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Prevalence and correlates of substance use among health care students in Nepal: a cross sectional study
Bimala Panthee ORCID: orcid.org/0000-0003-4866-751X1,2,3,
Suresh Panthee3,4,
Saroj Gyawali2,3,5 &
Norito Kawakami6
Substance use among health care students threatens professional standards and the delivery of quality services, potentially placing the public at risk. Therefore, our study aims to determine the prevalence and correlates associated with substance use among Nepalese health care students.
A cross-sectional survey using a self-administered health professional questionnaire was conducted among pharmacy, nursing, and public health students at three universities in Nepal in 2010.
We analyzed data from 407 respondents (response rate, 82%) with a mean age of 22 years (standard deviation = 3.71). The overall lifetime prevalence of substance use (i. e., illegal use of prescription drugs and illegal drug use) was 42.8%. Marijuana was the most commonly used illegal drug (8.8%) and minor opiates (e.g., codeine cough syrups) were the most widely used illegal prescription drugs (32.4%). Substance use was directly associated with cigarette smoking, peer influence, and heavy drinking. In addition, respondents reported some major and minor dysfunctions because of their substance use.
The prevalence of substance use among health care students at the three universities in Nepal was high. Peer influence, cigarette smoking, and heavy drinking were significant predictors of substance use.
Substance use is defined as the continued use of substances, illegal drugs, or the misuse of prescription or over-the-counter drugs with negative consequences [1]. The lifestyle of health care professionals plays an important role and has a significant influence on the lifestyle of patients or clients [2]. No health care professional is immune to substance use (e.g., illegal use of prescription drugs and illegal drug use). Substance use by the health care professionals might influence their professional behavior and threaten the standard of the delivered health care services, potentially placing the public at risk [3]. Abuse, often begins during adolescence in college [4,5,6] and early beginners are at the higher risk of psychosocial problems, such as behavior patterns, psychiatric disorders, family system, peer relationships, leisure/recreation, and work adjustment [7]. Furthermore, this is associated with the failure to stop using substances on one's own. Therefore, to promote the health of health care professionals and the quality of the future health care services provided, it is essential to assess health care students' substance use.
Overall, the prevalence of substance use among health care students ranges from 5% to 67% [8,9,10,11,12,13,14], with higher percentages (67%) being reported in developed countries like the United States [8]. Among developing countries, such as Iran [9, 10], Ethiopia [11], Nepal [12, 13], and India [14] substance use among health care students varies from 5% to 48%. Moreover, 91.7% of the medical students using illicit substances admitted using them despite knowing their ill effects and the legal consequences [14]. In Nepal, substance use by medical students ranges from 12.8% to 15% for cannabis [12, 13], 4% for hashish, 1.12% for lysergic acid diethylamide, 0.22% for opioids, and 0.22% for amphetamine [13]. With a few exceptions [8, 15], most of the previous studies did not investigate multiple types of substance use among multiple groups of students [9, 11, 16]. For instance, Ahmadi et al. focused on opium use among medical students in southern Iran [9] and Khanal et al. studied only on medical students in Nepal, although different substances (i.e., alcohol, tobacco, cannabis) were included [13]. Similarly, Deressa and Azazh studied khat (Catha edulis) chewing among medical students in Ethiopia [11].
The use of marijuana and heroin together with the misuse of psychoactive and sedative drugs is of great national concern in Nepal [17]. In 1998, the annual prevalence of cannabis abuse was 3.2% [18]. In 2006, the estimated prevalence of opiate abuse was to be 0.3% in the Nepalese adult population aged 15–64 years [18]. A large survey conducted in 18 out of 75 districts by the Ministry of Home Affairs identified 91,534 hard drug users, with more than 83% being polydrug users [19]. Cannabis and opiates were the most commonly used drugs. In decreasing order, the user preference was for cannabis, heroin, pain medicine, and cough syrup [19]. The annual growth rate of drug users is 11.4%, and nearly three-fourths (73.1%) of the current drug users had their first drug intake before they were 20 years old [20]. In addition, there was a rise in the rate of injectable drug use between 2008 and 2011 [21], with 57% of the drug users being injectable drug users in 2013 [19]. This situation was further exacerbated by the fact that 13% of the injectable drug users shared needles with someone else.
Taken together, there is a strong need to assess substance use among health care students. Therefore, this study was conducted to determine the extent of prevalence of substance use among health care students. In addition, we aimed to examine the correlates of substance use among health care students in the Nepalese context. The results of this study are expected to contribute to design preventive programs, primarily focusing on the health care students.
In 2010, we carried out a cross-sectional survey of undergraduate pharmacy, nursing, and public health students at three universities (i.e., Tribhuvan University, Pokhara University and Purbanchal University) of Nepal.
Study population and sample
All students taking pharmacy, nursing, and public health courses at those three universities were the study population. However, we purposively selected colleges and the students' academic year for our data collection, which limited our target population to 555. Based on the students' presence at the time of the survey, 499 students were asked to voluntarily participate in a lecture room setting and return the questionnaire in the same setting. Altogether, 498 responses were received (Additional file 1: Table S1). Excluding all the missing data, a total of 407 responses, i.e., 73.3% of target population, were used for the final analysis.
Survey measures
Data were collected using a modified version of the Health Professional Questionnaire developed by Kenna and Wood [15]. The survey instrument was pilot tested for face validity with a group of ten volunteers from the first-year medical students of Tribhuvan University, Nepal. No major changes were required on the questionnaire. The four-page final version of the survey contained information about basic demographic characteristics and details of substance use including the effects of the substance use, if any.
We asked respondents about their age, gender, faculty, year and university of the study, active participation in religion, family history of alcohol, and family history of drug use.
Cigarettes and alcohol use
We asked about cigarettes and alcohol use. Cigarette smoking and heavy drinking (5 or more drinks at one occasion) were asked as "how many times, if ever, have you smoked cigarettes?" and "how many times, if ever, have you had 5 or more drinks on the occasion?" respectively, for lifetime cigarette smoke and alcohol use. The rating was from "0" times to more than "30" times.
Participants were also asked about the number of times they received offers of alcoholic beverage and legal psychotherapeutic drugs (e.g., opiates, stimulants) by their friends and alcohol from pharmaceutical companies during the past year. They were also asked whether they had worked with a co-worker or a colleague who accepted self-medication with psychoactive drugs during the past year.
Illegal drug use
Participants were asked about their lifetime experience and the tendency of use of each of three commonly found street drugs (i.e., marijuana, cocaine, and designer drugs). For instance, "how many times, if ever, have you smoked marijuana or hashish?" In Nepal, both marijuana and hashish are commonly found street drugs. Respondents were asked to rate the frequency of use, using response option "0" times to ">30 times" in their lifetime, the past year, and the past month. These three substances were included in a single group as "illegal drugs". If the students used any of the illegal drugs, at least once in their lifetime, past year, and past month, they were regarded as illegal drug users during their lifetime, in the past year, and the past month, respectively. The lifetime, past year, and past month use of the illegal drugs was computed.
Illegal use of prescription drug
A total of seven groups of prescription drugs (major opiates, minor opiates, stimulants, sedative-hypnotics, tranquilizers, anxiolytics and other prescription pain medicines) with examples were provided to assess drug use without authorization or prescription. We asked, "How many times, if ever, have you used following medications/drugs on your own authorization or for uses other than the intended use?". To facilitate identification, examples of generic and brand names were provided for each medication class. Response options and duration of use were the same as that for illegal drug use. Similar to the operational definition of illegal drug users, if the students used any of the prescription drugs at least once in their lifetime, in the past year, and in the past month they were regarded as illegal users of the prescription drug during their lifetime, the past year, and the past month, respectively.
We further asked whether the use of illegal drugs or prescription drugs without a prescription caused any dysfunction in their daily activities or life using eight questions. We further subdivided these eight questions into "minor dysfunction" (initial four questions) and "major dysfunction" (following four questions) [15]. The list of dysfunctions caused by the drug use were as follows: (1) falling behind in work; (2) calling in sick or being late; (3) having trouble getting along with people; (4) worrying that you might be using too much or too often; (5) seriously considered suicide; (6) having an auto accident or other type of accident; (7) providing less than your best patient care performance; and (8) seeing a psychiatrist, psychologist, or a counselor. The example of minor dysfunction was "has your drug use ever caused you to get behind in your work?" Similarly, an example of major dysfunction was "has your drug use ever caused you to seriously consider suicide?"
All potential respondents were provided with the participant's information sheet about the study. Students were asked to complete the survey instrument in a ecture room setting voluntarily and anonymously and return the questionnaire in the same setting. No incentive was provided for completing the questionnaire. The study was approved by the Ethical Review Board of the Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.
All data were analyzed using SPSS software (version 20; Armonk, NY, USA). Cases with any missing data were excluded from the analysis. Demographic variables and substance use were analyzed using descriptive statistics. The frequency of substance use was recorded as 0 = never used, and 1 = any use (i.e., 1 time to >30 times use). Adjusted logistic regression was applied to identify the risk factors for substance use. Chi-square test was used to examine any differences in substance use by demographic characteristics and faculty (pharmacy, nursing and public health). Fisher's exact test was applied for cell count less than 5. P value for statistical significance was set as less than 0.05.
Completed responses were received from 498 respondents. However, only 407 responses were used for the final analysis because of the missing data, with a response rate of 73.3%. Respondents were from Tribhuvan University (50.4%), Pokhara University (28.7%) and Purbanchal University (20.9%), with the mean age of 22.2 years (standard deviation [SD] = 3.7). Among them, 37.8% majored in pharmacy with a mean age of 21.1 years (SD = 1.9), 39.1% majored in nursing with a mean age of 23.7 years (SD = 4.9) and 23.1% majored in public health with a mean age of 21.4 years (SD = 2.4). Nursing students were all women. Detailed demographic characteristics are presented in Table 1.
Table 1 Demographic characteristics and previous encounters with cigarette, alcohol, and drugs (N = 407)
Prevalence of substance use
The overall prevalence of substance use (illegal use of prescription drugs and illegal drug use) was 42.8% during lifetime; 26% in the past year, and 11.3% in the past month.
Reported illegal drug use
Overall, 8.8% of respondents used illegal drugs (i.e., marijuana, cocaine, and designer drugs) during their lifetime (Table 2); prevalence was 5.2% in the past year and 3.2% in the past month. Higher lifetime prevalence was observed among pharmacy students and public health students than nursing students; the difference being statistically significant (χ2 = 16.15, p < 0.01). Similarly, men (19.5%) reported higher lifetime illegal drug use than women did (2.4%) (χ2 = 34.75, p < 0.01).
Table 2 Prevalence of substance use during lifetime and its demographic correlatesa
Marijuana was the most commonly used illegal drug for pharmacy and public health students (13% and 10.6%, respectively), while only 1.3% (2/159) of nursing students reported using marijuana during their lifetime (χ2 = 16.15, p < 0.01) (Table 3). Pharmacy students used a significantly higher amount of designer drugs (χ2 = 10.50, p = 0.005) than did public health students, while none of the nursing students reported using them during their lifetime.
Table 3 Prevalence of substance use during lifetime, in the past year and in the past month among Nepalese healthcare students (N = 407)
Reported illegal use of prescription drugs
Overall, 38.6% of respondents reported the use of any kind of prescription drug without prescription in their lifetime followed by 22.6% in the past year and 9.6% in the past month. A higher percentage of nursing students (45.9%) reported the use of illegal prescription drug (in total) during their lifetime compared with pharmacy (34.4%) and public health students (33.0%). There was no significant gender difference in the frequency of illegal use of prescription drugs (Table 2).
Minor opiates (e.g., codeine cough syrups) was the most commonly misused prescribed drug (27.9%, 39.0%, and 28.7%) by pharmacy, nursing and public health students, respectively followed by pain medicine (e.g., Temazepam, Flurazepam) (Table 3). The difference among groups was not statistically significant. While all groups of health care students reported using a variety of prescribed drugs, a significant between-group difference was observed only for the use of sedatives during lifetime (χ2 = 7.01, p = 0.03); with pharmacy students being more likely to use sedatives. The rate of lifetime prescription drug use by pharmacy students ranged from 1.3% for stimulants to 27.9% for minor opiates. None of the nursing students reported the use of stimulants and sedatives during their lifetime. Similarly, none of the pharmacy students reported the use of major opiates during their lifetime.
