This post is part of our 'Pedagogy theory week' series.
For a very short presentation of pedagogy theory, see the Monday post. In this post, György Gergely starts to reply to Marion Vorms and Olivier Morin's comments of Monday, Tuesday, and Wednesday.
In their posts to kick off Natural Pedagogy Week, Olivier Morin and Marion Vorms both raise important – and in many ways converging – questions about some of the basic assumptions of natural pedagogy theory, the recent hypothesis proposed by Gergő Csibra and myself about the functional nature of preverbal infants' innate preparedness to be engaged in ostensive referential communication.
– Ostensive signals trigger a Genericity Bias of referential interpretation: Ostensive cues induce a Genericity Bias in infants: a default expectation that – unless further communicative and/or contextual information is made available to specify the intended referential scope of the manifested information to be more narrow – the communicative act is assumed to convey generic (rather than episodic) information that is generalizable beyond the 'here-and-now' of the referential situation to other contexts, other agents other actions of the same kind, or other instances of the generic object kind that the particular referent belongs to.
Olivier and Marion both seem to welcome the empirical evidence that support Natural Pedagogy as a significant step towards understanding the nature of humans' evolved capacity for ostensive communication.
In particular, they seem to endorse NP theory's first two proposals about the evolved human sensitivity to ostensive signals, and the presumption of relevance that the innate ostensive cues seem pre-wired to trigger. They raise, however, some highly relevant general questions as well as more specific critical remarks concerning our third and fourth proposals: the referential expectation and the Genericity Bias.
Olivier points out that "pedagogy theorists believe that we are hard-wired to expect communication to be referential and generic". He (rightly) argues that this differentiates Natural Pedagogy theory from other evolutionary accounts of ostensive communication (e.g., Mike Tomasello's), which consider the primary function for which communication has been selected to be the transfer of relevant episodic information between participants of cooperative interactions engaged in joint actions to realize shared goals. In this view, the adaptive epistemic function that communication has evolved to serve is to establish, monitor, and maintain as shared knowledge all the relevant episodic information that forms the common ground between cooperating partners that is necessary to support the efficient coordination of their joint actions to realize their shared goals.
Olivier then points out that according to NP "when someone addresses us… we expect their actions to be about something (that's referentiality), and we expect their actions to teach us something general about what kind of thing the thing we are referring to might be (that's genericity)". He reminds us, however, that many communications do not identify a clear referent and even when they do so they often do not teach us "anything generic about that reference". This raises obvious – and potentially damaging – questions for Natural Pedagogy. Does, for example, Natural Pedagogy's claim that young infants "expect communication to be generic and referential" imply that early on infants cannot yet infer the relevant contents of non-referential communications? And: Do infants, as a result of the Genericity Bias, compulsively (and often mistakenly) generalize any specific episodic information ostensively manifested to them about particular referents as encoding generic properties of the object kind exemplified by the referent?
I agree that if these were indeed the consequences of endowing infants with Natural Pedagogy, then the young child would face arguably non-trivial epistemic dangers when engaging in ostensive communication with others. So let me provide some clarifications as to what we do and what we do not mean by the assumptions of 'referentiality' on the one hand, and 'genericity' , on the other to indicate why we think that the envisioned epistemic abuse of communication can be prevented.
I shall start with the issue of referentiality. A second post will be devoted to genericity. In my third post, I will discuss the A-not-B experiment discussed by Marion.
First, as recently argued by Csibra (2010), infants' receptivity to ostensive signals is more than simply a recognition of being overtly addressed by the other. It also involves the recognition that the manifested communicative intention entails (makes implicit reference to) some further informational content (the other's informative intention) that should be inferred and encoded as relevant by the infant addressee. In that sense all ostensive communication is referential, whether or not it involves making direct deictic or linguistic reference to a particular object or not. We suggest that this sense of referentiality or aboutness (that entails implicit reference to the informative intention to be inferentially recovered by the addressee) is triggered as an interpretive expectation by ostensive signals in infants and adults alike.
Of course, to identify the relevant content of the other's informative intention the recipient must rely on relevance-guided inferences whose informational basis must go beyond the ostensive behavioural signals (which in themselves explicitly encode no more than the other's overt communicative intention towards the addressee). Ostensive signals induce therefore an expectation that the communicative manifestation will provide further relevant information that will serve to constrain and direct the addressee's inferences to recover the intended content and referential scope of the communicator's message. To referentially anchor the other's pragmatic inferences communicative demonstrations often employ deictic referential gestures that direct the addressee's attention to specific referent objects. Our proposal is that ostensive cues trigger in infants an active expectation of referent identification. It simply refers to infants' innate preparedness and behavioural tendency to follow such ostensively framed deictic gestures to their referential target. This is the second – and more specific – sense of 'referentiality' of communicative acts that we attribute to human infants: it is an ostensively induced expectation for communicative guidance to referentially ground the pragmatic inferences that the infant has to draw to identify the intended content of the other's informative intention.
What the referentiality assumption of NP does not claim, however, is that in preverbal infants the referential scope of ostensive communicative acts would be restricted to the particular referents that are picked out by the communicator's deictic gestures. Even though being directed by ostensive referential gestures to attend to a specific object is often compatible with inferring that the informative intention manifested is as an episodic property of the individual referent deictically identified, preverbal infants are not restricted to such episodic level interpretations of the manifested referential content even when the non-verbal communicative act employs deictic referential gestures only. To the contrary, as our results non-trivially indicate (and as our theory emphasizes) preverbal infants are equally prepared to interpret deictic referential manifestations not only as being about specific referents, but also as conveying relevant information about abstract referent types (such as generic properties of sortal kinds, general functional knowledge about types of instrumental actions applied to specific kinds of objects, or shared cultural knowledge about conventional behavioural traditions or normative manners of performing certain types of actions in particular types of situations, etc.).
Natural Pedagogy thus treats ostensive communicative manifestations as an evolutionarily designed distinguished source of demonstrative information that can be expected to guide the naïve learner's inferences to identify the intended level of genericity and width of referential scope of the communicator's informative intention.
Gergely Csibra and György Gergely.Natural pedagogy. Trends in Cognitive Sciences, 13:148–153, 2009.
Csibra, G. (2010). Recognizing communicative intentions in infancy. Mind & Language, 25, 141-168.


