text:
How to Use Google Advanced Search for Genealogy - Part I
- Getting the Most Out of Google Searches for Your Ancestors -
This article discusses how genealogists can get the most out of Google's advanced search capabilities. As many people quickly discover, simply typing in the name of your ancestor in Google is not going to get you what you want. You need to be a bit more sophisticated in your Google search queries if you want to have success in finding the correct genealogy record. In this article, we will show you simple and proven techniques that genealogists can use with Google to help you find your ancestors.
The first step in a genealogy search is to make sure you use the Google Advanced Search page, which can be accessed by clicking on the link on the main Google search page, as shown below.
The Google Advanced Search page looks as follows.


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According to the American Society of Plastic Surgeons…
"Breast Reduction, Also known as, breast reduction surgery removes excess breast fat, glandular tissue and skin to achieve a breast size in proportion with your body and to alleviate the discomfort associated with overly large breasts."
Some women are born with the genes to grow the unwieldy, heavy huge breasts that can work to make their lives challenging and think about surgery, but hesitate. Sometimes hesitate for years, a lifetime.
Cindy Dillion, 62, finally had enough earlier this year and determined to find a plastic surgeon to remove the excess burden of her oversize breasts.
Cindy's sister had breast reduction done 35 years ago. When the doctor asked what bra size, she wanted to be she answered – her only criteria – make breasts smaller and point my nipples, "nipples pointed at the sky." Thirty-five years later, Cindy's sister declares her nipples still "point at the sky."
Cindy's body was marked before surgery – sculpted according to her plastic surgeon artistic eye and examination of the patients shape. No to the fancy 'starburst' nipple – just smaller, balanced and each boob should be looking ahead. No pointy nipples.
Cindy lost five pounds off her breasts and another four pounds off her body when they liposuctioned the fat around her belly, shoulders and back.
In the six and a half weeks since the operation, she has lost twenty-one pounds and got more than she bargained for when her body rejected the stitches – she was allergic to them. Ten days post operation she developed an opening, by the twelfth day the slight opening was open around the nipple and caused the drain hole to shift. An infection followed, leading to extraordinary effort from her long time husband – the husband she now calls, "Rock Star."
The couple turned one of their empty nest bedrooms into a spotlessly clean medical wound changing room where twice a day Rock Star follows doctor's orders, changing the wrapping, and helping his wife heal through his devoted attention to the wounds.
Cindy cannot bring herself to look at her wounds, as her husband does, but noted she can now see her nipples for the first time in fifteen years AND noted her active support group had their "Boob Voyage" party and look forward to the next one – the BraBeque Party! (burning of the old painful reminder bras)
Her bra size at the time of the operation was 42 K and Cindy guesses she may drop back to the 36 D-bra size she has not seen in twenty-five years.
Cindy's Seattle doctor is surgeon Mary Lee Peters, M.D. I was impressed upon learning the doctor did not ask what bra size Cindy wanted since, it seems to me, a good plastic surgeon should be medically artistic enough to take the patient's body size and frame, in consideration to make the judgment call for each individual. Hip, hip – hooray!
Insurance did not cover the
cost of Cindy's Breast Reduction – their
deductible was too high and the out of pocket cost was
13,000 .00 $9,000.00 for breasts
and $4,000.00 for the liposuction[S1] .
[S1]Cindy Dillion is a professional Realtor working out of the Coldwell Banker Bain office in Gig Harbor. She will talk to anyone who has questions about one of the most underrated medical procedures I know – surgery to get relief from the pain and weight of oversize breasts.
Thanks for listening… Sharon O'Hara <firstname.lastname@example.com>
to get relief from the pain and weight of oversize breasts.

subset: commoncrawl


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Kristen*, 34, was getting it on. It was the spring of2008, and she was six months into a relationship with--how shall we describe it?—an energetic younger guy. So when she started feeling run-down, she chalked up her mild flulike weariness and the swollen lymph node in her groin to a yeast infection, which she knew could result from having lots of sex.
Unconcerned, she visited her doctor's office for a quick full-body exam, during which a physician's assistant pointed out something Kristen hadn't noticed: a single, painless bump near her vagina, smaller than a pencil eraser. It looked like a pimple. It wasn't. "After the word herpes, I don't think I heard anything else," says Kristen, a Michigan-based designer.
Her swollen lymph node was a telltale sign that she'd recently acquired herpes simplex virus 2, a.k.a. HSV-2 or genital herpes. Yet, her young lothario denied having it and refused to be tested, and their relationship imploded, leaving Kristen to nurse her incurable infection and damaged psyche alone.
More From Women's Health
Thing is, she wasn't alone--not by a long shot. What Kristen didn't know then is that, in any given year, more women will join Club STD than get married or give birth. The current numbers are astounding: An estimated 19 million new infections occur annually, and at least 80 percent of women will have a bout with at least one type of down-there bug at some point in their lives. But while STDs are some of the most commonly diagnosed diseases on the planet, they are also among the most stigmatized and life-altering. What Kristen knows now: They don't have to be.
What Lies Beneath
Ew. Not me. I'm not the type to get an STD. Let's be honest, most people view themselves that way. It's understandable, considering that the mind-blowing stats are often easier to tune out than digest The truth: You will likely encounter an STD, be it your own, a boyfriend's, or a friend's. What was once viewed as the exception has become the norm, says Kathryn Stamoulis, Ph.D., a New York City mental health counselor who specializes in sexual health.
The rising problem—for doctors and patients alike—is that most STDs have zero visible or tangible clues. For example, most people with genital herpes show no major symptoms, and as a result, they're probably less likely to visit or be screened by their doctors. And even though testing for chlamydia is easy and accurate, just 38 percent of sexually active young women were screened last year, despite the fact that their tender cervical cells are ultra-vulnerable to infections.
Also troublesome are the ever-multiplying wily strains of certain STDs. There are now more than 100 different types of HPV, for instance, and researchers have ID'd new drug-resistant strains of gonorrhea. Plus, almost all kinds of STDs have started jumping—via oral sex—into the mouth, where they can spread but are harder to detect, says ob-gyn Catherine Hansen, M.D., M.P.H., an assistant professor at the University of Texas Medical Branch.
Yet despite all the numbers and hard facts, there is perhaps a bigger match lighting the wildfire-like spread of STDs. One that makes life after diagnosis way more complex than necessary.
The Shame Factor
Tara's STD education started early. Her mom, a nurse, set a "medically accurate" tone in their Bay Area home, and at school, she had the usual sex-ed classes from elementary through high school. Even so, while Tara, 21, was careful to use the NuvaRing birth control with her boyfriend, she didn't bother with condoms—yet she was still taken aback when she was diagnosed with chlamydia earlier this year. "The worst part," she says, "was the shame."
You probably remember that middle school sex-ed class pretty well: close-up slides of infected genitals colonized by red sores or oozing pustules. The images are comically grotesque and send a clear missive: STDs are ghastly and shameful; they are not a normal part of human sexuality. It's a message that not only sets people up for later emotional turmoil but also increases their risk for infection, says Stamoulis.
"When STDs are presented as nasty, dirty abnormalities, people tend to downplay their own vulnerability," she explains. "We don't view ourselves as disgusting, and we don't view people we're attracted to that way either. So instead of weighing real probabilities, people adopt an it-can't-happen-to-me mentality that has an effect on their sexual decision-making well into adulthood." (Accordingly, some 53 percent of young adults go without contraception when bedding new partners, according to a 2011 report.)
The New Normal
"It can't happen to me" doesn't coexist easily with "It did happen to me." It's a psychological double whammy: Infected women blame and judge themselves and feel blamed and judged by others. "They see themselves as damaged and assume others will too," says Stamoulis.
The truth is that the medical reality of an STD often pales in comparison to the emotional fallout, says ob-gyn Melissa Goist, M.D., an assistant professor at The Ohio State University Wexner Medical Center. "Physically, something like chlamydia, for example, is just an infection, like a cold," notes Goist. When caught early, it is easily treated with azithromycin.
Of course, medical facts don't always change public opinion, leaving STD patients anxious and without practical information. One common fear is that they'll be denied health insurance coverage. Hansen says she has never been refused insurance payment for treating an STD. "Preexisting conditions are given numeric scores by insurance companies and, with the exception of HIV, having an STD could never bump up someone's score enough to prevent coverage," says Chelle Moat, M.D., M.P.H., a medical director at Premera Blue Cross. (HIV remains a serious disease and is a topic worthy of its own feature story.)
Another unwarranted fear is that an STD equals instant infertility. Left untreated, certain curable ones, including chlamydia and gonorrhea, can leave scarring in the reproductive organs, which can lead to fertility woes. HPV and herpes don't typically affect fertility, but an outbreak during pregnancy could hurt the baby and thus requires a C-section. The critical factor is ID'ing an infection before it can progress or threaten baby-making plans; share all of your health history with your doctor and get tested before you get knocked up.
Post-infection, though, the fear of a damaged love life looms largest of all. The worry can be so paralyzing that infected women often opt out of any intimacy at all. "But the reality is that the millions of people with STDs aren't all staying home; they're dating and falling in love and having kids," says Stamoulis. She helps her clients deal with shame and stigma through a talk-therapy process called cognitive restructuring, in which she counters false thoughts ("STDs are dirty") with facts ("STDs are no dirtier than the common flu"). Besides, the infections' sheer prevalence means your next partner will likely have had his own STD experience.
Tara's boyfriend did. After she nervously told him about her diagnosis—"I was worried he would think I was cheating on him"--he confessed he'd probably entered their relationship with chlamydia, the infectious equivalent of romantic baggage. They were both treated and are now chlamydia-free. Tara's new rule: She won't have unprotected sex with anyone until both of them have been tested.
For her part, Kristen rarely thinks about her genital herpes as more than a common skin disorder (most doctors feel the same way). Six months after her diagnosis, she met a guy at a party. After a cozy but sexless month of dating, she knew she had to tell him. She wrote a script, practiced it endlessly, and steeled her nerves with a glass of wine. Kristen expected him to bolt, but he seemed relieved. "He thought I was dumping him," she says. "After that, we were boyfriend-girlfriend. To be that vulnerable and have him accept me . . . it was intensely bonding."
Kristen rarely has an outbreak, so she doesn't take many meds (the genital-herpes drug Valtrex can be taken daily to prevent symptoms). If she knows she has a hot night coming up, she pops a pill a day or two beforehand to try to reduce the transmission risk, and they always use a condom. If she suspects an outbreak is coming, they don't have sex. Four years later, her boyfriend is still herpes-free.
"People think you get an STD only if you're morally bad, if you're slutty and sleep around," she says. She used to think that way too. Now she equates her STD to a paper cut--an annoying nuisance that won't kill you. Or your chance of having a hot, healthy love life. Provided, that is, you don't let shame or fear prevent you from acting responsibly and getting tested.
*Names and identifying details have been changed.
Additional reporting by Caitlin Carlson


