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Dec. 23, 2009— -- A lawyer for the Michael Jackson family said that the now public but heavily redacted FBI file on the late pop superstar shows that "there's not one scrap of evidence" that Michael Jackson ever harmed a child.
"In all these pages, hundreds of pages, many many hours of investigations ... there's not one scrap of evidence that Michael Jackson ever ... did anything wrong, committed any crime," said Brian Oxman, who represented several members of the Jackson family. "It's almost a vindication, when you look at this. The FBI looked at all of these matters and said, 'There's nothing here.'"
Oxman said the sheer scope of the documents -- 333 pages out of the 673-page file were made public -- came as a shock to the Jackson family.
"I spoke to Joe Jackson last night. He said that this FBI file was something he never heard of," Oxman said. "We're surprised and shocked by what we found."
Click here to read the FBI file from 2004 child molestation case.
Oxman said he knew the file existed but "had no idea" the FBI had investigated Jackson's home computers in search of child pornography as the documents state.
According to one of the FBI agents involved in the Jackson investigation, the bureau was brought in at the request of local police.
"We have the international and interstate capabilities that local law enforcement and local DAs don't have," agent James Clemente told "Good Morning America."
One major revelation in the more than 300 pages of government documents was that the FBI had assisted Santa Barbara, Calif., officials in their attempt to get cooperation from a person who could have been a key witness in the 2005 child molestation case against Michael Jackson: the boy who accused the pop star of molesting him in 1993.
No criminal charges were ever filed in the 1993 case. Instead, the then 12-year-old boy refused to cooperate with officials and accepted a multi-million dollar settlement from Jackson.
The documents released Tuesday under the Freedom of Information Act show that the FBI and Santa Barbara officials met in 2004 with Jackson's 1993 accuser but were unsuccessful in getting his cooperation.
Jackson was acquitted of all charges in the 2005 case, which went to trial.
Molestation Accuser Identity Redacted
The heavily redacted FBI documents do not reveal the name of the boy that officials met with.
"Victim indicates that he has no interest in testifying against Jackson," according to the documents, "and would legally fight any attempt to do so."
Prior to the FBI's interview with the accuser, the documents show that the FBI helped Santa Barbara prosecutors with "interview strategies for a victim who alleged that Michael Jackson had abused him in 1993."
The documents also quote the boy as saying that he "believed that he had done his part," presumably referring to his initial involvement with law enforcement before agreeing to a civil settlement with Jackson that is believed to be $20 million.
Former FBI Behavioral Unit agent Ken Lanning, who consulted on the 2003 molestation case, told ABCNews.com Tuesday that this kind of coordination is common.
"Child molestation cases are the type of cases that involve multi agencies," he said. "There were potential federal violations and the FBI has jurisdiction in a couple of areas. What the FBI behavioral analysis unit does is try to work on the approach, help them understand the issues."
The documents also reveal that Santa Barbara police had concerns about a possible terrorist attack related to the 2003 arrest of Jackson, which led to a request for FBI assistance. The FBI concluded there was no threat.
The 1993 accuser's mother, June did testify at the trial 2005 and told the court that the ordeal with Jackson in 1993 fractured the boy's family and cost her the relationship she had with her son.
The accuser's father Evan killed himself last month. A onetime Beverly Hills dentist, Evan was found in his New Jersey waterfront apartment dead from a self-inflicted gunshot wound.
Sources close to the family say his suicide most likely stemmed from his longtime debilitating illness.
During the 2005 trial it was known that the FBI's behavioral and forensics units had consulted on the case, but the file released Tuesday reveals that various arms of the FBI assisted the Santa Barbara district attorney's office.
They included the crimes against children unit (CACU), innocent images national initiative against children unit, computer analysis response team (CART), the FBI lab, Los Angeles NCAVC coordinator and the Department of Justice's child exploitation and obscenity section (CEO's).
The FBI examined Jackson's motor vehicle records to see if he "transported a minor across state lines for immoral purposes." The agency went to London and Manila to investigate other accusations that Jackson had engaged in improper behavior with boys.
The agency also investigated another allegation from a woman and her husband who worked in child services in Toronto, Canada. The couple had taken the same train as Jackson from Chicago to the Grand Canyon and said Jackson had a minor boy with him whom he identified as a "cousin." The couple reported that Jackson was possessive of the boy and that they heard questionable noises. The woman was concerned enough to notify a conductor.
Before the 2005 trial, the FBI and DA also met to discuss "…the collection of sexually explicit images in magazine and books" and a VHS videotape that the FBI analyzed as part of a child pornography investigation.
Also within the documents is a lot of material pertaining to threats made by Frank Paul Jones, who was convicted in 1993 of stalking Janet Jackson and threatening to commit mass murder at a Michael Jackson concert.
Click here to read the FBI file from the extortion investigation
This was all reported at the time, but it's not clear if Jones' letters were ever released.
In one letter, dated 5/21/1992, Jones threatened to kill Michael Jackson if "I don't get my money."
Jones copied the FBI and the late mob boss John Gotti on the letter. He also threatened to kill President George H.W. Bush.
On July 16, 1992 Jones threatened in another letter to "commit mass murder" at a Michael Jackson concert, if necessary, in an attempt to kill Jackson.


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(CNN) - Rep. Peter King said fellow Republican Sen. Rand Paul owes the nation's top intelligence official an apology after saying he should resign for "lying" to a Senate committee about a controversial surveillance program.
The New York congressman also said that Paul's comparison of National Intelligence Director James Clapper to NSA leaker Edward Snowden is "absolutely disgraceful."
"For Senator Paul to compare that patriot, General Clapper, with someone like Snowden, who is a traitor, who has put American lives at risk - Senator Paul should be ashamed of himself," King said Thursday on CNN's "The Situation Room."
"It's an absolute disgrace. He disgraced his office and he owes General Clapper an apology immediately."
Paul told CNN on Wednesday that public congressional testimony by Clapper last March denying the existence of a sweeping electronic data collection program at the National Security Agency had done more to damage the credibility of the intelligence community than the leaks by Snowden that blew the whistle on the spying initiative.
Rand Paul: Intelligence director should resign
Paul, a Kentucky Republican with strong tea party-backing, and King are both considered likely GOP presidential candidates in 2016.
Clapper apologized to the Senate committee for giving members a "clearly erroneous" answer about the surveillance programs.
Intelligence leaks exposed by Snowden, a former government contractor, revealed that the NSA, indeed, had extensive, classified electronic surveillance of telephone and e-mail records.
Clapper later said he was faced with trying to answer a question about a program that at the time was still classified when explaining the discrepancy in his testimony to Congress and the information that arose from the Snowden leaks.
In a letter to Attorney General Eric Holder on Thursday, seven Republican Senators said Clapper's "willful lie under oath fuels the unhealthy cynicism and distrust that citizens feel toward their government" and compromises Congressional oversight functions.
Responding to the letter, a spokesman for Clapper underscored the previous explanation of his testimony and highlighted his long-standing reputation of honesty.
"DNI Clapper has been testifying before members of Congress for more than two decades and he enjoys a well-earned reputation as a doggedly honest and honorable public servant," said Clapper spokesman Shawn Turner.
"He apologized for the confusion caused by his response and is focused on working with the intelligence committees to increase transparency while protecting critical intelligence sources and methods."
King said these Republicans calling for Clapper's resignation are part of "the isolationist wing of the party.
A review of NSA surveillance ordered by President Barack Obama and released recommended changes to the surveillance program including greater judicial oversight and more public transparency.
Rand Paul IS a waste of skin.
Rand Paul is correct... Rep king is starting to sound like Nancy pelosi... Whacked or a puppet for a corrupt admin/senate... Or both (probably both). Scary thought who the dems have become . The middle classes' new name? Serfdom USA
I'll stand with Rand, rather than the RINO King.
Rand Paul. The apple definitely falls pretty far from the tree, in this case. I respected Ron very much. Rand, absolutely not.
King is out of touch, as usual. His take on issues is usually out in the weeds and divorced from reality. AND he's a RINO.
Gen. Clapper we're sorry we called you a liar after lying to us.
Clapper Lies and King swears to it
When a public figure lies to congress there should be penalties
the same as if I lied to congress.
...geee ... Clapper was dishonest to the Senate and got caught ... does that make him a patriot ? ... King should resign too for being such an empty suit.
I hope the GOP runs Paul in 2016; he will get squashed like a bug.
I don't particularly care for Rand, however, Rand simply stated that Clapper's lying ALSO compromised the integrity of the agency. He also was under oath.
Not to worry Paul. Benjamin Franklin was a traitor to England for exposing them for what they were up to. King has no chance among independent voters. If Republicans want to go it alone again, go ahead. They'll be scratching their heads for another 4 years.
The only traitors are those who sit in power and protect each other.
I agree with Shawn . . . Rand will get my vote if he runs. We certainly need a change in D.C. and Hilary certainly is NOT the answer. ABC anybody but Clinton.
