Monday, December 31, 2012

Clinton's blood clot an uncommon complication

FILE - Secretary of State Hillary Rodham Clinton listens to a question during a joint news conference with Irish Taoiseach Enda Kenny at the government building in Dublin, Ireland, in this Dec. 6, 2012 file photo. Clinton has been admitted to a New York hospital after the discovery of a blood clot stemming from the concussion she sustained earlier this month. Spokesman Philippe Reines says her doctors discovered the clot during a follow-up exam Sunday, Dec. 30, 2012. (AP Photo/Kevin Lamarque, FILE)

FILE - Secretary of State Hillary Rodham Clinton listens to a question during a joint news conference with Irish Taoiseach Enda Kenny at the government building in Dublin, Ireland, in this Dec. 6, 2012 file photo. Clinton has been admitted to a New York hospital after the discovery of a blood clot stemming from the concussion she sustained earlier this month. Spokesman Philippe Reines says her doctors discovered the clot during a follow-up exam Sunday, Dec. 30, 2012. (AP Photo/Kevin Lamarque, FILE)

The kind of blood clot in the skull that doctors say Hillary Rodham Clinton has is relatively uncommon but can occur after an injury like the fall and concussion the secretary of state was diagnosed with earlier this month.

Doctors said Monday that an MRI scan revealed a clot in a vein in the space between the brain and the skull behind Clinton's right ear.

The clot did not lead to a stroke or neurological damage and is being treated with blood thinners, and she will be released once the proper dose is worked out, her doctors said in a statement.

Clinton has been at New York-Presbyterian Hospital since Sunday, when the clot was diagnosed during what the doctors called a routine follow-up exam. At the time, her spokesman would not say where the clot was located, leading to speculation it was another leg clot like the one she suffered behind her right knee in 1998.

Clinton had been diagnosed with a concussion Dec. 13 after a fall in her home that was blamed on a stomach virus that left her weak and dehydrated.

The type of clot she developed, a sinus venous thrombosis, "certainly isn't the most common thing to happen after a concussion" and is one of the few types of blood clots in the skull or head that are treated with blood thinners, said neurologist Dr. Larry Goldstein. He is director of Duke University's stroke center and has no role in Clinton's care or personal knowledge of it.

The area where Clinton's clot developed is "a drainage channel, the equivalent of a big vein inside the skull ? it's how the blood gets back to the heart," Goldstein explained.

It should have no long-term consequences if her doctors are saying she has suffered no neurological damage from it, he said.

Dr. Joseph Broderick, chairman of neurology at the University of Cincinnati College of Medicine, also called Clinton's problem "relatively uncommon" after a concussion.

He and Goldstein said the problem often is overdiagnosed. They said scans often show these large "draining pipes" on either side of the head are different sizes, which can mean blood has pooled or can be merely an anatomical difference.

"I'm sure she's got the best doctors in the world looking at her," and if they are saying she has no neurological damage, "I would think it would be a pretty optimistic long-term outcome," Broderick said.

A review article in the New England Journal of Medicine in 2005 describes the condition, which more often occurs in newborns or young people but can occur after a head injury. With modern treatment, more than 80 percent have a good neurologic outcome, the report says.

In the statement, Clinton's doctors said she "is making excellent progress and we are confident she will make a full recovery. She is in good spirits, engaging with her doctors, her family, and her staff."

___

Online:

Medical journal: http://dura.stanford.edu/Articles/Stam_NEJM05.pdf

Associated Press

Source: http://hosted2.ap.org/APDEFAULT/386c25518f464186bf7a2ac026580ce7/Article_2012-12-31-Clinton-Medical/id-10162a36d51d495085357db18bcbc63f

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NYT's Chris Buckley Expelled From China - Business Insider

New York Times journalist Chris Buckley was forced to leave China today after his annual media accreditation and residence visa were denied, John Garnaut of the Sydney Morning Herald reports.

While the official reason behind Buckley's apparent expulsion were not apparent, it is widely believed that Buckley was forced to leave due to a Times expose written by David Barboza that revealed the vast family fortunes of outgoing Chinese premier Wen Jiabao.

According to tweets from Beijing-based writer and Baidu employee Kaiser Kuo, Barboza and other members of the Times staff in China have not had problems with new visas.

Wen has strongly denied the accusations that his family were worth over $2 billion, and his lawyers had hinted at legal action against the Times. The New York Times' website has been blocked in China since the article.

A similar article about incoming President Xi Jinping's family finances resulted in Bloomberg being blocked, and reports of death threats against the authors.

Buckley, an Australian, had been working as a journalist in China for 12 years. His entire family were forced to leave the country. Garnaut describes Buckley as having a "a reputation in China for balance and rigour".

Earlier this year Al Jazeera's Melissa Chan was also refused a new visa for work in China. It is widely believed it was due to the strength of her reporting from the country.

UPDATE: The New York Times' own report on the situation clarifies the situation a little. Buckley had applied to transfer from Reuters to the Times for 2013, but the accreditation process had taken an unusually (suspiciously?) long time, forcing Buckley to leave.

The Times' new Beijing bureau chief, Philip P. Pan, is also waiting for his new accreditation, the Times reports.

Source: http://www.businessinsider.com/nyts-chris-buckley-expelled-from-china-2012-12

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Senate leaders offer dour take on 'cliff' talks

WASHINGTON (AP) ? A Capitol Hill deal to avert the "fiscal cliff" was proving elusive Sunday as a deadline to avert tax hikes on virtually every American worker and block sweeping spending cuts set to strike the Pentagon and other federal agencies grew perilously near.

Senate Majority Leader Harry Reid, D-Nev., and Senate Republican leader Mitch McConnell remained at odds on such key issues as the income threshold for higher tax rates and how to deal with inheritance taxes, among other issues. McConnell complained that Reid had yet to respond to a GOP offer made Saturday evening and reached out to Vice President Joe Biden, a longtime friend, in hopes of breaking the impasse.

One sign of progress came as Republicans withdrew a long-discussed proposal to slow future cost-of-living increases for Social Security recipients as part of a compromise to avoid the cliff. Democrats said earlier Sunday that proposal had put a damper on the talks, and Republican senators emerging from a closed-door GOP meeting said it is no longer part of the equation.

"I was really gratified to hear that Republicans have taken their demand for Social Security benefit cuts off the table. The truth is they should never have been on the table to begin with," Reid said late Sunday afternoon. "There is still significant distance between the two sides, but negotiations continue."

