text:
DATO' PROF. DR. CHRISTOPHER BOEY CHIONG MENG
Department of Paediatrics
ccmboey@um.edu.my
Born and brought up in Penang, Professor Boey graduated with a Bachelor of Medicine and Bachelor of Surgery (MBBS) from the University of London in 1987. Until 1992, he worked in various hospitals in the United Kingdom, including children's hospitals such as the Great Ormond Street Hospital for Sick Children in London and Birmingham Children's Hospital. During this period, he obtained his Membership of the Royal College of Physicians of the United Kingdom and Diploma in Child Health from the Royal College of Physicians of London. Upon returning to Malaysia, he was appointed a lecturer in the Department of Paediatrics at the Faculty of Medicine, University of Malaya on March 16th, 1992.
In addition to providing service and teaching in general paediatrics at the University of Malaya Medical Centre, he also started the Unit of Paediatric Gastroenterology, Hepatology and Nutrition in the Paediatric Department in January, 1993 as the head of unit and its only staff. The unit now has a team of three staff specialists and is recognised nationally as a centre of excellence for this subspecialty, receiving referrals from hospitals and clinics throughout Malaysia. In 1996-97, Professor Boey was Visiting Fellow in paediatric gastroenterology in Sydney and Brisbane, Australia. In March 2000, he was awarded 'The Young Clinician's Award' by the Asian Pacific Association of Gastroenterology and the Asian Pacific Society for Digestive Endoscopy and in August 2000, the World Congress Travel Outreach Award by The North American Society of Pediatric Gastroenterology and Nutrition.
In 1999, Professor Boey was admitted as a member of the Academy of Medicine of Malaysia and in November that same year, he was promoted to Associate Professor in the University of Malaya. In 2000, he was awarded a Doctorate in Medicine (M.D.) by the University of Malaya for his research on recurrent abdominal pain in Malaysian children. This was a comprehensive study based on hospital and community surveys. In 2002 and 2004, Professor Boey was conferred respectively Fellowship of the Royal College of Physicians of Glasgow and Fellowship of the Royal College of Paediatrics and Child Health of the United Kingdom. Recognising the importance of inter-faculty collaboration, he went on to perform extensive joint studies between the Faculty of Medicine and the Faculty of Education on the school performance of children with gastrointestinal problems. This resulted in the award of his second doctoral degree, Doctor of Philosophy (Ph.D.), in 2004. In 2004, he was also awarded the University of Malaya Excellent Service Award. The University of Malaya promoted him to the position of Professor in December 2005.
Professor Boey has served in the Faculty of Medicine as a coordinator of the undergraduate programme. In addition, he has been involved as an invited speaker in courses on paediatrics and paediatric gastroenterology for undergraduates as well as post-graduate students, both in Malaysia and in other Asian countries such as Singapore, the Philippines and Japan. In 2002, he was appointed Visiting Associated Professor of Paediatrics at the Juntendo University School of Medicine, Tokyo, and was subsequently promoted to Visiting Professor in July, 2007. In August 2008, he was appointed Visiting Professor of Paediatrics at Keio University School of Medicine, Tokyo. Since 1997, he has been involved in coordinating the clinical component of the MRCP(UK) and MRCPCH(UK) examinations, and in 2008, he was appointed by the Royal College of Paediatrics and Child Health as an examiner of the MRCPCH(UK) examination.
Professor Boey served as a committee member in the Malaysian Paediatric Association in 1993. In 2000, he served as secretary of the College of Paediatrics, Academy of Medicine of Malaysia and also chaired the subspecialty committee for Paediatric Gastroenterology in the College. He was also appointed an advisor to the Malaysian Breastfeeding Association in 2003. Professor Boey is currently the chairman of the Ministry of Health Specialty Credentialling Sub-Committee for Paediatric Gastroenterology. In 2007, he was conferred Fellowship of the Academy of Medicine of Malaysia.
At the international level, in June 2005, he was appointed Vice-President of the Asian Pan-Pacific Society of Paediatric Gastroenterology, Hepatology and Nutrition and became President in August 2008. In March 2009, he was appointed a Member of the European Academy of Sciences and Arts, which is based in Salzburg.
On a broader scale, in addition to activities in medicine, Professor Boey has also been active in numerous activities for the promotion of peace, education and cultural exchange. Some of the many activities he has been involved in over the years are the Fourth Asian Pacific Regional Conference organised by the International Physicians for the Prevention of Nuclear War in August1994; the 'International Seminar on Islam and Confucianism : A Civilisational Dialogue' organised by the University of Malaya in March 1995; and the National Conference on ' The Family in the K-Economy Age: Challenges to Parenthood' organised by Asia Pacific Forum on Families, Malaysia in November, 2001. In March,2005, he served as a rappateur at an 'International Conference on Peace in Palestine' held at the Putrajaya International Convention Centre. He lectured on "Media and Religion" at the Asia Media Summit in May, 2006. In January, 2008, he was invited by Kyoto University to speak on "The Role and Mission of Education at Universities in the 21st Century – from the Viewpoints of Health, Medicine and Bioethics". He was symposium chairman in July 2008 for a panel discussion on 'Internal and External Impediments in Religion's Quest for Global Justice and Peace' at the International Conference on 'Religion in the Quest for Global Justice and Peace' organized by the Centre for Policy Research and International Studies, Universiti Sains Malaysia.
Keynote speaker (persidangan)
Asia-Pacific Journal of Public Health Asia-Pacific Journal of Public Health
norzuraida
ngcj
subhashinij
yaomun
loheechin
sbtan
Universal Recommendations for the Management of Acute Diarrhea in Nonmalnourished Children.
The Suffering Pictogram: Measuring Suffering in Palliative Care
Rotavirus immunization: Global coverage and local barriers for implementation
Distress Reduction for Palliative Care Patients and Families With 5-Minute Mindful Breathing: A Pilot Study.
The Interaction between Mind and Body: Implications for Health for Health
Positive Parenting: Guide to Children\'s Digestive Health
The Treasure of Life: Buddhist Perspectives on Governance
Stress in Children
School performance, recurrent abdominal pain and other factors in year six primary school children
Somatization and Recurrent Abdominal Pain


text:
Smultronstället
Director / Screenplay: Ingmar Bergman
Production Co.: Svensk Filmindustri
Producer: Allan Ekelund
Cinematography: Gunnar Fischer
Editor: Oscar Rosander
Music: Erik Nordgren
Art Direction: Gittan Gustafsson
Costumes: Millie Strom
Sound: Aaby Wedin & Lennart Wallin
Isak Borg: Victor Sjöström
Sara: Bibi Andersson
Marriane Borg: Ingrid Thulin
Evald Borg: Gunnar Björnstrand
Agda: Julian Kindahl
Anders: Folke Sundquist
Viktor: Björn Bjelvenstam
Isak's mother: Naima Wifstrand
Mrs. Berit Alman: Gunnel Broström
Alman: Gunnar Sjöberg
Isak's wife: Gertrud Fridh
Åkerman: Max von Sydow
Swedish, with English subtitles
Wild Strawberries is constructed around dream sequences (notably the nightmare at the beginning) and flashbacks and is, in addition to a voyage through modern Sweden, a voyage through time, the past, and the unconscious. An old man approaching death (this was the last role of the great Victor Sjöström) takes stock of his life and its failings and is confronted by those who loved him, admired him for his contribution to science, and those who detested him as an inhuman, self-centred idiot. Sara, in the present, brings him back to the human simplicity of his youth and the time of wild strawberries and gives him a new sense of serenity. This is the best Bergman film of the fifties, much closer to a true philosophical tragedy than his more ambitious The Seventh Seal.
- Georges Sadoul, Dictionary of Films
Possibly Ingmar Bergman's finest film and a staple of film history, Wild Strawberries not only exemplifies one of Sweden's greatest director's greatest works, but the importance of a superb performance as well. Victor Sjöström stars as Isak Borg, a medical professor on his way to accept an honorary degree on the 50th anniversary of his graduation from the University at Lund. He rides with his daughter-in-law, Marianne, who has decided to leave her husband. Animosity exists between the opinionated Isak (as she sees him) and Marianne, mainly because the old man reminds her so much of her husband. En route, they stop at Isak's childhood house, where he recalls his family in the days of his youth (although he is unseen by the characters and not present in the flashbeck). He sees his sweetheart, Sara, picking wild strawberries and carrying on semi-innocently with his brother. Later he is awakened (in the present) by a teenaged girl named Sara. She asks the old man for a ride, bringing along two male friends. This foray proves less than ideal, hampered by a car crash and Isak's disturbing nightmares.
A fascinating, compelling picture, Wild Strawberries is viewed by many as Bergman's greatest achievement. Its most striking segment, which perhaps best illustrates Bergman's talents, is a dream sequence in which Isak walks through a desolate city, is approached by a faceless man, sees a clock without hands, and watches a funeral wagon crash and leave a coffin in the middle of the street. As he nears the coffin, it opens, and the corpse - Isak - emerges and attempts to pull him into the afterlife. The visual and aural symbolism is chilling, and the entire scene is perfectly integrated into the 'reality' of the rest of the picture. Sjöström, in his final film, delivers the finest performance in any Bergman film - a major accomplishment considering the virtuosity that Bergman's actors consistently display.
- The Third Virgin Film Guide, London, 1994
There is much in this film that is extraordinarily beautiful. The dream sequence at the beginning is a blend of Caligari and Kafka. The old man's reminiscences of his youth at the country place are done with a warm sense of family fun that makes one yearn to have been part of it. Bergman's touch in establishing period feeling is swift and sure - we see a young man seated in a tree reading a book, dressed in white trousers, white shirt, tie and straw boater, and we know at once where we are. He has a gift for eccentric characterisations, like the neurotic couple to whom the doctor gives a lift who shortly cram the interior of the car with their almost palpable unhappiness. And his basic concept - a day's ride, a life's journey - is a sound one.
This notice would be unfinished without mention of the excellent performance in the leading role of Victor Sjöström, who as Seastrom directed in Hollywood from 1923 to 1931 and has since been acting in Sweden. Some old actors' faces have an odd childlike purity; it radiates from Sjöström. Of his many moving scenes one moment stands out particularly. In a dream sequence, his parents, as they were when he was a child, are sitting on a rock while Father fishes. They see him, as he was then, and wave to him. We see the old man as he is now, and with all the sadness of time past and passing, his eyes fill at the sight of them. It is lovely.
- Stanley Kaufmann, A World on Film, New York, 1966
I began to write, and then I thought: who the devil can do this? And then it struck me that Victor would be best. So Carl-Anders Dymling had a word with him and asked whether I could speak to him about it. Victor was feeling wretched and didn't want to... I fancy he must have been seventy-eight. He was misanthropic and tired and felt old. So Carl-Anders had said to him: "All you've got to do is lie down under a tree and munch strawberries and think of your own past, so it won't exactly be hard work." Afterwards, when Victor had taken a look at the script, he wanted to back out. I had to use all my powers of persuasion to get him to play the part.
The first day we worked together Victor was in a vile temper. He said: "I don't want to do this, I don't think you're right." We fell out. I wanted him to do certain things he didn't want to do; or, to be more exact, I wanted him not to do certain things he wanted to... He was all tensed up and wanted to do a lot of things - I didn't want him to do anything at all. But after that he was wonderful to work with, ever so simple, sincere and fierce... As long as Victor got home at a quarter past five each day and had his whiskey punctually, all went well.
- Ingmar Bergman, Bergman on Bergman, New York, 1973