Rep. King epitomizes hypocrisy. I agree 100% with PM Ohio and RonFromNM. He is the one who should resign. Like 99.99% of politicians don't lie? Gimme a freakin' break! Snowden is an American hero, PERIOD!
Rand Paul is one ot the few in Congress with guts and intellect. King ,as well as others have been there way too long. King needs to go, And take most of the rest who think they own Congress. They have forgotten they work for the people. Unfortunately they think we work for them.
"...working with the intelligence committees to increase transparency while protecting critical intelligence sources and methods." In other words, he'll lie better next time.

subset: commoncrawl


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I recently found an old diary from my teenage years, where I blithely wrote about my future, figuring I would get married at around 28 and have children soon after. By the time I met the man of my dreams, however, I was 34 and had almost given up on the idea of a family; I'd convinced myself I could live a perfectly fulfilled life without children. But being with Evan soon convinced me otherwise — I knew we were meant to raise a family together.
Again, life had other plans. I was 36 when we married, and instead of getting pregnant, I got breast cancer. Once I came safely (more or less) out on the other side of the treatment merry-go-round, I was nearing 40 and had little hope of becoming pregnant.
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So we chose adoption. We went through three "failed matches" — adoptions that fell through at the last minute — and there were days when I literally curled up on the floor, threw things at the wall, and sobbed in despair, believing we'd never have a baby.
But then a beautiful young woman named Kim chose us to be the parents of her daughter. I'll never forget the warm night when we watched Annika Rose take her first breath. As Evan and I looked into her wide, alert blue eyes, we knew why we went through everything we did. And for Annika, we'd do it all again.
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There are about 135,000 adoptions in the United States every year, and each one is unique. My friend Michele chose adoption because she felt drawn to build her family that way; she and her husband now have a biological daughter, plus a beautiful son from Ethiopia. My friend Viki and her husband had two pregnancies end tragically in their quest for a third child. Then they adopted a son, now in elementary school, who is still close with his birth family. Our neighbor adopted from the former Soviet Union in her 40s, after coming to realize that not having a husband didn't mean she couldn't be a mother.
No one I know who has adopted would say that the journey came without heartache. And we all recognize that a lot of heartache is also experienced by the birth parents, and understand that just because they weren't able to raise their kids doesn't mean that they don't love them deeply. But even though growing our family has been a lot harder than I ever imagined when I made that simple life plan back in high school, I wouldn't change a single step on our path to parenthood — because each one led us to our daughter.
Why do I want to adopt?
There's one reason above all others to make this choice: You should do it, say experts, because you want to be a parent and love a child. If a personal concern for less fortunate kids is part of your motivation, then that may affect how you adopt — but it shouldn't be your driving impulse; adoption is about creating a family, not "saving" a child.
Can I handle an open adoption?
Twenty years ago, virtually all adoptions were "closed" — meaning that records were sealed and birth parents never had contact with the new parents, or with their children, after the adoption. Some professionals thought this preserved privacy for birth parents, secured the role of adoptive parents, and ensured that adopted kids didn't feel "different." In fact, many states still deny adult adoptees access to their original birth certificates.
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Today, most domestic adoptions are "open" or "semi-open," meaning there's some contact between the adoptive family and birth parents. A growing number of experts now view openness as healthy for several reasons: It reassures birth parents that their child is doing well; it gives adoptive parents information about their child's history as well as a sense of security (studies have shown that adoptive parents in closed arrangements are more anxious about losing their child than those in open ones); and it allows adopted children and adults to have longed-for connections to their biological family and roots.
What kind of child am I ready to adopt?
This question can be a very uncomfortable one. Does seeking a child of your own race mean you're a racist - or does it mean acknowledging that it can be tough for a child to look different from her parents? What would adopting a drug-exposed child or a child with disabilities mean to your family?
Be honest with yourself and do research before making your decision. If you're considering the adoption of a child with special needs, or a transracial adoption, explore your resources. Do you have access to services that a child with disabilities requires? Do you live in a multicultural neighborhood, or would you move to one? If there are multiracial families in your community, especially those formed by adoption, consider asking them for their perspective.
"People worry that their children might be confused by an open relationship with the birth parents," says Brenda Romanchik, director of Open Adoption Insight, a nonprofit organization in Michigan that provides resources and support for people involved in all sides of the adoption equation. "But if you're not confused about the roles and relationships, then your children won't be either."
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Have I come to terms with my infertility?
"Infertility is a grief that's revisited many times throughout life - for instance, when you see the birth family and know your child looks like them, not you," says Romanchik. "Can you handle that? You have to be able to accept that adoption isn't the same as having a child born to you." To get to that place, first understand that feeling ongoing pangs of loss over infertility doesn't mean you love your adopted child any less. Find support among parents who have adopted or are trying to - many have been down this path.
Can I handle being "different" from other families?
From "Did I grow in your tummy?" to "Who do I look like, Mom?" there will always be sticky issues that set you apart from other families. How will you discuss them with your children? "Very important - do you have a thick skin?" asks Romanchik. "People will say stupid things to you sometimes, like, 'Aren't you afraid the real mother will take her away?' Do you know how to deal with them in a way that's healthy for your child?" Good adoption agencies offer classes, programs, and counseling that can help you navigate these answers.
Domestic adoption
Laws vary depending on where you live — for instance, some states allow attorney-mediated adoption; others require you to use a licensed agency. Make sure that you understand the rules in your state as well as in the state where the child lives or will be born. You can look up state laws at laws.adoption.com, but attempting a completely do-it-yourself education on adoption law may leave you baffled. So seek a licensed adoption attorney through the American Academy of Adoption Attorneys (adoptionattorneys.org) for more advice.
Most domestic adoptions are at least "semi-open," meaning that at a minimum, letters, photos, and other information are exchanged periodically through an intermediary such as an agency. Adoptions that are more open involve direct contact through letters, phone calls, and e-mails. And in fully open adoptions, ongoing visits are common.
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Costs for domestic adoption run the gamut. Some agency adoptions add up to well over $30,000, while an "identified adoption" — in which the prospective adoptive parents themselves locate the birth parents through advertising and other outreach — can cost less than $10,000.
PROS: Domestic adoption gives you the greatest likelihood of bringing home a newborn, an experience many families yearn for. You are also more likely than with an international adoption to find out the birth family's medical history — and to have a more open adoption.
CONS: Your wait for a placement can be anywhere from less than a month to two years or more. Because the expectant parents usually choose the adopting parents — a situation known as a "match" — there's no way to know when you'll be selected. A survey found that 31 percent of families experience at least one failed match because the mother or father decides to parent the child; some agencies report that the rate of failed matches may be higher. It's vital to remember that they have this right, and to be prepared for the emotional upheaval of this possibility.
Foster-care adoption
More than half a million children were in foster care in 2005. Of those, 52,000 were adopted, and 115,000 were waiting to be. Many of the remaining children were awaiting possible reunification with their families. Adopting from foster care usually means working with your state's department of child and family services, but there are also private foster agencies, such as Casey Family Services (caseyfamilyservices.org), an East Coast nonprofit.
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PROS: Adopting from foster care can be much less costly than either domestic or international adoption — in some cases, free. State agencies usually don't charge fees for adoption from foster care, although some private agencies do. And all states have adoption-assistance programs designed to help parents recoup costs (such as legal fees) involved with adopting from foster care. Find out more from the fact sheet "Adoption Assistance for Children Adopted from Foster Care," available online (go to childwelfare.gov and type the publication's title in the search box).
CONS: Dealing with state foster-care bureaucracies can be frustrating, and many children in foster care have special medical or physical needs. You can learn more about foster adoption at adoptuskids.org.
International adoption
More than 20,000 children a year are adopted by U.S. families from a wide range of countries in Asia, Eastern Europe, Africa, and Latin America. The foreign adoption landscape has undergone some significant changes lately. Though China has been Americans' top choice - 6,500 Chinese children came into U.S. homes in 2006 - that number is expected to drop, thanks to stricter regulations now in place there. (For instance, a couple must be married for five years to adopt from China if either partner has previously been divorced.) By contrast, Ethiopia is seeing an increase in adoptions, thanks in part to a relatively speedy process - sometimes just six months, following approval from U.S. Citizenship and Immigration Services.
PROS: You don't have to wait for the birth parents to "pick" you - your adoption follows a standard process established by the country you're adopting from. Many people feel more comfortable adopting internationally rather than risking the heartbreak of a failed match domestically. There are many countries that U.S. citizens adopt from, so if one country's policies or requirements don't work for you, another one's might.
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CONS: The cost can be high, ranging from $7,000 to more than $30,000. A country's adoption relationship with the United States can also "close," temporarily or permanently, sometimes without much warning - as what happened with Vietnam, which closed adoptions to the United States between 2003 and 2005, and reopened in 2006.
Lydia Kirkham, 34, and her husband, Mike, 38, both legal professionals, live just outside Kansas City, MO. Their 2-year-old daughter, Addison, who loves to "play soccer," go on hikes, and feed her cat, was adopted at birth in a semi-open domestic adoption.
