text:
Battery Background
Mechanism of Injury
History/Incidence
Possible Complications
Future Directions
Education| April 2020
Anesthetic Implications of Button Battery Ingestion in Children
John B. Eck, M.D.;
John B. Eck, M.D.
From the Division of Pediatric Anesthesia, Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina.
Address correspondence to Dr. Eck: P.O. Box 3094, Duke University Medical Center, Durham, North Carolina 27710. john.eck@duke.edu. Information on purchasing reprints may be found at www.anesthesiology.org or on the masthead page at the beginning of this issue. Anesthesiology's articles are made freely accessible to all readers, for personal use only, 6 months from the cover date of the issue.
Warwick A. Ames, M.B.B.S., F.R.C.A.
This article is featured in "This Month in Anesthesiology," page 1A.
Submitted for publication September 2, 2019. Accepted for publication December 10, 2019. Published online first on January 29, 2020.
Anesthesiology April 2020, Vol. 132, 917–924.
John B. Eck, Warwick A. Ames; Anesthetic Implications of Button Battery Ingestion in Children. Anesthesiology 2020; 132:917–924 doi: https://doi.org/10.1097/ALN.0000000000003121
battery ingestion, child, esophagus
Foreign body ingestion is common in young children (those less than 5 yr of age).1,2 Most ingested items pass uneventfully through the gastrointestinal tract, but certain items may prove dangerous due to their size, composition, or location.3,4 The following Clinical Focus Review discusses the increasingly common problem of button battery ingestion, which, when left untreated can rapidly result in life-threatening complications, particularly in young children. The definitive management requires prompt recognition and endoscopic removal of batteries, often necessitating the use of general anesthesia. Awareness of the potential problems and recommended solutions for button battery ingestion is therefore of vital importance to practicing anesthesiologists.
Button batteries are round, flat batteries named for their resemblance to the button on an article of clothing. Sometimes referred to as disc batteries or coin cells, button batteries are increasingly common in small, portable electronic devices such as toys, hearing aids, watches, calculators, flashlights, and remote controls.5,6 Unlike common household batteries that are typically long, insulated cylinders with conducting electrodes at each end, button batteries have a relatively large, flat surface area for conduction of an electrical current. One side of the button battery is the positive terminal and the opposite side is the negative terminal.
Button batteries vary in voltage, size, and chemical composition. The nomenclature for button batteries is important in the identification of these characteristics. The 3-volt CR2032 battery (fig. 1) is one of the most common button battery types. By convention, the "C" indicates the battery chemistry as being lithium-based. The "R" signifies the round shape of the battery. The battery has a diameter of 20 mm and a thickness of 3.2 mm, hence the "2032" moniker.5 As the number and power requirements of small electronic devices have increased in recent years, a change to larger sized (greater than or equal to 20-mm diameter), lithium-based batteries with increased energy density (3 volt vs. 1.5 volt) has occurred. It is these larger, more powerful batteries that are associated with the most severe complications when ingested by children.7–9
CR2032 (20-mm diameter) lithium button batteries. (A) Size relationship to common U.S. coins. (B) Flat surface of positive battery pole (black arrow) on the left. Negative battery pole (white arrow) shown on the right with step-up to narrower flat surface.
Although button batteries can cause tissue damage when children put them in their ears or nose,6 they are particularly dangerous when swallowed. Especially in young children, larger button batteries may become lodged in the esophagus.6,7,10,11 Although a battery in the esophagus can be harmful in several ways, animal studies suggest that damage from lithium button batteries results from the generation of electrical current. With both poles of the battery in contact with the fluid medium of the esophageal mucosa, current can flow. The button battery's thin design and large surface area results in a low resistance circuit with high current flow driven by the power of the battery.8 Within a few minutes, electrolysis generates hydroxide at the negative pole of the battery, resulting in an increase in tissue pH. An alkaline caustic reaction ensues causing esophageal tissue liquefaction necrosis,8,12–14 beginning as soon as 15 min after battery contact.12,15 Injury may extend beyond the esophageal mucosa into deeper esophageal tissue layers as the battery-driven reaction continues. Clinically significant tissue damage can occur within 2 h of battery impaction.5,7,12,16 Esophageal perforation with extension into adjacent structures (mediastinum, trachea, vascular structures) may ultimately result, depending on the duration and the location of the battery within the esophagus.9,13,14,16–19 Progression to esophageal perforation is usually associated with a duration greater than 12 to 24 h (occurring only 2% of the time before 24 h) and becomes increasingly more likely with prolonged impaction.20 Importantly, even after battery removal, esophageal damage may continue to progress in the setting of a persistently high pH at the site of previous battery impaction,7 with late presentation of symptoms and even death reported several weeks after battery removal.17
Children are naturally curious about their environment. They often explore by placing foreign objects in their mouths and on occasion will accidentally swallow those items. The most commonly swallowed foreign bodies in the United States are coins, but shiny metallic button batteries are also appealing to children.3,14 More than 3,000 cases of button battery ingestion are reported in the United States per year and most of these occur in young children.6,7,21 Although this represents a small percentage of overall foreign body ingestions, it remains a significant risk of morbidity and mortality.3,7,14 The majority of fatalities and major complications associated with batteries lodged in the esophagus have been shown to occur in children less than 4 yr of age.7
The dangers associated with battery ingestion have been recognized for decades but have been evolving in recent years. For example, the number of emergency department visits related to battery ingestion has been increasing over time, rising from 0.14% of all foreign body ingestions in 1995 to 8.4% in 2015.3 Although the majority of children suffer no permanent harm from battery ingestions,6 outcomes have been worsening in recent years with a nearly sevenfold increase reported in the percentage of major or fatal outcomes associated with button battery ingestion.7 This increase is thought to be due to two factors: (1) a greater number of ingestions of larger-diameter (greater than or equal to 20 mm) batteries that are more likely to become lodged in the esophagus; and (2) more lithium cell button batteries with a higher energy delivery (3 volt vs. 1.5 volt) that are likely to promote a more severe alkaline caustic reaction at the tissue level.7 Regarding battery size, the diameter of an ingested button battery is the most important predictor of clinical outcome. Lithium batteries 20 to 25 mm in diameter account for more than 90% of major or fatal outcomes.7 Importantly, severe injury can occur with battery exposure in the esophagus for only 2 h, suggesting the need for prompt removal.7
Unfortunately, most of the fatal outcomes associated with button battery ingestion involve unwitnessed ingestions where a delay in diagnosis occurs.7 The diagnosis is also simply missed in many of the reported fatal cases due to nonspecific symptoms (for example fever, cough, irritability, drooling, vomiting, unwillingness to eat, or dyspnea).18,19 In the case of button battery ingestion, where rapid recognition and prompt removal is of paramount importance, this is particularly problematic.7
Radiographs are a necessary part of the diagnostic workup of a witnessed or suspected foreign body ingestion. If a button battery is found located in the esophagus, removal should be undertaken emergently.7,10,11,17 The radiograph may help to determine the size of the battery and its location. Compared to coins, button batteries have a characteristic double ring or "halo sign" when viewed on a plain chest x-ray. The negative terminal side of the battery is also narrower when viewed laterally (fig. 2).9,22,23 These findings may help differentiate a button battery from a coin but may also aid in determining the likely risk of complications if esophageal erosion were to occur by noting the level of the battery in the esophagus and its orientation. The "3 Ns" mnemonic (negative, narrow, necrotic) may be useful in anticipating potential risk since the negative pole is the narrow side of the battery on the lateral radiograph where an increase in local pH and tissue necrosis is most likely to occur.7 For example, if a button battery is located in the proximal esophagus with the negative pole facing anteriorly toward the adjacent trachea, there is a greater risk of developing a tracheoesophageal fistula.13,16,24,25
Button battery in esophagus. (A) AP view radiograph demonstrating a "halo sign" noted by ring around outer edge of disc. (B) Lateral view radiograph demonstrating a "step-off" sign noted by the change in diameter between positive pole (anterior) and negative pole (posterior) of the battery. AP, anteroposterior. Reprinted from Sahn et al.23 with permission from Elsevier, ©2014.
When button batteries are located in the stomach, the acidic environment and decreased likelihood of impaction compared to the esophagus make focal tissue damage in that area less likely.5 Clinicians may therefore elect to simply observe patients with gastric batteries.7,10,17 However, since esophageal damage can occur before reaching the stomach,16 symptomatic patients (pain, vomiting, or evidence of bleeding) may require a more urgent battery removal and evaluation for tissue damage.10,17,26
A number of complications have been reported in cases of button battery ingestion. Damage to the esophageal mucosa itself can result in long-term scarring and esophageal stricture formation. Perforation of the esophagus can lead to pneumothorax, pneumomediastinum, mediastinitis, or tracheoesophageal fistula formation.7,19 One of the more dreaded complications is erosion into the aorta or other major blood vessel, resulting in massive hemorrhage and death. Other complications include vocal cord paralysis from damage to recurrent laryngeal nerves, thyroid parenchymal hemorrhage, and spondylodiscitis of the spine, among others.16,27
Major efforts have been undertaken to inform the public of the hazards of button battery ingestion. Multiple government, industry, and academic entities throughout the world have issued public warnings and educational information on the hazards of button battery ingestion, many with recommendations for how to minimize the risk of exposure through prevention.27 Several highly publicized cases have also appeared in the press and have helped increase public awareness of the problem.28
In 2012, the Button Battery Task Force, was formed with a mission statement: "A collaborative effort of representatives from relevant organizations in industry, medicine, public health and government to develop, coordinate and implement strategies to reduce the incidence of button battery ingestion injuries in children."27 A multi-pronged approach from the Button Battery Task Force has promoted several improvements aimed at prevention. This includes child-resistant packaging of batteries with warnings on the outside of the packages, as well as on the batteries themselves. For example, Energizer button batteries (Energizer Holdings, Inc., USA) include a warning sticker on the negative terminal side that must be removed before use.27 Enhancements in battery compartment design on devices have also been recommended to include more secure housing in toys intended for young children, (e.g., they may require a tool to open them).27 These efforts may be helpful since most swallowed button batteries in children are taken directly from devices rather than from new battery packages.5 Legislative efforts have also been promoted by the Button Battery Task Force to address the problem. Unfortunately, despite these extensive efforts, button battery ingestions with associated complications continue to occur.3
The National Battery Ingestion Hotline (1-800-498-8666) at the National Capital Poison Center in Washington, D.C., provides information and guidance to both the public and clinicians regarding battery ingestions. Data from the hotline has been useful in identifying mechanisms to reduce the hazards of battery ingestion and in the creation and refinement of treatment guidelines. Analogous to the Malignant Hyperthermia Hotline, clinicians are urged to contact the hotline 24/7 for consultation and assistance with management in the care of patients with known or suspected battery ingestion. Detailed historical clinical information on outcomes and fatalities as well as safety tips and an up-to-date treatment algorithm for button battery ingestion are also available at the National Capital Poison Center website: http://www.poison.org/battery (accessed August 2, 2019).