At stake are sweeping tax hikes and across-the-board spending cuts set to take effect at the turn of the year. Taken together, they've been dubbed the fiscal cliff, and economists warn the one-two punch ? which leaders in both parties have said they want to avoid ? could send the still-fragile economy back into recession. Tax cuts enacted in 2001 and 2003 expire at midnight Monday, and $109 billion in across-the-board cuts in federal spending this year would also begin this week.

Sen. Dick Durbin, D-Ill., said the two sides remained at odds over the income threshold for higher tax rates and tax levels on large estates. Republicans said that Democratic demands for new money to prevent a cut in Medicare payments to doctors and renew jobless benefits for the long-term unemployed should be financed with cuts elsewhere in the budget. Republicans also balked at a Democratic proposal to use new tax revenues to shut off the across-the-board spending cuts, known as a sequester in Washington-speak.

President Barack Obama, in a televised interview, blamed Republicans for putting the nation's shaky economy at risk.

"We have been talking to the Republicans ever since the election was over," Obama said in the interview that was taped Saturday and aired Sunday on NBC's "Meet the Press." ''They have had trouble saying yes to a number of repeated offers."

"The mood is discouraged," said Sen. Joe Lieberman, a Connecticut independent who caucuses with Democrats. "The parties are much further apart than I hoped they'd be by now."

The pessimistic turn came as the House and Senate returned to the Capitol for a rare Sunday session. Reid and McConnell had hoped to have a blueprint to present to their rank and file by mid-afternoon.

"I'm concerned with the lack of urgency here. There's far too much at stake," McConnell said. "There is no single issue that remains an impossible sticking point ? the sticking point appears to be a willingness, an interest or courage to close the deal."

McConnell and Reid were hoping for a deal that would prevent higher taxes for most Americans while letting rates rise at higher income levels, although the precise point at which that would occur was a sticking point.

Obama had wanted to raise the top tax rate on individuals making more than $200,000 a year and families making more than $250,000 from 35 percent to 39.6 percent. In talks with Republican House Speaker John Boehner, he offered to raise that threshold to $400,000.

The estate tax issue was particularly tricky since several Democrats, including veterans like Max Baucus of Montana, disagree with Obama's proposal to increase the top estate tax rate from 35 percent to 45 percent.

Republicans said Democrats pressed to turn off more than $200 billion in the across-the-board spending cuts over the coming two years. This so-called sequester is the punishment for last year's deficit "supercommittee" failure to strike a deal.

Hopes for blocking across-the-board spending cuts were fading and Obama's proposal to renew the 2-percentage-point payroll tax cut wasn't even part of the discussion.

Obama pressed lawmakers to start where both sides say they agree ? sparing middle-class families from looming tax hikes.

"If we can get that done, that takes a big bite out of the fiscal cliff. It avoids the worst outcomes. And we're then going to have some tough negotiations in terms of how we continue to reduce the deficit, grow the economy, create jobs," Obama said in the NBC interview.

Gone is the talk of a grand deal that would tackle broad spending and revenue demands and set the nation on a course to lower deficits. Obama and Boehner were once a couple hundred billion dollars apart on a deal that would have reduced the deficit by more than $2 trillion over 10 years.

Republicans have complained that Obama has demanded too much in tax revenue and hasn't proposed sufficient cuts or savings in the nation's massive health care programs.

Obama upped the pressure on Republicans to negotiate a fiscal deal, arguing that GOP leaders have rejected his past attempts to strike a bigger and more comprehensive bargain.

"The offers that I've made to them have been so fair that a lot of Democrats get mad at me," Obama said.

Boehner disagreed, saying Sunday that the president had been unwilling to agree to anything "that would require him to stand up to his own party."

The trimmed ambitions of today are a far cry from the upbeat bipartisan rhetoric of just six weeks ago, when the leadership of Congress went to the White House to set the stage for negotiations to come.

But the deal under discussion Sunday appeared unlikely to settle other outstanding issues, including the sequester, which would total more than $1 trillion in cuts over 10 years, divided equally between the Pentagon and other government agencies. And off the table completely is an extension of the nation's borrowing limit, which the government is on track to reach any day but which the Treasury can put off through accounting measures for about two months.

That means Obama and the Congress are already on a new collision path. Republicans say they intend to use the debt ceiling as leverage to extract more spending cuts from the president. Obama has been adamant that unlike 2011, when the country came close to defaulting on its debts, he will not yield to those Republican demands.

Meanwhile, a senior defense official said if the sequester were triggered, the Pentagon would soon begin notifying its 800,000 civilian employees that they should expect some furloughs ? mandatory unpaid leave, not layoffs. It would then take some time for the furloughs to begin being implemented, said the official, who requested anonymity because the official was not authorized to discuss the internal preparations.

Lawmakers have until the new Congress convenes to pass any compromise, and even the calendar matters. Democrats said they had been told House Republicans might reject a deal until after Jan. 1, to avoid a vote to raise taxes before they had technically gone up, and then vote to cut taxes after they had risen.

___

Associated Press writers David Espo, Robert Burns, Julie Pace, Jim Kuhnhenn and Michele Salcedo contributed to this report.

Source: http://news.yahoo.com/senate-leaders-offer-dour-cliff-talks-192333199.html

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Obama, Congress struggle toward fiscal cliff deal

On Friday President Barack Obama met with congressional leaders once again to try negotiating a budget deal. Obama said he walked away from the meeting 'optimistic.'

By David Espo and Jim Kuhnhenn,?Associated Press / December 28, 2012

President Barack Obama delivers a statement on the fiscal cliff negotiations with congressional leaders in the briefing room of the White House on Friday, in Washington. The negotiations are a last ditch effort to avoid across-the-board first of the year tax increases and deep spending cuts.

Evan Vucci/AP

Enlarge

The end game at hand, the White House and Senate leaders took a final stab at compromise Friday night to prevent middle-class tax increases from taking effect at the turn of the new year and possibly prevent sweeping spending cuts as well.

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"I'm optimistic we may still be able to reach an agreement that can pass both houses in time," President Barack Obama said at the White House after meeting for more than an hour with congressional leaders.

Surprisingly, after weeks of postelection gridlock, Senate leaders sounded even more bullish.

The Republican leader, Sen. Mitch McConnell of Kentucky, said he was "hopeful and optimistic" of a deal, adding he hoped a compromise could be presented to rank-and-file lawmakers as early as Sunday, a little more than 24 hours before the year-end deadline.