text:
Does the VA Nudge Seniors Toward Death?
September 2, 2009 at 3:13 pm (By Amba) ("death panels", caregiving, end of life, health care, public option, VA)
I didn't buy the "death panels" rhetoric, but based on this, I'm reconsidering.
Note that neither Hot Air nor the WSJ actually links to the VA booklet. When you do, the first thing you get is this disclaimer:
Your Life, Your Choices was officially retired from use in VA in 2007, and an expert panel was convened to review and comment on an online module version of this document that was under development at that time.
Ha! So there are "panels." Expert panels. Doesn't that make you feel better?? God, I'm so sick of the fucking "experts." What does that word cover anyway? Psychologists? Economists? Are there any combat-disabled veterans on the panels? The only "experts" on this subject are the patients and families who've been there, and the good doctors and nurses who've been in the trenches with them.
The Your Life, Your Choices online module is currently being revised based on suggestions from the expert panel members and from chaplains representing eight different faith groups. The revised online module is scheduled to be released on the My HealtheVet Web site in the spring of 2010.
Please note that portions of this document have been interpreted by some to be negative in tone and insufficiently balanced. The revision process is addressing these concerns. Also note that some of the links contained in the document are no longer active.
Hey, wait, I found the Expert of Experts! His name is Robert A. Pearlman, he's the author of the VA booklet, and in this photo at least he bears an uncanny resemblance to Tim Geithner. (Purely rational Vulcans all?) He studied ethics at Harvard. How much more expert does it get?
He received post-residency training as a Robert Wood Johnson Clinical Scholar, a Fellow in the Ethics and the Professions Program at Harvard University, and a Faculty Scholar in the Project on Death in America. He joined the [National] Center [for Ethics in Health Care, apparently part of the VA] in the summer of 2000. His interests and expertise pertain to empirical research in clinical ethics (especially end-of-life care) and organizational ethics. His research has explored euthanasia, the role of quality of life in decision-making, the validity of life-sustaining treatment preferences, medical futility, advance care planning, physician-assisted suicide, and relief of patient suffering. He is the author of two books and over 100 publications in medical journals and book chapters. His most recent book, entitled Your Life, Your Choices, is an interactive workbook to help patients and family members with advance care planning. Your Life, Your Choices will be available to veterans through MyHealtheVet in 2007.
Forget Ezekiel Emmanuel: is this the government's Dr. Death?
But now I'm really confused. The preface to the online booklet now says "Your Life, Your Choices was officially retired from use in VA in 2007." Made available and retired in the same year?? Or am I misunderstanding?
Here's Jim Towey, creator of what he calls "the most widely used living will in America," "Five Wishes" (not unlike Your Life, Your Choices, "introduced in 1997 and originally distributed with support from a grant by The Robert Wood Johnson Foundation"), being vague about exactly when the workbook was instated (I'm trying to figure out whether the dates need to be jiggered to make Democratic administrations solely to blame for the thing and Republican administrations the blameless heroes who questioned it):
Last year, bureaucrats at the VA's National Center for Ethics in Health Care advocated a 52-page end-of-life planning document, "Your Life, Your Choices." It was first published in 1997 and later promoted as the VA's preferred living will [VA "Fact Sheet" rejoinders that it is "not an advance directive or a living will."] throughout its vast network of hospitals and nursing homes. After the Bush White House took a look at how this document was treating complex health and moral issues, the VA suspended its use. [VA "Statement" says "The document was developed under a federally funded research grant over a decade ago and in 2007, the Veterans Health Administration convened an outside panel of experts to review the tool and assess its merits. Overwhelmingly, the panel of experts, which included a diverse group from the faith based and medical communities, praised 'Your Life, Your Choices' and endorsed its use."] Unfortunately, under President Obama, the VA has now resuscitated "Your Life, Your Choices."
Who is the primary author of this workbook? Dr. Robert Pearlman, chief of ethics evaluation for the center, a man who in 1996 advocated for physician-assisted suicide in Vacco v. Quill before the U.S. Supreme Court and is known for his support of health-care rationing.
Here's a perfectly decent handout on advance directives which, however, refers people to Your Life, Your Choices at the end.
So the booklet was "developed" with federal money during the Clinton years; it's unclear when the VA began using it; and it's unclear what happened to it in 2007 and whether its use has now been reinstated without input from "faith panels." (The booklet encourages its users to consult religious advisers.)
Looking at the booklet, it certainly hits you right between the eyes with some gruesome though not unrealistic scenarios, and there is certainly a none-too-subtle bias in the discussions against taking heroic measures — or even antibiotics — to prolong a life clearly near its natural end:
Chris Larsen [age unspecified] never told his family what kind of medical measures he'd want if he became critically ill. He is in a nursing home after having suffered a severe stroke 9 months ago. He is paralyzed and unable to take care of himself or communicate in any way. Now he has pneumonia and will probably die unless he goes to the hospital to receive intravenous antibiotics. He also may need to be on a breathing machine for a week or so. The doctor says that his chances of returning to normal are remote, but that he has a fair chance of getting over the pneumonia. His family members disagree about what they should do. His son Bill says, "Dad was never a quitter. He'd want to fight to the very end, as long as there was the slightest hope." His daughter Trudy disagrees. "Sure, Dad wasn't a quitter, but he wanted to die naturally—he would be horrified to be kept alive this way."
In fact, Trudy's views were the closest to Mr. Larsen's true opinion. But the family never had a way to find this out. They treated his pneumonia and he lived another year in the nursing home without recovering his ability to communicate or care for himself.
This is on page 5. It's offered as an example of why you need to think and talk about these issues while you can. The trouble with such hypothetical scenarios is that not only do people differ in their values and beliefs, but each case is unique and often unpredictable in its particulars. After we got to Chapel Hill just about exactly three years ago, J declined both mentally and physically, until in December 2006 he ended up being taken to the hospital with pneumonia. He certainly would have died if he hadn't been treated. His doctors and I agreed that a DNR order (do not resuscitate, i.e. no ventilator or defibrillator) at least was appropriate, and a woman resident asked me if I didn't think it was time for "placement outside the home." However, IV antibiotics was all it took to resurrect J — in a matter of hours, he went from virtually comatose to sitting up in bed talking coherently on the phone to my mother — and it turned out that most of his steep mental decline over the autumn had been due to incipient pneumonia, not accelerating dementia. The rest is history. If he were in a late stage of neurological disease, contracted in a fetal position, uncommunicative, and uncomfortable, IV antibiotics would not be appropriate.
(No, he doesn't have a living will. Probably the best course for him is to ask him to sign a health care power of attorney. Though actually, I just learned from this very booklet that if you trust your spouse, that's who will be consulted in the absence of a POA. Either way, it will someday be up to me, who knows J best, to decide whether, based on his mental status, responsiveness and awareness, he who loves food so much would want to be kept alive by a feeding tube. J is also the kind who might well look me in the eye someday and say lucidly, "Let me die." But if something happens to me first?)
Naturally, the VA booklet is being quoted selectively by conservative culture warriors. (The exercise on "What makes your life worth living?" on p. 21, however, doesn't need selective quoting to be every bit as bad as they say it is.) Towey in the WSJ notes that "There is a section which provocatively asks, 'Have you ever heard anyone say, "If I'm a vegetable, pull the plug"?'" In full, that section merely notes that people sometimes do actually say things like that without being very clear about what they're talking about:
Have you ever heard anyone say, "If I'm a vegetable, pull the plug"? What does this mean to you? What's a vegetable? What's a plug? Even people who live together can have very different ideas about what the same words mean without knowing it. When you say, "pull the plug" it could mean a variety of things:
•Stop the breathing machine
•Remove the feeding tube
•Don't give me antibiotics
•Stop everything
The booklet's central question is, "For you, is there such a thing as unacceptable quality of life? Where would you draw the line?"
It's not that these are bad questions. It's, why is the government asking them? (A far more important question than "Did a Democrat or a Republican administration ask them?") Or, for that matter, why is an insurance company asking them, or a nursing facility which makes money when patients' lives are prolonged? All of these parties have classic conflicts of interest — as, for that matter, can family members eager to be rid of a burden or to collect an inheritance. Families are not always havens in a heartless world — as Your Life, Your Choices rather ghoulishly acknowledges when it invites you to check "Yes," "Not Sure," or "No":
I believe that my loved ones should take their own interests into consideration, as well as mine, when making health care decisions on my behalf.
I believe that it is acceptable to consider the financial burden of treatment on my loved ones when making health care decisions on my behalf.
The ultimate question is rather like that about sex education: is this a private matter, even if it inevitably means some kids will be kept in barbaric ignorance or misinformed? Do you really want some nanny bureaucracy with a "rational" agenda to impose its one-size-fits-all values on the intimate lives of your kids? Can the transmission of information about such issues ever be value-free?
It's doctors who should be educated, in the most humane possible way (I mean they should read the humanities, philosophy and literature, as well as psychologists and other "experts"), on these issues, and doctors, together with trusted family members and chosen religious advisers, who should be working out the decisions. Family doctors used to do this, and no doubt plenty still do. Yes, it's a priestly function. People do look up to their doctors that way in life-and-death situations, so doctors might as well live up to it.
Antibiotics are relatively new, and before that people who were weak — because they were very old or very young or very sick — often died. There weren't as many agonizing decisions,or enormous medical bills. It was normal for parents to lose at least one baby or young child. It was not nearly as common for terminally ill patients to hang on and suffer for years.
So now we have all these decisions and expenses, and it seems reasonable to communicate about them. Instead of pretending these decisions are normal and can be made easily.
When our society is in danger or drowning in medical expense I don't see anything wrong with questioning the value of terminal patients clinging desperately to life. Usually it's their relatives anyway, and the patients would probably just as soon die naturally.
I don't really understand why Catholics, who believe in heaven, became so fixated on earthly life.
I don't believe in euthanasia, or making old people feel guilty for living, or anything like that. But limiting futile health care might save a fortune.
As it is now, medical providers, malpractice lawyers, and health insurers are all taking advantage, and all of them need to be limited and controlled. Hospitals can make a fortune keeping terminal patients alive, lawyers can make a fortune suing doctors and hospitals, and insurers are doing just fine. But the public and the country as a whole are being destroyed.
So I think increasing consciousness about end of life expenses can't hurt. Yes it could go too far and become a nightmare, but that's true of anything.