redpajama_set_name: RedPajamaCommonCrawl


text:
ANC NEC 'was wrong' when it decided ANC members should not support Zuma – Niehaus
Mxolisi Mngadi
Carl Niehaus. (Deon Raath)
Zuma still dividing the SACP
SCA dismisses Ramaphosa's appeal against Zuma being forced to disclose reasons for Cabinet reshuffle
'I've never committed any crime' – Zuma
The ANC national executive committee (NEC) was wrong when it previously decided that ANC members should not support former president Jacob Zuma when he appeared in the KwaZulu-Natal High Court in Durban for corruption.
This is the view of Umkhonto weSizwe Military Veterans Association (MKMVA) spokesperson Carl Niehaus.
"The former president of the ANC, OR Tambo once told me, you never take a decision that you cannot implement, and you never take a decision that would divide the organisation. Out of those scores, the NEC of the ANC failed," he added.
READ: 'I've never committed any crime' – Zuma
Niehaus was speaking at a press briefing in Durban on Monday, held to unveil plans ahead of Zuma's court appearance on Friday, June 8.
Zuma is facing 16 charges which related to 783 payments he allegedly received in connection with the controversial multibillion-rand arms deal.
A vigil is expected to be held ahead of Zuma's next court appearance the following day.
"As MKMVA, we will participate in the events of the 7th and the 8th, not because we want to be rebels or disregard the decision of the ANC as our mother body, but because we believe that comradeship should extend all the way," said Niehaus.
'Special guard of honour'
He said the association believed that someone with Zuma's history, "who was one of the most successful commanders of MK, ought to be supported by the comrades of MKMVA".
"No soldier allows another soldier to be left behind on the battleground," he said.
Niehaus added that members of the MKMVA would be in full military combat during the two days.
"They will give a special guard of honour to leadership who will participate in the vigil, and especially to Msholozi when he moves from the court to the stage, where masses will be gathered in front of the court," he said.
READ: Zuma supporters defy NEC directive, wear ANC regalia during night vigil
He dismissed reports that Zuma had no support in the country when it came to the case.
"Anyone who tries to say he (Zuma) doesn't have the support in South Africa doesn't understand the politics of the country and doesn't understand the reality of the very broad and large number of South Africans who strongly associate themselves with what president Zuma had been working for,'' he said.
He said Zuma championed free education, land expropriation without compensation, the transformation of the country's economy for everyone to benefit and the state bank.
Black First Land First leader Andile Mngxitama said more than 15 civil organisations would also support the "Hands Off Zuma" campaign on the day of his court appearance.
"Zuma is being persecuted because of his programme of radical economic transformation which has been rejected, as we speak, by the current leaders of the ANC," he said.
He added that, since President Cyril Ramaphosa took over office from Zuma, "the country is no longer in our hands".
He said the reason Zuma's charges had been "revived" was politically driven.
Nkosentsha Shezi of Radical Economic Transformation Champions said they also in fully supported Zuma and believed that charges were politically motivated.
"Zuma fought for previously oppressed people. We don't buy the story that he is corrupt. We are calling upon the courts to withdraw the charges against Zuma because they have no basis in law," said Shezi.
"To the current sitting president (Ramaphosa), as black business we are still hungry. We still lack opportunities and we are waiting for tangible benefits."
The religious leaders organising the night vigil and march to court, said they did not have funders to host the events but used their own resources.
"We use our own resources and we knock on the doors of businesses and ask for donations. We also use sound systems from our own churches," said Bishop Timothy Ngcobo.
From 17:00 to 19:00 on Thursday, a motorcade is expected to start at Victoria Embarkment to Anton Lembede Street and Dr Pixley kaSeme Street, to the night vigil at Albert Park, Ngcobo said.
He said the night vigil will start at 19:00.
On Friday, from 07:00 to 09:00, there is expected to be a march from King Dinizulu Park to Victoria Embarkment, where they are expected to gather outside the court.
Zuma is expected to address supporters around 10:00 to 11:00, said Ngcobo.
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text:
Die Another Day Gadgets
DNA Replacement Therapy
A neat sub-plot to the chase and a pleasant change from the decoders / encoders / devices etc., featured in so many of its movie peers.
According to the Dr Alvarez, who explains the two phases to NSA agent Jinx, "First, we kill off your bone marrow, to wipe the DNA slate clean.
"Phase Two; the introduction of new DNA, harvested from healthy donors; orphans, runaways, people that won't be missed.
"I like to think of myself as an artist."
"It's a painful process, I am afraid. But all great art is."
Jinx is right though, "Most great artists are only appreciated after they're dead."
All very pleasant, but it is such a remarkable treatment that it is able to stretch the dimensions of probability to presume an Asian man could turn into a younger looking British man with a longer face of completely different proportions. Sadly, the early stages of the treatment cannot do anything about the tiny diamonds stuck in Zao's face. A pair to tweezers could have done the job, but the 'Artist' Dr Alvarez, was clearly waiting for the process to complete.
We later learn that Colonel Moon had already undergone the treatment and it had turned him from an Asian man into a posh British man. His hair had turned from black to ginger, his skin from a gentle warm brown tone to freckly and pasty white, change his Korean accent for a completely flawless posh English one. It even made him taller.
It may be that the newly spoken of Gene Therapy treatments being discussed in the world of science, were still in their early stages, but the movie version was very much like a Lottery winner claiming they would be a spaceship. Perspective was possibly in short supply four years before the possibility of Gene Therapy, a treatment that has subsequently been developed to alter an individual's genes as a therapy to treat disease.
Although conseptualized as far back as 1972, it wasn't until 1990 that treatments began. The 1992 film was perhaps a little eager in its futurological predictions - you still can't make a silk purse out of a pig's ear, and you won't look like Brad Pitt, however much money your partner has to spend on the treatment!
Next > > >
Photo: Die Another Day 2002 Danjaq, LLC, & United Artists Corporation. All rights reserved


text:
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redpajama_set_name: RedPajamaStackExchange


Jordan Halliday & Jeremy Parkin run Which Side Podcast which they've been running since 2012.
They interviewed me for one of their podcasts, which you can LISTEN TO HERE.
I spoke to them about veganism, animal rights, my festivals, and all the other stuff I do.
I also interviewed them about their process of creating podcasts and veganism. See the Video and Listen to the Podcast.