A quick diagnosis and rapid removal of the battery can be challenging. Even in circumstances where the ingestion is known and a prompt diagnosis is made, battery removal in children usually requires general anesthesia in a facility equipped to perform endoscopy or esophagoscopy in pediatric patients. This may involve consultation with subspecialists or transfer to another facility, both of which take time. The clock is ticking, but in many cases, the goal of avoiding injury by removing an impacted battery within 2 h is simply not realistic. Understanding these limitations to rapid removal of button batteries, recent efforts have been aimed at potentially mitigating the local effects of battery impaction in the esophagus by reversing the increased pH at the battery site while efforts to remove the battery are underway. One such strategy is for children with a known or suspected battery impaction to drink small amounts of a weakly acidic liquid in order to neutralize the alkaline environment at the battery site. To investigate this possibility, Jatana et al.12 took cadaveric sections of piglet esophagus and positioned the most commonly ingested button battery (CR2032) against isolated esophageal tissue to simulate battery impaction and allow current to flow. Several common household beverages (lemon juice, orange juice, water, or cola) were irrigated over the batteries every 5 min. pH and temperature were measured regularly for 2 h. The results showed that lemon juice and orange juice were most effective in neutralizing the pH and in reducing the visible tissue injury, compared to control. Temperature was unchanged, suggesting that any possible exothermic reaction associated with pH neutralization was minimal.12
Similar studies using acidic liquids with greater viscosities (honey and sucralfate) have also demonstrated effective pH neutralization at the battery site using an in vitro piglet esophagus model.14 These thicker liquids may effectively coat the battery (thereby limiting contact with the mucosa) and potentially provide greater mitigation of the pH-related changes compared to thinner liquids. They are also more likely to be acceptable to young children compared to lemon or orange juice. To test the effectiveness of this concept in vivo, Anfang et al. anesthetized piglets and after testing the voltage of a new 3-volt lithium button battery, placed it manually in the proximal esophagus. Serial irrigations were then performed at the battery impaction site using either saline (control), honey, or sucralfate every 10 min for 1 h. The batteries were subsequently removed and the animals were awakened and allowed to resume a typical diet for 7 days. The results showed that the batteries in both the honey and sucralfate groups had discharged less than in the saline group, suggesting a protective effect. Both honey and sucralfate were associated with effective pH neutralization at the battery impaction site compared to saline control. Grossly, half the control animals experienced esophageal perforation compared to none in the honey or sucralfate groups. Additionally, histologic examination of the esophageal tissue 7 days after battery exposure revealed a greater degree of tissue damage in the control group.14
Clinical experience suggests that the tissue destruction from a battery impacted in the esophagus can continue to progress even after the battery has been removed with delayed presentation of symptoms days to weeks later. In some cases, late exsanguination and death have occurred from continued erosion into deeper tissue layers and blood vessels.16,17 Because the alkaline environment at the esophageal tissue level may persist even after battery removal, another mitigation strategy is to irrigate with an acidic solution (dilute acetic acid 0.25%) endoscopically at the impaction site in the esophagus at the time of battery removal. This has been shown to effectively lower the tissue pH in an animal model and may be undertaken to help minimize the progression of tissue damage after button battery impaction.12
As a result of the animal studies suggesting the benefits of pH-lowering mitigation strategies, the button battery treatment guidelines from the National Capital Poison Center were updated in 2018 (fig. 3).26 Added was a recommendation that those with suspected battery ingestion consume honey at home or on the way to the hospital. Exceptions include children less than 12 months of age (due to the rare risk of botulism with honey consumption) and those with battery ingestion of more than 12 h (due to higher risk of esophageal perforation).26 Patients should otherwise be kept nonper os. Once in the hospital setting with an x-ray confirming esophageal location of a button battery, sucralfate suspension may be administered instead of honey. Regardless of these strategies, battery removal by endoscopy should not be delayed and should still ideally occur within 2 h of button battery ingestion. Importantly for those providing anesthesia, recent consumption of honey or sucralfate should be anticipated and regardless of recent consumption of any other food or drinks, anesthesia should not be delayed due to non per os status in the case of button battery ingestion.
National Capital Poison Center. Button Battery Ingestion Triage and Treatment Guideline,26 updated June 2018. Reproduced with permission ©2010-2019.
Although it is hoped that new treatment strategies will decrease the risk of esophageal damage and the potential for perforation, this has yet to be evaluated. As such, urgent battery removal should remain a priority. Hospitals and treatment teams should consider creating their own local protocols for the care of patients with button battery ingestion based on published guidelines and in consideration of their own resources. This might include simply designating button battery ingestion level 1 trauma status in order to expedite treatment.29 A more thorough approach could involve convening a multidisciplinary team of primary care and emergency physicians, gastroenterologists, otolaryngology specialists, surgeons, radiologists, and anesthesiologists, among others, to develop a comprehensive institutional guideline for management of complicated button battery ingestion.17 In developing local protocols, delays in care should be minimized through effective planning and communication. Some hospitals have put in place special notification systems that immediately alert relevant on-call specialists (including anesthesiology) when the emergency department is expecting or evaluating a patient with button battery ingestion. This notification includes patient name, age, location of battery, and estimated time of arrival in order for the various teams to prepare. Anesthesiologists should play a key role in the expeditious management of patients once that announcement is made. For hospitals that are not well-equipped to care for a child with an esophageal button battery, the local protocol could establish a clear mechanism for rapid transfer to a designated center while mitigation techniques are underway, if that is determined to be safe based on the patient's condition.
In most circumstances, the operating room is the preferred location for button battery removal since patients usually require general anesthesia, the operating room is accustomed to emergencies, and the treatment of potential complications is more readily accomplished in that setting. Some hospitals may utilize a "hybrid" operating room with additional endoscopic, endovascular, and imaging capabilities. Ideally, the patient should be brought directly to the operating room from the emergency department or helipad in order to expedite treatment. In consideration of the potential for a full stomach and the need to secure the airway with an endotracheal tube for safe retrieval of a foreign body, a rapid sequence induction of anesthesia may be appropriate. Anesthesia induction agents should be chosen based on the hemodynamic stability of the patient upon presentation to the operating room.
If diagnosed early, most button battery removal procedures are likely to proceed uneventfully. However, recognition of the risk of esophageal perforation (especially with erosion into vascular structures) remains a key element in planning for anesthesia care. The location and orientation of the battery in the esophagus should be considered in assessing risk but ultimately, when esophageal perforation is known or suspected, particularly when there is evidence of bleeding, a number of additional steps should be taken. Specialists from general and/or thoracic surgery, interventional cardiology, and/or radiology should be in attendance, depending on the hospital's available resources.16,17,30 The need for massive transfusion should be anticipated and the operating room prepared accordingly. Banked blood should be immediately available. Large bore IV access should be obtained. Intra-arterial blood pressure monitoring and the availability of a rapid infusion device should be considered. Depending on the circumstances, central venous access may also be appropriate, although placement should not appreciably delay battery removal unless absolutely necessary. Of note, children with a history of a previous sentinel bleed, even if hemodynamically stable and without evidence of active bleeding, are at increased risk for subsequent bleeding and should be treated as such.17
In cases of massive hemorrhage, especially after development of an aortoesophageal fistula, definitive treatment might include either primary surgical or endovascular repair. A Blakemore tube has been employed in some reported cases of esophageal hemorrhage to minimize bleeding while definitive treatment is undertaken.16,17 Regardless of the technique utilized, it should be recognized that the historical survival rate from hemorrhage associated with esophageal button battery ingestion is low.7
In uncomplicated cases where esophageal damage is minimal and the esophageal pH has been neutralized with acetic acid after battery removal, patients may be extubated at the end of the procedure and observed in the inpatient hospital setting. Patients with complications, including those with esophageal perforation, may be more appropriately cared for in the intensive care unit and may need to remain intubated and sedated. Evaluation after initial battery removal may include computed tomography angiography or magnetic resonance imaging if vascular injury is suspected.10,16 Repeat endoscopy or other subsequent evaluation, as well as the duration of inpatient observation, will be guided by the severity of injury and in recognition that complications (including bleeding) may not become apparent for days to weeks after battery removal.16,17
Most efforts aimed at prevention of injury from button battery ingestion have focused on public education, battery packaging and warning labels, and mitigation strategies, as well as improvement in the battery housing design on devices. One additional mechanism may be the design of the battery itself. Updated button batteries that only allow current to flow when solidly placed in the housing of an electronic device have been considered as a way to potentially improve safety.27 One such design is the quantum tunneling composite coated battery, which, by incorporating a specialized coating on the negative terminal of the battery, allows current to flow freely in the high pressure environment of the battery housing of a device, but reduces conductivity in the relatively low-pressure environment of the esophagus.31 Future work with this and other changes in battery design may help to decrease the risk of button battery ingestion.
Despite numerous ongoing efforts to decrease the incidence and associated complications from ingestion of button batteries, it remains a significant potential source of morbidity and mortality, especially in young children. Recognition of the importance of rapid removal of batteries lodged in the esophagus within 2 h and of the potential complications associated with button battery ingestion is of vital importance to all who care for these children, including anesthesiologists.
Support was provided solely from institutional and/or departmental sources.
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Litovitz
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J Pediatr Gastroenterol Nutr
Yardeni
Golladay
Severe esophageal damage due to button battery ingestion: Can it be prevented?
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Rhoades
Mildovich
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Takekawa
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Copyright © 2020, the American Society of Anesthesiologists, Inc. All Rights Reserved.
Button Battery Ingestion: A True Surgical and Anesthetic Emergency
Anesthesiology (March 2020)
SEE Question
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Dynamics of Ketamine-induced Loss and Return of Consciousness across Primate Neocortex