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Service members and Defense Department civilian employees who are eligible for the Thrift Savings Plan will soon have a new Roth option for retirement savings under the program, defense finance officials announced today.
The change will allow participants to contribute after-tax dollars to the federal government-sponsored retirement savings and investment plan, according to a Defense Finance and Accounting Service statement released today.
As with traditional and Roth individual retirement accounts, the TSP's two options will now allow plan participants to invest either before- or after-tax dollars, although limits on annual contributions, catch-up contributions and agency matching funds will remain the same, officials said.
The plan, which is similar to a 401(k), is open to federal civilian employees and military members. For 2012, the maximum contribution is set at $17,000. Catch-up contributions, available to participants 50 or older, are capped at $5,500 over the standard limit.
Agency matching contributions are one percent for all eligible employees, dollar-for-dollar for the first three percent of pay an eligible employee contributes to the plan and 50 cents on the dollar for eligible employee contributions of between three and five percent. Contributions above 5 percent of pay are not matched.
The current plan treats all contributions as pre-tax dollars ? participants do not pay taxes on pay they put into the plan, but will pay deferred taxes when they receive those funds in retirement.
The new Roth option will allow contributions that are taxed in the year they are made, but will be tax-free in retirement, TSP officials said.
Greg T. Long, TSP executive director, urged in a letter to participants that they carefully consider whether Roth TSP would be to their advantage.
"As with all tax matters, you should seek the advice of a qualified tax or financial advisor for information pertaining to your specific tax situation," Long wrote.
He added the plan's website will soon offer a Roth calculator, and other website content including forms and publications will be updated in May to include information about the Roth feature.
Defense finance officials said the Roth option will be available on a phased basis by military service from June to October. Officials said the schedule will allow service finance employees to complete and thoroughly test the complex changes needed to the various payroll systems.
Defense finance officials said more specific deployment dates on Roth TSP elections will soon be available on www.dfas.mil.
Officials said service members and their families may contact Military OneSource at 800-342-9647 to schedule an appointment with a financial consultant.
Related Sites:
Thrift Savings Plan [ http://www.tsp.gov ]
Defense Finance and Accounting Service [ http://www.dfas.mil ]
We Recommend


text:
From TEDxMidAtlantic, 2011. Eldar Shafir is the William Stewart Tod Professor of Psychology and Public Affairs in the Department of Psychology and the Woodrow Wilson School of Public and International Affairs at Princeton University. His research focuses on decision-making, and on issues related to behavioral economics, with an emphasis on empirical studies of how people make decisions in situations of conflict and uncertainty.
Related Situationist posts:
- The Situation of Poor Choices
- Rich Brains, Poor Brains?
- Poverty and Delinquency
- The Situational Consequences of Poverty on Brains
- Inequality and the Unequal Situation of Mental and Physical Health
- The Situation of Poor Education
- Consuming Merit, Gatekeeping, and Reproducing Wealth
- The Situation of I.Q.


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We help our newest citizens register to vote on the very day they become eligible.
NYC Votes facilitates voter registration of new US citizens by attending naturalization ceremonies throughout the year. CFB staff and NYC Votes partners distribute voter registration forms, assist new citizens with completing their registrations, and hand out pamphlets to educate new citizens about the importance of voting.
If you would like to help NYC Votes register new citizens, fill out the form below and an NYC Votes representative will be in touch.Error loading Partial View script (file: ~/Views/MacroPartials/InsertUmbracoForm.cshtml)


text:
Wilaya de Sétif
Mechta Tannouch
Start dating
Dating in in Mechta Tannouch, Algeria, Wilaya de Sétif (Online chat)
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Tillybom.com - free online dating Mechta Tannouch
The dynamics of our life today leaves almost no time for acquaintances in reality. We are busy with business / study and looking for new friends, and even more so a life partner, few people manage to carve out a few hours. Of course, there are girls and guys who get into relationships quickly and easily. But, nevertheless, the overwhelming majority of women and often men languish alone.
The world is not simple…
Why is this happening? This is the fault of our mentality. Not every girl (and guys are no exception) is able to take the first step towards her sympathy. Even deciding to talk to a stranger on the street is sometimes difficult. It is not easy for young people, and for middle-aged men and women, this problem is urgent. For some, a light flirtation is enough, while others are trying to find their love, create a family. How can we break this vicious circle? How to get out of loneliness?
An alternative for everyone: the dating app
The dating site Mechta Tannouch for you. Here you can easily find friends / partners in Algeria, and in any other city - country. Make acquaintances, start communicating with interesting interlocutors in an online chat. Perhaps you will find a serious relationship that you are looking forward to. Our Tillybom dating app is available to everyone. All you need to enter is a smartphone. Everything happens for free, quickly and without registration. Create your profile and start viewing photos in the gallery. Yes, we have all the profiles with photos! This is an indispensable condition for online dating on our website. Soon, someone will certainly show sympathy for you. Don't get lost and start chatting online!
Internet connects hearts
You will find that dating online is much faster and easier than in real life. First: the new communication does not bind you to anything. Not interested in the person - get acquainted further. Secondly: before you is a huge selection of questionnaires with photos. Watch, study, engage in conversation. Identify common interests. All in your hands! Thirdly: this is a unique opportunity to find not only your love, but also good friends of interest, to gather a company for entertainment, joint walks. As you can see, a dating site is able to brighten up loneliness from the very beginning. You are not yet ready for a meeting in real life, but you are already living with expectations, hopes for change. And it's great!
Start dating
Dating nearby, Mechta Tannouch
'Aïn Abessa
'Aïn Arnat
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Beni Bessez
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Bir Tachema
Bordj Bou Rerhda
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Bou Abed
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Cheïkh Salah
Dar er Razi
Douar Kassandji
Ech Chebna
El Allaoucha
El Anasser
El Eulma
El Hachichia
El Hamma
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El Marsa
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En Nemala
Er Rekta
Ez Zaouia
Kerm Ali
Kherbet Bel Medani
Kou Klas
Ksar et Til
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Mechta Ouled Ahmar
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Mechta Ouled Bou Aziz
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Mechtet Seb'a 'Ayoûne
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Oued Deheb
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Oulad Ali
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Oulad Bou Renane
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Oum Ladjoul
Outa Ben Aroun
Ras el Ma
Râs el Ma
Salah Bey
2023 © Tillybom - online chat for dating for free, no registration, Mechta Tannouch


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Arburg Mim Machines Web
February 14, 2022
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Movie Trailers
FOR GREATER GLORY Trailer Online!
What price would you pay for freedom? In "For Greater Glory," an impassioned group of men and women each make the decision to risk it all for family, faith and the very future of their country, as General Gorostieta (Andy Garcia), the retired military man who at first thinks he has nothing personal at stake as he and his wife (Eva Longoria) watch Mexico fall into a violent civil war. Yet the man who hesitates in joining the cause will soon become the resistance's most inspiring and self-sacrificing leader, as he begins to see the cost of religious persecution on his countrymen… and transforms a rag-tag band of rebels into a heroic force to be reckoned with. The General faces impossible odds against a powerful and ruthless government. Yet it's those he meets on the journey – youthful idealists, feisty renegades and, most of all, one remarkable teenager named Jose – who, reveal to him how courage and belief are forged even when justice seems lost.For Greater Glory will hit limited theaters in the U.S. on June 1st, 2012. [source: Comingsoon] What do you think of the trailer?


text:
A view of some nearby rooftops and a stunning sunset over Marrakesh, Morocco. In black and white I know, but I have a few more shots of the same sky coming! This was shot from Riad O2 in the city where Polldaddy recently stayed.
In the Medina many (most?) of the houses are jam packed in next to each other. We had to take a winding alley way from the main road to the building, going left, right, left, right, left (and maybe 2 more turns?) to get there. Like nothing I've ever experienced before.
What's Marrakesh like? The medina is the old fortified town which is where we were staying. You'll be woken each morning by the Muslim call to prayers as there are loud speakers dotted around the city. Currently the first one starts around 5:30am so I hope you can get back to sleep afterwards! I wasn't too fond of heading out in the city. It's very busy, vehicles of all sorts zoom up and down the streets. Everything from motorbikes to carts pulled by donkeys will pass you by. There are no traffic lights in the medina either and footpaths disappear without warning, if they existed at all.
The food we ate there was excellent, both in the riad and outside. Well, except for the one night we decided to sample what was on offer in the plaza. What a mistake! For the same price you'll get a top quality meal in a fancy restaurant elsewhere!
The hot air balloon guys were super friendly and I can recommend them, the locals taking care of us in the riad were too but out on the street was another matter. Talk to anyone and they'll either lead you to a particular area of the souk or demand a tip for "showing" you the way.
If only we could get a bit of their sun here in Ireland right now. Go on clouds, let the sun through!
Oh yes, I may have to change the tagline on this blog. This photo was processed by Adobe Lightroom. It's not Photoshop but it's close. I used this preset on this photo but Lightroom is really impressing me. It's ability to recover blown out detail is amazing, the noise reduction and sharpening tools are easy and effective. The one area it really falls down in is not being able to reassign keys. I fixed that by installing Paddy which let me assign hotkeys to my two main export presets.
I imported over 23k photos into a catalogue and it's running nice and fast. The next thing to do is write a preset and assign a hotkey to import images from my CF card.
|Canon EOS 40D
|Focal length
|Shutter speed


