However, the current rollout of the NBN, and the $37.4 billion price tag of the network, is something which Spenceley says reminds him of the dot com boom days of the Internet.
"We're kind of doing that dot com boom-day situation where you throw all the money in, you invest it, [say], 'We're going to build this fantastic website that's going to sell pet food online' and you list on the Nasdaq and you go up and suddenly the demand isn't there, the revenue doesn't turn up and it doesn't make sense.
"That kind of [sounds] like what we're going through. It's that 'build it and they will come' [attitude]. I think you're far better off in today's economic environments to be a little bit more careful about the way we invest money."
The future for Vocus Communications and the NBN
A change of government would provide an opportunity for Vocus Communications to be more strongly involved with the network, according to Spenceley, making it more likely to invest in the network with other RSPs.
"If the Liberals get in and there's a rethink [of the NBN], we'd like to have a lot of involvement, certainly on ideas and policy and different ways to think about rolling out broadband," Spenceley says.
"I suspect Malcolm Turnbull has a different view and Malcolm Turnbull comes from the industry, so he has a much sounder understanding of the industry, dynamics and consumer demand so I think there might be some more interest in hearing our opinion."
However, Vocus Communications is investing some money in the network. Last year it invested $8 million in developing its own fibre services around Australia, with the company spending $7 million this year.
The company's fibre and Ethernet division also recently recorded the company's strongest growth, with revenue increasing 201 per cent to $5.4 million and Vocus Communications expanding its fibre network by 298 per cent.
Spenceley says the company will continue to be involved in the NBN.
"I think we've been through a number of the processes to starting to add services and I think we'll progress that once we get customer demand," he says.
Follow Stephanie McDonald on Twitter: @stephmcdonald0
Follow Computerworld Australia on Twitter: @ComputerworldAU


text:
Check BNN and Bulbanews for up-to-date Pokémon news and discuss it on the forums or in the Bulbagarden Discord server.
Pokémon Center
A Pokémon Center (Japanese: ポケモンセンター Pokémon Center) is a type of building that provides regulatory services for Pokémon Trainers. Pokémon Centers are found in most towns and cities of the Pokémon world; every major city or town holds a Pokémon Center. Some Pokémon Centers can be found outside of towns next to large forests or caves. Pokémon Centers are built where many Trainers gather and the area becomes popular. This is to accommodate those Trainers in need and serve as a resting spot. The most common service the Pokémon Center offers is healing Pokémon free of charge.
Fly and Teleport always bring the player to the Pokémon Center they last visited or to the Pokémon Center of the city/town they are currently in.
- 1 In the games
- 2 In the anime
- 3 Differences among generations
- 4 Trivia
- 5 In the real world
In the games
In the Pokémon games, Pokémon Centers are important buildings found in most towns and cities, sometimes even on routes. Pokémon Centers are essential to Trainers as they provide many facilities and host most game mechanics. Non-player character Trainers and their own Pokémon are often found hanging around in Centers, offering general advice and information on the events in the town or area it is situated in. Though the setup of the Centers has varied slightly throughout each generation, all Pokémon Centers have these functions:
- A nurse heals all party Pokémon in a matter of seconds. This service heals all status conditions, recharges HP and PP of all party Pokémon, free of charge. The nurse is located at the main counter just as the player enters the Pokémon Center.
- Pokémon Centers also host the Cable Club and the Union Room, which facilitates multiplayer gameplay. Originally, linked players could only battle and trade one another, but in later generations, players can mix records and play games together.
- Trainers also have access to a PC so that they can change out their party. Players are able to deposit and withdraw Pokémon, along with ability to store and withdraw items and display their Hall of Fame details.
- In Generations I-III, saving the game inside a Pokémon Center is required to facilitate linking with console games such as Pokémon Stadium and Colosseum.