text:
January 11, 2020 January 11, 2020 Rafael García
In Cut Time: An Education at the Fights, Carlo Rotella expounds deeply on a thesis boxing fans have heard before; namely, that the fight game serves as a splendid vehicle for delivering life-lessons which hold intrinsic value and translate smoothly to the everyday lives of non-fighters. The art of pacing oneself for lasting the distance; mastering a switch of tack when a situation demands a different approach; the importance of accurately assessing an adversary's strengths and weaknesses; and, predictably but not less importantly, learning to roll with the punches — all count among those profound lessons.
Rotella presents us with a kind of binary memoir: half of it is dedicated to boxing-centered episodes of his life; the other offers personal stories as seen through the prism of the lessons learned from "The Sweet Science." Therefore, we get to accompany Rotella to see aging legend Larry Holmes train; to Madison Square Garden to watch Naseem Hamed do what he did best; to the Washington D.C. Hilton for a black-tie gala featuring Hector "Macho" Camacho in the twilight of his career. Big fights, club fights, sparring matches and bar brawls, all make appearances on these pages, all described in clear prose and all made compelling.
The stories, characters, events and venues encountered in Cut Time present us with the opportunity to learn something. This is only natural, since boxing is almost by definition an abstract representation of life itself. As they struggle to maximize the impact of their strengths and minimize the adverse effects of their liabilities, those who actively partake in the rituals of "The Sweet Science" are simultaneously offering synthesized and condensed lessons in good-living. The rewards of discipline, courage, intelligence, persistence and self-knowledge are to be found in the ring, while the misfortunes brought about by laziness, obliviousness, lack of preparation and even—inevitably—bad luck, lurk around all four corners as well.
Kelley and Hamed rumble.
Nevertheless, the strongest asset of the book is not its school-like approach to boxing, but instead the rich storytelling liberally peppered throughout. Rotella is a connoisseur of boxing, an avid watcher of films of ancient fights and ardent reader of the history of the sport. He's also a witty observer of human nature and has a keen ear for insightful quotes. Often, these factors compound to make his accounts sharp and witty, as in his description of Naseem Hamed's style as he approached the ring for his appointment with contender Kevin Kelley:
"Those crowd-pleasing KO's were understood to validate the shabbier elements of his showmanship: the vaguely embarrassing dance he performed during his ring walks, like a miniature Chippendale trained in European discos; the will-he-or-won't-he buildup before he performed the front flip over the ropes with which he entered the ring; the postfight rhapsodies about the wonderfully marketable power with which Allah had infused him, the incomparable Naz."
A couple of highlights of Rotella's book involve former heavyweight champion Larry Holmes, who lived and worked in Easton, PA during the waning years of his protracted career and at the same time as when the author taught at that town's Lafayette College. As Rotella struggled to help one of his college students make sense of his failing pugilistic efforts, the author is lectured by Holmes himself, as the champion states his business-first approach to the sport and accentuates the importance of making your passion pay for itself. Still, perhaps the champion goes too far in stating his real priority when he says to Rotella, "Why should Joe Frazier be mad at Muhammad Ali? Every time he fought him, he made five million dollars. That's fifteen million dollars. If you give me fifteen million dollars, I'll kiss your ass in Centre Square."
Larry Holmes pontificates in Cut Time.
There are also many touching episodes in Cut Time that arrive in vignettes featuring fights between unknowns. The undying existence of mismatches and the complexity inherent in assessing them is underlined by the author's recollection of a confrontation outside a rowdy bar between three frat goons and a local tough guy done wrong. There is also the tale of a perennial contender whose wish to transcend his underdog status leads him to an unlikely victory over a local favourite, only to succumb to his father's well-intentioned but mercilessly tough matchmaking. Though many battles appear to be mismatches on paper, every once in a while there will come a surprising twist that temporarily and abruptly alters our expectations, and the writer is the first to acknowledge this:
"More than one fighter has come back to win after his blood, sprinkled on my notes and shirt, has made me wish the referee would step in and save him. When that happens I feel a would-be meddler's guilt: had the bout been stopped when I wanted it stopped, he would have to cope not only with hurt but also with the defeat I wished on him."
Carlo Rotella
Cut Time is a more than recommended read thanks to the quality of the author's prose and the value of the boxing stories it contains. Rotella has lived around boxers, trainers, gyms and rings long enough to gain unique insight into the fight game, insight that fosters a touch of near-expertise in his accounts, without giving in to grandiloquence. It's a book not just for aficionados, but for everyone with even a passing interest in the hurt business. –Rafael García
← 2019 Fighter Of The Year
Atlantic City Fight Night: Smith Jr. Batters Hart →
The Darker Road Of Raging Bull
December 27, 2021 December 27, 2021 Alden Chodash
The Story Of The Cincinnati Cobra
January 11, 2021 January 16, 2021 Ronnie McCluskey
Gentleman Jim Speaks
September 18, 2021 September 18, 2021 Rafael García
Aug. 7th, 2004: Corrales vs Freitas
August 7, 2021 August 9, 2021 Jamie Rebner
Fight City Legends: The Mighty Atom
February 6, 2021 February 9, 2021 Robert Portis
April 25, 1998: Jones vs Hill
April 25, 2021 April 28, 2021 Jamie Rebner
March 10, 1986: Hagler vs Mugabi
March 10, 2021 March 12, 2021 Robert Portis


Welcome to The Ashley Press digital and lithographic printers website. We are the longest established printers in Poole, Dorset.
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Happy weekend everyone! How were your 4th of July celebrations? Eat anything brand new and delicious?! Hopefully you got to enjoy some extra-long vacation time!
We broke up this week with a little mini field trip and visited Fallingwater – the house that Frank Lloyd Wright designed for the Kaufmann family. It's about an hour and a half from where we live in Pittsburgh, situated in the Allegheny Mountains. Since we live so close and had never been there, we finally made it a point to visit. We took a one-hour tour and enjoyed exploring the house (and guest house) – it's beautiful, and it was amazing to think of how innovative so much of the design was for being built in the 1930's. (Heck, I think it's innovative even by today's standards!) It made me think of old-world glamour and how it would have been a perfect setting for James Bond to woo one of his ladies. Have you ever been there? What did you think?
Afterward, we enjoyed a lunch of Sicilian white pizza at Vallozzi's and then took a spin through DeLallo's market. I may or may not have purchased half of the bakery case. I love their massive cookies!
30 of My Favorite Ice Cream Recipes – A roundup of all of my favorite ice cream recipes. Get those ice cream makers ready!
Homemade Strawberry Ice Cream Topping – A wonderful homemade strawberry topping that tastes unbelievably fresh and is incredibly quick and easy to make.
Homemade Pineapple Ice Cream Topping – Another fabulous homemade ice cream topping – pineapple! It's a little tangy, a little sweet and just a tiny bit spiced.
Banana Split Ice Cream Cake – One of the best summer desserts you'll ever find. A massive banana split sundae camouflaged as a gorgeous cake!
Homemade Butterscotch Sauce – Rounding out my week of ice cream decadence is this wonderfully thick and rich butterscotch sauce. It's perfect for a homemade sundae!
These cupcakes are seriously a work of art! They're beautiful and I can't even imagine how delicious they must be.
I'm almost speechless. Marshmallows made with bourbon? S'mores made with said marshmallows and bacon? I won't consider my summer complete until I make this!
I love baking with fruit, but for one reason or another, cherries always take the backseat to my more beloved berries. I really need to do more baking with cherries, and this wonderful crumb-style cake seems like the perfect opportunity.
This looks like the perfect salad for summertime! It reminds me of the Chinese coleslaw I made a few weeks ago, but with chicken and lettuce and a dressing that sounds phenomenal! This will definitely be lunch this week!
You know I can't go a week without being hopelessly tempted by an insane chocolate and peanut butter dessert. This cake has me drooling!
Love this weekend dish! That homemade butterscotch sauce looks A-MAZ-ING! YUM! Thanks for sharing!!
Thanks for featuring our Cherry Almond Cake! Wish we could bake it together!
all of it sounds perfect for this hot summer days!
Fantastic round up. All the ice cream looks amazing and that banana split ice cream cake looks positively divine! I'm looking forward to trying out the butterscotch sauce.
I went to Hempfield High School and Fallingwater was a field trip. So cool! I was visting in Greensburg over Fathers Day and got to go to DeLallo's ,love that store ! All my dad wanted for Father's day was a Chocolate Raspberry Torte cake from there, it's so good ! Did you know that the bakery is not owned by DeLallo's ? It's Biscotti Brothers! I have recreated my own recipe for thier big filled cookies, I cann't believe I got it right on. We always bring home filled cookies from there,because 5 hrs is kinda far to drive for cookies! Now I don't even bring any home, I just make them! YUM!!!!
Hi Tina, I didn't know that until I was standing there at the case and saw the signs! Either way, those cookies are absolutely to-die-for! Love, love, love them!
Michelle you should check out the recipes of Elsie Henderson, she was the cook for the Kaufmann family at Fallingwater. Some are included in the QED books and I think she has written her own cook book about recipes she served to the Kaufmanns and when they entertained. She also worked for the Heinz family. I think she must be 90 years old and still going strong.
Hi Nancy, I actually bought her cookbook while we were there! They had it in the store at Fallingwater. I've already flagged tons of recipes I can't wait to try!
When I was a kid, I was slightly obsessed with Frank Lloyd Wright. We were members of the PA Conservatory so we could go all the time. Next time you should check out Kentucknob. It is nearby. We usually ate at the Road Toad or Rizzos. Sometimes we would ride bikes on the same day and rude to The River's Edge for lunch. I' happy you enjoyed your trip!
Hi Jess, Thanks for the recommendation; I will definitely plan to check that out the next time we make our way down there!
I ate a taco salad that I'd have to say was the best thing I had all week!
I'd love to visit Fallingwater someday. I've been to Taliesen West, which is amazing, so I'm sure Fallingwater would be great too.
And I absolutely love your ice cream series this week!


text:
Q: Repair DNS Hostname mac server I am getting this problem when checking the hostname of my server
Primary address     = 176.16.1.227

Current HostName    = grandcentral.xx.xx.xx

The DNS hostname is not available, please repair DNS and re-run this tool.

dirserv:success = "success"

How can I repair the DNS to ensure I get a result like
Primary address     = 10.20.30.3

Current HostName    = host.example.com
DNS HostName        = host.example.com

The names match. There is nothing to change.
dirserv:success = "success"

A: The key to this is going to be making sure that your DNS servers are responding with the same information for forward and reverse lookups, and that the server is configured to be reachable.
hostname and dig are two great tools to help determine if things are correctly configured.
My suggestion is to start with
dig -x 176.16.1.227 in order to find out what the DNS server is returning when queried for that address.   If you get a server error, check your basic DNS configuration to make sure you are talking to the right servers.  If you get a Not Found error, then you need to fix or create the reverse record for that IP address.   The process for doing that can be complicated depending upon where your IP addresses are administered.   For example, when using static IP addresses from an Internet provider, you often must have them create the mapping for you.   However, when using private IP addresses behind a NAT, this is most commonly provided by an interna
 Server.   Either way, the basic form is going to be a PTR record of class IN which looks like
227.1.16.176.in-addr.arpa.  IN PTR hostname.mydomain.com

