text:
//
//  OBAInfoViewController.m
//  org.onebusaway.iphone
//
//  Created by Aaron Brethorst on 9/17/12.
//
//

#import "OBAInfoViewController.h"
@import SafariServices;
@import Masonry;

#import "OBAAgenciesListViewController.h"
#import "OBACreditsViewController.h"
#import "OBAAnalytics.h"
#import "Apptentive.h"
#import "OneBusAway-Swift.h"

static NSString * const kRepoURLString = @"https://www.github.com/onebusaway/onebusaway-iphone";
static NSString * const kPrivacyURLString = @"http://onebusaway.org/privacy/";

@interface OBAInfoViewController ()<MFMailComposeViewControllerDelegate>

@end

@implementation OBAInfoViewController

- (id)init {
    self = [super init];

    if (self) {
        self.title = NSLocalizedString(@"Info", @"");
        self.tabBarItem.image = [UIImage imageNamed:@"info"];
    }

    return self;
}

#pragma mark - UIViewController

- (void)viewDidLoad {
    [super viewDidLoad];

    UIView *header = [self buildTableHeaderView];
    [self setTableViewHeader:header];
}

- (void)viewWillAppear:(BOOL)animated {
    [super viewWillAppear:animated];

    [[NSNotificationCenter defaultCenter] addObserver:self selector:@selector(unreadMessageCountChanged:) name:ApptentiveMessageCenterUnreadCountChangedNotification object:nil];

    [self reloadData];
}

- (void)viewWillDisappear:(BOOL)animated {
    [super viewWillDisappear:animated];

    [[NSNotificationCenter defaultCenter] removeObserver:self name:ApptentiveMessageCenterUnreadCountChangedNotification object:nil];
}

#pragma mark - Notifications

- (void)unreadMessageCountChanged:(NSNotification*)note {
    [self reloadData];
}

#pragma mark - Lazy Loading

- (OBAModelDAO*)modelDAO {
    if (!_modelDAO) {
        _modelDAO = [OBAApplication sharedApplication].modelDao;
    }
    return _modelDAO;
}

- (PrivacyBroker*)privacyBroker {
    if (!_privacyBroker) {
        _privacyBroker = [OBAApplication sharedApplication].privacyBroker;
    }
    return _privacyBroker;
}

- (OBALocationManager*)locationManager {
    if (!_locationManager) {
        _locationManager = [OBAApplication sharedApplication].locationManager;
    }
    return _locationManager;
}

#pragma mark - Table Data

- (void)reloadData {
    self.sections = @[
                      [self settingsTableSection],
                      [self contactTableSection],
                      [self privacyTableSection],
                      [self aboutTableSection]
                    ];
    [self.tableView reloadData];
}

- (OBATableSection*)settingsTableSection {

    OBATableRow *region = [[OBATableRow alloc] initWithTitle:NSLocalizedString(@"Region", @"") action:^{
        [self.navigationController pushViewController:[[RegionListViewController alloc] init] animated:YES];
    }];
    region.style = UITableViewCellStyleValue1;
    region.accessoryType = UITableViewCellAccessoryDisclosureIndicator;
    region.subtitle = self.modelDAO.currentRegion.regionName;

    OBATableRow *agencies = [[OBATableRow alloc] initWithTitle:NSLocalizedString(@"Agencies", @"Info Page Agencies Row Title") action:^{
        [self openAgencies];
    }];
    agencies.accessoryType = UITableViewCellAccessoryDisclosureIndicator;

    return [OBATableSection tableSectionWithTitle:NSLocalizedString(@"Your Location", @"Settings section title on info page") rows:@[region,agencies]];
}

- (OBATableSection*)contactTableSection {
    NSMutableArray *rows = [[NSMutableArray alloc] init];

    OBATableRow *contactUs = [[OBATableRow alloc] initWithTitle:NSLocalizedString(@"Data & Schedule Issues", @"Info Page Contact Us Row Title") action:^{
        [self openContactUs];
    }];
    contactUs.accessoryType = UITableViewCellAccessoryDisclosureIndicator;
    [rows addObject:contactUs];

    if ([Apptentive sharedConnection].canShowMessageCenter) {
      OBATableRow *reportAppIssue = [[OBATableRow alloc] initWithTitle:NSLocalizedString(@"App Bugs & Feature Requests",) action:^{
          [self presentApptentiveMessageCenter];
      }];
      reportAppIssue.accessoryType = UITableViewCellAccessoryDisclosureIndicator;
      if ([Apptentive sharedConnection].unreadMessageCount > 0) {
          reportAppIssue.accessoryView = [[Apptentive sharedConnection] unreadMessageCountAccessoryView:YES];
      }

      [rows addObject:reportAppIssue];
    }

    OBATableSection *section = [OBATableSection tableSectionWithTitle:NSLocalizedString(@"Contact Us", @"") rows:rows];

    return section;
}

- (OBATableSection*)privacyTableSection {
    OBATableRow *privacy = [[OBATableRow alloc] initWithTitle:NSLocalizedString(@"Privacy Policy", @"Info Page Privacy Policy Row Title") action:^{
        [OBAAnalytics reportEventWithCategory:OBAAnalyticsCategoryUIAction action:@"button_press" label:@"Clicked Privacy Policy Link" value:nil];
        SFSafariViewController *safari = [[SFSafariViewController alloc] initWithURL:[NSURL URLWithString:kPrivacyURLString]];
        safari.modalPresentationStyle = UIModalPresentationOverFullScreen;
        [self presentViewController:safari animated:YES completion:nil];
    }];
    privacy.accessoryType = UITableViewCellAccessoryDisclosureIndicator;

    OBATableRow *PII = [[OBATableRow alloc] initWithTitle:NSLocalizedString(@"Information for Support",) action:^{
        [OBAAnalytics reportEventWithCategory:OBAAnalyticsCategoryUIAction action:@"button_press" label:@"Opened PII controller" value:nil];
        PIIViewController *PIIController = [[PIIViewController alloc] init];
        [self.navigationController pushViewController:PIIController animated:YES];
    }];
    PII.accessoryType = UITableViewCellAccessoryDisclosureIndicator;

    OBATableSection *section = [[OBATableSection alloc] initWithTitle:NSLocalizedString(@"Privacy",) rows:@[privacy, PII]];

    return section;
}

- (OBATableSection*)aboutTableSection {

    OBATableRow *credits = [[OBATableRow alloc] initWithTitle:NSLocalizedString(@"Credits", @"Info Page Credits Row Title") action:^{
        [self.navigationController pushViewController:[[OBACreditsViewController alloc] init] animated:YES];
    }];
    credits.accessoryType = UITableViewCellAccessoryDisclosureIndicator;

    return [OBATableSection tableSectionWithTitle:NSLocalizedString(@"About OneBusAway", @"") rows:@[credits]];
}

#pragma mark - Email

- (void)mailComposeController:(MFMailComposeViewController *)controller didFinishWithResult:(MFMailComposeResult)result error:(NSError *)error {
    [self becomeFirstResponder];
    [self dismissViewControllerAnimated:YES completion:nil];
    [self.navigationController popViewControllerAnimated:YES];
}

- (void)cantSendEmail {
    UIAlertController *alert = [UIAlertController alertControllerWithTitle:NSLocalizedString(@"Please set up your Mail app before trying to send an email.", @"view.message")
                                                                   message:nil
                                                            preferredStyle:UIAlertControllerStyleAlert];

    [alert addAction:[UIAlertAction actionWithTitle:OBAStrings.dismiss style:UIAlertActionStyleDefault handler:nil]];
    [self presentViewController:alert animated:YES completion:nil];
}

- (void)openContactUs {
    [OBAAnalytics reportEventWithCategory:OBAAnalyticsCategoryUIAction action:@"button_press" label:@"Clicked Email Link" value:nil];

    MFMailComposeViewController *composer = [OBAEmailHelper mailComposeViewControllerForModelDAO:self.modelDAO
                                                                                currentLocation:[OBAApplication sharedApplication].locationManager.currentLocation];

    if (composer) {
        composer.mailComposeDelegate = self;
        [self presentViewController:composer animated:YES completion:nil];
    }
    else {
        [self cantSendEmail];
    }
}

#pragma mark - Public Methods

- (void)openAgencies {
    [self.navigationController pushViewController:[[OBAAgenciesListViewController alloc] init] animated:YES];
}

#pragma mark - OBANavigationTargetAware

- (OBANavigationTarget *)navigationTarget {
    return [OBANavigationTarget target:OBANavigationTargetTypeContactUs];
}

#pragma mark - Private

- (void)presentApptentiveMessageCenter {
    // Information that cannot be used to uniquely identify the user is shared automatically.
    [[Apptentive sharedConnection] addCustomPersonDataBool:self.modelDAO.automaticallySelectRegion withKey:@"Automatically Select Region"];
    [[Apptentive sharedConnection] addCustomPersonDataBool:(!!self.modelDAO.currentRegion) withKey:@"Region Selected"];
    [[Apptentive sharedConnection] addCustomPersonDataString:locationAuthorizationStatusToString(self.locationManager.authorizationStatus) withKey:@"Location Auth Status"];

    // Information that can be used to uniquely identify the user is not shared automatically.

    if (self.privacyBroker.shareableLocationInformation) {
        [[Apptentive sharedConnection] addCustomPersonDataString:self.privacyBroker.shareableLocationInformation withKey:@"Location"];
    }
    else {
        [[Apptentive sharedConnection] removeCustomPersonDataWithKey:@"Location"];
    }