Charlie (Colorado) said,
It's worth looking at the hiustory of that disclaimer, too. the document was retired in 1997, reappeared this year without the disclaimer, grew a milder version of the disclaimer after it was linked by Drudge, and got that version of the disclaimer after the designated fall person was was more or less destroyed by Chris Wallace.
Personally, I don't like this doc: honestly, there were times I would have filled it out to say "give me a DNR" several times in the early 90's when all I really needed was 20 mg of Prozac.
Donna B. said,
Whenever someone or some group sets about to raise consciousness, it's done with a goal in mind and it never hurts to question what the goal is and how it's to be accomplished.
The first thing that needs to be done is to define exactly what "end of life" means. Is it when a terminal disease is diagnosed? When there are no treatments left that would maintain or increase quality of life? And what does "quality of life" mean?
But… wait. The above is thing 2. Thing 1 is to ascertain whether our government has the power to define, educate, and/or encourage such discussions. Some will say that since the VA or Medicare is paying for the care that the government has a say. But that say is strictly based on cost.
Perhaps the gov agencies that pay for medical care should just say there's no coverage after you reach 80. That's a few years beyond life expectancy, so that should be plenty, right?
However aware the entire country might become of the need to address this issue, it still has to be individual/family choices. No regulations can be written that would not be unfairly arbitrary.
Whatever the choice should be, the government should not be involved in making it or paying others to encourage the decisions as a paid medical service.
PatHMV said,
The question, realpc, is who decides what is "futile," and how good are we at determining that? Read this, about concerns being raised in England about seniors being written off as dying, and basically placed under continuous sedation which will mask any signs of whether they are improving or not.
Even where we know that, say, 95% of people a particular age with a particular condition will die within 2 weeks, we can't distinguish those 95 from the 5% who will survive with moderate treatment and live several more months or years with good quality of life.
As I've said before, my grandmother was in very bad shape, about 4 or 5 years before she died. She was in a drug-induced coma while doctors tried to figure how and whether she could be saved. Eventually, they (in conjunction with my grandfather, of course) decided to amputate her leg. She perked right back up after that, and had several very good years after that. It's entirely WRONG, if not downright evil, for the government to insert itself into the decision-making process about whether the care given to my grandmother, while she was in fact close to death, was "futile" or not.
michael grant said,
I went through all of these questions — some of it fairly hair-raising stuff — when I had my will redrawn in North Carolina. Actually I would have appreciated someone to explain some of the scenarios. Someone other than a lawyer.
Yes, it's all rather grim. But it's something sensible adults should be able to cope with. And it's a service that the VA should provide. I really don't see the problem. People die — they should take a minute and think about it, plan for it.
The alternative is to simply assume that the doctor, hospital, relatives or the government — in the form of law — has a right to keep you in a sort of twilight world of pain near but not quite over the line into death. Personally I'd like to have the right to stop strangers from deciding my end. This is a case where the default setting — keep a person alive and damn the pain, the indignity, the cost to family — is barbaric.
I've got no problems with doctors, lawyers, priests, family, and other relevant parties initiating a discussion on the topic. Everybody should do so, because it could happen to you any day. All it takes is one bus and you being in the wrong place at the wrong time.
But I strongly object to government bureaucrats (which may include doctors, if they are government employees) steering the discussion in any particular direction. And it's very easy to steer and push a particular viewpoint in such conversations. It takes great care to avoid it, in fact.
Charlie: no, wait. The document was created in 1997, not retired. Then "later" — at some indeterminate time between 1997 and 2007 — it began to be used in the VA, given to retirees . Then in 2007 it was either suspended because of concerns the Bush admin had about faith-based perspectives being left out, or it was given an independent evaluation with positive results and submitted to an expert panel, including relgiious ministers. The timeline is very unclear.
Michael: yes, and sometimes it's family members who keep you alive and insist that everything possible be done. My uncle was like a Roman — a hedonist and harmless amateur roué when young, a Stoic in old age. One of his sons, raised secular and scientific, converted to Orthodox Judaism. I think it's against Jewish ethics, but that was the son who couldn't let his father go and insisted he be put on a ventilator when he'd had a foot amputated (he had atrial fibrillation and so was throwing blood clots), was in agonizing pain, and began to go down with pneumonia. Eventually they weaned him off the ventilator — i think they even put him back on it once and then my cousin finally agreed not to do it again. Then his kidneys failed and they did dialysis a couple of times before they finally let him go. It made altogether for about six weeks of misery for the sake of the living, who lived in Switzerland and California and needed to come and spend some time with their father before releasing him. He couldn't or wouldn't speak again after he finally got off the ventilator. He communicated some with his sons, grandchildren and me by raising and lowering his eyebrows.
Pat: Notice my story about J. What if someone at the hospital had been pushing me to withhold antibiotics?? The DNR about heroic measures was presented to me as a question, with great tact and delicacy. As it happened, the doctors and I agreed that it was common sense, but I didn't get the feeling that they were trying to sell me on that outcome. No one pushed me about anything except a little nudge about a nursing home, which I'm impervious to. (Seeing how J deteriorated during two days of uncomprehending generic care just confirmed me in that adamancy. People say, "But what about you?" What about me? What else/better have I got to do? By now I have — subjectively, at least — very little left to lose. What is this glorious full life I should be entitled to have? Cosmetic surgery and trying in vain to pretend I'm 15 or 20 years younger than I am? Ecotourism with Elderhostel? As far as I'm concerned, right now my life is as full as it's ever going to be again. Could it surprise me? Sure. I could fall in love with somebody's kid and wind up being an adopted granny-nanny. I could fall in love with some silver fox. I could write a best-selling book on cats. I could end up doing field research on tropical birds or Siberian tigers. But I'm not counting on any of it and it's all optional. At this age and beyond, I am optional. Or at least, seeing it that way is a good survival strategy right now.) But what if someone had been pushing me, saying "He has dementia, his quality of life is lost, why treat him?" We would have missed the fact that he wasn't nearly as far gone as he appeared.
amba said,
In keeping with my Compulsive Copyeditor penchant for eliminating unnecessary syllables from words, I think I'll just cut to the chase and have cosmic surgery.
Right, Annie. Sounds like you had good doctors, having an entirely proper conversation. But there's plenty of bad doctors, bad social workers, and bad bureaucrats out there, too. As you undoubtedly know, people faced with such decisions are very vulnerable, emotionally, and generally tired and very stressed. Existing tensions in the family are often magnified. So the family are going to either be in a lock-down mode, where they are fixated on some choice they've already made, or they are going to be highly susceptible to any type of persuasion or urging from an individual in authority.
From what you have written about J I consider him to be a "vital" person… one whose presence is full of life, though they may be confined to a wheel chair or bed. I picture him similarly to the way my grandmother was… in a wheel chair and blind but so active in her own way and interested in Life.
There is no way that one can predict what quality of life they may find acceptable. Had you asked J 20 years ago if he would want to live the way he is living today, what might his answer have been? Is it possible that he might have said… "no way would I want to be confined to a wheel chair!"
It is not possible for us to define a quality of life that we are not able to accept as long as mental faculties are still working. We are human and we want to live, unless we are suffering from a depressive illness of some type.
Donna, that's true. The human mind and spirit (Geist, dammit) is almost infinitely adaptable. People have devised livable lives for themselves in prison cells. The extreme case must be The Diving Bell and the Butterfly, a book a completely paralyzed man wrote by batting an eye.
Library Journal wrote:
[A] marvelous, compelling account of Bauby's life as a "vegetable," full of humor and devoid of self-pity. Although he was trapped in the diving bell of his body, Bauby's imagination "takes flight like a butterfly….You can wander off in space or in time, set out for Tierra del Fuego or for King Midas's court." His celebration of life against all odds is highly recommended. [Julia Tavalro, who suffers from the same condition, has also written an excellent account, Look Up for Yes.]
An Amazon reviewer wrote:
Public opinion surveys reveal an interesting contrast in modern opinions on the "right to die." Contrary to the accepted wisdom, the so-called right is favored by those who are young and healthy, but opposed by those who are old and sick. The very premise which underlies such a right is the belief that the quality of life experienced by the aged and the ill is so inadequate that they would willingly choose death instead. In fact, the evidence suggests that–despite the anecdotal horror stories with which all of us are familiar–people generally cling to life even in the face of suffering which seems unendurable to the well. . . . In these times when people tend to complain about the pettiest matters, [Bauby] reminds us that even when life is genuinely difficult, it is still quite beautiful and invaluable and well worth living.
Because I'm so athletic (not an obsessive exerciser-every-dayer, but someone who could've been a depressive deskbound intellectual for whom "getting physical" made life worth living), I can't imagine being physically incapacitated. Of course it could happen, though. And after a period of anger and depression I would probably adapt and find a quite satisfying way to live. People do it every day, unfortunately and fortunately.
Donna, we wondered the same things while considering whether to authorize the doctors to amputate my grandmother's leg. She was very politically active, and she danced with a tap dance group of fellow grandmothers and great-grandmothers. She also was very active with animal shelters, helping to take care of the dogs there. We jokingly would say that she will kill us if she wakes up without a leg. But, after it happened, she adapted and made the best of life, and enjoyed most of it.
Your second paragraph is so right. It's easy to say "if so-and-so happens, I'd rather just die." But even people who have said that, and survived to find themselves in such circmustances, very often continue to cling tenaciously to life, and to find joy in their lives.
Quickly, because I've got conference calls all day…
* The really interesting timeline is the progress of that disclaimer, the point being that it was originally published with no disclaimer.
* Serious question, I'm not trying to start a fight: how did you come to the conclusion the "death panels" thing was wrong? Or is it that the phrase itself was too much for you?
* Something I noticed the first time I was laid up with a bad knee injury is that being impared that way was itself very depressing. I don't know how to tell the difference between a serious conclusion life isn't worth living and a depression that could be treated.
To answer your serious question: there was no mandatory end-of-life counseling in the bill. If a patient wanted such counseling, Medicare was to pay a doctor for his time thus spent no more than once in five years. There was no requirement that people undergo such counseling or that doctors offer it aggressively.