In addition, 41 (10.1%) of the respondents reported that they suffered from one or all of the four minor dysfunctions because of their use of drugs. Similarly, 15 (3.7%) students reported major dysfunctions because of their drug use. A higher number of pharmacy students reported both major (5.8%) and minor dysfunctions (18.8%) as a result of drug use; however, a significant difference was observed only for minor dysfunction.
After adjusting for the effect of demographic variables, we found that cigarette smoking during lifetime was the most significant variable predicting illegal drug use (odds ratio [OR] = 10.33, confidence interval [CI] = 3.46, 30.79). Similarly, offer of drugs by friends (OR = 5.77, CI = 1.25, 26.49), offer of alcoholic beverages by friends (OR = 4.28, CI = 1.01, 18.02), and heavy drinking during lifetime (OR = 2.69, CI = 3.46, 30.79) also predicted illegal drug use. In addition, cigarette smoking and heavy drinking were the significant predictors of illegal use of prescription drugs (Table 4).
Table 4 Factors affecting lifetime illegal drug use and illegal use of prescription drugs
To our knowledge, this is the first survey conducted in Nepal that included a broad range of substances and multiple groups of health care students. The overall prevalence of substance use among health care students was found to be 42.8% during their lifetime, even excluding alcohol and cigarette smoking. Peer influence, heavy alcohol drinking, and cigarette smoking were the significant predictors of substance use among Nepalese health care students.
Marijuana was the most commonly used illegal drug. The rate of use of marijuana in our study (7.9%) differed from an earlier study (12.8% - 15%) among Nepalese medical students [12, 13]. Pharmacy and public health students had a higher prevalence of illegal drug use during their lifetime. Pharmacy students used marijuana and designer drugs more frequently. However, only a few and no nursing students reported the use of marijuana and designer drugs, respectively, in their lifetime. This difference was less apparent after adjusting for demographic variables. Our results differ from a report of lower prevalence of marijuana and cocaine use observed for pharmacy students than nursing students in the US [5, 8]. The observed higher prevalence of illegal drugs among pharmacy and public health students in our study may be attributable to differential demographic characteristics, such as gender, because nursing students in our study were all women and none of them reported the use of designer drugs.
The most commonly used illegal prescription drugs were minor opiates (codeine cough syrups) (32.4%) followed by pain medicine (Tramadol, Pentazocine) (15.5%) in contrast to the other reports [9], where none of the Nepalese medical students used opioids. In the US, misuse of prescription-type drugs (e.g., amphetamine, opiate, sedative/hypnotic, tranquilizer, or inhalant) by nurses was 6.9% [22]. In our study, nursing students had a higher lifetime prevalence of illegal prescription drugs use than other groups. This pattern still remained after adjusting for demographic variables. Nursing students used minor opiates (e.g., codeine cough syrups) and pain medicine (e.g., tramadol, Pentazocine) more frequently than did pharmacy and public health students, although the difference was not statistically significant. These results seem consistent with the higher prevalence of opiates use observed for nursing students than pharmacy students in the US [8]. However, care should be taken with this comparison because our study population comprised female nursing students. In Iran, the most commonly used substance by nursing students was opium [10]. In contrast, pharmacy students were significantly more likely to report the use of sedatives or hypnotics during their lifetime than nursing and public health students. This finding is consistent with the use of benzodiazepam (3.5%) by male medical students in Nepal, whereas no female medical students used it [13]. However, this observation is inconsistent with the earlier US report [8]. Pharmacy students in our study were probably more stressed about their studies than nursing and public health students, which led them to use these drugs more often.
Students reported both major and minor dysfunctions because of their use of drugs. These dysfunctions were higher among pharmacy students. A higher proportion of major dysfunction among pharmacy students is similar to the higher proportion of major dysfunction among pharmacists [15], which suggests potential vulnerability in the health of future health care professionals and the quality of the health care services they provid. Thus, a proper actions should be taken to address this issue.
Even after adjusting for demographic variables, we found heavy drinking and cigarette smoking were found to be significant predictors for substance use, which suggests that preventive programs to reduce drinking and smoking habits in health care students should be launched to reduce the risk of further substance abuse. It should be taken into consideration that all those controlled variables were significant predictors of substance use in a previous study [8].
Concerning the association between peer influence and substance use, we found that peer influence was also a significant predictor. This is consistent with a study in Ethiopia [11], where peer influence was a significant predictor of substance use among medical students, and a national survey among drug users in Nepal, where 83% of drug users reported the reasons of drug use as peer pressure [20]. This finding suggested that peer support programs could be implemented to reduce substance use and promote the health care service they provide. In itself, however, this is a challenging task because the students themselves displayed a lack of awareness and suboptimal attitudes towards substance use [23].
The considerably high prevalence of substance use among health care students suggests the vulnerability of health care students. In addition, some of the respondents who reported substance use at some point in their lives, also attributed some amount of dysfunction in their daily lives to substance use. Therefore, our findings indicate a need to educate health care students about substance use in any form. They need to know: (1) that self-treatment with prescription drugs, no matter how minor or infrequent, is inappropriate and hazardous; (2) that accepting offer of alcoholic beverage and drugs by friends may predispose them to substance abuse; (3) that alcohol and smoking may be an indicator of substance use; and (4) the warning signs of psychological and physical addiction.
About 20% of the data were excluded from the final analysis because of the missing values. In Nepal, only women can study nursing; therefore, comparison of our results with other reports including both male and female students as nursing students would not be valid. In addition, we did not include the medical students in this study; therefore, the study findings cannot be generalized to all health care students. As this was a cross-sectional survey, no causal relationship could be inferred. We recommend a longitudinal study including the questions regarding dependency on substance and initiation of each substance use that we lacked in this study.
However, our study has some methodological strengths. It was a large survey including three major universities in Nepal with a range of health care students. The survey also included a broad range of substances. In addition, a high response rate (73% after eliminating the missing data) strengthens the generalizability of the study findings within these student groups.
The prevalence of substance use in health care students (pharmacy, nursing and public health) is evident. Peer influence (e.g., offer of alcohol and drugs by friends), cigarette smoking, and heavy drinking are significant predictors of substance use among Nepalese health care students. Therefore, health care policy should address prevention of substance use through peer support programs among health care students.
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We would like to thank Dr. George A. Kenna, Brown University, for providing questionnaire and discussion during the course of study. We thank Dr. Simon Bell, Monash University for critical discussion during the whole course of research. We thank Drs N. Panthee, B. Sigdel, A. Subedi, and Mr. S. Shakya for the help during data collection.
The research was not funded by any organization or source.
The datasets used and/or analyzed during the current study will be available from the corresponding author on reasonable request. Individual responses will not be shared. The questionnaire used for the study can be found as Additional file 2.
Patan Academy of Health Sciences, Lalitpur Nursing Campus, Sanepa, Lalitpur, Nepal
Bimala Panthee
Research and Development Centre, Kathmandu, Nepal
Bimala Panthee & Saroj Gyawali
Sustainable Study and Research Institute, Kathmandu, Nepal
Bimala Panthee, Suresh Panthee & Saroj Gyawali
Graduate School of Biomedical Sciences, Tokyo Medical and Dental University, Tokyo, Japan
Suresh Panthee
Faculty of Environmental Management, Prince of Songkla University, Hat Yai, Thailand
Saroj Gyawali
Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
Norito Kawakami
BP and SP conceived the research and collected the data. BP and SG analyzed the data. NK supervised data analysis and manuscript writing. BP wrote the manuscript and all the authors read and approved the final manuscript.
Correspondence to Bimala Panthee.
The study was approved by the Ethical Review Board of Institute of Medicine, Tribhuvan University, Kathmandu, Nepal (approval number 6/11/E/461). An information sheet for the participants regarding the nature and purpose of the study was provided to each participant before distributing the survey questionnaire. The process of returning the survey was considered as consent to participate. The participants who did not consent to participate either did not return the survey or returned a blank survey.
Not applicable as no individual detail is presented in this report.
Additional file
Table S1. Total number of students and responses received. (DOCX 20 kb)
Health Professional Questionnaire. (PDF 182 kb)
Panthee, B., Panthee, S., Gyawali, S. et al. Prevalence and correlates of substance use among health care students in Nepal: a cross sectional study. BMC Public Health 17, 950 (2017). https://doi.org/10.1186/s12889-017-4980-6
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text:
If things are not so good, if she is not happy that day with me, my daughter, or herself, she will flirt belligerently. She will usually frighten away the man (or men) she flirts with (they almost never hang around long enough to flirt back) because she doesn't know how; her approach is threatening, her invitation to seduction a challenging attack, and there may be something of a scene if I don't step in quickly enough. It will always be with some man she knows and feels thoroughly safe with (she doesn't really want to flirt at all, I suppose) and usually one who appears to be enjoying himself and bothering no one. (Perhaps he seems smug.) It is saddening for me to watch her; I do not want other people to dislike her.
She will challenge the man openly, sometimes right in the presence of his wife, with a bald and suggestive remark or enticement, sliding her hand heavily up his shoulder blade if he is standing or squeezing the inside of his thigh if he is seated; and then, as though he had already rejected her, turn taunting, vengeful, and contemptuous before he can respond at all. As neatly and promptly as I can, before much damage is done, I will move in to rescue her, to guide her away smoothly with a quip and a smile. I never rebuke her (although I am often furious and ashamed); I humor her, praise her, flatter. I want her to feel pleased with herself. (I don't know why.) "You're just jealous," she will accuse defiantly, when I have led her away.
"Damned right, I am," I reply with a forced laugh, and sometimes I will put my hands on her intimately to help persuade her I am.
"You'd better be," she'll gloat triumphantly.
We have had better times together, my wife and I, than we are having now; but I do not think we will have them again.
Dinner, my wife says, will be ready soon. My mood is convivial (so many times when I am home with my family, I wish I were somewhere else) and I decide, magnanimously, that tonight (at least) I will do everything I can to make them all happy.
"Hello," I say as my children assemble.
"Hi," says my daughter.
"Hi," says my son.
"What's the matter?" I ask my daughter.
"Nothing," she says.
"Was that a look?"
"It was a look, wasn't it?"
"I said hello, didn't I?" she retorts, lowering her voice, maliciously, to a tone of unconcerned innocence. "What do you want me to do?"
(Oh, shit, I meditate pessimistically, my spirits sinking, what the hell is bothering her now?) "If something's wrong," I persist tolerantly (feeling myself growing incensed), "I wish you'd tell me what it is."
She grits her teeth. "Nothing's wrong."
"Dinner's ready," says my wife.
"I won't like it," says my boy.
"What's bothering her?" I ask my wife loudly, as we move together into the dining room.
"Nothing. I don't know. I never know, Let's sit down. Let's try not to fight tonight. Let's see if we can't get through just one meal without anybody yelling and screaming and getting angry. That shouldn't be too hard, should it?"
"That would suit me fine," says my daughter, emphasizing her words to indicate that it might not suit somebody else (me). (She has not looked at me directly yet.) "It's okay with me," says I.
"I still won't like it," says my boy.
"What does that mean?" I ask.
"I want two hot dogs."
"You can at least taste it," argues my wife.
"What?" asks my daughter.
"You can't keep eating hot dogs all your life."
"If you want them, you'll get them," I promise my son. "Okay?"
"Okay."
"Okay?" I ask my wife. "No fights?"
"All right."
"Amen." I conclude with relief.
"What does that mean?" my boy asks me.
"Ole." I answer facetiously.
"What does that mean?"
"Okay. Have you got it?"
"Since when?" intrudes my daughter.
"Ole," my boy replies.
"No, it doesn't," says my daughter in her soft, weary monotone without looking up, attempting (I know) to keep the bickering going. "Ole doesn't mean okay."
"If you were in a better frame of mind," I josh with her, "I would threaten to wring your neck for that."