Said Majority Leader Harry Reid: "I'm going to do everything I can" to prevent the tax increases and spending cuts that threaten to send the economy into recession. He cautioned, "Whatever we come up with is going to be imperfect."

Officials said there was a general understanding that any agreement would block scheduled income tax increases for middle class earners while letting rates rise at upper income levels.

Democrats said Obama was sticking to his campaign call for increases above $250,000 in annual income, even though in recent negotiations he said he could accept $400,000.

The two sides also confronted a divide over estate taxes.

Obama favors a higher tax than is currently in effect, but one senior Republican, Sen. Jon Kyl of Arizona, said he's "totally dead set" against it. Speaking of fellow GOP lawmakers, he said they harbor more opposition to an increase in the estate tax than to letting taxes on income and investments rise at upper levels.

Also likely to be included in the negotiations are taxes on dividends and capital gains, both of which are scheduled to rise with the new year. Also the alternative minimum tax, which, if left unchanged, could hit millions of middle- and upper-income taxpayers for the first time.

In addition, Obama and Democrats want to prevent the expiration of unemployment benefits for the long-term jobless, and there is widespread sentiment in both parties to shelter doctors from a cut in Medicare fees.

The White House has shown increased concern about a possible spike in milk prices if a farm bill is not passed in the next few days, although it is not clear whether that issue, too, might be included in the talks.

One Republican who was briefed on the White House meeting said Boehner made it clear he would leave in place spending cuts scheduled to take effect unless alternative savings were found to offset them. If he prevails, that would defer politically difficult decisions on government benefit programs like Medicare until 2013.

Success was far from guaranteed in an atmosphere of political mistrust ? even on a slimmed-down deal that postponed hard decisions about spending cuts into 2013 ? in a Capitol where lawmakers grumbled about the likelihood of spending the new year holiday working.

Source: http://rss.csmonitor.com/~r/feeds/csm/~3/ehL2k6sFZ_8/Obama-Congress-struggle-toward-fiscal-cliff-deal

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Sunday, December 30, 2012

How Are the Cliff Talks Going? Not Well, It Seems

CHICAGO (Reuters) - The FBI is still searching for one of two convicted bank robbers who escaped last week from a high-rise jail in downtown Chicago by lowering themselves on a makeshift rope nearly 20 stories to the street. Kenneth Conley, 38, and his cellmate, Joseph Jose Banks, 37, escaped from the Metropolitan Correctional Center early on the morning of December 18. The pair apparently broke a window in the cell they shared, squeezed through the opening and lowered themselves to the street. They then hailed a cab to make their getaway. ...

Source: http://news.yahoo.com/cliff-talks-going-not-well-seems-234444162.html

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Marisa Miller Bikini Photos: THG Hot Bodies Countdown #3!

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Rant/complainfest about Adobe and Google and bundling..

Rant/complainfest about Adobe and Google and bundling..

I'm really glad that I don't update Flash unless YouTube or something tells me I can't see their content unless I update.

Adobe Community: Bundling Google Chrome and Toolbar???

And yeah, I know this is somewhat old news, but as time goes on, the less and less I trust Google.

It seems that Adobe has made a deal with Google to automatically install Google Chrome unless you uncheck a box if you happen to update Flash player. Granted, I would probably notice this box, but many others don't. This move potentially installed Chrome on millions of computers. Sure, for people who usually used Internet Explorer, this might have been a good thing as IE is just utter crap, but that doesn't excuse this kind of intrusion, especially the way Google installs stuff--the program is located deep and hidden in your profile instead of the regular place it should be in Program Files, they do NOTHING the standard way, they set ALL of their own standards.

And I found this out after I read about how Adobe has dropped flash support for all browsers in Linux except Chrome which will update automatically through the "wonderful" GoogleUpdater that pretty much acts like a piece of spyware (that's as hard to get rid of) with no way to control when and how it does things.

I just wonder how much more nasty it's going to get, whether Adobe may eventually drop support on other platforms for Flash except on Chrome. I also wonder what software will eventually come out that flat out doesn't give you a choice, it would just install Chrome automatically...

Source: http://www.sluniverse.com/php/vb/science-tech/79596-rant-complainfest-about-adobe-google.html

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Big Island police searching for missing California man

BIG ISLAND (HawaiiNewsNow)- Authorities on the Big Island are searching for a 31-year-old California man who was reported missing.

Yogi Yoswara was last seen in Hilo at 9 p.m. on December 19.

He is described as 5-foot-7, 140 pounds with short black hair and brown eyes.

Police ask that anyone with information on his whereabouts call the police department's non-emergency line at 935-3311.?

Copyright 2012 Hawaii News Now. All rights reserved.

Source: http://www.hawaiinewsnow.com/story/20465643/big-island-police-searching-for-missing-california-man

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Hello all.

I'm completely new to this site and this community; however, I am far from new to the roleplaying game. I've been playing text-based RPs since I was about thirteen or so (nineteen now) courtesy of my sister who is an English major concentrating in creative writing. Fucking grammar Nazi.

All that aside, I'm a very relaxed individual. I love thick plot and vivid detail when writing; that being said, I post a shit ton in my posts.

I'm an avid pot smoker, partier, and music addict. I play the saxophone (and nearly every variation of saxophone) and the guitar. Not really sure what else to say, other than I am completely lost on how to do things around here. I'm sure I'll figure it out.

Source: http://feedproxy.google.com/~r/RolePlayGateway/~3/QE246W5Onpg/viewtopic.php

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Saturday, December 29, 2012

Transcendent artistic moments in 2012 - KansasCity.com

The assignment was deceptively simple: Tell us a story of one experience of the year during which you felt transported by art. Culture has the power to change our lives, to expand our hearts, to help us learn about and understand our increasingly complicated world. Undoubtedly it occurred in your world sometime this year. Here is how some of our local artists, trendsetters, regular contributors and culture professionals found moments of art in their lives in 2012.

