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Antibiotics and surgery for vesicoureteric reflux: a meta-analysis of randomised controlled trials
Community child health, public health, and epidemiology
D Wheeler1,
D Vimalachandra1,
E M Hodson1,
L P Roy1,
G Smith2,
J C Craig3
1Centre for Kidney Research and Cochrane Renal Group, NHMRC Centre of Clinical Research Excellence in Renal Medicine, The Children's Hospital at Westmead, Sydney, Australia
2Department of Urology, The Children's Hospital at Westmead, Sydney, Australia
3School of Public Health, University of Sydney, Australia
Correspondence to:
Associate Professor J Craig, Centre for Kidney Research, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, NSW 2145, Australia;
jonc{at}pub.health.usyd.edu.au
Aims: To evaluate the benefits and harms of treatments for vesicoureteric reflux in children.
Methods: Meta-analyses of randomised controlled trials using a random effects model. Main outcome measures were incidence of urinary tract infection (UTI), new or progressive renal damage, renal growth, hypertension, and glomerular filtration rate.
Results: Eight trials involving 859 evaluable children comparing long term antibiotics with surgical correction of reflux (VUR) and antibiotics (seven trials) and antibiotics compared with no treatment (one trial) were identified. Risk of UTI by 1–2 and 5 years was not significantly different between surgical and medical groups (relative risk (RR) by 2 years 1.07; 95% confidence interval (CI) 0.55 to 2.09, RR by 5 years 0.99; 95% CI 0.79 to 1.26). Combined treatment resulted in a 60% reduction in febrile UTI by 5 years (RR 0.43; 95% CI 0.27 to 0.70) but no concomitant significant reduction in risk of new or progressive renal damage at 5 years (RR 1.05; 95% CI 0.85 to 1.29). In one small study no significant differences in risk for UTI or renal damage were found between antibiotic prophylaxis and no treatment.
Conclusion: It is uncertain whether the identification and treatment of children with VUR confers clinically important benefit. The additional benefit of surgery over antibiotics alone is small at best. Assuming a UTI rate of 20% for children with VUR on antibiotics for five years, nine reimplantations would be required to prevent one febrile UTI, with no reduction in the number of children developing any UTI or renal damage.
randomised controlled trial
vesicoureteric reflux
RCT, randomised controlled trial
UTI, urinary tract infection
VUR, vesicoureteric reflux
Primary vesicoureteric reflux is thought to be caused by a maturational abnormality of the vesicoureteric junction, so that urine passes in a retrograde manner up the ureter. Although the exact prevalence in the general childhood population is unknown, about a third of children with urinary tract infection are consistently found to have reflux.1 Urinary tract infection occurs in approximately 5–10% of children, and so 1–3% of children are identified with vesicoureteric reflux.2
It is believed that vesicoureteric reflux is a predisposing factor for urinary tract infection, which in turn may involve the kidney substance and cause permanent renal injury. Thus, the central management strategy for children with vesicoureteric reflux has been the avoidance of urinary tract infection induced damage.3 This has been attempted by surgical correction of reflux and long term antibiotic prophylaxis, either singly or in combination. In addition to the common Politano-Leadbetter and Cohen surgical techniques, new, less invasive techniques which involve endoscopic periureteral injection of polytetrafluoroethylene, glutaraldehyde cross linked bovine collagen, dextranomer/hyaluronic acid copolymer, or polydimethylsiloxane have been trialled.4–6
Little has been published about the harms of diagnosing and treating vesicoureteric reflux in children. The diagnosis of vesicoureteric reflux is usually made by a micturating cystourethrogram, an invasive test that requires urethral catheterisation and is frequently disturbing to children and their parents.7 It also carries the theoretical risks of iatrogenic urinary tract infection and radiation exposure. Surgical reimplantation has general risks of anaesthetic use, postoperative infection, and ureteric obstruction.8 There is increasing concern about the development of antibiotic resistant bacteria following long term antibiotic use.9 Quantifying these potential harms is problematic.
Although a common problem in childhood and frequently managed by clinicians, there is considerable disagreement regarding the best form of treatment for children with vesicoureteric reflux.8 We conducted a systematic review of randomised controlled trials (RCT) of the effects of interventions in patients with vesicoureteric reflux (VUR) on urinary tract infection (UTI) and renal parenchymal injury. The aims were to evaluate whether any intervention is better than no treatment and to evaluate the benefits and harms of the different treatment options currently utilised.
We included randomised or quasi-randomised controlled trials, which evaluated the management of patients with primary VUR and included outcome data on UTI and/or renal parenchymal injury. The study subjects were patients of any age with VUR diagnosed by micturating cystourethrogram, but without any major urological or structural abnormalities such as obstructive uropathy or spina bifida. Any form of treatment of vesicoureteric reflux was analysed, including surgery (open and closed techniques), antibiotic prophylaxis, non-invasive techniques such as management of voiding dysfunction, and any combination of therapies.
Treatment outcomes were collected according to predefined criteria, and included incidence of UTI, renal parenchymal abnormality, end stage renal disease, hypertension, renal functional impairment, and any adverse effects of treatment such as postoperative obstruction.
Medline (1966 to February 2003) and Embase (1988 to February 2003) were searched independently by two reviewers (DV, DW) without age or language restriction. The optimally sensitive search strategy for trials developed for the Cochrane Collaboration10,11 was combined with medical subject headings and textwords specific for vesicoureteric reflux. The Cochrane Controlled Trials Register was searched in advanced search mode to identify any additional trials. Reference lists of retrieved articles were searched and those known to have conducted trials of treatment for vesicoureteric reflux were contacted.
Data extraction and analysis
Relevant abstracts were reviewed independently by two authors (DV, DW) to determine suitability of inclusion. Any disagreements were resolved by discussion with a third author (JC). Where suitability was uncertain or no abstract available, the full article was obtained. Authors were contacted to obtain missing data where necessary.
Data extraction was conducted independently by three reviewers (DV, DW, GS) using a standardised checklist for outcomes and quality. The methodological quality of RCTs was evaluated based on randomisation method, allocation concealment, standardisation and blinding of outcome assessment, intention to treat analysis, and losses to follow up.12 Any discrepancies were resolved by discussion with a fourth author (JC). Where the results of a study were published more than once or results were detailed in a number of publications, the most complete data was sought from all sources and included only once for each analysis.
For dichotomous outcomes the relative risks (RR) with 95% confidence intervals (CI) were calculated using Review Manager13 for individual studies and the summary statistics were calculated using a random effects model. The random effects model takes into account between-study variability as well as within-study variability. A fixed effects model was also used to test the robustness of the analysis and for outliers. Heterogeneity between studies was analysed using Cochran's Q statistic with an α of 0.1 used for statistical significance.14
Full paper assessment identified 11 RCTs. The International Reflux Study15 was reported in two arms, European and US, and so has been treated as two separate studies. Three trials were subsequently excluded. Two trials compared different materials for subureteric implantation with resolution of reflux being the only outcome recorded.6,16 One trial was excluded because it was not possible to separate the outcomes for randomised patients from those of a non-randomly selected group of children reported in the same publication.17 Two included trials were identified by review of personal reference lists of the authors and have been published in conference proceedings only.18,19
Trial characteristics
Seven RCTs were identified (table 1) which compared the effectiveness of long term antibiotic administration with a combination of antibiotic prophylaxis for 1–24 months and ureteric reimplantation by open surgery (six trials) or Dx/HA copolymer subureteric implantation (one trial). An eighth trial18 compared no treatment with two antibiotic prophylaxis regimens (daily or intermittent antibiotic administration). The eight trials enrolled 947 children under the age of 15 years from the USA, Europe, and New Zealand; data for at least one outcome were available from 859 children. No RCT of any intervention in adults was found. No RCT was identified which compared antibiotics alone with surgery alone or used other interventions including managements for voiding dysfunction. A variety of open surgical techniques were used to correct vesicoureteric reflux, and trimethoprim, trimethoprim/sulphamethoxazole, or nitrofurantoin were used for antibiotic chemoprophylaxis. Generally only children with higher (dilating) grades of vesicoureteric reflux were included in the trials and outcomes were reported at 1–10 years post-randomisation.
Characteristics of trials of interventions for children with vesicoureteric reflux
Trial quality
The method of treatment allocation was satisfactory in five trials (table 2). Only two trials reported that assessment of radiological outcomes was determined without knowledge of treatment groups. Intention to treat analysis was not performed in three trials; in the remaining trials it was not possible to determine whether the analysis had been done on an intention to treat basis. Losses to follow up were generally low: 0–2% at 1–2 years, and 9–42% at 4–10 years of follow up.
Quality of included trials of interventions for children with vesicoureteric reflux
Outcomes of trials comparing antibiotic prophylaxis with surgery and antibiotics
We combined the results of seven trials comparing antibiotic prophylaxis with combined surgery and antibiotics to obtain summary measures of treatment effects. There was no appreciable difference between the summary estimators using random and fixed effects models (data available on request). Only the results of the random effects models are reported here. The outcomes of urinary tract infection and renal parenchymal abnormality did not appear to be heterogeneous (figs 1 and 2), and formal testing for heterogeneity confirmed this. There were insufficient trials to explore potential effect modification using subgroup analysis or meta-regression.
Meta-analyses of relative risk (random effects model) of urinary tract infections. Subtotals pertain to all urinary tract infections at 2 years post-entry (outcome 01), all urinary tract infections at 5 years post-entry (outcome 02), and symptomatic (febrile) urinary tract infections at 5 years post-entry (outcome 03). BRS, Birmingham Reflux Study; IRS Europe, European arm of the International Reflux Study; IRS US, United States arm of the International Reflux Study. Trials are shown ordered by study weights. No heterogeneity was shown using Cochran's Q statistic (χ2 analysis with degrees of freedom, df). The test statistics Z indicate that there were no significant differences between the combined treatment group and the antibiotic only group of patients with vesicoureteric reflux except for febrile urinary tract infection (outcome 03).
Meta-analyses of relative risk (random effects model) for the development of renal parenchymal abnormalities diagnosed by intravenous pyelogram. Subtotals pertain to new defects at 2 and 5 years (outcomes 01 and 03), progression of those previously identified at 2 and 5 years post-entry (outcomes 02 and 04), and all defects, both new and progressive, at both 2 and 5 years (outcomes 05 and 06). BRS, Birmingham Reflux Study; IRS Europe, European arm of the International Reflux Study; IRS US, United States arm of the International Reflux Study. Trials are shown ordered by study weights. No heterogeneity was shown using Cochran's Q statistic (χ2 analysis with degrees of freedom, df). The test statistics Z indicate that there were no significant differences between the combined treatment group and the antibiotic only group of patients with vesicoureteric reflux.
Criteria for UTI, the primary outcome in most trials, were either not given or the microbiological threshold of >105 colony forming units per ml was used. Symptomatic and asymptomatic UTI were not differentiated except in the International Reflux Study (both arms) which distinguished between asymptomatic bacteriuria, cystitis, or acute pyelonephritis. The latter was a clinical diagnosis and was defined as bacteriuria and fever of at least 38.5°C, loin or back pain, or general fatigue which could not otherwise be explained. Results were expressed as cumulative incidence over 1–2 years and/or 4–5 years of follow up.
The frequency of all forms of recurrent UTI varied between 0% and 42% in the antibiotic only group, and between 20% and 22% in the combined treatment group by 2 years of follow up (fig 1). By 2 years, there was no significant reduction in the risk of urinary tract infection in the combined treatment group compared with the antibiotic only group (four trials; relative risk (RR) 1.07; 95% confidence interval (CI) 0.55 to 2.09). By 5 years the frequency of all forms of recurrent UTI was 29–42% in the antibiotic only group and 25–40% in the combined treatment group. By five years, there was no significant difference in the risk of UTI between groups (three trials; RR 0.99; 95% CI 0.79 to 1.26). The frequency of febrile UTI was reported only in both arms of the International Reflux Study and was 22% in the antibiotic only groups and 8–10% in the combined therapy groups by 5 years of follow up (fig 1). Children in the combined treatment group had fewer febrile UTI than the antibiotic alone group by 5 years (two trials; RR 0.43; 95% CI 0.27 to 0.70). The overall incidence of symptomatic UTI (febrile and non-febrile) was only reported by the European arm and showed no significant difference in risk between groups (one trial; RR 0.96; 95% CI 0.67 to 1.39). This occurred because the increased risk of febrile infections in the antibiotic only group was matched by a similar reduction in risk of afebrile symptomatic infections in the antibiotic only group compared with the combined treatment group.
Renal parenchymal abnormality
New and progressive renal parenchymal abnormality on intravenous pyelography were the primary radiological outcomes reported by five trials. No significant differences were found for the risks for new (two trials; RR 1.06; 95% CI 0.33 to 3.42) or progressive renal parenchymal defects (two trials; RR 1.62; 95% CI 0.25 to 10.48) between the treatment groups at 2 years of follow up (fig 2). Similarly the risks for new (four trials; RR 1.06; 95% CI 0.77 to 1.45) or progressive renal parenchymal defects (three trials; RR 0.97; 95% CI 0.67 to 1.40) were not significantly different at 4–5 years of follow up (fig 2).
The European arm of the International Reflux Study also ascertained renal parenchymal abnormality at 5 years using 99Tm-dimercaptosuccinic acid scintigraphy.31 Approximately 90% (287/321) of randomised children had scintigraphy performed. Relative to the antibiotic only group, there was a small (5%) but non-significant increased risk of new or progressive scan abnormalities in the combined treatment group (one trial; RR 1.05; 95% CI 0.62 to 1.77, 18% versus 16%).
Renal growth was evaluated in four studies21,32,34,36 at 2–10 years by measurements of changes in renal length standard deviation scores (three trials; 510 children) or renal area (one study; 82 children) on intravenous pyelogram (table 1). No significant differences between groups were found at any time point or in any age group. Combining of data in meta-analysis was not possible because of differences in reporting data.
Each study reported a number of other outcomes. The two outcomes of greatest clinical importance, end stage renal failure and hypertension, were reported by the two UK studies.21,36 In total six children developed end stage renal failure (three in each arm), and eight children developed hypertension (five in the antibiotic only arm and three in the combined treatment arm). Four studies5,19,21,36 reported data on glomerular filtration rates, but these were unable to be combined because of insufficient reported point estimate and variance data. Individually, no study reported any significant difference between groups.
Resolution of reflux was an outcome described in six studies, but combining of individual trial data was not possible because of differences in reporting practices (patients and ureters), not all patients having follow up micturating cystourethrograms and missing data. In four trials21,25,33,36 the postoperative resolution rate at 4–5 years for ureters was 93–99%. Over the same follow up period, between 16% and 49% of patients had spontaneous resolution of vesicoureteric reflux.21,26,34,36 The resolution rate at 12 months for patients after Dx/HA copolymer subureteric implantation was 69% compared with 38% in the antibiotics only group.5
Adverse events for either group were generally not well reported. Postoperative obstruction to the urinary tract occurred in 6.6% of children (10/151) in the European arm of the International Reflux Study. The Birmingham Reflux Study stated that no cases of postoperative obstruction were found after 5 years. No other study referred to obstruction. No other adverse outcomes of surgery, including anaesthesia, were reported.
Outcomes of the trial comparing antibiotic prophylaxis with no treatment
In a single study,18 children were randomised to receive no treatment, daily antibiotic prophylaxis, or prophylaxis given on three days each week. There was no significant difference in risk for UTI (29 children; RR 0.25; 95% CI 0.03 to 1.85) or renal parenychmal injury (29 children; RR 0.40; 95% CI 0.02 to 9.18) between children given no therapy and children given daily antibiotics. No data on adverse events were reported.
In children with VUR identified following UTI, no significant differences in the risk for UTI or renal parenchymal injury were found in a meta-analysis of seven trials with 833 evaluable patients comparing antibiotic prophylaxis with combined surgery and antibiotics. A single study involving 29 children found no difference in the risk for UTI or renal parenchymal injury between groups treated with antibiotic prophylaxis or no therapy. However, in the latter study small patient numbers resulted in wide confidence intervals so that differences between groups cannot be excluded.
The combined evidence from available randomised controlled trials of interventions in children with vesicoureteric reflux does not provide compelling reasons why the current practice of diagnosing and treating children with vesicoureteric reflux confers important health benefits. The diagnosis of vesicoureteric reflux is most commonly made after urinary tract infection in childhood, when it is widely recommended that children be investigated. With about a 5–10% cumulative incidence of urinary tract infection during childhood, many children have micturating cystourethrography. This test generally requires urethral catheterisation, which is distressing for the children and their families,7 involves exposure to ionising radiation, and may cause urinary tract infection. Medical intervention requires the use of long term antibiotics, which may contribute to the global problem of the development of antibiotic resistant bacteria.9 The diagnosis of vesicoureteric reflux may also cause psychological stress to parents and carers of affected children, who become concerned and anxious when they are told their children have a "kidney problem" and may be at risk of urinary tract infection, renal "scarring", hypertension, and chronic renal failure. These risks have been regarded as acceptable since the 1960s when the association was made between vesicoureteric reflux and renal parenchymal damage. Although there are associations between vesicoureteric reflux, urinary tract infection, and kidney damage, the assumption that vesicoureteric reflux is a modifiable risk factor is not based on strong empiric evidence from existing randomised controlled trials. In addition recent data from prospective cohort studies suggest that in approximately 50% of children, renal parenchymal abnormalities reflect renal dysplasia associated with dilating VUR rather than damage caused by UTI.37 The belief that children with vesicoureteric reflux should be treated with surgery, antibiotics, or both developed in the 1960s from animal data which showed that infection in the presence of vesicoureteric reflux caused kidney damage. This belief still needs appropriate evaluation with a placebo controlled trial in children with vesicoureteric reflux to determine whether any therapy is effective in preventing significant and progressive renal injury.
If vesicoureteric reflux were an important modifiable risk factor for the development of urinary tract infection and renal parenchymal damage, we would anticipate a significant reduction in these outcomes for the combined surgical and antibiotic group relative to the antibiotic only group. Instead, there was no significant difference in the risk of urinary tract infection by 2 or 5 years, and no significant reduction in the risk of new or progressive areas of kidney damage at 5 years using intravenous pyelography or DMSA scintigraphy. Combined surgical and medical treatment only reduced the risk of febrile urinary tract infection at 5 years. Assuming a constant relative risk, the number of children requiring a reimplantation operation at different baseline risk of recurrent infection can be calculated. If the risk were 20%, about nine children would need to be treated with combined reimplantation surgery and antibiotics compared with antibiotics alone to prevent one febrile UTI. If the risk were 10%, 17 children would need to be treated with combined surgical and medical therapy to prevent one febrile UTI. Of all the outcomes assessed, febrile urinary tract infection is the most subjective outcome and is liable to differential misclassification. If this were true of pyelonephritis we would expect to see a reduction in the incidence of new renal parenchymal defects, but this is not the case. A randomised comparison between surgical treatment and antibiotic treatment has not been performed; only trials designed to assess the incremental benefit of surgery over antibiotics alone have been conducted. These show that the incremental benefit of surgery over antibiotics alone is, at best, small and perhaps not worth the potential harms.
In summary, our systematic review of randomised controlled trials of interventions for children with vesicoureteric reflux has identified a number of important and unanswered questions. Most importantly, it is not clear whether any intervention for children with primary vesicoureteric reflux does more good than harm. Assuming intervention is beneficial, it is not clear whether antibiotics alone or reimplantation surgery alone are most effective in reducing the risk of urinary tract infection and renal parenchymal abnormality. Furthermore, the trials, which have been undertaken comparing surgery and antibiotics with antibiotics alone, have not shown any additional benefit of surgery except for a reduction in risk of febrile urinary tract infections. Well designed and adequately powered placebo controlled randomised trials of antibiotics alone in children with vesicoureteric reflux are now required. Paediatricians and general practitioners who care for children need to be aware that existing research data do not provide a firm basis for decision making as they consider how best to investigate children following urinary tract infection and treat those with vesicoureteric reflux.
The authors would like to thank Professor Les Irwig for his help with methodology and manuscript preparation, and those authors and experts in the field who replied to our requests for study information. This systematic review was performed under the auspices of the Cochrane Renal Group of the Cochrane Collaboration. This study was funded in part by a seeding grant from the Australian Kidney Foundation (Grant no. S2/99).
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Howard Bauchner
Archives of Disease in Childhood 2003; 88 651-651 Published Online First: 22 Jul 2003. doi: 10.1136/adc.88.8.651-a