"There's nothing wrong with my frame of mind," she replies. "Why don't you threaten to wring my neck anyway?"
"Because you wouldn't realize I was kidding now, and you'd probably think I really wanted to harm you."
"Ha."
"Can't we have a peaceful meal?" pleads my wife. "It shouldn't be so hard to have a peaceful meal together. Should it?"
(I grit my teeth.)
"It would be a lot easier," I tell her amiably, "if you didn't keep saying that."
"Forgive me," my wife answers. "Forgive me for breathing."
"Oh, Jesus."
"That's right," says my wife, "swear."
"I didn't mean it that way," I tell her harshly (lying, of course, because that was exactly the way I did mean it). "Honest, I didn't. Look, we all agreed not to argue tonight, didn't we?"
"I know I did," says my daughter.
"Then let's not argue. Okay?"
"If you don't shout," says my daughter.
"Ole," says my boy, and we all smile.
(At last we have agreed about something.) Now that we have agreed to relax, we are all very tense. (Now I am sorry I'm there--although I do enjoy my boy. I can think of three girls I like a lot and know a long time--Penny, Jill, and Rosemary--I would rather be with, and the new young one in our Art Department, Jane, who, I bet, I could be having dinner and booze with instead if I had taken the trouble to ask.) None of us at our dining room table seems willing now to risk a remark.
"Should we say grace?" I suggest jokingly in an effort to loosen things up.
"Grace," says my boy, on cue.
It's an old family joke that really pleases only my boy; and my daughter's lips droop deliberately with disdain. She holds that scornful expression long enough to make sure I notice. I make believe I don't. I try not to let it rankle me (I know my daughter often finds me childish, and that does rankle me. I have a bitter urge to reproach her, to shout at her, to reach out and hit her, to kick her very sharply under the table in the bones of her leg. I have an impulse often to strike back at the members of my family, even the children, when I feel they are insulting me or taking advantage. Sometimes when I see one of them in the process of doing something improper, or making a mistake for which I know I will be justified in blaming them, I do not intercede to help or correct but hold back in joy to watch and wait, as though observing from a distance a wicked scene unfold in some weird dream, actually relishing the opportunity I spy approaching that will enable me to criticize and reprimand them and demand explanations and apologies. It horrifies me; it is something like watching them back fatally toward an open window or the edge of a cliff and offering no warning to save them from injury or death. It is perverse and I try to overcome it. There is this crawling animal flourishing somewhere inside me that I try to keep hidden and that strives to get out, and I don't know what it is or whom it wishes to destroy. I know it is covered with warts. It might be me; it might also be me that it wishes to destroy) and, succeeding in stifling my anger beneath a placid smile, say: "Pass me the bread, will you, dear?"
My daughter does.
My wife sits opposite me at the head (or foot) of the table, my boy on my left, my daughter on my right. The maid pads back and forth without talking, delivering bowls of food from the kitchen. My wife spoons large portions out into separate plates and passes them. We are silent. We do not feel free any longer to converse without inhibition in front of our colored maids. (I am not even certain of this one's name: they do not stay with us long anymore.) "The salad is good, Sarah," my wife says.
"I did what you told me."
I am not comfortable having our maids serve us our food at our places (neither are the children), and I won't allow it (even though my wife, I suspect, would still prefer to have it
done that way, as it was done in her own family when she was a child, as she still sees it done in good middle-class homes on television and in the movies, and as she imagines it is also done at Buckingham Palace and the White House). I am not comfortable being served by maids anywhere, even less so in other people's homes (where I am never certain how much food I am supposed to take, always have difficulty manipulating the serving forks and spoons from a sideways position, and am in continual anxiety that I am going to bump the meat and vegetable platters with my shoulder or elbow and send them spilling to the floor. Of course, that's never happened--yet). I suffer the same discomfort even when they are white (the maids, I mean, not the friends. I don't have any Black friends and probably never will, although I do see more and more pretty Black girls these days that whet my appetite. They're all out of reach for me by now, I guess, unless they're Cuban or Puerto Rican).
"I think it's good," my wife says. "I hope it's good."
"I won't like it," my boy says.
"That's enough," I tell him.
"Okay." He retreats quickly. He cannot stand it when I am displeased with him.
"What is it?" my daughter asks.
"Chicken livers and noodles in that wine sauce you like with beef. I think you'll like it."
"I won't," mumbles my boy.
"Will you at least taste it?"
"I don't like liver."
"It isn't liver. It's chicken."
"It's chicken liver."
"Please taste it."
"I'll taste it," he answers. "And then I'll want my hot dogs."
"Can I have mine?"
My wife and I watch with bated breath as my daughter pokes at the meat solemnly, almost lugubriously, with her fork and touches a small piece to her mouth.
"It's good," she says without enthusiasm and begins eating.
My wife and I are relieved.
(My daughter is somewhat tall and overweight and should be dieting; but my wife, who reminds her endlessly to diet, makes such things as noodles and serves large portions, and my daughter will probably ask for more.) "It's delicious," I say.
"Can I have my hot dogs?"
"Sarah, put up two frankfurters."
"Can I have the bread back?"
I give my daughter the bread.
"I've got some good news," I begin, and each of them turns to look at me. I am still brimming with excitement (and conceit) over Arthur Baron's conversation with me: and in a sudden, generous welling of affection for them, for all three of them (they are my family, and I am attached to them), I decide to share my joyful feelings. "Yes, I think I may have some very important news for all of us."
The three of them gaze at me now with such intense curiosity that I find myself forced to break off.
"What?" one of them asks.
"On second thought," I hesitate, "it may not be that important. In fact, now that I think of it, it isn't important at all. It isn't even interesting."
"Then why did you say it?" my daughter wants to know.
"To tantalize you," I kid.
"What in hell does that mean?" my boy asks.
"Do you have something?" my wife asks.
"Oh, maybe yes," I tease her jovially, "and maybe no."
"To tease us," my daughter exclaims to my boy with mockery and distaste.
(My daughter makes me feel foolish again. And again I have that powerful, momentary, spiteful impulse to injure her, to wound her deeply with a cutting retort, to reach out over the dining room table and smack her hard on the side of the face or neck, to kick her viciously under the table in her ankle or shin. I can do nothing, though, but ignore her and try to maintain my facade of paternal good humor.) "Then why don't you tell us?" my wife inquires. "Especially if it's good."
"I will," I say. "All I wanted to say," I announce, and my spirit turns manifestly arch and tantalizing again as I pause to butter a piece of bread and take a bite, "is that I think I may have to start playing golf again."
There is a thoughtful, puzzled, almost rebellious silence now as each of them tries to figure out before the others what it is I am waggishly withholding from them and presently intend to disclose.
"Golf?" asks my nine-year-old boy, who is still not certain what kind of game golf is, whether it is a good game or a bad one.
"Why golf?" asks my wife with surprise. (She knows I hate the game.)
"Golf," I repeat.
"You don't even like golf."
"I hate golf. But it may have to be golf."
"Why?"
"I bet he's getting a better job!" my daughter guesses. (In many ways, she is the smartest and most devious of all of us.) "Are you?" asks my wife.
"Maybe."
"What kind of job?" My wife's reaction is suspicious, almost morose. I know she has assumed secretly for several years that I have been longing for a different job that would take me away from home more often.
"Selling."
"Selling what?" asks my boy.
"Selling selling."
For an instant, my boy is confused, almost stunned by the riddle of my reply. Then he understands it was meant as a joke, and he bursts into laughter. His eyes sparkle, and his face lights up joyously. (Everybody likes my boy.) "Do you mean it?" probes my wife, studying me. She is still unsure whether to be pleased or not.
"I think so."
"Will you have to travel more than you have to travel now?"
"No. Probably less."
"Will you make more money?" my daughter asks.
"Yes. Maybe a lot more."
"Will we be rich?"
"Will we ever be rich?"
"I don't want you to travel more," my boy complains.
"I'm not going to travel more," I repeat for him, with a trace of annoyance. "I'm going to travel less." (I begin to regret that I brought it up at all. The questions are coming too swiftly; I can feel my self-satisfaction ebbing away, and an army of irritations mobilizing too rapidly for me to keep track of and control. I am already replying to them with my slight stammer.) "Are you going to start talking to yourself again?" my boy cannot resist baiting me mischievously.
"I wasn't talking to myself," I declare firmly.
"Yes, you were," my daughter murmurs.
"Like last year?" my boy persists.
"I was not talking to myself," I repeat loudly. "I was practicing a speech."
"You were practicing it to yourself," my boy points out.
"Will they let you make a speech this year?" my daughter asks. "At the company convention?"
"Oh, yes," I respond with a smile.
"A long speech?"
"Oh, yes, indeed. I imagine they might let me make a speech as long as I want to at the company convention this year."
"Will you be working for Andy Kagle?" my wife asks.
The question brings me to a halt.
"A little something like that," I stammer evasively. (The fun goes out of my family guessing game, and now I am sorry that I started it.) I laugh nervously. "It isn't definite yet. And it's all a pretty long way off. Maybe I shouldn't even have mentioned it."
"I'm glad you'll be working for Andy Kagle," my wife asserts. "I don't like Green."
"I didn't say I'd be working for Kagle."
"I don't trust Green."
"Don't you listen?"
"Why are you snapping at me?"
"I don't want you to be a salesman," my daughter exclaims with unexpected emotion, almost in tears. "I don't want you to have to go around to other people's fathers and beg them to buy things from you."
"I'm not going to be a salesman," I protest impatiently. "Look, what's everybody talking about it so much for? I haven't got it yet. And I'm not even sure I'm going to take it."
"You don't have to shout at her," my wife says.
"I'm not shouting."
"Yes, you are," she says. "Don't you hear yourself?"
"I'm sorry I shouted."
"You don't have to snap at everybody, either."
"And I'm sorry I snapped."
My wife is right, this time. Without my realizing it, I have moved from optimistic conceit into a bad temper; and without my being conscious of it, my voice has risen with anger, and I have been shouting at them again. We are all silent at the table now. The children sit with their eyes lowered. They seem too fearful even to fidget. I am guilty. My forehead hurts me (with tension. Another headache is threatening). I am numb with shame. I feel so helpless and uncertain. I wish one of them would say something that would give me a clue, that would point the way I must follow toward an easy apology. (I feel lost.) But no one will speak.
I pounce upon an energetic idea. I whirl upon my son without warning, shoot my index finger out at him, and demand: "Are you mad or glad?"
"Glad," he cries with laughter and delight, when he recognizes I am joking again and no longer irate.
I spin around toward my daughter and shoot my index finger out at her.
"Are you mad or glad?" I demand with a grin.
"Oh, Daddy," she answers. "Whenever you make one of us unhappy, you always try to get out of it by behaving like a child."
"Oh, shit," I say quietly, stung by her rebuff.
"Must you say that in front of the children?" my wife asks.
"They say it in front of us," I retort. I turn to my daughter. "Say shit."
"Shit," she says.
"Say shit," I say to my son.
He is ready to start crying.
(I want to reach out instinctively to console and reassure him and rumple his soft, sandy hair. I am deeply fond of my boy, although I am not sure anymore how I feel about my daughter.) "I'm sorry," I tell him quickly. (I have the shameful, shocking apprehension that if I did put my hand out to comfort him, he would cringe reflexively, as though afraid I were going to strike him. I recoil from that thought in pain.) I turn to my daughter. "I'm sorry," I say to her too, earnestly. "You're right, and I'm sorry. I do act like a child." Now it is my eyes that are down. "I think I want another drink," I explain apologetically, as I stand up. "I'm not going to eat anymore. You go on, though. I'll wait in the living room. I'm sorry."
They continue eating after I leave, their voices subdued.
I do such things to them, I know, even when I don't intend to. But I cannot admit this to my wife or children. My wife would not understand. I cannot really say to my wife: "I'm sorry." She would think I was apologizing. My wife and I cannot really talk to each other about the same things anymore; but I sometimes forget this and try. We are no longer close enough for honest conversation (although we are close enough for frequent sexual intercourse). She would respond with something as vacuous and frustrating and galling as "You should be," or "You didn't have to snap at everybody," or "You don't have to shout at me that way." As though my snapping or her snapping at me (she can snap too), were any part of the problem. She would say something exactly like that; and I would be brought to a stop again, as though slapped sharply; I would be stunned; I would feel abandoned and isolated again, and I would sink back for safety again inside my dense, dark wave of opaque melancholy; I would feel lonely and I would be brought face to face again with the fact that I have nobody in this world to confide in or reach toward for help; I would miss my mother (and my father?) and my dead big brother, and I would begin daydreaming once again about some new job with a different company that would take me far away from home more often. Someday soon someone may be dropping bombs on us. I will scream: "The sky is falling! They are dropping bombs! People are on fire! The world is over! It's coming to an end!"