Generation I
In Generation I, a Pokémon Center consisted of two counters on a single floor. The counter on the left has a nurse that will heal the player's Pokémon. The counter on the right contains the Cable Club, which allows players to link with each other. Talking to the women at the desk will allow the player to enter the Cable Club. Furthest to the right is the PC to deposit and withdraw Pokémon or items. Generation I also includes two of the few examples of a Pokémon Center that isn't in a town, which are the Pokémon Center on Route 4 outside Mt. Moon, and the Pokémon Center in Route 10 outside the entrance to the Rock Tunnel. Future generations employ rest houses that only offer healing services in areas similar to that.
Cable Club
The original link-up place was at the far end of the Pokémon Center in Generation I Kanto. Players can link together to simply battle each other in a one-on-one fight and trade Pokémon with each other. Two players linked by a first generation Link Cable can enter the cable club. Pokémon Yellow featured an extended version of the Cable Club with the option to choose special battle rules or cups.
Generation II
In Generation II, to accommodate greater linkup functionality, the Pokémon Centers of both Kanto and Johto expanded to two floors. On the first floor remained the counter where a nurse would heal Pokémon, as well as a PC, while on the second floor resided the Cable Club.
Cable Club
Located upstairs in Pokémon Centers throughout Johto and Kanto, this Cable Club consisted of three rooms. The Cable Club Trade Center facilitated trading, the Cable Club Colosseum allowed battling, and the Cable Club Time Capsule provided a way to trade Pokémon with the Generation I games. Because there were no female player characters prior to Kris's introduction in Pokémon Crystal, a player who has chosen Kris must be "changed" into the male player sprite before they may link with any other game. This is still the case if the game is linked with another copy of Crystal Version, even though sprite data for the female choice exists.
Two players can enter the Cable Club with a first generation Game Link Cable.
Johto Mobile Center
Only in the Japanese Crystal version, the Pokémon Communication Center in Goldenrod City. Added was the ability to battle over mobile phones upstairs, and two new items downstairs: Pokémon News, a news machine which aggregated news about Trainer accomplishments and Trade Corner, which let a Trainer place a Pokémon up for trade. This process was in essence a prototype for the GTS.
Generation III
Pokémon Centers during Generation III remained in a two-floor setup, similar to the way they were in Generation II. The only difference is that the stairs to the second floor are larger and more noticeable, taking the shape of an escalator.
In Orre, there are only three official Pokémon Centers. They are located in Phenac City, Agate Village, and Gateon Port. The Agate Village and Gateon Port Centers do not have facilities for linking with the Generation III Game Boy Advance games, however.
Cable Club
Similar to the Cable Club in Johto, the Hoenn Cable Club's Pokémon Center has a Cable Club Colosseum and a Cable Club Trade Center. Now four players can link with a third generation Game Link Cable to battle in a double battle. A new feature was added to the Cable Club called the Cable Club Record Center, which allows two to four trainers to swap data. Similar to the Pokémon News in Crystal version, swapped trainer data shows up on television shows on televisions found all across Hoenn. Also, trainers' secret bases are copied over in the record mixing.
Wireless Club
The Generation III Kanto and Emerald version Hoenn have a Wireless Club. The Wireless Club meets in the Union Room, where up to 40 trainers may (in groups of five) talk and battle, as well as trade via a trading board similar to the Crystal version Trade Corner. The Cable Club's room has the standard Trade Center and Colosseum. Pokémon Emerald version's Cable Club also has the Record Center.
Generation IV
In Generation IV, Pokémon Centers introduce a basement floor, utilizing Nintendo Wi-Fi Connection. Opposite the second floor escalator, another escalator downstairs to the basement appears. While the second floor retains the same functionality that it did during Generation III with four player on the DS's wireless connection, the basement floor is where players can link up with others around the world using Nintendo Wi-Fi Connection. The first floor, as always, is where a player can heal their Pokémon and a PC. As of Pokémon Platinum players can also challenge a Trainer or Trainers inside some Pokémon Centers.
In Pokémon HeartGold and SoulSilver the Pokémon Center was redesigned again. The second floor became a mezzanine, located above and directly behind the main desk, and two staircases were added on each side of the desk for access to it. The PC was moved to the corner of the desk. All functions remain the same. The player's partner Pokémon will return to its Poké Ball while being healed. Also, if the first Pokémon in the player's party had been fainted prior to healing, it will return to being the partner as soon as it has been revived.