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The Women of the World festival at the Southbank Centre in London is in its 5th year, and going strong. It lasts for an entire week, and involves hundreds of women and men from around the globe. For a mere £20, you get a full day pass on the Saturday or the Sunday. This gives you the opportunity to see bands and choirs, take self-defence classes, do yoga, laugh along to comedy, listen to inspirational women discuss current issues, take part in workshops, and listen to some brave women tell their personal tales of suffering. All of this in the lovely setting of the Southbank, with bright flags and colours everywhere, friendly staff to help you around. Even if you didn't pay for an evening ticket for the big names (Salma Hayek, Hugh Grant) you still got to see and talk to some pretty awesome people. There were so many amazing experiences in just the day I was there, I wish I'd spent the whole week listening and talking to amazing women.
To pre-empt any backlash, no, it wasn't in any way anti men. Or anti anything else. It concerns me that whenever something is held up as a celebration of a particular marginalised group, there are always cries of 'what about straight people!' 'what about white people!' Celebrating and empowering anyone isn't about saying they're in any way better than anyone else. A completely equal world (for gender, race and everything else) makes sense for all human beings. But people are marginalised. People are treated differently for who they are. And it felt pretty awesome to be in a space where being who you are was celebrated, encouraged and dissected. Through positive experiences like this, hopefully all people can appreciate how the struggle of a particular group is linked intrinsically to everyone else's, and that the empowerment of one leads to the empowerment of the whole. There were quite a few men there, too.
We started out with a look at the news. A little depressing, to say the least. A 'women's day' pullout in one newspaper had one story about a female sportsperson and some adverts for makeup. A large image emblazoned with the title 'are men the new women?' featured a man relaxing by a pool with some bubbly in his hand. The key words associated with women included 'pores!' and 'angst!' A case about an industrial tribunal for unfair dismissal and a lawyer calling the teenage victims of gang rape 'slags.' So far so not surprising. After this initial look at how things currently are, the feeling was overwhelmingly one of how things are, and will, change for the better. The inspirational Leslee Udwin who made the documentary 'India's Daughter' was there and framed it in such a beautifully simplistic way. The rape and murder of that girl were awful. But who are we to say which of these is any worse than any other rape or torture. Her message was simple. From sex trafficking to objectification in the media, from rape to catcalling, from being denied basic human rights to being treated like a less employable or intelligent human being, they are all born of the same issue; the lack of value placed on females. In some countries this manifests itself far more shockingly and in others it is more subtle, but it still exists. The backlash from her film has led to criminal proceedings and a prisoner being stoned to death. While the average Jane wouldn't expect something quite so extreme, the message quite clearly was that we can make a difference. What followed was a group experience where if a statement applied to us, we stood up. It was wonderful to realise how many people shared both happy and difficult life experiences, and set the tone for a sense of togetherness that lasted all day.
We heard from other people who are also having a massive impact on the world of equality and perception. The woman who devised #ThisGirlCan (if you haven't seen it – the fantastic campaign around normal women exercising to feel great and look great, even if they wobble) and EverydaySexism (something which started out as a website and is now working to implement changes in government policy). Normal women who saw something they were unhappy about and tried to do something about it were making a difference. WOWNOW was produced by Gemma Cairney (Radio 1 DJ, I'm not cool enough to know who she is), and produced a shocking video where young teenage girls talk honestly about the way they feel about themselves, the pressures of things like exams, Instagram and ASKFM, and how porn is infiltrating their friendships and relationships (a boy was asked why he didn't stop having sex with a girl when he saw she was crying. He thought it was normal). I was left looking at the different areas of my life and if I could in some way help to spread a more realistic and empowering image of women to the world. Watch this space!
As our day continued, we went into some smaller rooms for more specific discussions. In 'Hollywood, Sci-fi, Computer Games and Rape,' I discovered the term 'fridging.' This is when a female character is raped, murdered, or tortured, which is then used as a plot device to drive forward the protagonist's desire for revenge. All too often, rape is depicted as an issue to do with men (look at Vietnam war films), power or control (Game of Thrones) rather than the horrific and terrifying thing it is for the victim. We also talked about the lack of male-male rape, or even female-male rape, and how the media supported the myth that false rape claims are more prevalent than they actually are. Where we go with this was left open. While using something horrific as a plot device is arguably lazy and insensitive writing, exploring the darker sides of humanity and its effects is something that art is often concerned with, so how to navigate through this is very interesting. Unless we want to return to the 18th Century idea of a novel being morally instructional, it is unclear. Obviously, each one of these sessions could have taken an entire day's discussion!
The most harrowing was the personal sharing of victims of domestic abuse. I find it hard to write my response to this without feeling like I am trivialising these brave women's experiences. Suffice to say that I was left with a sense of the tragedy people go through every day. We left the session talking about the need to connect more with others, to allow a greater support network so people don't feel alone.
We finished with a talk with biographer Rachel Holmes and her work on writing books about women who changed the face of society. She talked about Eleanor Marx (I'm embarrassed to say I had never heard of her) and Sylvia Pankhurst. I'm definitely buying her books! She unfolded the stories of two amazing women starting to tread the boards of a life as yet unlived by most women, and the differences they made to socialism and women's rights are phenomenal. Once again, the message we were left with was that not just at elections but in between, the things we do every day can raise awareness and bring about real change.
So where to leave this post? At times depressing, always frustrating and often heartbreaking, the plight of women the world over is a sad thing to behold, and unfortunately still seems to be something that needs to be defended as worth investigating and supporting. Having said that, the leaps forward made in so many areas of the world cannot be underestimated. But there is so much more to be done. Young women today are under such pressures and have things to deal with that we simply can't understand, so our thinking and ideas around how to help them need to change in line with technology and other changes in the modern world. If so many people are prepared to gather in one place, of all genders, sexuality, races and creeds, and raise their voices in affirmation of a world where everyone is respected equally, surely the world our children grow up in will look different than it does now.
Myself and I
Dear Terry,