This VA booklet, however, reveals how bureaucracies work in practice without the details of their regulations necessarily being spelled out in legislation. Having seen the booklet, I can imagine it being spread beyond the VA throughout the government health system, especially if there was a public option. The "expert panels" that approve, prescribe, or revise it seem to have no accountability to the public (they're unelected), and there appears to be no public input into the process. It's bureaucrats choosing "experts." That smiling Dr. Pearlman strikes me as a creepy character! And it's NOT that I think the subject of death and dying is taboo. I DO think we need to think more about when and how to let go — of our own lives or of each other. (And of course even then we won't get it 100% right. That's impossible.) But I also think (based on experience) that every situation is so unique that there is no way to make a set of rules that will apply to all UNLESS the criterion is the completely impersonal Procrustean bed of cost limits.
It's very complicated. I've just been reading about current cancer treatments, and how some very expensive, highly touted new cancer drugs (Erbitux?) in fact prolong life by only a matter of weeks. We never get enough of life (unless we're depressed!), but should the rest of society pay for terminally ill people to extend their dying by a few weeks? On the other hand, the person who wrote that was knocking all those drugs as overhyped, across the board, and mentioned Gleevec, and I happen to know someone who has chronic myelogenous leukemia, which can be kept in remission by Gleevec for many years (and is, in his case), even if it's almost the only disease that can.
"At this age and beyond, I am optional."
You are genuinely selfless. That is good, or not entirely good, just depending on anyone's point of view. However it's a bad message for old guys/girls who have been selfish all their lives and now it's too late for us to change. And when I say I'm selfish I really just mean there are some things I love to do, and I am not different now than when I was a child with crayons. I am selfish exactly the same way as I was then, or in any phase of my life when I became obsessed with trying to learn something. And no matter how obsessed I was with whatever guy I was in love with, the things I loved doing and learning prevented me from being totally relationship-obsessed. These things prevented me from getting depressed in spite of all life's normal problems.
These things I have been obsessed with are the center of my life, more important than romantic relationships or family, even though those are very important to me. No one I love intensely has ever died, but that day will come and I don't know how I will survive it. But I do know that I will still play my banjo.
And Amba you don't seem like the women I know whose lives are 100% about relationships and love. You are a creative intellectual, a writer, someone who is interested in many different subjects.
My advice, which you don't want to hear, is to work on your selfishness because you won't always have J to take care of. I am not advising you to be like me, because I am weird, at least for a female (I seem to know a lot of guys with obsessive hobbies and interests, and not as many women).
But you should find balance, and also please do us oldies a favor and stop saying we are optional after a certain age. I would get so depressed if I ever believed that. I try to pretend age is irrelevant — well actually some things even get better because we have solved some of our worst problems over the years, and we got over our shyness and time-wasting nonsense like that.
I try to continue loving the things about life I always loved, at whatever age. Of course I think about my age every day and am horrified.
Aw heck, I'm selfish that way too. Instead of conversing with J, or keeping him diverted and stimulated, much of the time I've got my head in the computer conversing with all of you, or reading something or writing something. In a way I'm just already practicing having a fulfilling life within given limitations. So rather than suggesting that I don't matter, I should say I've found ways to matter enough to stay in the game.
And no matter how obsessed I was with whatever guy I was in love with, the things I loved doing and learning prevented me from being totally relationship-obsessed.
Thank God. I can say the same about myself, but just barely, back in the day. Hormones are a bitch.
Obviously, if I outlive J, which seems likely (I am not pessimistic about that, just aware that no one ever knows), I'm going to figure out how to have a life. It's more that there's no point in longing for more freedom just now. It's better to think I wouldn't know what to do with it. It's good not to want more than I have just now, and not to think that I'm entitled to put J in a nursing home because I have such pressing and important things calling to me.
When it comes to talking about age, we can't help being propagandized by the culture we live in, which is so horrified by age, especially (but not only) female age, that celebrities would rather erase their individuality (which is what cosmetic surgery does) than proudly declare their vintage. We do need to resist that. I'm different than you in that I would probably feel better about all of it if I had had the child. I really feel I sentenced myself to a kind of obsolescence, irrelevance, exile from the busy center of the world, because 1) you continue to be embroiled in the world through ties to the next generation, and 2) as you get older you see that the ties that really count are the vital ones — especially parents, children, and lovers, then siblings and old friends. These are our visceral priorities. Aunts (even aunties! — an in-joke for a couple of people) are a frill.
But that's bullshit too. I'm embroiled with the next generation through this blog, as well as the karate dojo. (I have ties to my nieces and nephews, but dormant and needing to be activated; they're all elsewhere and busy and I don't see or communicate with them much. One of them was actually in Chapel Hill and never told me. She was very busy and wouldn't have had time to come visit us, so she just came and went without a word. That hurt — but she's promised never to do it again.) And I'm amazed by the responsiveness of little kids to older people, the way they open up and come towards you, all alight, even when you're a stranger. (According to anthropologist Sarah Blaffer Hrdy, the tie between grandparents, especially grandmothers, and children may have been part of what made us human and enabled us to survive as such, so that affinity may be instinctual, and that would explain why it's so vital.) I certainly remember older people, and not only my grandparents, being intensely important in my life as a child, and memorable. There were women in their 50s or 60s — teachers, relatives –I had what I can only describe as crushes on.
You do mourn the drama of being young, when you're right at the center of life. It's not just vanity, it's the excitement and the sense of being in the thick of things. I'm feeling that like everybody else, plus I don't think I'll ever get over the abortion.
We have a youth-oriented culture. But our generation still has the massive numbers, so that might change a little. i mean, our generation created most of the youth-obsession, didn't it? So we could just uncreate it. We aren't different when we're old, we just have done more things and had more thoughts. That could be an advantage in some ways, and in traditional cultures it was.
I am glad you are not revolving around J all the time and that you have a healthy kind of selfishness. It's so obvious you are not a traditional woman who lives only for her man. Not that I think there is anything wrong with that! What I mean is, complete selflessness would be wrong for a creative thinking person like you.
As for needing offspring to feel connected to the world, I really don't know. They do not always grow up to be your pal, and in many cases you would only see them on Thanksgiving, or else on Skype or whatever.
Since you did not have the child, there is no use in regretting it. But since you obviously have a great love of children you could always adopt a kid that no one wants. So what if it isn't your own DNA? Wouldn't it be so much nicer to take in a stray and give a hopeless person a chance at life?
It's wonderful that you are doing so much for J, but I am also glad to hear you also spend a lot of time reading and communicating. Do not feel guilty about it! It makes you a better companion for him, because otherwise you would be unhappy.
The worn cliche says "save yourself first," and it's true. A sick depressed person cannot help anyone at all.
We aren't different when we're old
We are different. We have less energy, more aches and pains, and less hormones — the latter, a huge difference, and not all for the bad! It's disorienting but freeing not to be driven by sex.
Of course, guys won't know what I'm talking about. Desire, at least driven desire, (as well as desirability) does track fertility. I don't mean sex is gone, or that it couldn't be an expression of love. But it isn't the rocket tied to one's tail that it used to be.
"it isn't the rocket tied to one's tail that it used to be."
Yes that is one thing that is different. It's exactly the same as ever, if someone else starts it, but you would never think of it otherwise. The mind is freed to obsess over less important things.
That fits my experience, actually. Of course, I'm half woman anyway. (On my mother's side.)
Rockets in one's tail? Better be careful, or Titus will be joining us here soon! ;-)
The only trouble is that the rocket powered more than just sex.
Pat: Shhhh!
I guess the physical drive lets up some for everyone. It may be more in the mind that men stay so interested, maybe because they actually still have a shot at it. There's something self-protective about not wasting energy wanting what you're not likely to get (if you're not happily paired up. Or very rich). Fortunately nature helps.
Maybe it was Gloria Steinem? who said something like, When my middle-aged girlfriends yowl about the agonies of love, I tell them, So stop taking hormones!
Chris the Feldenkrais teacher/PT came to J's strength training session and she and I did a Feldenkrais Awareness Through Movement "lesson" in the other room. At the end of it my lower back felt like a sixteen-year-old's and just walking was pleasurable and surprising. I keep forgetting (because I don't do it enough) how that method banishes the "same old same old" feeling and the "the vital part of life is over" feeling. Not only that, but it's something you could do and feel renewed even if you were very limited in your ability to move — it's about quality, mostly quality of attention, not quantity. It's a fount of endless discovery just of the dimensions of being alive. It's right up there with the pictures from the Hubble telescope. Taking that training from 2002-2004 really fortified and replenished me during the years when J was slowly getting sicker, even though I then had to drop out when he was falling and could no longer be left alone. But I needed a reminder that going back to that can be just as much of a lifegiver again as it already has been. I could probably also find a way to take a class here once a week, or twice a month, if I made it a priority.
I don't know anything about Feldenkrais, but have practiced yoga, or my version of it anyway, all my life. There are all kinds of things like this, and maybe most of them can be helpful. I think one reason we assume pain has to increase with age is that most Americans sit in chairs most of the day. This is unnatural and creates muscle tension and subluxations, and the life energy (qi) gets out of balance. I think we really should pay attention to our spine and muscles, and breathing, and it should be a priority. I had fibromyalgia since I was 30 so I really had to focus on health, which is not what I wanted to focus on back then. I still believed in modern medicine then so I expected MDs to know and fix what was wrong — they told me it was just normal aging! I was 30 for heaven's sake!
As a result I learned a lot about chiropractic theory, and I know from direct experience that their theory is pretty much correct. But I think yoga, or similar kinds of exercise, are better than chiropractic adjustments, because no one else can really do it for you.
Anyway, I imagine Feldenkrais has some resemblance to yoga, chiropractic, Alexander technique, etc., which all involve correcting subluxations and balancing life energy.
I really think you should make it a very high priority, because I believe mental health starts with physical health. And vice versa, I suppose. But we do need both. If we want to avoid focusing on how we are old and tired and have no energy, we can just do these things that we already know work very well.