text:
Bengt Anders Flodin, född 27 mars 1961 i Almby, är en svensk tonsättare, musiker och musikpedagog. Han undervisar sedan 1996 i musikteori, komposition och arrangering vid Musikhögskolan vid Örebro universitet.

Anders Flodin studerade åren 1980–82 musikteori och komposition för Sune Smedeby på Kävesta folkhögskolas musiklinje. Mellan åren 1983 och 1987 studerade han vid Musikhögskolan i Örebro för bland andra Olov Helge. Under åren 1987–89 bedrev fortsatta kompositionsstudier för Olav Anton Thommessen vid Norges Musikhögskola. Åren 1990–1993 studerade han komposition för bland andra Vladimir Bokes på Musikhögskolan i Bratislava och för Svatopluk Havelka på Musikhögskolan i Prag. Under åren 1985–1990 återvände han till flera sommarkurser i elektroakustisk musik för Rolf Enström och i komposition för Jan W. Morthenson på Nordens Folkhögskola Biskops-Arnö.

Anders Flodins musik har framförts såväl i Sverige som utomlands och han har samarbetat med flera framstående solister, ensembler och orkestrar.

Flodin är sedan 1995 medlem i Föreningen svenska tonsättare.

Priser och utmärkelser
1982 – Örebro läns landstings kulturstipendium
2001 – Carin Malmlöf-Forsslings Pris

Verkförteckning
Timat, balettmusik för kammarorkester (1990)
Klapperfält för flöjt (1991)
1991 för orgel (1991)
Nocturne för saxofonkvartett (1992)
Konsertant musik för blåskvintett, violin, viola, cello och kontrabas (1994)
Såg i min natt, vi störtade alla, sade: kom kom kom för blandad kör a cappella till text av Arne Johnsson (1994)
Trio för 3 gitarrer (1994)
Preludium för piano (1995)
Sinfonia för orkester (1996)
Musik för orgel (1996)
Konsert över fragment till en pianokonsert i h-moll av E Grieg för piano och orkester (1997)
Pianotrio (1997)
Bildningsoverture för orkester (1998)
1998, resonansmodeller för orgel (1998)
Tre sånger för sopran och piano till text av Joseph Brodsky (1998)
"Alla hundar är uppätna"
"Jag var bara det"
"När isen sopar igen havet"
Fragment utan titel för piano (1999)
Stråkkvartett nr 3 (2000)
Studio-Cadenza för klarinett (2000)
Il ritorno di Gottfried Reiche för orkester och tape (2001)
Presto (misura 80–83) för stråkorkester (2001)
12 upplevelsepassager, sonat för violin och piano (2001)
Momenti d'organo för orgel (2001)
Konsert violin och stråkorkester (2002)
Aria för piano (2002)
Col age för stråkorkester (2003)
Tid efter mörkrets färger, en skräckopera med libretto av tonsättaren (2003)
Svart stämma för valfria instrument (2004)
Danza macabra för gitarr (2004)
Handdeltats slut, stråktrio (2005)
Mellan två vatten för fyrhändigt piano (2005)
En alltför högljudd ensamhet, tre instrumentala madrigaler för flöjt och stråkorkester (2006)
Cold Prometheus för blandad kör med ackompanjemang (2007)
Purgatorio för kör och orkester (2008)
Venetianska strofer för saxofonkvartett (2008)
Fanfar och eko för 2 trumpeter och 2 tromboner (2008)
Marsyas för oboe (2008)
... för den stund, då din högra hand behöver vila ... för piano vänster hand (2008)
Rejchametamorfoser för slagverk (2008)
Cadenza e coda för flöjtorkester (2009)
Quattro pezzi för gitarr (2009)
Tre sånger för sopran/mezzosopran och piano till text av Federico García Lorca (2010)
"Si muero, dejad el balcón abierto"
"Me despediré"
"Ya pasó el fin del mundo"
Marche pour la cérémonie des Turcs för blandad kör och orkester (2011)
Corona – Apotheosis för stråkorkester (2011)
Nuage nuage för flöjt, horn och kontrabas (2011)
Arezzo – viaggio delle figure för piano (2011)
Sonata quasi una fantasia för cello och piano (2012)
Die Harmonie der Sphären för 2 pukor (2012)
Canzoniere, elektroakustisk musik för kontrabas och dator (2012)
La storia di Gilgamesh – Sintesi för fyrhändigt piano (2013)
Pre-Senza för 2 slagverkare (2013)
Kailash, elektroakustisk musik (2013)
Suono, testa, allucinazione, virus för piano (2014)

Källor
Verkförteckning på Svensk Musik

Referenser

Svenska klassiska kompositörer under 1900-talet
Svenska klassiska kompositörer under 2000-talet
Personer verksamma vid Örebro universitet
Medlemmar i Föreningen svenska tonsättare
Alumner från Örebro universitet
Män
Levande personer
Födda 1961

redpajama_set_name: RedPajamaWikipedia


text:
Autism shares gene expression pathways with schizophrenia and bipolar disorder
Nicholette Zeliadt | Spectrum | February 9, 2018
Gene expression patterns in the brains of people with autism are similar to those of people who have schizophrenia or bipolar disorder, according to a large study of postmortem brain tissue. The findings appear [Feb. 8] in Science.
All three conditions show an activation of genes in star-shaped brain cells called astrocytes, and suppression of genes that function at synapses, the junctions between neurons. The autism brains also show a unique increase in the expression of genes specific to immune cells called microglia.
"This study demonstrates for the first time that [gene expression] can be used to robustly define cross-disorder phenotypes that are shared and distinct," says lead investigator Daniel Geschwind, professor of neurology, psychiatry and human genetics at the University of California, Los Angeles. "And these phenotypes are related to the molecular and cellular pathways that likely have gone awry."
The analysis revealed that autism, schizophrenia and bipolar brains show low levels of gene expression in three modules characteristic of neurons.
Two of these modules are important for neuronal communication; the other one is involved in the function of mitochondria, which generate energy for cells.
"This is starting to pinpoint some of the common pathways," says Tomasz Nowakowski, assistant professor of anatomy at the University of California, San Francisco, who was not involved in the study.
Read full, original post: Autism Shares Brain Signature with Schizophrenia and Bipolar Disorder
Autism ethics: Is search for cure the right goal?
Older mini-brains could boost study of autism, schizophrenia
Some schizophrenia, bipolar disorder linked to brain pH imbalances
Depression, bipolar disorder, ADHD, schizophrenia and autism genetically linked

redpajama_set_name: RedPajamaCommonCrawl


Have you ever wanted to bring the timeless charm of Ancient Rome, with its stunning columns and grand marble statues, into your home? Or perhaps you prefer the equally resplendent era of the Greeks, with their heroes and gods and temples to both? Thanks to Multipanel's Classic Marble design, you can now achieve the aesthetic of either – and all at a price which won't empty the coffers or take an age to create. Rome might not have been built in a day, but that doesn't mean your bathroom can't be.
The clever design of Multipanel products means that they are mounted directly onto your wall's structural supports, eliminating the need for grouting. This not only means you can reduce installation times by up to 75%, but you can also ensure the panels will remain looking as resplendent as the day of purchase for years to come. That's because without any grooves or crannies in which mould and mildew can accumulate, all it takes is one wipe of a damp cloth and your bathroom's walls will return to their original brilliant sheen.
The panels themselves are constructed from 9mm waterproof plywood and come in three different sizes to meet the specific needs of any homeowner. There is the 2,400mm x 598mm option for those decorating a smaller space, the 2,400mm x 900mm alternative for slightly bigger environments and the 2,400mm x 1,200mm panel for generously-sized master bathrooms. Of course, even larger rooms can be accommodated for by fitting more than one panel together; the unlipped edges with which these ones are supplied allow you to do so in any way you please.
Those who are obliged to store the panels for a period prior to installing them are advised to allow them to acclimatise to ambient temperatures for at least 48 hours beforehand, especially if they have been kept in cooler conditions. However, as long as the installation is conducted as per manufacturer guidelines, each panel comes with a 15-year guarantee safeguarding the condition of its surface. Now that's peace of mind worth holding a forum over.