redpajama_set_name: RedPajamaCommonCrawl


If you have any question regarding GenGMF just leave a comment and we will answer.
Is GenGMF compatible with Eclipse Galileo?
Currently the SVN HEAD revision is compatible with Eclipse Galileo. The last revision compatible to Eclipse Ganymede is 61.


Monterey-Salinas Transit 1201 (ex-Monterey Peninsula Transit 201)349 viewsMonterey-Salinas Transit #1201 working shuttle service for the 2002 Winter Olympics in Salt Lake City. Photograph taken in February, 2002 by Fred Reutzel.
Peninsula 609 (ex-Green Lines 902, exx-Jamaica 603)952 viewsPeninsula Bus #609 at Fourth Avenue & Marine Parkway in Bay Ridge. Photograph taken July 6, 1981 by Steve Zabel; collection of Joe Testagrose.
Peninsula 655792 viewsPeninsula Bus #655 at Broad Channel. Photograph taken September 17, 1978 by Doug Grotjahn; collection of Joe Testagrose.


The multidisciplinary artist from Sweden has several strings on her harp. When she is not writing, singing or producing music, she is creating visual art. The interest for drawing started in young age and with years developed into an artform rich of details, expression and imagination. Her art are recognized as soulful, imaginative & inspirational. It brings life to any room and and speaks to all ages.
the world who follows me on my social media, I decided to put together this Coloring Artbook for adults. Behind each illustration, I have included uplifting quotes to give this book an extra dimension. My love for writing poems was the start of my music career.
Do You want to have a look? Click on the book!
Paintings made with Acrylic on Canvas.