Once your reverse is working, you should then verify that the forward request goes the same place.   So, if your host name is www.foo.bar, then use dig www.foo.bar to look up the IP address.   It should resolve to the same IP address.
If the forward DNS for the host name you are using doesn't match the reverse DNS of the IP address you are using, server won't be happy.
One other thing to consider is the primary IP address of the machine.   When considering the host name, I have often found that OS X wants to get the host name and IP address from the primary network interface.   For OS X, the primary interface is the one that appears first in the Network control panel.   If this is out of order, use the Set Service Order... command in the Network settings to change the order.


text:
September 2019 - Volume 134 - Issue 3
Online ACOG Publications
Perinatal Palliative Care
ACOG COMMITTEE OPINION, Number 786
This information is designed as an educational resource to aid clinicians in providing obstetric and gynecologic care, and use of this information is voluntary. This information should not be considered as inclusive of all proper treatments or methods of care or as a statement of the standard of care. It is not intended to substitute for the independent professional judgment of the treating clinician. Variations in practice may be warranted when, in the reasonable judgment of the treating clinician, such course of action is indicated by the condition of the patient, limitations of available resources, or advances in knowledge or technology. The American College of Obstetricians and Gynecologists reviews its publications regularly; however, its publications may not reflect the most recent evidence. Any updates to this document can be found on www.acog.org or by calling the ACOG Resource Center.
While ACOG makes every effort to present accurate and reliable information, this publication is provided "as is" without any warranty of accuracy, reliability, or otherwise, either express or implied. ACOG does not guarantee, warrant, or endorse the products or services of any firm, organization, or person. Neither ACOG nor its officers, directors, members, employees, or agents will be liable for any loss, damage, or claim with respect to any liabilities, including direct, special, indirect, or consequential damages, incurred in connection with this publication or reliance on the information presented.
All ACOG committee members and authors have submitted a conflict of interest disclosure statement related to this published product. Any potential conflicts have been considered and managed in accordance with ACOG's Conflict of Interest Disclosure Policy. The ACOG policies can be found on acog.org. For products jointly developed with other organizations, conflict of interest disclosures by representatives of the other organizations are addressed by those organizations. The American College of Obstetricians and Gynecologists has neither solicited nor accepted any commercial involvement in the development of the content of this published product.
Number 786
Committee on Obstetric Practice Committee on Ethics
The American Academy of Pediatrics and the Society for Maternal-Fetal Medicine endorse this document. This Committee Opinion was developed by the Committee on Obstetric Practice with the assistance of committee member Russell S. Miller, MD and the American Academy of Pediatrics' liaison member James J. Cummings, MD; and the Committee on Ethics with the assistance of the American Academy of Pediatrics' liaison member Robert Macauley, MD and the Society for Maternal-Fetal Medicine's liaison member Steven J. Ralston, MD, MPH.
Published online on August 22, 2019.
Obstetrics & Gynecology: September 2019 - Volume 134 - Issue 3 - p e84-e89
Perinatal palliative care refers to a coordinated care strategy that comprises options for obstetric and newborn care that include a focus on maximizing quality of life and comfort for newborns with a variety of conditions considered to be life-limiting in early infancy. With a dual focus on ameliorating suffering and honoring patient values, perinatal palliative care can be provided concurrently with life-prolonging treatment. The focus of this document, however, involves the provision of exclusively palliative care without intent to prolong life in the context of a life-limiting condition, otherwise known as perinatal palliative comfort care. Once a life-limiting diagnosis is suspected antenatally, the tenets of informed consent require that the pregnant patient be given information of sufficient depth and breadth to make an informed, voluntary choice for her care. Health care providers are encouraged to model effective, compassionate communication that respects patient cultural beliefs and values and to promote shared decision making with patients. Perinatal palliative comfort care is one of several options along a spectrum of care, which includes pregnancy termination (abortion) and full neonatal resuscitation and treatment, that should be presented to pregnant patients faced with pregnancies complicated by life-limiting fetal conditions. If a patient opts to pursue perinatal palliative comfort care, a multidisciplinary team should be identified with the infrastructure and support to administer this care. The perinatal palliative care team should prepare families for the possibility that there may be differences of opinion between family members before and after the delivery of the infant, and that there may be differences between parents and the neonatal care providers about appropriate postnatal therapies, especially if the postnatal diagnosis and prognosis differ substantially from antenatal predictions. Procedures for resolving such differences should be discussed with families ahead of time.
Recommendations and Conclusions
The American College of Obstetricians and Gynecologists makes the following recommendations and conclusions:
Perinatal palliative care refers to a coordinated care strategy that comprises options for obstetric and newborn care that include a focus on maximizing quality of life and comfort for newborns with a variety of conditions considered to be life-limiting in early infancy. For the purposes of this document, the term "life-limiting" includes lethal fetal conditions as well as others for which there is little or no prospect of long-term ex utero survival without severe morbidity or extremely poor quality of life, and for which there is no cure.
With a dual focus on ameliorating suffering and honoring patient values, perinatal palliative care can be provided concurrently with life-prolonging treatment. The focus of this document, however, involves the provision of exclusively palliative care without intent to prolong life in the context of a life-limiting condition, otherwise known as perinatal palliative comfort care.
Perinatal palliative comfort care is one of several options along a spectrum of care, which includes pregnancy termination (abortion) and full neonatal resuscitation and treatment, that should be presented to pregnant patients faced with pregnancies complicated by life-limiting fetal conditions.
Although specific offerings may vary between institutions, some care components are generally advisable across perinatal palliative comfort care programs: a formal prenatal consultation; development of a birth plan; access to other neonatal and pediatric specialties, as needed; and support and care during the prenatal, birth, and postnatal periods, including bereavement counseling.
The birth plan is an individualized proposal for delivery and neonatal care and a critical prenatal component of perinatal palliative comfort care.
The perinatal palliative care team should prepare families for the possibility that there may be differences of opinion between family members before and after the delivery of the infant, and that there may be differences between parents and the neonatal care providers about appropriate postnatal therapies, especially if the postnatal diagnosis and prognosis differ substantially from antenatal predictions.
The prenatal diagnosis of a fetal abnormality that may be life-limiting necessitates challenging and complex discussions between patients and health care providers to establish individualized care plans. Historically, choices for patients faced with such a diagnosis were distilled down to a basic dichotomy: termination of pregnancy or pregnancy continuation with a plan for postnatal resuscitation and life-prolonging treatment (1). Although each may be a valid option for some patients and families, for others perinatal palliative comfort care may be the preferred approach.
Perinatal palliative care refers to a coordinated care strategy that comprises options for obstetric and newborn care that include a focus on maximizing quality of life and comfort for newborns with a variety of conditions considered to be life-limiting in early infancy. With a dual focus on ameliorating suffering and honoring patient values, perinatal palliative care can be provided concurrently with life-prolonging treatment. The focus of this document, however, involves the provision of exclusively palliative care without intent to prolong life in the context of a life-limiting condition, otherwise known as perinatal palliative comfort care.
This publication is intended to clarify which patients would be appropriate candidates for perinatal palliative comfort care, to discuss essential components of this care, and to explore some of the challenges this kind of care poses for patients, health care providers, and health care entities.
Although healthy newborn survival is expected for the majority of infants born in developed nations, this is not the outcome of some pregnancies. In the United States, 23,455 infant deaths were reported in 2015, of which two thirds occurred in the neonatal period (2). Among these deaths, congenital malformations and chromosomal abnormalities were the most common cause, accounting for 20.6% of cases, followed by deaths related to prematurity and low birth weight, which comprised an additional 17.4% of cases.
Numerous conditions for which life is anticipated to be short or associated with extremely poor quality can be identified by modern prenatal diagnostic techniques. Lethal fetal anomalies are likely to be fatal in utero or shortly after birth. For the purposes of this document, the term "life-limiting" includes lethal fetal conditions as well as others for which there is little or no prospect of long-term ex utero survival without severe morbidity or extremely poor quality of life, and for which there is no cure. These severely morbid conditions may include those for which intervention is of questionable efficacy or deemed to be unacceptably burdensome to the neonate. In some cases (such as hypoplastic left heart syndrome), there may be ameliorative treatments available, but parents may choose not to pursue these treatments because of their invasiveness, complexity, or uncertain outcomes.
Patient Selection for Perinatal Palliative Comfort Care
Consideration for perinatal palliative comfort care requires that there first be a diagnosis of a life-limiting fetal condition. A life-limiting diagnosis may be obvious from fetal imaging or genetic testing, but this diagnosis also may require interdisciplinary input from maternal–fetal medicine specialists, geneticists, or pediatric subspecialists. However, it is important to note that although the medical ability to prenatally identify a life-limiting prognosis is high, it is not infallible. In a small, retrospective, single-center study that involved 49 women with pregnancies referred for perinatal palliative care, a specific life-limiting prenatal diagnosis was not confirmed postnatally in four cases, although in each of these the infant had a substantial comorbid condition (3). There also have been case reports of prenatal genetic diagnoses that were not as phenotypically severe as anticipated (4), which highlights the need to acknowledge any prognostic uncertainty that may exist and, when appropriate, seek postnatal confirmation of the diagnosis.
Once a life-limiting diagnosis is suspected antenatally, the tenets of informed consent require that the pregnant patient be given information of sufficient depth and breadth to make an informed, voluntary choice for her care (5). Health care providers are encouraged to model effective, compassionate communication that respects patient cultural beliefs and values and to promote shared decision making with patients (6). Information shared with the patient should detail the diagnosis, its anticipated prognosis, and interventions, if any, that may alter the natural disease course. The degree of confidence regarding a life-limiting determination should be discussed, and diagnostic and prognostic limitations disclosed. All care options should be discussed, including pregnancy termination (abortion, within legal limitations), prenatal and postnatal intervention intended to promote survival, and palliative comfort care, which may include interventions to promote comfort and improve quality of life without intending to promote survival.
Pregnant patients may want to include a spouse or partner, family members, other loved ones, trusted clinicians (such as a primary obstetrician–gynecologist), and religious and spiritual guides (if any) in these discussions. The emotional impact of these decisions will likely affect other family members, and the palliative care team should be prepared to offer emotional, spiritual, and mental health support where needed. A model of shared decision making between the pregnant patient, her family (if she desires), and the palliative care team will help to foster the partnership and communication that are essential to an effective palliative care program and the overall patient experience (6).
If a patient opts to pursue perinatal palliative comfort care, a multidisciplinary team should be identified with the infrastructure and support to administer this care. There is no evidence to support an optimal model for providing perinatal palliative care (7). Therefore, perinatal palliative care programs may differ between institutions based upon personnel, resources, and practice style. An effective perinatal palliative care team may include obstetric care providers, neonatologists, health care providers with expertise in pediatric palliative care, nurses, social workers, mental health professionals, religious counselors, lactation specialists, and child life specialists. The goal of this team is to provide support and continuity of care throughout pregnancy, delivery, and the postpartum and neonatal periods.
Components of Perinatal Palliative Comfort Care
A goal of this document is to provide a framework to support provision of perinatal palliative comfort care but not to be overly prescriptive or to mandate certain practices. Although specific offerings may vary between institutions, some care components are generally advisable across perinatal palliative comfort care programs: a formal prenatal consultation; development of a birth plan; access to other neonatal and pediatric specialties, as needed; and support and care during the prenatal, birth, and postnatal periods, including bereavement counseling (8).