Steve Paul, The Star IN THE CIRCLE OF LIFE, WAGNER?S RING CYCLE BRINGS COMFORTMy brother, Jack, passed away in April. Although he had a Ph.D. in biology and was steeped in science, he also loved classical music. After he was diagnosed with Stage 4 kidney cancer in July 2010, we went to as many classical concerts together as possible. Jack was a huge fan of the operas of Richard Wagner, and it just so happened that not long after his fateful diagnosis, the Metropolitan Opera in New York started to broadcast its newest Ring Cycle to movie theaters around the country. Jack and I attended all of them as over a period of months: ?Das Rheingold,? ?Die Walkure? and ?Siegfried.? And in between the operas, we watched the entire eight-hour Wagner biopic starring Richard Burton on DVD. We were wallowing in Wagner.On Feb. 11 of this year, the Met broadcast the final opera in the Ring Cycle, ?G?tterd?mmerung.? By this time, Jack?s condition had worsened considerably, and he was suffering from severe bone pain, especially in his legs. But he was determined to sit through one of the longest and most demanding operas ever written. I made ham sandwiches for intermission, Jack took powerful painkillers, and we both settled in for six plus hours of Wagnerian cataclysm. I could sense that Jack was in intense pain as we watched the doomed gods and goddesses play out their tragedy on the screen. But he insisted on sticking it out, and we made it. Valhalla was destroyed, and Jack accomplished his goal of seeing the complete Ring Cycle before he crossed his own rainbow bridge a month or so later. Watching Wagner?s transcendent masterpiece with my brother as he faced his own epic saga was profoundly moving for both of us. Music, as it has done for untold millions of others, was able to lift my brother out of his pain and take him to a place that is beyond all suffering, a place of eternal and infinite beauty. A MOMENT OF LITERARY TRUTH IN A SAN FRANCISCO CATHEDRALIt was a good year in publishing, as it always is. So many great books to read: new collections by Alice Munro and Junot Diaz. Translations of Peter Nadas and Laszlo Krasznahorkai. Chris Ware?s new project, ?Building Stories?? the list goes on. But if I had to identify the most significant literary ?moment? of the year, a moment when I experienced the transformative power of storytelling, I would have to look back. Way back. All the way to Victor Hugo. A chilly spring morning in San Francisco. My father and I are standing outside a cathedral, somewhat uncomfortably ? partly because we are in dress clothes, which neither one of us favors, and partly because we are early for the baptism of my niece and nephew, my sister?s twins. We are so early, in fact, that the doors of the church haven?t even been unlocked. Neither of us is known for our punctuality or competence in any kind of logistical operation ? getting to places in strange cities, remembering our keys and wallets and phones, etc. ? and to compensate for our notoriety we have overdone it a bit. We have overdone it a lot.My father remarks that he can remember being early for only one other event in his entire life. Oddly enough, my daughter?s baptism 10 years prior. There, too, he waited outside the church, and as he waited something strange happened. About 30 minutes before Mass was to begin, he saw a woman mounting the steps to the church. She was terribly hunched over, struggling as she walked, suffering from some illness or disability. She wore a veil over her face, and as she passed my father on the steps he could see that something terrible had happened to her. Her face was severely deformed, its features out of the usual alignment. She walked past him and into the church. Then, a few minutes later, walked out again. It occurred to my father that it was too difficult for her to attend Mass with, as it were, the masses. That she must do this every week ? arrive early, spend a few minutes in quiet prayer, then slip out before the first parishioners arrived. Or at least the people who thought of themselves as the first. This was her secret. That by the time anyone else arrived, she had already come and gone. My father?s father suffered from polio, and so my father has always been especially attuned to people struggling with their bodies, struggling to maintain their independence and dignity. He often notices the afflicted, their efforts at concealment ? the bulky coats, the elevated shoes ? even when these afflictions and efforts are obvious to no one else. We talked a bit about suffering, why it exists, why it strikes at random and so unevenly.Then something even stranger happened. People started to arrive for the baptism. The doors were unlocked, and we filed in. The twins appeared ? perfect specimens of humanity, fat and pink and happy, beautifully dressed ? and the service began. Not five minutes in I saw someone moving about the perimeter of the church, making his way through the stations of the cross. The man walked on two legs but couldn?t be said to be upright, for his spine was bent at a seemingly impossible angle, his torso absolutely parallel to the ground. Perhaps polio, perhaps a congenital disease. His posture was so tortured, his suffering so obvious, that it hurt to watch him walk. He prayed aloud at each station, shuffled to the next. He was dressed in loose gray clothing, his pants secured with a rope. Members of the audience shifted their gaze back and forth between the twins ? the picture of health ? and the praying man. I don?t know what others were thinking, but for me it was hard not to think that we were experiencing something significant. That we were being reminded of something, taught something. Formal ceremonies were nice, of course, but what did it really mean to come to church? Had any of us ever come to church with the devotion that this man did? My father is an English teacher, and so am I. When we talk to each other, which is all too rarely, we tend to talk in literary references, quotes and allusions. Each of us tends to focus on the moments in life that seem unbelievable, like fiction. It was right out of a novel, we say to each other. Quasimodo, we said, in this instance. Unreal. It had felt, to both of us, that we had been visited by the character from ?The Hunchback of Notre Dame,? that we had witnessed something outside of the boundaries of ordinary life. The baptism, to us, felt not like life but like a scene, something that distilled and encapsulated one of life?s truths. And the juxtaposition! The repetition! We had just been talking about my daughter?s baptism, the veiled woman. We couldn?t get over the timing, the coincidence.After that weekend, I thought many times of the hunchbacked man. I even went back to Hugo, whom I hadn?t read since high school. And it occurred to me that this habit of mine ? of comparing extraordinary moments and people to their literary predecessors ? is all wrong. Is in fact entirely backward. We tend to compare people ? real people ? to characters from Shakespeare, Dickens, Hugo. These people are so exaggerated, we say, in their features, their attitudes, their mannerisms and habits, that they have become a fiction. When in fact we might look at it another way. That Shakespeare, Dickens, Hugo, et.al, were true to life, attuned to not only its subtleties but its extremities.The man in the church wasn?t a character; his condition was real, one he lived and felt every day. To compare him to a character would be to deny, in a way, the lives that are dissimilar to our own ? to embrace the ignorance we live in, if we are fortunate enough to be among the parishioners who arrive on time to Mass, unaware that others have already come and gone. It seems to me now that looking at ?extraordinary? people and things as a fiction is a kind of injustice. That it takes away somewhat from the validity of the actual suffering or mania or grandeur around us. And so this literary ?moment,? this visitation, reminded me that we might look at reading less as an ?escape? from real life and more as a meditation on its actual truths. We might look at life?s players ? our colleagues, our politicians, our neighbors, our families, the strangers we encounter ? less as characters, more as people. HOW I BROKE MY GLASSESI was reading a poem called ?Body and Soul,? by B.H. Fairchild, from his 1998 book, ?The Art of the Lathe,? handy on my bookshelf that Saturday morning, where I worked alone in my office. In my imagination, I was reading aloud to my students, which I planned to do soon, a poem about sandlot baseball among men in Depression Oklahoma, in which a boy, 15, stands in to