    NSDictionary *regionInfo = self.privacyBroker.shareableRegionInformation;
    for (NSString *key in regionInfo) {
        if (self.privacyBroker.canShareRegionInformation) {
            [[Apptentive sharedConnection] addCustomPersonDataString:regionInfo[key] withKey:key];
        }
        else {
            [[Apptentive sharedConnection] removeCustomPersonDataWithKey:key];
        }
    }

    for (NSData *logData in self.privacyBroker.shareableLogData) {
        [[Apptentive sharedConnection] sendAttachmentFile:logData withMimeType:@"text/plain"];
    }
    [[Apptentive sharedConnection] presentMessageCenterFromViewController:self];
}

- (void)openGitHub {
    NSURL *URL = [NSURL URLWithString:kRepoURLString];
    SFSafariViewController *safari = [[SFSafariViewController alloc] initWithURL:URL];
    safari.modalPresentationStyle = UIModalPresentationOverFullScreen;
    [self presentViewController:safari animated:YES completion:nil];
}

+ (UILabel*)centeredLabelWithText:(NSString*)text font:(UIFont*)font {
    UILabel *label = [[UILabel alloc] initWithFrame:CGRectZero];
    label.textAlignment = NSTextAlignmentCenter;
    label.numberOfLines = 0;
    label.translatesAutoresizingMaskIntoConstraints = NO;
    label.text = text;
    label.font = font;
    [label setContentHuggingPriority:UILayoutPriorityDefaultLow forAxis:UILayoutConstraintAxisHorizontal];
    [label setContentHuggingPriority:UILayoutPriorityDefaultHigh forAxis:UILayoutConstraintAxisVertical];
    [label setContentCompressionResistancePriority:UILayoutPriorityDefaultHigh forAxis:UILayoutConstraintAxisVertical];
    [label setContentCompressionResistancePriority:UILayoutPriorityDefaultHigh forAxis:UILayoutConstraintAxisHorizontal];
    return label;
}

- (UIView*)buildTableHeaderView {
    UIView *header = [[UIView alloc] initWithFrame:CGRectZero];
    header.backgroundColor = [OBATheme OBAGreen];

    NSMutableArray<UIView*> *views = [[NSMutableArray alloc] init];

    UIImageView *iconImageView = [[UIImageView alloc] initWithImage:[UIImage imageNamed:@"infoheader"]];
    iconImageView.contentMode = UIViewContentModeScaleAspectFit;
    [iconImageView setContentHuggingPriority:UILayoutPriorityDefaultLow forAxis:UILayoutConstraintAxisHorizontal];
    [iconImageView setContentHuggingPriority:UILayoutPriorityDefaultLow forAxis:UILayoutConstraintAxisVertical];
    [iconImageView setContentCompressionResistancePriority:UILayoutPriorityDefaultHigh forAxis:UILayoutConstraintAxisVertical];
    [iconImageView setContentCompressionResistancePriority:UILayoutPriorityDefaultHigh forAxis:UILayoutConstraintAxisHorizontal];
    [views addObject:iconImageView];

    UIFont *headlineFont = [UIFont preferredFontForTextStyle:UIFontTextStyleHeadline];
    UIFont *subHeadlineFont = [UIFont preferredFontForTextStyle:UIFontTextStyleSubheadline];

    UILabel *headerLabel = [self.class centeredLabelWithText:NSLocalizedString(@"OneBusAway",) font:headlineFont];
    [headerLabel setContentCompressionResistancePriority:UILayoutPriorityRequired forAxis:UILayoutConstraintAxisVertical];
    [views addObject:headerLabel];

    UILabel *copyrightLabel = [self.class centeredLabelWithText:[NSString stringWithFormat:@"%@\r\n%@", [OBAApplication sharedApplication].fullAppVersionString, @"© University of Washington"] font:subHeadlineFont];
    [copyrightLabel setContentCompressionResistancePriority:UILayoutPriorityRequired forAxis:UILayoutConstraintAxisVertical];
    [views addObject:copyrightLabel];

    UILabel *volunteerLabel = [self.class centeredLabelWithText:NSLocalizedString(@"OneBusAway for iOS is made and supported by volunteers. To help, tap the button below.",) font:subHeadlineFont];
    [volunteerLabel setContentCompressionResistancePriority:UILayoutPriorityRequired forAxis:UILayoutConstraintAxisVertical];
    [views addObject:volunteerLabel];

    UIButton *volunteerButton = [OBAUIBuilder borderedButtonWithTitle:NSLocalizedString(@"Visit Us",)];
    [volunteerButton addTarget:self action:@selector(openGitHub) forControlEvents:UIControlEventTouchUpInside];
    [volunteerButton setContentHuggingPriority:UILayoutPriorityDefaultLow forAxis:UILayoutConstraintAxisHorizontal];
    [volunteerButton setContentHuggingPriority:UILayoutPriorityDefaultLow forAxis:UILayoutConstraintAxisVertical];
    [volunteerButton setContentCompressionResistancePriority:UILayoutPriorityDefaultHigh forAxis:UILayoutConstraintAxisVertical];
    [volunteerButton setContentCompressionResistancePriority:UILayoutPriorityDefaultHigh forAxis:UILayoutConstraintAxisHorizontal];
    [views addObject:volunteerButton];

    UIStackView *stack = [[UIStackView alloc] initWithArrangedSubviews:views];
    stack.axis = UILayoutConstraintAxisVertical;
    stack.spacing = [OBATheme defaultPadding];
    stack.distribution = UIStackViewDistributionFill;
    stack.alignment = UIStackViewAlignmentFill;

    [header addSubview:stack];
    [stack mas_makeConstraints:^(MASConstraintMaker *make) {
        make.edges.equalTo(header).insets([OBATheme defaultEdgeInsets]);
    }];

    return header;
}

/*
 This whole song and dance routine with the table header
 is necessary because table headers don't play very well
 with auto layout. In order to make the header work,
 we need to install it, calculate the height, set the
 height and then reinstall it. Ugh.
 */
- (void)setTableViewHeader:(UIView*)header {
    self.tableView.tableHeaderView = header;
    [header setNeedsLayout];
    [header layoutIfNeeded];
    CGFloat height = [header systemLayoutSizeFittingSize:UILayoutFittingCompressedSize].height;

    CGRect headerFrame = header.frame;
    headerFrame.size.height = height;
    header.frame = headerFrame;
    self.tableView.tableHeaderView = header;
}

@end


text:
Mourners say goodbye to FDNY hero
NEW YORK (FOX5NY) - Thousands of mourners came together Saturday to say goodbye to a hero.
During his funeral in Yonkers - 44-year-old FDNY deputy chief Michael Fahy was remembered for his bravery, dedication and selfless nature.
Fahy was a 17 year FDNY veteran whose most recent role was as battalion chief in the Bronx. On Tuesday, while on the job, he was fatally struck by debris from a house explosion. Investigators said it was possibly due to a tampered gas main. After his death, Fahy was promoted to the rank of deputy chief, the highest civil service promotional achievement in the FDNY.
Fahy leaves behind his wife, Fiona who made a touching eulogy. He also leaves behind three young children.
At the funeral, Mayor de Blasio told Fahy's kids that no one can ever take their dad's spirit or heroism away from them.
Cops are investigating whether the home that exploded, in the Kingsbridge section of the Bronx, was being used to grow marijuana. Two people have been arrested in the case, but no arrests can take away the big hole that's left in so many hearts.