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Keynote: The Language of Peace in Colombia
Title: The Language of Peace in Colombia (13:00-15:00, Wednesday 13 June)
Keynote speaker: Juan-Luis Suárez, Director, CulturePlex
Our Keynote lecture looks at words used by the negotiating parties of the peace agreement signed in 2016 between the Government of Colombia and the FARC guerrillas. It specifically explores language of "conflict" and its inseparable term, "victims". The attempt to avoid the word "war" and its replacement by "conflict", "internal conflict" and "armed conflict" provokes a cascade of linguistic effects related to the temporality of peace, the political and legal condition of victims, and the analysis of the causes of Colombian war.
Juan-Luis Suárez is currently a full Professor at Western, holding a joint appointment in the Department of Modern Languages and Literature, and in the Department of Computer Sciences. He obtained a PhD in Hispanic Studies from McGill University, and a PhD in Philosophy from the Universidad de Salamanca. He also holds several other advanced degrees, including an executive MBA.
An internationally-recognized scholar in his field, Dr. Suarez's research interests are on 16th and 17th century globalization, on current sectors affected by digital innovation, and on cultural analytics and digital humanities. He has published over 70 articles and several books. He is currently the director of the CulturePlex Laboratory, which helps explore how culture affects the spread of ideas and changes the ways people think and behave. His most recent work focuses on the analysis of language around peace in Colombia, the use of computing techniques to assist in processes of transitional justice and the societal, legal and philosophical issues emerging out of the massive introduction of AI in human systems.
Dr. Suarez is a creative, multidisciplinary collaborator who has established extensive and wide-ranging, international connections. Much of his multidisciplinary work involves using big data analytics, digital innovation and engagement with companies and organizations to help them better understand and adjust to the digital world.


Big Savings for Small Business Contest Begins!
PUSH Buffalo is excited to announce Big Savings for Small Business, new referral program and competition hosted by PUSH Green!
PUSH Green's Building Retrofit Program, a newly formed program of PUSH Buffalo, has been created to help not-for-profits and small businesses with 10 or less employees.
-Receive a free Green Jobs/Green NY comprehensive energy assessment.
-Access low interest financing, including On Bill Recovery which allows customers to pay for energy efficiency improvements using the energy savings they realize after eligible measures are installed.
-Receive up to 50% grant subsidy for qualified energy efficiency retrofit readiness improvements, such as repair or replacement of roofs, foundation repair, moisture management systems, and/or remediation of environment hazards such as lead, asbestos, and mold.
1. Improve your own building – If you own a small business or represent a non-profit, call today to schedule an appointment for a free energy assessment to see what improvements could help you save on your utility bills. Call 716.881.1780 or visit WWW.PUSHGREENWNY.ORG to get started!
2. Help Others Save by Greening Their Buildings – Share the names of businesses or not-for-profits you know in Western New York who might benefit from energy efficiency improvements by clicking here by November 15, 2013. You can fill it out as many times as you want and, the more people you refer, the better your chance to win! We ask that you let them know that a representative of PUSH Buffalo will be touch.
Prizes for those who refer the largest number of small businesses and not-for-profits interested in learning about PUSH Green include Buffalo Bills Caps by New Era and more!
Let's work to green our community while creating quality jobs through Big Savings for Small Business!


John Baxter invites a stranger to share Christmas Eve dinner with his family. But not just any stranger. This woman is the recipient of his daughter Erin's heart.
Ashley Baxter Blake searches for the brother who disappeared from her family years ago. But, when she receives difficult news, she questions her need to carry on the search.


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Cultivating Strengths Interview
Reflecting Guidelines
Trust Interview
Documents/Readings
The Strengths Landscape Project
P&G Murang'a County 2017
Thika, Kenya & Johannesburg, July 2015
Reflective Practice Following Trust Interview
Individuals develop micro skills for success
To develop a team language of strengths
Team develops skills and rules of engagement needed for dialogical process
To increase team trust and connection
• Witnessing
• Listening
• Respecting (e.g., eye contact)
• Validation
• Mirroring
• Self-reflection
• Reflection-in-action
• Giving and receiving feedback
• Strength spotting
Background Information for Team Leaders
Why pay attention to Character Strengths? Character Strengths and Resilience?
There is a growing body of research that indicates that character strengths predict success in challenging contexts. For example, Duckworth, et al. (2007) found that "grit" or perseverance was a strong predictor of successful completion of basic training among West point cadets and US Army Special Forces completion (in Cornum et al., 2011). The character strengths of teamwork, courage, optimism, honesty, leadership, persistence and self-regulation are important mediators of success in situations characterized by significant physical, cognitive and emotional challenges (Matthews, 2008). Hope, kindness, social intelligence, self-regulation, and perspective buffer against the negative effects of stress and trauma (Park & Peterson, 2006, 2009). Posttraumatic growth in various dimensions corresponds with particular character strengths: improved relationships with others (kindness, love), openness to new possibilities (curiosity, creativity, love of learning), greater appreciation of life (appreciation of beauty, gratitude, zest), enhanced personal strength (bravery, honesty, perseverance), and spiritual development and religiousness (Tedeschi & Calhoun, 1995). Persistence, honesty, prudence, and love were inversely related to acts of aggression (Park & Peterson, 2008).
In her review of the US Army Comprehensive Soldier Fitness (CSF) Program, with a sample of over 1.1 million participants, Cornum, et.al. (2011) says "research has linked character strengths to positive adjustment among people who had experienced a significant psychological or physical illness (p.6)." While traditional organizational development measures have focused on repairing weakness, these approaches have little to offer with respect to how to improve the performance and well-being of large numbers of people. The resilience agenda outlined by USAID similarly suggests that they are "doing business differently" to help vulnerable communities emerge from cycles of crisis onto a pathway toward development by connecting humanitarian assistance and development programs more effective "across the common goal of building resilience (http://www.usaid.gov/resilience)." There is a clear and voiced need for "resiliency programming that contributes to a sustainable reduction in vulnerability and more inclusive growth." This cannot be realized in isolation. If these goals are to be reached within communities, NGO's will need parallel effective and measurable interventions for resiliency within their own teams and organizations.
The need for a team intervention model
Cooperrider (2011) suggests that for true organizational and community transformation the relevant question is: "How do we take isolated strengths and help take them to a new octave?" In addition to empirically based assessment and analysis, interventions need to have measurable impact. Clifton and Harter (2003) suggest that changes in one's sense of self helps interpret the situation and context around that person through a different lens and leads to changed behaviors and improved performance at work. Mayerson (2013) suggests that when people think that their organization is attending to optimizing their character strengths they are motivated and feel that they are up to the challenge. "Adequate resources have to do with not only having the right amount of person-power and associated physical resources, but also the degree to which people feel they and their co-workers are deployed to optimize their talents and motivation. In this light it becomes important to not only explore the prevalence of certain VIA character strengths but also the degree to which people feel that their top strengths and the top strengths of their colleagues are being maximized (2013, Mayerson, personal communication)."
Pre-step.
Please form a large circle with the group. Check-in and recall the rules of engagement. The team will unite for a common task. You will aim to have a feeling of oneness. You can speak one language and appreciate each other's strengths for the growth of your group and community.
The first pair of interview partners start the process. The first pair pulls their chairs outside of the circle and face each other. The rest of the group forms a semi-circle and gets ready to observe and listen with full attention. Each person tells the other one's story about trust while the group just listens.
Reflective feedback - This part occurs after the trust storytelling is over and the first interview pair has shared their stories. Now, the group offers appreciative reflections using the Walking the Journey Together rules of engagement. The pair stays outside of a closed circle and are free to just listen to the team reflect on the stories. They do not respond. They are free to purely listen. Each team member takes a turn and offers brief reflections. Usually speaking for about 2 minutes each, but this is flexible.
After the reflections are complete, the pair express gratitude for the reflections and then rejoin the group and another pair takes their place. Repeat with the next pair (see Step 1.)
When everyone has had a turn, the group discusses the process all together.
Rules of Engagement for Dialogical Practice
For your group to be successful, the members must trust and come from their strengths:
Suspend assumptions and keep an open mind. A dialogue is a shared quest for meaning.
Lift every voice. Our intention is to lift everyone's voice higher. Make sure every voice is heard.
Honor our differences. We can honor our differences without trying to reconcile them; Wonder, "Where is our common ground?" How do we walk the journey together?
We create meaning together (a "memorandum of understanding"). Without others meaning breaks down, value is lost, and the team loses its vitality.
Create a safe place. There must be a "safe container" created for the conversation, a place without hostility or fear.
Observe and listen to one another. Also listen to your own inner voice.
Be appreciative, attentive and respectful, allow space for the other without interrupting and offer positive rather than judging comments or questions…