make the sides even ? who he is, exactly, doesn?t matter here. I then reread the poem?s final 15 lines, which address why those men would pitch five times to a kid who each time sent a homer over their heads. Why not walk him? Because, the poem says, the Depression and a war and the idea of being a man ?had cost them just too ? damned much to lay it/ at the feet of a fifteen-year-old boy.? The poem, here, begins to soar into the harsh light of that Oklahoma Sunday, and my eyes became weak, and I could do nothing but fumble with my glasses and throw them at the wall, and grab hold of the final phrase, which I had by heart and still have, and offer it up. | Robert Stewart, poet, teacher and editor of New Letters A POWERFUL BREAKTHROUGH DURING ?NIXON IN CHINA?There was a section of Act 3 of John Adams? opera ?Nixon in China? that I have never ?understood,? despite a quarter century of history with the score. Richard Nixon is reliving an intense World War II bombing experience ? the orchestra basses are insistently and rhythmically pulsing, Nixon is emoting intensely, and Adams has written this strong viola solo with a disjunct musical line that seems to be in active combat with Nixon?s vocal line. They seem to have nothing to do with each other, and I never understood musically or dramatically what the composer was thinking. It always sounded like a mistake to me.Suddenly, during one of our early performances last March, while I was ?in the moment? and in the thick of things as the conductor, we came to that section, James Maddalena began singing it as he has so many times before, and the viola entered. This time, I became transfixed as the entire musical structure (including the inscrutable viola line) jelled in my ears and heart, and I became entranced in what I can only describe as intense musical/dramatic passion. My head seemed to buzz sympathetically as I was swept along by the power of the music and emotion. Somehow I now ?understood? what Adams might have been trying to convey with his unconventional music writing. Moreover, the power of this section of music seemed to open up my understanding of the remaining minutes of the opera that followed, and I had a similar experience at this place in the remaining performances. This experience was highly subjective and personal. Perhaps it has nothing to do with the composer?s original intentions. Nevertheless, this was a moment in performance when a piece of music I had known for a long time became special for reasons I will never be able to completely understand or explain. As a music lover and performer, I live for such moments. LONDONERS DISCOVER THE MAGIC OF KC NATIVE KRYSTLE WARRENWhen Kansas City native Krystle Warren ambled out of the blue side lighting at London?s Hammersmith Apollo one night last month, the applause was welcoming but reserved. My husband and I had an idea what we were going to hear, but a few thousand Londoners did not. On the candlelit stage, she gave a brief nod before singing Kate McGarrigle?s ?I Don?t Know,? accompanied sparingly by piano. ?You ask me what it?s all about,? she crooned, her voice dusky, deep for such a small frame, her hands gently twisting the air as she spun out the phrases. She has sung all over the world to innumerable crowds, but with the same intimacy that she displayed when she was couch-surfing in Kansas City, performing at such humble places as Prospero?s Books or the RecordBar.Warren was on tour as a backup singer with Rufus Wainwright, in a show that ranged from flamboyant pop-rock to heart-on-sleeve sorrow to a manic finale featuring tinsel, body glitter and a man-sized foam sandwich.Her solo was a respite of introspective singularity, bereft of hyperbole and overzealous flash.Warren wrenched lyrics around, eliding phrases, sustaining, almost gnawing on syllables. Her voice absorbed energy, and we were all twisted up in that energy, pulled forward with every breath. The audience?s response when she finished shook the plaster in its enthusiasm. HEEDING THE SIREN SONG OF A BEAUTIFUL BOOKThe boys were loud, gangly, full of energy as they burst through the library doors. Joshing and cutting up, they filled the quiet space with their exuberance. Shouting ?we?re late,? one darted off, but the other?s attention was arrested by a book. A 17th-century volume on virginity, bound with a single folio from a choir book. The notes of a hymn for the Virgin Mary carefully penned by a medieval hand ran up the front cover. Perched in an open display case, the book demanded attention. The boy, likely no more than 15, stopped short, arrested in wonder. He inched forward, drawn by the beauty of the calligraphy. He slowly extended a brown index finger. Glancing left, then right, he hesitated before gently touching the manuscript page, yellowed by time. He had to touch. He wanted a tangible interaction with this piece of animal flesh that had been tanned, scraped and decorated with Latin words by a medieval scribe ? a page that had been repurposed as a book cover when the need for handwritten songbooks had long passed. His friend called, and the boy was gone, one of many to have stopped to appreciate the artistry of a book. DANCE AND DRUMS CONJURE ANCIENT SPIRITS ON NEW MEXICO PUEBLOThe air was January crisp, and the sky was brilliant blue above the unpaved plaza of the Jemez Pueblo in northern New Mexico. From one end of the road a procession of musicians and dancers rounded the corner into view, as a comparable group ? dozens of men and boys, wearing hides and antlers ? rhythmically marched off the other way. It was Jan. 6, the pueblo?s annual and culturally complex Three Kings feast day and Buffalo Dance. For hours on end the dancers performed this ancient ritual and celebration, at the center of which were two men in buffalo guise and a young buffalo maiden. Framed by two-story row houses along the plaza, the trio stepped high and slowly turned in unison as they dipped this way and that. They faced a haunting pulse of drumbeat and chant from the corps of musicians, staff-bearers and elk dancers, who were channeling spirit forces of which I knew very little. But I was mesmerized, and in the declining chill of the afternoon I was moved by something utterly magical.My friends and I stood on the edges as the processions came and went, the clans aiming to embody the animal power and good fortune that accrue to those who carry on the stories of the ancients. As the drums deeply sounded and the dancers stepped, it did not seem that far-fetched to consider that what we were witnessing was one of the few, last expressions of authentic American art. A JOLT OF JAZZ HITS THE POWER & LIGHT DISTRICTThe seemingly unrelenting series of setbacks endured by partisans of Kansas City?s jazz scene weighed on my mind moments before I entered the Kill Devil Club for the first time in October. I wondered if the new establishment, at the southwestern edge of the Power & Light District, was destined to become yet another entry on an increasingly lengthy list of ill-fated jazz venues. My trepidation was transformed into awe as I entered the handsome room. The decidedly masculine space offers a panoramic vista of the entertainment district?s neon lights and the distinctive H&R Block building. Hermon Mehari, one of the leading figures of Kansas City?s current musical renaissance, led an energetic band in an eclectic set of jazz standards, R&B classics and contemporary hip-hop. A youthful audience of well-heeled revelers swayed appreciatively. None of them were fretting about the future of live jazz in Kansas City or the ongoing efforts to augment the area?s commercial prospects. On that vibrant fall evening inside the Kill Devil Club, Kansas City?s artistic promise and the potential of a redeveloped downtown were neatly aligned. VIBRANT VOICE UNITES ART AND MUSIC AT THE NELSONI acknowledge: I am totally biased toward the Nelson-Atkins Museum of Art. There are so many magical moments that I witness every day here that it makes it difficult to boil it down to one.So I will not mention the great exhibitions, powerful speakers or great cultural celebrations that we present but will suggest the power of moments that I glimpse casually, unexpectedly. They can be as simple as overhearing a child expertly explaining to her parents an artwork that moved her during a class visit, or finding a group of children sitting on the floor of our ancient galleries, enthralled by the other-worldliness of a non-technological society, or at the moment at dusk when I?m in my office and the Bloch Building suddenly illuminates.But if I were to choose one specific and sublime