redpajama_set_name: RedPajamaCommonCrawl


text:
First RICH Housing Rehab Project Complete in Washington Park Neighborhood
By Dylan Deprey
Ald. Russell Stamper II acknowledges the first renovated house for the RICH program. (Photo by Dylan Deprey)
The Hassan family had waited 24 years to finally call a house their home.
Before Isha and Osman Hassan and their two sons and eight daughters were renting a three-bedroom and one-bathroom house in Milwaukee, they lived in Kentucky for four years. Before that, they lived in a refugee camp in Dabaab, Kenya for ten years after being forced out of Somalia due to ongoing conflict.
After a decade of stuffing their family into a small rental property, the Osman's finally closed on their newly renovated Washington Park home on Aug. 31st 2017, as the first Re-Invest in City Homes (RICH) program.
Ald. Stamper II sponsored the RICH program as his first piece of legislation four years ago, and he was just as excited to see the transformation of the former foreclosed home.
"It feels great to see everybody that came out today to celebrate with a great family," said Ald. Russell Stamper II.
Brian Sonderman, Executive Director Milwaukee Habitat, hands the Hassan family a Habitat for Humanity windsock to fly on their front porch. (Photo by Dylan Deprey)
The RICH Program works as a partnership between the City of Milwaukee and Milwaukee Habitat for Humanity. The program provides low-income loans to allow Habitat for Humanity to purchase city-owned foreclosed homes, complete rehabilitation work and then sell them to qualified homebuyers.
The selection process for program participants includes, those who must not have owned property in Milwaukee within the last two years, have an uninterrupted employment for at least a year, and a favorable rent, utility, and debt repayment history.
"We say this a lot and we will keep saying it, but without the help from our volunteers it would be near impossible to do what we've accomplished today," said Eric Gremonprez, Critical Home Repair Manager Habitat for Humanity.
Gremonprez said the old green house that once sat on N. 36th Street was transformed after the siding completely stripped, and re-framed the house into a five bedroom. He added that this house was distinctive because it allowed volunteers to do framing.
"Doing the framing was a unique experience because we've never attempted to do that with volunteers before, so it was a really cool experience," Gremonprez said.
Brian Sonderman, Executive Director Milwaukee Habitat, thanked financial sponsors Wells Fargo, We Energies Foundation, CDBG Milwaukee and The City of Milwaukee.
"We could not do this without our volunteers, and we certainly do this for the families but we couldn't pay for this without our sponsors," Sonderman said.
After a ceremonial ribbon cutting, the Hassan's welcomed neighbors and news crews to check out their brand-new home. Whether it was the spacious kitchen with marble countertops or fresh wood flooring laid down, the Hassan's were all smiles during the entire event.
"I didn't expect lot of people to show up today and I'm very glad to let people come in through my home, and now I say, 'Thank you and God bless you,'" Hassan said.
Popular Interests In This Article: Brian Sonderman, Dylan Deprey, Eric Gremonprez, Habitat for Humanity, Isha Hassan, Osman Hassan, Re-Invest in City Homes Program, Russell Stamper
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The Public Policy Program of the Fair Housing Center of Central Indiana works to increase the awareness of policy-makers and regulators about the issues associated with fair housing. We work with local, state and federal legislators to ensure strong fair housing laws and policies. We also collaborate with fellow organizations to strengthen fair housing laws. Funding restrictions impact significantly the ability of the FHCCI to be involved on issues of public policy.
SB 240 (2018): Emotional support animal restrictions in rental housing and infraction for medical professionals. Provides that a dwelling that is exempt from the Indiana fair housing law is not subject to the requirements applicable to emotional support animals. Defines "emotional support animal". Specifies who may use an emotional support animal, who may prescribe an emotional support animal, and when an individual may be prescribed an emotional support animal. Provides that an individual with a disability that is not readily apparent who submits a request for an emotional support animal that falsely suggests the individual has a disability that entitles the individual to the use of an emotional support animal in a dwelling commits a Class A infraction.
SB 558 (2017): Bans cities from passing ordinances to promote inclusionary zoning as it relates to affordable housing and adds language for landlord's use regarding occupancy limitations in rental housing. Provides that a county or municipality may not adopt or enforce any land use or planning ordinance or regulation that has the effect of: (1) controlling rental or purchase price; or (2) requiring real property to be reserved for lease or sale to certain owners. Provides that a county or municipality may not require the owner of privately owned real property to agree to: (1) any requirement that would have the effect of controlling rental or purchase price; or (2) the payment of a fee, in lieu of a requirement that would have the effect of controlling rental or purchase price, as a prerequisite to consideration or approval of: (A) certain permits; or (B) any primary, secondary, or revised plats. Provides that a county or municipality retains the right to: (1) manage and control the development of a commercial or residential property in which the county or municipality has an ownership interest; and (2) enact, enforce, or maintain any general land use or zoning regulation that does not have the effect of: (A) controlling rental or purchase price; or (B) requiring real property to be reserved for sale or lease to certain owners. Allows an owner of privately owned real property to voluntarily enter into an agreement with a county or municipality that: (1) controls rental or purchase price; or (2) requires real property to be reserved for sale or lease to certain owners; in exchange for incentives or grants. Also includes language as it relates to nuisance ordinances.
HB 1300 (2015): Section 8 discrimination protection ban. Prohibits a county, municipality, or township from adopting an ordinance that requires or would have the effect of requiring a landlord to participate in: (1) a Section 8 program of the federal Housing Act of 1937; or (2) a similar program concerning housing. Also includes non-fair housing issues.
HB 1165 (2015): Rental registration and inspection programs. Exempts programs that apply only to rooming houses and hotels from provisions regulating local government rental registration or inspection programs.
HB 1403 (2014): Provides that the owner of a rental unit assessed any fee by a political subdivision pertaining to the rental unit may: (1) notify the tenants of the rental unit of the assessment of the fee; and (2) require the tenants of the rental unit to reimburse the owner for the payment of the fee. (Current law refers to "inspection, registration, or other fee".) Requires fees regarding rental units and rental communities to be deposited in a dedicated fund to for reimbursement of costs actually incurred by the political subdivision relating to the imposition and amount of the fee. Restricts the circumstances and conditions in which a political subdivision may require a rental unit's owner or landlord to obtain a permit. Allows an owner of a rental unit to obtain an exemption from a political subdivision's inspection and inspection fee requirements if the rental unit satisfies certain requirements. Allows a political subdivision to impose a penalty for an act constituting a nuisance or ordinance violation. Allows a successful county, city, or town or a successful defendant to recover attorney's fees incurred in a nuisance action. Provides that a political subdivision may assess an annual registration fee. Repeals superseded statutes relating to local regulation of residential landlord and tenant relations.
Update: The City of Hammond challenged this law. In 2018, the Court of Appeals ruled this law unconstitutional. See news story and ruling. Pending decision by Indiana Supreme Court.
General Guidance: Nonprofits can lobby! In Indiana, nonprofits interested in providing testimony on specific legislation may need to register as a lobbyist with the Indiana Lobby Registration Commission. You should also review this excellent resource on nonprofit lobbying put together by our colleagues at Prosperity Indiana. Please speak out in the General Assembly on bills impacting your constituents or members and provide your valuable knowledge.


text:
Pancha Bhoota Shivalinga Temples in South India
According to Hinduism the entire physical existence is a combination of physical elements. These five elements are known as Pancha Bhootas. The five elements are Prithvi (Earth i.e the solid state), Aakaash (Space / Ether), Agni (Fire), Jal / Neer (Water i.e the liquid state) and Vaayu (Air i.e the gaseous state) - the states of matter according to science.
Lord Shiva is believed to manifest Himself in 5 different elements in the Lingam form. There are five Shiva temples in South India that are dedicated to Pancha Bhoota Lingams and are known as Pancha Bhoota Sthalams. These five places are considered Holy for Shaivites and these temples are heavily crowded with devotees on Maha Sivaratri day.
There is one Pancha Bhoota Shivalinga temple in Andhra Pradesh while the rest of the four temples are in Tamil Nadu. Following are the five Panchabhoota Shivalinga temples in South India:
Ekamreswara Temple in Kancheepuram, Tamil Nadu - Prithvi Lingam
Ekamreswara / Ekambareswara temple in Kancheepuram (also known as Shiva Kanchi) is located in Tamil Nadu. Kancheepuram is at a distance of around 70 Km from Chennai. The main deity, Ekambareswara represents Earth and is in Prithvi Lingam form. The temple was rebuilt by the Pallava Kings, Cholas and Vijayanagara Kings. It dates back to 600 C.E (Current Era).
The temple is very spacious with inscriptions in Telugu language in old Telugu script on the stones. There is a 3,500 years old mango tree in the temple which is considered highly sacred. There is a belief that Goddess Parvati Devi (Siva's wife) installed the Lingam under the shade of this oldest mango tree. In the temple, it is Pradhiva Lingami.e made of Earth (soil), 'abhishekams' (i.e pouring of water / liquids) are not performed to the Lingam here.
The Raja Gopuram i.e the tower of the main entrance gate is one of the tallest one in India. It has 11 storeys with beautiful sculptures.
Goddess Parvati Devi resides in Kancheepuram in the form of Kamakshi Devi which is one of the Ashtadasa (18) Shakti Peethams.
Jambukeswara Temple in Jambukeswaram, Tamil Nadu - Jala Lingam
Jambukeswara temple is located in Tiruchirapalli (Trichy) in Tamil Nadu. Due to the popularity of the temple, the place is also known as Jambukeswaram. Lord Shiva is known as Abhisheka Priya i.e the one who is fond of 'abhishekams'. The Jala Lingam in this temple is immersed in pool of water. In this temple Goddess Parvati Devi is worshiped as Akhilandeswari.. It is said that Lord Siva meditated under the Jamun tree here, hence known as Jambukeswara.
The temple is very spacious with tall gopurams i.e towers.
Arunachaleswara in Arunachalam, Tamil Nadu - Tejo (Agni) Lingam
As per the mention in the legends, Lord Siva has evolved in the form of Agni Lingam on Mahasivaratri night. Arunachalam also known as Tiruannamalai gained popularity as Siva Lingam in this temple is in the form of Agni. As per sthala puranam i.e legend of the place, it is said that to settle the dispute between Lord Vishnu and Brahma, Siva took the form of Tejo Lingam at this place. Parvati Devi is worshiped in the named of Apeetakuchalamba Devi in this temple. It is a large temple complex.
Kartika Masam is specially celebrated in this temple with specially lit Kartika Deepam. The temple is heavily crowded with devotees to see the oil lit lamp. Many devotees do giri pradakshina i.e going round the sacred hill.
Sri Kalahastiswara in Srikalahasti Temple, Andhra Pradesh - Vayu Lingam
Sri Kalahasti in Andhra Pradesh is located near Tirumala-Tirupati. It is on the bank of River Swarnamukhi. Sri Kalahastiwara is in the form of Vayu Lingam in this temple. One can see the moving flames of the oil lit lamps inside the garbhalaya i.e sanctum sanctorum. The flames of oil lit lamp keep moving due to the wind that comes from the hollow lingam which confirms that it a Vayu lingam. In this temple Parvati Devi is worshiped as Sri Gyana Prasunamba.
Pilgrims from Tirumala, compulsorily visit this place as it is believed that visiting the temple is equivalent to visiting Kailash - the abode of Lord Siva.
The temple gained popularity for Rahu-Ketu pooja specially performed to get rid of doshas. This is the only temple in India that remains open even during Grahan / eclipse time.
Nataraj temple in Chidambaram, Tamil Nadu - Akasa Lingam
In Nataraja temple in Chidambaram, Lord Siva is in Aananda Tandava pose i.e in dance pose in Cosmic Bliss. Behind the idol of Nataraj is the Akasa Lingam. There is a curtain which is raised for a fraction of a second by the temple priest after the pooja. Devotees can only see the hanging garland of bilwa leaves which keep moving due to the wind. It is said that there is no lingam but the devotees are made to believe that there is Akasa lingam that is invisible.
In this temple, Parvati Devi is worshiped as Sivakama Sundari. The temple architecture here is awesome.
These five famous Siva temples together make the Pancha Bhoota Sthalam temple. A visit to these temples makes one spiritually elevated.
Andhra Pradesh Tamil Nadu Temple Tourism Tourism
Labels: Andhra Pradesh Tamil Nadu Temple Tourism Tourism