Conway Conservatories residing in Highfield Lane Trumfleet. Listed below are some information about double glazing that you just might not know.
Double glazing is a very vitality environment friendly dwelling improvement but the quantity you save will depend on the home windows you select and the other insulation you have. To get probably the most from your new home windows you also needs to think about improving loft and cavity wall insulation.
The most typical double glazing installations are white uPVC windows however uPVC is also accessible in other colours, and double glazed home windows will also be made in metallic (usually aluminium) which can be coloured any color, or timber ? which will be stained or painted to a color of your choice.
Most double glazing corporations buy within the components they want and put them together of their workshop.
If you are environmentally acutely aware this may be an alternative for you, although these recycled frames don't usually last so long as new, 'virgin' frames.
Glazing beads are what keeps the glass in place in your window. Beading might be internal or external. Inner is usually really helpful as it's more secure.
If rubber seals between the window body and the pane of glass are fitted individually in four (or more) lengths then they'll shrink at the joints. It's better to buy windows where the rubber is in a single length.
FENSA and the GGF now provide assist and safety for consumers. This help contains guidance, insurance, regulation of corporations, and a complaints service.
The size of ensures on windows varies so examine the small print. It may be anything from 5-20 years relying on the kind of window and where it's installed. Some guarantees embody installation, some don't.
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text:
Q: Variables not adding themselves correctly. Netlogo I have been working on modelling competing airlines in a flight leg. So, the agents that I have modelled are the passengers, which I have modelled as different agents for each time frame they want to fly in. The airlines and the actual time slots of an airport. The idea is that the airlines will vary their fares and schedule to fly on different times depending on their previous flight(iteration) to attract the highest number of passengers or be profitable. The costs are linked to what time slot they want to fly in (higher demand- higher costs). I have allready modelled more or less the passenger choice model using a utility function:
to flightchoice2

let potential-destinations out-link-neighbors

let best-patch max-one-of potential-destinations [utility-for1 myself]

ifelse random-float 1 > q

[move-to best-patch][move-to one-of potential-destinations]

end

to-report utility-for2 [businessman89] ;; Schedule Choice

let beta1 1

let beta2 1

let utility (beta1 * (1 / airfare) + beta2 * abs(time - time1))

report utility

end

"where the (time-time1) basically represents the time difference between what the airline offers and what the passengers want.
My problem comes with actually making the payment so that the turnover of the airlines increases and the agents for the passengers are eliminated. I have followed the sheep-wolf model a-bit and I've got to the point of getting rid of the passengers, but the turnover to the airlines will just not add on right:"
to airfare-payment  ;; payment procedure

let customers1 business1-here

if customers1 != nobody

[ ask customers1 [ die ]

set turnover turnover + airfare ]

let customers2 business2-here

 if customers2 != nobody

[ ask customers2 [ die ]

  set turnover turnover + airfare ]

 let customers01 leisure1-here

 if customers01 != nobody

[ ask customers01 [ die ]

  set turnover turnover + airfare ]

  let customers02 leisure2-here

 if customers02 != nobody

[ ask customers02 [ die ]

  set turnover turnover + airfare ]

end

Can anyone help with why does the turnover for the airlines is not adding itself correctly?
EDIT 1- A very simplified version my model is uploaded to show the precise problem
Agents are Loaded, links are created to the airplanes from the passengers

Airplanes move to their " departure time slots" which are represented by the houses, and then based on the time slot and airfare the passengers make their choice of airplane

From this figure it is possible to see that the passengers are placed at the same position of the airplane, but when the [airfare-payment] procedure runs (described before), somehow the turnover doesn't add up correctly.

This image shows the count of turnover before the go procedure and after, even though the turnover increases for the airlines it does not do so by the right count.

I'm pretty sure that the problem comes from the way the variables are set-up when creating the agents. Turnover is set to be a "turtle-own" variable and airfare is set as an variable for each of the airlines.
breed [business1 businessman78]  ;; business is its own plural, so we use "businessman" as the singular.
breed [business2 businessman89]

breed [Airline1 airplane1]
breed [Airline2 airplane2]

breed [leisure1 leisureman78]
breed [leisure2 leisureman89]

breed [Runway1 r78]
breed [Runway2 r89]

airline1-own [ start-patch time1 airfare capacity turnover]
airline2-own [ start-patch time1 airfare capacity turnover]
turtles-own [ time cost ]

Then the value for airfare and turnover is set when creating the airplanes in the setup. Airfare for A1 is 100, 1000 for A2

A: This code is incorrect:
let customers2 business2-here
if customers2 != nobody

The if condition is always true, because customers2 is an agent set, and nobody isn't, so they are never equal to each other.  nobody represents the lack of a single agent; it is not an empty agentset.
(Think of it this way: just because I don't have an apple, that doesn't mean I have an empty bag of apples. I might have nothing at all, not even a bag.)
I think you mean:
let customers2 business2-here
if any? customers2

I don't know if this is the cause of your bug or not, but in any case, you'll want to fix it.

redpajama_set_name: RedPajamaStackExchange


text:
New York Statler Hilton Hotel
A hotel in Manhattan which was the site of a number conventions, including:
1967 — Nycon 3
1972 — Lunacon 15, an early Star Trek Convention
1973 — Lunacon 16
1976 — 2nd World Fantasy Convention, Lunacon 19 (marred by much minor vandalism)
1981 — Empiricon 3
It was opened in 1919 as the Hotel Pennsylvania of "PEnnsylvania 6-5000" fame and renamed the Hotel Statler in 1948. In 1954, Hilton bought it and renamed it the Statler Hilton, which is how it was known when its history crossed with fandom's. Starting in the early 80s it went through various owners and names: The New York Statler, the New York Penta, and finally back to Hotel Pennsylvania.


In their ongoing efforts to provide effective early childhood education and supports that prepare children to succeed in school, the W.K. Kellogg Foundation funded a five-state study to find out what the legacy of their Supporting Partnerships to Assure Ready Kids (SPARK) project was. SPARK, which ended two years ago, did not provide direct educational services, but rather looked at ways to get all the major parties working in this area to collaborate and leverage resources. As a partner in the SPARK project, CRDG worked with the Kellogg Foundation, the Institute for Native Pacific Education and Culture, the Kamehameha Schools, the Good Beginnings Alliance, and the Hawai'i Department of Education to improve the transition from home to school for children aged three to seven.
As part of the current study, entitled Ready Kids Follow-up (RKF), CRDG is conducting longitudinal studies of SPARK participants to determine whether the interventions had a significant impact on children's school readiness and subsequent success. Participants (both SPARK beneficiaries and non-SPARK beneficiaries) are evaluated using the Bracken Basic Concept Scales, the Pre-kindergarten Behavior Scale, the Individual Hawai'i School Readiness Assessment, and a mock report card. Initial results in Hawai'i are showing a benefit from the children having participated in SPARK and in the sustained SPARK initiatives.


Confessing our sin to fellow believers is an important part of sanctification. But it isn't enough to simply talk about our struggles. on Truth For Life, Alistair Begg describes why confession must be accompanied by diligent prayer, rather than gossip or even slander.