An initial consultation for perinatal palliative comfort care should include a review of the fetal diagnosis, an introduction to the goals of palliative medicine, and a review of the variety of decisions that the woman and her family may face both antenatally and in the newborn period. It can be helpful to identify the patient's preferred terminology (such as "baby," "pregnancy," or "fetus") and also to inquire if the fetus has been given a name, by which the fetus may then be referred if that is favored by the patient.
Other objectives of the initial consultation are to establish a therapeutic alliance for ongoing care, to validate a patient's decision to pursue palliative comfort care, and to ensure that the patient's goals align with reasonable expectations for the pregnancy. In a study that explored the hopes of parents of children who lived with trisomy 13 and 18, commonly cited parental goals after diagnosis included having a live birth, spending time as a family, bringing their child home, and giving their child "a good life" (9).
The birth plan is an individualized proposal for delivery and neonatal care and a critical prenatal component of perinatal palliative comfort care. Intrapartum fetal monitoring and mode of delivery considerations should be clarified within the birth plan. For example, antenatal testing may be reasonably deferred for a fetus with a presumed life-limiting diagnosis provided the parents understand that the result may be an unmonitored fetal demise. Intrapartum fetal monitoring similarly may be deferred during labor because a cesarean delivery for fetal indications would entail maternal operative risks without prospect for lasting neonatal benefit.
Conversely, there may be scenarios for which intrapartum fetal monitoring, timed delivery, or cesarean delivery for fetal indications may be valid parts of a perinatal palliative comfort care birth plan. For example, intrapartum fetal monitoring and cesarean delivery may reasonably be requested by a well-informed patient who wishes to have a live birth or desires a religious ceremony involving a liveborn neonate. There may additionally be situations for which intrapartum monitoring of a fetus with a life-limiting condition can assist with maternal delivery management. One such circumstance involves a woman with a fetus with a life-limiting condition undergoing trial of labor after prior cesarean delivery. In this case, fetal heart rate monitoring may provide supplemental information regarding cesarean scar integrity that could contribute to safe maternal intrapartum care. Decisions regarding the appropriateness of intrapartum fetal monitoring in cases like this should be individualized.
The birth plan also must include plans for assessment and care of the newborn and should include considerations such as newborn bonding and skin-to-skin contact, warmth, hydration, feeding and lactation, management of respiratory distress, and pain control. The plan may be further tailored to address specific patient wishes such as who will attend the birth and what their roles will be in the delivery room. The birth plan ideally should be discussed with health care providers before delivery, placed in the medical record, and available for review by delivery care providers. It should be stressed that the plan for neonatal care is a provisional understanding and may be subject to reassessment if postnatal assessment reveals a different diagnosis or prognosis (3).
When timing and logistics permit, patients who pursue perinatal palliative comfort care should have regular follow-up with the palliative care team. These ongoing interactions provide opportunities to address patient grief and other emotions, to review the birth plan and related concerns that may arise, to receive anticipatory guidance, and to identify additional opportunities for patient advocacy. Some patients may benefit from an emphasis on the routine aspects of pregnancy to normalize their experience, although this should be tailored to patient needs (8). Repeated interactions with the perinatal palliative care team also may serve to reduce patient anxiety regarding the upcoming delivery.
When physically available, a member of the palliative care team should be present for the delivery of a patient pursuing a perinatal palliative comfort care plan. However, if a clear plan is in place and documented in the chart, it can be executed even if a member of the perinatal palliative care team is not present. In such a case, someone from the team should be available for consultation, if needed. The delivery should be a family-centered experience, with comfort and support offered to the newborn, parent, and family. In addition to supporting the plan established before birth, and if consistent with patient wishes, there may be opportunities for constructive memory making such as patient and family photography, collecting delivery keepsakes, recording the baby's heartbeat, and making molds of handprints or footprints.
After delivery, emotional and spiritual support should be provided for parents and their families. For neonates receiving palliative comfort care who survive the immediate newborn period, some parents may desire to have their newborn room with them during the postpartum period. When a patient opts for newborn rooming-in, the neonatal and palliative care teams should visit the family to ensure the baby's comfort and to provide practical and emotional support to the parents, while also respecting the family's privacy during this important time. These visits are intended to provide newborn palliative care at the bedside, to educate, to offer emotional support, and to minimize stress. Throughout this process, the newborn's parents and caregivers should be encouraged and allowed to participate in the care of the newborn, including feeding, bathing, and diapering. However, rooming-in may not be appropriate in all situations, and some patients may not desire it.
Some infants who receive palliative comfort care may survive long enough to be discharged from the hospital. In these cases, the perinatal palliative care team should work with parents and families to determine appropriate dispositions, which may include hospice care at home or in a health care setting.
After a child's death, bereavement counseling is strongly encouraged. Additionally, it is important to acknowledge that complex end-of-life decisions also can be stressful for physicians, nurses, and other members of the obstetric, neonatal, and palliative care teams, and institutions are encouraged to provide support for team members dealing with emotional distress (10).
Often, there will be consonance and agreement between all family members, the obstetric team, and the neonatal team in devising care plans. Nevertheless, the perinatal palliative care team should prepare families for the possibility that there may be differences of opinion between family members before and after the delivery of the infant, and that there may be differences between parents and the neonatal care providers about appropriate postnatal therapies, especially if the postnatal diagnosis and prognosis differ substantially from antenatal predictions. Procedures for resolving such differences should be discussed with families ahead of time.
Challenges and Benefits
Although perinatal palliative care is a growing field, nationwide use remains low (11). In a retrospective cohort study that involved more than 40 children's hospitals from across the country, neonates represented 41% of all hospital deaths but only 2% of them received palliative care services (12). Factors contributing to low perinatal palliative care use include availability of programs, patient access issues, and physician education and training barriers. Despite these obstacles, the benefits of these programs justify their continued development.
The implementation of perinatal palliative care programs appears to influence the specific care provided to newborns with suspected life-limiting conditions. In one retrospective study that involved a single regional level IV neonatal intensive care unit, introduction of a perinatal palliative care program was associated with a significant increase in redirection of care and palliative medication use and a decrease in variability of use of end-of-life interventions (13). Qualitative data similarly support the benefit of these programs. In a single-center study of parental perceptions regarding the care that their newborns with life-limiting conditions received from participation in a standardized program, most parents believed that their children were treated respectfully in a "caring, peaceful, and noninvasive environment," and that an overall state of comfort was achieved (14).
The prenatal diagnosis of a life-limiting condition can be very stressful for patients and their families, eliciting feelings including grief, loss, and anxiety (15). There is literature to suggest that parents can derive satisfaction from participation in a perinatal palliative care program, and this may facilitate adjustment to the news of a life-limiting fetal diagnosis. One study of parents who chose to continue pregnancies after life-limiting fetal diagnoses reported that, although perinatal palliative care was not available to all, the majority were happy "to meet their baby" after delivery even if the newborn lived only briefly after birth or was stillborn (15).
Women should have control over decisions that affect their bodies, and it should be their decision as to how to manage a pregnancy complicated by a life-limiting fetal condition (16). Perinatal palliative comfort care is one of several options along a spectrum of care, which includes pregnancy termination (abortion) and full neonatal resuscitation and treatment, that should be presented to pregnant patients faced with pregnancies complicated by life-limiting fetal conditions. Indeed, the tenets of informed consent require that patients be presented with this full array of reasonable and ethically acceptable options (5).
Offering perinatal palliative care to pregnant patients should be seen as an opportunity to further their autonomy and promote beneficent care. Physicians should support patients and their families in a shared decision-making process that respects individual autonomy as well as the complex web of relations and emotional influences in their lives, while also guarding against coercion and undue influence from family members, spouses, partners, or even health care providers themselves (17). Nonetheless, after birth, the ethics of complex decision making for newborns requires the input of both parents, when practical.
Perinatal palliative care refers to a coordinated care strategy that comprises options for obstetric and newborn care that include a focus on maximizing quality of life and comfort for newborns with a variety of conditions considered to be life-limiting in early infancy. Perinatal palliative comfort care is one of several options along a spectrum of care, which includes pregnancy termination (abortion) and full neonatal resuscitation and treatment, that should be presented to pregnant patients faced with pregnancies complicated by life-limiting fetal conditions. Health care providers and institutions are encouraged to develop perinatal palliative care programs, which generally may include the following: a formal prenatal consultation; development of a birth plan; access to other neonatal and pediatric specialties, as needed; and support and care during the prenatal, birth, and postnatal periods, including bereavement counseling. Once a life-limiting condition is suspected antenatally, the tenets of informed consent require that pregnant patients be given information of sufficient depth and breadth to make an informed, voluntary choice for their care.
Copyright 2019 by the American College of Obstetricians and Gynecologists. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, posted on the Internet, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission from the publisher.
Requests for authorization to make photocopies should be directed to Copyright Clearance Center, 222 Rosewood Drive, Danvers, MA 01923, (978) 750-8400.
American College of Obstetricians and Gynecologists 409 12th Street, SW, PO Box 96920, Washington, DC 20090-6920
Perinatal palliative care. ACOG Committee Opinion No. 786. American College of Obstetricians and Gynecologists. Obstet Gynecol 2019;134:e84–9.
1. Hoeldtke NJ, Calhoun BC. Perinatal hospice. Am J Obstet Gynecol 2001;185:525–9.
Cited Here
2. Heron M. Deaths: Leading Causes for 2016. Natl Vital Stat Rep 2018;67:1–77.
3. Parravicini E, Lorenz JM. Neonatal outcomes of fetuses diagnosed with life-limiting conditions when individualized comfort measures are proposed. J Perinatol 2014;34:483–7.
4. Kidszun A, Linebarger J, Walter JK, Paul NW, Fruth A, Mildenberger E, et al. What if the prenatal diagnosis of a lethal anomaly turns out to be wrong? Pediatrics 2016;137:e20154514.
5. Informed consent. ACOG Committee Opinion No. 439. American College of Obstetricians and Gynecologists. Obstet Gynecol 2009;114:401–8.
6. Effective patient–physician communication. Committee Opinion No. 587. American College of Obstetricians and Gynecologists. Obstet Gynecol 2014;123:389–93.
7. Balaguer A, Martín-Ancel A, Ortigoza-Escobar D, Escribano J, Argemi J. The model of Palliative Care in the perinatal setting: a review of the literature. BMC Pediatr 2012;12:25–25.
8. Cole JC, Moldenhauer JS, Jones TR, Shaughnessy EA, Zarrin HE, Coursey AL, et al. A proposed model for perinatal palliative care. J Obstet Gynecol Neonatal Nurs 2017;46:904–11.
9. Janvier A, Farlow B, Barrington KJ. Parental hopes, interventions, and survival of neonates with trisomy 13 and trisomy 18. Am J Med Genet C Semin Med Genet 2016;172:279–87.
10. Wool C. State of the science on perinatal palliative care. J Obstet Gynecol Neonatal Nurs 2013;42:372–82; quiz E54–5.
11. Currie ER, Christian BJ, Hinds PS, Perna SJ, Robinson C, Day S, et al. Parent perspectives of neonatal intensive care at the end-of-life. J Pediatr Nurs 2016;31:478–89.
12. Keele L, Keenan HT, Sheetz J, Bratton SL. Differences in characteristics of dying children who receive and do not receive palliative care. Pediatrics 2013;132:72–8.
13. Samsel C, Lechner BE. End-of-life care in a regional level IV neonatal intensive care unit after implementation of a palliative care initiative. J Perinatol 2015;35:223–8.
14. Parravicini E, Daho' M, Foe G, Steinwurtzel R, Byrne M. Parental assessment of comfort in newborns affected by life-limiting conditions treated by a standardized neonatal comfort care program. J Perinatol 2018;38:142–7.
15. Cote-Arsenault D, Denney-Koelsch E. "Have no regrets:" parents' experiences and developmental tasks in pregnancy with a lethal fetal diagnosis. Soc Sci Med 2016;154:100–9.
16. Refusal of medically recommended treatment during pregnancy. Committee Opinion No. 664. American College of Obstetricians and Gynecologists. Obstet Gynecol 2016;127:e175–82.
17. Maternal–fetal intervention and fetal care centers. Committee Opinion No. 501. American College of Obstetricians and Gynecologists and American Academy of Pediatrics. Obstet Gynecol 2011;118:405–10.
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Perinatal Palliative Care: ACOG COMMITTEE OPINION, Number 786
Obstetrics & Gynecology134(3):e84-e89, September 2019.
ACOG Publications: September 2019 Issue
ACOG: Committee Opinions
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ACOG Practice Bulletin No. 207: Thrombocytopenia in Pregnancy
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ACOG Practice Bulletin No. 212: Pregnancy and Heart Disease
Quantitative Blood Loss in Obstetric Hemorrhage: ACOG COMMITTEE OPINION, Number 794


