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10:50 AM BLOOM 4 comments
As the parent of a child with a disability or special needs, what type of stories or resources are you most interested in? Are there areas that you feel haven't received adequate attention or dialogue? Is there a taboo topic you'd like discussed?
Please help me ensure that BLOOM is covering issues related to parenting kids with disabilities that matter most to you as parents – and which can assist the professionals working with our kids.
Thanks! Louise
Protecting your non-verbal child
9:44 AM Child abuse, non-verbal, Parent-talk 10 comments
Parents of children who don't speak fear their child's vulnerability. When your child is non-verbal, he can't tell you if something bad happens at school, in the community or with a worker. Last week I received an e-mail from the mother of a four-year-old boy with autism. She wrote to tell me that while receiving ABA therapy at a private centre, inappropriate photos of her son were taken. She shares her story in the hope that by alerting others parents to the potential for abuse, she can save another family from going through a similar experience.
My son had been going there for a year and every session I would stay and wait for him. I could hear him scream through the walls and they would tell me he needs to 'pair' with his therapist and it's his 'behaviours.' In October there were changes and we had a new therapist. Her first day with my son she came running out of the therapy session into the waiting room and asked if I had a camera. I said no and why? She asked the administrator, who said yes, take my iPhone. The therapist said: "Your son is painting, he is covered in blue paint so I want to show you" and ran out of the room. Over the next little while she returned the iPhone to its owner and I asked to see these pictures. I was in shock to see my son standing in his diaper covered in blue paint, crying. There were many pictures taken. But none of him actually painting, just of him crying with blue paint all over him. There were pictures of him being cleaned up and pictures of him naked: three full frontal photos. I felt sick to my stomach.
Does my child not have a right to privacy? When you send your child to school do you expect them to be painting in their underwear or diaper? Why would someone take pictures of a child naked? My son could have been cold for two hours, standing in his diaper. When your child is non-verbal, he can't tell you what's happening. The guilt I feel that I trusted this private centre with my child is unexplainable. Our local children's aid is investigating this case and the police said that while the photos are not pornographic, they are inappropriate. No apology or explanation has been given to us by the director of the centre. I would like to educate as many parents as possible to prevent this kind of horrible occurrence from happening to another child.
Following are precautions I've learned to take in choosing a private therapy centre or daycare:
Call your local children's aid to ask if any incidents at the facility have been reported, or if the facility has been the focus of an investigation.
Ask to see qualifications of the person working with your child.
Check references yourself. Don't be afraid to make enquiries with the police regarding records.
Expect timely responses to your concerns and questions.
Before committing yourself to a facility, ask to speak with other parents and view the facility while in operation.
Make an unannounced visit to get a realistic view of how the place runs and the involvement of the senior staff or directors.
Be involved. Don't take a kind smile as proof that your child is well taken care of.
If you can view your child under someone else's care, do it.
Look for sudden changes in behaviour in your child. You know your child best.
Read contracts carefully and don't be afraid to question.
Share information and network with other parents.
'All of life is fragile and uncertain'
10:07 AM Down syndrome, Parent-talk, prenatal testing 13 comments
I'm delighted to share a guest blog today from Amy Julia Becker, mom to Penny and William, above. Amy Julia is a writer and a student at Princeton Theological Seminary. At Thin Places she blogs about "theology, disability, children and parenting, education, and the intersection of grief and hope." I like the way she makes me think. Thanks Amy Julia! Louise
by Amy Julia Becker
I remember how I felt two hours after my daughter Penny was born, when I first found out she had Down syndrome. I wracked my brain for information about this thing that had just happened to our family. All I could come up with was early death and mental retardation. The doctors didn't help much. In the hospital, we received a list of all the things that might go wrong: heart defects, leukemia, celiac disease, developmental delays.
Two years later, I'm pregnant again. Recently a colleague exclaimed, "I didn't know you were expecting!"
I grinned and patted my round belly: "Hard to miss."
"I assume you've done all the screening on this one to find out, if, you know . . . "
I tried to explain why I wasn't opting for amniocentesis, why I was uncomfortable with the prenatal testing industry in general, and why I wasn't particularly concerned about having another child with Down syndrome. She didn't seem to understand.
Penny is 27 months old. She says "no" with the gusto of any of her peers. She uses spoken and signed words to tell me what she did at school today, and the names of her friends, and what she would like for her afternoon snack. Penny loves music. She's learning her shapes and colours. She gives lots of hugs. She's also very small, and she wasn't able to walk steadily until a few months ago. She is my daughter. She is my daughter with Down syndrome.
Asking whether I am at risk for having another child with Down syndrome (statistically speaking, yes, my "risk" at age 31 being 1 in 100), is akin to asking whether I am at risk for having another child with brown hair, gorgeous green eyes, her father's hand-eye coordination, or her mother's love for books. It implies that Down syndrome is something separate from Penny, something that could be extracted if only we had the proper tools and procedures. But that extra chromosome is intrinsic to Penny's being. To take away Down syndrome is to take away Penny.
Later, I heard a report on NPR about a new ethics recommendation from the American College of Obstetricians and Gynecologists (ACOG), stating that doctors unwilling to provide abortions have an obligation to refer their patients to another physician who will provide them. The spokesperson said: "If a physician has a personal belief that deviates from evidence-based standards of care . . . they have a duty to refer patients in a timely fashion if they do not feel comfortable providing a given service."
Studies show that women who receive a prenatal diagnosis of trisomy 21 (the technical term for Down syndrome) terminate the pregnancy 85 percent of the time. Since new medical guidelines - including "evidence-based standards of care" - suggest that all women, regardless of age, be screened for trisomy 21, it is most likely that the number of prenatal diagnoses, and the number of terminated pregnancies, will increase. Evidence-based standards of care result, more often than not, in the elimination of people like my daughter from our society.
As a result, I am somewhat skeptical about the standard of care offered to these mothers. I'm skeptical, too, when "personal beliefs" are pitted against evidence, implying that a physician unwilling to perform an abortion has defied ("deviated" from) the facts. I understand that many women face unbearably difficult choices about the health of their babies. Some choose to terminate their pregnancies because they have been given information about the near certainty of physical abnormalities and high possibility of early death. Yet many also choose to terminate based on probabilities, fear and misinformation. In the case of Down syndrome, many receive incomplete and outdated data.
The most recent ACOG parent education brochure entitled "Genetic Disorders," published in 2005, defines Down syndrome as "a genetic disorder resulting from an extra copy of the 21st chromosome in which mental retardation, abnormal features of the face, and medical problems such as heart defects occur." The brochure reads the same as the brochure published in 1995; by definition, it is not up-to-date.
One has to hope that in following "evidence-based standards of care," doctors and nurses will do better by their patients than 10-year-old boilerplate. I hope they include the fact that the life expectancy of people with Down syndrome has doubled in the past 25 years, or that the average IQ of a person with Down syndrome has doubled over the course of the 20th century, or that many physical "defects" can be corrected relatively easily because of advances in medical care. (Penny had a hole in her heart, for instance, that may well have killed her a few decades ago. Now, it didn't even warrant an overnight stay in the hospital.)
I will follow my doctor's orders and have a level 2 ultrasound. I will pray that this baby's heart, lungs, brain and limbs look healthy and whole. I will try to remember what I felt when the words Down syndrome first became a part of our reality. I will try to have compassion for every person who has trouble understanding the blessing Penny is to our family.
I will also hope and pray that physicians advising women who are frightened, confused and faced with life-changing decisions will offer those women a true choice, an informed choice, a choice based on the evidence that all of life is fragile and uncertain, with potential for heartbreak, and for great joy.
This article was originally published in the Philadelphia Inquirer on July 13, 2008, with the headline: Down syndrome is a part of who my daughter is.
Born to be different
9:10 AM documentaries, Parent-talk 3 comments
I participated in a TVO panel discussion about parenting children with special needs that's been uploaded to YouTube. It followed the airing of a British documentary called Born to be Different, which follows six families of children born with a variety of disabilities. I was surprised that my voice sometimes still cracked when I spoke about the birth of my son Ben, above, 15 years ago!
http://www.youtube.com/watch?v=8BEF8xg0Ib8
Katie's ballet dream comes true
10:11 AM accessibility, adaptive living, cerebral palsy, dance, Parent-talk 10 comments
Like many little girls, five-year-old twins Katie and Emily Suggitt wanted to dance. But until last year, Katie had to watch her sister at the ballet barre because she has cerebral palsy and can't walk. Determined to see Katie don her own pair of pink slippers and take her place with the other dancers, mom Sarah – working with Emily's dance school and one of Katie's therapists – created an accessible class. Ballerina Dreams at Turning Pointe Academy of Dance in Toronto is for girls with physical disabilities. In addition to the traditional tights, leotards and frilly tutus, some dancers wear leg braces, use canes or walkers, and are assisted by high school students rolling around on stools with wheels. In the photo above, Katie waits backstage to perform at a recital with volunteer Julie Gass. I asked Sarah how she got the program up and running.
Me: What motivated you to start a ballet class for children with disabilities?
Sarah Suggitt-Nixon: Emily started ballet when she was three. At Emily's first recital we were all in the audience, with Katie on my knee. Katie watched the other girls her age up on the stage and kept pointing to herself saying "I want to do it" and at the time I'm in tears thinking, how are we going to make this happen?
Me: How did you create the class?
Sarah Suggitt-Nixon: Katie was having a therapy session with Barb MacDonald, her occupational therapist, and I asked her "What do you think of this idea of starting a ballet class for kids like Katie?" She said "I think it's great to find activities that are useful from a therapy perspective, but the kids don't think it's therapy." She offered to volunteer her time. We found a book called Ballerina Dreams about a class in New York for children with cerebral palsy, but in talking to the staff, it sounded like an expensive program to start. It seemed to me that we should try to find a school in Toronto that was already established and would entertain a class for these girls, so I called the director of Emily's school at Turning Pointe. She said: "Wow, I love that idea. I'd like to figure out how to make it happen."
Me: How does the class work?
Sarah Suggitt-Nixon: There are about six girls, aged five and six. The ballet teacher took the typical program she does and adapted it a little. Turning Pointe helped us find high-school student volunteers to be one-on-one helpers with each child. The volunteers have stools on wheels and in Katie's case one holds her waist to help her stand up. They do a lot of coaching to remind her to reach her arms straight up over her head, or not to cross her feet or to lift her foot up. They work at the barre and work with colourful scarves to do the arm movements. Katie doesn't use her voice device in the class, but Barb printed off some sheets so she could pick colours for different games they do in a circle. They use the same moves and music that they use in the classes for typically-developing children.
Me: How did they know how to adapt the program for each child?
Sarah Suggitt-Nixon: The occupational therapist put together a two-pager for parents to fill out to give a picture of their diagnosis and relevant information on how their little dancer moves and she met them on the first day and worked with the student volunteers. We didn't do a lot of preparation as far as meeting with the dancers or volunteers up front. We told them "If you want to come and be a dancer, come, and if you want to come and be a volunteer, great," and then we figured it out from there.
Me: What impact has the class had on Katie?
Sarah Suggitt-Nixon: She loves it. Saturday mornings in our house are ballet. Emily goes at 9:15 and Katie goes at 11:15. For all the girls, the biggest highlight at the beginning was putting on the outfit. Katie gets to be like every other girl. At their first recital, the director did an amazing job of not making the Ballerina Dreams class any different. She didn't give a preamble to the class. It was just: "next up is Ballerina Dreams" and out they came in their walkers or with their volunteer. There wasn't a dry eye in the house. After the recital they had a waiting list of high school students wanting to volunteer.
Me: What have you heard from parents of other kids in the class?
Sarah Suggitt-Nixon: "I can't believe my little girl with special needs is doing a ballet class like her sisters or friends." One mom told me she had been looking for this kind of program for two years. One of the girls who started in November is now taking steps, where she wasn't before ballet. They're ordering her a walker to use in addition to her wheelchair.
Me: How have other parents and dancers responded?
Sarah Suggitt-Nixon: You can peek through the window at the class and a lot of people stop by to watch. I heard one teenager say to her mom: "This is the class I was telling you about that I want to volunteer in. When they get more dancers, I'm next on the list to volunteer." For many of the student volunteers it's the first time they've been involved with kids with special needs and it normalizes these kids for them. They're not different or weird. One mother said her daughter who's going to university is now interested in looking into occupational or physical therapy as a career after working with these kids. There haven't been any negative reactions.
Me: What was the greatest challenge in starting the class?
Sarah Suggitt-Nixon: You know what, there wasn't a big challenge! The studio is accessible and there are no stairs. I let families in the Bloorview School know about it, so we had dancers lined up and ready to go. Turning Pointe needed to schedule the time slot and teacher and get the volunteers. But I was very pleased at how receptive everyone was.
Ballerina Dreams was profiled in this Toronto Star article last weekend. Check out the online video. Photo above by Jamie MacDonald.