text:
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Newburyport is among the smallest cities in the state and is felt with some justification by its residents to be among the most beautiful, retaining as it does a large number of spacious, gracious Federalist homes built with the whaling and clipper ship fortunes of this 19th century seaport. The city is very proud of its history: proud of the fact that the first tea party in opposition to England's tax on tea was held in Newburyport, well before the more famous one in Boston, and pleased to be the birthplace of the United States Coast Guard since the first ship commissioned for the Coast Guard, the frigate Massachusetts, was built in the city. Protective of its heritage, the city launched a massive redevelopment scheme in the early 1960's, using state and federal funds to reclaim its historic neighborhoods of granite, brick and cobblestones and provide up-to-date infrastructure such as water and sewer renovations. But however steeped in the past, the city did not neglect to prepare for a lively present and built an industrial park at the same time, which now houses diversified small industries. The city has a strong tourist industry and was the first community in the state to complete a master plan and a harbor plan. Its adjacent river is used for recreation and its old fire station now houses a theatre and restaurant. Many residents of the heavily residential community commute daily to Boston, and wait in hopes that the last 9 miles of the railroad route between Boston and Newburyport will be completed soon. It is expected that the completion of that link would encourage the growth of the community. Residents are proud of the fact that many families have lived in the city for generations, and equally proud of the fact that the city welcomes newcomers and the new ideas they bring.
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text:
Parliamentary press corps blacklists NDC's Mintah Akandoh for 'gross disrespect'
Sat, 25 Sep 2021 Source: classfmonline.com
Ghana's parliamentary press corps (PPC) has blacklisted the Minority Caucus' spokesperson on health issues, Mr Kwabena Mintah Aknadoh, for "consistently" showing the corps "gross disrespect", a statement signed by Mr Stephen Odoi-Larbi on behalf of the Dean of the corps has announced.
"He has, on several occasions, hand-picked his own reporters from the PPC to, either cover his personal event or that of the Minority Caucus in Parliament", the group complained, adding: "Hon. Akandoh has, on about two or three occasions, been engaged by the Dean of the PPC, who, during the meeting, drew his attention to respect the structures of the PPC".
However, the corps noted, "none of those engagements has yielded fruitful results as the honourable Member keeps on disrespecting the leadership of the corps".
It has come to the attention of the executive body that the honourable Member of Parliament (MP) for Juaboso, Kwabena Mintah Akandoh, has consistently shown gross disrespect to the Leadership and structures of the Parliamentary Press Corps (PPC).
He has on several occasions hand-picked his own reporters from the PPC to either cover his personal event or that of the Minority Caucus in Parliament.
Hon. Akandoh has on about two or three occasions been engaged by the Dean of the PPC, who, during the meeting, drew his attention to respect the structures of the PPC.
However, none of those engagements has yielded fruitful results as the honourable Member keeps on disrespecting the Leadership of the Corps.
At the time of writing this notice, the honourable MP has engaged some of the PPC members to tour some abandoned health facilities across the country without the knowledge of the leadership of the PPC.
By this notice, members are hereby informed that when the House reconvenes, all press activities of Hon. Akandaoh, shall not be recognized by the Leadership of the PPC. That means, he has been blacklisted and will not be assigned the podium to address the press on any issues of his choice.
Further to that, should any member attend events organised by Hon Akandoh and something happens, the leadership of the PPC will not come to your aid.
The leadership of the PPC has, from time to time, reminded all to respect the structures of the PPC for harmonious coordination of events.
This, we will not depart and urged all and sundry to respect this position.
Signed on behalf of the Dean of the PPC.
Stephen Odoi-Larbi
Source: classfmonline.com
MPs to prioritize matters of concern to SALL - Ablakwa
We need leadership skills not bullying in Parliament – MP
Bagbin not endangered over temporal withdrawal of security detail – Ghanaians told
Leave my name out of discourse on military protection – Fmr. Speaker Oquaye prays
We cannot do everything as MPs - Sheila Bartels


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New BMW R nineT /5 Invokes Memories of the Past
Everyone that looks at new BMW motorcycles for sale in Riverside, CA, wants to learn more about the new BMW R nineT /5. That's because the BMW Motorrad anniversary model brings out the heritage and passion of the older models. If you want to honor the 50th anniversary, you can see this bike near Ontario, CA today.
Remembering the BMW R nineT /5
Back in 1969, BMW motorcycle production began. It came after the success of the automotive lineup. At first, the company only had 400 employees, but they still produced the first round of /5 models. This initial lineup included the R 50/5, 60/5 and 75/5 models. The bikes saw instant success, which further increased the demand.
Enjoying the New BMW R nineT /5
To mark the occasion, BMW created a stunning anniversary model. This invokes a feeling of nostalgia while showcasing the latest innovations. This bike features standard knee pads, heated grips, a Lupine Blue metallic finish complete with a double line on the fuel tank, and smoke effects. It also has plenty of chrome parts such as the rear view mirrors, rear silencer and exhaust manifold.
The bike manufacturer used Aluminum Silver to create the engine coatings, fork slider tubes, wheel hubs, spokes and gearbox. The 1170cc engine produces 110 horsepower and all of the models come standard with ABS. Of course, the Automatic Stability Control further balances out the ride. It's the perfect bike to take for a ride near San Bernardino, CA.
Test it Out
Don't you think it's time to test ride a new BMW bike near Corona, CA? With the latest BMW R nineT /5 lineup, you are sure to find the bike of your dreams. Visit us today at BMW Motorcycles of Riverside and take a look through our extensive inventory of new and pre-owned motorcycles. Contact us today to schedule a test ride near Ontario, CA. You won't be disappointed.


Russian air strikes in Syria on Wednesday killed at least 36 civilians and targeted areas where Islamic State and al Qaeda-linked fighters are not present, the head of the Western-backed Syrian political opposition said.
"All the targets in today's Russian air raid over northern Homs were civilians," Khaled Khoja, head of the Turkey-based Syrian National Coalition, wrote on his Twitter feed.
Khoja, who is in New York for a U.N. General Assembly meeting, said the civilians had been killed in five different areas.
"The targeted areas in today's Russian air raid in Homs were those areas which fought ISIL and defeated it a year ago," he said, using an acronym for Islamic State.


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text:
Q: J-Query Context Menu updating via Knockout call We are implementing a rather complex single page application and decided to use the "Jquery-context-menu" toolbox. However, we have a fundamental question, and after two days of searching, and reading stuff on the web we are somewhat out of ideas.
The basic question is: If and if yes, how, it will be possible to access the update function (i.e the disable function) from outsite the menu, while the menu is still upon?
The scenario:
We are implementing a game.  We use the "jquery context menu" as a context menu for an icon that can be activated by the user (think of a rpg type of icon). After activating it via a click it will be deactvitated automatically (after a few seconds) and then be ready for reactivation again after a while. What we what is that the menu is capturing this state of the icon, by enabling or disabling the menu, while the menu is held open.
There is one example of how to change the visibility of a menu item, via a button press in the same menu, as can be found here:
http://medialize.github.io/jQuery-contextMenu/demo/disabled-changing.html
However, we aim to update the menu from outsite (via a knockout subscribe call). So we would like to do something like:
myknockoutobservable.subscribe(function(newValue){
correctRefernceToThis.data('disableItem1', newvalue)});

while the disabled function looks somehitng like:
disabled: function(key, opt) {
return !this.data('cutDisabled')};

OR,  if this does not work we maybe could directly call the update fucntion
 myKnockoutobservable.subscribe(function(newValue){
$.contextMenu.op.update(correctRefernceToOpt,correctRefernceToroot)});

and then querying the  knockout observable in the callback
if (!myKnockoutobservable) {
return true;}
else {
return false;

The main problem seems to be that we don't reference the context correctly,  so we don't have a handle on the correct this, opt, to root, variables, from outside of the Jquery context menu (At least that is our current opinion). We would be very happy if someone could help us finding a solution, or even some good ideas what to try (what we haven't yet).

A: You won't subscribe, you'll just have an observable in your viewmodel that you set to true or false, and the menu item will toggle in response. The disabled member of your menu item will look like this:
disabled: function() {
    return myobservable();
}

As James Thorpe commented, you'll want to create a custom binding handler to set up your context menu.
It sounds like you're working with several unfamiliar tools. Here is a Fiddle with a minimal example: http://jsfiddle.net/sv3m7ok8/
Update
It occurred to me that since the context menu doesn't bind to a single element, but uses a selector, it makes more sense to do the binding on the body tag. So an updated example: http://jsfiddle.net/sv3m7ok8/1/
Updated again
I now understand that you are specifically trying to get the menu item to enable/disable while the menu is open (and that it doesn't do that normally). I had to go under the covers to get at the menu item node, and hook up a subscription to set the disabled class on it.
init: function (element, data, allbindings, data) {
    var dynamicDisable = false;
    $.contextMenu({
        selector: '.context-menu-one',
        callback: function (key, options) {
            var m = "clicked: " + key;
            window.console && console.log(m) || alert(m);
        },
        items: {
            "edit": {
                name: "Clickable",
                icon: "edit",
                disabled: function (opt, key) {
                    if (!dynamicDisable) {
                        var node = key.items.edit.$node[0];
                        data.disableMenu.subscribe(function (dis) {
                            $(node)[dis ? 'addClass' : 'removeClass']('disabled')
                        });
                        dynamicDisable = true;
                    }
                    return data.disableMenu();
                }
            }
        }
    });
}

My fiddle sets an interval to toggle disableMenu. You can watch the menu item become active and gray.
http://jsfiddle.net/sv3m7ok8/3/

A: Thanks you for your help! I understand your approach and it is indeed exactly what  we have done:-) I might have not been so clear on this issue but this is the current code od the disabled callback.
disabled: function(key, opt) {
                        if (!self.item._blocks.Feature._processedStack().canBeActivated()) {
                            return true;
                        }
                        else {
                            return false;
                        }
                    }

This works such that when the menu in closed and reopned again the state is updated. However the update is NOT working while the menu is still open because nothing is triggering the menu to update to the new value.
At the moment we are trying to solve the issue with a different library, will keep you updated.
best, Caspar

redpajama_set_name: RedPajamaStackExchange


text:
Триарсенид тетрапразеодима — бинарное неорганическое соединение
празеодима и мышьяка
с формулой PrAs,
кристаллы.