When I asked how her day went, my 10 year-old daughter, Clara, said she had a little trouble at recess.
I was driving when she said this to me, so I pulled the car over to capture her language as precisely as possible.
"Will that be hard?" I asked.
A couple hours later, Elysha asked Clara how the boy took the news of the divorce, and Clara reported that he was fine.
"Anything else?" I asked, feverishly typing into Evernote as I spoke.
I don't remember every recess I enjoyed when I was a child, but I am fairly certain that none of them were anything like the recesses that my daughter enjoys these days.
At least I think she enjoys them. They sounds incredibly stressful to me.


text:
North Shore Ski Trails
Our Favorite Cross-Country Skiing Trails
by Ricky Williams
The North Shore of Massachusetts is full of beautiful scenery, lush forests, and snaking Nordic skiing trails. Both professional and recreational cross-country skiers can appreciate the dozens of sinuous paths that wind their way through the historic region. Below, we have detailed a few of our favorites—they surprise and delight year after year, and we hope you have the opportunity to experience them.
Ipswich River Wildlife Sanctuary—Topsfield
Length: 12 Miles
This wildlife sanctuary is composed of a series of interconnecting trails—skiers can experience forests, meadows, and wetlands in the course of a single outing. The trail is also home to several endemic bird species, including owls, wild turkeys, woodpeckers, and hummingbirds. Crossing through the wetlands? Watch for river otters, painted turtles, and great blue herons.
Martin H. Burns Wildlife Management Area—Essex
Length: 3.4 Miles
Once used for a trolley line, this trail winds its way through a heavily-wooded 1,555-acre wildlife area. The trail ends before reading busy I-95, making for a quiet and peaceful ride. Skiers can glimpse deer, fox, beaver, and several bird species. Looking to extend your ride? Riders can choose to take one of two wide trails leading toward Newbury, and a connection can be made heading in the direction of the Merrimack River.
Ward Reservation—Andover
These trails link three major hills—Shrub Hill, Boston Hill, and Holt Hill. If you hike to the top of these hills, beautiful "Solstice Stones" mark the summits. Holt Hill is the highest point in Essex County. These ten miles of easy/moderate trails make for a wonderful place to spend a sunny, snowy day. The trails themselves are part of the larger Bay Circuit Trail, which is a greenway linking the North and South Shores of Massachusetts.
Bald Hill Reservation—Boxford
This quick and easy trail is perfect for beginning Nordic skiers. It touches on parts of North Andover, Boxford, and Middleton, winding through Ball Hill's 1,700 acres of forested land. The conservation area is home to white-tailed deer, fisher, mink, otter, and several species of birds.
Discover Your Own Favorite Trail for North Shore Cross-Country Skiing
Find Your North Shore Ski Trail
How to Choose Cross-Country Skis
Why Nordic Skiing Is the Perfect Socially Distanced Activity
A First-Start Checklist For Nordic Skiing
Video: How to Skate Ski
Your Guide to Skiing in Massachusetts
© Copyright 2022 - North Shore Ski Trails