"Mike and I spent nearly five years trying to get pregnant - first on our own, then with a total of nine intrauterine insemination and in vitro fertilization cycles. It took a toll on me and my body, and it was so discouraging. It was the biggest relief when we decided to adopt.
"We signed up with a big national agency around Christmas of 2004. In April, we got the thrilling news that we'd been matched with an expectant mother, but a few weeks later, we found out she'd never been planning to place the baby and instead was scamming to get support money from us; she'd even registered for shower gifts. This happened the day before Mother's Day. I'd had some sad Mother's Days in the past, but that one was the worst - I've never felt so angry and frustrated.
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"We got the next call from the agency on July 19. The birth parents were a married couple in South Dakota who had two children and knew they couldn't provide for another baby, at least not the way they wanted to. We visited them three weeks before the due date, and when they gave us the baby's sonogram pictures, we knew that this was it. After being burned once before, we were cautious, but we really felt like we could trust them.
"Addison's birth mom really wanted Mike and me to be there when the baby was born, and her doctor planned to induce her on a Friday. We went the day before, and in the middle of the night, the birth father called us and said she was going into labor. Addison was born at 9:28 the next morning. Her birth mom kept saying, 'She was just waiting for you guys to get here.'
"We were all in the room together when she was born. Both Mike and the birth father cut the cord. The whole experience was just surreal. Mike and I stared at this beautiful baby with tears streaming down our faces, thinking, This is the most incredible, selfless decision these people can make, to let us be included in her birth.
"We have a semi-open adoption. Addison's birth parents called us last Christmas, and I send them pictures regularly - they usually call us right after getting the pictures, and we talk about all the new things that Addison is doing. We have a whole album for her that includes her birth parents before she was born, and we talk about who they are.
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"Someday we'll have visits. It wouldn't be right to discourage Addison from knowing these people. We've always told her that she's loved by more people than she could ever know."
Shelby Nickel, 36, and his wife, Jen, 33, are raising four sons in Williams Lake, British Columbia, Canada: Greg, 12, and Eric, 11 - biological siblings who were adopted through the Missouri foster-care system - as well as Tanner, 10, and Caden, 6. Shelby is a commodities broker, and Jen homeschools the boys.
"When I started dating my husband, I told him I wanted to adopt, as in: 'If you want to marry me, this is it!' A few months after Tanner was born, we investigated adopting through foster care both in Canada and the United States and were eventually matched with two brothers in Missouri, Greg and Eric, who were 4 and 3 at the time.
"To help get the boys ready, we made a video of ourselves showing them our home and things like the table where we'd eat - with places set for them. Then we spent a week in Missouri getting to know them. They'd been with their foster mom for three years; even though she'd prepared them well, their first year with us wasn't easy. Greg had a breakdown in a restaurant, crying that we'd stolen him. It took Eric longer to show his grief, but he was processing a lot of pain, too. We loved the idea of our kids even before we were matched with them, but loving the reality of your children - that's a process, one that's both wonderful and hard.
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"I found out I was pregnant again 18 months after the boys came home. When Caden was born, he was all of ours - the first member of our family that we all had from the very beginning.
"We've worked hard to establish relationships with the boys' birth parents. Their birth dad is in prison, and over the years, we've worked our way from letters to phone calls with him. It's hard to have kids deal with serious grown-up issues, but it also helps them to understand why they were removed from their environment and love the reality of who their birth family is, not the fantasy of who they'd like them to be.
"We want our kids to grow up with a strong sense of self and racial pride, so we switched to a church with an African-Canadian pastor and a multicultural congregation. And every year, we go to the Harambe Festival Camp, a weeklong camp for families with children of African heritage - the kids love it. Fortunately, we live in an area that's racially integrated, but sometimes there are inappropriate questions, like, 'Are they really brothers?' My answer is, 'All four of our boys are really brothers.'"
Scott and Karen Petty, both 33, live in North Carolina. They adopted their 2-year-old daughter, Gwen, from Jiangxi Province in southern China in September 2005. Karen, a stay-at-home mom, is a freelance copywriter; Scott is a marketing manager for a swimming pool company.
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"One day, Scott walked through the door and said, 'What do you think about adopting from China?' We'd been trying to get pregnant for years and endured a difficult year of infertility treatments, and we had finally started discussing adoption. Then Scott went on a business trip to China and spent the flight home sitting next to a family that was bringing home their adopted daughter. It just felt right to him, and as soon as he suggested it, it was one of those 'aha!' moments for me, too. Ten days later we signed with our agency.
"I treated the dossier of vital documents that we prepared for the adoption with such care. Turning in that paperwork to the agency was hard for me because to me, it symbolized our little girl — and it was like I didn't have her anymore. But it got us one step closer to our daughter!
"Six weeks later, a woman from the agency called with our referral. It was July 28, 2005. I fell apart — when I told her that I had to call my husband, I couldn't remember his name! She e-mailed me a picture of my daughter. In the photo, she had a doll on her lap that was almost as big as she was. Her Chinese name was Lin Ying Tong; we'd name her Gwendolyn Faye Ying. I slept with her picture that night. Our daughter. At last.
"Two months later, we were in China. Our guide at the civil affairs office told us, 'Your baby is sick, but she's okay.' We didn't know what that meant, but we were ready to deal with anything.
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"Gwen was 7 months old and weighed 8.2 pounds. She was sicker than we thought, and her highest fever was 105.8. She was having seizures and was hospitalized multiple times while we were there. The minute we got back home, we took her to the hospital, where she was diagnosed with a respiratory infection that isn't serious in most children but can be life-threatening in children who are already small and weak, like Gwen.
"Her first year home was hard. She was also developmentally delayed, not sitting up or rolling over. So we put her in physical therapy and occupational therapy; we had her work with sleep specialists and nutritional specialists. Now I look back and realize I got to experience everything with Gwen. I saw her sit up, roll over, take her first steps. If it hadn't been for those struggles, we wouldn't have had those moments.
"Today Gwen runs everywhere, loves to laugh, loves to play in the water, and she's entranced by books. She's on track with all the other kids. Some people say love can't conquer all, and maybe not, but love and a whole lot of work can get you very far, and all I have to do to know that is look at Gwen."
Four years ago, Breanna Conner gave birth to a daughter and placed her in an open adoption with John Sgro, 30, a minister in the Chicago area, and his wife, Amanda, 31. Breanna, now 22, recently graduated college and works for a family-services program in Indiana.
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"When I found out I was pregnant at 17, my family and my ex-boyfriend's family both suggested adoption, since they thought life would be difficult for me as a single mom still in school. At first I was against it. I couldn't imagine placing my daughter with people I didn't know and never seeing her again. But when I went to the doctor, I also met with a social worker who brought up the idea of open adoption. I researched it more and thought it could be a good option. Open adoption would be a way I could give my baby the best.
"I found an agency that offered the opportunity for real openness — not just letters, but calls and visits. I e-mailed couples I liked, and John and Amanda just fit. I wanted a Christian family, and he's a minister. And I'd spend hours on the computer talking to Amanda — my mom and her husband would both tell us to go to bed!
"When I was five months pregnant, we met and became even closer. I went to Amanda's baby shower and she came down to go through birthing classes with me and my mom. On September 26, Eden was born; John and Amanda chose her name. Amanda and my parents were in the room, which is what I wanted. I held Eden first, and Amanda cut the cord and gave Eden her first bottle.
"We visit all the time. When they were living closer — they moved from Indiana to Illinois when Eden was almost 2 — I'd babysit for them. Now I visit every two months or so. Eden is very possessive of me — she'll say, 'I'm talking to my Bre!' She also tells everyone how she came out of Bre's belly.
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"I got engaged earlier this year, and when I marry next August, John will perform the ceremony, Amanda will be a bridesmaid, and Eden will be the flower girl.
"I do sometimes wish she could be here with me; birthdays, holidays, and Mother's Day are hard. But then I wouldn't have her parents in my life. It's a catch-22. I have hard days, but for the most part, I believe my daughter is where she's supposed to be."
Cheryl Sams, a 41-year-old computer programmer in Atlanta, adopted her daughter, Lauren, now 2, through a national Christian agency. Cheryl is exploring adopting a second child through foster adoption.
"I've known since high school that I wanted to adopt a child someday; I'm not sure where the desire came from. As I grew up, I knew that adoption was for me whether I got married or not. I even began going to adoption conferences years before I actually brought my daughter home.
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"I got started around my 37th birthday because I wanted to adopt an infant and thought I'd be too old for an agency to place a baby with me if I didn't adopt soon. The social worker told me I should expect to wait awhile, because birth parents often don't choose single parents. Usually single parents get chosen when the birth mothers don't want to choose and leave it to the agency.
"But only three months later, on a Monday, I got 'the call' from the social worker, who said, 'I have a baby for you!' I said, 'Really?' I was both excited and scared!