Получение
 Сплавление стехиометрических количеств чистых веществ:

Физические свойства
Триарсенид тетрапразеодима образует кристаллы
кубической сингонии,
пространственная группа I 3d,
параметры ячейки a = 0,8984 нм, Z = 4,
структура типа тетрафосфида тритория ThP
.

Примечания

Соединения празеодима
празеодима

redpajama_set_name: RedPajamaWikipedia


text:
Rs 9000 Crore Allocated for Swachh Bharat
Rasu (Author) Published Date : Mar 01, 2016 10:51 IST
This year budget aims for rural areas development and cleanliness. This budget gave disappointment for the corporate owners. It had allocated Rs. 9000 crore for the government's Swachh Bharat Mission which is aimed at to clean roads, streets and for the infrastructure. It aims at developing toilets at the rural places. Fund was allocated ensures 80 lakh for every village Panchayat. For urban areas Rs. 2,300 crore was allocated for the Swachh Bharat Mission. Totally Rs. 11,300 crore was allocated for this mission.
The union minister Arun Jaitley spoke at the Lok Shaba on the budget session. 'This subject were very close to the heart of Father of Nation. For the first time since the independent our parliament had a comprehensive debate on sanitation. This has become a topic of discussion in almost every home. We have introduced raking of urban areas in sanitation which has resulted in constructive competition along towns and cities,' said Finance Minister Arun Jaitley.
Swachh Bharat aims to construct sanitation facilities to all rural areas. It plans to construct 12 crore toilets within the year 2019 in rural areas. It was doubled from 46 lakh in 2013 to 93 lakh was constructed in 2016.
Rs. 38500 crore was allocated for MNREGA (Mahatma Gandhi National Rural Employment Guarantee Act).
Moreover this budget concentrates to make the steady income of the farmers. Minister announced 35,984 crore for the farming sector and said 5 lakh acres land will be brought into organic farming in 3 years under Krishi Vikas Yojana.
A Young girl received appreciation letter from Prime Minister
Prime Minister Narendra Modi appreciated the efforts taken by a girl who is studying 10 std. She was more interest in her social works inspired by mother Teresa. She is active in social works since 5 years. She had worked for creating awareness to save girl child and also campaigned against alcohol and cigarettes. She had joined in Prime Ministers' Swachh Bharat Mission and currently she is very active. She often writes letter to PM, broadcasting minister, Chief justice of India regarding various issues.
She received appreciation letter from Modi with a biography book of Vivekanandha. She is Jhanvi Behal studying class 10 in DAV Public School, Ludhiana in Punjab.
Tags : 2016 budget Swachh Bharat, Arun Jaitley, Arun Jaitley at lok Shabha, Budget allocated for Swachh Bharat, Budget allocated got rural areas, Budget for Krishi Vikas Yojana, Budget for Swachh Bharat, Farming budget, Jhanvi Behal, Jhanvi Behal social works, Krishi Vikas Yojana, Ludhiana girl, MNREGA budget allocation, PM letter to Jhanvi Behal, Rural budget, Rural India Budget, Swachh Bharat mission


text:
Top 10 Arctic Explorers
Zegrahm Contributor|December 13, 2017|Blog Post
Historical records suggest that humans have explored the planet's northern extremes since at least 325 BC. Throughout the centuries, unpredictable weather, extreme cold, and treacherous pack ice have posed a huge challenge for Arctic explorers, making this region one of the final frontiers of human discovery. At Zegrahm, we celebrate the spirit of exploration and the brave adventurers that expanded the known limits of our world. Here, we give homage to some of our favorite explorers, whose heroic exploits helped put the Arctic regions, quite literally, on the map.
Erik Thorvaldsson, "Erik the Red"
Born and raised in Iceland, Erik was banished in 980 AD and decided to search for a new home. Following rumors of a large landmass to the west, he discovered and settled in Greenland, a journey crossing approximately 900 nautical miles of open ocean.
Leif Eriksson
The son of Erik the Red, Eriksson is considered by many to be the first European to reach North America, nearly four centuries before Christopher Columbus. According to legend, he sailed off course on his way to Greenland and landed on the North American continent, possibly Newfoundland, where he explored a region he called Vinland, due to the abundant grapes growing there. After spending the winter in Vinland, Leif sailed back to Greenland, and never returned to North American shores.
Willem Barents
This Dutch navigator set out on three voyages from 1594 - 1597, trying to find a Northeast Passage to Asia; he ended up discovering Spitsbergen and the Barents Sea. On his last voyage, his ship became trapped by sea ice and he and his crew were forced to winter ashore on Novaya Zemlya. They became the first Western Europeans to winter in the high Arctic and survive! …though Barents himself perished before the crew was rescued.
An English explorer and navigator, Hudson made three voyages from 1607 - 1611 in search of a passage to Asia. Though unsuccessful, he did discover Hudson Strait and the vast Hudson Bay where, after a challenging winter, his crew mutinied, and set Hudson, his son, and several crewmen adrift in a small boat. They were never heard from again.
Vitus Bering
A native of Denmark, Bering was hired by Tsar Peter I of Russia to determine whether Asia and North America were connected by land. From 1725 - 1741, his expeditions mapped—for the first time—thousands of miles of the coast of Siberia. Bering is credited for discovering numerous bays, gulfs, capes, and islands, as well as the Gulf of Alaska and the Bering Strait, proving that the Asian and North American continents were not connected.
William Edward Parry
A British naval officer, Parry led four voyages in search of the Northwest Passage from 1819 - 1831. He discovered Cornwallis, Bathurst, and Melville islands and his was the first expedition to enter the Arctic Archipelago. On his fifth and final expedition attempting to locate the North Pole via Spitsbergen, he traveled north to 82°45'N—a record that stood for 52 years. While each of Parry's ventures were unsuccessful, he made significant contributions to European knowledge of the Arctic. The Parry Islands in the Arctic Archipelago are named after him.
Another English naval officer, Franklin set out in 1845 in search of the Northwest Passage with two ships: Erebus and Terror. This expedition is one of the greatest mysteries of Polar exploration—the entire team of 129 men disappeared, prompting a number of search and rescue expeditions that would last for 11 years after their disappearance. The Erebus was only recently located in 2014, near King William Island in the Canadian Arctic; Terror was discovered two years later in Terror Bay.
Swedish geologist, mineralogist, geographer, and explorer, Nordenskiöld completed the first successful navigation of the Northeast Passage in 1878 aboard the Vega.
Robert Peary
An American explorer, Peary organized eight expeditions to the Arctic. He crossed the Greenland ice cap and, from 1898 – 1902, he made his first unsuccessful attempt to reach the North Pole. Finally, between 1908 and 1909, Peary reported that he had reached the North Pole with his friend, Matthew Henson, and four native people.
Norwegian explorer, Roald Amundsen, completed the first successful navigation of the Northwest Passage from 1903 - 1905. It would be another 34 years before this feat was accomplished again.
For more information about Arctic exploration, visit:
Ultimate Iceland | June 17, 2018 | Overland Adventure
The Untamed North: Greenland to Iceland | June 24, 2018 | Aboard the Hebridean Sky
Svalbard: A Polar Bear Quest | July 10, 2018 | Aboard the Ocean Adventurer
Wild Norway & Svalbard | May 17, 2019 | Aboard the Ocean Adventurer
Path of the Vikings: Reykjavik to Quebec | August 27, 2019 | Aboard Le Champlain
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A wonderful way to experience Switzerland's incredible scenery is aboard Swiss trains. Our luxury Switzerland tours feature privately guided day excursions on the most impressive mountain railways and funiculars, including the most scenic sections of the renowned Glacier Express train route.
An excursion by cogwheel railways to Jungfraujoch in the mountains of the Berner Oberland—one of the most iconic train trips in Switzerland—features spectacular views of high alpine peaks, towering waterfalls, UNESCO-listed glaciers, and typical Swiss mountain villages such as Wengen and Grindelwald.
Outside Lucerne is the renowned Pilatus Railway. The steepest cogwheel railway in the world, it climbs at a maximum gradient of 48 percent to the craggy top of Mount Pilatus, where viewing terraces overlook Lake Lucerne, Mount Rigi and other classic Swiss landscapes.
For some of the best views of the stunning Matterhorn, we arrange privately guided excursions aboard the Gornergrat Bahn mountain train. Starting in the village of Zermatt, the train climbs up to the hilltop terminus of Gornergrat, offering dramatic views of the Matterhorn, surrounding glaciers and the beautiful Matter Valley below.
The breathtaking Engadine, a region encompassing the resort towns of St. Moritz and Pontresina, offers many scenic journeys by train and cable car. One of our favorites is taking the funicular through a stone pine forest up the slopes to Muottas Muragl, where a hilltop restaurant offers unbelievable postcard vistas of mountains, glaciers, valleys and lakes.
Artisans of Leisure can combine scenic train rides in Switzerland with privately guided day hikes and scenic walks in the alpine landscapes. A highlight of such tours is enjoying local meals of rosti, fondue, sausages and other typical Swiss cuisine at charming mountain restaurants.
We also arrange rides on sections of the eight-hour Glacier Express route for travelers interested in experiencing the highlights of Switzerland's most famous rail journey without spending all day on the train.
One of the most popular sections is the Rhaetian Railway's spectacular Albula line between Chur and St. Moritz. This UNESCO World Heritage-listed route winds over high stone viaducts and through tunnels, passing picturesque mountain villages along the way. Another option is taking the Matterhorn Gotthard Bahn on the breathtaking alpine route over Oberalp Pass (6,706 ft/2,044 m) between Andermatt and Disentis/Muster.
Our Switzerland tours typically include private transfers between destinations by luxury vehicle, but we can easily incorporate train rides on the Glacier Express, Golden Pass, Bernina Express and other routes as part of the journey. For longer rides, we also transfer luggage separately so you can relax and focus on the unforgettable views.
Contact Artisans of Leisure to start planning a customized private Switzerland tour that includes our favorite Swiss train rides.