Human skulls hung from a beam, staring vacantly at mortals below. What do they know that we still have to discover? I wondered. Death should have been instant – the head being severed from life-giving blood in one stroke of the blade - but surely it must have taken at least a few cuts, plus no doubt a bit of sawing back and forth to release bone from sinew. And this after first hacking through skin and muscle. God only knows how that must have felt – anything but instantaneous I'd have thought.
We stood beneath them, lined up as they were, with grass 'hair' hanging limply over their crowns. I counted 42 in all. Did their families come and visit, to stare at their relative's rotting flesh? It must have stunk in there in the heat, and how the flies must have feasted. It didn't bear thinking about – what on earth could you say to a child gazing up at Daddy's empty cranium?
'He fought well, my son. Be proud. His head will hang there for 300 years and instead of flies, it will attract visitors from all over the globe.' Better than an anonymous grave, I suppose.
We had driven for about 30 minutes from Kota Kinabalu in the Sabah peninsula of Borneo, Malaysia, to Monsopiad Cultural Village in the surrounding countryside. The village is named after a famous Kadazan native headhunter and warrior, and lies on the banks of the Penampung River. It is almost obscured from view by shady trees and is surrounded by paddy fields. It would be easy to drive past it and miss it altogether.The skulls have been collected by villagers for 300 years. Apparently no one could match Monsopiad's prowess. His descendants have preserved the skulls and run the village in his honour. Also on display was the thigh bone of the giant Gantang. Perhaps he was the famous Wild Man of Borneo, whom one of our group was for some reason desperate to encounter?
After viewing the gruesome skulls we walked past traditional farmhouses to watch a cultural dance performance and sample the rice wine tapai, which tasted quite weak to my alcohol-friendly system but was, I'm told, quite strong.
We were ushered away from the skulls towards an open barn where local dancers were preparing for a performance – just for our benefit.
Weird clashing noises emanated from behind a screen, when suddenly out popped a semi-naked man wearing full warrior regalia, accompanied by pretty girls in colourful tunics, immaculately made up and groomed. I wondered when Madame Arden had taught them how to embellish their naturally beautiful complexions with cosmetics and creams. An inevitable extension of nature's own potions I guess: humans have always liked to disguise themselves behind masks of some sort. And sure enough, within moments the warrior reappeared sporting a terrifying shield, and began leaping around the platform making threatening gestures, stopping every now and then to glare at one spectator, who looked around nervously to check that he was not doing anything unacceptably remiss. The warrior brandished his blowpipe ostentatiously for a few minutes, then withdrew a 'poisoned' dart from his quiver and set about waving it in front of the by now worried-looking gentleman. He needn't have feared – the dancer gestured for the spectator to join him, handed him the bow and pointed to a rather incongruous yellow balloon hanging at the corner of the platform. Aha! The idea was to have a go at shooting the dart by blowing it into the balloon! Relieved, our hero had a go and managed to pierce said balloon, to thunderous applause from the six other members of the audience. Our warrior leapt around for a few more minutes, adopting scary postures every now and then, and skipped away behind the screen.
It was our turn now to provide the entertainment. As an accomplished fool I joined in the next act – after all I'd had experience at bamboo pole dancing during my tour leading days. The idea is to hop between long poles which are clapped together in time to an ever increasing beat without getting your ankles trapped. Looks easy, sounds easy, and is nigh on impossible, especially in heavy hiking boots. Fortunately this time I was wearing trainers, slightly easier to lift every second or two. Three of us visitors stepped gamely, if hesitantly, up the steps onto our stage. The music began; the screeching pipes and reed-like voices of the singers creating a nearly authentic ambience (a pity that most of the spectators had gone outside for a fag) and to a rapturous clap we stumbled down from the platform.
Outside, my friends were attempting to cross a rope bridge suspended a few metres over a muddy river, no doubt imagining themselves as Indiana Jones striding along a swaying cord hundreds of metres above swirling rapids.
From the village we made our way to the Rasa Ria luxury resort to walk through their beautifully appointed cabins towards the jungle, where we were among a privileged few allowed to see orphaned baby orangutans in the wild. These delightful creatures cling onto their handlers for dear life, insecure and lonely, until after a few months they are left on a platform in twos, to rehabilitate them for independent life in the surrounding rainforest. Cameras clicked, there was much ooh-ing and aah-ing, and after forty minutes or so we made our way down to a nearby beach for a swim in the gloriously warm South China Sea.
So ended our day our in Borneo, one of the loveliest destinations in the Far East, and well worth a visit - if only to be able to return with a photograph of a real human skull.


The Interim Orders Committee (IOC), a statutory committee of the Council, considers whether it is necessary to make an order affecting an individual's registration for the protection of the public or otherwise in the public interest or in the interest of the individual concerned pending the outcome of an inquiry by one of the Practice Committees. The IOC does not investigate the allegations or conduct a fact finding exercise. These functions are reserved for the Practice Committees.
Decide that no order is necessary.
A case may be referred to the IOC at any stage.
In the interests of public accountability, hearings before the IOC are generally open to the public. They may, however, be heard in private where the interests of the parties or the protection of the personal life of the registrant so requires, or if the Committee considers that publicity would prejudice the interests of justice.
All interim orders must be reviewed by the IOC at a hearing. The GDC recognises that attending can be stressful to registrants and aims to avoid this potential stress when the need for a registrant to be present at an interim order review is not completely necessary.
The GDC has introduced the process of carrying out all interim order reviews based on the documents submitted by both parties "on the papers" without the need for the registrant or defence to attend the hearing day unless an oral hearing is requested.
Membership of the IOC is drawn from the fitness to practise panellists who are both dental professionals and lay members. If a panellist sits on an inquiry for the IOC they will not sit on the same inquiry when it is heard at a Practice Committee.
The rules governing the procedure of the IOC are the General Dental Council (Fitness to Practice) Rules Order of Council 2006.


text:
Home > Uncategorized > Week Fourteen Postmortem
Week Fourteen Postmortem
You see, this is why I fucking hate weeks like week fourteen. Too goddamn many giant spreads. Means what? Means you know there's gonna be a few upsets straight up, but you can't for the life of you figure out where. And it's even worse trying to pick against the spread, because what the fuck are you supposed to do? You look at the numbers and they tell you all the favorites should cover. Except you know they're not all gonna cover, because they're not all gonna win. And, in truth, probably only half of them will cover. But there's no saying which half. So you guess. Me, I mostly guessed wrong. I was 12-4 picking straight up (no big accomplishment in a week like this — I picked conservatively; there were three upsets and I missed every one of them), but only 4-12 against the spread. Here's a list of excuses.
Chicago (-7) at Jacksonville
I said: Take the Jaguars and give the points.
The final was: Jacksonville 22, Chicago 7
So what happened? I said Bears quarterback Chad Hutchinson, who had a big day in his debut in week thirteen, would struggle against the Jaguars D and he did. Chad threw for 212 yards, which ain't terrible, but he had no touchdowns and he gave up two turnovers, which ain't good. The good news for Chad is that his Bears host the Houston Texans, who have trouble stopping the pass, this week, so he might turn things around yet.
Cincinnati (+11) at New England
I said: Take the Patriots and give the points.
The final was: New England 35, Cincinnati 28
So what happened? It's hard to prepare for trick plays, like fake field goals. And it's all but impossible to prepare for a veteran quarterback you're not supposed to face and who hasn't taken a snap all season. Fortunately for the Pats, no one could ever prepare to stop a quarterback who can throw perfect passes while sitting on the field.
Cleveland (+11.5) at Buffalo
I said: Take the Bills straight up, the Browns with the points.
The final was: Buffalo 37, Cleveland 7
So what happened? Seventeen net yards of offense, that's what happened. The Browns managed 17 net yards. Not for one play. Not for one series. Not for one drive, one quarter, one half. For the whole fucking game. Seventeen yards. If this were really the Browns — which, of course, it isn't — Paul Brown would be spinning in his grave. Seventeen yards. There's no accounting for that kind of incompetence.
Indianapolis (-10.5) at Houston
I said: Take the Colts and give the points
The final was: Indianapolis 23, Houston 14
So what happened? I said to ignore all the talk about how the Texans play good teams tough when they're at home. I said Colts QB Peyton Manning would shred Houston's suspect pass D and put up four, if not five, touchdowns. I take it all back.
New Orleans (+7) at Dallas
I said: Take the Cowboys straight up, the Saints with the points.
The final was: New Orleans 27, Dallas 13
So what happened? I didn't think it mattered that the Cowboys got away with one in their Monday night win over Seattle coming into this game. I figured the Saints defense was bad enough that they'd lose no matter how not good the Cowboys really are, though I figured the New Orleans offense would score a bit. I was right about one of those things.
NY Giants (+10) at Baltimore
I said: Take the Ravens straight up, the Giants with the points.
The final was: Baltimore 37, NY Giants 14
So what happened? It wasn't that I thought the Giants would keep it to within three or anything. I figured the Ravens would win by seven. I was thinking maybe 20-13 or something. I just didn't think the Ravens had a 37-point game in them. I wasn't counting on the Giants to give the ball away six fucking times. The good news for Giants quarterback Eli Manning, who looked awful, is that he'll be facing the Steelers' notoriously soft D this weekend, which should help him … wait, what's that? you don't say? … oh, umm, never mind that last bit. Sorry, Eli.
Oakland (+7.5) at Atlanta
I said: Take the Falcons and give the points.
The final was: Atlanta 35, Oakland 10
So what happened? What do you think happened? Raiders quarterback Kerry Collins completed all of 50 percent of his passes. And Falcons running back T.J. Duckett scored every third time he touched the ball (literally). That's what.
Seattle (+7) at Minnesota
I said: Take the Vikings straight up, expect a tie vs. the spread.
The final was: Seattle 27, Minnesota 23
So what happened? I forgot about the Vikings' traditional December meltdown. And Vikings coach Mike Tice apparently forgot that Randy Moss isn't a fucking quarterback. Thanks for the reminders, Seahawks (I guess).
Miami (+11) at Denver
I said: Well, actually, I guess I didn't say anything, but I implied you should take Denver and give the points.
The final was: Denver 20, Miami 17
So what happened? Dolphins quarterback A.J. Feeley managed to go a whole game without throwing a touchdown to a opposing DB, which is almost miraculous. In fact, Feeley only threw one interception all day, and both of his fumbles were recovered by his own teammates. Broncos quarterback Jake Plummer, meanwhile, hit two Dolphins defenders. And one of Denver running back Reuben Droughns' two fumbles went to Miami. That kept it closer than it ever ought to have been. I hope the Patriots are watching tape of what can happen when you don't take a team like Miami seriously just because they suck.
N.Y. Jets (+6) at Pittsburgh
I said: Take Pittsburgh straight up, the Jets with the points.
The final was: Pittsburgh 17, NY Jets 6
So what happened? I figured Jets running back Curtis Martin would have a decent day and would keep his team in the competition. And while Curtis didn't have an awful day (24 carries for 72 yards; three catches for 35 yards), especially considering how tough the Steelers D is, he sure didn't do well enough to offset New York quarterback Chad Pennington's three interceptions. And, unlike Pittsburgh running back Jerome Bettis, Curtis didn't throw any touchdown passes. So there you go.
I said: Take the Packers and give the points.
The final was: Green Bay 16, Detroit 13
So what happened? You know, I'm not sure. I said it wouldn't matter that Green Bay's defense had been giving up serious yards, and it sorta didn't. Detroit had only 228 net yards (156 of them from one guy, running back Kevin Jones), which is pretty average as this season goes. Trouble was, the Packers only managed 301 net yards themselves. And, more important, the Pack's offense kept stalling out in the red zone. And you just don't cover nine-and-a-half-point spreads when you have to settle for field goals three quarters of the time.
San Francisco (+7) at Arizona
I said: Take the Cardinals and give the points.
The final was: San Francisco 31, Arizona 28
So what happened? You know what? Maybe 49ers fans are right; maybe running back Kevan Barlow really does suck. Maurice Hicks rushed for 139 yards and a touchdown in Barlow's absence. And the Niners would have run away with this thing if their defense hadn't collapsed in the last 20 minutes of regulation. Or maybe there's something weird going on where the 49ers must always beat the Cardinals 31-28 in overtime (this game marked the second occurrence of that result this season). I suppose it could just be that.
St. Louis (+6.5) at Carolina
I said: Take the Panthers straight up, the Rams with the points.
The final was: Carolina 20, St. Louis 7
So what happened? I'm not sure what made me think the Rams, with Chris Chandler under center, would be able to keep up with the resurgent Panthers, but I'm looking into it. Chandler went 16 for 29 for 243 yards with one touchdown, and six picks. Chris might have a better day against Arizona's D this week. Or he might not. One way or the other, the Rams' season is pretty much cooked.
Tampa Bay (+5.5) at San Diego
I said: Take the Chargers straight up, the Buccaneers to cover.
The final was: San Diego 31, Tampa Bay 24
So what happened? With four minutes remaining and the game, which had been close throughout, tied, Chargers inside linebacker Donnie Edwards picked off Buccaneers quarterback Brian Griese and ran 30 yards for a touchdown. Three plays later, Griese, who's starting to look like his old self after getting off to a good start with the Bucs, coughed the ball up at the Tampa Bay 28. Griese got his team down into scoring position once more before the game ended, but couldn't close the deal. A field goal, followed by a failed on-side kick, kept the margin at seven. Oh, well.
Philadelphia (-9) at Washington
I said: Take the Eagles straight up, the Redskins to Cover
The final was: Philadelphia 17, Washington 14
So what happened? The 'Skins still have a damned good defense and a mostly awful offense. The Eagles still have a damned good offense and an inconsistent defense. And when you put those things together, this is what you get.
Kansas City (+2) at Tennessee
I said: Take the Titans to win, the Chiefs with the points.
The final was: Kansas City 49, Tennessee 38
So what happened? "It's a coin toss, really, so do what you like," I said. "Me, I'm going with the home team to win it by a point. (Oh, and Priest or no Priest, I'm betting the over. Way, way over.)" With a minute and 39 seconds left to play, it looked like I'd picked it right straight up, wrong against the spread. With 32 seconds left to play, it was looking the other way around. And with eight seconds left, it was a done deal. What can you do? I got the over/under bit right, though. So that's something. And, considering the way Denver played against Miami Sunday afternoon, you've now gotta think the Chiefs have at least an outside shot at fucking up the division rival Broncos' playoffs hopes, which would be nice (said the Raiders fan, feeling miserable as all getup and desperate for company).
Danny Kanell? Really? Week Fourteen Picks