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How to Identify Pastern Problems
Lumps below the fetlock on your horse's pastern can mean trouble. Here's how to identify irregularities on the horse's pastern and learn which are serious problems and which are merely blemishes.
Emily Kilby
Ah, the well-turned pastern: slender, shapely, yet incredibly strong, the bearer of thousands of pounds of pressure relentlessly imposed during the million steps of a lifetime. So much rides on the pastern, and so little goes wrong with it, at least compared to the fetlock above and the ever-challenged hoof below. Accidents, including fractures, cuts and abrasions, do afflict the area, for sure, and strains and pulls of tendons and suspensory ligaments crisscrossing the pastern do occur. But only two abnormalities--ringbone and sidebone--pop up on the pastern often enough to have earned labels in common stable parlance.
Both "bones" are evidenced by visible irregularities on the pastern, yet neither is always or even often the cause of lameness. Sidebone, especially, is usually more a matter of abnormal appearance than of altered function. Ringbone, on the other hand, does disable horses, sometimes temporarily, sometimes permanently.
Your greatest ally in deciding the seriousness of a pastern irregularity is the horse himself: You can bet that no matter how awful the landscape there may look to you, if the horse isn't limping, there's no cause for panic. Even if he is "off," the lumpy pastern may well be blameless in the lameness, an unfortunate concurrence with another painful place in the lower leg. By familiarizing yourself with the normal pastern landscape and function, you'll be prepared to determine which lower-leg lumps are harbingers of trouble and which are merely blemishes.
The Normal
The two bones called phalanxes or phalanges that make up the pastern are equivalent to your two longest finger bones. Your third phalanx resides within your fingertip and the horse's within his hoof, where it's called the coffin or pedal bone. So little movement takes place in the pastern joint connecting the long and short pastern ones that casual observation would lead you to believe a single bone links the fetlock and hoof. Yet the joint is visible just below a pair of dimplelike depressions on the inside and outside of the pastern two or more inches above the hoof. This pair of hollow spots is one of the "good" irregularities you'll find on the normal pastern. The joint connecting the short pastern bone and the coffin bone is not visible and barely palpable because it's just within the hoof capsule and overlaid, on its sides, by thick cartilage pads (collateral cartilages).
Flexibility is the primary feature of your own joined phalanxes, allowing you to curl your fingers to grasp and manipulate. In contrast, the equine design requires rigidity between the upper two bones so the pastern can act as a stiff strut and firm anchor for the soft-tissue "straps" that hold the leg bones in line. Because of the tendons' pulleylike action, which wouldn't be possible without an immobile pastern joint, the fetlock and the coffin joints rotate in concert with each other and the larger hinges up the leg during the touchdown, support, liftoff and airborne portions of each stride.
The tendons and ligaments on a weight-bearing pastern are difficult to discern because they hug the bone surfaces so tightly. If you lift your horse's leg and manipulate his hoof while palpating the pastern with your other hand, you should be able to feel the play of the extensor branches of the suspensory ligament angling forward over the sides of the pastern just below the fetlock. The deep digital flexor tendon lies along the rear aspect of the pastern joint: The one small window of opportunity for palpating it is in the vaulted arch formed by the superficial flexor tendon where it encircles the deep tendon just above the cleft between the heel bulbs. The extensor tendon, the strap that advances the in-flight foot to its landing position, runs down the front of the pastern toward the tip of the toe. On fine-skinned horses, these supporting structures are discernible not as bulges or lumpiness but as clean-edged ridges slanting across the bones.
The joining of hoof wall to skin is accomplished at the coronary band or coronet, the raised, rather hard area encircling the foot from heel to heel. Just inside the coronet, on the sides and toward the heels, are the cartilage pads overlying the coffin joint. These collateral cartilages, so called for their location on each side of the hoof, are partly within the hoof wall and partly above it. In addition to serving to smooth the transition between the slender column of the pastern bones and the wide "mouth" of the hoof capsule, these cartilages contribute to shock absorption and circulation. Rigid enough to protect the blood vessels and nerves passing through them to the hoof's interior, these cartilages are just sufficiently flexible to participate in the hoof's expansion and contraction during weight bearing and flight. Normal collateral cartilages are readily visible and palpable as smooth, somewhat "giving" bulges that are wider and higher near the heels and taper toward the toe. Draft horses and other individuals with blocky, upright pasterns may have collateral cartilages that, even when healthy and functioning normally, are quite prominent.
Just as normal human ankles range from fleshy to fine, stumpy to fragile, horses' pasterns exhibit a variety of normal "looks." By studying the lower limbs of many horses carefully with your eyes and your fingers, you'll come to appreciate the array of structural possibilities, from the long, sloping, slender model to the short, stocky, upright tree trunk. Versed in the normal landscape of bones, joints, soft-tissue supports and cartilage pads, you're set to recognize the lumps that could spell trouble.
The Abnormal
An angry streak of scar tissue running over one heel. An unyielding ridge jutting above the coronet at the quarters. A disorderly blossom of bone on the front surface of one pastern. A squishy bulge just above the cleft of the heels. These are some of the sights that can stop you cold when they pop up within your herd or show up on a prospective purchase. Unfortunately, looks alone aren't reliable indicators of each condition's implications for present and future soundness. Even before you engage a veterinarian to examine and x-ray these questionable sites, you can deduce a lot of vital information about a lump's seriousness from its location and characteristics.
Location: The where of the case indicates which type of tissue and which particular structure are currently or were once inflamed by a single traumatic event or chronic wear and tear. The possible sites include a joint surface, cartilage, a tendon or ligament, and skin and connective tissue.
The pastern provides two opportunities for joint-associated swellings. When the pastern joint is involved, the condition is called high ringbone. The bulge appears one to two inches above the coronet, usually with the greatest swelling on the pastern's front surface. Low ringbone affects the coffin joint, with the lumpiness appearing at the coronet, most often in the toe region. "True" ringbone (veterinarians call it "articular" ringbone) arises from joint edges or surfaces, with bone eventually proliferating in response to damage to the cartilage. Some articular ringbones are painful and progressive; others are "silent" for years or a lifetime.
"False" or "periarticular" ringbone is a similar response to bone-surface damage in the vicinity of, but not within, the joint. Direct injurious blows are the usual cause. Strains and tears of tendon and ligament attachments near the joints and periosteum-damaging wounds also can trigger the inflammatory process responsible for "false" ringbone. Only a radiograph can show for sure if the ringbone is true or false.
Hard ridges above the coronet at one or both quarters of the hoof tell you that the collateral cartilage(s) there have ossified, or converted to bone. A foot affected by sidebone, as the condition is called, may look boxy and upright and have contracted heels. When you apply finger pressure on the heels behind the pastern, you'll feel the resistance of bone rather than the slight give of cartilage.
A bulge or swelling at the back of the pastern just above the heel bulbs reflects wither tendon strain or inflammation of the tendon sheath through which the deep digital flexor tendon passes. These rear supports structures run all the way from the coffin bone to the knee/hock, and through the tendons are more likely to "blow out" from excess stress. Filling of the usual hollow between the long pastern bone and the side of the digital flexor tendon indicates strain of the inferior sesamoidean ligament.
Characteristics: The lump's appearance, feel and effect on the horse indicate how recently the problem has arisen and how painful it is.
The swelling's consistency reflects both the structure being affected and the strength and stage of the inflammatory response. A fluid-filled swelling is most often a sign of current inflammation in which the injured tissues are awash with healing juices. Sometimes injury or infection causes fluid-producing joint capsules and tendon sheaths to develop bulges that remain even after inflammation subsides. Bone-hard lumps are exactly that, calcification gone awry in reaction to a months-earlier disturbance in the bone's covering of cartilage or periosteum. Scarring of the skin tells of crises on the surface months or years ago.
Temperature of the tissues is a useful gauge in assessing the current activity of a lump. Heat is swelling's partner in inflammation, a sign that something is definitely amiss and an indication that there still may be an opportunity to halt the destruction. A cold lump is set, and though it's probably painless, it's unlikely to go away on its own.
Sensitivity to palpation indicates whether the lump is inflamed, the injury is recent or resolved and if pain is affecting the gait at least a little. The presence or absence of sensitivity is crucial to your veterinarian's diagnostic procedure: Palpation, flexion tests, temporary nerve blocks and having the horse jog in circles and sharp turns on a variety of footings all help pinpoint sensitivity in pastern structures.
No single characteristic will tell you that one pastern lump is benign and another is a career stopper. Instead, it's the convergence of characteristics with location and the horse's reaction to it that speaks of the present and long-term implications of the abnormality. The swelling, heat and pain associated with a superficial rope burn on the pastern can be intense enough to cause the horse to limp, yet good nursing care will make the lower leg as good as new. Conversely, a little on-again, off-again choppiness arising from a gradually developing ringbone won't look like much early on but later can mean the end of the horse's usefulness under saddle.
The Bad and Just Ugly
Owners of conformation horses don't want to see even the tiniest nick blemishing their animals' pasterns, but the critical issue for most other lines of work is whether an abnormal lump has or will have soundness implications. The joints are the most likely sites of lameness-associated swellings. Because high ringbone affects a joint with almost no mobility anyway, its prognosis is more optimistic, in many cases, than the outlook for low (within the hoof) ringbone. If articular inflammation eventually fuses the pastern joint (in a process called ankylosis) or if surgery produces the same effect through the use of screws and plates, the horse may return to his previous performance level. However, neither of these "cures" is swift, painless or, in the case of surgical intervention, without risk of complications.
On the other hand, low ringbone is a diagnosis you'd never like to hear for your horse. Given the need for a smoothly operating hinge at the coffin joint and its location within the hoof capsule, swelling, pain and diminished movement there really affect the horse's soundness. Painkillers help control the discomfort, but nothing will reverse the joint restriction, which translates into permanent gait deficits.
Tendon and ligament damage signaled by a soft lump or a hard "filling" on the back of the pastern just above the heels is less common but possibly as debilitating as low ringbone. Strains and tears of the support tissues are quite painful and often more sluggish about healing than bone fractures. Lengthy rest, restricted movement and pain management may encourage resolution of the inflammatory reaction, but injured tendon tissues never regain their previous flexibility and strength. Patience can be rewarding in cases of strained sesamoidean ligaments, which heal to soundness with 12 to 18 months of quiet pasture rest.
When a pastern irregularity does not involve the joint surfaces, tendons or ligaments, it rarely affects the horse's soundness. Scars from accidental injuries--the wire cuts, abrasions, rope burns and such that are so common on horses' lower legs--remain blemishes so long as they involve just the skin and immediate subcutaneous tissues. Wounds that disturb deeper structures, such as the periosteum and joint capsules, trigger calcification in all the wrong places and may or may not affect soundness. You can distinguish the just ugly from the bad by palpating the area: If the scar or lump moves feely over the underlying hard tissues just as the normal, surrounding skin does, it shouldn't limit the horse's movement or cause him pain.
Nonarticular bony lumps rarely are anything but blemishes. The calcification most likely occurred in response to a traumatic event, but, located away from a joint, it doesn't produce pain or impede movement once inflammation has turned to bone.
Rarely does sidebone cause lameness. Ossification of the collateral cartilages may be a normal aging-related change that robs the foot of some of its elasticity. Lateral hoof imbalance and injury of the quarters also produce the characteristic bony ridges just above the coronet. Only when the area is actively inflamed, with signs of heat and sensitivity to pressure, can a lameness possibly be linked to sidebone. Radiographs won't reveal the "truth," as many horses have bony changes in that area without exhibiting any gait changes. If someone points to sidebone in a lame horse, look elsewhere for the cause of the limp.
Preventing pastern injuries is part good management and part wise stock selection. Keeping your horse's lower legs out of injurious entanglements with wire, animal burrows and the like and assuring him sage footing beneath functionally balanced feet will protect him from the majority of pastern-damaging accidents. When selecting or breeding horses for activities high on concussion, quick, lateral moves and abrupt stops, avoid the conformation that makes the pastern vulnerable to breakdown.
For vulnerable horses in risky occupations, train and compete conservatively, and heed the earliest warnings that the joints and support structures are being hit with more stress than they can endure. Better to give the pastern-weary horse a restorative rest, improve his working conditions and maybe even change his occupation. This stretch of anatomy may sport a bunch of bumps and lumps that look worse than they really are in terms of their effects on function, but once the truly serious pastern conditions become entrenched, there's no curing them.
This article originally appeared in the March 1997 issue of EQUUS magazine.
How Equine Bones Mend
Common Equine Dental Problems
The Truth About Swaybacks
How to Handle Horse Head Injuries
Glands at a Glance: A Horse's Endocrine System
EQUUS Pop Quiz: Tendon Troubles
Q&A: A pastern joint problem
Analyze Your Horse's Proportions