text:
RT by @FuckupSolutions: I appreciate a lot of the work associated with the Centre for the History of Hermetic Philosophy at the University of Amsterdam! But I occasionally find myself deeply troubled by the political implications of the rhetoric of some of the scholars and books associated with it.
I appreciate a lot of the work associated with the Centre for the History of Hermetic Philosophy at the University of Amsterdam! But I occasionally find myself deeply troubled by the political implications of the rhetoric of some of the scholars and books associated with it.
Tag : Fuckup Solutions
http://RAWIllumination.net: New 'Sex, Drugs & Magick' book group http://www.rawillumination.net/2022/03/new-sex-drugs-magick-book-group.html?spref=tw
RT by @FuckupSolutions: Describing the discovery of esotericism's importance to the history of philosophy as becoming "red-pilled" or critiquing postmodern deconstruction or the critical theory of the Frankfurt School while identifying both as Marxist or Jewish is close to the rhetoric of the far right.


In Miami Beach, grassroots activists have put together a powerful campaign for roads that suit bikers and walkers, along with cars.
I took a tour of Miami Beach this morning. No, not in person (though I wish), but via the wonders of Google Earth. And I didn't see South Beach, the grand hotels, or the ocean, for that matter. So what was the point?
I wanted to see a stretch of road on the backside of the community – away from the Atlantic – that is being reconstructed by the Florida Department of Transportation. It's a 1.3-mile stretch of Florida Route 907, known locally as Alton Road. My first set of impressions varied from it's nondescript, to it's chaotic, to it's every road in America, to "are you kidding me, it's sunshine and palm trees, where's the beef?"
But, as I looked closer, I noticed the stranded pedestrians. They wouldn't be in the middle of the roadway if they were better accommodated, and I even felt frightened for one or two of them. This is not an easy road to cross conveniently. And, to tell the truth, it doesn't even look that pleasant to drive on. Isn't the reconstruction – required mostly for flood control – an opportunity to make it work better for everyone with a "complete streets" approach?
That's exactly what a grassroots group called the Alton Road Reconstruction Coalition thinks. I love the graphic below, which sets out the possibilities and the coalition's position about as clearly and sensibly as I've seen. What they are proposing wouldn't cost that much more, if anything, and it would make both the road safer and that part of the community more pleasant to be in. There are all sorts of wins here, and no real losses that I can see. It's a terrific example of how to do local advocacy, in my opinion.
This is at least partially about flood control. Why not add some green infrastructure in the form of pervious pavers in the sidewalks and crosswalks, and with sophisticated landscaping specifically designed to absorb rainwater? It makes sense to work on complete streets and green streets at the same time. By the way, some of this may be implicit in the proposal; if so, I would highlight it so the DOT has to respond.
The illustration does show pavers in the bike lanes. That's the wrong place for them. Bumpy pavement is okay for pedestrians but horrible for cyclists, and wet pavers are especially slippery for bicycle tires. Keep the bike lanes smooth.
I also would not encourage runners and cyclists to use the same space, particularly a two-way space, as seems to be the proposal here. That diminishes the experience for both and is an accident waiting to happen, especially since so many runners wear headphones while they are out and can't hear warnings.
Those are minor tweaks, though. On the whole, this is a great idea and very well presented. Let's hope the coalition gets the results they and the community deserve. Thanks to Wanda Mouzon for bringing this issue to her friends, including me.