redpajama_set_name: RedPajamaCommonCrawl


your employees their copies of Form W-2 for the previous year. If an employee agreed to receive Form W-2 electronically, post it on a website accessible to the employee and notify the employee of the posting by January 31st.
File an income tax return (Form 1040, 1040A, or 1040EZ) and pay any tax due. If you want an automatic 6-month extension of time to file the return, file Form 4868, Application for Automatic Extension of Time To File U.S. Individual Income Tax Return, or you can get an extension by phone if you pay part or all of your estimate of income tax due with a credit card. Then file Form 1040, 1040A, or 1040EZ by October 15.
If you paid cash wages of $1,900 or more in the previous year to a household employee, file Schedule H (Form 1040) with your income tax return and report any employment taxes. Report any federal unemployment (FUTA) tax on Schedule H if you paid total cash wages of $1,000 or more in any calendar quarter of the previous 2 years to household employees. Also report any income tax you withheld for your household employees.
File a previous calendar year return (Form 1065). Provide each partner with a copy of Schedule K-1 (Form 1065), Partner's Share of Income, Deductions, Credits, etc., or a substitute Schedule K-1. If you want an automatic 5-month extension to file the return and provide Schedule K-1 or a substitute Schedule K-1, file Form 7004. Then, file Form 1065 by September 15.


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Here Are the Local Elected Officials Who Expressed Sympathy With Capitol Rioters
Baked Alaska No-Shows Scottsdale Hearing, Warrant Issued
Could the Arizona Cardinals Possibly Suck Any More Than They Did on Sunday?
Matthew Hendley
Matthew Hendley | December 11, 2012 | 6:00am
"Well, it can't get any worse than that," we've said for several weeks now of watching the Arizona Cardinals lose in miserable fashion.
After seeing the Cardinals lose by 58 points -- by a score of 58-0 -- to the Seattle Seahawks, we're now wondering if it's actually possible to be any crappier.
-Arizona Cardinals Suck More Than Ever, Lose 58-0 to Seattle Seahawks
Seriously. Is it within the realm of possibility to compile a bigger shit sandwich than the Arizona Cardinals did in Seattle on Sunday?
There were eight turnovers. John Skelton -- who, in all seriousness, was named the starting quarterback at the beginning of the season -- threw four interceptions, and fumbled the ball away once. Ryan Lindley also fumbled, as did Patrick Peterson. Peterson also muffed a punt.
The Cardinals made it inside the Seahawks' 40 on two occasions. The first was on the first drive of the game, and Skelton tossed his first interception.
The second time, the Cardinals faced a fourth down on the Seahawks 39, after one of the Cardinals' best drives of the game, which lasted six plays and went 23 yards. Coach Ken Whisenhunt sent in Dave Zastudil for the 30-yard punt with the Cardinals down 51 points.
Only two teams have been shut out worse in the Super Bowl era than the Cardinals were on Sunday, and they both suffered 59-0 losses -- one point crappier than the Cardinals.
So, let's go to this morning's question: could the Cardinals possibly suck more than they did on Sunday?
Cast your vote below:
Arizona Democrats Call for Federal Investigation into Local...
Scottsdale Prosecutors Seek to Revoke Baked Alaska's Release...
Andy Biggs Refused to Wear a Mask in the Secure Room During...
Two Congresswomen Stuck in Room With Maskless Andy Biggs...


What steps should millennials take to get better sleep at night? Dr. Daniel Gartenberg is a sleep coach and consultant that is devoted to helping people sleep better. There are a number of environmental triggers that have an impact on each person's individual 24 hour sleep cycle. As Dr. Daniel Gartenberg states in the interview: " Getting that sunlight in the morning for at least 30 minutes is a really good way to entrench your rhythm and ensure that you'll be tired at night".
Whether you are a college student working on assignments late into the night or busy running a successful company, each of us can benefit from getting a good night's sleep. In this episode Hala Taha and our guest Dr. Daniel Gartenberg discuss how we can develop a better understanding of our sleep cycles and adjust them to improve our daily lives.
For more on Dr. Daniel Gartenberg follow him on Twitter @DanGartenberg and visit his website at: http://danielgartenberg.com/.
There's a ton of research showing that people perform better on various memory and procedural tasks when they sleep compared to say not sleeping and practicing a lot.
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Prone vs. Supine
It's easy to confuse the meaning of prone and supine — and it's important to distinguish between them, because they're antonyms. (I also discuss here some of the synonyms of each word.)
Prone, from the Latin term pronus, means "inclined to," and it is commonly used in this figurative sense as well as to mean "lying face down." Pronate, used both as a verb and as an adjective, means "to bend forward" or "bent forward," respectively.
Prostrate, a synonym for prone, means not only "lying flat"; it has the additional connotation of "stretched out" and often refers to the adoption of that position to indicate submission, as a subject lying prostrate before a monarch. (Prostrate, not prostate; that's the name of a gland in male mammals.) Prostrate is also the verb form, and prostration is the noun form. (Prostration is not to be confused with obeisance, which refers to the mere act of bowing.) Procumbent is another synonym; it also describes nonrooting plant stems that trail along the ground.
Supine, from the Latin word supinus, means "thrown or turned backward," and describes someone who is lying on one's back; unlike prone, it has no figurative sense. Supinate is also an adjectival form, and supination is a noun meaning "the act or state of lying on one's back."
Recumbent is a synonym that also suggests the act of leaning back or resting, as on a bed or couch; in addition, it describes such a pose in visual art. Decumbent, meanwhile, also means lying down and in botany denotes a plant that does that but has vertical parts. (Yes, incumbent, meaning "one who occupies an office or position," is related to the other -cumbent terms here.)
Prone and supine each have rarely used adverbial and noun forms: pronely (or simply prone) and supinely, and proneness and supineness.
Pronation and supination are used in anatomical and medical contexts to refer to the position of limbs, especially, in sports medicine, to the placement of the foot while running; supination (or underpronation) can cause injury.
Supine also has a meaning as a noun; it refers to an infinitive phrase starting with to or, in Latin, to a specific type of noun.
Two terms similar to prone and supine are dorsal and ventral; dorsal refers to the back, and ventral refers to the abdomen. To help you remember which is which, think of how the first syllable of dorsal rhymes with porpoise, distinguished by its dorsal fin. Ventral, meanwhile, though its first syllable is not etymologically related to vent, can be remembered as the side from which you breathe.
Mnemonic clues to help you remember which is which include thinking of the pro- in prone (which actually means "forward") to remind you that when you are prone, your face is toward the floor or ground. Supine, meanwhile, can be related to spine, which when you are supine is in contact with the floor or ground.
Keep learning! Browse the Misused Words category, check our popular posts, or choose a related post below:
20 Types and Forms of Humor
Ten Yiddish Expressions You Should Know
15 Names and Descriptions of Effects
5 Responses to "Prone vs. Supine"
Geosota on April 10, 2012 10:30 am
Probably the best-known misuse is by (original) Black Panther Party leader Stokely Charmichael. In response to a 1964 article titled, "The Position of Women in SNCC" reputedly responded, "The only position for women in SNCC is prone." Of course, he meant "supine".
Sally on April 11, 2012 12:57 am
And Stokely deserved castration, whatever word he used!
venqax on October 11, 2012 2:04 pm
Why do you have to say prostRate? Why not just prostate in every case? See, I'm thinking of FebUary, and the rule of English pronunciation that says you can drop Rs whenever you want to, cuz they're just too dang(ed) hard to say in the middle of a word. Tempature and libary are two other perfectly acceptable examples.
Freima on October 15, 2016 2:36 pm
@Venqax – Why not say prostate instead of prostrate? Because 'prostate' is a different word entirely and has a meaning that is not at all related to 'prostrate'.
As for February, you can miss out the middle 'r' if you want to, but it's lazy and incorrect. The rest of us will continue to spell and say the word correctly.
Also – what 'rule'? My grammar school didn't teach that one.
Mary-Margaret Swofford on August 09, 2017 5:29 am
"Prone only sees the ground; supine sees the sunshine.". Supine and sunshine both begin with an "S", and "supine" and "sunshine" rhyme.
Another mnemonic for children:
"I write with my right and this is what's left", or
" I write with my left and that is all right!