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Game:Oliver Twist
Oliver Twist, the extremely old and popular novel by Charles Dickens, was turned into a text-based adventure game in the late 1980's. The game borrowed 90% of its script directly from the book, with the player taking on the role of Oliver during the famous Victorian Workhouse scene in which he asks for more gruel. The game was rated 41/2 stars by numerous reviews, and was composed of high end graphics. The officially licensed music CD that accompanied the game was recorded by the 80's band Soft Cell, and was said to be reflective of the flavor of Dickens' great work. In the 2008 version, the in-game music was a collaboration by DJ Tricky and the Southern banjo quartet, Mary Sue Ellen and the Tubthumpers.
You are Oliver Twist, in the kitchen of the orphanage. You are a young, extremely hungry boy stuck in the metaphorical "craw" of 19th century England. You get up from your extremely cold stone seat after your first bowl of gruel and are heading directly toward "the master", a large man in a dirty apron who dishes out said gruel.
Text Adventures
Abyss • Choose Your Own Adventure • MMORPG • The Seven Not-So-Deadly Sins • Zork • Zork 2 • Zork 3 • Zork Abridged
Miscellaneous Games
Alone in the dark • Automated Telephone System • Digital Fortune Cookie • Confucius Says • HyperSquare • Infinite Loop • Oliver Twist • Oregon Trail • Pick Up the Phone Booth and Aisle • SimCity • Castle • Doodle Champion Island Games •The Blue Screen Of Death • VMCSE
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|Featured Article (read another featured article)
|Featured version: 10 May 2008
|This article has been featured on the main page. — You can vote for or nominate your favourite articles at Uncyclopedia:VFH.


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2007 6.7L Dodge Cummins Diesel
Smarty-J67 JR
Junior J-67 POD
Smarty-J67 JR / Junior J-67 POD
* CaTCHER Softwares
* DTC ( Diagnostic Trouble Codes ) reader in
plain text interpretation
* ABS programming for tire height adjustment
* Upgrades throuch built in USB connector
* 5 minutes requiered to update ECM
* Power on Demand ( POD )
Fast guide to Smarty-J67 JR Features
* CaTCHER software's inside
* Three different performance levels: 40 / 70 / 100 hp
* Improved fuel economy
* Optimized drivability
* Fastest download in the industry, up to three times faster
than the competition, a typical ECM update takes about
5 minutes
* ABS tire height updates in just few seconds from 22,5" to 44"
*Manual High Idle is enabled in all softwares
With the Truck in park, activate cruise control. When dash light
illuninates hit set, this will activate high-idle. Use accell button on
steering wheel to set the rpm's in increments to the level you desire.
To turn the feature off, simply hit cancel on the cruise control or
tap the brake pedal.
* Reads Diagnostic Trouble Codes in plain text
* No tools required, no fuses to pull
* USB built in for simple updates from internet
* Easy installation
* Reliable, it works off your OEM hardware
* Programmable parameters for fine tuning
* Power on Demand function
Fast guide to Smarty-J67 JR software levels
The horsepower settings have a modified "Torque
management" ( TQM ). The throttle response is greatly
improved but is set to a safe limit. With "Safe" Smarty means
safe for your tranny and rest of the driveline.
* SW # 1 : 40 Hp increase
* SW # 2 : 70 Hp increase
* SW # 3 : 100 Hp increase
Tested on stock trucks on a Dyno.
Stock means just that. Stock! Even the air filters were stock...
The trucks were S T O C K, even the wastegate settings!
Smarty checked the "baseline" ( the stock truck Hp at the rear
wheels ) twice in a day in order to be sure about Smartys findings.
The above declared HP numbers are all rounded down to the
closest number.
ABS / Speedo recalibration
The tire height can be adjusted up to 44" in increments of 10
tenth of an inch in just a couple seconds. Of course, Smarty
needs to be VIN# locked to the truck in order to get into the ABS
adjustment section.
DTC Code reader
The name says it all.
You can read and erase codes. Codes are displayed also in
plain English. That's old news by now. Smarty S-03 was the first
one to provide that utility, others found the idea to be a good
one too.
( Smarty does erase ABS codes too but does not display them )
ECM update speed
Faster than anything else on the market! Again Smarty has done their
homework on the protocol. Less than 5 minutes. Three times
faster than a Star-Scan diagnostic tool or competitor.
Smarty has developed its own bootloader in order to not have to
pull fuses should an update become interrupted for any reason.
All you have to do is to turn the key off / key on Smarty
does everything else on it's own.
The CaTCHER softwares as they are today are only a starting point.
Call Toll Free: 1-888-857-0391
Outside Continental US: E-mail


text:
Renovation Style Guide: March 2012
Stone Forest's Eau soaking tub is fashioned from a single slab of Carrara marble. It measures 42" h. x 38" w. x 48" dia. and holds a generous 75 gallons. Priced at $25,500 without fittings, the tub can be custom sized and carved in a variety of stones, including limestone and granite. 888-682-2987; stoneforest.com
Darryl Carter, a decorator known for his spare, tailored interiors, has collaborated with Benjamin Moore for his first line of paints. The collection of 24 subtle colors encompasses such calming shades as, from top, Pinecrest Gray, Bayard Blue, and Dalton Blue. A gallon of the self-priming paint costs $66, and a quart is available for $24. 800-672-4686; benjaminmoore.com
Zurich-based designer Alfredo Häberli's exclusive line for Georg Jensen includes a striking assortment of glass and stainless steel containers. Ideal for storing kitchen staples or bath products, the ergonomic canisters ($30 to $70 each) look good solo or as a collection. Sizes range from approximately 8 to 68 ounces. 800-546-5253; georgjensen.com
Thermador's 48" Pro Grand steam range is the first appliance to offer home cooks a combination steam and convection oven, a six-burner gas cooktop, an electric grill, and a warming drawer all in a single unit. The range is made from high-grade stainless steel and costs $14,000. 800-735-4328; thermador.com
The Giada fireplace surround from Eldorado Stone is hand made using a blend of materials—including limestone particles, minerals, and natural pigments—so that it is lighter than traditional limestone. The clean-lined piece measures 67" w. x 52" h. It costs $2,600 and comes in three colorways and two finish options (Oyster Shell in a honed finish is shown). 800-925-1491; eldoradofireplaces.com
Barnaba Fornasetti designed Fornasettiana ceramic tiles in homage to his father, Piero, the legendary Italian designer. The 8" sq. tiles are hand-painted and are available in a matte or glossy finish. An assortment of 12 costs $413 and comes with one of each design, including Fornasetti's iconic moons, hands, and a pair of ruby-red lips. 212-674-9700; hastingstilebath.com
• What the Pros Know: Cleaning
This article was featured in the March 2012 issue.
Click here to subscribe to the magazine.
Joanna Gaines Reveals Her Budget Renovation Tips
How to Paint Your Kitchen Cabinets
Common Mistakes People Make on Kitchen Cabinets
The Ultimate Guide to Choosing the Right Paint


text: Back Pneumonia and Influenza Flu and pneumonia are respiratory illnesses that should not be taken lightly. In the U.S., pneumonia and the flu combined are the eighth leading cause of death. Older adults are at greater risk than younger adults for contracting pneumococcal pneumonia, the most common bacterial form of the disease. Taking steps to prevent pneumonia, recognizing the symptoms, and getting early treatment are vital to maintaining good health. What is pneumonia? Pneumonia is an inflammation of the lungs—either one or both—caused by an infection. The inflammation makes it difficult for oxygen to reach your blood. Pneumonia can have more than 30 causes, but the five main culprits are bacteria, viruses, mycoplasma, other germs such as fungi and parasites, and chemicals. The most common form of pneumonia is caused by viruses; half of all pneumonias fall into this category. Bacterial pneumonia can develop after a case of the flu, when your immune system is weak from fighting the flu virus. Bacterial pneumonia is commonly caused by Streptococcus pneumoniae, but this form of pneumonia can be prevented with a vaccine. Pneumonia can be a serious, potentially fatal condition, particularly in the very young and in older adults. Although most people think of pneumonia as affecting only the lungs, the bacteria that cause pneumococcal pneumonia can attack other parts of the body, according to the National Institute on Aging. When these bacteria attack the covering of the brain (meninges), they cause meningitis. When they enter the bloodstream, they cause bacteremia or septicemia. They can also cause middle ear and sinus infections. The pneumococcal bacteria are found in many healthy people. They are spread from person to person through coughing, sneezing, or close contact. Researchers don't know why the bacteria suddenly invade the lungs to cause illness. What is influenza? Influenza—or the flu—is a highly contagious respiratory infection caused by a virus. Although the flu is usually mild in children and younger adults, it can cause life-threatening viral pneumonia in older adults. Influenza epidemics such as the one in 1918 (Spanish Flu) have killed millions of people worldwide. The best medicine Experts recommend the pneumococcal vaccine for people at high risk for serious problems if they get pneumonia, and for everyone 65 or older without serious problems. High-risk adults include those with chronic conditions like asthma, alcoholism, COPD, and diabetes—all of which affect the immune system; residents of nursing homes and long-term care facilities; and people who smoke cigarettes. The CDC says that some strains of the bacteria causing pneumococcal pneumonia have become resistant to the drugs used for treatment. This makes prevention through vaccination even more important. Anyone age 6 months or older should receive an annual seasonal flu vaccine. Influenza viruses are constantly changing, so it's important to get a new flu shot each year. It's best to get a flu shot in the fall, when the vaccine becomes available in your community. Flu vaccine is generally available from the end of September or early October until the end of the season in January or February. The CDC recommends that people ages 65 and older have a second dose of the pneumococcal vaccine if it has been five years since the first dose and if they were younger than age 65 when they received it. These steps can also help prevent pneumonia and the flu: Wash your hands frequently, using soap and water or an alcohol-based cleanser. Don't smoke. Get adequate sleep, exercise regularly, and eat a nutritious diet. Know the symptoms Prevention is the best medicine, but recognizing pneumonia symptoms and getting professional care right away can help you protect your health. The symptoms of bacterial pneumonia can appear gradually or suddenly: Fever, which can be as high as 102 degrees F (38.9 C) Shaking chills Sharp chest pain Abdominal pain Profuse sweating, confusion, rapid breathing and pulse rate, shortness of breath, and severe fatigue Cough that produces greenish or rust-colored mucus Worsening of symptoms after a cold or the flu These are symptoms of viral pneumonia: Initial flu-like symptoms: Fever, headache, muscle aches, and dry cough Worsening of symptoms after 12 to 36 hours: Fever, breathlessness that may become extreme and a more severe, dry cough that produces small amounts of mucus These are symptoms of the flu: Headache Chills Dry cough Muscle aches Fever Stuffy nose Sore throat Flu symptoms typically come on suddenly and stomach or abdominal symptoms more common in children than adults. Get treatment quickly Early treatment of bacterial pneumonia helps with recovery, so see your health care provider as soon as symptoms appear. If your doctor diagnoses bacterial pneumonia, treatment typically includes antibiotics and possibly other medications to help relieve coughing and chest pain. No treatment usually is given for viral pneumonia, although medication can be taken to relieve symptoms. Early treatment of the flu with antiviral drugs is effective in older adults.