Greetings from Jim and Joel, your Co-Race Directors for The Dirty Kanza 200, and from the entire crew at Heartland Sports Promotions. We have some new updates to share with each of you. Hopefully this information will assist you with your event planning.
6:00 to 7:30 pm: Pasta Feed. Cost is $11 per person, all-you-can-eat. Pasta, Salad, Veggie, Bread, Coffee/Tea/Water. See "Special Note" below.
4:00 pm to Midnight: The 800 and 900 blocks of Commercial Street will be blocked off from vehicular traffic, to accommodate all Dirty Kanza event activities. We'll have food and beer vendors, an inflatable Super Slide for kids, massage therapists for sore racers' muscles, live music, and more. DK racers will have access to free showers and changing rooms inside the Granada Theater. So bring your gear bags to the start, then plan on sticking around after you finish the race so you can cheer on all the remaining finishers. Beer sales must cease at Midnight. So finish early.
Note on Parking… The public parking lot, located in the 700 block of Mechanic Street will be reserved for all-day Dirty Kanza parking. This lot is located one block east and one block south of the Granada Theater. Please use this lot. Please refrain from using other public parking spaces, if possible, as we need to leave these for regular shopping and business activities by the citizens of Emporia.
Returning riders will hopefully see a noticeable improvement in our maps this year. They should be easier to read, and will have more road names identified. One more change… Due to the dramatic increase in the number of participants, we are no longer going to place the individual maps inside ziplock bags. If you want to keep your map waterproof (from rain, snow, sweat), please bring your own ziplock bag. Maps will be sized to fit the 1-Quart (6-7/8″ x 7-3/4″ approx.) size bags.
Just a reminder about our DK Video Contest. Document your 2010 Dirty Kanza 200 experience… including your preparation for the event, your participation in the event, and your recovery from the event. Then post your creation on your personal blogsite, on YouTube, or on another similar internet site. Send us a link to your video or digital slide show. Begin shooting anytime. However, entries should not be submitted prior to 06-06-10, as your video should include your post-event condition (physical, mental & emotional) and comments. Deadline for entry is 08-15-10. Get creative. Get crazy. Have fun recording your Dirty Kanza 200 experience. Then share it with us. We'll pick the best video from all the entries, and that person will receive a FREE ENTRY into the 2011 running of The Dirty Kanza 200. Our Winner will be announced on or around 09-15-10.
We understand life sometimes gets in the way of fun. Sometimes plans need to change. If you are pre-registered for Dirty Kanza, and now discover you can not attend for any reason, we have a process in place for you. Go here… http://forums.mtbr.com/showthread.php?t=604316 Let folks know you have a spot available. Chances are you can find someone anxious to take your spot. We'll then look forward to seeing you in 2011.
In closing, we want to once again thank our sponsors for their generous support. Throughout the Dirty Kanza weekend, when you see representatives from Salsa Cycles, Swiftwick, Epic Ride Research, Adventure Monkey and High Gear Cyclery… please stop them, shake their hand, and tell them "Thank You". Without their support, this event would not be possible.
That's it for now. More updates will surely follow.