Wireless Club
In Generation IV, Sinnoh and Johto both have a wireless club just like Hoenn and Kanto, but with a lack of a Record Center. However, the Pokémon Centers in these regions have a basement, where the Wi-Fi Club is located, for people to connect to each other if they are registered on each other's Pal Pad. Here they can battle and trade, and they can talk to each other through the built-in microphone of the DS, instead of with a chat box like it was in Generation III.
Wi-Fi Plaza
The Wi-Fi Plaza is an enhancement to the Wi-Fi Club in Pokémon Platinum, HeartGold and SoulSilver. It is found downstairs in the Pokémon Center. Players from around the world can enter a "plaza" to make Poffins and play mini-games together via Nintendo Wi-Fi. The player can walk around the plaza and communicate with other players in the plaza. A leap in multiplayer gameplay is introduced, allowing up to twenty players to enter the Wi-Fi Plaza at a time. The player may only spend a certain amount of time at the Wi-Fi Plaza each day.
Generation V
In Pokémon Black and White, the Poké Mart has been combined with the Pokémon Center, this is similar to how the Elite Four lobbies of previous generations contain both a Poké Mart and a Pokémon Center. As with HeartGold and SoulSilver, the second floor is a mezzanine above the healing station.
In the anime
In the anime, a Nurse Joy heads each Pokémon Center. The healing process takes place in real time, unlike in the games. All Pokémon Centers are connected and, in times of crisis, all Pokémon can be transferred from one to another, as seen in Pokémon Emergency!. Pokémon Centers are considered an important service, as shown in Celebi and Joy where, in the past, the town residents built a Pokémon Center as a community project.
Pokémon Centers are designed for Trainers so they can rest between activities. Trainers use Centers as gathering places, so they can share information about Pokémon. They also have access to video phones, PC with trading functions and most offer free food and lodging. Inside a typical Pokémon Center, one can find a front desk, a lobby (sometimes with vending machines), a Poké Ball room, an Emergency Room with plenty of beds for injured Pokémon, a recovery room, a waiting room, rooms for lodging, and a cafeteria. A lobby may also have a widescreen TV so Trainers can watch typically Pokémon-oriented shows, such as Sinnoh Now, Pokémon Contest broadcasts, and major competitions like the Pokémon Leagues of each region and the Grand Festival. A typical sleeping room has a desk and chair and two sets of bunk beds to maximize space, and girls do not have to sleep in separate rooms from boys. At least one Center was shown in Uncrushing Defeat! to have a small library with a computer (presumably connected to some kind of internet), as an information room. It is unknown how these activities performed by a Pokémon Center are financed. On the outside, they come in all shapes and sizes, but usually have a rather large P somewhere.
Differences among generations
- Pokémon Center RBGY.png
Generation I (Kanto)
- For Dawn of a New Era!, Professor Oak's lecture is about Pokémon Centers. He writes this Pokémon senryū about it: ジョーイさん あいたくなったら ポケモンセンター Jōi-san aitaku nattara, Pokémon sentā. "When I want to meet Nurse Joy, Pokémon Center."
- If a Trainer gets at least four stars on their Trainer card in Generation IV, the nurse at the Pokémon Center will make special mention of this, and then refer to the player by name upon subsequent visits.
- A man in the Resort Area describes how Pokémon Centers come to be in an area. When Pokémon appear, Trainers will also come. When Trainers appear, Pokémon Centers will also come about.
- The Pokémon Center's theme music has remained essentially the same throughout the franchise. It is notably different at night time in Generation IV.
- A remix of the theme music was used in Super Smash Bros. Brawl.
- In the Japanese and Korean versions of the Generation II games, the sign of Johto's Pokémon Centers have a Poké Ball logo and the letters PC while Kanto's use the same sign as Generation I. However, the Generation I sign was used for both regions in the international versions.