text:
Nigeria reaching maximum capacity to borrow, says El-Rufai
By Kehinde Olatunji and Gloria Nwafor
Lagos State Governor Babajide Sanwo-Olu (second right); his Kaduna State counterpart, Nasir el-Rufai (second left) and his aides, Jimi Lawal (left) and Muyiwa Adekeye (right) during el-Rufai's visit to Sanwo-Olu in Lagos…yesterday
•'We must be proactive to avoid external shocks'
• Avoid unnecessary spending, Sanwo-Olu charges counterparts
•Tasks tax experts on revenue generation
Governor Nasir el-Rufai of Kaduna State has raised the alarm that the country has almost reached its maximum capacity to borrow. He said that with the collapse of the crude oil prices, the nation should be more proactive to avoid external shocks.
The governor, who spoke yesterday at the 22nd Annual Tax Conference of the Chartered Institute of Taxation of Nigeria (CITN) held in Lagos, said the country should start developing tax extraction capacity and create an effective tax system that influences structural change.
El-Rufai, who spoke on "Taxation and Economic Competitiveness: Imperatives for National Development", said poor administration, sub-optimal collection of taxes, low accountability, corruption and high tax rate, among others, were factors and major challenges hindering tax growth in the country.
At the event, Lagos State Governor Babajide Sanwo-Olu charged his counterparts to look into their expenditure profile and do away with unnecessary spending to preserve more resources to meet the basic needs of the people.
He stressed the need for better utilisation of tax payers' money by public office holders to build the trust of the citizens. He urged his fellow governors to work toward having a better tax reform process.
According to Sanwo-Olu, who declared that he has not used state resources to purchase any vehicle for himself since he assumed office as governor on May 29, 2019, it is not necessarily fanciful that governors must buy brand new vehicles when there is no need for them.
"We need to look at our expenditure profile as chief executives of our states and ask ourselves: where can I cut the red tape, what can I do away with so as to increase the revenue of my state or even make available more money for my state?
"Till date, I have not purchased any single official vehicle for myself, for any of my personal staff or any of my family members from the government purse. If you see me have a convoy of 10 vehicles, these are all vehicles I was using during my campaigns.
"Governor el-Rufai joined me in one of my cars this morning and I can tell you that the vehicle is one of the ones I used for my campaign; it is not a brand new car.
"I say to my people that it is not a fanciful thing that every governor must begin to buy brand new vehicles when you do not need to. So, all of those millions have gone back into the treasury of the state and we are using it to develop the state very well."
Governor Sanwo-Olu who stressed the need to increase revenue generation without being totally dependent on money from oil, charged tax practitioners, especially members of CITN, to take leadership position to increase government revenue and change the narrative in the country.
El-Rufai commended Sanwo-Olu on managing the affairs of Lagos and the effort to rebuild the state after the massive destruction that marred the peaceful protests organised by the youth recently.
"Whatever happens in Lagos concerns everybody because it is the economic hub of the country while Kaduna State is the political hub. I can assure you that all the 35 governors will support your rebuilding Lagos project," el-Rufai promised.
The President of CITN, Dame Gladys Simplice, urged the executive arm of government to ensure that the economic policies in generating revenue are matched with tax reforms that encourage growth through executive orders and sponsorship of legislative bills capable of promoting entrepreneurship development.
She also advised the National Assembly to "address the nature" of the Value Added Tax (VAT) by including more items under the exemption list and giving clarity to the existing ones.
Babajide Sanwo-OluCITNNasir El-Rufai


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Q: sub-algebra of inductive limit Let $A_{i}$ be sequence of C* algebras, $\alpha_{i}:A_{i}\rightarrow A_{i+1}$ be sequence of *-homomorphisms. Consider some sub-algebra $B$ of its inductive limit $A$. Denote the canonical homomorphism be $\beta_{i}:A_{i}\rightarrow A$. Are $\beta_{i}^{-1}(B)$ a sub-algebra of $A_{i}$?
I know that the kernal of $\beta_{i}$ form an ideal in $A_{i}$, but I don't know if it works on preimage of other elements.

A: Yes, and this has nothing to do with inductive limits. If $\alpha\colon A_1\to A_2$ is an algebra homomorphism and $B$ a subalgebra of $A_2$, then $\alpha^{-1}(B)$ is a subalgebra of $A_1$. I assume you know this result for vector spaces and linear maps, so I'll just prove that $\alpha^{-1}(B)$ is closed under taking products.
If $x,y\in \alpha^{-1}(B)$, then $\alpha(x),\alpha(y)\in B$ by definition and therefore $\alpha(xy)=\alpha(x)\alpha(y)\in B$ since $B$ is an algebra. Thus $xy\in \alpha^{-1}(B)$.
The same holds for (unital) $\ast$-homomorphisms and (unital) $\ast$-subalgebras by a similar argument.


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Beneath Baidu's positive results lie brand, trust burdens
|In Heavy Hitters, The Numbers
|By Chris Udemans
(Image credit: Jon Russell/Flickr)
Search giant Baidu has faced mounting challenges to its consumer-facing businesses, as the Chinese government cracks down on online content and trust in its search and aggregation services among consumers wanes.
Nonetheless, the company on Friday reported solid revenue growth in the fourth quarter, while net income fell 50% year-on-year as the company sought to expand its content, artificial intelligence, and cloud computing offerings.
Total revenue reached more than RMB 27 billion (around $4 billion) during the quarter, up 22% year-on-year, but slowed compared with the same period last year.
Operating income slid 77% as the company increased spending on content, which included shows and films on video-streaming site iQiyi. Other expenses included those related to research and development, traffic acquisition, and promotional activities—including its "red envelope," or hongbao, campaign over Chinese New Year.
"The diversification of Baidu's business from mobile internet to the smart home, smart transportation, cloud, and autonomous driving markets will require heavy investments," Baidu CFO Herman Yu said in a statement.
These investments, along with slowing quarterly growth in Baidu's online marketing business, represent a broader turn from the consumer market as the Chinese economy sees its most significant slowdown in nearly 30 years. Rivals Tencent and Alibaba have also increased their focus on enterprise, while all three companies have restructured to counter challenges in the consumer sector—including increased regulation and competition in the content market.
In a note following Baidu's earnings, Bernstein analyst David Dai listed declining users of the company's search platform and advertisers migrating away from search, among others, as possible loss-making risks.
"We have entered a new stage in China's internet where the population and penetration dividend has gone," Baidu CEO Robin Li said during an earnings call on Friday.
Eyes on AI
In December, Li announced plans to restructure Baidu, upgrading its Artificial Intelligence and Cloud Computing Unit into a business group, as the company seeks to increase its focus on enterprise customers.
Following the move, Li told employees in an internal memo that the Chinese economy had "shifted to a lower gear," and that the country's firms were under "severe pressure from nationwide economic restructuring." Li called for Baidu employees to decrease costs and improve efficiency for its business clients.
While the opportunity to pivot to enterprise-facing applications was always there, Chinese tech companies have been given an extra incentive following the slowdown in consumer spending, analysts told TechNode.
To boost revenue, company executives have been looking to deploy Baidu's AI technologies beyond its consumer-facing search, feed, and smart assistant businesses to enterprise and government-led initiatives—including intelligent transportation and smart city projects. Baidu has already partnered with the municipal governments in Shanghai and Xiong'an, in the northern province of Hebei, among others, to provide their AI and cloud computing services to increase efficiency within urban areas.
"With the support of local governments, we see commercial opportunities to minimize traffic congestion, reduce pollution, and improving road safety," Li said on the earnings call.
The company is also focused on self-driving vehicles. In 2018, China's central government named Baidu one of five Chinese "AI Champions," tasking it with spearheading the country's autonomous driving development. In January, Baidu released a significant update to its self-driving platform, Apollo, enabling autonomous vehicles to navigate "complex urban and suburban environments." At the same time, it also unveiled its Apollo Enterprise platform, designed for AVs that have been pegged for mass production.
Its Apollo program has been granted over 50 licenses for road testing in Chinese cities, including Beijing, Tianjin, and Chongqing. This year Baidu will roll out a fleet of robotaxis in the central Chinese city of Changsha.
Difficulties in the market
China's internet regulator, the Cyberspace Administration of China (CAC), has targeted online service providers as part of a broad crackdown on "vulgar" content. The move has prompted Chinese tech companies to employ legions of moderators that they attempted to keep up with increasingly strict regulations.
Baidu hasn't been immune to the campaign. Last month, the company said it had removed more than 50 billion "harmful" pieces of information in 2018, up 11% compared to the previous year. Baidu said the removals included content relating to pornography, drug use, gambling, and fraud. According to an annual content management report, the company intercepted 1,500 pieces of information per second.
But it wasn't enough to appease regulators. In the same month, the CAC ordered Baidu, along with Sohu, to suspend a number of their news services for a week as part of a six-month campaign to clean up the Chinese internet. The company and the regulator didn't provide further details.
Baidu has also faced scrutiny for its ad placement, leading to waning trust in the company's search results following a 2016 incident in which a 21-year-old college student died of cancer due to ineffective treatment he had found through ads in Baidu search results.
This was followed by a similar incident last year. An internet user from Shanghai was directed to what she thought was the reputable Fudan University hospital through Baidu's search results. She underwent an operation that cost tens of thousands of RMB at a similarly named institution. Following the procedure, she found her ailment could have been cured by medication costing RMB 200.
"I would see public sentiment as the biggest challenge Baidu faces," International Data Corporation research manager Xue Yu told TechNode in an email, adding that difficulty in acquiring new users has increased the company's traffic acquisition costs. "The negative impression of Baidu's brand is still a major concern when people use apps," he said.
The company was again subject to censure in January after it was accused of promoting its own results and low-quality articles on its content aggregator Baijiahao by Chinese journalist Fang Kecheng.
"Baidu no longer plans on being a good search engine. It only wants to be a marketing platform," Fang wrote in an article. Baidu responded by saying that it would continue to improve its search results and content aggregator. The company also said just 10% of its results come from Baijiahao.
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I haven't had a chance to wear these socks yet, but I am very pleased with their stout construction and fabulous colors.
I've been a devoted customer of Unsimply Stitched for the past 5 years. I NEVER wear any other socks because their socks are of excellent quality, durable, comfortable, reasonably-priced, and FUN to wear! I get a lot of great comments on my socks - Hey U.S. you've got yourself a customer for life! Thanks so much.