What makes us human?
1:48 PM Down syndrome, ethics, Latest Research, Parent-talk, quality of life 14 comments
I was hoping my agitated reaction to the New York Times' Motherlode column "Should Down syndrome be cured?" would fade, but it won't.
The post covers research from Stanford University that shows that a drug can temporarily restore some learning and memory skills in mice with Down syndrome.
Jenn Power, a Canadian mom of twin boys with Down syndrome, said she greeted the news with tears. "I find it hard to read this article without hearing a judgment on the value of my children, children who have transformed my life and the lives of many others – for the better…In the debate surrounding disability, there is an assumption that we all agree on a definition of what is good, what is better, what is the ideal. Who decided that smarter is better? Who decided that independence takes precedence over community? Who decided that both the individual and the society are better off without Down syndrome?"
Contrary to the Motherlode headline, lead researcher Dr. Ahmad Salehi in the Contrarian notes that his findings are "far from being a cure," but could eventually lead to greater independence in people with Down syndrome. "There are many places in the world that may not look at Down syndrome the way that Jenn does," he writes. "For these children, finding a way to even partially restore cognition or preventing further deterioration in their learning and memory would be extremely important and helpful in their very competitive societies."
The research (while in its infancy) sounds positive to me.
What bothers me is the way the media have framed it as a full-blown cure – as in eradication of people with Down syndrome – and the slew of reader comments that imply life with intellectual disability is somehow less than human.
"The reason it is called a disability is because it is a lack of something…that makes a complete human being," one reader noted. "That is a tragedy; it is not another equally good form of personhood." Says another: "You'll never meet a doctor or a lawyer with Down syndrome."
Is a good life – a happy and meaningful life – tied to brain power? Are doctors and lawyers inherently better "people?" What does it mean to be a good human being? Are we less human when our academic intelligence is limited?
Another Motherlode reader equates learning ability in people with Down syndrome to her suffering with untreated bipolar disorder. But does having a low IQ, in and of itself, cause physical and mental suffering?
I can only look to my son, Ben (in photo above with sister Lucy), who has mild mental retardation, in trying to answer this question.
It seems to me that the bulk of suffering for children and adults with low intelligence comes from being judged and excluded by others.
In Ben's case, I think he experiences anxiety and frustration, and that is a form of suffering. But for the most part I do not see his intellectual disability causing suffering.
Is he suffering when he's laughing hysterically while playing computer games designed for younger children? Is he suffering when I pull him around on a swim noodle in the heated pool at Bloorview – or when he balances on the swim noodle himself and pretends he's a cowboy? Is he suffering when he looks down from a height of 20 feet to see a group of children cheering his descent on the zip line at camp?
My son does have physical pain, and that is a terrible form of suffering. But I don't believe that his intellectual disability causes him to suffer.
Years ago I was asked to fill out a survey by genetics counselling students about aborting fetuses based on disability and quality of life. It bothered me tremendously that there were questions like: "Would you terminate if you learned your child had mental retardation that would affect his quality of life?"
People with mental retardation are marginalized and discriminated against in our culture. That's a social problem.
Does intellectual disability limit one's ability to have a rich, joyful life? I don't believe it does. I do believe it makes life harder – much harder – but I don't equate a good life with an easy life.
I did like this comment on the Motherlode blog, from the mother of a child with Down syndrome: "It is hard to believe that she won't be able to solve problems or read literature. And yet it is easy to believe that she will rush to a friend, or even a stranger, in need. Easy to believe she will bring joy and light and life. Can you live a full life without ever solving a quadratic equation? Without reading Dostoyevsky? I'm pretty sure she can. Can I live a full life without learning to cherish and welcome those in this world who are different from me? I'm pretty sure I can't."
What bothered me most about the Motherlode comments was the hatred and fear that intellectual disability seems to elicit in so many otherwise educated people.
A blog, a film, and faith
2:24 PM documentaries, TV 9 comments
Ellen at To the Max posted an interesting blog yesterday about choosing to have another child after having a child with special needs. Were you scared of going for kid no. 2 after having one with special needs? generated 40 moving responses and is worth a read.
Ontario parents may be interested in Born to be Different (see photo above), a British documentary airing on TVO this Sunday, January 10 at 8 p.m. The film follows the families of six children born with a variety of disabilities over a 10-year span. Sunday's segment covers the first year and I'm delighted to be sitting on a panel afterwards to discuss it with Dr. Wendy Roberts, a developmental pediatrician at Bloorview, and Barbara Muskat, a social worker at SickKids Hospital here in Toronto.
Readers in the UK can watch the entire series at http://www.channel4.com/programmes/born-to-be-different/episode-guide.
A family minister recently contacted me to ask if I knew of a bible study for a group of parents of children with special needs. Amy Julia Becker, mom to a child with Down syndrome and a theology student who blogs at Thin Places, helped me identify these sources:
The Elizabeth M. Bogg Center on Developmental Disabilities (part of the University of Medicine and Dentistry at New Jersey) has created three faith-based publications related to autism, brain injury and other developmental disabilities.
Also suggested were:
Special Strength for Special Parents: 31 Days of Spiritual Therapy for Parents of Children with Special Needs
His Name is Joel: Searching for God in a Son's Disability and
Resources listed at the Faith Inclusion Network.
Perhaps readers can make other suggestions.
Does physical disability make a parent less fit?
2:19 PM cerebral palsy, disabled parenting, quadriplegia 9 comments
There's been a lot of discussion in the blog community this past week about the rights of disabled parents to care for their own children.
The Chicago Tribune has been following the story of Kaney O'Neill, a 31-year-old woman with quadriplegia who's being sued by her ex-boyfriend and the father of their son Aidan, five months, for full custody, charging that her disability "greatly limits her ability to care for the minor."
O'Neill – who has no use of her legs and limited use of her arms – worked with rehab staff for months before Aidan was born to build her physical strength and put adaptive baby equipment in place. She's never alone with her son and has the assistance of a full-time attendant, her live-in brother, a mother who helps on weekends, and a trained service dog. A good overview of the case can be found at the New York Times' Motherlode blog.
Still, headlines asked: Can a quadriplegic woman be a good parent?
It reminded me of a column by a single mom with cerebral palsy we ran in BLOOM eight years ago. Lisa Jones, then a health planner, was raising two daughters aged four and 10 (see photo above). She used a power wheelchair and had minimal use of her hands – perhaps not unlike O'Neill's level of physical function. This made it challenging to lift her daughters when they were babies, to support them as they began to walk, or to push a stroller.
How did she do it? I wondered.
Lisa addressed the practical challenges of caring for her daughters' physical needs in this piece below, which I think is as relevant today.
'I know that I'm raising really good girls'
By Lisa Jones
My philosophy is that even if I wasn't disabled – and maybe because I am – it takes a whole village to raise a child.
My name is Lisa Jones and I'm raising two girls – Laural, 10, and Emily Grace, 4 – on my own. I think my role as a parent is to guide my daughters and help them along, but my family and friends also play a huge part. When parenting with a disability, I think it's important to embrace the fact that we are all interdependent and we each have different skills to contribute in raising happy, healthy children.
I have cerebral palsy and work as a health planner. I use a power wheelchair and have limited use of my hands.
When I was growing up, I always knew I wanted to have children. I knew I had a lot of stuff to pass on to a child and that I could help a little person become a really good individual. I wasn't exposed to the common stereotypes that suggest a person with a disability is somehow less of a parent, so it came as quite a shock when some of my relatives expressed these sentiments after I became pregnant with my first child.
In spite of this opposition, I believed in myself, and since my children were born, I've rarely dealt with attitudinal barriers. The greatest challenges I've faced involved caring for my girls physically during their early years. Because I have poor fine motor skills, I couldn't easily lift my children when they were babies, support them as they began to toddle about, or push a stroller.
I met each of these challenges through problem-solving, trial and error and the fervent belief that I would be able to work something out. Many of the adaptations I came up with were based on simple ideas. For example, when Laural was born, my father built a crib with a side that slid away so that I could wheel right up to the crib. The crib was at a perfect height so that I could feed and change her there.
In order to lift Laurel, I would roll her up in a receiving blanket, then grasp the sides of the blanket and pull her onto my lap.
I couldn't push a stroller, so in order for us to go for a walk, I figured out a way to carry Laural – who was then seven months – on my lap while I pushed my wheelchair. I made a padded apron that I would wear, and which Laural could lean against. It included a fabric strap that fit around Laural's chest. Then I had my wheelchair repair store make an extra long seat belt that fit around Laural and me.
When Laural was first walking, I took her out wearing a harness with a long strap that I held. I would take her to enclosed playgrounds so that she could run freely without any danger of running away.
What I have found, over the years, is that my daughters are incredibly resourceful, adaptable and safety-conscious because they know that I can't rescue them like other parents can. I've noticed that able-bodied parents are very protective of their children. I can't be, so my children have become very good at self-managing. They understand – at a level far beyond any other child – that if they take a physical risk, they're on their own. I support them by giving them the confidence that they can figure out situations and by allowing them to participate in decision-making.
For example, I remember when Laural was about 18 months, she climbed up on the back of our couch and began inching along the narrow top. I said "You better be careful, because Mom can't get you down, and if you fall, you'll really hurt yourself." I couldn't scoop her up like other parents, all I could do was sit beside the couch and talk her through it. I could see her reasoning it out, figuring out whether she could move a little further, then deciding it was a bit too scary. She pulled her legs back over the front and was able to fall safely onto the couch.
What has made the difference in my ability to raise my daughters has been the support of my family and friends. Transportation is a big issue, as I don't drive. One of the ways my parents help out is to drive my children to school and to other activities. One of my friends picks my kids up after school and that's her contribution to my "little village." I do things for my girlfriend's children in exchange, such as helping with French homework. It's that interdependence with other people that is so essential in raising children. Everyone has different skills, but we share what we can give.
During Emily Grace's first year, I received five hours of attendant services each day. Today, I receive two on weekdays and three to four on the weekend. Our attendants primarily meet my personal care, grocery and cooking needs, although they do help the girls with small things like braiding their hair. When the girls were young, the attendants spent more time helping them with bathing and dressing.
When Laural was a baby, it used to bother me that I couldn't do everything for her. I missed the feeling of being able to lift my baby up easily to my shoulder, or of being able to dress her when she was tiny. What I've learned is not to sweat those things. I focus on what I am able to do, and I do it as often and fully as I can. I know my kids won't grow up with a complex because I didn't wash their hair when they were three months old, or because someone else tied their shoes. Regardless of who's braiding their hair, they know that I'm their mother. They come to me when they're hurt, when they want direction or when they want a hug.
I've always been open and honest with my daughters about my disability and talked about why I do things differently. In turn, I've also given them the licence to do things in their own way.
I think my disability has given my children the ability to be hugely independent, adaptable and able to reason for themselves. It's also given them a strong sense of social justice. Laural and Emily Grace don't see disability or diversity because they just accept that everyone does things differently.
As a parent, I've gained a real sense of peace, fulfillment and purpose. I know that I'm raising really good girls – not in terms of them being well-behaved, but in terms of them being good people at their core. I hope that in hearing my story, parents of children with disabilities will see that their child can have a full, rich life – one that might even include children.
1:52 PM cerebral palsy, Down syndrome, inspirations 3 comments
We may only go 'round one time
As far as I can tell
It's the time of your life so live it well!
Listening to that song from A Bug's Life is one of my best memories from Christmas. We gave Ben a CD of Pixar theme songs and he and I sat on the couch and swayed side to side to these somewhat goofy songs with such irrepressible spirit that I couldn't help smiling.
I think Ben would make the perfect Pixar movie character – an underdog with a heart of gold and an impish, mischievous character. An unlikely hero.
Recently, I met and wrote about some people who inspire me to live my life to the fullest (click on the links to read their stories).
Lauren Daly and Nicole Flynn are elite athletes who train up to 17 hours a week as synchronized swimming duet partners. Lauren has cerebral palsy and Nicole has Down syndrome. These teenagers were a delight to interview because they're great friends who are passionate about what they do (I even got to see a modified routine on land). They make me want to go out and try something new and not give up no matter what.
Gavin White was an avid hockey player and cyclist when his arms and legs went numb and he began falling over. Six weeks later the 16-year-old was diagnosed with an auto-immune disorder that left him in hospital for four months, paralyzed and on life-support. When he came to Bloorview for seven months of gruelling, painful rehabilitation, he couldn't move. 'Grace' is the word that came to mind when I interviewed Gavin. He recently defied the odds by running with the Olympic torch.
And Louise Kublick has spent her career making swimming accessible to kids with all degrees of disability.
I salute them and wish you a Happy New Year!