moment from this year it would have to be listening to the colorful voice of Kansas City?s native son, tenor Vinson Cole, filling the Adelaide Cobb Ward Sculpture Hall. During an intimate recital, Cole shared that when he was younger, he?d visit the museum and it would give him a renewed sense of beauty and hope. Those feelings were clearly in the air as his vibrant voice rejoiced, making the museum the house of all arts and bringing to all an overwhelming sense of peace and promise. A TOAST TO GENERATIONS OF TRADITION IN MADEIRAThe wine business sounds so romantic, and truth be damned, at times it is. I?m in Funchal, Madeira, on an island 200 miles off the coast of Africa; I?m on the third floor of a centuries old factory building with about 35 bottles of Madeira standing open and ready. They range from a few years old to some from other eras: 1968, 1920, 1910. Drinking wines that old, in itself, renders the quotidian silliness of my career less tedious. Madeira, the island and the wine, offers time and more. Its volcanic soils and warm, humid landscape generate wine that is eternal, or close enough. A bottle of 1920 Bordeaux might be good, but it?s a crapshoot. A 1920 Blandy?s Bual (the bottle in front of me as I type this) is money in the bank. Delicious, caramel, honey, citrus, nuttiness: Those are its ancient and lively flavors. The island is a tropical lemonade stand for the wine-obsessed. Jagged, lush mountains above vineyards and banana plantations. Old wines for sale everywhere. The winemakers here are bred to this; they are their family?s third generation, or fifth, or seventh. The wines speak of a heritage that defines our aspirations for all wine. KC BALLET BRINGS DANCE TO ?NIXON IN CHINA?One of the highlights of 2012 for me was an ambitious and distinctive collaboration between the Kansas City Ballet and the Lyric Opera of Kansas City. Ward Holmquist, artistic director of the Lyric Opera, asked me to create the choreography for an extensive dance sequence in Act 2 of ?Nixon in China.? I selected two brilliant lead dancers, Nadia Iozzo and Logan Pachciarz, along with six other company dancers, and we began our creative work in the new Bolender Center studios. The existing Vancouver, British Columbia, production of this contemporary opera by John Adams included beautiful scenic elements, with projections and an unusually shaped dance floor. We were able to replicate the stage dimensions in our new, large studios and make a seamless transition into the Kauffman Center for the Performing Arts. That fact, combined with exhilarating performances from singers, dancers and Symphony players, all in a contemporary opera, exemplified the definition of a successful artistic collaboration. Additionally, Nadia Iozza?s heroic performance, particularly during the rainstorm scene, was compelling and transcendent. ?ANIMALS DO NOT TAKE VOWS? EMBODIED HUMAN FRAILTY AND FRATERNITYKansas City artist Anne Austin Pearce comforted me. Her Charlotte Street Award exhibition work at H&R Block Artspace titled ?Animals Do Not Take Vows? underlined life?s fantastical journey and its fragile impermanence in a way that felt bold, tender, wistful and contemplative, but never overwhelmingly sad. Her painted scrolls presented a beautiful allegory for life?s complexities, for things said and unsaid, done and undone, and opportunities gained, missed or passed over. While deeply poignant, the liquidy blues, silvers, grays and blacks of her scroll paintings seemed to mark a passage through time that reminded me of how tender yet beautiful are the tracings we leave behind. The work spoke to me as if the artist herself had sketched out the last two years of my life?s complexities and reminded me to see it all as extraordinary, even the hardest parts. While the skeptic in me may hesitate to write it, the more important child in me embraces how Pearce?s art reminded me that everything and everyone is connected and deeply intertwined, and that that alone, is a spectacular truth. A DAY AND A NIGHT UNDER THE SPELL OF ?KENTUCKY CYCLE?A November afternoon found me in the Metropolitan Ensemble Theatre?s production of ?The Kentucky Cycle.? I set my schedule to take in the first part of Robert Shenkkan?s epic drama on a Saturday expecting to return the following week for the second. Transfixed from the opening command, ?top of the show,? to the end 3?1/2 later, I lost my sense of place, duty, time and resolve.The story?s arc, the actors? presentation, the audience?s reaction drew me the way a good book calls to me. I could not wait a whole week to know the end. Surely the actors would not be as primed a full week hence as they would be three hours later. I took stock of the things I had to do that night. Some were pressing, while others were as inviting as pulling teeth. Outside of rest, I could not see what was so important about a promise made under duress when compared to a magnificently acted story. I called my partner, convinced her to come and share my madness, and spent the evening in the clutches of the second three hours of a well-told story with no obligation but what the best of art dictates ? your presence and attention. ?DRAMA QUEEN? DIDONATO INVITES THE AUDIENCE INNov. 16, Helzberg Hall: Music lovers were treated to a magical concert by Joyce DiDonato and Il Complesso Barocco. The evening highlighted music from DiDonato?s recent recording, ?Drama Queens,? featuring arias from Baroque operas sung by royal characters.The music-making was superb. DiDonato and instrumental ensemble Il Complesso Barocco were on fire, with extremely accomplished, historically informed and stylistic performances. However, what ultimately inspired me most was DiDonato?s insistence on and ability to engage the audience and invite them into the experience. Both through onstage comments during the recital as well as the talk-back at the conclusion, she made the listener a part of the concert, breaking down the invisible wall between performer and listener. As producers and artists, we aspire to create these intimate moments of connection. This performance magnificently achieved one. A STORY OF TRIUMPH TOUCHES TEDXKCOver the last four years, TEDxKC has delivered a number of inspiring presentations and musical performances, none more so than an 18-minute segment at this year?s event, in August at the Kauffman Center for the Performing Arts.Janine Shepherd, former Australian champion cross-country skier, shared the story of her horrific cycling accident and determined recovery. Training for the Winter Olympics, Shepherd was hit by a truck and suffered a dizzying array of life-threatening injuries; she was rendered a partial paraplegic.At TEDxKC, Shepherd slowly and gracefully moved down a line of five chairs, using them along the way for props and balance. At some point during the arduous recovery process she came to realize her real strength never actually came from her body; it came from her heart. ?Although my body may be limited,? Shepherd said, ?it was my spirit that was unstoppable.? Shepherd not only overcame the most improbable odds to walk, she also learned to fly, first earning a private pilot?s license; she now has a commercial license and instructor?s rating. More than 1,400 people listened in rapt attention to the details of her journey, and since then, some 250,000 have viewed her story on TED.com.And while Janine Shepherd?s personal challenge was extraordinary, her message is relevant for everyone who has experienced it: You are not your body. QUIXOTIC REACHES NEW CREATIVE HEIGHTSI am writing about two moments of cultural magic that originated from one source: Kansas City?s own Quixotic. Each time I think that this creative ensemble of musicians, dancers, aerialists, composers, designers and choreographers can?t top their last performance, they blow past it.This happened at the international TED conference in California in February and at the Midland in April. The TED performance gave me chills as I watched dancers commingling with video projections to a captivating beat. The performance earned them a standing ovation from a crowd that regularly witnesses world-class speakers and performers. The Midland show, titled ?One,? layered performances that were quiet and delicate with full-throttle, aggressive pieces. I saw concepts and movements and costumes that were from a different universe. Solos and duos and trios on stage. Then everyone at once. Then the curtain. Sigh, show?s over.Quixotic doesn?t just raise the bar. They leap from the bar, coil and curve, hold the gaze of the audience, and float back to the ground before soaring into another dimension.