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Health Ministry: New claims, no new programmes (Special to IANS)
New Delhi, July 23 (IANS/IndiaSpend) During Prime Minister Narendra Modi's first year in office, the health ministry has relaunched existing programmes and claimed credit for programmes not launched by the National Democratic Alliance (NDA) government.
Factchecker took a look at the claims and realities:
1. Mission Indradhanush, a new immunisation programme: Only the name is new
Claim: A new programme named Mission Indradhanush will target areas of low immunisation.
Reality: Mission Indradhanush is the new name for Special Immunisation Weeks (SIWs), which have been conducted every year in areas of low immunisation under the Universal Immunisation Programme (UIP).
Special vaccination campaigns were planned for seven to 10 days in 201 high-focus districts during March-June 2015 under Mission Indradhanush. But this has routinely been done in preceding years. For example, in 2013-14, four rounds (April, June, July and August) of SIWs were conducted in 31 states and union territories. More than 9.8 million doses of various antigens were administered to children.
Similarly, during 2012-13, SIWs were carried out in low-coverage areas and more than 17.3 million doses of various antigens were administered.
2. Mission Indradhanush will be world's largest immunisation drive: It already is
Claim: Mission Indradhanush, "the largest-ever immunisation drive", will immunise 8.9 million children.
Reality: UIP is one of the largest programs in the world, according to immunisation summary report jointly published by United Nations Children's Fund and World Health Organisation.
More than 20 million pregnant women and children were immunised during 2011-12, according to data released by the health ministry.
3. India Newborn Action Plan (INAP): One of many existing plans
Claim:Â INAP aims to end all preventable new-born deaths and still births by 2030.
Reality:Â INAP is the latest entrant to a long list of existing interventions under the National Health Mission (NHM) to reduce neo-natal and maternal mortality.
A few of these interventions and programmes are:
* Round-the-clock maternal care services at community health centres and primary health centres promotion of institutional delivery through Janani Suraksha Yojana (JSY) and Janani Shishu Suraksha Karyakram (JSSK) new-born care corners at all health facilities
* Special new born care units (SNCUs) and new born stabilisation units
* Home-based new born care through Accredited Social Health Activists (ASHAs)
* Prevention and treatment of anaemia with iron and folic acid tablets during pregnancy and lactation prevention of anaemia due to malaria, tackled by long-lasting insecticide nets and insecticide-treated bed nets
* Name-based tracking of pregnant women to ensure ante-natal, intra-natal and post-natal care integrated management of neo-natal and childhood illnesses
* Universal immunisation programme for about 135 million children against seven vaccine-preventable diseases through nine million immunisation sessions each year
* Capacity building of healthcare providers through training of nurses under NHM
Engagement of more than 0.89 million ASHAs village health and nutrition days
* Reproductive maternal new-born child-health+adolescent interventions in 184 high priority districts
The two targets proposed in INAP are (a) reducing preventable new-born deaths and (b) reducing preventable still-births to single digits, fewer than 10 per 1,000 live births by 2030 (as against 22 per 1,000 live births today).
4. India's first mental-health policy launched: Work began in 2011
Claim:Â Launched the country's first-ever mental health policy.
Reality: The work of framing a national mental-health policy began in April 2011, following a resolution on mental disorders adopted at the World health Assembly. The government constituted a policy group to frame a mental-health policy, launched in October 2014.
(In arrangement with IndiaSpend.org, a data-driven, non-profit, public interest journalism platform. Factchecker is a part of IndiaSpend. Manoj K can be contacted at [email protected])Â
← AAP leaders meet Rajnath, complain against police
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Hero MotoCorp's July sales up nine percent
Congress, BJP slugfest over Gen. V.K. Singh


Are you getting ready for the 18th annual Grove Park National Gingerbread House Competition! The competition date is November 15, 2010 and the sweet sugar and spice masterpieces will be on display November 17, 2010 – January 2, 2011 in ASHEVILLE, NORTH CAROLINA. I can't wait to see the incredible creations for 2010!! DETAILS HERE.
Gerry Hempel-Davis, A judge at every National Gingerbread House Competition since its inception. She was a lifestyle contributor for several years on NBC's Today Show and part of the production team at CBS for the Ed Sullivan Show.
Nicholas Lodge, Chef Lodge is recognized worldwide as a top instructor in the sugar craft arts and the author of numerous books. He has been a judge of the National Gingerbread House Competition since 2004.
Nadine Orenstein, Curator of the Department of Drawings and Prints of The Metropolitan Museum of Art specializing in Dutch, Flemish and German art. She brings her artistic eye and historical knowledge to the appreciation of gingerbread houses.
Mark Seaman, Founder of Marked for Dessert, a boutique cake shop in Chicago. He teaches the art of gum paste flowers at the Wilton School of Cake Decorating and the French Pastry School's L'Art du Gateau Professional Cake Decorating and Baking Program.
Carol Gable, has been a producer the last 15 years for the newsmagazine, "Dateline NBC".
Michelle Pulliam, Food and Leisure Coordinator for Southern Hospitality Magazine—Traveler.
Jane Robelot, is a nationally acclaimed television news anchor and correspondent and the recent recipient of a Peabody award. Jane interviewed such newsmakers as President Bill Clinton, First Lady Hillary Rodman Clinton, Evangelist Billy Graham as well as many actors and authors.
Denny Trantham, is the Executive Chef for The Grove Park Inn Resort & Spa. His southern Appalachian culinary skills are reflected today in his innovative and diverse Southern elegance cuisine that is offered throughout the resort. He also works closely with the local famers in order to provide the freshest ingredients, while also supporting the local economy.


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Santi Bartolomeo e Alessandro dei Bergamaschi é uma pequena igreja localizada na Piazza Colonna, em Roma, Itália, perto do Palazzo Wedekind.  Era conhecida antes como Santa Maria della Pietà por causa de um alto relevo sobre a porta, é dedicada a São Bartolomeu Apóstolo e a Santo Alexandre de Bérgamo. A moderna igreja de Santa Maria della Pietà em Roma está localizada no Vaticano. É a igreja regional de Bérgamo em Roma.

História
A origem da igreja (1591) está numa capela erguida pelo padre Ferrante Ruiz para o Ospedale dei Pazzarelli, o primeiro manicômio de Roma. Quando a instituição se mudou para a Via della Lungara, na década de 1720, a igreja foi entregue para a Archiconfraternità dei Bergamaschi, que a reconstruiu entre 1731 e 1735 a partir de um projeto de Giuseppe Valvassori. O patrono da confraria, Santo Alexandre, foi acrescentado à dedicação e o hospital passou a ser utilizado pelos próprios doentes da confraria. Ali está enterrado o cardeal Giuseppe Alessandro Furietti, um colecionador, antiquário e nativo de Bergamo.