text:
Throughout the two terms, the students will learn about:
Drama: A practical introduction to acting skills and exercises, focusing on vocal work, movement, improvisation and script work with a practical performance at the end of the course.
Creating a Character: By using acting techniques and improvisation, you will focused on character development. Practical exercises are given to understand movement, how the body works, vocal work, creating different accents and objectives and what moves the character.
Working with Props & Costumes: This is a lively and funny class. Props and costumes are used to create characters and story lines for plays. It is a great way to develop creativity and self confidence.
Making a Play: The aim is to take students through the process of making and writing a play. The first half of the course is focused on creating characters and working on ideas through improvisation. Once the idea and the characters are devised a script is written and rehearsals begin to perform the play for a live audience. The group are fully involved in the making of the play and develop a clear understanding of drama and the theatre.
Improvisation: Improvisation is brilliant in developing self confidence and creativity. Students learn to think and react on the spot, try out new ideas and explore and develop new techniques' in acting. Students will explore the principle of character development and movement.
Vocal Work: students are taken through valuable exercise's and technique's in improving their vocal range and vocal projection. It is very important to have good projection for stage work in order for the audience to hear you clearly and enjoy your show.
Script Work: is where the students will look and explore a script focusing on; the play structure, plot and themes. Students will act out the parts and by practical guidance will develop a clear understanding in how to read, interpret and act out a script.
Speech & Drama Examinations: Here we look at poetry, mime, theory, reading aloud, improvisation and solo drama pieces.
All Classes are student centered, to insure full personal development in creativity and confidence.
Term One in Kiltimagh on Mondays. Eleven weeks costing €90.
September: 9th, 16th, 23rd, 30th. October 7th, 14th, 21st. (no class on the 28th). November 4th, 11th, 18th, 25th
Term one in Swinford on Wednesdays. Eleven weeks costing €90
September 11th, 18th, 25th. October 2nd, 9th, 16th, 23rd, (No class on 31st). November 6th, 13th, 20th, 27th.
Phone: 094 93 84262
Email: info@giggles.ie
Giggles Drama School,
Carragolda,
Bohola,
Co. Mayo.
A: Giggles Drama School, Carragolda, Bohola, Co. Mayo - M: 0877929138 - T: 094 93 84262 - E: info@giggles.ie | designed by designwest