"The next day, the social worker e-mailed me beautiful pictures. And on Wednesday, I met the baby and the interim-care mother at the agency office. The little girl had been in temporary care for five weeks while the birth parents' rights were terminated so that she would be legally free for adoption. When I first saw her, she was in this little yellow sleeper with Tweety Bird on it, and I just sat with her for an hour and held her and looked at her and fed her and changed her. Afterward, the social worker asked me if I wanted to accept the placement, and I said, 'Of course!' I decided to name her Lauren.
"It's hard to juggle everything — work, maintaining a household, caring for Lauren, and finding time for myself. My days start early in the morning and end late at night. But — and this might sound like a cliché — it's so hard to imagine my life without Lauren. If she wakes up in the morning before I do, she comes into my room with a big smile and a 'Good morning, Mommy!' Those moments, and the hugs and kisses, are priceless. She's so funny, so happy, naturally inquisitive, and so much fun.
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"I'm now on the waiting list for foster adoption. I had a great experience with a private agency, but I couldn't save the fees needed for a second adoption, and I have friends who have had great experiences with adopting from foster care. I've been waiting for a month, and I'm hoping to bring home another girl, younger than Lauren. It'll be good for her to have a sibling, and I love being a mother."
For your guide to books and organizations that can show you the ins and outs of adoption, plus more info on international adoption, visit: redbookmag.com/adoptionresources.
Reprinted with Permission of Hearst Communications, Inc. Originally Published: This Is What Adoption Feels Like


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Larry Flynt Writes Shortest, Orneriest Essay on Online Privacy Ever
Did you know Hustler publisher Larry Flynt has a Huffington Post column? Whereas most celebrity Huffington Post columnists say nothing in as many words as possible, Larry Flynt says nothing in as few words possible. His post today on online privacy is a strange masterpiece of brevity.
Here is one of the two paragraphs that make up the post.
The Feds have no problem letting companies collect and exploit our personal information because it makes running a surveillance state that much easier to do. Whenever the government wants to find out what weird shit you're up to on the Internet, guess what they're going to find out? You can thank Google, Facebook, Walmart and all the other megacorps for that.
Be alert: Big Brother is watching you.
There is one other paragraph, and it's basically exactly the same. In fact this post is now probably longer than the original. Thank you, Larry Flynt: There's something strangely refreshing about someone being so inanely brief on the internet, about a topic so overly-written about as internet privacy.
[Image via Getty]


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Dungeon Prompts inspired me to introduce you to Jode Gray. I think the world of her.
Jode Gray's Ivy might lead you to think that her blog is a stroll in a park. However, her headers on each page can tip you off that this blogger is an unusual artist.
I have read very few of Jode's posts. I wandered into her mysterious world when I clicked on her Articles link on her homepage. Most of what she wrote was over my head, until she conversed with me in the comments section. She is a great teacher. For example, she introduced me to Toruses, and explained how they, and one of her sketches, resemble magnetic fields.
Then, she taught me how to draw Toruses, and then how to be one. I have been studying her Toruses page for over a month. It is fascinating.
Each of her pages includes videos and/or a feast of links for more information.
She is like the umbrella in a picture that she drew years ago:
She guides us as we venture from a familiar, plain white page to places where new experiences are like colorful drops of rain: bewildering and enticing.
Jode Gray: "Like" her and leave her (comments) 😀


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Customize your JAMA Network experience by selecting one or more topics from the list below.
Katon W, Lyles CR, Parker MM, Karter AJ, Huang ES, Whitmer RA. Association of Depression With Increased Risk of Dementia in Patients With Type 2 Diabetes: The Diabetes and Aging Study. Arch Gen Psychiatry. 2012;69(4):410–417. doi:10.1001/archgenpsychiatry.2011.154
© 2023
Author Affiliations: Department of Psychiatry and Behavioral Sciences, School of Medicine (Dr Katon), and Department of Health Services, School of Public Health (Drs Lyles and Karter), University of Washington, Seattle; Kaiser Permanente Division of Research, Oakland, California (Ms Parker and Drs Karter and Whitmer); and University of Chicago, Chicago, Illinois (Dr Huang).
Context Although depression is a risk factor for dementia in the general population, its association with dementia among patients with diabetes mellitus has not been well studied.
Objective To determine whether comorbid depression in patients with type 2 diabetes increases the risk of development of dementia.
Design The Diabetes and Aging Study was a cohort investigation that surveyed a racially/ethnically stratified random sample of patients with type 2 diabetes.
Setting A large, integrated, nonprofit managed care setting in Northern California.
Participants A sample of 19 239 diabetes registry members 30 to 75 years of age.
Main Outcome Measures The Patient Health Questionnaire 8, International Classification of Diseases, Ninth Revision (ICD-9) diagnoses of depression, and/or antidepressant prescriptions in the 12 months prior to baseline were used to identify prevalent cases of depression. Clinically recognized dementia was identified among subjects with no prior ICD-9 Clinical Modification (ICD-9-CM) diagnoses of dementia. To exclude the possibility that depression was a prodrome of dementia, dementia diagnoses were only based on ICD-9-CM diagnoses identified in years 3 to 5 postbaseline. The risk of dementia for patients with depression and diabetes relative to patients with diabetes alone was estimated using Cox proportional hazard regression models that adjusted for sociodemographic, clinical, and health risk factors and health use.
Results During the 3- to 5-year period, 80 of 3766 patients (2.1%) with comorbid depression and diabetes (incidence rate of 5.5 per 1000 person-years) vs 158 of 15 473 patients (1.0%) with diabetes alone (incidence rate of 2.6 per 1000 person-years) had 1 or more ICD-9-CM diagnoses of dementia. Patients with comorbid depression had a 100% increased risk of dementia during the 3 to 5 years postbaseline (adjusted hazard ratio, 2.02; 95% confidence interval, 1.73-2.35).
Conclusion Depression in patients with diabetes was associated with a substantively increased risk for development of dementia compared with those with diabetes alone.
Depression and diabetes mellitus are 2 of the most common illnesses in older primary care populations. The link between these 2 disorders appears to be bidirectional, with depressive episodes developing earlier in life leading to an increased risk of diabetes1,2 and adult-onset diabetes increasing the subsequent risk of depression.2
Recent systematic reviews have found that both depression and diabetes independently increase the risk of dementia. Lu and colleagues3 found 16 studies examining the association of diabetes with dementia. Persons with diabetes compared with those without had a 47% increased risk of all-cause dementia, a 39% increased risk of Alzheimer disease (AD), and more than a 2-fold increased risk of vascular dementia.3 Two recent systematic reviews found that depression doubled the risk of subsequent AD and all-cause dementia.4,5
Up to 20% of adult patients with type 2 diabetes meet criteria for comorbid major depression.6 Comorbid depression in patients with diabetes is associated with poor self-care (nonadherence to diet, exercise, smoking, and taking prescribed medication),7 poor glycemic control,8 and an increased risk of microvascular and macrovascular complications.9,10 Poor glycemic control,8 vascular risk factors, and vascular changes10 associated with depression in patients with diabetes may increase the risk of dementia. In addition, both depression and type 2 diabetes are associated with biologic changes such as increased proinflammatory factors,11,12 decreased insulin sensitivity,12,13 and abnormalities in autonomic nervous system homeostasis,14,15 which may also increase the risk of dementia.
We are aware of only 1 study examining whether patients with comorbid depression and diabetes compared with those with diabetes alone are at increased risk of all-cause dementia.16 Since depression affects up to 20% of diabetic patients, it is critical to estimate if it is a risk factor for dementia since it is potentially modifiable. The previous study of approximately 4000 patients with type 2 diabetes found a 2-fold increased risk of dementia (3-5 years postbaseline) among patients with comorbid depression and type 2 diabetes compared with those with diabetes alone.16 Limitations of this prior study include that it was completed in a single large health care system serving 1 geographical region and included a population with limited racial/ethnic diversity. The current study replicates these results in a much larger and more diverse population of approximately 20 000 patients enrolled in a managed care setting.
The Diabetes Study of Northern California (DISTANCE) is a cohort investigation to address significant gaps in existing knowledge regarding the natural history, service use, and self-care of adults living with diabetes.17 Subjects come from a well-characterized, multiethnic cohort of insured patients with diabetes, the Kaiser Permanente Northern California (KPNC) Diabetes Registry.18 The registry has been maintained since 1993; is updated annually by adding all patients identified as having diabetes using standardized criteria from automated health records including pharmacy, laboratory, hospitalization records, and outpatient diagnoses; and has an estimated sensitivity of 99% based on medical record review validation.18 In addition to the extensive electronic records, DISTANCE collected patient-reported information through a survey of a race-stratified random sample of members of the registry.17 The DISTANCE survey assessed a range of social, behavioral, clinical, and health care–related factors that might influence diabetes outcomes. Surveys were offered in 5 languages and could be completed by mail or telephone or on the Web. The Diabetes and Aging Study is an ancillary study of DISTANCE that focuses on medical issues particularly relevant to older patients with diabetes (eg, dementia).19 This research has been approved by the review boards of the Kaiser Foundation Research Institute and the University of California, San Francisco, School of Medicine and the University of Chicago.