Heraclitus of Ephesus said, "You can never step into the same river twice because new waters are always flowing around you." This is certainly true of each new day at camp as the staff and campers continue to develop their skills, trust, and friendships. After six days of camp there is a different complexity and a deeper joy as friendships grow and young men become more confident.
Each new day the sunrise beckons many of our youngest campers to the Eden Hall deck for fishing. They are often rewarded with bream, bass, catfish, and on some days, a giant carp. There are always plenty of stories of broken line and the "one that got away". Yesterday was no different, as one of our campers, Aiden Dittmer from Tampa, caught a very big bass that was easily 18 inches and weighed three pounds! I am sure this fish will grow in size as the story is told.
Breakfast was biscuits, bacon, fruit, and sugar cereal, which was a special treat to celebrate the 4th of July. Everyone was dressed in red, white and blue! We had a fine time singing patriotic songs and sharing interesting facts of our American heritage.
Breakfast was followed by cabin clean up (yes, your boys make their bed every day at camp) and Morning Watch. Morning watch is a favorite for the guys. We sing old songs, learn new ones, and share encouraging words and scripture to start the day. Some of the songs and lyrics yesterday were: "How, wide, deep, long, and high is the love of God," "When I grow up I want to be a tree," "It is good to walk with the Lord," and an Austrian yodeling song that your sons will need to teach you on the way home.
The rest of the morning and afternoon was devoted to skills. The guys continue to work on their mastery of lessons learned during the week. I watched as some of your sons continued their lessons in Kayaking, Blacksmithing, sailing, paddle boarding, and Fly Tying. These art forms take a young man's full attention and all the guys were up to the task.
Following afternoon skills all the Bear campers headed up the mountain for their campouts. It's always exciting to see the youngest campers with their packs hiking into the woods. They will have fun and learn new things on their campout. We have a saying at Rockmont, "people who learn new things each day…expect to learn new things each day." The same is true for friendship and growth and we are witnesses to this at camp. All the Bear campers completed their hikes and enjoyed a hardy supper in the woods after starting a fire to get warm.
The Deer Campers played powerball and braveheart on the upper fields of camp. These are always special activities because they offer campers just the right balance between guts, glory, and grace.
Evening activity for the Mountain campers was "Movie Night". After a week of camp, a restful evening activity is a necessary break from all the running around the guys enjoy each day. I hope that each of you is experiencing some time for rest and preparing for your son's return later next week.