redpajama_set_name: RedPajamaCommonCrawl


text:
Electric Co-ops Celebrate 25 Years of Commitment to Community, Core Values
PublishedSeptember 29, 2020
As cooperatives in the United States prepare to observe National Co-op Month in October, it's hard to imagine life without the seventh principle: concern for community. But until 25 years ago, it wasn't officially part of co-ops' core set of values.
On Sept. 21, the International Co-operative Alliance, the service organization for co-ops around the world, celebrated the anniversary of the Statement on the Cooperative Identity and the adoption of guiding co-op principles, including concern for community. The measures were among those passed in 1995 at the World Cooperative Congress in Manchester, England, a gathering of more than 2,000 co-op representatives from across the globe.
The meeting is recognized as a watershed for the global cooperative movement, on par with the founding of the first co-op in Rochdale, England, more than 175 years ago, said Martin Lowery, NRECA executive vice president emeritus and chair of the ICA Cooperative Identity Committee.
"It was the best effort since the Rochdale pioneers in 1844 to present our common DNA to ourselves and to the world," Lowery said. "For the first time, the ICA defined co-ops and instituted standards and values for a common cooperative identity."
Lowery noted that adding concern for community has been particularly meaningful to U.S. electric co-ops.
"Principle seven has made an important, positive difference because it's a constant reminder that it's the community that matters," he said. "Electric cooperatives take that responsibility very seriously."
The lead-up to the World Congress in 1995 was 15 years in the making. Under pressure by its member co-ops, the ICA had been studying how to adapt broad values and principles to better fit changing times. The global economy was evolving, the Iron Curtain had fallen, and co-op memberships were becoming more diverse.
"Just as every human being has an identity, a self-identity, cooperative enterprises do as well," said Lowery. "Cooperatives are people-driven, or member-driven, and as a member, you actually own it and can make a difference in terms of the direction of the business and the services that are provided."
In honor of the 25th anniversary of the addition of the seventh cooperative principle, here are seven co-op moments in 2020 that embody concern for community:
Pennsylvania Co-op Helps Build Drive-In Movie Theater to Attract Crowds Safely
The new IMAX-sized screen at Pennsylvania's Bedford County Fairgrounds was built with donated labor and materials from Bedford Rural Electric Cooperative and some of its commercial-industrial account holders. (Photo By: Bedford Chamber of Commerce)
It was a double feature of concern for community and socially distanced summer fun when Bedford Rural Electric Cooperative helped build a drive-in movie theater. (See the full story.)
Grateful Wisconsin Co-op Employee Pays Member's $300 Electric Bill
Dave and Heather Chavie and their daughter, Sophia, center, at the family's home. (Photo By: David Chavie)
An engineering technician and an elderly member reconnected over a powerful moment experienced years ago. (See the full story.)
North Dakota Co-ops Grow Connections Between Local Growers, Small-Town Grocers
Little Greens' Kolter Karges stocks local markets with kale, spinach and other produce straight from his greenhouses. (Photo Courtesy Kolter Karges)
When the pandemic threatened food distribution chains, North Dakota's electric co-ops helped connect local farmers and grocery stores. (See the full story.)
Co-ops, Restaurants Team Up to Provide Meals During COVID-19 Pandemic
Mohave Electric Cooperative's Ardie Lauxman and Donna Hill prepare meals for seniors in a coffeehouse that was converted into a community kitchen. (Photo By: Anita Gill)
Kindness was on the menu when co-ops and restaurants, struggling with loss of business, provided meals during the pandemic's early days. (See the full story.)
Oregon Co-op Helps Bring Virtual Reality Training to First Responders
Baker City, Oregon, first responders help set up the scene for a video on downed power line safety. (Photo Courtesy: OTEC)
First responder training in remote areas of Oregon is going high-tech, thanks to a co-op initiative that ties technology to economic development. (See the full story.)
Amid Pandemic Shortages, Co-op Partners With Distillery to Produce Hand Cleanser
Victory Electric Cooperative CEO Shane Laws (center) helps bottle hand cleanser at a distillery in Dodge City, Kansas. (Photo By: Jerri Whitley/Victory EC)
A Kansas co-op and a local whiskey distillery teamed up to fill an urgent need for hand cleanser amid a nationwide shortage. (See the full story.)
Co-op Speeds Broadband Connection to Clinic for COVID-19 Testing
To meet a 72-hour deadline, a NineStar Connect crew manually digs the last 30 feet of an 1,800-foot conduit to deliver broadband to a medical clinic during the coronavirus pandemic. (Photo By: NineStar Connect)
An Indiana co-op crew shoveled through snow to provide broadband internet access to a new clinic opened to test patients for the coronavirus. (See the full story.)
Download your own wallet-sized card or poster on the seven cooperative principles on cooperative.com.
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Companies both big and small are embracing the benefits of artificial intelligence (AI), expanding its use to the edge and endpoint. Surprisingly, they're seeing little slowdown in deployment plans due to the coronavirus pandemic.
At the same time, they express concern about AI ethics in a way that suggests the need for a holistic approach to AI projects, according to a new report from MIT Technology Review Insights in conjunction with Arm.
The survey of 301 business and technology leaders indicates widespread optimism around AI as companies re-architect their businesses and customer experiences. At the same time, the report shows that the economic and social effects of the pandemic have done little to dent plans around deploying AI. Nearly 40 percent of respondents indicated their AI plans are unchanged, while a third said the pandemic has actually accelerated their plans.
Survey respondents are members of the MIT Technology Review Global Panel, a group of professionals asked to share their expertise on technology and business. Respondents were asked about their organizations' AI strategies, how they're using AI technologies, and how the coronavirus pandemic has affected their deployments.
A report generated off the back of the survey also includes interviews with a number of tech executives who offer their unique perspectives on AI deployment.
AI is enabling companies to re-imagine and re-architect their business
Companies are leveraging AI for reasons that include real-time decision-making, gaining a competitive edge, product development and improving customer experience. In short, AI is enabling companies to re-imagine and re-architect their business.
Most of the AI efforts in the surveyed universe directly leverage cloud-based compute, although more and more projects are utilizing AI compute at the edge and endpoint devices.
Ibrahim Gokcen, who was until recently chief technology officer at Schneider Electric, the energy management company, said the cloud has been imperative "not only to transform our company digitally but also to transform our customers' businesses digitally."
"It was a clear, strategic area of investment for us before the crisis," added Gokcen, who was one of a handful of AI adopters interviewed as part of the MIT Tech Review report.
Report highlights clear bifurcation of compute
Some organizations that are deploying AI solutions are doing so with clear bifurcation of compute duties in mind. For example, Marc Raibert, chairman of the robotics company Boston Dynamics, describes this as "athletic AI" versus "cognitive AI." The former is computed largely on the device, such as a robot, where algorithms are tightly coupled with the machine and low latency is crucial. The latter is about thinking, planning and learning from a given environment. Here, companies are leveraging the cloud.
The MIT Tech Review survey also offers some relief for those who worry about the deleterious effects of AI. When it comes to the ethics of AI, business and tech leaders are most worried about AI falling into the wrong hands, and they're uneasy about a lack of transparency and human bias coming through in algorithms.
"We realize people will judge us based on how sophisticated we are in thinking of ethics and community concerns around AI," says Gokcen.
Read the MIT Technology Review insights report
The MIT Technology Review Insights report, A new horizon: Expanding the AI landscape is packed with insights that can help inform your development and deployment plans. Download a copy here.


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Thompson On Schiavo
A counter-Christianist blast, reflecting his own family's painful choice to end the life of his own daughter, Elizabeth "Betsy" Thompson:
"I had to make those decisions with the rest of my family," Thompson said. "And I will assure you one thing: no matter which decision you make, you will never know whether or not you made exactly the right decision."
GOP hopeful Thompson said that "making this into a political football is something that I don't welcome, and this will probably be the last time I ever address it. It should be decided by the family. The federal government -- and the state government too, except for the court system -- should stay out of these matters, as far as I'm concerned."
For all his weaknesses as a candidate, Thompson has one attribute now rare among Republicans: a lack of zeal.


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El túnel de Belate es un túnel de doble sentido de circulación situado en el norte de Navarra. Por él discurre la carretera de altas prestaciones  uniendo los municipios de Ulzama y Baztan. Es el séptimo túnel de carretera convencional más largo de España.

Sus obras se iniciaron en 1993, con un presupuesto de casi 11.000 millones de pesetas (6.010.121,04 en euros).

El rey Juan Carlos I, inauguró el túnel el 29 de noviembre de 1997, acompañado también de una inauguración de una central eólica.