| Patrick Neas, a freelance writer and The Star?s Classical Beat columnist, who usually appears weekly in this section ? | Christie Hodgen, assistant professor of English and creative writing at the University of Missouri-Kansas City and author of the novel ?Elegies for the Brokenhearted? and other works of fiction ? ? | Ward Holmquist, artistic director of the Lyric Opera of Kansas City ? | Libby Hanssen, a freelance writer whose music reviews appear frequently in The Star ? | Virginia Blanton, professor of English at the University of Missouri-Kansas City ? | Steve Paul, arts editor and senior writer at The Kansas City Star ? | Bill Brownlee, freelance writer whose music reviews appear frequently in The Star ?ss | Juli?n Zugazagoitia, director and CEO of the Nelson-Atkins Museum of Art ? | Doug Frost, a wine and spirits consultant whose column appears monthly in The Star ? | William Whitener, artistic director of

Source: http://www.kansascity.com/2012/12/28/3983690/transcendent-artistic-moments.html

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Gun owner map ricochet: Blogger publishes journalists' personal data

A newspaper published names and addresses of thousands of legal handgun owners, generating widespread criticism. In retaliation, a blogger mapped the names and addresses of the journalists.

By Brad Knickerbocker,?Staff writer / December 27, 2012

Hand guns that were turned in by their owners in a trash bin at a gun buyback held by the Los Angeles Police Department. People can anonymously trade in their guns, no questions asked, for $200 grocery store gift cards for automatic weapons and $100 gift cards for shotguns, handguns and rifles.

David McNew/REUTERS

Enlarge

The flap over the newspaper that published information about handgun owners in two New York counties has ricocheted back toward the news organization.

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Thousands of critics ? including some journalism professionals ? have weighed in. And at least one blogger has retaliated by publishing the names and addresses of editors and executives at the Journal News, the publication headquartered in White Plains, N.Y., north of New York City and part of the Gannett organization.

Still, the Journal News is not backing down. Editors say they?ll publish information on handgun owners in a third county (Putnam) once county officials have responded to the Freedom of Information Act (FOIA) request that resulted in tens of thousands of names and addresses in Westchester and Rockland Counties.

The controversy began over the weekend when the Journal News ran a story on some 44,000 registered handgun owners in?the two counties, including names and addresses showing exactly where those gun owners live using Google Maps. ?The gun owner next door: What you don't know about the weapons in your neighborhood,? read the headline.

In the wake of the Newtown, Conn., school massacre that killed 20 first-graders and six school employees, quickly followed by a raging debate over gun control and Second Amendment rights, it?s not surprising that journalists would look for fresh and provocative angles to cover the story.

David Gregory, host of NBC?s ?Meet the Press,? has taken flak for showing an ammunition magazine in his interview with National Rifle Association CEO Wayne LaPierre last Sunday. Such large-capacity magazines are banned in the District of Columbia, where the show was taped.

The online magazine Slate has partnered with the anonymous creator of?the Twitter feed @GunDeaths to craft what it calls ?an interactive, crowdsourced tally of the toll firearms have taken since Dec. 14? ? the day when 20-year-old Adam Lanza, armed with an assault-style rifle, two handguns, and hundreds of rounds of ammunition in large-capacity magazines, forced his way into the Sandy Hook grade school in Newtown.

The Slate map details 206 gunshot deaths in the United States since Sandy Hook, including 21 teens and children.

But publishing the names and addresses of legitimate handgun owners is seen as very different from tallying gun deaths or discussing aspects of weaponry. (The Journal News report does not include ?long guns? ? shotguns and rifles, including assault-style rifles ? which do not require licenses.)

Source: http://rss.csmonitor.com/~r/feeds/csm/~3/KoZ8_n-ciWo/Gun-owner-map-ricochet-Blogger-publishes-journalists-personal-data

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State Dept. issues revised Haiti travel warning

WASHINGTON (AP) ? The State Department has issued an updated warning to Americans traveling to Haiti, citing murder, robbery and infectious disease.

The advisory issued Friday warns that no one traveling to Haiti is safe from kidnapping, regardless of occupation, nationality, race, gender, or age.

In recent months, the department says, travelers arriving in Port-au-Prince on flights from the U.S. have been attacked and robbed after leaving the airport. At least two Americans were shot and killed in robbery and kidnapping incidents this year.