Kaiser Permanente Northern California is a nonprofit, prepaid, integrated health care delivery system serving approximately 3.2 million members in Northern California. The KPNC enrollment is demographically similar to that of the area population, except in the extremes of the income distribution. From May 2005 to December 2006, researchers conducted the baseline DISTANCE survey among a racially/ethnically stratified, random sample of diabetes registry members aged 30 to 75 years, targeting 6871 African American, 4333 white, and 7018 Latino individuals and 11 417 members of unknown race/ethnicity and achieving a 62% overall response rate (N = 20 188).17 Participation was somewhat lower in racial/ethnic minority groups compared with white individuals and those with a high school or less education compared with those with 1 or more years of college.17 Further details about the study methods17 and diabetes registry18 have been previously published.
The main predictor of interest was having clinically significant depression symptoms20 as determined by a score of 10 or more on the Patient Health Questionnaire 8 (PHQ-8)21 and either a physician diagnosis of depression in the 12 months prior to baseline survey, which was based on International Classification of Diseases, Ninth Revision (ICD-9) codes 296.2, 296.3, 298.0, 300.4, 309.0, 309.28, or 311, or a prescription of 1 or more of the following medications: citalopram hydrobromide, fluoxetine, fluvoxamine, paroxetine hydrochloride, sertraline hydrochloride, escitalopram oxalate, bupropion hydrochloride, isocarboxazid, maprotiline, mirtazapine, nefazodone hydrochloride, phenelzine sulfate, tranylcypromine sulfate, trazodone hydrochloride, venlafaxine hydrochloride, and duloxetine hydrochloride. The PHQ-8 is a self-report measure based on the DSM-IV criteria22 for major depression. A PHQ-8 score of 10 or more has been found to have 88% sensitivity and 88% specificity for diagnosis of major depression based on clinical interview.21 To meet DSM-IV criteria for major depression, patients were required to have at least 5 symptoms endorsed for more than half the time, including at least 1 of the cardinal symptoms: depressed mood or anhedonia.
A positive response to a patient self-report question that asked "Has a clinician ever diagnosed you as having depression?" was also used as evidence of depression in a sensitivity analysis. This depression diagnosis allowed estimation of lifetime history of depression rather than current depression diagnosis with risk of dementia.
Potential confounders obtained from the DISTANCE survey included sociodemographic characteristics (age, sex, education, and race/ethnicity), diabetes duration, height, weight, and standardized questions on health risk behaviors, including smoking23 and physical activity.24 Individual diabetes complications (nephropathy, neuropathy, myocardial infarction, retinopathy, stroke, peripheral vascular disease, and cerebrovascular disease), clinical control (hypertension and glycated hemoglobin [HbA1c] level), and a validated comorbidity index (DxCG) to summarize illness burden25 were based on the prior 12 months of KPNC automated ICD-9 diagnostic data and laboratory data (based on the test result closest to the baseline survey). Type 1 diabetes was identified by self-report or age at onset less than 30 years and treatment with insulin alone at baseline. Because depression has been shown to increase health care use in patients with diabetes26 and potentially provide more opportunity for the physician to diagnose dementia, we used KPNC automated data to ascertain number of primary care visits per year over the 5-year period.
Incident cases of clinically recognized dementia were identified from both outpatient and inpatient databases based on the presence of 1 or more ICD-9 Clinical Modification (ICD-9-CM) diagnostic codes of uncomplicated senile dementia (290.0), AD (331.01), vascular dementia (290.4), or dementia not otherwise specified (290.1) over the 5-year period after baseline. We excluded patients with evidence of 1 or more dementia diagnoses prior to baseline.
These ICD-9-CM codes have been used successfully in recent studies to identify patients with dementia among those with diabetes.27,28 In a recent study in another large health care setting, having 1 of these ICD-9-CM diagnoses for dementia was found to have a sensitivity of 77% and a specificity of 95% compared with a consensus diagnosis of dementia based on a neuropsychiatric battery, physical examination, structured interview with informants, and review of medical records (P. Crane, MD, MPH, written communication, 2009). A similar battery of ICD-9-CM codes from 5 years of Medicare claims data had sensitivity of 87% for identifying cognitive impairment compared with a neuropsychiatric battery among patients in an AD registry, and patients with more severe cognitive impairment were more likely to be identified.29
We described baseline demographic and clinical characteristics and health risk variables of the depressed and nondepressed groups. We estimated the association between depression and incident dementia diagnosis in years 3 through 5 of follow-up using the proportional hazards model. The primary outcome ignored the first 2 years of dementia diagnoses to minimize the possibility that depression may occur as a prodrome of dementia or secondary to dementia.30
We censored individuals at the time for development of dementia, disenrollment, death from any cause, or the end of the follow-up period, whichever came first. We fit 4 proportional hazards models to the dementia outcome: the first model included only baseline depression (depression vs no depression); the second model added demographic characteristics (age, sex, education, and race); the third model added demographic characteristics and clinical characteristics (duration of diabetes and evidence in prior year of stroke, myocardial infarction, hypertension, neuropathy, nephropathy, retinopathy, cerebrovascular disease, and peripheral vascular disease as well as HbA1c level and a claims-based comorbidity score (DxCG)25; and the fourth model added demographic and clinical characteristics and health risk behaviors (body mass index [BMI] [calculated as weight in kilograms divided by height in meters squared] and smoking) and number of health care visits during the 5-year follow-up.
Effect modification of depression on risk of dementia was also evaluated by specifying interactions (with depression) for 5 variable categories: age (<65 vs ≥65 years), race/ethnicity (white, African American, Latino, East Asian, Filipino, mixed race, and other/unknown), number of diabetes complications (<3 vs ≥3), intensity of diabetes treatment (insulin vs diet and/or oral hypoglycemic drugs), and health risk behaviors including BMI (<30 vs ≥30), current smoker vs past or nonsmoker, and HbA1c level (<8.0% vs ≥8.0% [to convert to proportion of total hemoglobin, multiply by 0.01]).
The DISTANCE used a stratified random sampling design that oversampled minority patients to provide adequate power for ethnic contrasts. To account for this design effect, we weighted analyses using expansion weights (reciprocal of the nonproportional sampling fractions for each ethnic group) in all multivariable models. While the amount of missing data for the survey-derived covariates was small (<3%), a complete case analysis would include only 11 310 of the available 19 239 observations, resulting in a loss of approximately 41% of the data. To eliminate bias due to missing data, we created a multiple imputed data set (20 iterations) using the multivariate normal model and Markov chain Monte Carlo approach and used this in our analyses.31,32
We conducted a series of sensitivity analyses. The first included all incident dementia diagnosis in the 5-year postbaseline period to examine differences from our primary analyses that excluded dementia diagnosis in years 1 and 2. A second sensitivity analysis estimated the association between depression and incident dementia diagnosis during follow-up in years 4 and 5 only. A third sensitivity analysis specified a proportional hazard model of incident dementia (in years 3-5), using patient self-report of receiving a prior diagnosis of depression before baseline survey as the independent predictor. A fourth and final sensitivity analysis estimated the association of depression defined by a PHQ-8 score of 10 or more alone and incident dementia (in years 3-5).
Of the 20 188 consenting patients in DISTANCE, 161 were excluded based on 1 or more ICD-9-CM dementia diagnoses prior to baseline, 163 were excluded based on a dementia ICD-9-CM diagnosis within the first 2 years after baseline, 477 were excluded because of meeting criteria for type 1 diabetes, and 148 were excluded because of lack of any follow-up, leaving a study cohort of 19 239.
A total of 3766 (19.6%) of the 19 239 patients with diabetes met criteria for clinically significant depression. Compared with those without depression, patients with depression were younger; more likely to be female; had a shorter duration of diabetes; had less education; were more likely to be white and less likely to be Asian or Filipino; had higher BMI; were more likely to smoke; had higher rates of nephropathy, neuropathy, myocardial infarction, retinopathy, peripheral vascular disease, and cerebrovascular disease, poorer glycemic control (HbA1c level >9%), and a greater burden of comorbidities; and had a higher number of primary care visits per year (Table 1).
During the follow-up period, a total of 238 participants (1.2%), representing 76 002 person-years of follow-up, met our definition of dementia based on 1 or more ICD-9-CM dementia diagnoses in years 3 through 5 for an incidence rate of 3.1 cases per 1000 patient-years. When examining this by depression status, a total of 80 of 3766 patients (2.1%) with comorbid depression and diabetes, representing 14 528 person-years of follow-up, met our definition of dementia in years 3 to 5 for an incidence rate of 5.5 per 1000 person-years. In contrast, a total of 158 of 15 473 participants (1.0%) without depression, representing 61 474 person-years of follow-up, met our definition of included dementia diagnosis in years 3 through 5 for an incidence rate of 2.6 cases per 1000 patient-years.