Discussion in 'Adapted Lenses' started by robperks, Jan 12, 2010.
I tried looking this up, and either it is so obvious I was missing it, or I was searching with the wrong key words.
In particular I use a GF1. When I use adapted lenses is there a rule of thumb to determine the 35mm equiv. focal length? I know the standard lenses you multiply the focal lengthn by 2. What about when I use a standard 4/3 or 35mm lenses with an adapter?
Thanks for your help in my pursuit of lens knowledge.
Same exact thing. Whether you use a native :43: lens or any other 4/3 or adapted lens, the focal length written on the lens is the actual lens focal length, and if you want to get an idea of which focal length would give you the same angle of view in 35mm frame terms, multiply by two.
One good thing about having a site/forum/commuinity of :43: users is that we don't need to think in 35mm frame equivalents at all! In fact, we should be translating other formats to :43: equivalents .
I look forward to the day when someone posts here something like "I was using my Canon 5D III and 85L (42.5mm equivalent AOV) and..." :smile:.
Eventually I am sure I'll learn to speak in Micro, but until then here's a question: if one is using an older regular lens of say 50mm on one of these new 4/3 cameras with an adapter what does that do? I thought I understood it but now am getting a bit confused.
Note that all of the above are true whether you use an OM lens via adapter, regular 4/3 lens via adapter, native :43: lens, or medium format lens via adapter. Any 50mm f/1.4 lens used in any fashion on a :43: body will give you the same framing and DOF as a 100mm f/2.8 lens on a 35mm frame (135 format) body, and the speed of the lens is based only on the actual f-number without any calculation factor.
Not a problem. I remember asking the same question last year!