- In Pokémon HeartGold and SoulSilver, the nurse's speech line after healing the player's Pokémon was changed from "We hope to see you again!" to "Please, come back again any time!" This was probably because of the fact that the Pokemon center is often used to heal fainted or extremely damaged Pokemon.
- In Generation IV, if the "Walk through walls" cheat is used to go past the desk, and the cash register-like object is interacted with, the dialog will be the same one used when interacting with the shelves in a Poké Mart.
In the real world
- Main article: Pokémon Center (store)
The Pokémon Company and Nintendo have a group of Pokémon-themed stores called Pokémon Centers throughout major cities in Japan. The stores sell exclusive merchandise (dolls, T-shirts, themed items) with Pokémon characters. There was a Pokémon Center in the United States at 10 Rockefeller Center in New York City which operated from 2001 through 2004, but the store was closed and converted into Nintendo World in May of 2005, which has a smaller collection of Pokémon-based items. Also, The Pokémon Company International ran a website catering to internet shoppers called PokémonCenter.com, but closed the site on January 31, 2008 to focus on brick-and-mortar stores who sell licensed merchandise.pt:Centro Pokémon


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Bridgeport lands on top-10 underwater mortgage ranking
The Haas Institute for a Fair and Inclusive Society at the University of California at Berkeley has ranked Bridgeport 10th on its list of cities contending with a flood of "underwater" mortgages.
Forty-two percent of mortgages held for homes in the state's largest city are underwater, but Hartford tops the Haas national list with 56 percent.
Underwater mortgages are when the balance on a mortgage is higher than the free-market value of the home. It often prevents the homeowner from refinancing, and the home could fall into foreclosure if the owner cannot afford the mortgage payments or sell the house for a suitable price to satisfy the lender.
The rash of underwater residential properties and the transfer of them through foreclosure or short sale has hurt the selling price of homes offered through the regular market process, said Joe Formato, an agent with the Fairfield office of Coldwell Banker and the owner of several multi-family properties in Bridgeport.
`Not good'
"It's not good. Every time you put a two-family home up for sale and other properties (in the neighborhood) have been short-saled or sold through foreclosure -- it's reflected in the fair-market sale, bringing the price down. Until the foreclosures are done, sales prices are not going to start going up."
Many of those underwater homeowners bought their properties at the height of the housing market, when interest rates were high, according to Formato.
According to the Haas report, which obtained its data from Zillow, 34 percent of the 100 hardest-hit cities have median household incomes below $40,000. In 71 of the 100 hardest-hit cities, African Americans and Latinos account for at least 40 percent of the population. In 146 of the 395 hardest-hit ZIP codes, African Americans and Latinos account for at least 75 percent of the population.
`Call to action'
"We believe the reason is because of large communities of color that live there. African Americans and Latinos were targeted for predatory and subprime closings during the housing boom," said Saqib Bhatti, a fellow at the Nathan Cummings Foundation and an author of the report. "We're hoping this will be a call to action."
Although areas are seeing an improvement in their housing markets, many cities are lagging and might not recover for a long time, he said.
"Connecticut is one of the wealthiest states and has some of the poorest cities. There may be an improvement in housing numbers in Greenwich and Cos Cob, but not in Hartford or Bridgeport," Bhatti said. "Prices in Bridgeport are still 39 percent below peak levels."
Katherine Pancak, professor of finance and real estate at the University of Connecticut, echoed Bhatti's comments.
"The underwater mortgage situation will only improve with rising of home prices and/or a greater willingness of lenders to engage in short sales," she said.
Jeffrey Gentes, foreclosure prevention managing attorney with the Connecticut Fair Housing Center in Hartford, said he is surprised that Bridgeport was not higher on the Haas list.
"We see people who owe two to three times what their properties are worth. We're in this for a few more years."
Bridgeport Mayor Bill Finch didn't appear to be surprised by the report, either.
"Like many cities, Bridgeport was hit hard by the mortgage crisis, and too many families continue to struggle," Finch said. "My administration has worked diligently with state and federal government, law enforcement, community groups, and others over the years to crack down on predatory mortgage practices that harm Park City residents. And, my administration regularly meets with residents who are in need, helping to seek out ways that they can make home ownership work."