text:
From everyone at Abt, we wish you a happy and healthy holiday season.
We are here to assist you in the store, on the phone, or via live chat until 6 p.m. this evening.
The Abt's showroom, phone sales, and live chat will be closed on December 25, but our website is always open!
Again, Happy Holidays from the Abt Family to you!
-Kelly B.


text:
Hello, Slate Plus members! We're going to send you a weekly letter from a Slate staffer giving you a little bit of a roundup on who we are and what Slate's been up to. This week, your guest editor is … me!
I'm Dan Kois. I'm a Capricorn. I work at Slate D.C., where my office is right next to Weigel's and across from Dobson's, so I am like a lonely bastion of Culture among all the philistines of D.C. (Just kidding, Weigel watches more movies than me.) I came to Slate in 2009 from my basement, where I worked as a freelance writer, and before that from New York magazine, where I was a founder of the Vulture blog.
My association with Slate is long and proud; the first freelance article I ever got paid for was in Slate, in 2004, when I quit/was fired from a job in book publishing and I was like, Screw this, I am gonna WRITE. It was an incisive, crucial Explainer answering the question "Does peeing on your hands really make them tougher?" Now 10 years later I edit our TV coverage and the Slate Book Review, plus other culture stuff. I also host the Audio Book Club and co-host Mom and Dad Are Fighting. And I've been the editorial lead on Slate Plus, helping Jennifer and Jeff make all this sweet content.
This week at Slate was marked by the official launch of Slate Plus. We were in beta for the last few weeks, but now we're real. (I think the term is "gamma" now, right tech people?!) I spent all of Monday commenting madly on Plotz's official Slate Plus welcome, which I hope you checked out.
But I also edited regular Slate pieces this week! Here's a piece I ran, reprinted from our friends at Orion magazine, about the amazing new plans to revitalize the New York and New Jersey shorelines, post-Sandy, using oysters and sand dunes and other methods of letting nature take the coast back.
Here's the most important piece Slate ran all week.
This TV Club on Sally and Don in the second episode of Mad Men is the piece this week I agree with the most.
Here's the piece on Slate this week whose argument I most strongly disagree with.
Here's the wrongest piece in the history of Slate, now and forever, forever and ever, amen.
Thank you for being a member of Slate Plus! I am thrilled that we have such active, engaged, passionate readers, and honored that you guys want to spend some money on us. I hope you continue to enjoy your Slate Plus membership for months. No, years! Jeff and Jennifer told me to say "years."
As always, email Jeff and Jennifer at firstname.lastname@example.com if you have any questions or concerns or suggestions. And thanks again!


text:
Alex Nott is visiting New York City and heard gunshots near the Empire State Building this morning, and documented the scene with video shot on his cell phone.
The video you will see shows the gunman on the ground, along with wounded bystanders. This is part of the crime scene, located on a crowded city street. This video was shot during the aftermath of the shooting, and is graphic and terrifying.
Anderson Cooper spoke to Alex about what he witnessed.
Post by: Anderson Cooper
Filed under: Anderson Cooper • Empire State Building shooting
Anderson Cooper goes beyond the headlines to tell stories from many points of view, so you can make up your own mind about the news. Tune in weeknights at 8 and 10 ET on CNN.
Questions or comments? Send an email
Want to know more? Go behind the scenes with AC361°


text:
e-Commerce Revenue Analytics babylux.be
babylux.be is an online store with nationally-focused sales. Its eCommerce net sales are generated almost entirely in Belgium. With regards to the product range, babylux.be specializes in the Toys, Hobby & DIY category, particularly in the area of Toys & Baby.
Global net sales (2021)
Global rank (2021)
Main country
Main category
Toys, Hobby & DIY


text:
It seems that only yesterday, Internet Explorer was a clunky abomination of a browser that lagged behind its competition in all features, crashed constantly, and was generally frowned upon by anyone with the knowhow to download something better. Seeing as the latest version, Internet Explorer 8, was just released yesterday, that embarrassing recollection of failure literally was last week.
While browsers like Firefox, Chrome, Opera and Safari have made quantum leaps in performance, feature set and general usability within the past year, Microsoft's offering, Internet Explorer 7, has remained practically stagnant since its release in 2006, riding on its success as the de facto "browser of choice" (or lack of choice) for lazy Windows users everywhere. With Internet Explorer 8, Microsoft has taken an incremental step forward, but probably not one big enough to lure power users back to the brand they abandoned many versions long ago.
Internet Explorer 8 includes all the usual claims that come with a fresh release, including faster performance, more security, and better reliability, but the gang up in Redmond have thrown in a few new toys as well. Accelerators, for instance, allow users to highlight words on a page and then quickly perform tasks with them. Highlight an address, click on IE8's blue Accelerator icon that pops up beside it, and you can view it on a mini map almost instantly. Tabbed browsing now uses color coding, and Web Slices allow you to grab pieces of a page that change constantly (like a weather forecast) and turn them into a sort of mini bookmark that appears on the favorites tab.
We gave Internet Explorer 8 a fair shake, exercising features new and old in our daily browsing to see how far the software has come. While the latest version definitely marks an improvement over its ailing predecessor, we stumbled across enough caveats and pitfalls in the new features to dismiss it as a freshly revamped – but still fundamentally lame – browser.
Hands On
The very first stumbling block we ran across came as soon as we attempted to import our settings from our usual browser of choice – Firefox. While Chrome had no problems automatically duplicating bookmarks from an existing browser of choice and setting itself up to instantly feel like home, IE8 neglected the toolbar bookmarks –the most important – to keep its own mish-mash of "Suggested Sites" and "Get More Add-ons" pegged to the favorites bar. Thanks, but no thanks.
Visually, Internet Explorer 8 hasn't moved forward much from previous versions either. A few years back, we could call the browser's aesthetic "clean," but with the likes of Opera, Chrome and Safari setting new standards in clean interface design, IE8 still looks somewhat cluttered in comparison. Like the old version, Vista does help improve the look quite a bit, though.
Browser Comparison
Microsoft has touted improvements to tab browsing as one of its biggest steps forward with IE8. Clicking on links from within one tab now opens them in separate tabs it color codes to show where they came from. All the news articles we read this morning, for instance, took on a pale yellow background, while the new tab we opened to start checking on eBay items showed up in purple. This can be useful for keeping different online endeavors separated within the same window, rather than opening a new browser for different tasks. You can also click a button marked with a tile icon to view all open tabs by as graphic thumbnails, rather than name, which can be useful when you have 14 different tabs open and only a few letters of each title to browse by. Both of these additions turned out to be genuinely helpful, but were nearly negated by one intensely annoying faux pas: The tab you have maximized is highlighted so weakly that it can be difficult to look at a bar full of five of them and pick out which is on top.
The premise behind Accelerators seems to be taking one step out the usual copy-and-paste routine we all play while Web browsing. Normally, for instance, you might find the address of a business, copy it, open a new tab, load Google Maps, and paste it in. With Accelerators, you can highlight it, click a blue icon beside the highlighted text, hover over "Map with Live Maps" and the map will flash open beside it in a square mini window. Alternatively, you might highlight a word you don't know, and get the definition the same way. It's a neat trick, to be sure, but the non-Microsoft implementations of it so far still require some polishing. When we substituted Google Maps for Live Maps, for instance, we no longer got a mini window, we had to open a new tab. And though the Wikipedia Accelerator tried to pull off mini window functionality, more often than not, it just spit out "We are unable to display this view" instead.
Web Slices also leverage this simple overlay technique, sitting on the favorites bar like bookmarks until you actually click them, when they open as a mini window instead of a new tab. If you just need to know the weather, for example, a Web Slice is a faster way of pulling it up in a hurry, compared to navigating to the full Weather.com page for your city. Trouble is, there aren't many Web Slices out there right now, and those that do exist didn't seem too useful. You can check out the top stories on Digg in a hurry, for instance, but unless you're interested in the top four stories, you're better off just taking the extra second to visit the real page and see them all.
Microsoft has made a point of reminding the public that Internet Explorer runs significantly faster than the previous version, which is a bit like bragging about beating a Ford Festiva in a drag race in your new car. Internet Explorer 8 undoubtedly improves on that track record, but not enough to run with the latest crop of hares, including Firefox and Chrome. Multiple benchmarks, including Java's SunSpider, show IE8 lagging behind its competitors. But those are benchmarks, and in real life we noticed little difference between Chrome and Internet Explorer. We pitted three browsers against one another in our own informal test – how fast each could load Gmail. Chrome did it in 1.9 seconds, Firefox in 2.2 seconds, and Internet Explorer 8 in 3.1. That's a large disparity between the top and bottom, but in real life, you're not likely to notice without a stopwatch in hand.
There's more of course – a visual search that pulls up a list of thumbnails as you type from the search bar, a slate of useful options that appear in every new tab, and a "compatibility view" that allegedly improves the look of pages coded for old browser. There's even the much snickered-about "InPrivate" mode that allows you to turn off the history on your browser altogether. But in truth, all of these features are pretty easy to overlook unless you know what you're looking for, and equally easy to dismiss as gimmicks.
We're glad that Microsoft hasn't forgotten about Internet Explorer entirely. With about three quarters of the browser market nailed down, it very well could. But Internet Explorer 8 makes it clear that Microsoft is doing the bare minimum in the innovation department to keep up, and hasn't been attempting anything near as ambitious the projects Google and Mozilla have cooking away at their labs. None of Microsoft's more unique features, like automatically colored tabs, Accelerators or Web Slices really blew us away or tempted us to move on from other browsers. Chrome remains faster, Firefox remains more customizable, and Safari remains more user friendly. Until Microsoft can topple one of these all-important categories, Internet Explorer remains where it has always been – the standard for people who don't care.
Editors' Recommendations
- The Windows 11 taskbar is getting an important new update
- Bing Chat: how to use Microsoft's own version of ChatGPT
- How to convert a PDF to a Word document
- How to record your computer screen
- Ranking all 12 versions of Windows, from worst to best