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« Champagne Kisses
War For A Rose: 1459 »
Fucking Her Best Friend's Dad
Katie inhaled the calming aroma of her tea as she looked out into the familiar back yard. Steph puttered around in the kitchen as she made them a snack, the sound of the lawn mower droning on the other side of the house on the sunny spring afternoon.
It had been almost a year since Katie's parents had moved across the harbour to be closer to work. They had lived here on the other side of the street for as long as she could remember. But first her dad's office moved a few years ago, then mom's a couple years later, and with Kate planning to begin college out of town last fall they figured it was time. So during the summer, right after high school finished, they packed up and relocated, shortening both of their commutes by almost an hour each day.
When she arrived she had seen the new family with their two adorable little kids in the front yard of her old house, they seemed nice. She missed her room. Steph had made Katie promise to visit when she came back to town for spring break, which was great because she missed her best friend most of all. School work and making new friends had left them both so busy they had not been keeping in touch like they used to.
The buzz of the lawn mower got louder as Curt finished the front and methodically mowed his way around back. In his mid-forties, he invested a lot of effort into keep his abs flat and his athletic build chiseled. He enjoyed his exercise and setting goals for himself, as well as all of the positive attention that being in great physical condition afforded him.
Katie stared at his firm ass through his sport shorts, watching his thighs flex as he pushed the mower passed in the yard.
"Mmmm. Your dad is so hot." she purred, almost to herself.
"I know you have been saying that for years, still weird." Stephanie sighed as she came to the table with eats for the two of them, "Besides, don't you have a boyfriend?"
"Not as of two weeks ago it seems…" Kate sighed.
"Spill it." Steph demanded, feeling out of touch ever since they had both gotten so busy with school.
Kate shook her head as she described the two month relationship: Everything had seemed great, he was cute and nerdy and smart… And when they had finally slept together it was as awkward as she figured two virgins would be, and that things would improve. She guessed he had other opinions. He had gotten really self conscious and distant, then he ghosted her.
"Sounds like you dodged a bullet there." Steph said, repeating the age-old break-up response.
Kate smiled and nodded, thankful that her friend was there to cheer her up, but still feeling wounded by the whole ordeal.
Steph turned on some tunes in the background as she cleaned up in the kitchen, "And? How was the sex?" she asked, curious as she was still a virgin herself.
Katie rolled her eyes and looked down into her tea, "About as bad as I could have expected," she sighed. "I was so nervous I was sweating and so was he. He was having trouble, uh, performing and I wasn't sure about the best way to help. I offered to, uh, suck him hard… I think I scraped him with my teeth…"
"Aw, girl." Steph murmured in support.
"Well we got his 'Ahem' working," she continued, blushing, "but we we're both pretty clutzy with the condom and I think he was having trouble keeping it up at first. He kept asking if he was big enough, if I could feel it. He felt fine to me, not a porn star maybe. I don't think I was very warmed up, so I was pretty tight. He didn't last very long… I didn't even orgasm."
Katie noted how quiet the pause was as the last word passed her lips. She looked up to Steph grimacing, swiping her finger across her throat to silently tell her to cut her words short. It was then she realized she couldn't hear the lawn mower under the music anymore.
"It gets better with practice," Curt chimed in from the doorway behind her with a wink and a grin having walked in from the garage to get a drink, only hearing the last bit as he approached.
Katie turned five shades of red as she slunk down in her seat. How long had he been there?
Stephanie covered her mouth as she laughed at Kate's predicament, getting away with it as only a best friend can.
"The guest bedroom has been set up for you, Katie." Curt politely changed the subject, "Towel and face cloth are on the dresser. Steph has agreed to make dinner tonight while her mother is out of town, so you won't have to be subjected to my cooking."
He walked out of the kitchen to give the girls their privacy. Steph made them all a fantastic meal that evening and the two girls curled up on the couch in the basement with popcorn and a cheesy movie, just like old times.
It was three in the morning when Kate woke up and couldn't get back to sleep, the sheets in the guest bed were too stiff or something. After tossing and turning for almost an hour she carefully padded back down to the den in the basement so she wouldn't disturb anybody.
As she flipped izmir escort through the channels with the volume turned way down she glanced over at the old futon in the corner right next to the couch. The girls had broken it rough-housing back when they were ten, so it hadn't folded back up into a sofa in years. The cozy matress had since accumulated what appeared to be Stephanie's entire stuffed animal collection on top of it, a small mountain of fuzzy creatures.
In a pang of nostalgia Kate hopped off of the couch and crawled into the pile of stuffies, heaping the ones that fell off back on top of her as she snuggled in underneath. She felt very sneaky with only her eyes and the end of the TV remote visible under the chaotic heap, and with the warmth and the comforting weight on top of her she turned off the show she wasn't really watching and drifted back to sleep.
Curt woke up at five a.m. as always, with or without an alarm. He tip-toed down to the den so he wouldn't disturb the girls as he went to workout. Years ago he had customized the basement so that he could exercise at home with a dumbbell set, workout bench, chin up bar, treadmill and other bits of gear that had accumulated over the years.
Katie woke up to the rhythmic thumping of his feet as he started his warm up with a heavy dumbbell in each hand for weighted vertical jumps. After a set of thirty he was sucking wind pretty hard as he heaved the weights back onto their cradles.
He shucked his snug t-shirt and pyjama bottoms now that he was warmed up, leaving only his silk boxer shorts on as he rolled out the yoga mat and began stretching.
She had laid there watching him jump, enjoying the view as she tried to come up with a witty line to pop out of the stuffie pile to spook him. But before she acted he had stripped down and then it felt a little too awkward and personal to make a scene.
Curt began his mobility routine, stretching and contracting through the basic yoga moves as he eased his body into the new day.
Katie felt a familiar tingle between her legs as she silently watched his bare muscles ripple, slowly sliding her fingers down into her panties. He was facing towards her when he moved into a lunge, one leg straight back with the other forward and his heavy cock and balls slipped down out of the stretched leg hole. He rolled his eyes but didn't stop in the privacy of the basement, this happened every time he only wore boxers to stretch.
She couldn't help but stare, his soft shaft was almost the same size as her ex's erection as it dangled pointing at the floor. She rubbed the little circles around her tingling clit a bit faster as she quietly controlled her breathing.
Once his stretches were complete he moved on to his calisthenics and weights. Working up a sheen of sweat as he pushed himself through forty minutes of hard effort.
Rolling up the mat he wandered over to the basement bathroom, coming back out with a bottle of lotion and a wad of toilet paper. Katie's heart sped up as she assumed what was about to occur in front of her, based on her brother's past history at least.
Curt grabbed a pillow and laid across the couch facing away from her hiding spot, resting his tablet on his ribs as he started browsing for porn.
She could see most of the screen from her angle as well as his hardening cock in his hand. He reached over and squirted some lotion onto his palm, lubricating his whole shaft before beginning to stroke with soft squelching sounds.
Fuck was she getting turned on as he fast forwarded and jumped around through different videos, his thick cock towering over his fist at the bottom of every stroke. She could feel she was getting wet, but starting to cramp a little in her unchanged position after so long. There was something deliciously naughty about watching him in secret.
After ten minutes he settled on a video of a young lady who had remarkably familiar features. Her hair was about the same length and color as Katie's and her skin tone and build were strikingly similar… The acting was pretty horrendous, and the plot was supposed to be a teenage babysitter getting fucked by a horny dad, whose face was rarely on camera and coincidentally also had a very muscular physique, and a big cock.
Katie started breathing more heavily and stroking her hungry little clit faster, still being careful to stay quiet. Watching the tiny porn actress' pussy get stretched around his thick cock while Curt's heavy, throbbing shaft disappeared under his fist faster and faster.
"Mister! Mister! I'm gonna cum!" the young lady's lines sounded pretty bad coming from the little speaker on the tablet, and not just because of the sound quality.
She could see Curt's abs begin to twitch and tighten as he got closer, her own approaching orgasm causing her legs to quiver.
"Mmmmm. That ass…" he groaned as he started to cum, pumping jet after jet of stickiness back towards the wadded paper alsancak escort on his chest. Her own orgasm crashing silently over her while she watched his seed spray in her direction.
Her twitching knocked a stuffed animal from the pile above her and she froze as the eye of the dilapidated little bunny clicked on the floor with shocking volume, not even daring to breathe as he looked back awkwardly over the arm of the couch in surprise. "Oh shit, I am so busted!" she screamed in her head.
Curt glanced back in confusion, but saw only the pile, quickly assuming he had moved the couch and bumped the futon after he paused for a second.
As she calmed down she though about what he had said, 'Mmmmm. That ass.' It didn't really make sense with the shot in the video, where the girl was spread on her back being pounded.
Katie's eyes wandered past to the wall and it clicked: the photo had been up since Kate and Steph had made it to the volleyball finals last year. The focus of the picture was on Stephanie diving for the ball in a save that ended up being instrumental in their win, but to the right, in front of Steph's flying legs, Katie's gorgeous ass was beautifully displayed in her tight volleyball shorts and knee-high socks.
Curt sat up and turned giving her a much better view as he milked the last drops from his softening cock and wiped up the rest of his mess.
He stood up, his fat dick still drooping proudly out of the the hole in his boxers and headed to the washroom.
As he finished washing up Katie could hear creaking coming from the floor above, Steph was up. Curt heard her as well and got dressed before heading up to the kitchen for breakfast.
Katie breathed a sigh of relief and extracted herself from the stuffie mound, piling them back up behind her as she massaged the crick in her neck and rolled her shoulders. She crept quietly back up to the guest bedroom and then 'got out of bed' officially.
Looking at her bag she was feeling a strong urge to tease him. Kate pulled out her soft, mid-thigh nightie and thong undies (packed in case of a night of clubbing) and changed out of her baggy t-shirt and sweatpants, debating for a minute before deciding to skip the bra in favor of her zip-front hoodie. Then she headed for breakfast.
"Good morning, sleepy-head." Stephanie smiled as she looked up from the table.
Kate mumbled a reply while she yawned and made her morning coffee, turning toward them not realizing that her hoodie had slid back to her sides and the soft nightie was revealing every provocative detail of her breasts.
Steph raised her eyebrows theatrically, tilting her head and staring pointedly at Kate's boobs, "Uh, Kate?"
Kate glanced over at Curt who had noticed as well and was staring at her with naked lust in his eyes. Looking down at herself her heart dropped as she saw that the nightie was clinging to her skin with static from rubbing inside the hoodie, hugging every smooth curve from her breasts on down between her thighs like a second skin. Even as she fumbled to close her hoodie he sat transfixed.
As soon as she covered up he regained his composure, but it took a second. His warm smile returned, but now did she see that hunger in the sparkle in his eyes?
Kate was beet red as Stephanie mouthed, "What the fuck?!" with a giant grin cracked across her face.
"Oh shit, I've never worn these together," she mumbled lamely as her cheeks throbbed with embarassment, "Maybe I should go change…"
Her toast popped.
"Uh, if you go and get changed now your toast will either be cold or dried out," Curt pointed out the truth of the situation with a playful grin still on his face, knowing how obviously self-serving he was being.
He had a point, she hated cold dry toast. Katie carried her plate to the table with one hand, holding her hoodie shut with the other until she sat down.
They all chatted for a few minutes while Kate ate. Steph's phone dinged with an incoming text. She read it, "It's Todd, he's asking if I can help this morning with a project he has that's due on Monday when we get back."
"OoOo," Kate chimed, "Todd? Is he hot? Is he single?" she teased.
"Yes and yes," Steph shot back. "Can I trouble you to find your own way back to your parents place… Or give you a ride now?" she asked, hopeful that Kate could accommodate.
"I can give her a ride once she is awake," Curt offered.
"Thanks Dad, you're the best!" Steph cleared her place at the table and headed upstairs to get ready, leaving the two of them alone with their coffees.
The sexual tension was thick in the air as soon as Steph left the room.
Katie got up to clear her dishes before sitting back down with her coffee, mostly just to busy herself. When she sat back down her hoodie had wandered back off of her boobs, showing off all of her curves again. She could see that her nipples were clearly visible as she looked up at Curt buca escort and made no effort to cover them, she was so horny right now.
"You seem very perky this morning," he teased, unabashedly enjoying her private display. Her soft flesh so close he could reach out and touch her, "What's the occasion?"
Now that they were alone she was feeling uncharacteristically bold. Maybe because she couldn't get the thought of his fat, spurting cock out of her head. Maybe because she knew he was happily married and this was just a fantasy, she figured he wasn't going to jeopardize everything for a fling with a family friend. So really, she reasoned, she might as well tease him back mercilessly, at least in private – it would let her blow off some steam.
"Well… I caught a hot stud masturbating recently and thinking about it has me really wound up." Kate quipped, a little surprised at her own bluntness now that the words were out.
"Did you get to see much?" he asked, envisioning her possibly stumbling in on a fellow student in her dorm or something.
"Oh, he didn't know I could see him, or that anyone was watching. I got to see everything." she responded suggestively.
Curt was stirring in his silk boxers as the sight of her firm, aroused nipples teased him along with her words, "Any juicy details? Did you like what you saw at least?"
She got up and put her empty mug by the sink while nodding, "I definitely liked what I saw…" she let the words hang in the air, turning to head to the bathroom she looked back and said, "Mister! Mister! I'm gonna cum!" playfully parroting the corny line, then exiting the room before he had time to respond.
It took a heartbeat for her words to sink in, but the look of surprise was priceless as he put the pieces together.
When she came back to the kitchen it was his turn to blush. He was still sitting at the table nursing his coffee as she walked over to the sink, "So uh, exactly what did you see?" he probed, still trying to figure out what had happened.
She leaned over with her elbows on the counter, presenting her ass like the picture downstairs as she pulled the hem of her hoodie up to the small of her back. The nightie shrink-wrapping every curve of her gorgeous butt, "Mmmmm. That ass…" she mimicked in a smoky voice, winking back at him.
Curt turned even redder as he realized she knew exactly what had been going on, tearing his eyes away from her sexy display to type something into his phone.
"Dad! The toilet is overflowing!" Stephanie hollered from upstairs in panic.
Curt bolted out of the kitchen and raced to assist, missing the power button on his phone as he put it down.
Katie could see the screen was still lit and her curiosity was piqued as she wondered what was interesting enough to peel his eyes away from her ass.
His phone dinged and another message scrolled up his screen. She picked it up and read the last few posts in the text conversation with "Babe":
Curt: Shit! I think Kate caught me rubbing one out this morning.
Babe: Ha! How much did she see?
Curt: Not sure. Sounds like everything maybe.
Babe: Not sure? I'm guessing there is a story here that you will fill me in on when I get home, while you fill me with something else 😉
Curt: Damn girl, I am so wound up right now. She's walking around in a night shirt that's practically painted on and she's teasing me.
Babe: Did Steph ever tell her the two of us are swingers?
Curt: Fuck she is such a sexy little thing… I dunno.
Babe: Just remember she is your daughter's best friend, Casanova.
Kate's heart was pounding as she read the exchange. Her hands were shaking as she imagined fucking him, stretching her pussy around his cock like the starlet in the video.
The text scrolled up as the next message came through while she held the phone.
Babe: Well I know you had 'fuck the babysitter' on your bucket list and we kind of missed the opportunity… I don't mind giving you a pass if you are very careful about her feelings. Let her know that it's just for fun and that you are taken 😉 BTW there is a hot sales rep at this conference who has been all over me. He just asked if he could take me out to dinner tonight and I said yes. Deciding if I should wear panties or not. Don't worry, I will check in before anything happens. Love you!
She reread the message a few more times before she put his phone back down on the table, walking away just as he came back into the kitchen having averted the impending disaster upstairs.
Why was she so nervous again? Now that she knew he was fair game her mouth was so dry she could barely talk. She blushed as she thought about him calling her a 'sexy little thing.'
A few minutes later Stephanie thumped her way down the stairs with a backpack slung over her shoulder, yelling back when she reached the front door, "Thanks again for giving Kate a ride, Dad! Kate call me tonight, You are staying over again before you leave town and I'm not going taking 'no' for and answer! Miss you already, bye!"
They both yelled "Bye!" from the kitchen as the door slammed, and with that the sexual tension was back again so thick you could cut it with a knife.