The Fair Housing Center will host assistance programs on May 21 at 6 p.m. at Norwalk City Hall and June 18 at 6 p.m. at Bridgeport City Hall.


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Ginger Green Tea Ice Cream Recipe
I scream, you scream, we all scream for...
Bittersweet matcha pairs beautifully with the crisp, refreshing heat of ginger.
Note: Freshly grated ginger has a tendency to slightly coagulate dairy proteins, so don't be surprised if your dairy-ginger mixture is thick and a little clumpy after steeping. It'll smooth out once you cook it into a custard, strain it, and churn it.
Read more: Scooped: Ginger Green Tea Ice Cream
- Yield:makes 1 quart
- Active time: 1 hour
- Total time:2 hours
- 4 tablespoons (1/4 cup) matcha green tea powder
- 3 cups half and half
- 3 tablespoons finely grated ginger, with juice
- 6 egg yolks
- 1 1/2 cups sugar
- 1 teaspoon kosher salt
Add matcha powder to a heavy-bottomed saucepan and very slowly whisk in half and half, stopping frequently to smooth out any lumps. Lumps will not cook out.
Once half and half is fully and smoothly whisked in, place saucapan over medium heat and bring to a simmer, whisking occasionally. Remove from heat, stir in ginger, cover, and let steep for 1 hour.
In a mixing bowl combine egg yolks and sugar and whisk until combined. Mixture will be very thick. When dairy finishes steeping, uncover and quickly stir in egg yolk mixture, whisking to fully incorporate. Put saucepan on medium heat and cook, stirring frequently, until a custard forms on the back of a spoon and a swiped finger leaves a clean line. Stir in salt to taste.
Pour custard through a fine mesh strainer into an airtight container and chill overnight. The next day, churn according to manufacturer's instructions. Transfer ice cream to container and chill in freezer for at least 3 to 4 hours before serving.
This Recipe Appears InScooped: Ginger Green Tea Ice Cream
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The 20 minute documentary, Thornton Dial, examines the extraordinary life and work of this 77-year-old contemporary artist from Bessemer, Alabama. Born in Emelle — in the heart of the Black Belt—Dial is a former migrant farmer and steel worker who neither reads nor writes, and has never formally trained as an artist. Yet art critics call him genius.
Alabama Power


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Drafted By The Royals – 1968
Because every day of the off-season may not have a story to tell (though you would be surprised how many do) I wanted to start a new quick hit entry for the blog called – Drafted By The Royals.
Now as a baseball fan you know that every player drafted by an organization does not sign with that club. But that is exactly the dynamic that makes for some intriguing history. Over the years you get some interesting connections, some what might have beens and some outright oddities. This first edition is one of the interesting connections, especially as we recall great moments from the 1985 World Series.
The Royals, along with their 1969 MLB expansions brethren, were allowed to take part in the 1968 June Free Agent Draft beginning in the fourth round. The Royals chose shortstop Kenneth O'Donnell from Neptune High School (Neptune, NJ) – See if you can win a bet with that one.
But the interesting connection came in the 16th round when the Royals took another SS – this one from Arcata High School (Arcata, CA) by the name of Dane Iorg. Yes that Dane Iorg, how many could there be?
Now we all know Dane did not sign with the Royals, but Kansas City was the first MLB club to draft him. He would go on to play baseball at Brigham Young University before being the Phillies first round pick in the 1971 June Draft (Secondary Phase) where he signed and began his professional career.
Just A Bit More: It would be nearly 16 years later when Dane first donned the Royals uniform. He was actually purchased by the Royals from the St. Louis Cardinals on May 10, 1984. Whatever the price was, I'm going to say in retrospect it was a serendipitous bargain of a deal.
(Curt Nelson, Director – Royals Hall of Fame)


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Free or Discounted Hospital Care
Elizabeth Savage
If you have lupus or any other illness that requires hospital care, and you are uninsured or have high healthcare costs, you may be eligible for free or discounted hospital care.