text:
The Problem
Clavicle fractures are common injuries, accounting for 8-15% of all fractures in children and adults. They are caused by direct trauma, falls on the shoulder, or falls onto an outstretched arm. Clavicle fractures occur at three locations:
Mid-shaft clavicle fractures – most common, accounting for 85% of all clavicle fractures
Lateral clavicle fractures – 10-15% of cases
Continue Reading
Type 1 – Lateral to the coraco-clavicular (CC) ligaments (minimal displacement)
Type 2 – Medial to the CC ligaments (may have significant displacement)
Type 3 – Intra-articular fracture extending into the acromioclavicular (AC) joint
Medial clavicle fractures – rare, <5% of cases
Anterior displacement
Posterior displacement
Are often a fracture through the medial clavicle physis (e.g., Salter Harris type II injury), and may be associated with sternoclavicular dislocations
Clinical Presentation
Patients with clavicle fracture generally present with a clear history of trauma, pain over the affected clavicle, and deformity depending on the extent of displacement that is present. Patients may present with associated injuries and other symptoms, such as: dyspnea (from pneumothorax), weakness, paresthesia or paralysis (from brachial plexus injury), and difficulty swallowing or speaking (from injury to trachea or esophagus in medial clavicle fractures with displacement).
It is important to examine the clavicle for deformity, crepitus, or motion in poly trauma patients who are unable to communicate (e.g., intubated patients). There is a high prevalence of clavicle fractures in these patients, which may be missed if not property examined.
Diagnostic Workup
Physical examination
Physical exam findings are based on location of fracture:
Mid-shaft clavicle fractures – generally there is pain and deformity in the middle aspect of the clavicle. The deformity is more appreciated with severe displacement. (The proximal fragment displaces superiorly, the distal fragment inferiorly).
Lateral clavicle fractures – Lateral clavicle fractures may present similar to AC joint separation injuries, with superior displacement of the proximal fragment. The extent of deformity depends on the amount of displacement at the fracture site.
Medial clavicle fractures – These patients may complain of sternal pain. They should have detailed examination of the mediastinal contents, to rule out injuries to the lung, esophagus, trachea, or great vessels. Any difficulty in breathing or swallowing should alert the physician to further investigation.
In all cases is important to examine the entire affected extremity, assess the neurovascular status of the limb, and look for associated injuries (pneumothorax, associated fractures). Physical examination should include assessment of the following:
Pain – Patients with clavicle fractures have focal pain with palpation over the fracture site.
Deformity – It may be possible to appreciate obvious deformity, motion, or crepitus depending on the extent of displacement and injury severity.
Vascular – The vascular status of the limb should be examined, and compared to the contralateral side. Any sign of arterial injury should be further investigated with appropriate workup (e.g., CT angiogram) and vascular surgery consultation.
Neurologic – Neurologic assessment of brachial plexus should be assessed and documented, and compared to the contralateral side.
Respiratory – Patient should have assessment of their respiratory function. Any sign of respiratory distress or abnormality should be further worked up, to rule out possible pneumothorax or other intra-thoracic injury.
Mediastinal contents – Injury to the esophagus, trachea or great vessels should be assessed in cases of medial clavicle fractures, especially if there is posterior displacement of the fragment.
Radiographic Assessment
Appropriate X-ray views include:
Upright antero-posterior (AP) clavicle view – Ensure upright views are obtained. Supine radiographs may underestimate the amount of displacement at the fracture site. The deformity is more pronounced when the patient is upright sitting or standing.
Zanca view – For distal clavicle/AC joint. AP X-ray centered over AC joint, with 10° cephalic tilt.
Serendipity View – For medial clavicle or sterno-clavicular (SC) joint. AP view centered over SC joint, with 40° cephalic tilt. It is best to compare this to the contralateral side.
AP chest – If there are any concerns regarding pneumothorax.
CT scan
Medial clavicle fractures are difficult to appreciate with plain radiographs. A CT scan can better delineate the injury, the direction of displacement (anterior versus posterior), and possible injuries to mediastinal contents.
CT angiogram can assist with delineating injury to the vascular structures, especially if there is concern regarding arterial injury.
EMG, nerve conduction studies
In rare instances with brachial plexus injuries, further testing with EMG and nerve conduction studies can assist with extent of involvement, and prognosis.
Non-Operative Management
Indications for non-operative treatment
Non-displaced or minimally displaced fractures, in any location are typically managed non-operatively. This includes fractures of the mid-shaft, medial or lateral clavicle.
Displaced fractures of the clavicle may be treated non-operatively in selected cases. These include those with <100% displacement and ≤ 2 cm shortening on radiographs. Even if the radiographs meet the criteria for surgical fixation, patient factors are important to consider. The following patient factors should lead one to strongly consider non-operative treatment: older patients (> 65 years old), those with multiple medical co-morbidities, those with a high risk of surgical complications (diabetes, smoker), those likely to be non-compliant with postoperative care and rehabilitation (alcohol/drug use) those with a sedentary occupation and those with minimal symptoms.
Non-operative treatment protocol:
Regular arm sling applied to affected extremity for 1-2 weeks, patient may remove the sling and perform pendulum exercises of the shoulder to prevent stiffness. Wean off sling after 2 weeks, continue with range of motion exercises. Strengthening exercises after 6 weeks.
Indications for Surgery
Mid-shaft clavicle fractures
Prospective studies regarding surgical indications for clavicle fracture fixation are focused on mid-shaft clavicle fractures. The current indications include:
Open fractures
Fracture associated with vascular or neurologic injury
Floating shoulder (associated fractures of scapula)
100% displacement
>2 cm shortening
Young, active, healthy patients
Lateral clavicle fractures
Type 2 lateral clavicle fractures are known to have a higher rate of non-union (up to 50%), compared to type 1 and type 3.
While there is no level I evidence present, type 2 fractures with 100% displacement may benefit from surgical fixation in select cases.
Medial clavicle fractures
These injuries are rarely treated surgically.
Surgical indications include: severe displacement, especially posterior displacement which may cause symptoms such as difficulty with swallowing or dyspnea.
Surgical Technique
Mid-shaft clavicle fractures
Necessary equipment/instrumentation
Pre-contoured clavicle plates – Refrain from using pelvic reconstruction plates, especially in larger adults – there is a higher rate of hardware failure in adult patients (plate breakage, plate bending).
Intramedullary nail devices – these may also be used, but generally they are better indicated for stable, non-comminuted fractures. There is an issue with lack of rotational stability (lack of distal locking in most models). Also many of these nails need to be removed after fracture union.
Patient set-up
General anesthesia, with or without regional block.
Beach chair semi-sitting position (Figure 1).
The ipsilateral arm may be tucked in by the side (our preferred choice), or draped free.
The involved shoulder is prepared and draped (Figure 2).
Surgical procedure
Our preferred technique is open reduction internal fixation (ORIF) with plate and screws: anterosuperior approach:
Oblique incision is made centered over the clavicle.
Supraclavicular nerve branches may be present, and should be protected and retracted away.
Subcutaneous layer is developed all around.
The myofascial later is split longitudinally over the clavicle, and the fracture site is identified. (In case of anterior plating, more soft tissue dissection of the pec muscles is required to expose the anterior aspect of the clavicle)
Fracture site is cleared of debris and hematoma, and the fracture reduced anatomically.
Provisional reduction is held with a K-wire or reduction clamp and definitive fixation applied.
A lag screw may be used in lag fashion if possible.
If there is comminution with an intervening Z fragment, this can be lagged to one of the main fragments, creating a simple fracture pattern for fixation. Ensure this Z fragment is reduced and secured while maintaining soft tissue attachments to the fragment.
A pre-contoured clavicle plate is applied for fixation along the anterosuperior or anterior aspect of the clavicle, with a minimum of three screws in the distal and proximal fragments. (Screw lengths are usually 12-16mm) (Figure 3)
Following fixation, a two-layer closure is performed: the myofascial later is closed with figure of eight No. 1 Vicryl absorbable sutures, and skin/subcutaneous tissues with non-absorbable 3-0 Prolene horizontal mattress sutures (Figure 4).
A standard sterile dressing and sling is applied.
Lateral Clavicle Fractures
Necessary equipment/instrumentation
Pre-contoured lateral clavicle plates – these plates have a distal flair with multiple screw options at the distal end of the plate, for improved fixation of the distal fragment.
Hook plates – may be used if the distal fragment is too small to obtain adequate fixation with a plate.
The decision to use the hook plate may be more apparent intra operatively after assessment of the distal fragment.
The hook plate is placed in a similar fashion as when treating AC joint injury.
The hook plate may need later removal after fracture healing.
Patient set-up
General anesthesia, with or without regional block.
Beach chair semi-sitting position.
The ipsilateral arm is tucked in (our preferred technique) or draped free.
The involved shoulder is prepared and draped with stockinet over the arm.
Surgical procedure
Antero-superior surgical approach centered over the fracture site (as described above for mid-shaft fractures).