A ordem, confraria, fundada em 1539, cuida da igreja até hoje, apoiando a cultura, os valores e as tradições de Bergamo em Roma.

Bibliografia

 Touring Club Italiano (TCI), Roma e Dintorni 1962:175.

Ligações externas

Igrejas de Roma
Igrejas barrocas de Itália
1735
1591
Igrejas nacionais em Roma
Giovanni Battista Contini
Roma R. III Colonna

redpajama_set_name: RedPajamaWikipedia


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PHOTOS: PCHS Volleyball hosts home opener
The Park City High School volleyball team hosted their home opener against Lone Peak Thursday evening, August 31, 2017. The Miners fell 3-1. (Tanzi Propst/Park Record)
Park City High School junior outside hitter Grace Stover (38) high-fives her teammates as she's announced as a starting player for the Miners at the beginning of the game against Lone Peak Thursday evening, August 31, 2017. The game was the Miners' home opener. (Tanzi Propst/Park Record)
The Park City High School volleyball team celebrates on the court after scoring a point against Lone Peak during the first set of the evening Thursday, August 31, 2017. The game was the Miners' home opener. (Tanzi Propst/Park Record)
Park City High School senior libero Audrey Malloy (11) serves the ball during the first set of the evening against Lone Peak High School Thursday, August 31, 2017. The game was the Miners' home opener. (Tanzi Propst/Park Record)
Park City High School senior Hali Lukacs (24) serves the ball during the first set of the evening against Lone Peak High School Thursday, August 31, 2017. The game was the Miners' home opener. (Tanzi Propst/Park Record)
Park City High School junior Emily Smith (6) sets the ball before it's sent over the net during the second set against Lone Peak High School Thursday evening, August 31, 2017. The game was the Miners' home opener. (Tanzi Propst/Park Record)
Park City High School senior center Bella Buchanan (10) cheers with sophomore teammate Jaynie Glasmann (22) after scoring another point against Lone Peak High School in the second set of the evening Thursday, August 31, 2017. The game was the Miners' home opener. (Tanzi Propst/Park Record)
Park City High School senior Bryna Simmons (16) celebrates a successful spike, scoring another point for the Miners, with teammates Jaynie Glasmann (22) and Emily Smith (6) during the second set of the evening Thursday, August 31, 2017. The game was the Miners' home opener. (Tanzi Propst/Park Record)
Park City High School junior Emily Smith (6) cheers on the court after the Miners score another point against Lone Peak during the second set of the evening Thursday, August 31, 2017. The game was the Miners' home opener. (Tanzi Propst/Park Record)
Park City High School's Bella Buchanan (10), from left, Jaynie Glasmann (22), Hali Lukacs (24), Audrey Malloy (11) and Grace Wiczek (42) celebrate on the court after winning 25-21 during the second set of the evening against Lone Peak High School Thursday, August 31, 2017. The game was the Miners' home opener. (Tanzi Propst/Park Record)
The crowd goes wild and Park City High School junior Emily Smith (6) cheers on the court after the Miners score another point against Lone Peak during the second set of the evening Thursday, August 31, 2017. The game was the Miners' home opener. (Tanzi Propst/Park Record)
Park City High School senior libero Audrey Malloy (11) barely makes it to the floor to return a volley during the third set of the evening against Lone Peak High School Thursday, August 31, 2017. The game was the Miners' home opener. (Tanzi Propst/Park Record)
Categories: Local News, Park City, Photography, Sports
Tags: canon, fall, gallery, high school, knights, local, lone peak, lone peak high school, matchup, Miners, Park City, Park City High School, pchs, photography, sets, sports, team, volleyball


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Rita - Jade Gooseberry Dress
£98.00GBP £145.00GBP
06 - £98.00GBP 08 - Sold Out 10 - Sold Out 12 - Sold Out 14 - Sold Out 16 - Sold Out 18 - Sold Out 20 - Sold Out 22 - Sold Out
About the Style: Rita is a shining star of a dress. She's the one you'll want to dance the night away in… Her shape is exceptionally flattering and helps enhance a beautiful hourglass silhouette. Her tulip sleeves are non-restrictive and allow for full arm movement. Rita's shape is inspired by original dresses of the 1940s and she's definitely got ...read more
About the Style: Rita is a shining star of a dress. She's the one you'll want to dance the night away in… Her shape is exceptionally flattering and helps enhance a beautiful hourglass silhouette. Her tulip sleeves are non-restrictive and allow for full arm movement. Rita's shape is inspired by original dresses of the 1940s and she's definitely got that special touch of vintage elegance about her. We make Rita from Tencel which has the same floaty weight and feel to rayon (the material that this style of dress would have been originally made from).
About the Print: Cultivated gooseberries were unknown until late in the 16th century yet by the end of the nineteenth there were as many as 2,000 named varieties. This was due almost entirely to the ingenuity of amateur growers, especially in the industrial Midlands, who were spurred on in their breeding programmes by annual competitions (still held in a few villages).
About the Fabric: We continue to use the ethical superhero fabric, Tencel™, for many of our clothes. Tencel™ is made from the pulp of Eucalyptus trees. It has the feel of vintage rayon - beautifully floaty and drapey, it washes really well and is biodegradable. It's the most environmentally responsible fabric that we have come across and we love the look it gives to our dresses.
Eco credentials:
100% Tencel™
Corozo Nut buttons (plastic free and biodegradable)
Siri is 5' 4" and is wearing a Size 10.
Our dresses are designed to be hand washed or machine washed at 30 degrees. It's always a good idea to wash with similar colours. For further details please refer to the label inside the garment.


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Q: Real Time Data from Sqlite database through Room outside Activity/Fragment following MVVM Model I am following the MVVM Model. I would like to have Real-time data from SQLite database through Room (Results shall available as soon as data changes in Database). With LiveData, we can get results in Activity/Fragment. Callback also won't good on this type of requirement since data should be pushed from the database. Is there any way I can get in any class outside of activity/fragment?.
Thanx in advance for your help.
EDIT
Putting sample code for better understanding..Is there a way to observe Room database Table so that we always have latest data from table?
  Filter filter =  mCustomerFilterDao.fetchcustomerSettings(settings);
  // Want to add observe for filter table so that we have latest customer
  //settings. This is my Query.
  List<Book> booklist = new ArrayList<>();

 for(Book book:bookrecords)
 {
   if(book.status == filter.status)
     {booklist.add(book);}
  }

redpajama_set_name: RedPajamaStackExchange


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AI used to detect genetic anomalies in people with autism
An artificial intelligence (AI) system has been used to detect a collective of genetic causes for autism spectrum disorder.
Chloe Kent
The results of the study prove that mutations in regulatory DNA can cause a complex disease. Credit: Shutterstock
Researchers at Princeton University Lewis-Sigler Institute for Interactive Genomics analysed the genomes of 1,790 families with simplex autism spectrum disorder, in which one child presents with the condition but no other family members do. The AI then sorted through 120,000 genomic mutations detected in each of the participants to isolate those which were affecting the behaviour-related genes of people with autism.
The results have been published in the journal Nature Genetics.
The deep learning AI performed successive layers of analysis to pick out patterns that would be indiscernible to human analysts. It was able to teach itself how to identify biologically relevant sections of DNA and predict whether or not they played any role in the 2,000+ protein interactions known to impact gene regulation.
The system also predicts whether disrupting a single pair of DNA units would have a substantial effect on those protein interactions.
"The algorithm 'slides along the genome' analysing every single chemical pair in the context of the 1,000 chemical pairs around it, until it has scanned all mutations," Princeton University researcher Olga Troyanskaya said.
This means the system is able to predict the effect of mutating each and every chemical unit in the entire genome. In the end, it reveals a prioritized list of DNA sequences that are likely to regulate genes and mutations that are likely to interfere with that regulation.
Less than 30% of the participants affected by autism had a previously identified genetic cause for their diagnosis prior to the study, but the newly found mutations are likely to significantly increase that fraction.
The AI's predictive ability proved key, the researchers said. Previous studies into the genetic route of autism struggled to detect any significant difference in the number of mutations in the behaviour-regulating genes of people with autism versus neurotypical people. However, the Princeton researchers' AI looked into mutations predicted to have a high functional impact and found a significantly higher number of these in affected people.
The researchers said this information could be hugely important to the family, friends and physicians of people with autism as it will help discourage them from making overly general assumptions how one person's autism might be classified with others.
Princeton University researcher Chandra Teesfeld said: "They say that when you meet one person with autism you have met one person with autism because no cases are alike. Genetically, it seems to be the same way."
The results of the study prove that mutations in regulatory DNA can cause a complex disease, and the researchers now believe their algorithm can be generalised to discover the genetic contributions to a wide range of conditions. The approach could be particularly helpful for neurological disorders, cancer, heart disease and many other conditions that have eluded efforts to identify genetic causes.
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8124610500 this number holder Mr.gobi.his Rs.10000 amount taken in the my room. please his now here the city & address given.
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The biggest mystery of Super Bowl LI has been solved, and, no, it's not how the Atlanta Falcons managed to blow a 25-point lead in the second half.
As first reported by FOX Sports NFL Insider Jay Glazer, the FBI and NFL security have found Tom Brady's stolen jersey, which has been missing for a month and a half.
The NFL issued the following statement regarding the investigation, saying Brady's Super Bowl XLIX jersey was also found. They were both found in the possession of a credentialed member of the international media.
The jersey was valued at $500,000, which makes this potential crime a first-degree felony, assuming it was indeed stolen.
At the time, Brady said he placed his jersey in a bag in the locker room. When he returned, it was no longer there, and thus the search began.
Because the game was in Houston, Texas Lt. Gov. Dan Patrick enlisted the Texas Rangers to help find it. They were unable to do so, but the FBI apparently was. Glazer added that the jersey was found on "foreign soil," which is why the FBI was involved.