Véase también
 Anexo:Túneles de España

Túneles de carretera de España de los años 1990
Infraestructuras de Navarra
Arquitectura de España de 1997
Edificios y estructuras de Navarra

redpajama_set_name: RedPajamaWikipedia


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Constructing a Sports Injuries Physiotherapy Clinic?
By elitehealthphysio 24/09/2015 Health
Constructing a sports injuries clinic in a area or location is a very awesome idea, however it is also very important that one makes better research when making choices such as where to and how to build. More like the classically outlook and appearance of the Sports injuries physiotherapy in Monaghan, every construction company or contractor handling the building project of a clinic as such should be should take reference from them.
Constructing or erecting a very exclusive sports injury clinic building can be achieved to a larger extent through careful and in-depth planning. How do I really mean? Ok have you ever seen or visited a construction site surveyor in his office before, and seeing him plan out his strategies on building construction? The same thing applies with the architects in charge of a building block. If you have, then there are chances that you will understand what and where I am trying to drive at.
Constructing an orthopedic or Neck pain physiotherapy clinic in the likes of the Neck pain physiotherapy in Monaghan demands care. And means that you will have to plan accordingly and accurately in order to avoid irreversible mistakes as a building contractor. Below are some of the researched and verified things that should be monitored when building or constructing a sports Injuries Physiotherapy clinic or complex in any locality or neighborhood.
1. The presence of sports centers: Most building contractors don't really care about important factors and elements like this, but it is very obvious that they are not really to blame. But the planners of the project. Ensuring that there is a reasonable number of sporting centers or complex in a particular area before locating a clinic like the Sports injuries physiotherapy in Monaghan clinic is important. This is because it will not just become a very big benefit to the people of such an area, but will also to bring more money into the owners' coffer. Be it a government owned or for a private individual.
2. The presence of sports Persons: This indeed another most important thing that you have to consider. Making sure that there are people who have love and passion for sports is undeniably important too. Especially when you are sure that such people are plenty and are around the location. This also has its own special effect to play in the growth of the Physiotherapy home.
3. Availability of Funds: A whole lots of people might probably say, this is not important and does not really concern the concentration of hospitals like Sports injuries physiotherapy in Monaghan clinics. Or the Neck pain physiotherapy in Monaghan homes where the injured and other casualties are treated. But it really does, think about it and provide yourself with a candid answer. For example, let's take it as if it was the Neck pain physiotherapy in Monaghan, and you are the director. If the persons residing in the community does not have money to pay for all your services as a Neck pain or Sports injuries physiotherapy in Monaghan clinic. How then do you make up for the expenses and investment made on you hospital? Moreover there wouldn't be any sign of growth. Because you will end up giving out treatments for free to customers.
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Life sometimes presents unexpected surprises. And they are not always pleasant. A similar story happened with the main character of the series. At a young age she was left without means of subsistence, without a husband and a career. Yes, and in the status of a single mother. In fact, to work for a woman was simply not necessary. Overcoming despair and pain, Lisa rushes to find a job to feed herself and her child, to provide him with everything necessary. It turns out that over the long fifteen years the world has changed. Therefore, all attempts to get a prestigious place end in failure. As it turned out, forty-year-old women without experience and failures in their personal lives are not suitable for work. Acquaintance with the young tattoo artist Josh and romantic feelings give Lisa a second youth. Having tried on a new image, with the help of a friend, she becomes a twenty-six-year-old carefree beauty, ready to conquer the peaks. Luck waited nearby. Temperamental Diana chooses a candidate as an assistant. Familiarity with the employees at the site of a new job convinces Lisa that her appearance is no different from them. The goal is achieved, but in order to secure the result, you need to hide your life experience and age.


In this video, This Old House landscape contractor Roger Cook helps a homeowner select and plant a deciduous shade tree.
1. Call the local utility company to confirm that there aren't any buried cables or pipes beneath where you want to plant the tree.
2. Have the nursery deliver the tree and drop it right beside the proposed planting spot.
3. Drive a wood stake into the center of the planting hole.
4. Measure the diameter of the tree's root ball. The planting hole must be twice as wide as the root ball.
5. Wrap a loop of rope around the stake, then tie it off so that its length equals to the radius of the root-ball diameter.
6. Slip an edging tool into the rope loop, then pull out on the edger to straighten the rope.
7. Stomp the edger into the ground to cut through the grass. Lift up the edger, move over a few inches and stomp it into the grass again.
8. Repeat the previous step until you've cut a circular outline of the planting hole all the way around the center stake.
9. Pull out the stake and rope.
10. Use a garden mattock and shovel to remove the grass from within the planting-hole outline. Shovel the grass into a wheelbarrow.
11. Dig the planting hole to a depth equal to the height of the root flare on the tree. Shovel the dirt onto tarps.
12. Set the tree into the hole, then rotate it until its best-looking side faces the house.
13. Check the tree to make sure it's perfectly straight and not leaning to one side. If necessary, shovel soil under the low side to straighten out the tree.
14. Cut the burlap off the root ball.
15. Scratch the sides of the root ball with a three-tine cultivator to loosen matted roots.
16. Check the top of the root ball for any girdling roots that are wrapped around the tree trunk. If you find any, cut them away with pruners.
17. Carefully scrape away the soil from the top of the root ball to expose the root flare.
18. Mix compost, superphosphate, and starter fertilizer into the excavated soil.
19. Backfill around the tree with the amended soil.
20. Water the tree immediately after planting.
21. Pound into the lawn two metal stakes, one on each side of the tree. Tie the tree to the stakes with plastic chains.
22. Spread about 2 inches of bark mulch around the tree, but don't pile it up against the trunk.
23. Tie two drip-irrigation bags to the base of the tree. Fill the bags with water every day for one week, then twice a week after that.


give the readers the opportunity of knowing what the great personalities of Islam have been doing in their life and how their character has been an example for us to follow.
We hope that the presentation of Gems & Jewels will be a continuing process, and we will be compiling and publishing one volume after the other providing the readers gems and jewels from our glorious history.
The writings in this series will be of equal interest to all Muslims whether they are children or adults, and similarly they will gain a lot of virtues, develop good character patterns, and adopt intellectual behavior in their lives. Because of the usefulness of the series, we are planning to produce it in other languages also so that a majority of the Muslims may be able to benefit from it. We pray to Allah for the success.


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Akatsi är en ort i sydöstra Ghana. Den är huvudort för distriktet Akatsi South, och folkmängden uppgick till 31 884 invånare vid folkräkningen 2010.

Källor

Orter i Voltaregionen


This school year is going to be very different, because I have been incredibly inspired by a book called Guerrilla Learning.
At the end of each chapter the exercises for the reader (the parent!) had some new ideas about learning- specifically how to incorporate your own continued learning with your child.
So this homeschool year I will be learning along side my boys- for instance, they will be doing handwriting each day and I will be learning hand lettering with my own workbook too! This not only makes the start of each day exciting for me (one of my weaknesses is getting tired of a project and not being consistent) because I will have my own creative outlet to do right next to my boys.
I am also going to continue with our mother/son book club this year! My older son Brooks is a very strong reader and last winter we started reading the same books together- 30 pages a day and then got to talk about the books! It was a huge hit! A little tip for picking books: choose award winning books! Our library had an entire section of them so it made our choices very easy. Most of them were older classics (which I loved!) and new children's authors for us to discover too.
I have also decided we will add volunteering to our homeschool year. We have visited a sheep farm called Shepherd's Cross located in Claremore, OK several times during their fall pumpkin festival and I always feel so drawn to that farm. I am going to call and request volunteer paperwork and hopefully we can serve there twice month.
We are also branching out and starting a history curriculum with the boys! We are switching over to Precious People World History from The Peaceful Press and I am so excited about this change most of all- since this curriculum is guiding the rhythm of our day it will be more literature based, which is what I have always wanted for our homeschool but never felt I had the time or effort to create!
Since my son has struggled with math for about 2 years I decided to try Saxon math… rather reluctantly though! I remember using this curriculum when I was homeschooled myself and apparently remembered it wrong. My mom reminded me that this was the curriculum that changed everything for me so here we go! I researched Saxon and through several youtube video suggestions bought a used 1st edition book because these were closest to the author's (John Saxon) vision for math. I found the kindergarten used for $30 and the Grade 4/5 used for $5 locally at Bibliomania and the Teachers Guide used on eBay for $16!
My mom also shared a fun book/tape set called Lyrical Life Science and I will be getting the audio tape put on CD this week. We will listen to the science songs on fridays! Here is a youtube link if you are interested in hearing them!
The week before homeschool we are doing "Character Camp" in which each morning we will read about one character trait, study the animal and read the bible story! I am using the 3-volume books Character Sketches that my mom used when homeschooling my sisters and I- I love these books!!!
I chose Determination (Salmon/Elisha) Responsibility (Otter/Moses) Courage (Skunk/David) Contentment (Porcupine/Nehemiah) Gratefulness (Eagle/Ruth & Boaz) We will focus on an obedient heart and a good attitude, the idea is to transition into school with this camp style week before school.
Here's to a great year with my boys.


Jay is an author working to make it as a full time author :) The Night Before The Night Before Christmas is Jay's first children's book project!
Darren works as a lead artist in game development. The Night Before The Night Before Christmas is Darren's first children's book project!


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Q: How to merge a list of maps in java? I have two lists of maps.
List<Map<String,String>> catDataToCache = new ArrayList();
List<Map<String,String>> catDataToCache2 = new ArrayList();

Each map looks like this
map('referer'=>'abc.com','category'=>'def.com')

I have to merge these two. I tried List.addAll(); However I get a garbled collection.

A: I believe you're trying to merge mappings from two or more Maps. If so, you do it using Map#putAll() without involving Lists unless the Maps are actually stored in there which seems rather unlikely.
Map<String, String> map1 = new HashMap<String, String>();
map1.put("referrer", "abc.com");

Map<String, String> map2 = new HashMap<String, String>();
map2.put("category", "def.com");

Map<String, String> map3 = new HashMap<String, String>();

map3.putAll(map1);
map3.putAll(map2);

for (Map.Entry<String, String> mapping : map3.entrySet()) {
    System.out.println(mapping.getKey() + " = " + mapping.getValue());
}

Output :
category = def.com
referrer = abc.com

If you're actually getting your Maps within a List, simply iterate over it and use putAll() as shown above for each Map. If there are multiple such Lists, repeat the Iterator loop for each one of them.