The complaints most often associated with implementing an enterprise resource planning system (ERP) focus on flexibility, scalability, and upgrade and maintenance costs. To avoid snafus, do your homework before making a purchase. David F. Ross, senior manager, professional department, at APICS, The Association for Operations Management, offers this advice to guide your selection.
1. Consider industry expertise. The ERP vendor should have extensive industry experience and expertise to help you tackle complex business challenges and achieve rapid ROI.
2. Confirm that the ERP vendor will serve your current and future needs. Your ERP solution should allow you to continually adapt to new business, changing market environments, and technology strategies. Ask the ERP vendor for evidence of its ability to provide strategic, enterprise-wide, mission-critical applications to support your evolving business model.


Mackenzie Brown is all about precision. Just ask her opponents at the Aquece Rio tournament last week, otherwise known as the Rio 2016 Olympic test event. At the Sambodromo – site of what will be the world's biggest archery party next summer – Brown's arrows sliced the air for 70 meters and hit the center repeatedly to win a bronze medal.
Brown got her archery start in the National Archery in the Schools Program during her middle- school days in Texas. At age 13, she was invited to a training camp for the Junior Dream Team, a program that identifies young archery talent, and provides coaching and training. Mackenzie's efforts in the Junior Dream Team helped fast-track her into a coveted spot at the U.S. Olympic Training Center, where she lives and trains full-time in Chula Vista, California.
Mackenzie said in a recent interview that she loves match play, which is head-to-head, Olympic-style competition where one competitor wins the match to eliminate their opponent from the game. "My strong suit is in match play," she said. "I think it's a little bit more psychological. It's almost two different games. When I'm right there with a competitor, it's game on." At tournaments, she's quick to support friends and teammates, and then she snaps photos and laughs easily in her spare time. But when it's time to step into the zone, Mackenzie's all business.
She's been competing internationally for several years, but Mackenzie started dialing up her performances this year, just in time for Rio 2016. She started her season by helping her team to a bronze-medal win at the Shanghai World Cup in April. She then just missed a berth in the World Archery Championships and Pan Am Games, which kept her home for two of the year's biggest events. She didn't let that stop her, though. She won a silver medal at the World Archery Youth Championships in June, followed by double gold at the World Cup in Poland, and a team bronze at the World Cup in Medellin. This week's bronze medal at the Olympic test event gave her six international medals in just five months.
Mackenzie's next goal: not just make the Olympic team, but win at Rio 2016. To get her best shot at a medal, she knows two things must happen. First, Team USA must qualify a full women's team for the Olympics. Second, if she makes the team, Mackenzie must help her teammates as much as she competes with them.


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Asheville names next police chief: Chris Bailey of Indianapolis
Joel Burgess
ASHEVILLE - The deputy chief of criminal investigations for Indianapolis has been named the new police chief here.
Chris Bailey was selected by City Manager Debra Campbell after months of community input and a national search, according to a June 13 release from the city.
Bailey comes from a department of 1,650 sworn officers serving nearly 1 million people. Much of the force's efforts have been focused on homicides which broke records for four years in a row, making Indianapolis the 12th-most dangerous U.S. city, according to CBS News.
Bailey is a graduate of Indiana University-Indianapolis and the FBI National Academy. He will take the lead of the Asheville Police Department, the biggest law enforcement agency west of Charlotte, on July 29.
Campbell said she selected Bailey from among "very high-caliber candidates."
"It was clear that Chris Bailey understands the need for community connection and engagement," she said in the release. "Chris has demonstrated his ability to connect with the community and his fellow officers. We fully anticipate an engaged and inclusive community-focused and connected police department under his leadership."
Bailey is married to Dawn Bailey and they have three children.
"I am excited and honored to join the Asheville Police Department team," he said in the release. "My wife and I instantly fell in love with Asheville and its people when we visited a few weeks ago. I know I still have a lot to learn and I am eager to get started."
APD is staffed by 238 sworn officers and 64 non-sworn positions. Patrols are split into three areas: Adam District (West Asheville), Baker District (South and East Asheville), and Charlie District (North and Central Asheville). APD deploys community resource officers in a variety of roles, from neighborhoods to our schools. The department also has a number of specialty units.
More:Asheville police chief search draws 89 applicants, nears end
More:Asheville Police Chief Tammy Hooper resigns
Wade Wood has served as interim chief since the Jan. 2 resignation of Tammy Hooper. Hired in 2015, Hooper was the first woman and openly LGTBQ chief.
She earned praise for fixing an evidence room from which guns and drugs had gone missing under previous administrations. Hooper enacted use-of-force reforms, emphasizing de-escalation.
Other parts of her tenure were marked with tumult, including accusations of heavy handedness in dealing with protesters of the shooting of a black man by police and revelations she authorized monitoring of civil rights groups. The publication of a leaked body camera video of the police beating of an African American pedestrian threw APD and the city into crisis, leading some to call for her immediate resignation.
Including Hooper, the city has had three full-time chiefs in the last 15 years.
Asheville Police Department
238 authorized sworn officer positions and 64 authorized non-sworn positions.
$29.6 million budget (up $1.1 million, or 4% from last year). Second-biggest city expenditure after water.
Four divisions: special services, investigations, administrative services, patrol.
(Patrol is broken into three areas: Adam District (West Asheville), Baker District (South and East Asheville), and Charlie District (North and Central Asheville).
Current - Interim Chief Wade Wood
2015-Jan 2, 2019 - Tammy Hooper
2012-2014 - William Anderson
2004-2011 - Bill Hogan
1993-2003 - Will Annarino
1989-1993 - Gerald Beavers
1979-1989 - Fred Hensley