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An asylum seeker is a person who has left their country of origin and formally applied for asylum (international protection) in another country but whose application has not yet been concluded.
A refugee is a person who has fled conflict or persecution, applied for asylum in another country and been granted refugee status by the government of that country; been recognised as needing international protection because it is too dangerous for them to return home. They are protected under international law by the 1951 UN Refugee Convention, which defines what a refugee is and outlines the basic rights afforded to them.


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I have a post on Expo.Live.com regarding Scam activity. This post is fairly prevalent on the site and gets a fair number of views. More recently Microsoft has become slightly more proactive in handling this situation on their site (previously it was a free for all). There are still a lot of people who are not sure where to go for timely support, or who have found information and would like to share what they have discovered. I am offering this blog and post to help with that effort.
One thing that I would like to point out is that there are a lot of scams that claim to be originating from people in Nigeria (and a lot of other countries), when in fact they are from here in the states and the addresses they send you are part of their scam. Please be aware and use the resources at the end of this post to help guide you in the right direction.
I will start with my experience on expo and add a few resources I have. Please give me your feedback here or on expo and I will be happy to keep it around for everyone to benefit from.
Offer advice on how Western Union will verify the shipment prior to releasing payment.
If you follow through they send you a label with a Nigerian postal address. The email they send you is not from customerservice@firstdatacorp.com which is the valid western union customer service email address (mine was from firstdatacorp@mail.com).
http://www.ripoffreport.com consumer advocacy site where consumers who have been wronged can share their experience or read about others experience..
Beware of unsolicited I.M's/Faxes/letters or emails from a foreign government official requesting assistance in the transfer of excess funds from a foreign country into your bank account. + Delete all foreign lottery emails and throw away foreign lottery faxes and letters cause they are ALL scams.
Visit http://www.bbb.org/alerts/Scam.asp and educate yourself about scams.


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Digital Music News has put together this handy little GIF showing the change in music consumption over the past 30 years. The pie charts show dramatic changes from the dominant LP and cassette formats in the eighties, the subsequent takeover by the compact disc in the 90's right up to the present day which includes the previously non-existent formats of downloads, ringtones, streaming and paid for subscription services.All the data is provided from the Recording Industry of America, head over to Digital Music News to see each individual image from the GIF.
Makes ya wonder what it will look like in 2044?
← New Mastersounds and The Nth Power to play Nectar Lounge September 23rd.


Actor Ryan Gosling and Director Damien Chazelle meet on set once again to showcase the remarkable achievement the U.S. made in 1969 by becoming the first country to visit the moon. The pair that brought us "La La Land" now feature the challenges that led up to the successful launch of spaceflight Apollo 11 on the big screen.
The opening scene sets the precedent for the turbulent journey ahead, as Neil Armstrong played by Gosling, struggles to overpower an out of control plane. His navigation through the turbulence shows just how strong his character is further intriguing moviegoers to see how this pilot lands a position with NASA.
"First Man" explores the painstaking race Americans faced to get to the moon back in the 1960s before the Soviet Union. A moment in history often depicted in television shows and movies has not quite been executed as precisely as this time.
Not only do we see the emotions through the trials and tribulations faced by the team at NASA but we see the way Armstrong dealt with the struggles that came with the out of the world challenges. While Gosling has said if given the opportunity to go to the moon he would "pass", the actor does a great job at highlighting Armstrong's real life endeavors and passion for space exploration.
Although space travel is often seen as a magical experience Chazelle focuses his time on highlighting the humanity of it all. The raw emotions astronauts felt during their attempts into space contrast the anger Americans felt after the loss of lives and millions spent.
From the opening scene to the ending, Chazelle does what many in "space movies" fail to do as he brings fear and endearment forward as a theme that usually is dismissed.
A man who is portrayed as beyond this world, indeed struggled with the reality of life and death throughout the course of his career. Armstrong seems to maneuver the world so eloquently, reacting to the opportunity to work with NASA almost the same as he did to the death of his ill daughter.
Cliche as it may be the movie reveals a side of the accomplished, history makers as just like everyone else. Overall the movie is just as much about Armstrong's historical achievement, as his struggle to find balance in the world and fight his internalized pain.


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https://www.mysanantonio.com/news/local/article/Texas-family-raising-money-to-bail-teen-out-of-7970406.php
Texas family raising money to rescue teen from 'Bible-based' gay conversion therapy camp
By Mariah Medina, San Antonio Express-News
Updated 10:51 am CDT, Wednesday, June 8, 2016
The family of a 17-year-old Austin-area girl are asking the public for help in their quest to "Save Sarah" from an East Texas Christian camp designed to "pray the gay away."
Photo: GoFundMe
A Texas teen's extended family is asking the public for help to "Save Sarah," a 17-year-old girl whose parents sent her off to an East Texas boarding facility to "pray the gay away" after she took her girlfriend to prom.
Joey Jordan, a University of Texas at San Antonio student, put together a GoFundMe page that has raised more than $39,000 that will go toward legal expenses incurred in the fight to rescue the teen from the facility.
RELATED: Central Texas student's 'Some people are gay. Get over it.' t-shirt too 'disruptive,' school says
While many have given without apprehension, others have expressed doubt in the story. Jordan updated the page to answer questions regarding where the funding would be going, who will be representing the family in the legal battle and why the teen is not legally allowed to leave the facility at her own will.
"Although 17-year olds are considered adults for certain purposes in Texas, state law permits parents to force their children to stay in a residential boarding facility until their 18th birthday," Jordan wrote on the page. "Additionally, the facility is in an extremely rural area. When Sarah attempted to walk out of the facility shortly after being placed there, staff quickly apprehended her and returned her to the facility, and she was punished for her escape attempt. When close friends of Sarah drove up to the facility in an attempt to free her, local law enforcement threatened to arrest them."
RELATED: Report: Texas pastor says Whole Foods 'did nothing wrong,' drops lawsuit over gay slur on cake
The Austin-area teen has not been identified by last name to avoid any unwanted publicity or scrutiny, but many have validated the claims of the GoFundMe page indicating that they have first hand knowledge of the situation, or their children go to school with the teen.
According to the GoFundMe page, Sarah will be forced to stay at the facility for an entire year. The boarding school, however, does not allow electronic communication visitors.
"So instead of being surrounded by friends and extended family who love and support Sarah for who she is, she'll be isolated in a place where the fact that she is gay is treated as a sin and an illness," Jordan wrote. "Instead of preparing for college and competing in the state debate tournament, she'll be doing forced labor every day and enduring Bible-based 'therapy' for her 'disease.'"
RELATED: Christian rock star Trey Pearson comes out as gay
Jordan said all left over funds will go toward a college fund for the teen who is also a member of the National Honor Society, top 10 percent of her class, cross country team and debate team.
The CHA Law Group representing the teen and her family confirmed the statements on the GoFundMe page on Wednesday.
"I can't comment on pending litigation, other than to authenticate that to the best of my knowledge, the background information on the GoFundMe shared by Sarah's cousin is truthful," Sarah's lawyer Christine Andresen said.
MMedina@mySA.com
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