The AC joint is identified; a needle can be placed into the joint to confirm the location.
The fracture fragments are then examined for best mode of fixation:
ORIF with pre-contoured lateral clavicle plates:
The fracture is reduced and reduction is held with use of K-wires.
An anatomic plate designed for the distal clavicle is applied to the superior.
Locking or cancellous screws are placed in the distal fragment (which is softer cancellous bone).
Cortical screws are placed in the shaft.
Fixation with hook plate (Figure 5):
If the distal fragment is too small for optimal distal fixation, a hook plate may be used.
The fracture is reduced in a similar fashion to that used for mid-shaft fractures.
The appropriate length hook and plate size is selected based on patients anatomy.
Ensure the hook is placed more posteriorly underneath the acromion.
It is important to ensure the hook matches the contour of the acromion, and avoid over reduction of the distal clavicle at the AC joint.
Minimum 2 cortical screws are placed in the shaft fragment.
Single lag screw or suture fixation may augment the distal fragment fixation.
Distal clavicle excision:
This may be an option if the distal fragment is very small, especially in the presence of AC joint arthritis or delayed presentation.
It is important to examine the stability of the shaft fragment; if the shaft is unstable, coraco-clavicular stabilization is needed.
The wound closure is performed in two layers as for mid-shaft clavicle fractures.
A standard sterile dressing and sling is applied.
Medial Clavicle Fractures
Necessary equipment/instrumentation
Sutures – Non-absorbable sutures (e.g., number 2 ethabond).
Plate and screw sets – 1/3 tubular plates, or pelvic reconstruction plates.
Hook plates – may be used if the displacement is in the anterior direction.
Patient set-up
General anesthesia, with or without regional block.
Beach chair semi-sitting position.
Prep and drape the chest, including both SC joints, as well as the entire clavicle from AC to SC joints on the affected side, and including the contralateral SC.
Place a bump between the scapula, for better visualization of the SC joints.
Surgical procedure
There are complications associated with these techniques, and these procedures should be performed by advanced surgeons with expertise in the field.
If there is a pure dislocation without a medial clavicle fracture, which is reducible and relatively stable, we choose to treat this with suture fixation, by placing figure of eight sutures from the medial clavicle to the sternum.
If there is instability with sutures alone, we may augment this by placing a small plate (1/3 tubular plate, or pelvic reconstruction plate) across the SC joint, spanning the joint onto the sternum. The plate will need to be removed in 6-12 weeks time, after fracture union.
If there is anterior displacement of the lateral fragment, we will consider the use of a hook plate, by placing the hook under the sternum, and placing at least two screws into the medial clavicle. Although there is no literature on this mode of fixation, we have found it to be effective in select cases. The hook plate needs removal in 6-12 weeks.
Pearls and Pitfalls of Technique
Majority of clavicle fractures can be treated non-operatively with good outcomes, surgical indication must be met for patients undergoing surgical fixation.
The screw lengths are generally 12-16mm depending on the size of patient. If the screw length measures much longer than 18mm, this should be confirmed. An error is to drill into the first rib, and inserting a longer screw than is needed, with possible injury to lung and neurovascular structures.
Avoid use of pelvic reconstruction or 1/3 tubular plates, these have higher rates of failure in most North American adult size individuals. If there is no pre-contoured clavicle plate available, a small fragment compression plate may be used with use of plate benders to contour to the desired shape. Pelvic reconstruction plates may be used in very select cases (e.g., small female patients), but have high rates of failure in larger patients.
In case of hook plate use for distal clavicle fracture, ensure the AC joint capsule and ligaments are not violated during the approach. The hook is placed along the posterior aspect of the acromion, and most of the AC joint capsule should be left intact.
The hook of the hook plate should be contoured appropriately to avoid over reduction of the clavicle at the AC joint.
Two layer closure is important for adequate soft tissue coverage over the plate and screws, to help decrease wound complications and infection.
Avoid operative fixation in unreliable individuals (e.g., substance abuse, homeless, etc). Despite the strongest anatomic fixation, there is high rate of hardware failure in the acute period if the patient suffers a fall, a withdrawal seizure, or is involved in an altercation.
If there is a worry about violation of the pleura/lung (e.g., while drilling): fill up the wound with saline irrigation and ask the anesthesiologist for a Valsalva maneuver. If air bubbles are seen coming up from underneath the clavicle, there has been a perforation of the pleura/lung. A chest x-ray is required immediately post-op, and a chest tube may be required depending on the size of pneumothorax and patient symptoms.
There have been reports of Brachial Plexus injury after surgical fixation of clavicle fractures. While there is a potential of penetrating injury from drills/screws, there is also potential for stretch/neuropraxia injury from reduction techniques and traction on the distal fragment. Overly aggressive traction should be avoided, as should over distraction or lengthening.
In case of profuse bleeding from underneath the clavicle, there may be an injury to the subclavian vein/artery (usually penetration from from drills/screws). It is important to pack the wound, apply pressure, alert the anesthesiologist, and ask for immediate vascular surgery consultation. This complication can be life threatening, leading to haemorrhagic shock, or air embolus.
Potential Complications
Non-operative complications
Nonunion – 15%-20%
Symptomatic malunion – 15% (including ongoing pain, weakness, fatigue)
Thoracic outlet syndrome
Shoulder asymmetry, deformity
Pain with backpacks, clothing straps over malunion "bump"
Scapular winging with scapulothoracic dyskinesia
Intra operative complications
Vascular injury: subclavian vein or artery (may lead to aneurysm, pseudo aneurysm, air embolism, etc)
Brachial plexus injury: from stretch/over distraction, or iatrogenic injury from deep dissection
Post operative complications
Hardware irritation, need for hardware removal (higher risk for shorter individuals, or use of non-contoured plates)
Nonunion 1%, malunion <1%, hardware failure
Infection, wound complications
Heterotophic ossification, thoracic outlet syndrome
Post-operative Rehabilitation
Sling x 2 weeks with gentle pendulum range of motion (ROM) exercises.
At 2 weeks start ROM exercises.
At 6 weeks start resistance/strength training (if evidence of radiographic fracture healing).
Avoid contact activity or upper body strength training for minimum 8-12 weeks (e.g., pushups, weight training).
Outcomes/Evidence in the Literature
Hill, JM, McGuire, MH, Crosby, LA. "Closed treatment of displaced middle-third fractures of the clavicle gives poor results". The Journal of bone and joint surgery British volume. vol. 79. 1997. pp. 537-9. (The first study which used patient based outcome measures when assessing patients with clavicle fractures. This study reported poor outcomes of displaced clavicle fractures, a discrepancy compared to accepted knowledge. Patients had 15% rate of nonunion, 32% of patients were dissatisfied.)
McKee, MD, Pedersen, EM, Jones, C, Stephen, DJ, Kreder, HJ, Schemitsch, EH. "Deficits following nonoperative treatment of displaced midshaft clavicular fractures". The Journal of bone and joint surgery American volume. vol. 88. 2006. pp. 35-40. (This study conducted strength testing of patients with malunion of the mid-shaft clavicle fractures. They reported significant decreases in maximal and endurance muscle strength testing (compared to the uninjured side), especially in abduction. The results were worst in cases with > 2cm shortening of the clavicle.)
"Nonoperative treatment compared with plate fixation of displaced midshaft clavicular fractures. A multicenter, randomized clinical trial". The Journal of Bone and Joint Surgery American volume. vol. 89. 2007. pp. 1-10. (The first randomized controlled trial of mid-shaft clavicle fractures, reporting improved outcomes and decreased nonunion and symptomatic malunion rates in patients treated with surgical fixation compared to non-operative treatment. Inclusion criteria were: young healthy adults, > 100% displaced clavicle fractures with >2cm shortening.)
McKee, RC, Whelan, DB, Schemitsch, EH, McKee, MD. "Operative versus nonoperative care of displaced midshaft clavicular fractures: a meta-analysis of randomized clinical trials". The Journal of bone and joint surgery American volume. vol. 94. 2012. pp. 675-84. (Meta analysis of 6 RCTs of mid-shaft clavicle fractures, demonstrating improved outcomes and lower complications with surgical fixation, as compared to sling treatment.)
Clavicle fractures are common injuries, and the majority should be treated non-operatively. In select young adult patients who are active, and have >100% displaced clavicle fractures, with >2cm shortening, surgical fixation leads to improved outcomes, compared to non-operative treatment. There is little high-quality evidence regarding the best treatment strategy for medial and lateral clavicle fractures. Lateral clavicle fractures with >100% displacement may benefit from surgical fixation. Medial clavicle fractures may be associated with SC dislocation, and in select cases with severe posterior or anterior displacement these may benefit from surgical fixation.
Copyright © 2017, 2013 Decision Support in Medicine, LLC. All rights reserved.
No sponsor or advertiser has participated in, approved or paid for the content provided by Decision Support in Medicine LLC. The Licensed Content is the property of and copyrighted by DSM.
- The Problem
- Clinical Presentation
- Diagnostic Workup
- Non-Operative Management
- Indications for Surgery
- Surgical Technique
- Pearls and Pitfalls of Technique
- Potential Complications
- Post-operative Rehabilitation
- Outcomes/Evidence in the Literature
- Summary