Our primary analysis included proportional hazard models of dementia occurring in years 3 through 5 as the primary outcome using a fully imputed data set to account for missing covariate information (Table 2). Depression at baseline based on a PHQ-8 score of 10 or more and/or evidence of diagnosis or treatment of depression in the year prior to baseline (mean [SD] PHQ-8 score of this group was 9.5 [5.8]) was associated with a 2.02 (95% CI, 1.73-2.35) greater risk of dementia compared with those with diabetes alone after adjustment for age, sex, education, race/ethnicity, duration of retinopathy, cerebrovascular disease, peripheral vascular disease, HbA1c level, comorbidity score (DxCG), BMI, smoking, and number of primary care visits per year.
No evidence of effect modification of depression with number of diabetes complications, BMI, current smoking, or HbA1c levels was found. There was a significant depression × age interaction (χ21 = 26.8; P < .001); in stratified models, those younger than 65 years had a substantially higher risk of dementia associated with depression (hazard ratio [HR] = 4.42; 95% CI, 3.11-6.29) compared with those 65 years and older (HR = 2.01; 95% CI, 1.65-2.45). There was a significant depression × treatment intensity interaction (χ21 = 7.9; P = .005); in stratified models, those taking insulin (with or without oral hypoglycemic treatment) had a substantially lower risk of dementia associated with depression (HR = 1.59; 95% CI, 1.17-2.18) compared with those not treated with insulin (HR = 2.82; 95% CI, 2.33-3.42). There was also a significant depression × racial/ethnic group interaction (χ26 = 33.2; P < .001); in stratified models, the risk of dementia associated with depression with each racial/ethnic group was white: HR = 2.01; 95% CI, 1.62-2.49; African American: HR = 1.86; 95% CI, 1.03-3.39; Latino: HR = 3.28; 95% CI, 1.92-5.63; mixed race: HR = 4.43; 95% CI, 2.59-7.59; other/unknown category: HR = 4.25; 95% CI, 1.15-15.68; East Asian: HR = 0.82; 95% CI, 0.20-3.43; and Filipino: HR = 0.59; 95% CI, 0.05-6.90.
The first sensitivity analysis included the incident cases of dementia in all 5 years of follow-up, including those from years 1 and 2, which were ignored in the primary analysis. In this analysis, the increased risk of dementia associated with depression was slightly higher (HR = 2.35; 95% CI, 2.10-2.63), as seen in Table 3. The second sensitivity analysis only included dementia diagnoses farther from baseline (ie, in years 4 and 5) and also found a slightly higher HR (HR = 2.30; 95% CI, 1.93-2.74). The third sensitivity analysis that examined patient self-report about having a prior diagnosis of depression from a clinician (mean [SD] PHQ-8 score, 7.4 [5.7]) in relation to dementia diagnoses in years 3 to 5 found an HR associated with depression of 2.60 (95% CI, 2.14-3.15). The fourth sensitivity analysis that used a baseline PHQ-8 score of 10 or more alone to define depression (mean [SD] PHQ-8 score, 13.9 [3.6]) and examined dementia diagnoses in years 3 to 5 found an HR associated with this depression definition of 3.29 (95% CI, 2.67-4.04).
We also compared these results with complete case analysis among the 11 310 respondents who had full covariate information. While the imputed results showed a 2-fold increased risk for developing dementia in years 3 to 5 among those with depression, the complete case results showed a slightly higher risk (HR = 2.37; 95% CI, 1.97-2.85).
In this prospective study in patients with type 2 diabetes, comorbid depression was associated with an approximately 2-fold increased risk of dementia compared with patients with diabetes alone. Prior meta-analyses have found that both depression and diabetes are risk factors for dementia,3-5 and our study suggests that having both of these illnesses occurring together is associated with even greater risk. Our findings with a diverse sample of approximately 20 000 patients with type 2 diabetes are consistent with the only prior smaller study, which found an approximately 2-fold increase in risk of dementia over 5 years in patients with depression and diabetes.16 Effect sizes were quite robust across the primary and sensitivity analyses. The sensitivity analyses that only included dementia diagnoses in years 4 and 5 or that used 1 question about having had a previous diagnosis of depression or that only used the PHQ-8 score of 10 or more each showed an even higher risk of dementia associated with depression, suggesting that these results are not due to depression being a prodromal phase of dementia or the depression definition.
Depression in patients with diabetes compared with those with diabetes alone is associated with poorer adherence to diet and exercise regimens, increased rates of smoking, and higher HbA1c levels,7,8 which could worsen the course of diabetes33,34 and increase the risk of dementia associated with depression. However, controlling for these behaviors and intermediate risk factors had a negligible effect on risk of dementia. These data suggest that biologic factors associated with depression may be important risk factors for dementia in patients with type 2 diabetes.
There are several biologic mechanisms that could link depression and dementia. The fact that the PHQ-8 score of 10 or more was associated with a higher risk of development of depression compared with those with a patient report of having a prior depressive episode or those identified by either a PHQ-8 score of 10 or more and/or a physician diagnosis of depression or treatment with an antidepressant in the prior 12 months suggests that severity of depression may be an important factor. Depression severity has been associated with a higher risk of biologic abnormalities such as hypothalamic-pituitary axis dysfunction.35,36 Dysregulation of the hypothalamic-pituitary axis associated with depression has been linked to higher glucocorticoid production and impaired negative feedback.30 Dysregulation of cortisol may damage brain areas involved in cognition such as the hypothalamus37,38 as well as decrease neurogenesis in key brain areas.39 Several studies have reported that chronic or recurrent depression is associated with hippocampal atrophy.40,41 Elevated cortisol levels also independently predict several components of the metabolic syndrome such as abdominal obesity, hypertriglyceridemia, and decreased high-density lipoproteins, all of which are thought to be risk factors for vascular dementia and AD.30,42,43 Depression has also been linked to increased proinflammatory factors, such as increased cytokine levels including interleukin 6 and tumor necrosis factor α,44 as well as increased platelet aggregation.45 Dysregulation of the hypothalamic-pituitary axis and increased proinflammatory factors both are associated with increased insulin resistance, which has been identified as a risk factor for vascular dementia and AD.46
Patients with depression and diabetes compared with those with diabetes alone have been found to be twice as likely to have 3 or more cardiovascular risk factors.47 Higher numbers of cardiovascular risk factors have been linked to a higher risk of AD and vascular dementia.48,49 Both depression and diabetes are also associated with a higher risk of cardiovascular and cerebrovascular events, which may increase the risk of dementia in an additive fashion.9,10,50-52
The finding that depression is associated with a greater risk of dementia in patients with diabetes younger than 65 years compared with those 65 years and older is worrisome from a public health and cost perspective. Depressive episodes often begin early in life and depression increases the risk for development of type 2 diabetes.1,2 Prior research reported a 5 to 6 years' earlier onset of diabetes among patients with comorbid depression and diabetes than among those without a history of depression.53 The temporal patterning (earlier onset of diabetes with depression and greater risk of dementia in younger compared with older patients with comorbid depression and diabetes) underscores the importance of developing early interventions to potentially reduce the incidence of dementia.
The finding that depression is associated with a higher risk of dementia in diabetic individuals who are not being treated with insulin is interesting given that both depression and diabetes have been found to be associated with decreased insulin sensitivity.12,13 There is increasing evidence that insulin dysregulation contributes to the pathophysiology of AD.54 Insulin modulates levels of β-amyloid in the brain and protects synapses against the negative effects of β-amyloid.55,56 Moreover, intranasal insulin may preserve memory and general cognitive abilities in patients with mild cognitive impairment or mild to moderate AD.54
Although we detected differences in risk of dementia in patients with depression among the 7 racial/ethnic groups, there was a strong and consistent risk of dementia associated with depression in 5 of the 7 groups (white, African American, Latino, mixed race, and other/unknown) but no significant association in 2 groups (East Asian and Filipino). Racial/ethnic differences in risk of dementia among depressed, diabetic patients needs replication, with further exploration for putative mechanisms that may explain why an effect is observed in some, but not other, ethnic groups.
Recent data based on prospective follow-up of a cohort of 1433 persons in the general population older than 65 years found that effectively treating depression and diabetes as well as increasing fruit and vegetable consumption could potentially lead to a 20.7% reduction in incidence of dementia.57 Eliminating depression from this elderly population made the greatest potential contribution with an estimated 10% reduction in the number of dementia cases over 7 years.57 Primary care–based health services models have been developed that have been shown to reduce the burden of depression in elderly populations with chronic medical illnesses such as diabetes.58,59 Depression interventions in chronic-condition populations should be tested for their potential to decrease incidence rates of dementia.