California law (Assembly Bill 774, The Hospital Fair Pricing Act of 2006) requires every hospital to offer reduced rates to uninsured and underinsured patients that may have low or moderate income, and to provide policies that clearly state the qualifications for free care and discounted payments.
With some exceptions, you could qualify for free or discounted care if:
1. Your income is below 350% of the Federal Poverty Level -- currently $38,115 for one person or $78,225 for a family of four, and
2. You do not have health insurance of any kind, or have health insurance but your medical costs were more than 10% of you income in the last year.
If you or someone you know needs to avail of free or discounted hospital care, more information as well as searchable list of hospital policies on this issue, can be obtained by visiting this Website.
For additional list of resources on disability, unemployment and health insurance in California, click HERE.


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Pikes Peak House is a 501(c)(3) non-profit organization.
We are independent and not affiliated with any religious organization.
We promote self sufficiency and base recovery around the 12 steps
of Alcoholics Anonymous. We provide transitional housing for adults
with alcoholism and substance-abuse problems.
Acceptance into the recovery house is not contingent
upon one's ability to pay up front. We will work with those
who are homeless and indigent if they have the desire to stay clean
and sober and work towards recovery, accountability and responsibility.
Currently we operate five homes. We began our work
in 2004 when our first home, Alteza House, was opened to women in
the Colorado Springs area who were seeking help from alcohol and
drug addictions and a safe place to live. Increased demand from women
desperately seeking a safe and sober living environment led us to
open our second house, Pikes Peak House, in 2006. In 2008 and 2010
Chestnut House and Cooper House sober living homes for men were begun
and are showing great success. All our homes have two live-in house
managers that are members of Alcoholics Anonymous. The structure
the houses provide combined with and the support of other responsible,
working self-supportive residents gives new residents a positive
example of how to apply those attributes in their own lives.


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Listed April 05, 2019
Age: 5 yrs.
Gender: Female
Weight: Not Specified
Adult Size: 26-60 lbs.
Fixed: Yes
Shots: No
Breed:American Staffordshire Terrier
Views:This pet has been viewed 52 times.
DescriptionAmerican Staffordshire Terrier (medium coat)
Special NeedsIf you are interested in adopting or would like more information about this pet, visit at the Pasadena Humane Society (361 South Raymond Ave, Pasadena, CA, 91105) Tues-Fri 9a-4p, Sat 9a-3p, or Sun 11a-3p.
Our website www.phsspca.org has more information on adoptions, directions, and listings of all pets available, updated every hour.
Please note: we do not ship pets.
Thank you for your interest in adopting a pet! Spay or neuter today!
Adoption Fee Details
Dogs are $125; Cats are 1 for $70 or 2 for $85; and Rabbits are $30. Other fees vary by animal.


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by Gregg Gethard
I was at an open mic recently when no less than six straight comedians did a bit about vaginal smell. This is not uncommon. Every open mic has a lot of comics who talk a lot about vaginal smell.
This is a problem.
Here are the reasons why this is problematic:
If at least half of the performers are doing material about a topic, you should probably not do material about that topic. The main point about open mics is to get better and to find a way to get booked at an actual show. You think doing the same exact thing as everyone else is going to get you there?*
If the material is something a doofus high school kid would say in the locker room, you should probably not do material about that topic. (I put something on my Twitter about this. A response from someone: "What, is everyone in Philly comedy 16?")
Doing bits about vaginal smell essentially boils down to saying "girls are icky." Confusion about sex is a great concept for a bit that's incredibly relatable. However, the joke should be about how confusing it is for both parties (or, even better, the performer). The joke shouldn't be about vaginal smell. You're just coming off like some creep wanna-be lothario bragging about doing a sex act.
I put something about this on my Facebook wall. Here is a comment my friend Alanna (a girl and not my wife) said about vaginal smell jokes: "Anecdotally, I have found that men who trash women and their vaginas the most are the men who seldom have the opportunity to get inside one."
Just a head's up as to what a girl who frequents comedy shows thinks about your jokes about girl parts.