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City of Morris Life
http://www.morrissuntribune.com/news/3813417-prairie-inn-under-new-management-hotel-200
In the near future, they plan to reopen the restaurant, formerly the Ranch House, as the Brickhouse Restaurant and Lounge. The restaurant has had limited hours or been fully closed since June.
Since the restaurant was closed, reopening will take longer than initially expected because they'll need to hire staff and purchase new inventory. Although the restaurant will have a different name, Beth said patrons can expect a similar menu and style to the former restaurant.
You can find more information about Hotel 200 online at http://www.thehotel200.com, by calling (320) 589-3030, or sending an e-mail to reservations@thehotel200.com.
MN Broadband Task Force highlights
https://youtu.be/adJv6RPnqwA
Good News Morris
http://www.goodnewsmorris.info
Morris Minnesota (events) https://www.facebook.com/pg/SalPhotoVideography/photos/?tab=album&album_id=1601206166560916
City of Morris: New Developments https://www.facebook.com/pg/SalPhotoVideography/photos/?tab=album&album_id=1758042207543977
Morris (Minnesota) Over the Years https://www.facebook.com/media/set/?set=a.696691627012379.1073741868.443035202378024&type=3
https://www.facebook.com/SalPhotoVideography/
https://salphotobiz.smugmug.com/Weather/Winter/Winter-Season-in-Morris/i-ZWwxpms https://salphotobiz.smugmug.com/School/University-of-Minnesota-Morris/i-n9t7tsF Parks https://www.facebook.com/pg/SalPhotoVideography/photos/?tab=album&album_id=1724719120876286
Morris Area High School Evacuated Following Bomb Threat https://minnesota.cbslocal.com/2020/01/03/morris-area-high-school-evacuated-following-bomb-threat/ January 3, 2020 at 10:33 amFiled Under:Bomb Threat, Morris, Morris Area High School MINNEAPOLIS (WCCO) – Police in west-central Minnesota say students were evacuated Friday morning following a bomb threat at an area high school. The Morris Police Department says an "unknown bomb threat" was made to Morris Area High School. Students were evacuated from the building to a nearby gymnasium on the University of Minnesota-Morris campus, from which they will be bused home. Parents are urged not to go to the gymnasium. In a message posted to Facebook, Superintendent Troy Ferguson said the threat was found in a message written on a white board. He said that no one will be allowed back into the building until authorities have searched and cleared it. https://www.voiceofalexandria.com/news/local/morris-police-investigating-bomb-threat-at-school/article_7e70cd44-2e44-11ea-a408-5f51e0477dc1.html (Morris, MN) Law Enforcement were on scene at the Morris Area Public School in reaction to a bomb threat Friday. According to Morris Police Chief Reggie Welle both Elementary and High School students were evacuated and bussed home from the UMM's Regional Fitness Center (RFC). Superintendent Troy Ferguson says that this morning a staff member found a bomb threat message written on a white board. He says local law enforcement coordinated a sweep of the building and no one was allowed back into the building until it was cleared. He asked staff "to please walk your students to UMM now." No one was allowed to take a car or backpacks no going to lockers. The Morris Area School has been thoroughly searched and has been cleared. The Morris Police Department was assisted by the Stevens County Sheriff's Office, University of Minnesota Morris Police Department, Federal Bureau of Investigation, Bureau of Criminal Apprehension, Minneapolis St Paul Airport Police, and Morris Fire Department. This investigation will continue. If anyone has any information, please contact the Morris Police Department at (320)208-6500. Police find written bomb threat at Stevens County high school, students evacuated https://kstp.com/news/police-find-written-bomb-threat-morris-area-high-school-stevens-county-students-evacuated/5597197/ Morris Police Chief Reggie Welle reports that Morris Area High School staff located a bomb threat message written on a white board in the high school. At this point, all students and staff have been evacuated. The Morris Police Department, Morris Fire Department and assisting agencies are still on scene continuing the investigation. 23 9 72 https://goodnewseverybodycom.wordpress.com/2020/01/05/deep-thought-what-happens-when-there-are-threats-at-schools/
Bomb threat at Morris Area High School, students evacuated https://bringmethenews.com/minnesota-news/bomb-threat-at-morris-area-high-school-students-evacuated https://www.kvrr.com/2020/01/03/morris-area-schools-evacuated-after-bomb-threat/ https://www.wctrib.com/4848957-Morris-schools-evacuated-after-bomb-threat-discovered


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WATCH: NASA astronaut Scott Kelly smuggled a gorilla costume on to the International Space Station
Hilarious footage shows astronaut Scott Kelly dressed as a gorilla onboard the ISS and chasing after astronaut Tim Peake, who frantically tried to get away from the ape.
Footage of Irish American astronaut Scott Kelly pulling a hilarious prank on his crewmate on board the International Space Station by dressing up in a gorilla costume has recently gone viral on social media.
The footage, from February 2016, shows Kelly dressed as a gorilla emerging from a bag dressed on board the ISS and chasing after ESA astronaut Tim Peake, who frantically tried to get away from the ape.
Astronaut Mark Kelly runs for John McCain's Arizona Senate seat
A Twitter user shared the hilarious footage recently, erroneously accrediting Kelly's identical twin brother Mark, a former astronaut who now serves as an Arizona Senator.
The 15-second video has been viewed over nine million times since it was posted and has racked up more than 356,000 likes and 75,000 retweets.
Astronaut Mark Kelly once smuggled a full gorilla suit on board the International Space Station. He didn't tell anyone about it. One day, without anyone knowing, he put it on. (source: Reddit) pic.twitter.com/v7aVunL7QF
— SPENCE, TODD (@Todd_Spence) January 9, 2022
According to NASA, Mark Kelly, who retired in 2011, arranged for the suit to be sent to his brother as a surprise for his birthday.
Scott Kelly had been in space for almost a year as part of the ISS mission Expedition 46.
Scott tweeted footage of the hilarious prank on February 23, 2016, adding that he "needed a little humor" to help brighten up his year in space.
"Needed a little humor to lighten up a #YearInSpace. Go big, or go home. I think I'll do both. #SpaceApe," Scott Kelly said in February 2016.
Needed a little humor to lighten up a #YearInSpace. Go big, or go home. I think I'll do both. #SpaceApe https://t.co/Ift8VdDR4C
— Scott Kelly (@StationCDRKelly) February 23, 2016
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If you are in the midst of planning a party for family members or friends, one thing you make the experience more enjoyable for them is to offer them a party favor. There are numerous types of party favors to choose from, and some of them can be very fun to create on your own or with friends. Let's look at three types of party favors that you can try for your next gathering.
First, consider offering your guests a drink glass. This is a fun gift because it can be the drink glass that they actually use at your party. And it doesn't necessarily have to be an alcoholic drink glass. For example, you can use a regular wine glass, but you can serve juice, punch or other beverages out of it.
If you really want to get creative with this idea, and consider putting the name of each cast on their own glass. Of course, this will be most useful if you already know who will be at your event and where they will be sitting. Another idea is to put the names of your guests on each class and set them at a table near the entrance of the event. Once they enter the event, they can find their own glass. This is a great way to know who has arrived and who is missing from your party as well.
Again, making something yourself can be a fun way to give party favors to your friends and family members. There are numerous things you can make to offer as party favors. The most likely thing is a tasty treat. Do you have a desert that you are especially good at making? Is it something that can be divided into individualized portions and wrapped separately? This will be a best option.
Cookies are a good example. if you're really creative with your baking, you can make personalized cookies, but any cookies will do. If they are small cookies, consider putting two or three in each package for each person. You might also try something else creative, such as a name plate that personalized or a handmade flower.
Finally, consider giving something away that is native to the area where you're having your party or event for example, if your area is known for a specific type of wine or other drink, you could purchase small portions of that to giveaway. Many regions are famous for jams or other canned goods as well. You might live in a place where maple syrup is tapped. Or perhaps there is a specific type of pastry that is special to your home area. All of these will make equally good party favors for your guests.
According to PicFlips Flipbooks, the key to choosing a good party favor is to put some effort into it and make it special for all of your guests. You should also try to come up with things that everyone can enjoy. For example, choosing to give away a bottle of pink nail polish to every single person at a party where they will be both men and women may be a bit of a stretch. What's a guy going to do with a bottle of nail polish? But choosing a drink or a food can pretty much be a good party favors for anyone, no matter their age or gender.
Finally, if none of the above ideas seem good to you, you can consider giving away something that can actually be used at the party itself. For example, if you are at a wedding, why not give away noise makers that you can use for the newlyweds to kiss while at the reception. You can also give away sachets of flower petals or rice to throw at them as they leave their actual service. Bubbles are also good for this, and kids love to play with them.
Choose something that you know your guests will love, and there will be no problem with your party favors. Just the fact that you are giving away something is great for all!