A limitation of this study is that the population was derived from 1 large health care system in 1 geographic region, potentially limiting generalizability. While rates of depression and dementia may differ in the uninsured, observed associations between depression and dementia are likely not substantively different across populations. Depression ascertainment was based on either the PHQ-8 score or physician diagnosis and treatment of depression, not clinical interviews. However, the relatively high specificity of the PHQ-8 score compared with the diagnosis of depression by clinical interview suggests few false positives.21 We lacked a control population of patients without diabetes and thus were unable to estimate the strength of the depression-dementia association in nondiabetic patients. Using clinically recognized dementia rather than cognitive testing is also a limitation. However, a prior study in a similar health care organization has shown that ICD-9-CM codes of dementia have high specificity (ie, 95%) but only about 77% sensitivity compared with prospective comprehensive case ascertainment (P. Crane, MD, MPH, written communication, 2009). This suggests low rates of false positives based on physician diagnoses. The majority of our dementia diagnoses came from a primary care setting since we were interested in the first indication of dementia; thus, we were unable to accurately evaluate the role of depression on risk of dementia subtypes. An aim of our future work is to understand the role of depression on the risk of vascular dementia and AD in patients evaluated in one of Kaiser Permanente's memory clinics. The 5-year follow-up period is also a relatively short time to determine risk of dementia. A final limitation is that, although our model adjusted for a range of socioeconomic, clinical, and health risk behavior factors, residual confounding may still be a factor.
Depression was associated with significantly increased risk of dementia among patients with type 2 diabetes. Given that depression is potentially modifiable, future studies are needed to further evaluate whether effective depression interventions reduce the risk of dementia and identify the mechanisms that may explain our observation.
Correspondence: Wayne Katon, MD, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, 1959 Pacific St NE, PO Box 356560, Seattle, WA 98195 (email@example.com).
Submitted for Publication: May 25, 2011; final revision received September 29, 2011; accepted October 1, 2011.
Published Online: December 5, 2011. doi:10.1001/archgenpsychiatry.2011.154
Financial Disclosure: Dr Katon's relevant financial activities outside the submitted work include board membership for Eli Lilly and Wyeth and honoraria for lectures for Eli Lilly, Wyeth, Pfizer, and Forest.
Funding/Support: This study was supported by grant MH069741 from the National Institute of Mental Health Services, Bethesda, Maryland, Division (Dr Katon). This work was supported by National Institute of Diabetes and Digestive and Kidney Disease grants R01DK081796, RCI DK086178, R01DK080726, and R01DK65664. The University of Chicago's Diabetes Research and Training Center was supported by National Institute of Diabetes and Digestive and Kidney Disease grant P60 DK20595. The Kaiser Permanente Division of Research and University of Chicago were also supported by P30 Centers for Diabetes Translation Research grants P30 DK092924 and P30 DK092949.


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By Dave Stancliff/For The Times-Standard
I remember growing up with one phone in our house. It was considered a luxury, not a necessity. You couldn't take the phone outside, but if you were out in public, there were things called phone booths.
If you're thirty or younger, you can Google "phone booths" to see what I'm talking about. The other day I read about a collector (of what the article didn't say) who bought a "gently" restored (mostly original parts) 1905 phone booth for $35,000! Who knew?
Part of the reason that old phone booth sold for $35,000 was because it was a first of it's kind. It really looked nice with a solid wood panel door and double-glass windows and walls for sound proofing.
I seldom used phone booths. They always made me claustrophobic. I seldom called anyone until I was a teenager, at which time my calls were made from home so I didn't have to put my money into a pay phone. Another reason I didn't like phone booths.
At no time - and you can quote me - was I ever worried about having to make a phone call. If an emergency came up I dealt with it. The result wasn't always pretty, but I'm still here, right?
I assure you, the idea of carrying a phone around with me was as foreign as those little people in Asia fighting over some country called Vietnam. I never dreamt of the possibility. I was clueless as to the onrushing technology that would soon be found in nearly every American home.
In 1977, my second son was born and the first cell phone was made in Chicago. Then companies in other places started to make cell phones. As you may suspect, there are now more cell phones than landline phones.
The results of last year's semiannual US wireless industry survey (go to http://www.ctia.org/advocacy/research/index.cfm/AID/10316 ) were stunning to say the least; 91 percent of Americans have a mobile phone!
All of which leads me to my main point today: The fear of being without your mobile phone is on the rise. The experts even have a name for this fear; nomophobia, or No Mobile Phobia. It's defined as the anxiety a person feels when out of range of a cell phone tower, or if they don't have their mobile phone with them for some reason.
This phobia, according to a recent CBS News report, is a growing problem. A recent poll in the United Kingdom said sixty-six percent of respondents reported being nomophobic.
It came as no surprise to me that the 18 to 24-year olds were the most likely to report being afraid without their mobile phone. This new condition is a generational thing, from everything I've read thus far.
The younger you are, the more likely you will be stricken with this fear, according to the researchers. The study said women are more likely to worry than men if they don't have their mobile phone with them. That makes sense to me.
The study also concluded that "more than one in two" nomophobes never switch off their mobile phones.
Old timers like myself are less likely to panic if we forget to take our cell phones with us. That's not to say I haven't got a tiny bit spoiled by the convenience of carrying one. I seldom use the thing, but I admit it's comforting to know that if I fall down and can't get up, I can fish it out of my pocket and call for help.
In a complete moment of transparency, I'm copping to a growing case of nomophobia! I can sympathize with those youngsters today who never knew about things like phone booths, and who got their first mobile phone when they learned how to string sentences together using abbreviations and popular slang.
There's no turning back now. Any day I expect to hear that newborn cell phones - pink or blue, take your choice - will be given to new mothers and fathers when they check out of the hospital (sponsored by one of the megalithic mobile phone makers, of course).
It sure would be nice if I could swap phobias. Out with the old claustrophobia, and in with the new nomophobia.
As It Stands, unfortunately it doesn't work that way. I just have two phobias now.


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Add to All is a simple, yet powerful plugin that will allow you to add HTML, JavaScript or CSS to your header, footer, content or feed.
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Navigate to Plugins within your WordPress Admin Area
Click «Add new» and in the search box enter «Add to All» and select «Keyword» from the dropdown
Find the plugin in the list (usually the first result) and click «Install Now»
Manual install
Download the plugin
Extract the contents of add-to-all.zip to wp-content/plugins/ folder. You should get a folder called add-to-all.
Activate the Plugin in WP-Admin.
Goto Settings » Add to All to configure
Preguntas frecuentes
If your question isn't listed here, please post a comment at the WordPress.org support forum. I monitor the forums on an ongoing basis. If you're looking for more advanced paid support, please see details here.
If you would like a feature to be added, or if you already have the code for the feature, you can let me know by posting in this forum or creating an issue in the Github repository.
Colaboradores y desarrolladores
«Add to All – Headers, Footers, Everywhere» es un software de código abierto. Las siguientes personas han colaborado con este plugin.Colaboradores
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Registro de cambios
Release post: https://webberzone.com/blog/add-to-all-v1-8-0/
New feature:
- New constant
ATA_DISABLE_SNIPPETScan be added to your wp-config.php to disable snippets. Perfect for WordPress multisite
- New placeholder
%updated_time%to display the updated date
- New feature to display the estimated reading time. You can use
%reading_time%in the Settings page. Alternatively use the shortcode
[ata_reading_time]to display the reading time
- New constant
- Upgraded Settings_API to v2
Release post: https://webberzone.com/blog/add-to-all-v1-7-0/
- Bug fixes:
- Feed copyright placeholders were not processed
- Bug fixes:
- Fixes PHP error introduced in v1.7.1
Release post: https://webberzone.com/blog/add-to-all-v1-7-0/
- Bug fixes:
- Process shortcodes didn't work
- Snippets HTML was added into content were added even when no snippet was found
Release post: https://webberzone.com/blog/add-to-all-v1-7-0/
- Features:
- New Settings API class to control the plugins settings
- New Snippets Manager – create custom snippets that can be added to Header, Footer and Content based on inclusion criteria
Check changelog.txt for older entries the Releases page on Github


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Chris Brown Sentenced to 1,000 More Community Service Hours
Chris Brown was sentenced to 1,000 more hours of community service on Friday for faking community service, TMZ reports.
The singer had already had his probation, stemming from assaulting his then-girlfriendRihanna in 2009, revoked by a judge in July after Brown was allegedly involved in hit-and-runs. On Friday, Brown's probation was reinstated as long as he completes the additional community service.
Who's the most scandalous of them all? Charting Chris Brown, Lindsay Lohan and more
Brown was originally sentenced to 1,440 hours, but because of the forged records, any service he might have actually already completed will no longer count. Brown also must now be supervised by Los Angeles County officials, whereas before he was allowed to complete service in his home state of Virginia. Brown has the option to choose between highway cleanup, beach cleanup, probation alternative work services or graffiti removal.
The setback comes one day after Brown's recent hit-and-run case was dismissed.
Brown's probation is set to end in August 2014.