Making a joke about smelly girl parts is making fun of someone's body. Would you make a joke about someone in the crowd who is overweight? I would hope not. And I'm not saying this to be sensitive or PC. I'm saying this because making fun of an overweight person (or something similar) is just bullying.
Stage time is precious. Open mics give you, what, five minutes at the most? You're going to use five minutes of stage time to talk about something almost everyone else is talking about that most men have stopped talking about when they hit college? Be better than that. Respect the stage. Try to do something different and unique and new. That's why I love going to comedy shows.
I'm not god's gift to comedy. I know this. I've done really well at some shows and I've bombed at a lot more. But anytime I get on a stage I try to do something that the audience hasn't seen or heard before that reflects my personality. You really want to tell a group of mostly strangers that your personality largely revolves around high school lunch humor?
* To show I'm not a PC prude – there have been a lot of pro-gay marriage bits lately. I support gay marriage. But again – if 10 people are talking about gay marriage, do you really want to talk about gay marriage?
Vaginal smell jokes are not a problem as serious as rape jokes, which has become the dumbest controversy in modern comedy because it shouldn't be a controversy since no one should tell a rape joke. I have to applaud the Philly open mic community because the amount of comics telling rape jokes at one point approached the 50 percent mark. It's now down to roughly 25 percent, and it appears that most of the comics telling jokes about committing sex crimes with punchlines at the expense of victims are new to the scene.**
**I talked with a young comic who had a rape joke up front in his otherwise pretty brainy set and told him he (and hopefully he took it in the right way – I was trying to offer advice and hopefully I didn't come off like a dick, but I probably did) should get rid of it because he was better than that. He seemed to agree with my statement. But he said he was nervous since the night was sort of dead and he knew that he'd get a laugh. I get that – god knows my earliest comedy used shock nonsense (and probably a rape joke) as a safety blanket. But then I learned the difference between a shock laugh and an earned laugh and I think this kid will get that difference soon. Respect.
Gregg Gethard has been performing comedy in some form since 2007 and is best known for hosting/producing the long-running Bedtime Stories and co-hosting The Holding Court Podcast. He will be hosting A Comedy Tribute to Boston on Sunday, June 23 at L'Etage (624 S. 6th Street) at 7 pm. He will also appear live on the Used Wigs podcast on May 21st at 8 pm (also at L'Etage). He can be followed on Twitter @holdingcourtpod.


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The midnight screams of a taxi driver being bashed by men allegedly trying to rob him alerted residents in a suburban Tauranga street, who tackled one of the alleged attackers trying to escape.
He was held until police arrived while another alleged attacker was arrested after being chased by a police dog and officer.
The assault, in which the assailants allegedly delivered 15 blows with their fists and elbows, happened on Ohauiti Rd, Welcome Bay, on Wednesday night.
The victim spent a night in Tauranga Hospital being treated for head injuries before being discharged yesterday.
A senior detective says it was an unprovoked attack that will "haunt" the victim for the rest of his life.
The two arrested men, aged 18 and 19, faced a joint charge of aggravated robbery when they appeared in Tauranga District Court yesterday.
They were remanded in custody and are due back in court on January 29.
Detectives have asked for the public's help to identify two other men who were in the taxi and fled afterwards.
Detective Sergeant Iain Chapman said the Tauranga Mount Taxis driver picked up four men from Welcome Bay shops and drove them to Ohauiti Rd.
At their destination, he was allegedly put in a headlock and attacked by the front-seat passenger and another man who was seated behind him.
"Their intent was to steal cash from the cab and they also ended up with the driver's cellphone, so coupled with the fact that it was a very vicious assault, the men were charged with aggravated robbery," Mr Chapman said.
"The driver suffered extensive bruising and scratches from this vicious, over-the-top assault.
"The offenders used their fists and elbows ... and the violence they showed was absolutely unnecessary. You could count the blows on this man's body. There was an excess of 15 punches to his head."
Despite continuing to be hit, the driver managed to get out of the taxi and screamed, Mr Chapman said.
"That alerted the neighbours because the assault happened in a residential street, and the neighbours came out to his aid."