X-PAD CalMaster enables the checking as well as adjustments for construction lasers, including laser rotators, pipe as well as line or point lasers.
The hardware reads out the measurement values and the results can be immediately seen on the screen. The software guides the user step by step through the measuring process.
The solution's hardware is very light weight and can be easily transported in a carry case. It is ideal if calibration services would like to be offered at the customer's premises. It is the perfect system to allow customers to offer an enhanced service portfolio.


text:
Two Indians honoured in Christchurch
June 10, 2018 Indian Newslink
Shirish Paranjape
Christchurch, June 11, 2018
Two Indians, one of them a ten-year-old student, were honoured by the Indian community at an event held here on Saturday, June 9, 2018.
Nishitha Maarka, who has been on a winning spree at Tennis Tournaments in recent weeks on either side of the Tasman, her parents and Gaurav Sharma, a photographer and media person on his move to Auckland, were felicitated at the Fendalton Community Centre.
Indian Social & Cultural Club President Shilpa Shailaj and 'Revel Events' Founder and Organiser of Christchurch Holi Festival of Colours Hitesh Sharma were the Chief Guests.
They presented Certificates to Nishitha and Gaurav at the Ceremony.
Nishitha Maarka
As reported by Indian Newslink on May 28, 2018, Nishitha was the winner at her first overseas tennis tournament held in Melbourne from March 30 to April 2, 2018.
She was a runner-up at the Bendigo Tennis Association 2018 McDonalds Classic 10 and Under Girls Singles Tournament played in Melbourne.
She received a Gold as the winner of the Under 10 Girls Doubles Tournament, with her doubles partner Yasmin Matthew.
Ten days later, Nishitha scored Silver as she became a runner up at the Tennis Central Tier 2 Technifibre Junior Open 2018 Girls 10 and under Singles in Wellington.
Former Editor of the 'Migrant Times,' Gaurav Sharma is moving to Auckland to take charge as the 'Editor-in-Chief' of 'Multicultural Times,' a new publication, scheduled to be launched in Auckland in August this year.
It is understood that 'Multicultural Times' will be released every alternate Wednesday and cater to ethnic communities all over New Zealand.
Ethnic communities ignored
"New Zealand has 213 ethnic groups calling them their home. Unfortunately, though, inspite of all the good intentions of the average Kiwis and efforts of the government, ethnic communities still feel 'alienated,' 'left out' and 'voiceless.'
What aids such a feeling-and this is a general consensus- is that ethnic issues, news, views, struggles, successes or celebrations, do not find adequate representation in the country's public discourse," he said on his Facebook posting.
Shirish Paranjape is Indian Newslink Correspondent based in Christchurch.
Nishitha Maarka with her Certificate
Gaurav Sharma with his Certificate
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It's hot, hot enough to suffocate. There is nothing except this table upon which I sleep, a rectangular hall with four doors and twelve windows. On each side a door. On the shorter sides, two windows, each with a door between them, and on the longer sides, two windows to the left of the door and two to the right.
The town is absolutely empty but for the sound of my thoughts straying from me to the point of anger. Alone I am in this hall, alone on the table, alone in the town, I, alone, the only one after whom death does not lust. I, alone, am stretched upon the table into which I have begun to sink, to blend, its wooden slats having nearly become the marrow of my bones. Rising requires a tremendous effort, much like a snake stripping itself of its skin. I struggle to rise. Where did I put the case? I wonder. It must be somewhere outside. The table is in the middle of the hall, so I leave through one of the doors on the longer side, as leaving through the shorter side would only double my effort.
It's as hot outside as inside. Ah, here, I think, is the case squatting by the door. I don't know where it came from. All I know is that, since I began to recover my senses, I've seen that case with its bottles of finely aged wine. Not that the wine has any effect. Nothing does, anymore. In my depths I had thought that perhaps some wine would bring about a desired effect, perhaps help me to remember something, anything. Perhaps, at the least, I would remember who I was. My name. Where I came from. Where the others have gone and who they might have been.
It's hot, hot enough to suffocate, as if this plot of land were the only place where the sun was assigned to shine and the wind had reached the age of retirement and perhaps died. I grab a bottle of wine and begin to drink, then throw the bottle aside. I am still in my right mind. A thought occurs to me: perhaps I could look around town. I start to walk down the road. Where were the people? I wonder. How much I hoped that some living creature would appear in front of me, a person, an animal, tame or wild, no matter. Why am I alone here?
The town is still and soundless. The only thing I hear is the beating of my own heart. I enter one of the houses easily through an unlocked door. The house is a bit dark but it is still easy to see. What beautiful furniture it has! I glance over some pictures on the wall. They seem to be of a family. What a handsome young man, I think. And those people, are they his parents? It seems so. Where are they now? I wonder. And suddenly I feel a chill run through me and decide to leave the house.
I continue walking down the road. The houses on both sides of the street appear to be completely still. Wait, I think, what is that over there? A windmill, how ironic! A windmill? It looks like they built it before the wind retired. Indeed, the wind must have worked here. Is there anyone inside? I sneak in and see a number of spiderwebs—and even they look abandoned. But where are the spiders? I spin around. There are a number of flour sacks and a container of unmilled grain. Someone must be here, I think. Yes, it is ridiculous to think that there is no one here, not a single person, not even a spider. Even a rat would be enough for me. I ask you, please, I will call out in my loudest voice and perhaps some people will wake up. But let me not be greedy. It's enough to ask for one person, a single person to awake. Fine, I will cry out . . . But oh my god. Can I not shout? Why will the words not come out? It would be enough if I could pronounce the letters one by one, but what language do I speak? I know I am able to speak, I am certain of it because I am always thinking in this language. Yet I speak only to myself and I do not speak to myself out loud. Is this because I am afraid that I will be called crazy or that I'm afraid someone will hear my secrets? How I wish they would call me crazy, just let them appear before me and call me crazy and I would be ecstatic.
Had I remembered that people eavesdrop on anyone who talks to himself so that they can gossip about him, I would have spoken in every language in the universe and in the loudest possible voice just to draw my fellow man. But there is no point to any of that now. I have lost my last hope, lost my voice for all eternity. What a loss. A voice draws people like honey attracts ants. What? Did I just say the word "honey"? Ah! I remember I saw honey in the house that I was just in, great, honey, ants, I found it, fine, I found it. I leave the windmill and sprint back to the house, open the door and rush inside trying to remember: where did I see it? Here it is. I take the honey and leave with it. It is closed tight but this is no problem for someone who has nearly lost hope when it reappears unexpectedly from far away. Naturally I am now stronger than a mountain, and here, the jar opens in my hands. I taste it—not bad. It still tastes like honey. I grab the jar and run back along the road, letting the honey spill over the side. It was almost gone but that was fine, the area I had covered would have to do.
Now I must await the ants, hoping they do not take too long. No, I would not have to wait long, for I know that those slender ants which have the strongest sense of smell in the whole colony would smell the honey and inform the others. It would be only a few hours before I saw the ants. And when they arrived I would reach the height of happiness simply seeing another being: alive, small and beautiful. Finally I would be able to see life coursing through their legs. I must sit and wait. When the sun had almost set, the ants still had not appeared. No problem. I will wait. There is nothing to do but wait.
And wait. They will come. I know that ants cannot resist honey. And so I wait.
And when I had waited so long that the sun's daily work began to wane, I knew I could not wait any longer. I would return to the table for which I longed. It is unusual for me to spend a night far from it to the point that I feel sores along my back that resembled precisely the lesions of an amputee. I do not lose the way back home. Finally my table. I attempt to embrace it, to hug each of its four sides and kiss them, and then I do the only thing I know how to do: I stretch myself out upon it. Yes, finally, I feel a type of peace and security until I no longer feel my sores and lesions.
Stretched upon the table, I engage in my gift for dreaming. It seems like my long wait for other living things and my yearning to see them has affected my dreams. I dream that I am staring distractedly at the ceiling, without any attention to its details, dreaming that I am some small green being, some vile, useless thing, some primitive, viscous, singled-celled creature. I feel two enormous gelatinous eyes with which I stare left and right without turning my head, blinking. What is that hole? It's on the ceiling, meaning my dream must have ended. I hope it does not pull me back into those strange and absurd feelings.
Has war passed through these parts? If so, and everyone was killed, how did I escape my death? And where are the corpses? If it was a long time ago, where are what remains of their bones? That cold shiver passes through me again and I won't hide from you a secret: when the heat intensifies to the point of rousing my anger, I muse over such questions which, naturally, bring about the cold shivers that reduce the heat significantly and make the weather more bearable. I would enjoy this and think myself quite smart on account of this single trick I have managed to perfect. But I'm afraid I may have ruined some brain cells by doing so, and the trick itself slipped its reins and I am no longer able to control it. It has begun to come when a feeling of estrangement took possession of me.
Once again I am by myself in the hall, on the table, in the town, I, alone, the one for whom death does not lust. Stretched upon the table into which I have begun to sink, to blend, its wooden slats having nearly become the marrow of my bones.
And so I arrive at the following: as long as I do not find anyone with whom to speak in this town, I will have to find a partner in another way. With that, I decide to divide myself into two imaginary beings, one, "I," and the other, "He." He resembled the image of me reflected in the bottles of finely aged wine. So, my dear handsome being, what shall I call you?
I sense an expression of anger on the glasslike curves of his face.
"Why aren't I 'I' and you 'He'?" He asks.
He overwhelms me, truly, and so I throw him and all the wine bottles while screaming, "Get out, you strange gelatinous being, go to hell!" That being which resembled me disappears and I look to the table tenderly and rush to lie upon it.
"Don't be afraid, nothing will take me from you, not even death. You know well that death can't swallow me up nor digest me. Like me you're a stranger in this place, and I love you."
For the first time I sink into a deep sleep and dream that I am that boy in the myth who lies near the sea and contemplates his reflection in its surface. As for me, I am stretching out on the table, close to the sea, contemplating our reflection—the table and I—on its surface. The gods punished the boy by transforming him into a flower where he stood. And these same gods transform us into two beautiful flowers.
When I wake up, I pass some time gazing up at the ceiling in a good mood until, ever so gently, that mood evaporates because I am alone in the hall, on the table, in the town, alone, the only one after whom death does not lust. Stretched upon the table into which I have begun to sink, to blend, its wooden slats having nearly become the marrow of my bones.
I try to recover that pleasant mood which carried the scent of . . . I don't know! I try but it seems like I've lost it. Fine. I still have some of my dreams. No. I don't want to be that being. It seems that there is no other choice. Not so bad. I am now some small green being, some vile, useless thing, some primitive, viscous, singled-celled creature. I have two enormous gelatinous eyes with which I stare left and right without turning my head, blinking.
© Sabah Babiker Ibraheem Sanhouri. By arrangement with the author. Translation © 2013 Max Shmookler and Najlaa Eltom. All rights reserved.