View original Chris Brown Sentenced to 1,000 More Community Service Hours at TVGuide.com
Other Links From TVGuide.com


text:
Chapter 2: The Stages Of The Stations Of The People Of Sulūk
Know that there are for the people of sulūk, in this station (i.e., paying attention to the humility of servitude and the Glory of His Lordship) and other stations, countless stages and degrees, only to a few of which we can generally refer, since comprehensively knowing all their aspects and counting all the stages are beyond the capacity of this humble creature: "The ways to Allah are as numerous as the breaths of the creatures."1
One of those stages is the stage of Knowledge ['ilm], which is such that it proves, by scientific conduct [sulūk] and philosophic argument, the humility of servitude and the Glory of (His) Lordship. This is a pure sort of knowledge, since it is clearly proved in the high sciences and supreme philosophy that the entire House of Realization [dār-i tahaqquq] and the complete circle of existence are mere relation and attachment and nothing but poverty.
The Glory, Kingdom and Sovereignty belong to His Sanctified Essence of Majesty. No one can have any share of Glory and Majesty, while the humility of servitude and poverty is engraved on the forehead of everybody, and is registered in the innermost part of their truth.
The truth of gnosis and vision [shuhūd], and the result of suffering and sulūk, are in lifting the veil off the face of the truth, and discerning the humility of servitude and the origin of poverty and lowliness in oneself and in all the creatures. The invocation ascribed to the master of all beings (the Prophet of Islam) (s): "O Allah, show me the things as they are,"2 may be a reference to this stage, i.e. wishing to see the humility of servitude which requires discerning the Glory of the Lordship.
Therefore, if the sālik on the road of the truth, the traveler in the way of servitude, covers this distance with the steps of scientific sulūk and the mount of intellectual advance, he will fall in the veils of knowledge and attain the first station of humanity. But this veil is a thick one, as it is said: "Knowledge is the greatest veil." The sālik should not stay behind this veil. He is to tear it, since, should he be contented with this stage and keep his heart chained by it; he would fall into istidrāj (being engaged in other than the Haqq).
Istidrāj in this stage, means becoming engaged in the numerous secondary branches of knowledge, presenting many arguments justifying his intellectual roamings in that field, and depriving himself of the other stages, because his heart is attached to this stage only, neglecting the wanted result, which is attaining annihilation in Allah.
He, thus, would spend his life in the veil of argument [burhān] and its branches. The more these branches are, the thicker the veil and the greater the distance from the truth. The sālik, therefore, should not be deceived, in this stage, by Satan, secluding himself from the truth and reality, and stopping his journey to the goal on the pretext of being a great scholar, a very learned person and a powerful man of argument. He must set to work briskly, be serious in his quest for the real demand, and take himself to the next stage, which is the second stage.
And that is such that he should write what (his) reason has understood through irrefutable proof and scientific conduct, with the pen of intellect on the tablet of the heart, to convey the truth of the humility of servitude and the Glory of Lordship to the heart and free himself from the chains and the veils of knowledge. We shall refer to this stage presently, inshā' Allāh. So, the result of the second stage is acquiring belief in the facts.
The third stage is that of "tranquility and calmness of the soul," which is, in fact, the perfect stage of faith. Allah, the Exalted, said to his "friend" [khalīl] Ibrāhīm:
"Have you not believed [yet]?" He said: "I have, but just to have a calm heart."3
A reference to this stage may come later.
The fourth stage is that of "vision" [mushāhadah], which is a divine light and a divine manifestation, as a consequence of the manifestations of the Names and the Attributes appearing in the secret of the sālik, and lightening his complete heart with the visionary light. This stage comprises many degrees that are out of the capacity of these pages. In this stage an example of the effect of the nāfilahs: (I would be his hearing, sight and hand)4 will appear, and the sālik will see himself drowned in limitless ocean, beyond which there is another very deep ocean, in which the secrets of "fate" are partly disclosed.
Each one of these stages has its special istidrāj (being engaged in other than the Haqq) through which the sālik is exposed to great perishing [halākat]. So, he will have to rid himself, in all stages, of egoism and I-ness. He should not be self-conceited or egotistic, both of which are the sources of most of evils, especially for the sālik. However, we shall have another reference to this subject presently inshā' Allāh [Allah willing].
- 1. This hadīth is ascribed to the Prophet (s) in Jāmi' al-Asrār wa Manba' al-Anwār by Sayyid Haydar Āmulī, pp. 8, 95 and 121. Also in the Lāhījī's Commentary on Gulshān-i Rāz, p. 153; Naqd an-Nusūs, p. 185; Minhāj at-Tālibīn, p. 221; Al-Usūl al- 'Asharah, p. 31.
- 2. In 'Awāliy ul-La'ālī, vol. 4, p. 132, it is stated: "Oh Allah, show us the facts as they are." Commenting on the same, quoting at-Tafsīr al-Kabīr by al-Fakhr ar-Rāzī, vol. 6, p. 26, and in Mirsād al-'Ibād, p. 309, it is stated as follows: "Show us the things as they are."
- 3. Sūrah al-Baqarah 2:260.
- 4. Refer to footnote 21


text:
Chevy 700R4 Transmission
I was wondering if you had to do any tail shaft modifications if you replace your 700R4 with a turbo 400??? Please HElP!!
crash727 Member Posts: 1Do I need to connect any wires To the 700R4 Trans Electrical connection. I'm only using the for cruising and don't have cruise control thanks for any help0
smolson Member Posts: 1I have an 81 gmc 1/2 ton w/ 305 motor.
I have a 700R4 transmission from a mid-eighties suburban.
I want to put the 700R4 in my 81 gmc, but the wires don't match up. Currently I have 2 wires to my tranny but the 700R4 has more wires. how should I proceed?
paisan Member Posts: 21,181You'll likely need the TCU and the associated harness from the 700R4
deyhey Member Posts: 1I have just purchased a 91 1/2 ton 2wd u/p that the transmission doesn't work. A friend has a 700r4 with 25000 mile on it that he swaped out of a 89 camaro with a 350 engine. my question will this camaro tranny fit my 91 u/p with no problems?0
stockbrocker Member Posts: 1heres my story:
bought an '85 k10 scottsdale a year ago. seller said the tranny was freshly rebuilt.
I took the next year rebuilding the engine, ignition, carb., intake, etc.
Finally got her running and drove her to the exhaust shop to have the new pipes welded up. When I drove her away from the shop, the speedo didn't work. No big deal, I thought... probably just the sensor got disconnected while the welder was under the belly or at worst, faulty.
a dozen miles later, the tranny "slips" to 1st gear when should be shifting from 2nd to 3rd and in 1st it stays. If I run it in 2nd... no problems.
I checked the fluid for the first time since buying (about 100 miles tops)... bone dry. I have added fluid... but no difference.
So before I buy a new tranny... any thoughts, ideas, or suggestions?
Thanks for your expertise.0
LLOYD68 Member Posts: 1I recently bought a 68 camaro with a ZZ502 and a 700R4 transmission. The previous owner got the trans from a 98 camaro. The tail housing is the 3 bolt type, 2 on the bottom and 1 on the top. The problem is that I'm having trans fluid leaking from the rear most bolt hole on the bottom. I'v checked all around the area to confirm that. Is there a seal or any thing thats leaking or possibly a crack and I need to replace the tail housing? Any answers to this will be greately appreciated.0
91chevyman1 Member Posts: 1i have a 1991 chevy 1500 its a 350 with the 700r4 trans my reverse is starting to go out i was wondering if a 700r4 ou of a chevy s-10 blazer willfit please help thanks0
Lady3bglover Member Posts: 24You may want to reference conversion kits on the 700R4...I'm sure you can find something on the net.0
planks36 Member Posts: 1i have an 88 chevy scottsdale, i am on the 5th trans. in a year, they work fine when i first put them in...but within a week they are slipping not going into gear, the tv cable is adjusted as it says to do it in the book, i figured that i had my tranny lines backwards and figured that would take care of the prob. but it didnt, do any of the electronic brains have anything to do with the trans? i really need my truck for a new job i am starting, so pls if you have any input on this prob...pls. let me know, any info. will help, and it does have a tranny cooler too. :sick:0
jminski28 Member Posts: 1I have a 700r4, I cracked the outer shell on my transmission, took it to a shop to have the inner shell put in a new outer shell. The transmission has only 2800 miles on it. I reinstalled the transmission, I had reverse, put the truck into drive and lost reverse. I then took off the valve body and replaced it with a new one, I got reverse back, and then put it into drive and reverse disappeared again. Both times when I had reverse, I was at a high rev moving very slow. I took off the valve body and checked all the check balls and they are all in place. I have a shift kit in it, so replaced the spring for the pressure regulator out of the front pump. Reinstalled, and made sure the clip ring was in the proper grove. I put everything back together, got reverse put into drive, and lost reverse again. I am stuck. Don't know what to do next....0
jdl2911 Member Posts: 1I have a '91 chevy g30 van, 350 5.7lt. The tranny is stamped "Hydro-Matic". I've lost reverse without any warning, ie, No smells, no noises, nothing. All other gears seem to work fine. Hopeing I didn't just loose the tranny. Any help would be appreciated. I really need it for work and I've kept it up very well and don't want to get another van, it runs excellent. Thanks and GOD Bless!0
This discussion has been closed.