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Hosted by Jason A. Hill & Ezra Stead with special guests: Alan Tracy and Pete K. Wong.
The MIDG Oscars Podcast, 2016 edition.
Oscar discussion and predictions for the show Sunday night, February 28th, on ABC.
Duration: 1 hour and 45 minutes.
Intro Music: The Danish Girl
Outro Music: Mad Max: Fury Road


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Night of Miracles by Elizabeth Berg
Pub. date: November 13, 2018 – Random House
Review galley courtesy of the publisher and NetGalley
Lucille Howard is getting on in years, but she stays busy. Thanks to the inspiration of her dearly departed friend Arthur Truluv, she has begun to teach baking classes, sharing the secrets to her delicious classic Southern yellow cake, the perfect pinwheel cookies, and other sweet essentials. Her classes have become so popular that she's hired Iris, a new resident of Mason, Missouri, as an assistant. Iris doesn't know how to bake but she needs to keep her mind off a big decision she sorely regrets.
When a new family moves in next door and tragedy strikes, Lucille begins to look out for Lincoln, their son. Lincoln's parents aren't the only ones in town facing hard choices and uncertain futures. In these difficult times, the residents of Mason come together and find the true power of community—just when they need it the most. (publisher)
My take: I liked this follow-up as much or maybe even more than The Story of Arthur Truluv. We met Arthur, Maddy and Lucille in that book and the story continues in Night of Miracles. I found the characters in the small Missouri town of Mason charming and recognizable. I grew up in a small midwestern town and know "these people" and wanted to know them all – from octogenarian Lucille to Tiny, the town cabbie to Iris, a new arrival to town (and several more people). They're all at various stages in life and learning to let go of long-held fears. I loved their courage to move forward despite their current and past challenges. The novel is told in short chapters that felt like vignettes but soon became connected. It was a comforting read that I quite enjoyed and recommend to fans of Elizabeth Berg and novels with a small town setting.


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Fellowship Story Showcase
Court Rules Abortion Restrictions Unconstitutional
Less than 24 hours before new abortion regulations were set to take effect in Texas, a U.S. District Court judge blocked the implementation of two provisions challenged by abortion providers, ruling that they could place an undue burden on women and are therefore unconstitutional.
This story is part of an ongoing series that 2013 Dennis A. Hunt Fund for Health Journalism Grantee and National Health Journalism Fellow Becca Aaronson will write for the Texas Tribune on women's health care in the state. For a complete look at Aaronson's extensive coverage, click here.
Monday, October 28, 2013
The Texas Tribune
October 28, 2013
Less than 24 hours before new abortion regulations were set to take effect in Texas, U.S. District Judge Lee Yeakel blocked the implementation of two provisions challenged by abortion providers, ruling that they could place an undue burden on women and are therefore unconstitutional.
In his opinion, Yeakel wrote that a provision of House Bill 2 that requires doctors performing abortions to have admitting privileges at a hospital within 30 miles of the abortion facility "places a substantial obstacle in the path of a woman seeking an abortion of a nonviable fetus and is thus an undue burden to her."
He wrote that a second provision requiring women to follow a federally-approved regimen for drug-induced abortion — as opposed to a more commonly used evidence-based regimen — would not generally place an undue burden on women seeking abortions. But he said it would be unconstitutional for the state to ban a woman from having such an abortion if it was safer for the woman in a physician's "appropriate medical judgment." Yeakel's ruling allows a physician to use the evidence-based protocol for drug-induced abortions in certain situations that present a risk to the health and safety of the mother.
Yeakel indicated during court proceedings that he believes his decision will be appealed to the Fifth Circuit U.S. Court of Appeals, which has recently upheld numerous laws that restrict abortion. He said it could eventually make its way to the U.S. Supreme Court.
The plaintiffs, who represent the majority of abortion providers in Texas, including four Planned Parenthood affiliates, Whole Woman's Health and other independent abortion providers, asked the court for an injunction to block the implementation of the two provisions originally slated to take effect on Tuesday.
The plaintiffs argued that the hospital privileges and drug-induced abortion provisions are unconstitutional because they place an undue burden on women attempting to access the procedure. They said a third of abortion facilities in Texas would not have a physician with hospital admitting privileges if the law was upheld, and would likely close, causing 22,000 women to lose access to abortion. The plaintiffs also argued that the FDA regimen that women would be required to follow is outdated compared to a commonly-used evidence-based regimen, which multiple national studies have shown is more effective, less costly and has fewer negative side effects, as it requires a lower dosage of medication.
The state's attorneys countered those arguments, claiming that the law advances the state's interest in protecting life and would not place an undue burden on women. They also argued that doctors should petition the FDA, not the state, if they believe that the agency's protocols are outdated.
Two additional provisions in House Bill 2 remain unchallenged — a ban on abortions after 20 weeks of gestation, which will still take effect on Tuesday, and a requirement that clinics meet the same standards as ambulatory surgical centers beginning in September 2014.
Shortly before the ruling, the Texas Alliance for Life sent out a press release saying the new provisions were needed to improve safety standards for women. They highlighted a state inspection report for the Whole Woman's Health facility in Beaumont, which indicated that the facility had numerous violations as of Oct. 3, including rusty equipment and a six-inch hole in the flooring of a cabinet used to store sterilization materials.
"Whole Woman's Health and Planned Parenthood want the public to believe that abortion facilities are safe for women," Joe Pojman, executive director of Texas Alliance for Life, said in a statement. "No woman should be exposed to such horrendous conditions. Women deserve better."
In September, a Texas Tribune review of state inspection records for 36 abortion clinics from the year preceding lawmakers' approval of HB 2 turned up little evidence to suggest the facilities were putting patients in imminent danger. State auditors identified 19 regulatory violations that they said presented a risk to patient safety at six abortion clinics that are not ambulatory surgical centers in Texas. None was severe enough to warrant financial penalties, according to the Department of State Health Services, which deemed the facilities' corrective action plans sufficient to protect patients.
After gubernatorial candidate and state Sen. Wendy Davis, D-Fort Worth, filibustered a bill with the same provisions as HB 2, Gov. Rick Perry called state lawmakers back to pass the legislation in a second special session. Thousands of people from across the state and the nation rallied at the Capitol to show their opposition to and support of the strict abortion regulations. When Perry signed the bill into law in July, he said, "Today's signing definitely builds upon our continued commitment to protecting life in the state of Texas."
Since its passage, the impact of the provisions in HB 2 has continued to draw national attention. Thousands of people have submitted comments on the proposed rules to implement the law, according to the Department of State Health Services. Given the volume of the submissions, it's currently unknown how many of those comments are in support of or opposition to the proposed rules.
The chief executives of four Planned Parenthood affiliates in Texas wrote in a letter submitted to the state on Thursday that the proposed rules "would do nothing to protect Texas women's health, and in fact would jeopardize their health by forcing safe abortion providers to close down, making safe and regulated abortion services far less accessible." According to the letter, no more than eight abortion facilities would remain open in Texas if the proposed rules took effect, depending on whether additional abortion providers were able to obtain hospital admitting privileges or open ambulatory surgical centers.


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No. 21 Oregon edges USC
Los Angeles, CA – Oregon extended its winning streak to six games, but it was hardly a cakewalk.
Damyean Dotson and E.J. Singler each shined in the second half to help the 21st-ranked Ducks escape the Galen Center with a 76-74 victory over a USC Trojans team that played its first game under interim coach Bob Cantu.
Dotson scored 11 of his 16 points after halftime, while Singler supplied 12 after being held to two in the first half.
Tony Woods, Carlos Emory and Dominic Artis finished with 10 points apiece for Oregon (15-2, 4-0 Pac-12). The Ducks have won their first four conference games for the first time since 1973-74, when the league was called the Pac-8.
J.T. Terrell had 22 points for the Trojans (7-11, 2-3), who nearly forced overtime but saw their rally fall short in Cantu's debut.
Cantu took over for Kevin O'Neill, who was fired Monday.
Singler nailed a 3-pointer to put the Ducks up 75-65 with 2:57 remaining, but USC charged back with a 9-0 run. Terrell sank two free throws to trim the deficit to 75-74 with 33.1 seconds remaining.
After Artis made 1-of-2 at the stripe, the Trojans called a timeout to draw up the tying or possible winning play. USC missed a 3-pointer for the lead and then couldn't convert two putbacks before Oregon's Arsalan Kazemi secured the rebound.
Game Notes
Oregon has won the last six meetings with USC ... Eric Wise scored 17 points for the Trojans ... The Ducks led 35-31 at halftime ... USC shot 45.3 percent from the floor, but missed 12 free throws ... Oregon finished shooting 42.9 percent.