text:
By John Council
PRO BONO-TURNED-CONTINGENT FEE CASE RESULTS IN REPRIMAND
What happens when an attorney accepts a pro bono case from a local bar association-sponsored legal services program and converts the suit into a contingent-fee arrangement? The unusual scenario can result in a public reprimand from the State Bar of Texas and the forfeiture of the fee, according to a recent decision from Houston's 1st Court of Appeals.
But legal ethics experts disagree over whether a pro bono case should ever be changed to a contingent-fee arrangement. Some say it's OK if the attorney complies with the Texas Disciplinary Rules of Professional Conduct.
Normally, the kinds of cases in which attorneys agree to represent poor people for free have little chance of economic recovery. That's why many local bar organizations have volunteer lawyer programs that assist low-income clients who can't otherwise afford representation in matters such as obtaining protective orders, writing wills and completing no-contest divorces.
But the Oct. 5 opinion in Stephen E. McCleery v. Commission for Lawyer Discipline involves the rare pro bono case where an attorney stood to earn a fee. According to the 3-0 decision, McCleery violated Rule 1.04(a) of the Texas Disciplinary Rules of Professional Conduct by charging an 'unconscionable fee' by changing the nature of the attorney-client fee arrangement just prior to trial.
Rule 1.04(a) provides that 'a lawyer shall not enter into an arrangement for, charge, or collect an illegal or unconscionable fee. A fee is unconscionable if a competent lawyer could not form a reasonable belief that the fee is reasonable.'
The opinion sets out the following: In 1998, McCleery agreed to represent Alonzo Williams in a case involving a dispute over a contractor's lien on Williams' house. Because of the lien, Williams' house was threatened with foreclosure. McCleery received the case as a referral from the Houston Volunteer Lawyer Program (HVLP), a Houston Bar Association program.
Williams and McCleery, a Houston solo, signed an HVLP professional services agreement in which McCleery agreed to represent Williams at 'no charge.' It was also HVLP's written policy that its volunteer-attorneys donate any fees recovered during litigation to HVLP.
The evening before the May 22, 2000, trial of Williams' suit, McCleery presented a contingent-fee contract to Williams in which McCleery would receive 40 percent of 'all sums collected.' Williams signed the contract. After Williams won a $450,000 jury verdict, the case settled for $50,000. As part of that settlement, McCleery received $20,000 in attorney's fees.
Williams later filed a grievance against McCleery with the State Bar of Texas. A Bar grievance panel recommended that McCleery receive a private reprimand and make restitution. McCleery rejected the proposed disciplinary action and appealed to a state district court.
A state district court issued a public reprimand ordering McCleery to pay Williams $20,000 in restitution — a decision the 1st Court affirmed.
'The trial court found that McCleery's eleventh-hour fee agreement was unconscionable. We do, too,' wrote Justice George C. Hanks Jr. in an opinion joined by Justices Evelyn Keyes and Tim Taft.
'We hold that the evidence is legally and factually sufficient to support the trial court's finding that McCleery violated Rule of Professional Conduct 1.04(a),' Hanks wrote.
The 1st Court also found that McCleery had failed to advise Williams that he should have an independent lawyer review the contingent-fee contract before Williams signed the document. It also found McCleery violated Rule 1.04(c), which states that fee agreements between lawyers and clients shall be communicated 'within a reasonable time after commencing the representation.'
When asked why he changed the nature of his fee agreement with Williams from pro bono to a contingent-fee arrangement, McCleery says the answer is simple: 'My client asked that I do that. I think he thought we were doing a really good job in this case and there were some more important issues to him than getting a recovery' — namely saving his house from foreclosure.
McCleery also says he never believed the suit would amount to much of a recovery — $5,000 at most. But McCleery says he worked so hard on the case, Williams stood to win more at trial.
But in trial court testimony in McCleery v. Commission for Lawyer Discipline, Williams disputed the notion that he suggested McCleery recover a fee and said the first he learned about the new arrangement was at trial. 'He never explained to me nothing about how it worked, was going to be charged or nothing,' Williams testified according to the 1st Court opinion.
Linda Acevedo, first assistant disciplinary counsel for the State Bar who represented the Commission for Lawyer Discipline throughout the grievance case, says the 1st Court reached the right conclusion.
'Typically if you take on a case pro bono, it's pro bono,' Acevedo says. But the change in the fee agreement might have been permissible if McCleery had handled it differently, she says. If McCleery had given Williams plenty of notice about the change and advised Williams that he should have an independent lawyer review the fee change proposal, the arrangement could have been acceptable, Acevedo says.
It's the circumstances of the case that make it egregious, Acevedo says. 'The opinion was very fact-specific.'
Rex Davis, a shareholder in Waco's Sheehy Lovelace & Mayfield who represents McCleery and a former chief justice of the 10th Court of Appeals, says his client is considering appealing the decision.
McCleery adds that he cleared the contingent-fee contract with someone at HVLP before Williams signed it, but he can't recall who he talked to.
'I even called the HVLP and said, 'Hey, can I do (that?' ' McCleery says. 'And they said, 'Whatever the nature of your arrangement is with your client is your own."
Peggy Montgomery, who chairs HVLP's board of directors, doubts anyone associated with the organization would have blessed McCleery's fee arrangement.
'That is not what he would have been told by HVLP. If he's a volunteer lawyer and he gets a recovery, that goes back to HVLP,' says Montgomery, in-house counsel with ExxonMobil Corp.
Montgomery says HVLP generally does not accept cases that could generate fees. The program usually refers damages cases to lawyers not involved with HVLP, she says.
McCleery's situation is atypical, she says.
'I've been involved with pro bono for more than 20 years, and I've never seen this,' Montgomery says.
While McCleery's fee arrangement with his client was unusual, even some advocates of pro bono work say that lawyers should not be forbidden from receiving compensation for their work for pro bono clients.
An attorney who accepts a pro bono case has an obligation to keep the case as a pro bono case, says Frank Newton, the former dean of Texas Tech University School of Law and a former State Bar president. 'Arguably the pro bono client could choose to make a gift to the lawyer after the fact, if it were truly a gift and was completely voluntary.'
'There's nothing wrong with an attorney who encounters a client in a pro bono environment and recognizes that the case has some economic merit and signs them up on a contingent-fee basis,' says Daniel Sheehan, a legal malpractice attorney with Dallas' Daniel Sheehan & Associates. 'The real problem here is he took it . . . and changed the fee [arrangement] well into the representation. It raises a presumption of unfairness.'
But Ellen Pryor, an associate provost at Southern Methodist University Dedman School of Law who has long been involved with pro bono work, says there is no circumstance in which a lawyer should accept a fee for working on a pro bono case.
'It raises the interesting point that pro bono work is needed for cases where there will be some economic recovery,' Pryor says. Pro bono organizations have to take some cases where only a small fee recovery is possible — so small that for-profit lawyers will not accept the cases.
'[O]nce you say you're the lawyer pro bono, I can't imagine a circumstance where you should change that,' Pryor says. 'I can't imagine a situation where you could get away with it.'
Bruce Campbell, a partner in Dallas' Campbell & LeBoeuf who defends attorneys in the disciplinary system, says lawyers should be careful when turning pro bono cases into contingent-fee arrangements.
'Contingent fees on the whole are looked at much more carefully by courts and in the disciplinary process than ever before,' Campbell says. 'And this is just a good example of what can go wrong if you wait until the last minute and you don't give the required notice to seek independent counsel.
'He's being punished for outstanding results,' Campbell adds of McCleery. 'If he'd only gotten 5,000 bucks, it's unlikely that anybody would have raised a stink about it. It doesn't make it any more right. But it would have gone under the radar.'
McCleery says if he had it to do all over again, he probably wouldn't have signed a contingent-fee contract with Williams.
Notes McCleery, 'In retrospect, would I have still taken the fee from him? After all of this, probably not, because of what happened, not because I think it was the wrong thing to do.'