List<Map<String,String>> listOfMaps = new ArrayList<Map<String,String>>();

// initialize map1, map2, map3 same as above

listOfMaps.add(map1);
listOfMaps.add(map2);

for (Iterator<Map<String, String>> iterator =
                        listOfMaps.iterator(); iterator.hasNext();) {
    map3.putAll(iterator.next());
}

for (Map.Entry<String, String> mapping : map3.entrySet()) {
    System.out.println(mapping.getKey() + " = " + mapping.getValue());
}

A:     List<Map<String,String>> catDataToCache = new ArrayList<Map<String, String>>();
    List<Map<String,String>> catDataToCache2 = new ArrayList<Map<String, String>>();

    List<Map<String,String>> mergedDataToCache = new ArrayList<Map<String, String>>();

    mergedDataToCache.addAll(catDataToCache);
    mergedDataToCache.addAll(catDataToCache2);

    Map<String,String> mergedMap= new HashMap<String, String>();

    for(Map<String,String> map:mergedDataToCache){
        mergedMap.putAll(map);
    }

redpajama_set_name: RedPajamaStackExchange


Have only used my cup once but I found it worked well and fitted better then previous cups I have owned. I wish I had found the one earlier.
So easy to use. I love not having to use pads or tampons anymore, and not creating any waste. I find the cup hygienic, comfortable and it doesn't leak. Highly recommend!
I'll never go back! Life changing!
Takes a bit of practice the first time, Don't stress – second and third cycles just get smoother and smoother.
I was sceptical that I would 'fit' any cup, let alone the first one I tried. I can only sometimes get tampons to sit right, and I wasn't overly full of confidence.
First cycle and I'm loving the switch! Removal was very tricky at first (took me a solid hour!) but some googling and patience worked wonders. No leaks after 12 hours, don't feel a thing, such a fantastic product! Highly recommended!!
Note: I got the 'low cervix' option because I can feel my cervix halfway between my 1st and 2nd knuckles. I can find the stem of the cup easily, but I can't feel it at all, and apart from the usual cramps I could easily forget I even had my period!


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8614 Centreville Road
Call for emergency
Referral Veterinarians
The Lucas Fund
Internal Medicine Services
An ultrasound is a machine that operates by sending sound waves out through a hand-held probe or transducer. These sound waves go across the area the probe is applied to and these waves return back to the probe to create an image on the screen. The image will show a picture in shades of gray, white, and black, depending upon the density of the tissue that is being imaged. Based on the veterinarian's experience, they can then compare the image they are seeing to a normal image and give feedback about their findings.
Endoscopy utilizes a flexible, fiber optic instrument to examine the stomach, small intestines, and colon. The endoscope is 1.1 meters long, 1.0 cm wide, and has a channel through which biopsies can be obtained. There are two small light sources at the end of the scope that measure about 3 mm in width that allow visualization of the internal intestinal lumen. The endoscope can get small 3-4 mm biopsies of the stomach, small intestines, and the colon.
Endoscopy is a non-invasive method by which to get biopsies of the GI tract. The gastrointestinal tract is five layers thick when examined under a microscope. The endoscope forceps can only biopsy the first two of these five layers. Endoscopy is limited if the disease is present in the three layers of the wall that the endoscopic forceps cannot reach.
With endoscopy there are no incisions to heal; thus, therapy can be started when results are back without waiting for incision lines to heal before starting some medications. With endoscopy there is only minor gas discomfort that passes within eight hours and there is no pain or healing as occurs with surgery.
During endoscopy, the patient is under general anesthesia with analgesics, intravenous fluids, continuous blood pressure, EKG, and oxygenation monitoring performed by nationally and state accredited Licensed Veterinary Technicians.
A cystoscopy is a scoping of the urinary bladder. This procedure is performed using a small 1.2-2.1 cm rigid fiber optic scope. The urinary bladder is filled with sterile saline and distended so the scope can enter. Upon entry into the urinary bladder, the bladder wall can be seen. The entrance of ureters (lines from the kidney to the bladder) can also be seen during this examination. The bladder wall can be examined for masses, polyps, plaques, or the presence of free-floating stones. Based on the veterinarian's discretion, biopsies and cultures can be collected.
Cystoscopy is performed under general anesthesia with analgesics, intravenous fluids, continuous blood pressure, EKG, and oxygenation monitoring performed by nationally and state accredited Licensed Veterinary Technicians.
A Laparoscopy is a procedure in which two trocars and a tiny insufflations needle are inserted into a patient's abdomen. The insufflations needle is used to introduce air (carbon dioxide) into the abdomen to distend it and allow viewing of the abdominal organs. One trocar holds a camera in it to be able to visualize inside the abdomen. The second trocar holds the biopsy instrument used to collect biopsy samples within the abdominal cavity. The camera allows visualization of the liver, spleen, gallbladder, stomach, and diaphragm.
Biopsies can be taken of an organ based on the veterinarian's discretion. Most often this technique is used to biopsy the liver.
Laparoscopy is performed under general anesthesia with analgesics, intravenous fluids, continuous blood pressure, EKG, and oxygenation monitoring performed by nationally and state accredited Licensed Veterinary Technicians.
Laparoscopy is a less invasive method by which to obtain a biopsy. There are only three tiny 0.5 cm incision sites through which the scopes are inserted. These sites heal quickly; thus the procedure is not as invasive as an abdominal surgery.
A bronchoscopy is a scoping of the lungs. This procedure is performed using a sterile, fiberoptic scope with a diameter of 0.5 cm with a biopsy channel and small 0.2cm light source. A bronchoscope is used to examine all seven lung lobes for masses, foreign bodies, polyps, or other abnormalities. Depending on which lung lobe is selected, the doctor will then "wash" the lungs with sterile saline and then suction the wash fluid back to obtain cells for cytology and a sample for culture.
Since this is an upper airway procedure there are risks involved, just as with any anesthetic procedure, and your doctor will discuss these risks with you beforehand.
Bronchoscopy is performed under general anesthesia with analgesics, intravenous fluids, continuous blood pressure, EKG, and oxygenation monitoring performed by nationally and state accredited Licensed Veterinary Technicians.
Rhinoscopy
A rhinoscopy is a "scoping of the nasal cavity." The nasal cavity is comprised of many scroll-like bones called turbinates that function like a maze within the nasal cavities of both dogs and cats. Careful examination of the nasal cavity is done with a small, rigid, fiber optic scope that shows an image on the video monitor while the doctor is examining the nasal cavities.
Rhinoscopy is done to look for tumors, fungus, foreign bodies, structural abnormalities, or other abnormalities. During the rhinoscopy, biopsies and possibly cultures are taken for further diagnosis.
Rhinoscopy is performed under general anesthesia with analgesics, intravenous fluids, EKG, blood pressure, and oxygenation monitoring performed by nationally and state accredited Licensed Veterinary Technicians.
Aspirate
An aspirate is very low risk, non-invasive technique by which cells from an area are collected or aspirated by using a syringe and a small needle. The collection of these cells is done via ultrasound guidance to reduce the risk of bleeding. By collecting these cells, they can be put on a microscope slide and reviewed for further diagnosis. If the sample is of good quality, it can then be sent out for review by a board certified veterinary pathologist for a more definitive diagnosis.
Aspirates can be done on the liver, spleen, GI masses, lymph nodes, skin nodules, or other structures. Sometimes, an aspirate does not yield enough cells to be read and a more invasive procedure called a biopsy is needed.
A biopsy is a term to describe the collection of tissues for review by a veterinary pathologist. A biopsy can be collected via endoscopy, rhinoscopy, cystoscopy, laparoscopy, with a tru-cut needle or a punch biopsy of the skin. Biopsies are superior to aspirates because the amount of tissue present for the pathologist to review is much larger.
Although the biopsy specimen is larger, it does not come without risks. Risks inherent with biopsy procedures are bleeding or infection. Your doctor will discuss the risks of any procedures that are recommended and every measure of care will be taken to prevent bleeding or other complications.
A biopsy can be performed on the liver, spleen, a GI mass, lymph nodes, or other structures.
Digital radiology may represent the greatest technological advancement in medical imaging over the last decade. The use of radiographic films in x-ray imaging might become obsolete in a few years. An appropriate analogy that is easy to understand is the replacement of typical film cameras with digital cameras. Images can be immediately acquired, deleted, modified, and subsequently sent to a network of computers.
The benefits from digital radiology are enormous. It can make a radiological facility or department filmless. The referring physician can view the requested image on a desktop or a personal computer and often report in just a few minutes after the examination was performed. The images are no longer held in a single location; but can be seen simultaneously by physicians who are in separate locations. In addition, the patient can have the x-ray images on a compact disk to take to another physician or hospital.
Internal Medicine FAQs
Internal Medicine Veterinarians
The Veterinary Referral Center of Northern Virginia
Phone: (703) 361-8287 Address: 8614 Centreville Road, Manassas, VA 20110
Emergency Veterinarians
Portosystemic Shunt (Liver)
Arnold is Doing Well after Removal of a Rare Cancerous Tumor
Astra Recovering Well After Jump from Car Window
Bailey Is Recovering Quickly after Neck Surgery
Beamer's Bowing on Both Front Legs Successfully Addressed with Surgery
Blue Began Urinating in the House
Buoy – The Beautiful Lab Puppy That Beats the Odds
Caine Is Feeling Better Following Surgery
Dexter Recovering Well after Delicate Removal of Mass on Adrenal Gland
Diesel is Back on the Road Again!
Diesel Recovered Quickly after Front Leg Amputation
Dino Is Back to Being a Happy, Healthy Puppy
Drake Was Fortunate to Keep His Leg after a Giant Leap
Drew is Making an Amazing Recovery after Back Surgery
Dukester Is on the Road to Recovery
Emergency FAQs
Emergency Treatment Plans
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text:
La Universidad de Yibuti (francés: Université de Djibouti) fue creada por decreto el 7 de enero de 2006. Provee de enseñanza superior general y técnica a la población del país de forma continua. Utiliza el sistema de Licenciatura-Master-Doctorado cuyos principales objetivos son la movilidad de los estudiantes armonizando los diplomas y el acceso al saber para todos.