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Writer travels Europe with a 1963 guidebook
When Minneapolis writer Doug Mack found a 1963 copy of Frommer's "Europe on Five Dollars a Day," he first laughed at how outdated it was, and then he got inspired. He decided that he would try to follow the nearly half century old guidebook on a trip through Europe's great cities.
Mack's mother had used the same book to make a "Grand Tour" of Europe in the late 1960s. He dug up her old letters from the trip, and along with the book, used them to begin planning his trip.
Now he's written about his modern day budget-conscious adventure in a new book, "Europe on Five Wrong Turns a Day."
Cathy Wurzer talks with Doug Mack about his travels.
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text: Tun Tavern Brewery and Restaurant Bars / Clubs Location 2000 Kirkman Boulevard Atlantic City, NJ 8401 View Map | Get Driving Directions Contact Information 609-347-7800 Other Dining and Nightlife in Atlantic City 2825 Restaurant A and B Food Market A C Diner A C Popa Pizza Abe's Westside Soul Deli Staying in Atlantic City for a While? Check out these Places to Stay. A Family of Luxurious Inns & Lodges Ascot Motel Atlantic City Airport Hotel/Travel Lodge Atlantic City Hilton Casino Hotel Bally's Park Place April 2, 2023, 6:27 am VisitNJShore Editor


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Rupp, Adolph Frederick
Rupp, Adolph Frederick, 1901–77, American college basketball coach, b. Halstead, Kans. He attended the Univ. of Kansas (grad. 1923), and began coaching at the Univ. of Kentucky in 1930, leading the Wildcats for 43 seasons and earning the nickname
Baron of the Bluegrassbefore retiring in 1972. His teams achieved a then unprecedented 874 wins, establishing a winning record of more than 82 percent, and Kentucky became famous for its aggressive fast-break, man-to-man offense. Among his teams' titles were 27 Southeastern Conference championships, four NCAA tournament victories (1948, 1949, 1951, 1958), and a National Invitational Tournament (1946). Rupp also was co-coach of the 1948 gold medal Olympic team, and was named (1969) to the Basketball Hall of Fame.
See his Championship Basketball (1949, repr. 1957); biography by R. Rice (1994).
The Columbia Electronic Encyclopedia, 6th ed. Copyright © 2023, Columbia University Press. All rights reserved.
See more Encyclopedia articles on: Sports: Biographies


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Retail sales up 1 percent in February
Shoppers snapped up new cars, clothing and electronics in February, pushing retail sales up for the eighth straight month.
Retail sales rose 1 percent last month, the Commerce Department reported Friday. Part of the gain reflected higher prices for gasoline. Still, excluding sales at gas stations, retail sales rose a solid 0.9 percent.
February's jump in sales followed a strong upward revision that showed a 0.7 percent increase in January. That was more than double the original estimate.
Sales totaled $387.1 billion, up 15.3 percent from the recession low reached in December 2008. A Social Security tax cut and rising employment will likely encourage consumers to spend more this year, although higher gas prices will cut into their disposable income.
"This is a very encouraging report," said Paul Ashworth, chief U.S. economist at Capital Economics. He said spending should be a strong 3 percent or more in the first three months of this year. This category is closely watched because it accounts for 70 percent of total economic activity.
The tax cut is "undoubtedly still providing a temporary boost," Ashworth said. But he cautioned that higher energy prices would start affecting household budgets in the next month or two.
Auto sales led the February increase, rising 2.3 percent. Dealers have been enjoying stronger demand in recent months as the economy improves and more people find jobs.
The major automakers offered discounts last month and that gave added momentum to sales. All the major car companies reported double-digit gains for February.
Higher oil prices also pushed sales up. Gas station sales climbed 1.4 percent, the biggest jump since December.
Better weather brought people back to department stores. Sales rose 1 percent, a rebound from a 0.4 percent drop in January when winter storms kept people from shopping.
Online shopping, which had benefited from the bad weather in January, showed a 0.3 percent dip in February.
Sales at electronics and appliance stores rose 0.9 percent in February after falling 0.2 percent in January.
Sales at specialty clothing stores rose 0.8 percent. Sales at hardware stores bounced back in February, rising 0.6 percent after having fallen 1.3 percent in January, a reflection of the severe weather.


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With a capsule collection for knitwear brand Brora out this month, it's no wonder Michael van der Ham describes himself as "busy, busy, busy." Known for his collage-style paneled dresses, the Dutch-born, London-based designer also created costumes for dancers performing in the 2012 Summer Olympic Games opening ceremony. For his Spring 2013 collection, expect pieces inspired by the works of artist Joan Miró and Malian photographer Malick Sidibé. To find out more about what makes the Central Saint Martins grad tick, van der Ham answered ELLE.com's top ten questions.
1. What is your favorite smell? "The Chateau Marmont candle."
More From ELLE
2. What do you consider to be the epitome of happiness? "I love that I have my own business, and my friends and family."
3. How do you define luxury? "Something that's not necessary but very desirable."
4. What is the last dream you remember? "I keep dreaming I am lost in a theme park."
5. What's your favorite childhood memory? "Probably skiing with my whole family in the French Alps every year."
6. What is the last book you read and loved? "The latest Madame Grès book on her entire career—it's amazing."
7. Describe your home's aesthetic. "Quite messy unfortunately."
8. What are your vices? "Holidays!"
9. Describe yourself in five words or less. "Busy, busy, busy."
10. What possession will you never throw away? "The photo albums my mom made with pictures of my sister and me taken during our childhood."


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Sussex fishermen can now report archaeological finds through the Fishing Industry Protocol for Archaeological Discoveries (FIPAD) online form.
On April 1st 2012, Wessex Archaeology launched the FIPAD on behalf of English Heritage. Working in collaboration with the Sussex Inshore Fisheries Conservation Authority (Sussex IFCA) the Protocol is a pilot project to help fishermen report any archaeological finds they come across during their work. The aim is that the protocol will eventually run nationally.
The UK's fishing fleets are responsible for some of the most important archaeological discoveries of the past 40 years, with anything from Palaeolithic flints to modern shipwrecks snagged or dredged up in fishing gear.
The online form is one of several hassle-free ways to report a find. You can report a find by either:
- Clicking the Report Now button on the FIPAD website (www.fipad.org )
- Printing out a Report Form and posting it to the "Fishing Protocol Team"
- Telephoning 01722 326867 and ask for the "Fishing Protocol Team"
- Reporting your find directly to a FIPAD Contact at your land port. Click here for a list of FIPAD Contacts.
The FIPAD website (www.fipad.org) also offers downloadable resources, which provide information on identifying archaeological finds, how to report them and what to do with a find after its discovery. Click here to visit our resource page.
This stone statue, possibly medieval in date, was reported during the preliminary development of the project. A lobster fisherman discovered it in Chichester Harbour. The statue will soon be laser-scanned by a team at Bournemouth University, which may help date and identify the piece, as there are the faint traces of lettering across the bottom of the figurine.
The Fishing Protocol Team are at hand to deal with any reports and will make sure new discoveries are highlighted on the FIPAD website. If you have questions or queries contact the team by email or phone.


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As we eagerly await the production debut of the 2015 Subaru WRX, the latest in a long line of rally-bred, turbocharged all-wheel drive machines, let us pause and reflect on what may have been the ultimate Subaru: the Impreza 22B.
The 22B wasn't just any old Subaru. It was special. Only 424 were made in 1998 to commemorate Subaru's 40th anniversary as a company, as well as their third consecutive manufacturer's title in the World Rally Championship. Loaded down with go-fast parts, widebody fender flares and an engine bumped to 2.2 liters, it remains kind of the genesis of what we know an STI to be today.
Subaru decided to pull one of the only two 22Bs in the U.S. out of their vault recently to let us see and hear what made it so incredible.
Hey, Subaru — while it's out, feel free to loan it to us for a weekend. I'll take really good care of it, I swear.


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Actually, before I go on, the pictures here do not come across well, so I have uploaded them on to flickr as well - they give you a much better idea.
This is the view down from the house, towards our yurt which always makes a good focal point for photographs. A lot of what you see in terms of visual impact now is stuff that has put itself there, notably the wild Anthriscus sylvestris and forms of Aquilegia vulgaris. Increasingly this garden is about managing self-sowing. The visual impact is also about having a limited number of species widely distributed, which is also one of the advantages of seeding - as the plants do the work for you.
The aquilegias are remarkable. Originally from seed from Jelitto, they continually seed and spread, and with a continued ability to produce a very wide range of colours, as well as occasional doubles. So often a seed strain ends up going back to a murky version of the wild plant, but not these, they almost get better and better in terms of genetic variation.
Symphytum caucasicum. A very aggressive spreader which is in its own bed, which gets mown around. It is a fantastic bee plant, for wild bumble bees rather than honey bees. In less fertile soils it struggles.
Persicaria bistorta 'Superba' in the background here. Between clumps of bamboo, which are almost the only evergreens here. They have a softness so often lacking in evergreen shrubs and fit into the landscape better.
* * * * *If you like this blog, why not check out my e-books, which are round-ups of some writing I did for Hortus magazine back in the early 2000s, along with an interview with the amazing Beth Chatto. You can read them on Kindle, or Kindle packages for smartphones or the computer. You can find them on my Amazon page here. You will also find my soap opera for gardeners - currently running at eight episodes.
I write this blog unpaid (of course) and try to do two postings a month, to try to provide the garden, wildflower and plant-loving community with information, inspiration and ideas. Keeping it coming is not always easy to fit into a busy working life. I would very much appreciate it if readers would 'chip in' (as we say in England) and provide a little financial support. After all, you pay for magazines and books, and it is only for historical reasons that the internet is free. Some money coming in will help me to improve quality and frequency, and to start to provide more coherent access to hard information, which I know is what a lot of you really want. So – please donate now!! You can do this through PayPal using email address: email@example.com
Thank you!
And thank you too to the folk who have contributed so far.********


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Iris Collection--Presby Memorial Iris Garden 2013
Welcome to my part of my 2013 collection of tall bearded iris portraits for the year, one of two galleries of the beautiful iris flowers that I was lucky to see and photograph. It was a glorious season and I happily visited the Presby Memorial Iris Gardens several times. The images make wonderful wall art and also provide iris names for those looking to confirm iris varieity identification. Many other iris images can be found in various folders under the Flowers tab at the top of the home page. Images are available in a wide range of sizes, formats and also products.Read More