The U.S. National Highway Traffic Safety Administration has closed the investigation into the Tesla Motor's Model S electric car determining that no 'defect trend' has been identified.
The investigation launched following three Tesla Model S fires in a relatively short time frame.
This announcement follows on from one made by the Kraftfahrt-Bundesamt — the German Federal Motor Transport Authority — in December 2013 who carried out a full safety analysis of the Tesla Model S following three incidents and determined there was no safety issue.
ODI believes impacts with road debris are normal and foreseeable. In this case, Tesla's revision of vehicle ride height and addition of increased underbody protection should reduce both the frequency of underbody strikes and the resultant fire risk. A defect trend has not been identified. Accordingly, the investigation is closed.
Tesla today announced that is is improving the underbody protection of the Model S, using a triple-layer Aluminium-Titanium-Aluminium battery shield on all new cars. This is upgrade will also be made available to all current Model S drivers at their next service or sooner if they wish.
In response to this news, Tesla's shares on the Nasdaq have gone up.
What is your view of the whole 'Tesla fire' story? Has this been handled correctly by all those involved? Let us know in the comments.


text:
Center for Teaching Excellence focuses on faculty
Daniel Green|September 10, 2013
The Center for Teaching Excellence officially opened in the Cerritos College Library on Thursday with a ceremonial ribbon cutting.
The center coordinator Dr. David Betancourt said, "The mission of the center is to provide professional development for our faculty, and also to provide a one stop resource center so they can come in and ask questions about anything that's going on (around) campus."
According to Amparo Atherton, one of the center's educational technology trainers, the center holds different workshops and trains faculty and staff in new programs that are used in the classroom.
"I usually train faculty and staff on any instructional and institutional programs. We teach how to use the web email, Talon Net, PowerPoint, Word, Excel (and) anything they need for the class."
The center was originally thought up by Bryan Reece, former dean of the Student Success Center.
Reece said, "We had a place called the Innovation Center, which did a lot of training on technology and wanted to generally expand the center and rebrand it to create a place that offered more than just technology training."
Reece designed the center with Anthony Fortner, a professor from the Woodworking Manufacturing department.
Fortner explained that students were brought in from the department's "capstone class" to complete the center.
"(The class is) called Production Design Team," said Fortner. "They come in and their class is to make these projects."
The class project was completed over two semesters with each class putting 144 hours into the room.
One of the classes built the room dividers near the entrance to the room while the other class built the rolling doors in the back of the room.
During the ceremony, students and faculty from the Woodworking Department were given a plaque for their hard work, while a second plaque was hung on one of the office walls.
"We thought it was a really good opportunity to help create a situation where students can apply the knowledge they're learning in classes," Betancourt said.
Robert Lemen, who graduated from Cerritos with a certificate in cabinet making, was one of the students who helped in the building of the center.
Lemen wasn't expecting to be acknowledged during the ceremony or be given the plaque.
"It was nice," Lemen said. "I was just told to come for the ribbon cutting ceremony."
The office also has space dedicated to Cerritos's Outstanding Faculty on the walls.
As visitors walk in, they can see pictures of the recipients from this year's Outstanding Faculty Awards, while the back wall honors the Most Outstanding Faculty Award winners from the previous years.
"The ultimate goal of course is to help the faculty in the areas they feel they need help in and provide the training they need so we can help increase student success," Betancourt said.
bryan reece
Daniel Green, Managing Editor
Daniel Green is a third year member of Talon Marks and the current Managing Editor. He started as the Associate News Editor and later became News Editor.
He was born back east in Waterbury, Connecticut and moved to California as a baby. Even though he wasn't born here he considers California his home. He lived in Vermont during his teenage years learning snow is overrated and that California's one season is superior to the four seasons the rest of the country shares.
In his off time he enjoys exercising, exploring new places, being with friends and reading. Daniel believes dogs are the best pets but cat are acceptable. He likes movies and comics and will argue about Spider-man with anyone.
Daniel also looks forward to the day he will finally vanquish his foe Carlos Holguin from the face of the Earth.
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Cerritos College recognized for Latino representation
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This prado parking challenge drive is an ultimate driving and parking game with multiple luxury cars, prado, jeep and different automobile car effectively on respective stations and terminal point. In this prado car master parking practice game, you will learn how to move sensibly from one station to other for careful park your parking car on specific parking spot . This crazy prado offroad drive game play is a creative and inspiring practice for both kids and adults. You have to start the ride with desired prado car and continue journey towards destination. Your physical and mental attention will make you able to understand how do you drive prado parking 3d how to steer up the wheels professionally to become a real master parking driver of this challenging game. Stunning and remarkable graphics of this modern prado park free game and realistic environment will develop your attention towards the game play of this prado parking 3d you can complete the stages effectively. You have to follow the instructions and road signals while driving prado parking 3d game and take care of the obstacles and road barriers to save the automobile car from accidents.
how to drive prado parking 3d ?
There are many interesting and creative stages of this drive super park prado simulation game in which you have to learn the tactics and strategies how to park the different types of car successfully on parking mania. First of all, you have to start the engine and fasten your seat belt. Different prado car and jeep selection mode will entertain you in your prado parking 3d driving. So, you have to start the ride and continue to travel towards parking point. Multi camera angles and views will help you in your driving so that you may be able to learn professionally with different parking cars. Your continuous struggle and motivational effort will be helpful in careful parking. So, understand the driving capabilities in this championship rival race and prove yourself professional prado parker. In the last stages, challenges will be exciting and you have to move in required time limit. Your continuity in driving and parking will be judged by different hurdles that will come on your way. So don't be afraid from troubles and make yourself all-rounder driver and parking master of different luxury auto cars. In this mountain off road prado adventure parking, your goal is to present your services for sensational driving and parking vehicles like cars, prado, land cruiser and jeep. Multi driving vehicle practice will creative an incredible feeling in the players.
Enjoy this prado vehicle driver park contest and struggle hard to park at parking plaza effectively. Smooth control and compatible graphical interface will entertain you in your vehicle drive.


Us Post Office, post office, listed under "Post Offices" category, is located at 18 E Main St Breedsville MI, 49027 and can be reached by 2694277762 phone number. Us Post Office has currently 0 reviews.
Browse all Post Offices in Breedsville MI. Discover census data for Breedsville, MI.