La Universidad de Yibuti contribuye a la investigación, a la producción científica y pedagógica.

Se da una gran importancia a la multipolaridad, es decir, facilitar el acceso de cada uno a una enseñanza superior de claidad.

En el curso 2014-2015, acogió ma 7000+ alumnos con 54 programas universitarios distintos.

Universidades de Yibuti
Edificios y estructuras de Yibuti (ciudad)
Universidades fundadas en el siglo XXI
Instituciones educativas establecidas en 2006


For most of you cat owners, this will be familiar to you. I can hardly do anything around the house without my lovely roommate (cats are not owned by anyone, mind you) Eddy the cat. So while I wanted to review the "It's potent" eye cream by Benefit, Eddy decided he can do that so much better and who am I to argue. So well here is the review modelled by Eddy.
I have to start with admitting that I am a Benefit fan so when I got this little luxury sized sample, I was over the moon. I have been looking for a good eye cream for a while. I used to use a Nivea one, but my skin did not agree with it. So well now I tried this one.
It promises to brighten your eyes and make them look younger. It also claims to remove dark circles and fine lines. Now I can't talk to much about effects on fine lines since this is one of the few things, nature (my genes) have blessed me with, I have no lines yet. However, dark circles? Oh yes!
The cream has no strong colour or scent as far as I can tell. It applies very well and does not leave a fatty film (good for when you want to apply make up afterwards). Indeed it seemed to immediately brighten my skin. It was very nicely cooling and soothing for my under eye skin. I do not suffer from dry skin under my eyes so I am not sure how it would be there but for my eyes it was very good. I have not noticed a long term strong reduction of dark circles but to be honest i do not expect that from a cream either. Never the less i keep you posted as I continue using it, that is when Eddy let me have it. So far, I think, I will definitely purchase the full size.
The Goblins attacked: Essence Rock out blusher!!!
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I looooove.... my new Wintercoat by "Only"


The newest bike of the trio here, the UM Renegade Classic, is a cruiser, just like the Royal Enfield Thunderbird 500, while the Mahindra Mojo is an upright naked that is being touted as a long distance tourer. Which is why we have such wild variations in terms of their dimensions and cycle parts. With its low-slung split seats and wide-spaced handlebars, the Renegade Classic is a cruiser in the tradition American mould, and is being marketed as such in India. The Thunderbird 500 has been around for some time now, and is also in the same mould, albeit with its own Royal Enfield styling cues. Both the bikes employ generous splashes of chrome, throughout their bodywork, just as you'd expect from most cruisers.
Then there's the Mojo, with its upright and just-so-slightly leaned forward posture. It also boasts of the most upmarket suspension components: beefy upside-down forks up front and a monoshock at the rear. At 195 kg, the Thunderbird 500 is the heaviest of the lot by quite a margin, followed by the Renegade Classic at 172 kilos, while the Mojo is the lightest of the bunch here at 166 kilos (all kerb).
The Mojo is the best equipped bike here by a big margin. It gets twin exhaust cans at the rear –something that has divided opinions here at the ZigWheels office - as well as petal discs at both ends. Along with the aforementioned upside down front forks and the rear monoshock, it is also the only one here to employ an analo-digital console, along with a shift light (though the other two has small LCD readouts). The Mojo also comes with the option of higher-spec Pirelli tyres for better handling and grip. It features LED daytime-running lights and twin headlamps while the Thunderbird gets projector headlamps for better illumination at night and LED tail lamps. The biggest standout feature of the Renegade Classic that the other two motorcycles lack is an USB port that can be used to charge cellphones and sundry small electronic gadgets on the move. The Renegade also gets "blind-spot mirrors" that reportedly give riders a better view of the rear's surroundings. None of the three bikes here come with ABS, even as part of optional equipment.
Powering the Renegade Classic is a 278cc, air-cooled single cylinder engine producing 25PS of power and 22Nm of torque, mated to a six-speed transmission. UM claims a top speed of 125 kmph for the bike, which we think is pretty optimistic for a cruiser of this size, and can't wait to test out when it comes to us for a review. Motive power on the Mojo comes from a 295cc liquid-cooled, single-cylinder engine fed through an electronic fuel-injection system, producing 27PS and 30Nm, while the transmission is also a six-speeder. Then there's the Thunderbird 500 whose 499cc air-cooled engine produces 27.5PS and 41.3Nm, paired to the only 5-speed transmission here.
All the three bikes here are priced within Rs 10,000 of each other, which is why we have zoned in on them for the purpose of this spec comparison in the first place. At Rs 1.73 lakh, the Royal Enfield Thunderbird 500 is the most expensive of the bunch here but, in its defence, it comes with the largest engine in this bunch, although low on power and torque. It is also a Royal Enfield, and this is a brand that enjoys a dedicated fan following in the country like no other. The UM Renegade Classic, the most premium among three variants that also comprise of the Renegade Commando and the Renegade Sport S, will set you back by Rs 1.69 lakh, while the Mahindra Mojo – with its more upmarket cycle parts - retails for Rs 1.63 lakh (all ex-showroom, Delhi).


(sale pending) Well if you want color Apache has it. He is a 10 year old black and white gelding. He is proving to be extremely gentle and a great horse for a beginner or a novice rider. He is quiet and nice to ride. . Apache stands at 15 hands.


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Grand Light's lighting restoration experts restored the Grand Ballroom historic crystal chandeliers & plaster wall sconces from the Marriott Syracuse Downtown.
Grand Light's restoration specialists recently restored a historic crystal chandelier from Wadsworth Atheneum's Goodwin Parlor. On-site specialists diligently undressed all crystal strands and disassembled all components for transportation to the Grand Light's lighting restoration and custom lighting manufacturing facility.
Grand Light's lighting restoration team recently revisited the famous Otesaga Resort Hotel days before the 2016 National Baseball Hall of Fame Induction Ceremony to repair damaged components on an antique crystal chandelier.


If you're a fan of actor Paul Koslo then you're going to love this forty-one minute documentary that has the actor talking about the 1977 film MANIAC! (aka ASSAULT ON PARADISE). He talks about how he got involved with that film and from here he goes into its production including what it was like working with that all-star cast. Of course, the main focus is working with Oliver Reed and some of the craziness that would come from that. From here the rest of the running time is devoted to countless films from his filmmography including ROOSER COGBURN, VOYAGE OF THE DAMNED, the two Charles Bronson films THE STONE KILLER and MR. MAJESTYK as well as several others. If you're a fan of Koslo then you're definitely going to want to check this out. The stories about Reed are priceless but we get some terrific stories dealing with Bronson, John Wayne and countless other stars that the actor got to work with. Best of all is that Koslo is a wonderful storyteller so what we get to hear is just downright fun and priceless.


text:
Q: Categorical interpretation of disjoint cycle notation for tracing permutations For a natural number $n\in\mathbb{N}$, let $\underline{n}$ denote the finite set $$\underline{n}:=\{1,2,\ldots,n\}.$$
A permutation $\sigma\in Aut(\underline{n})$ can be uniquely written (up to order) as a product of disjoint cycles. To set an example we'll use $n^~_0=8$ and
$$\sigma_0^~=(1247)(358)(6).$$
I'm looking for a categorical interpretation of this notion of maximal cycle decomposition. A bit more precisely, let $\mathcal{Bij}$ denote the symmetric monoidal category of finite ordinals $\underline{n}$ as objects, automorphisms as morphisms, and disjoint union as the monoidal structure. That is, $\mathcal{Bij}$ is a skeleton of $FinSet$. I'm looking for to understand maximal cycle decomposition category-theoretically in terms of $\mathcal{Bij}$.
My motivation comes from the fact that there is a trace on $\mathcal{Bij}$  whose definition is quite simply expressed in terms of the "disjoint cycle notation". Namely, suppose given a bijection $\sigma:X\sqcup U\to Y\sqcup U$ for which you want the trace $Tr^U_{X,Y}(\sigma):X\to Y$. To obtain it, simply write $\sigma$ in maximal cycle notation, and remove every element of $U$ you see.
The above formula is not precisely stated, which is exactly the problem---how can I state this formula precisely?---but it is quite easy to think about. An example will help.
Let $X=Y=\underline{5}$ and $U=\underline{3}$, and let $\sigma_0^~: X\sqcup U\to Y\sqcup U$ be $(1247)(358)(6)$ as above, where the elements of $X$ and $Y$ are denoted $1,2,3,4,5$ and the elements of $U$ are denoted $6,7,8$. Then the trace is given by
$$Tr^U_{X,Y}(\sigma^~_0)=(124)(35).$$
We simply removed the elements of $U$ from the cycle notation and dropped of the now-empty cycle where $(6)$ was. (There is another traced monoidal category $\mathcal{Bij}'$ with the same objects, but which keeps track of the number of empty cycles.)
Category theoretically, we are just performing a trace. But this trick with disjoint cycle notation appears to be the simplest way to write the operation. How do we think about this strange but simple description?