text:
October 2005, VOLUME 116 / ISSUE 4
Early Analgesia for Children With Acute Abdominal Pain
Robert Green, Blake Bulloch, Amin Kabani, Betty Jean Hancock, Milton Tenenbein
Objectives. The objectives of this study were to determine whether the administration of morphine to children with acute abdominal pain would impede the diagnosis of appendicitis and to determine the efficacy of morphine in relieving the pain.
Methods. This was a double-blind, randomized, placebo-controlled trial involving 5- to 16-year-old children who presented to the emergency department of a children's hospital with a chief complaint of acute abdominal pain that was thought by the pediatric emergency attending physician to require a surgical consultation. Subjects were randomized to receive intravenously administered morphine or normal saline solution. Clinical data and the emergency physician's confidence in his or her clinical diagnosis (0–100%) were recorded systematically with a standardized form. This was repeated 15 minutes after administration of the study medication. The surgeon assessed the child within 1 hour and completed a similar data collection sheet. Pain was assessed, with a color analog scale, before and after study medication administration. Each subject was monitored for 2 weeks after enrollment.
Results. One hundred eight children were enrolled; 52 received morphine and 56 received a placebo saline solution. There were no differences between groups in demographic variables or the degree of pain. There were no differences between groups in the diagnoses of appendicitis or perforated appendicitis or the number of children who were observed and then underwent laparotomy. The reduction in the mean pain score was significantly greater in the morphine group (2.2 vs 1.2 cm). The emergency physicians' and surgeons' confidence in their diagnoses was not affected by the administration of morphine.
Conclusions. Our data show that morphine effectively reduces the intensity of pain among children with acute abdominal pain and morphine does not seem to impede the diagnosis of appendicitis.
Pain is a common symptom among children presenting for care at emergency departments (EDs). Traditionally, the physician's focus has been on the diagnosis of the condition producing the pain, rather than on the relief of the pain. However, emergency physicians are now concerning themselves with the latter, and several authorities have produced position statements on the management of pain in EDs.1–3
Fifteen percent of school-aged children are brought to a physician because of abdominal pain, making this symptom a common presenting complaint in the pediatric ED.4 The most common serious, pediatric, abdominal emergency is appendicitis.5 As with adult patients, it has been thought that analgesic use among pediatric patients with surgical abdominal findings may impede the diagnosis. Theoretically, analgesia may mask pain and subsequently diminish the physical signs associated typically with a surgical condition. Current practice in pediatric emergency medicine and pediatric surgery dictates that children should not receive analgesics when presenting with acute abdominal pain.6,7 This practice among children is a result of traditional teaching and only recently has been challenged in a manner similar to that for adults.8
There is a need to determine whether the practice of analgesic administration to pediatric patients with acute abdominal pain impedes the diagnosis of the condition causing the pain. The objectives of this study were to assess whether morphine would increase the rate of missed appendicitis, to determine its efficacy in treating acute pediatric abdominal pain, and to examine its effect on physician confidence in the diagnosis of the condition causing the pain.
This study was conducted in the ED of a tertiary care, academic, pediatric ED with an annual census of 39 000. This facility is staffed by pediatric emergency medicine attending physicians. The study was a double-blind, randomized, placebo-controlled, clinical trial, with the primary outcome measure being the rate of missed appendicitis among children who received intravenous morphine treatment. The secondary outcomes were rates of perforated appendicitis, delays in diagnosis, pain relief, and confidence of pediatric emergency physicians and pediatric surgeons in the diagnoses. Ethics approval for this study was obtained from our university's institutional review board.
Male and female patients between the ages of 5 and 16 years (inclusive) who presented with nontraumatic abdominal pain of <48-hour duration were eligible for the study if, after assessment by the attending pediatric emergency physician, it was thought that a surgical consultation was warranted for a possible surgical condition. Exclusion criteria included allergy to opiates, previous opiate use within the past 4 hours, hypotension, or the absence of a parent.
Children were enrolled 7 days per week between the hours of 8:00 am and midnight. After midnight, often an attending surgeon was not available within the protocol time limits. The study center has 3 pediatric surgeons, but convenience sampling was used because 1 surgeon did not participate.
After emergency physician assessment, informed written consent was obtained from the parents and verbal assent was obtained from the children. For children who met the inclusion criteria, a premedication assessment form was completed by the emergency physician. Data collected on this form were clinical signs and symptoms, including the location of the pain, the presence or absence of abdominal tenderness, guarding, and psoas, obturator, and Rosving signs, and whether there was pain associated with jumping. The physician documented his or her diagnosis, with a degree of confidence ranging from 0% to 100%, on the form before the results of any laboratory testing or imaging studies were available.
A pain assessment was conducted with a validated color analog scale (CAS).9 Children were asked to mark their current pain severity on the thermometer-shaped, standardized CAS anchored by the descriptors "no pain" and "worst pain." Children were asked to slide the marker to the point on the thermometer that best described the pain they were experiencing currently. The reverse side of this instrument has a numerical rating scale divided into unit marks separated by 0.25 cm, so that a number from 1 to 10 can be assigned to the individual assessments. A team of dedicated study nurses supervised compliance with the study protocol and administered all pain scales with a scripted dialogue.
Randomization was performed by the hospital pharmacy in a blinded manner, using a computer-generated, random-number list in blocks of 10. The pharmacy prepared identical syringes of morphine sulfate and normal saline solution as numbered prepacked syringes, to which all investigators and emergency staff members were blinded. Children were randomized to receive either 0.05 mg/kg morphine sulfate (maximum of 10 mg) or an equivalent volume of normal saline solution. Patients underwent continuous oxygen saturation monitoring, and vital signs were recorded by the study nurse every 10 minutes.
Fifteen minutes after administration of the study medication, the emergency physician reexamined the child and completed an identical assessment form, including an assessment of his or her confidence in the diagnosis. The study nurse repeated a pain scale assessment for the child at this time. All children were blinded to their initial CAS scores. If a child had ongoing pain, then the same dose of study medication was repeated at the emergency physician's discretion. The emergency physician reassessed the child within 15 minutes after the second dose. The emergency physician completed a second, identical, postmedication assessment form, and the study nurse repeated the pain scale assessment. Children who had ongoing pain after 2 doses of study medication (total dose of 0.1 mg/kg morphine sulfate) did not receive additional medication until assessment by the pediatric surgeon.
Surgical assessment had to be performed within 1 hour after the initial study medication infusion. Attending pediatric surgical staff members or a senior surgical resident (postgraduate year 4 or higher) completed a surgical assessment form and arranged disposition. The surgical assessment form evaluated abdominal tenderness, guarding, the presence of positive or negative psoas, obturator, and Rosving signs, and whether there was pain with jumping. The surgeon was then asked to make a diagnosis and to indicate his or her confidence in the diagnosis, from 0% to 100%. Additional analgesia and other medications were administered at the surgeon's discretion.
Children were monitored if they were admitted to the hospital. All children who were discharged from the hospital received follow-up telephone calls from the study nurse within 2 weeks, to ensure that no surgical condition had been missed. Operating room and pathology reports were reviewed for final diagnoses for all children who underwent laparotomy.
Mean pain scores were analyzed with repeated-measures analysis of variance. The χ2 test or Fisher's exact test (when appropriate) was used for comparisons of proportions, and the t test was used for comparisons of means. All statistical analyses were performed with SAS software, version 8.2 (SAS Institute, Cary, NC).
During the 25-month study period from February 1, 2000, to March 30, 2002, 162 patients were eligible for our study. Of these, 54 were not enrolled because they met exclusion criteria (n = 17), refused (n = 16), or were missed (n = 21). A total of 108 children completed the study (Fig 1).
Fig 1.
Study flowchart.
Fifty-two patients were randomized to receive morphine, whereas 56 received normal saline solution. The groups were similar with respect to mean initial pain scores, physical findings, and time from study drug administration to surgical assessment (Table 1).
Initial Assessment Before Study Drug Administration
The outcomes for the 108 children are shown in Table 2. Appendicitis was missed for only 1 child, and this patient was in the normal saline solution group. There was no difference between groups in the diagnosis of appendicitis (P = .25) or perforated appendicitis (P = .51) or in the number of children who were observed and then underwent laparotomy (P = .77). Overall, there were 31 patients in the morphine group and 26 in the placebo group who had final diagnoses of appendicitis. Perforated appendicitis occurred for 27 patients, with no difference between groups (P = .51). Laparotomies were performed for 4 patients with normal appendices in the placebo group and 1 in the morphine group. The incidences of other diagnoses and self-resolving abdominal pain were not different between the groups (P = .70).
Of the 41 children admitted for observation, 13 underwent a laparotomy subsequently, ie, 7 in the morphine group and 6 in the placebo group. All 7 children in the morphine group had appendicitis (3 perforated), as did 4 in the placebo group (1 perforated). There was no difference in the proportions of patients admitted for observation and subsequently found to have appendicitis (7 of 19 patients in the morphine group and 4 of 22 patients in the placebo group; P = .29).
Both groups experienced reductions in recorded CAS scores, as assessed by self-report. The mean pain scores and 95% confidence intervals (CIs) before and after morphine or placebo administration are shown in Table 3. Figure 2 shows that the reduction in the mean pain score was 2.2 cm in the morphine group, compared with 1.2 cm in the placebo group (P = .015).
Mean (and SD) pain scores before (Pre) and after (Post) administration of morphine or normal saline solution for 108 children with acute abdominal pain (morphine versus normal saline solution: P = .15).
Pain Scores
The emergency physicians thought that the pain had diminished for 46 (88.5%) children who received morphine, compared with 33 (63.5%) children in the placebo group (P = .0005). No emergency physician thought that the pain grew worse in either group, but physicians thought that the pain was unchanged for 6 (11.5%) children in the morphine group and 23 (44.2%) children in the placebo group (P = .0002).
Physician confidence in diagnoses was not altered for children who received morphine. Emergency physicians recorded no change in their confidence in diagnoses after patients received either morphine or placebo. The emergency physician confidence in diagnoses was 68.9% in the morphine group before study medication administration, compared with 65.5% in the placebo group. After morphine administration, physician confidence increased to 69.5% (effect size: 1.2%; 95% CI: −2.9% to 5.3%), compared with 70.9% in the placebo group (effect size: 5.3%; 95% CI: 2.7–7.9%). Similarly, there was no demonstrable effect of morphine on the surgeons' confidence in diagnoses. The surgeons were 73.8% confident of their diagnoses for the morphine group, compared with 73.6% for the placebo group (effect size: 0.01%; 95% CI: −0.39–0.40%).
Two children in our study were discharged from the hospital after receiving the study medication and subsequently returned with acute appendicitis. One child was in the morphine group and returned 4 months later with a perforated appendix. This child was asymptomatic in the interval between study enrollment and return to the hospital, making it unlikely that morphine had any effect in delaying the diagnosis. The other child was in the placebo group and returned 5 days later with acute appendicitis.
All children were monitored specifically for apnea, hypoxemia, hypotension, or changes in the level of consciousness. These adverse events were not observed in either group.
Four of the 13 children who underwent a laparotomy after being admitted to the hospital for observation were found to have a perforated appendix and intraabdominal infection. Their operations were performed 20 to 48 hours after presentation to the ED. Their case histories are as follows.
Patient 1 (randomized to the morphine group) was 12 years of age when she visited the ED because of abdominal pain that had begun 4 days previously, in the periumbilical region. During the previous 3 days, her pain had been in the suprapubic region and she had been vomiting. Diarrhea began 1 day before presentation, and the patient had dysuria. She had experienced a normal menstrual period 2 weeks previously. She walked with a hunched-over gait, and her vital signs were as follows: heart rate: 96 beats per minute; respiratory rate: 28 breaths per minute; temperature: 38.0°C; blood pressure: 122/76 mm Hg. There were decreased bowel sounds, with suprapubic tenderness. The patient had a positive psoas sign and rebound tenderness. Admission to the surgical inpatient unit was arranged. The following investigation results were obtained: white blood cell (WBC) count: 17 800 cells per mm3 (14 600 neutrophils per mm3); urinalysis: normal findings. A sonogram of the patient's abdomen found no abnormality; the report stated, "The appendix is well visualized and appears normal pre and post compression. A normal appearing appendix." The patient experienced pain requiring 3 doses of morphine through the night. In the morning, the surgeon noted tenderness and rebound tenderness in both lower quadrants but greater on the left side. Laparotomy was performed 20 hours after presentation to the ED. Free pus was found in the peritoneal cavity. The perforated appendix was found in the high pelvic region on the sacral promontory, with the sigmoid colon wrapped around the left side of it. Infected exudate was found on the sigmoid mesentery. The patient fared well after her operation and was discharged from the hospital 5 days later.