Q. I am currently looking at a Mitsubishi asx to buy however i am struggling between petrol and diesel. Currently I am looking at the 2.2 diesel as i would be using it mainly in the suburbs with the once a year holiday in the country while keeping the car for at least ten or more years. As i understand your articles on the subject I should be choosing the diesel is this correct?
Your choice of car puts (Mitsubishi ASX you in an unusual position. Why is that so you might ask? The equivalent modes (Aspire) in both diesel and petrol cost exactly the same. As I've mentioned in my article, in most cases, the diesel equivalent to the petrol car cost substantially more. This means that the payback period does not apply in your case.
If you don't mind the horrible diesel noise that is emitted from the engine, or the fact that it will be cost a little more in servicing and that it's not quite as environmentally friendly as the petrol, then the diesel should be your choice.
What you should take note however is the post on CarGuru about the individual who was interested in purchasing the Mitsubishi Challenger re. the particulate filter blocking up. It seems that your circumstances are similar to this individuals. Just thought it would be good to be aware of.
Enjoy whatever car you do decide to purchase.


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Home/Association News/Working Together for Home Fire Safety
Team members with Quick Response Fire Protection volunteered their time and manpower to install the residential sprinkler system.
Working Together for Home Fire Safety
September 14, 2021	Association News, Chapter, Education, Featured Articles, Industry, Membership Leave a comment
Industry Partners Donate Fire Sprinkler System to Firefighter and His Family
Nine out of every 10 fire deaths happen at home, and most of these fires happen at night while people are sleeping. These are industry statistics that Jon Rocasi knows well and not just because he's a firefighter in Tampa, Florida. Those numbers are on his mind every time he leaves his Palm Bay home to go to work. He can't help wondering if one of those times while he's on duty, his wife and children will be victims of a home fire.
During his 15 years of career fire service with agencies across the country, Rocasi had witnessed the heartbreaking loss of lives and possessions due to fire and resolved to do whatever he could to keep his own family safe. He began by researching fireproof construction materials with an eye on retrofitting his house. While options did exist, the cost was significant—certainly more than the family budget could absorb. So, his next step was to seek grants from local municipalities that would help offset the costs.
Although he was not able to secure financial assistance, he did get help in another form: information about residential fire sprinkler systems. Rocasi knew most commercial buildings had those types of systems, but he was not aware of a contractor who installed a residential version. As he did more investigation and compared quotes from various companies, Rocasi also learned that, from a cost perspective, a residential fire sprinkler system was more affordable than fireproof drywall—roughly $1.35 per square foot of sprinklered space in new construction.
Unfortunately, however, even that cost savings would be a strain on the family finances, leaving Rocasi in the untenable position of having to weigh the cost of equipment and installation against the value of his family's safety.
Firefighter Jon Rocasi and his family are now protected by residential sprinklers, thanks to AFSA Florida Chapter members.
That's when Quick Response Fire Protection entered the picture. The company installs residential fire sprinkler systems manufactured by Viking SupplyNet, and when Gene Robinson, who handles contract and Virgin Island sales at the company, learned of Rocasi's story, he resolved to do what he could to ensure that at least this firefighter could go to work each day knowing his family was safe at home.
Robinson made a call to Viking, hoping the company would be willing to donate the equipment. "Our industry has great respect for first responders, and Jon's story really touched me," said Robinson. "We work with manufacturers who share the same respect, so I called my Viking representative, and asked if they could give a break on the material. Viking ended up donating all the material."
But the story doesn't end there. News of the equipment donation from Viking spread throughout Quick Response and team members at the company took up the cause. Project designer Jason Ehrlich volunteered to design the system on his own time, and Charlie Bracket, Marty Brasher, Daniel Burgess, John Henderson, Dion Hudson, Jarmen Mann, Gene Robinson, and Johnathan Rodreges donated their time to install the system.
"Gene making the material donation ask to Viking sparked the rest of the guys to donate their time," says company owner Marty Brasher. "I couldn't be more proud of the Quick Response team."
Rocasi was deeply gratified by the help he and his family received. "I was talking with my wife about how we were going to cover the cost of the fire sprinkler system when Quick Response called and said their employees wanted to donate the design and labor, and Viking wanted to donate all the materials. We are blessed," states Rocasi. "I feel like our family now has a full-time firefighter inside our house."
Far from being a high-end add-on, a residential fire sprinkler system can literally mean the difference between succumbing to a home fire or surviving it. A home fire can become deadly in two minutes or less. Even more alarming, new homes built of common unprotected lightweight building materials and flooring can burn faster than older construction houses, making them even more deadly. Yet residential fire sprinkler systems are often not considered when buying or building a home.
Jason Ehrlich with Quick Response Fire Protection designed the residential sprinkler system for the Rocasi family.
"It's important to us at Viking that we find ways to give back to fire service officials whenever possible," comments Ben Johnson, who is the director of sales for Viking, adding, "We were grateful to have a hand in the installation and look forward to future collaboration initiatives that allow us to support our community."
Learning about residential fire sprinkler systems has also sparked an interest in Rocasi and his wife to create a not-for-profit. "I'm that guy who wanted a system and had to figure out how to pay for it," notes Rocasi. "Our family received an incredible blessing, and we'd like to find a way to pay it forward. Maybe it hasn't touched you, but you know someone who has had a home fire. It's time to start talking about residential fire sprinklers and how we get them in our homes."
To learn more about residential fire sprinkler systems, visit the Home Fire Sprinkler Coalition (HFSC), the leading resource for independent, noncommercial information about home fire sprinklers, with resources and informational materials for developers, land planners, and homebuilders, at homefiresprinkler.org.
ABOUT THE AUTHOR: Jessica Cox is the executive director of the AFSA Florida Chapter. For more information about the chapter and its activities, visit afsafl.org or email Cox at jessica@afsafl.org.
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Select: return the subset of the columns of a data frame. It is fast when you are working with large dataset with many columns but few are actually of interest to you. See ?select for more details.
Filter: filter() function allows to extract a subset of rows from a data frame based on logical condition. The first argument of filter function takes as data frame and the second argument as well as subsequent argument takes as logical expressions that filter the data frame.
Mutate: mutate () function allow to adding new variable or transform variable in the data frame.
Arrange: arrange () function allow you to order the rows by one or more columns in ascending or descending order.
Summarise: summarise() function allow to generate or calculate summary statistics for a given columns in the data frame such as finding mean, median etc.
We are going to show how to manipulate and transform airquality data set and explore some important information based on this data set.
##  "Ozone"   "Solar.R" "Wind"    "Temp"    "Month"   "Day"
We often face large data set in the real world, where we are only interested in few variables. select() function allow you to zoom in on extracted subset.
Note : You can notice that we don't use airquality$Ozone, airquality$Day and airquality$Month as we generally do in the base R. We can get the columns in the same order in the output as we specified. Day is the right-most column in the original data set but we show this column in the mid of output.
## Use of : (colon) operator offer selecting a range of columns by name.
## select columns that contains "o" charater such as Ozone, Month etc.
filter() function subset a data from data set by keeping rows that meet specified condition and do same work as subset() function in base R except you can give it any number of filtering condition.
Note : You can use comma or ampresand (&) to represent AND condition.
## select all rows where day is less than 5 and Solar radiation greater than or equal to 200.
arrange () function sorting your data either descending or ascending order. It is similar to order() function in base R.
## arrange the rows in the ascending order of Day and then in the descending order of Month.
mutate() function generally create add new variable that are function of existing variable. It is similar to transform() function in the base R except mutate() function allows you to refer to columns that you have just created.
## A group_by function allow to split the data set according to categorical variable. we are going to create temperature categorical variable which indicate whether teperature is hot or cold depending the temperature was over 80 degree or not.
summarise() function is mainly useful with data that has been grouped by one or more variable. In this process, group_by() function creates the group and summarise() function provides aggregation to summarise each group.
## summarize hot_cold object which split according to tempreture. So we are going to show what is mean Ozone, what is median Solar radiation and what is max Wind during hot and cold day.
## compute the average number of  Fahrenheit degree and Celsius degree of Temprature according to month, apply the mean() function to the column Temp and call the summary value mean_temp and mean_in_celsius .
The important part of dplyr is when you start to "chain" different verbs together. The magrittr R package contain the pipe function %>%. We use %>% operator to connect one command to another. The output of one command becomes the input for the next command. It is very useful when you are performing several operations on data, and don't want to save the output at each intermediate step. This pipe operator works when you combine multiple data manipulation operations, you have to read from the inside out and the arguments may be very distant to the function call. These functions providing an alternative way of calling dplyr (and other data manipulation) functions that you read can from left to right.
Example : dplyr provides the %>% operator x %>% f(y) turns into f(x,y) so you can use it to rewrite multiple operations that you can read left-to-right, top-to-bottom.
## select Ozone and wind from airquality of data set.
## we want to see, what is the average number of Ozone in last 6 days of May Month.
## compute mean temperature of month where month starts from May to August.
## re-arranging the data set and select all rows that display only hot days in the Temperature category (TempCat).
## Whether cold days or hot days effect to max wind speed and average solar radiation.


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Sterling Cruz-Herr (Founder, Emeritus)
Sterling Cruz-Herr is the founder emeritus of dapperQ. As a teacher, executive, and entrepreneur, Sterling is passionately committed to advancing ideas that matter. They founded dapperQ in 2009 on the hunch that fashion could build solidarity in the LGBTQ community and positive visibility for masculine presenting women, gender queers and trans-identified individuals in the broader media landscape. For Sterling's work with dapperQ, they have been quoted in media outlets that include the Washington Post, Huffington Post, Daily Beast, Curve, and Diva. They were also named to Go Magazine's 100 Women We Love. Sterling lives in Brooklyn with their wife Shannon.
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