A: I'm not completely clear on what answer would be considered satisfactory, but here's one categorical way to think about tracing in $\mathbf{Bij}$.
The morphisms of the symmetric monoidal category with duals obtained by applying the Joyal-Street-Verity construction to $\mathbf{Bij}$ can be pictured in terms of string diagrams that are essentially 1-cobordisms, i.e, curves bounded by compact 0-manifolds that are built from string diagrams for permutations and from cups and caps (which are counits and units of dual pairs) by applying the usual composition and juxtaposition operations. Now cobordisms generally are certain types of cospans in the category of manifolds. Thus, what we can do is consider $\mathbf{Bij}$ (or more generally $\mathbf{Set}$) as embedded in the bicategory of cospans between sets, where a bijection or function $\sigma: A \to B$ is mapped to the cospan
$$A \stackrel{\sigma}{\to} B \stackrel{1_B}{\leftarrow} B.$$
Composition of cospans (i.e., of 1-cells)
$$(A \stackrel{f}{\to} B \stackrel{g}{\leftarrow} C) \; ; \; (C \stackrel{h}{\to} D \stackrel{k}{\leftarrow} E)$$
is obtained by taking the pushout of $g$ and $h$, and composing $f$ and $k$ with the pushout coprojections. The disjoint sum induces an obvious tensor product on cospans.
The category obtained by taking isomorphism classes of 1-cells is a symmetric monoidal category $\mathbf{Cospan}$ with duals, in which each object is dual to itself. This works in a manner dual to the situation for $\mathbf{Span}$, where the unit and counit are given by "equality predicates"; thus for each object $U$, the unit and counit of $U \dashv U$ are given by coequality cospans
$$\eta_U = (0 \to U \stackrel{\nabla_U}{\leftarrow} U + U), \qquad \epsilon_U = (U + U \stackrel{\nabla_U}{\to} U \leftarrow 0).$$
Thus, given a bijection $\sigma: A + U \to B + U$, the tracing $Tr_{A, B}^U(\sigma)$, given by a composite of cospans
$$A \cong A + 0 \stackrel{1_A + \eta_U}{\to} A + U + U \stackrel{\sigma + U}{\to} B + U + U \stackrel{1_B + \epsilon_U}{\to} B +0 \cong B,$$
can be read off by taking a pushout in $\mathbf{Set}$ of the diagram
$$A + U \stackrel{1_A + \nabla}{\leftarrow} (A + U + U \stackrel{\sigma + U}{\to} B + U + U \stackrel{1_B + \nabla_U}{\to} B + U) \qquad (1)$$
and then composing the pushout coprojections with the canonical inclusions $A \hookrightarrow A + U$, $B \hookrightarrow B + U$.
This gives a precise categorical description of the trace operation in terms of pushouts in $\mathbf{Set}$, but: it's the trace operation that pertains to the traced monoidal category denoted $\mathbf{Bij}'$ in the original post (where one keeps track of loops formed in the tracing process). If one wants to ignore loops that are formed by composing cospans, i.e., work with the traced monoidal category $\mathbf{Bij}$, one ought to work with co-relations instead of cospans.
By definition, a co-relation is a cospan $A \stackrel{f}{\to} C \stackrel{g}{\leftarrow} B$ such that the induced map $(f, g): A + B \to C$ is epic. In other words, a co-relation is a relation in the category $\mathbf{Set}^{op}$. One should pause to note that the power set functor $P: \mathbf{Set}^{op} \to \mathbf{Set}$ is monadic, and since a monadic category over $\mathbf{Set}$ is Barr exact and in particular a regular category, the usual calculus of relations goes through. In particular, to compose co-relations in $\mathbf{Set}$, one composes them as cospans but then one applies the epi-mono factorization to the composition cospan $(f, g): A + B \to C$; the epi part $q: A + B \to C'$ gives the composition co-relation. All the relevant structural features one had from $\mathbf{Cospan}$ carry over: $\mathbf{Corel}$ is a symmetric monoidal category in which each object is dual to itself, using the same formulas for the unit and counit of $U \dashv U$.
So, in summary, the result of the pushout (1) above induces a cospan from $A$ to $B$, and after applying the appropriate epi-mono factorization to get a co-relation, one can check that the result is a bijection from $A$ to $B$ (i.e., a cospan obtained by applying the inclusion functor $\mathbf{Bij} \hookrightarrow \mathbf{Corel}$ to a suitable bijection). This is the trace in $\mathbf{Bij}$.
It's not hard to see what is really going on. Tracing is basically the introduction of a feedback loop where outputs of $\sigma$ in $U$ are fed back in as inputs in $U$ living in $A + U$, and iterating through cycles until you exit $U$. That's exactly what the string diagram picture suggests (with the proviso that we are dealing with co-relation composition, which elides over free-floating loops where one never exits $U$). The meaning in terms of the cycle decomposition is hopefully clear. For instance, to take the example of the OP, we have in one of the cycles of $\sigma$ a path $5 \to 8$; this output $8 \in U$ is reinterpreted as an input where the next step in the cycle is $8 \to 3$, at which point we have exited out of $U$.


text:
Home / featured post / OML 11: Our aim is to promote Rivers interest says Governor Wike
Rivers State Governor, Nyesom Ezenwo Wike ( r) and President-General of Ogbakor Etche, Sir Machy Nwodim during a Solidarity Visit by the Ogbakor Etche on Tuesday at the Government House Port Harcourt.
OML 11: Our aim is to promote Rivers interest says Governor Wike
December 3, 2019	featured post, News 134 Views
Rivers State Governor, Nyesom Ezenwo Wike has declared that the state government's investment in Oil Mining License (OML) 11 is aimed at promoting the interest of host stakeholder communities and ensure peace for the operation of the oil facility.
Speaking during a Solidarity Visit by the Ogbakor Etche on Tuesday at the Government House Port Harcourt, Governor Wike said the efforts of the Rivers State Government are geared towards ensuring that the communities get the best from the acquisition of OML 11.
He said: "What Rivers State Government wants is for the interest of our state to be protected. Whoever that is coming to take over will have the interest of the communities protected.
"When the communities are part owners of OML 11, there will be peace. But some people sit down and engage in unnecessary propaganda. "
Governor Wike said that the acquisition of OML 11 is the height of resource control struggle.
He urged Ogoni people to appreciate the efforts of the Rivers State Government in this regard.
"When you talk about resource control, this is is resource control. Instead of Ogoni people to thank us, they are allowing criminals, charlatans to go on radio and talk, with their leaders pretending not to be aware, when they know.
"They talk as if OML 11 belongs to them alone, which is not correct. Etche, Bonny, Oyigbo, Ogu/Bolo and Okrika are part of OML 11", he said.
Governor Wike took time to explain the process that led to the acquisition of OML 11. He said that the Rivers State Government stepped in after the High Court ordered the sale of Shell's stakes already attached as part of the enforcement of the court judgement initiated by the Ebubu Community.
On the OML 25 which was eventually given to Shell Petroleum Development Company by the Federal Government, Governor Wike stated that a fraudulent businessman claimed that the Federal Government would grant him the license of the facility. He noted that when it turned out that he was lying, the State Government worked with stakeholder communities to ensure that their interests were protected.
Governor Wike said it turned out that the businessman who sponsored falsehood on OML 25 was merely seeking surveillance and labour supply contracts from Shell Petroleum Development Company.
The Governor assured Etche people that his Administration would always invest in the development of the area. He outlined the projects that will be commissioned in Etche land during the first year of his second term.
He informed the Etche delegation that his administration will revive the Delta Rubber Company through Public Private Partnership.
He added that by May 2020, the Rivers State Government will commission the Cassava Plant. He said that with the commissioning of the Cassava Plant, the Rivers State Government will purchase cassava from farmers at prevailing market prices for processing. He said that way the farmers will be empowered to remain in business.
Earlier, the President-General of Ogbakor Etche, Sir Machy Nwodim commended the Rivers State Government for acquiring the oil facility. He said as part owners of OML 11, Etche Ethnic Nationality views the action as a welcome development.
He appealed to the Rivers State Governor to take a similar action on OML 17, where the bulk of Etche oil is found.
While congratulating the Rivers State Governor on his electoral victory, he called for electronic voting to ensure that credible violence free elections in 2023.
The President-General of Ogbakor Etche urged the Rivers State Governor to sustain his developmental projects in Etche land and initiate new projects.
It will recalled that the
Rivers State Government fully acquired Shell Petroleum Development Company of Nigeria (SPDC) 45% interest in Oil Mining Lease (OML) 11 of the State following it auction by the High Court.
Simeon Nwakaudu,
Special Assistant to the Rivers State Governor, Electronic Media.
3rd December, 2019.
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