Our application window for the upcoming academic year is open from 1 February to 15 March each year.
Your application and supporting documentation will only be accepted online! Please do not mail any paper to us; it will not be considered.
The current application link is posted each year on our Facebook page. Follow us now to get the latest information.


text:
Hobart NewsChild Abuse Survivor Awarded Over $5 Million In Lawsuit Against Abuser
Child Abuse Survivor Awarded Over $5 Million In Lawsuit Against Abuser
A breakthrough for child abuse survivors
A child abuse survivor has just been awarded a record setting settlement by the Tasmanian courts after taking his abuser to trial.
The man was awarded over $5 million in the settlement after suing his abuser and convicted paedophile John Wayne Millwood.
The man told the court he was abused by Millwood for a period of around six years during the 1980's.
Millwood was trialled for child sexual abuse back in 2016, pleading guilty to a number of child sex offences.
The judge handed down four years behind bars but Millwood was eligible for parole in 2018 after only two years in prison.
The man, who we legally cannot name, said in a statement that he had decided to take legal action against Millwood due to the convicted paedophile's "lack of remorse and aggravating conduct".
He also said the civil suit would hold Millwood accountable for his "crimes and disgraceful behaviour since" and that the mammoth payout ""sets a new benchmark for compensation of sexual abuse survivors".
This judgement tears through decades of Millwood's lies, persecution, and underhand dealings intended to discredit and intimidate me into silence," he said.
"But as he bullied me both before and during the legal process, as he spread offensive slurs and mired himself in deceit, the more clear-eyed I became: I saw this as a moral and ethical battle, not just a legal one."
The man went on to defend child sex abuse survivors everywhere, condemning those who victim blame and unfair treatment by the legal system.
"No survivor of child sex abuse should ever be subjected to victim-blaming, gaslighting, harassment, misuse of defamation laws, surveillance by private detectives intended to intimidate, and arguments that children can consent to sexual abuse."
The survivor also went on to describe the permanent impact child sex abuse can have on a person's life.
"It recognises that this impact is felt in every facet of life, directly causes physical and psychological injury, and has negative long-term economic consequences," he said.
"I am very proud of what my legal team has achieved. This is a victory for all child abuse survivors."
John Wayne Millwood is a 75-year-old man who managed a pathology practice in Launceston.
Millwood would use the guise of medical examinations as a cover to abuse his victims despite not being a real medical practitioner.
During the civil proceedings, Millwood attempted to claim that the 10-year-old he assaulted consented to the sexual abuse.
Chief Justice Alan Blow said when he handed down his ruling that the survivor was clearly suffering from PTSD as well as other mental disorders including major depressive disorder as a direct result of the sexual abuse he suffered at the hands of Millwood.
The judge ordered Millwood to pay the victim $5,313,500.
John Wayne Millwood


You may be aware that my awesome wife was a finalist in RWA's Golden Heart competition. So it gives me great joy to announce that she was the winner in her category!!
Thought I'd add a link to the speech my sister helped me write. It got me a couple of requests for my manuscript, so bravo Andy!
Way to go!!! Very excited for you, Lorenda!!
Way to go Lorenda! The only thing I can think of that is more impressive then this excellent writing is that you managed to do so well that Jason posted on his blog!
It's a really good picture also!
Ha - John, I mentioned your comment to Jason in an attempt to nudge him into posting more often.
Thanks for the congrats and I'm really looking forward to returning the favor on Nov 3rd!


Tour New York City with the most fashionable pigeon - clad in Chanel on the Upper East Side, Delpozo in Gramercy and of course converse on the Lower East Side. This deck contains 15 illustrious watercolor images. It makes for the perfect hostess gift or item to keep in your purse for the day in the park!


Kidney Dis (Basel). 2016 Apr;2(1):20-7. doi: 10.1159/000441913. Epub 2015 Dec 5.
Recent Progress in Stem Cell Therapy for Diabetic Nephropathy.
Division of Nephrology, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, SAR, China.
Diabetic nephropathy (DN) represents the leading cause of end-stage renal disease. Current therapeutic strategies for DN are very limited, and none of them can stop end-stage renal disease progression. Stem cell-based therapy showed encouraging outcomes in kidney disease, including experimental DN.
Both podocytes and proximal tubular epithelial cells play key roles in the pathogenesis of DN and, accordingly, could be regarded as treatment targets. Multiple kinds of stem cells contribute to the regeneration of the injured kidney, including embryonic stem cells (ESCs), mesenchymal stem cells, and induced pluripotent stem cells (iPSCs). Stem cells exert reparatory effects mainly by homing to injured sites, directing differentiation, paracrine action, and immunoregulation. However, poor survival after transplantation under diabetic conditions and unsatisfactory animal models of advanced DN are major obstacles for achieving an efficacious therapeutic effect from stem cell transplantation. Recently, remarkable progress has been made both in the direct differentiation of human ESCs and iPSCs into renal cells and in the generation of tissue- and patient-specific iPSCs, offering a powerful tool to investigate DN mechanisms and to identify the ideal candidate cell for future clinical application.
This review provides updated information on recent progress and limitations of stem cell-based therapy for DN.


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England and Wales High Court (Queen's Bench Division) Decisions
You are here: BAILII >> Databases >> England and Wales High Court (Queen's Bench Division) Decisions >> CTB v News Group Newspapers Ltd & Anor [2011] EWHC 1334 (QB) (23 May 2011)
URL: http://www.bailii.org/ew/cases/EWHC/QB/2011/1334.html
Cite as: [2011] EWHC 1334 (QB)
Neutral Citation Number: [2011] EWHC 1334 (QB)
Case No: HQ11X01432
IN THE HIGH COURT OF JUSTICE
THE HONOURABLE MR JUSTICE TUGENDHAT
(1) NEWS GROUP NEWSPAPERS LIMITED
(2) IMOGEN THOMAS
Hugh Tomlinson QC and Sara Mansoori (instructed by Schillings) for the Claimant
Richard Spearman QC (instructed by Farrer & Co) for the First Defendant
David Price QC (of David Price Solicitors & Advocates) for the Second Defendant
Hearing date: 23 May 2011
Mr Justice Tugendhat :
At about 1430 this afternoon Eady refused NGN 's application to remove the anonymity he had granted to the claimant on 20 April. He said at para 23 ([2011] EWHC 1326 (QB)) that "It is important always to remember that the modern law of privacy is not concerned solely with secrets: it is also concerned importantly with intrusion". Intrusion in this sense includes harassment.
Very shortly afterwards a name was mentioned by Mr Hemming MP in the House of Commons in the course of a question which was interrupted by the Speaker. On that basis NGN asked me to hear a further application shortly after 5pm for the anonymity of the claimant to be removed. As the public now know, anyone who wanted to find out the name of the claimant could have learnt it many days ago. The reason is that it is has been repeated thousands of times on the internet. NGN now want to join in.
It is obvious that if the purpose of this injunction were to preserve a secret, it would have failed in its purpose. But in so far as its purpose is to prevent intrusion or harassment, it has not failed. The fact that tens of thousands of people have named the claimant on the internet confirms that the claimant and his family need protection from intrusion into their private and family life. The fact that a question has been asked in Parliament seems to me to increase, and not to diminish the strength of his case that he and his family need that protection. The order has not protected the claimant and his family from taunting on the internet. It is still effective to protect them from taunting and other intrusion and harassment in the print media.