As the men tried to run off, the neighbours managed to grab one of the alleged offenders and restrained him until police arrived.
Another man was arrested a short time later after being tracked and caught by a dog handler, Mr Chapman said.
The other two men fled and police have released CCTV footage from inside the taxi of one of them.
Mr Chapman said it was not believed this person physically took part in the assault but police want to speak to him as he was part of the group.
Police praised the efforts of local residents who came to the victim's aid.
"Although we never want the public to put themselves in danger we couldn't do the job that we do without the invaluable help of people willing to stand up for what is right."
Tauranga Mount Taxis did not return calls but the attack has left the Tauranga taxi community shocked.
Anyone with any information is asked to call Iain Chapman at Tauranga police on 577 4300, or alternative ring the Crimestoppers line on 0800 555 111.


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April 28, 2011
This Weekend
The Blue Green rivalry between UCSB and Cal Poly SLO will reignite again this weekend as both teams head off in a dual meet held at the Westmont College Track on Saturday April 30. This event is the only other home meet besides the Gaucho Round-Up for the Gauchos' 2010-2011 Track and Field schedule. Favorable conditions and a projected high of 72 degrees will set the scene for record breaking potential.
As part of the Blue and Green Rivalry, Cal Poly remains UCSB's biggest rival of the season. Last year the meet was split and the UCSB women won the meet while the Cal Poly men racked up the most points. With the Big West Conference Championships coming up in a little over two weeks, the "Cal Poly Dual Meet will be a great stepping stone for the athletes to get a taste of the Championship season. We're heading into this meet ready to put up some big marks and ready to compete," says Josh Priester Associate Director of Track and Field. Results will be posted after the last event at 4:30pm here.
Last Time
The Gauchos took part of the UCSD Triton Invitational last weekend and posted some good marks and times at the meet. Cassie Brooker lead the women in the 1,500m and ran a new personal best to finish second in 4:32.02. Jean Lightfoot finished second in the discus throw with a throw of 162'2" and also set a new personal best. Ryan Martin highlighted the men's 800m run with his first place time of 1:50.82 and André Piñon had a strong finish in the 400m hurdles in a time of 52.75 to place second overall. Piñon also helped the men's 4x400m relay team to a first place finish and a time of 3:12.37.
Moreno Rocks the Record Books
Senior Amanda Moreno from Escalon, Calif., had a stellar performance in the 5,000m at Mt. SAC to break not one, but two records. Moreno's time of 15:58.02 broke the UCSB school record in the 5,000m set by Danielle Domenichelli in 2010 and has also broken the Big West Conference record. Her performance earned her another Big West Athlete of the Week Award to add to the two she picked up for her performances at Ben Brown Invite and Stanford Invite. Since the beginning of the season, Moreno has been able to improve by nearly a minute and has her sights set on the US Track and Field Championships on June 25 in Eugene Ore.


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Watch previews and get more information about some of your favorite WORLD TV programs. View the complete WORLD schedule here. Visit the WORLD TV website for additional program information.
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Supernature | Wild Flyers
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American Experience | The Boys of '36
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At Pure 4Runner, you will find the largest selection of 4Runner parts and accessories on the web. We are dedicated to providing you with the best customer service around.
We do our best to ship all items the same day the order is placed, custom requests may take longer. We do our best to deliver most items within 5-6 business days, most will show up much sooner. Not all items come from our shop in Texas. If your order contains items from multiple suppliers/warehouses, you will potentially receive tracking numbers and items at different times.
Here at Pure 4Runner, a Pure Auto Parts Inc company, we understand the importance of maintaining our customers privacy online. We understand that in this time of spam e-mail, and credit card fraud our customers want to know and have the right to know how personal information is handled.
The ultimate solution in winching techniques! The self-locking mechanism is easy to operate, and will never open under load. The hook is large enough to take both ends of a double-ply tree strap for fast and safe recovery when and where it's needed most.
Product 46/62
WARNING: This product may contain chemicals knownto the State of California to cause cancer, birth defectsand other reproductive harm.