Patient 2 (randomized to the normal saline solution group) was 11 years of age when he visited the ED because of generalized abdominal pain that had been present for the past 15 hours. This had been preceded by a 7-day history of flu-like symptoms (sore throat, malaise, and fever). Amoxicillin treatment had been started 1 day before presentation. The patient had a poor appetite and no vomiting or diarrhea. His vital signs were as follows: heart rate: 112 beats per minute; respiratory rate: 20 breaths per minute; temperature: 37.3°C; blood pressure: 122/77 mm Hg. The patient had generalized tenderness over his abdomen, slightly increased in the right lower quadrant, and no rebound tenderness. Admission to the surgical inpatient unit was arranged. The following investigation results were obtained: WBC count: 12 900 cells per mm3 (11 400 neutrophils per mm3); urinalysis: normal findings. The findings of an abdominal radiograph were consistent with gastroenteritis. During the first 24 hours in the hospital, the patient experienced 6 episodes of diarrhea, with no vomiting, and his pain diminished. During his second night in the hospital, his temperature increased to 39.5°C and the patient was found to have marked tenderness in the right lower quadrant. Laparotomy was performed 48 hours after presentation to the ED. A periappendiceal abscess was found in the middle lower abdomen, extending toward the right. The patient fared well after surgery and was discharged from the hospital 6 days later.
Patient 3 (randomized to the morphine group) was 10 years of age when he visited the ED because of 3 days of lower abdominal pain in both quadrants. There had been no nausea, vomiting, diarrhea, dysuria, or anorexia. The patient's vital signs were as follows: heart rate: 84 beats per minute; respiratory rate: 24 breaths per minute; temperature: 36.7°C; blood pressure: 116/67 mm Hg. The patient had normal bowel sounds and left lower quadrant tenderness, with rebound tenderness. Admission to the surgical inpatient unit was arranged. The following investigation results were obtained: WBC count: 11 500 cells per mm3 (9 500 neutrophils per mm3); urinalysis: normal findings. The results of an abdominal radiograph were normal. The patient's abdominal pain persisted during the first 24 hours in the hospital. The patient was allowed fluids and had no emesis. At 13 hours, he was found to have mild left lower quadrant tenderness, with no guarding or rebound tenderness. His temperature increased to 39.1°C on the evening of his first hospital day, 24 hours after admission. However, his abdominal findings were unchanged. The patient slept well through the night and was afebrile in the morning. He had some abdominal tenderness. The results of an abdominal sonogram were normal. Later that day, however, the patient experienced marked right lower quadrant pain and tenderness. Laparotomy was performed 43 hours after presentation to the ED. A small amount of pus was encountered after entry into the peritoneal cavity. The cecum had turned up on itself in a cranial manner, with the appendix being adherent behind the ileum toward the middle of the abdomen, in a wall of omentum. Free pockets of pus were found. The patient fared well after surgery and was discharged from the hospital 6 days later.
Patient 4 (randomized to the morphine group) was 5.5 years of age when she visited the ED because of abdominal pain that had begun 1 day previously. The pain was generalized and progressive in severity. The patient had vomited once and passed 1 normal stool. She had a 2-day history of sore throat, cough, and rhinorrhea. Fever began 8 hours before arrival. The patient preferred to lie still, and her vital signs were as follows: heart rate: 199 beats per minute; respiratory rate: 20 breaths per minute; temperature: 38.3°C; blood pressure: 119/74 mm Hg. The patient had normal bowel sounds, with tenderness in both lower quadrants and a distended bladder. After voiding, she seemed more comfortable and her abdomen seemed softer. Admission to the surgical inpatient unit was arranged. The following investigation results were obtained: WBC count: 8500 cells per mm3 (6800 neutrophils per mm3); urinalysis: 2 to 6 pus cells per high-power field. No imaging studies were performed. The patient was allowed clear fluids, and there was no emesis. In the morning, the patient's temperature was 38.1°C and her condition was judged to be improved. The patient seemed to be more comfortable, and her pain seemed diminished. Her abdomen was soft, and she had periumbilical and right lower quadrant abdominal pain. The notation in the record at that time stated, "I do not think this is appendicitis." Several hours later, the patient's abdomen was distended and she had decreased bowel sounds and increased tenderness. Laparotomy was performed 23 hours after presentation to the ED. The appendix was found behind the bladder. There was purulent exudate confined to the periumbilical region. The patient fared well after surgery and was discharged from the hospital 3 days later.
These 4 children demonstrate the well-known heterogeneity of the presentation and clinical course of appendicitis and the challenge of making this diagnosis for some children. Common to all 4 of these children was the fact that their inflamed appendix was not in the right lower quadrant, which is the likely explanation for their atypical presentations and clinical courses. Their clinical courses demonstrate that the delays in diagnosis and the development of perforation were not consequences of analgesic administration.
Pain is one of the most common presenting symptoms in primary care practice. Some estimate that 5% of patients seek medical attention for a variety of painful conditions.10 These patients expect pain relief. However, the practice of analgesic use in the ED is a relatively recent topic in the literature. Wilson and Pendleton11 retrospectively reviewed 198 charts of patients with "painful medical and surgical conditions," such as chest pain, abdominal pain, and renal colic, and found that 56% of these patients received no analgesia. Although 44% did receive some analgesia, 69% of them waited >1 hour. The authors concluded that "oligoanalgesia" is prevalent in the ED setting. Other studies have also demonstrated inadequate analgesia use in the ED.12,13
This has also been studied among children. Friedland et al14 retrospectively reviewed the charts of pediatric patients who presented to the ED with 3 painful conditions. They found that children with sickle cell crisis received analgesia 100% of the time but those with long-bone fractures and burns received analgesia in only 31% and 26% of cases, respectively. The authors concluded that there was suboptimal use of analgesia for children.
The realization that frequently physicians do not provide their patients with optimal analgesia has led to widespread concern, with many organizations publishing policies that integrate the need for pain management with an ethical obligation.1–3,14,15 Abdominal pain is often a diagnostic challenge. Surgical practice has dictated that no analgesic should be given to these patients, for fear of obscuring the diagnosis. An editorial in the British Medical Journal addressed this issue in 1979,16 but studies were conducted only more recently. Zoltie and Cust17 were the first to address this issue and others followed,18–20 by comparing opiate use with placebo use among adults with acute abdominal pain. All found analgesic use to be safe and effective in reducing pain without increasing morbidity.17–20 These studies changed practice in adult emergency medicine and adult general surgery. It is now the accepted standard of care to provide pain relief to adults with acute abdominal pain, before definitive diagnosis and before surgical assessment.
Typically, children with acute abdominal pain requiring surgical referral are not provided with analgesia. This stems from a combination of traditional surgical teaching, limited confidence in the assessment of pediatric acute abdominal conditions by referring physicians, and healthy skepticism in the extrapolation of adult data to the pediatric population.21 Unfortunately, despite the frequency of abdominal pain as a presenting complaint in the pediatric ED, only 1 previous study addressed this issue. Kim et al8 randomized 60 children to received morphine or placebo and found a significant reduction in pain scores between the study groups, with no change in the number of areas of abdominal tenderness or decrease in the diagnostic accuracy between the study groups. In their study, however, surgeons evaluated children both before and after study medication administration; in our study, the surgeons performed their evaluation after the intervention.
One of our primary outcome variables was whether morphine administration would result in an increase in missed appendicitis cases. This condition was missed for only 1 child, who was treated with placebo. The number of patients with a normal appendix who underwent an appendectomy can also indicate diagnostic accuracy; there were 5 such patients, 4 of whom were treated with placebo.
Another of our primary outcome variables was whether morphine decreased acute abdominal pain among children. Our data demonstrated a significant decrease in abdominal pain, as measured with a CAS. A statistically significantly greater decrease in mean pain scores was found for the group that received morphine, compared with the placebo group. Statistical significance does not necessarily indicate clinical significance. Previous studies demonstrated that reductions in mean pain scores, with the CAS, must be at least 2 cm to be clinically significant.9 Children in our placebo group had a reduction of 1.2 cm and, although it was statistically significant, this was likely not clinically significant. The reduction of 2.2 cm in the morphine group was both statistically and clinically significant.
Studies among adults with acute abdominal pain concluded that analgesic use may increase diagnostic accuracy.19 In our study, there was no difference between groups in diagnostic accuracy or confidence in diagnoses by emergency physicians or surgeons.
The sample size is a limitation of this study. A post hoc sample size calculation determined that this study had a power of 0.16 to detect a difference in missing the diagnosis of appendicitis. From this, it was calculated that >1000 children per group would need to be enrolled in a randomized, controlled trial to attain a power of 0.80.
Our data showed that morphine effectively reduced the intensity of pain among children with acute abdominal pain, and it seems that morphine does not mask the physical signs of acute appendicitis. A multicenter trial to study this issue in more depth may be warranted.
This study was funded by a grant from the Manitoba Institute of Child Health (a division of the Children's Hospital Foundation of Manitoba).
Accepted June 1, 2005.
Reprint requests to (M.T.) Department of Pediatrics and Child Health, Children's Hospital, 840 Sherbrook St, Winnipeg, Manitoba, Canada R3A 1S1. E-mail: mtenenbein{at}hsc.mb.ca
No conflict of interest declared.
CAS, color analog scale • ED, emergency department • CI, confidence interval • WBC, white blood cell
Ducharme J. Emergency pain management: a Canadian Association of Emergency Physicians (CAEP) consensus document. J Emerg Med.1994;12 :855– 866
American College of Emergency Physicians. The use of pediatric sedation and analgesia. Ann Emerg Med.1993;22 :626– 627
Agency for Health Care Policy and Research, Acute Pain Management Guideline Panel. Clinical Practice Guideline: Acute Pain Management: Operative or Medical Procedures and Trauma. Washington, DC: Agency for Health Care Policy and Research; 1992. AHCPR Publication 92-0032
Reynolds SL, Jaffe DM. Children with abdominal pain: evaluation in the pediatric emergency department. Pediatr Emerg Care.1990;6 :8– 12
Boenning DA, Klein BL. Gastrointestinal disorders. In: Barkin RM, ed. Pediatric Emergency Medicine. 2nd ed. St. Louis, MO: Mosby; 1997:795–864
Landsman IS, Cook DR. Pediatric anesthesia. In: O'Neill JA, Rowe MI, Grosfeld JL, Fonkalsrud EW, Coran AG, eds. Pediatric Surgery. St. Louis, MO: Mosby; 1998:197–228
Surana R, O'Donnell B. Acute abdominal pain. In: Atwell JD, ed. Pediatric Surgery. London, United Kingdom: Oxford University Press; 1998:402–415
Kim MK, Strait RT, Sato TT, Hennes HM. A randomized clinical trial of analgesia in children with acute abdominal pain. Acad Emerg Med.2002;9 :281– 287
Bulloch B, Tenenbein M. Validation of two pain scales for use in the pediatric emergency department. Pediatrics.2002;110(3) . Available at: www.pediatrics.org/cgi/content/full/110/3/e33
Rosen P, Barkin R: Emergency Medicine: Concepts and Clinical Practice. 4th ed. St. Louis, MO: Mosby; 1998:1888
Wilson JE, Pendleton JM. Oligoanalgesia in the emergency department. Am J Emerg Med.1989;7 :620– 623
Karpman RR, Del-Mar N, Bay C. Analgesia for emergency centers' orthopaedic patients: does an ethnic bias exist? Clin Orthopaed.1997;1 :270– 275
Jones JS, Johnson K, McNinch M. Age as a risk factor for inadequate emergency department analgesia. Am J Emerg Med.1996;14 :157– 160
Friedland LR, Pancioli AM, Duncan KM. Pediatric emergency department analgesic practice. Pediatr Emerg Care.1997;13 :1322– 1324
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Analgesia and the acute abdomen [editorial]. Br Med J.1979;2 :1093
Zoltie N, Cust MP. Analgesia in the acute abdomen. Ann R Coll Surg Engl.1986;68 :209– 210
Attard AR, Corlett MJ, Kidner NJ, Leslie AP, Fraser IA. Safety of early pain relief for acute abdominal pain. Br Med J.1992;305 :554– 556
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You are going to email the following Early Analgesia for Children With Acute Abdominal Pain
Pediatrics Oct 2005, 116 (4) 978-983; DOI: 10.1542/peds.2005-0273


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The Anderson Cabot Center for Ocean Life has similar priorities — having previously helped create the Fisheries and Aquaculture Solutions Program which develops sustainable practices around seafood sourcing — and was therefore seen as an ideal partner for the program.