Lovebites, White Bear, London. Review by Barbara Lewis.
The London theatre scene could easily manage without another musical about love. But the UK premiere of this Australian-born celebration of the greatest of emotions by Peter Rutherford and James Millar is nevertheless as welcome, even as necessary, as every generation's attempts to redefine love for themselves.
Twang!! Union Theatre. Review by Barbara Lewis.
As far as 1960s audiences were concerned, Lionel Bart – famed for the musical Oliver – had lost his "twang" when he came up with the box office flop "Twang!!", with two exclamation marks. But if the audiences of the swinging sixties weren't ready, the 21st century theatre-goers of London's Union Theatre – renowned for alternative, low-budget, high-entertainment musicals – are.
The Cherry Orchard, Union Theatre, London. Review by Barbara Lewis.
With a new version of The Cherry Orchard transposed to the time of the 1917 Russian revolution, director Phil Wilmott's aim was to reflect "our current edgy relationship with Russia," he tells us in his notes.
Lock and Key, Vault Festival, London. Review by Barbara Lewis.
Women bosses who bully their ambitious young rivals are one aspect of female careerism that is under-explored. Bella Barlow and A.C. Smith at least start to redress the balance with a miniature musical played out underneath Waterloo's railway arches as part of London's vibrant Vault festival.
When Christopher Marlowe wrote Doctor Faustus at the end of the 16th century, he was already drawing on German accounts of a medieval legend with eternal and universal reach. Two centuries later, the epic struggle of good and evil was translated back into German in Goethe's towering tragedy.


One of our fashion designers – Katrina Kaubi – shares pictures of the products used as base material for her collection "Point of View".
And have a look at the new pieces made from these pre-consumer products.
The raw materials for Katrina Kaubi collection are men's shirts and trousers from Beximco, which is one of the biggest fabric and garment producing companies in Bangladesh. It was interesting for me to see the real things from which new designs are made – I hope it will interest you, too.
I am also excited to announce that there is a new accessories designer up in the TTT webshop called Sag+Sal. They make bags from used printing blankets by offset printing technique.
Sag+Sal designers are Rupert Jensch and Andjelko Artic. Both studied printing technology, and Rupert has additionally studied product design.
Each bag is unique and extremely resilient – the material is waterproof and can be easily cleaned. The design has a clear shape – it is simple, solid and functional, reduced to the essential. Each bag is handmade in Berlin-Neukölln.
Offset printing is a technique where the inked image is transferred from a plate to a rubber blanket (the printing blanket) and then to the printing surface. During the different printing processes, the blankets are exposed to varying colors, causing the individual color nuances of the bags.


In a food processor, puree frozen strawberries, then set aside in a large bowl. Without cleaning out the processor, puree the watermelon and add that to the bowl with the strawberries. Add lemon juice. Stir until all mixed up. Cover with plastic wrap and put in the fridge to chill.
Pour water, sugar, and mint into a small saucepan and set over low heat. The date sugar takes longer to break down than normal sugar - one of the good and bad things about it. It took me about 20 minutes before it finally melted completely, which worked out quite nicely as the mint had really saturated the sugar with its oils by then and smelled heavenly!
Set to medium heat and let boil for 1 minute. Then pour through a wire-mesh sieve into a heat-safe bowl and mash with the round side of a spoon until nothing else will go through. Save the remaining non-liquid date/mint mixture for later. Cover with plastic wrap and put in the fridge. Set a timer for ~1 hour. It can stay in longer if you want. I don't think an hour or two will make much difference at this stage.
When you come back after at least an hour, pour the liquid sugar/mint mixture into the strawberry/watermelon mush and stir until well combined.
Pour this into a metal pan (about 8x8 should do), cover with plastic wrap, and place in the freezer for 4-8 hours. Scoop all the frozen fruit and sugar out, run it through your food processor until it's chopped up, and pour it back in the metal pan again. Freeze again. In 2-4 hours, it should be crisp, cold, and delicious. Although you may need to let it thaw a bit before serving.
This will be saved for summer!
I really, REALLY need to get myself a food processor already.
Gotta get on that if I want to start making your yummy recipes!
Is Momo what you call your mother? And if so, why?
I made this. Except I used fresh berries and mint, and substituted splenda as a sweetener. DELICIOUS.
Did that answer the question? Yes. "Momo" is a nickname that stuck after an amusing text-induced misspelled signature.


TPMs (Total Process Management System, trade name owned by Maeda Corporation) is Maeda's solution to transparency and accountability. By combining state-of-the-art ICT (information and communications technology), TPMs makes it possible to share and visualize user needs and business processes so as to visualize the value of buildings. At the planning and design stage, for example, tasks such as exterior design, efficient layout design of factory equipment, and logistic planning checks and simulation can be done by using the MAEDA 3D-CAD System. At the construction stage, a rational construction plan is drawn up and quality information is made transparent by using such tools as Web cameras. After completion of the building, information thus collected is transferred to Maeda's own building information and history management system for efficient management.
Maeda adopted the heavy lift construction method to construct the side spans of the Stonecutters Bridge, one of the world's largest cable-stayed bridges, in Hong Kong. In this method, a number of segments were first welded together on the ground to form two segment decks, and these decks were simultaneously lifted into place. Compared with the method of joining the segments while on supports, the heavy lift construction method offers significant economic and safety benefits by greatly reducing the amount of steel needed for temporary structures and decreasing dangerous work at height.
Maeda's urban civil engineering projects include a number of shield-driven tunnels in Japan and other countries including Hong Kong and Taiwan. For the construction of an underground line in Taipei, Taiwan, Maeda undertook the construction of six tunnels and three stations as a non-joint-venture project. We are carrying out, safely and economically, the challenging construction work directly under existing subway and bullet train lines crisscrossing the busy streets in the city.


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Q: Hide label of inputfield in visualforce page using jQuery I can get the visualforce page to hide the input field but I'm unsure how to hide the associated label.  How can I hide the label as well?
                <apex:inputField value="{!Fiscal_Year__c.name}" onclick="test();"/>
                <apex:pageBlockSectionItem id="isCurrentQ">
                    <apex:outputLabel value="is Current" for="isCurrent"/>
                    <apex:inputField value="{!Fiscal_Year__c.Is_Current__c}" id="isCurrent"/>
                </apex:pageBlockSectionItem>

                </apex:pageBlockSection>
        </apex:pageblock>
    </apex:form>

<apex:includeScript value="{! $Resource.jQuery }"/>
<script type="text/javascript">
    function test(){
        $('[id$="isCurrentQ"]').hide();
     }
</script>

A: Once sure fire way to remove the labels is to put your apex:inputField inside a  tag
Like so:
<apex:pageBlockSection id="yearInfoPageBlock" title="Fiscal Year Information">

    <apex:pageBlockSectionItem>
        <apex:inputField value="{!Fiscal_Year__c.name}" onclick="test();"/>
    </apex:pageBlockSectionItem>
    <apex:pageBlockSectionItem>
        <apex:inputField value="{!Fiscal_Year__c.Is_Current__c}" id="isCurrent"/>
    </apex:pageBlockSectionItem>

</apex:pageBlockSection>

Give it a try!
Oh right.. re-reading your question, that might not be what you are trying to achieve.
If you are trying to "hide" the whole input thing with a bit of Javascript. I would recomment wrapping them in output panels, and then calling "hide" on those.
<apex:pageBlockSection id="yearInfoPageBlock" title="Fiscal Year Information">

    <apex:inputField value="{!Fiscal_Year__c.name}" onclick="test();"/>

    <apex:outputPanel Id="isCurrent">
        <apex:inputField value="{!Fiscal_Year__c.Is_Current__c}" id="isCurrent"/>
    </apex:outputPanel>

</apex:pageBlockSection>

<apex:includeScript value="{! $Resource.jQuery }"/>
    <script type="text/javascript">
        function test(){
            $('[id$="isCurrent"]').hide();

            $('[id$="isCurrent"]').hide();
        }
    </script>

Also: are you familiar with the "rendered" tag on all elements, which you can use to control their display (both label and input in the case of form elements) from your Apex controller/other formulaic values?

A: Figured it out:  Set a dataStyleClass on the apex:pageBlockSectionItem.
here is the VF
<apex:pageBlock>
    <apex:pageBlockSection>
        <apex:pageBlockSectionItem dataStyleClass="page-block-section-item">
            <apex:outputLabel value="My nice field" for="myField"/>
            <apex:inputCheckbox value="{!dummy}" id="myField" styleClass="myField"/>
        </apex:pageBlockSectionItem>
    </apex:pageBlockSection>
</apex:pageBlock>

You can hide the page block section item just by selecting the  tag by class then using the parent method.
$('td.page-block-section-item').parent().hide();

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