Haitian authorities, the department says, have limited capacity to deter or investigate violent crimes.

The State Department also notes that cholera persists in many areas of Haiti. Medical facilities, including ambulance services, are particularly weak.

Associated Press

Source: http://hosted2.ap.org/APDEFAULT/cae69a7523db45408eeb2b3a98c0c9c5/Article_2012-12-29-US-Haiti-Travel-Warning/id-ebb35382c14d4fa49ad285881c4ccef7

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In simpler agreement affiliated and afresh staring after-effects in the breach ducts approved of accident the abundance aloft which to aftermath tears connected in a activity declared dry eyes.beats by dre mixr canada. Abounding end up aggravating to cope with shortsightedness by affairs spectacles, and to boredom of the eyes buy affairs bogus tears or breach suppliments. But I will stick to the old saying-?Prevention is bigger than cure?.If you like animate with computers but animate as a software artist is currently is a attempt afresh you allegation to analysis what the could could could cause is. Do you absolutely animosity autograph cipher or do you animosity it for added reasons, such as debugging struggles and annoying aggregation mates? It is hasty how abounding bodies are animate in a computer job afterwards absolutely the able abilities and / or adeptness to do it.Always use accustomed faculty if browsing the internet and never download files that you are not accustomed with. If it comes to your anti-virus software, be assertive that you beforehand in a adequate one and use any that are attainable to you. Webroot Anti-Virus is a abundant anti-virus software, and is the one I use on my computer. Depending on your internet provider, you may acquire a chargeless adaptation of an anti-virus software such as Macafee. Macafee is not as adequate as Webroot, but it is nice to acquire added that one anti-virus. Use it, it is nice to acquire a aback up. Just bethink to break alert and abreast on Mal ceramics software. You do not allegation to be an able to atom alarming software a lot of will acquire a altered architectonics and attending strange.If you currently acquire a job accompanying to the acreage of computer science but you?re not absolutely autograph cipher afresh let us apperceive by announcement a comment. Computer technology is so accustomed and I?m abiding there are added types of jobs that don?t absorb coding.I sometimes feel like the American Picker of freeware, I?m able to acquisition altered and advantageous software in the aphotic corners of the internet that few acquire anytime heard of.Here is a accumulating of some actual advantageous computer programs that you may not acquire heard about afore but they do appear in accessible from time to time. I acquire accustomed a abrupt description of anniversary and a download link.

Source: http://forum.jbidwatcher.com/forums/9/topics/3846

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The Wing Fort House is located at 69 Spring Hill Road, East Sandwich, Massachusetts. Open Tuesday through Saturday from June 15 to September 30 from 10:00 a.m. to 4:00 p.m. There is a small admission fee. For off-season visits please call the Caretakers at (508) 833-1540. Cousins, if you ever have the opportunity, this is a "must do" visit. It is something you will never forget and something you will never tire of talking about.

The oldest house in New England owned and occupied continuously by the same family for over three centuries. Built in 1641.? In 1646 it became the home of Stephen Wing, one of the early settlers of Sandwich, son of the Reverend John Wing and Deborah Bachelor. Stephen?and his descendants occupied the house from then on, adding on as families grew and changing tastes dictated. Now restored, it is furnished almost entirely with Wing family antiques showing the different periods of its long history. The house is maintained by the Wing Family of America and open to the public.

?This house is a must see on my list of Historic Landmarks!

Source: http://mypairofboots.blogspot.com/2012/12/old-fort-wing-family-home.html

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Source: http://surayashah55.blogspot.com/2012/12/tahminalucchi-my-pair-of-boots-old-fort.html

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Review The Incurables Nd Sullivan Prize Short Fiction - Book Review

Winesburg . . . Revisited
Rating By : Red Radiator, Review The Incurables  Nd Sullivan Prize Short Fiction    best seller

If you?re a lover of linked-story collections, add this to your collection. A fabulous read, beautifully linked, grounded in place and with recurring characters. Like revisiting Winesburg, Ohio, one hundred years later and finding the town name changed to Sherman and ?the grotesques? with a contemporary label. And Sherwood Anderson even turns up, too! Brazaitis?s stories never fail to enlighten, amaze, and delight.

Other people said about The Incurables Nd Sullivan Prize Short Fiction

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Source: http://sapjournal.com/review-the-incurables-nd-sullivan-prize-short-fiction

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Racial disparities in pediatric appendicitis treatment tied to hospital type

Dec. 28, 2012 ? When researchers from UCLA Medical Center investigated the link between racial disparities and appendicitis outcomes in children, they found that the type of hospital in which black, Hispanic and other minority patients receive care -- community, children's or county -- affects their odds of developing a perforated appendix. The study published in the January issue of the Journal of the American College of Surgeons is a first-of-its-kind look at the role hospital type plays in race-based treatment variances among this patient subset.

Appendicitis -- a painful, inflamed appendix -- is the most common reason for emergency abdominal surgery in children. Approximately 80,000 pediatric cases are diagnosed in the U.S. annually.* Since the inflamed appendix can sometimes become perforated if the condition is not treated in a timely fashion (usually one to two days from the time symptoms first appear), researchers have used appendix perforation as a marker for inadequate access to health care. While existing research shows that a number of factors (such as age, socioeconomic status, the distance a family lives from a hospital) increase the risk for developing a perforated appendix in minorities, these factors don't tell the whole story.

"Appendicitis is a time-dependent disease process that leads to more a complicated medical outcome, and that outcome, perforated appendicitis, has increased hospital costs and increased burden to both the patient and society," according to study author Stephen Shew, MD, FACS, associate professor of surgery, UCLA Medical Center, and a pediatric surgeon at Mattel Children's hospital, both in Los Angeles.

To determine whether there is a link between hospital type and racial disparities, as measured by appendiceal perforation (AP), Dr. Shew and colleagues looked at data from the California Patient Discharge Dataset. Their analysis involved 107,727 children between the ages of two and 18 years old who were treated for appendicitis at 386 California hospitals between 1999 and 2007. Of these children, 53 percent were Hispanic, 36 percent were white, 3 percent were black, 5 percent were Asian, and 8 percent were of an unknown race. The children were sorted by hospital type, which included community, children's and county hospitals.

After accounting for age, income level and other known factors that increase risk for a perforated appendix, researchers found that at community hospitals, Hispanic children were 23 percent more likely to experience appendix perforation than white children, and Asian children were 34 percent more likely than white children to experience appendix perforation. Further, Hispanic patients treated at children's hospitals were 18 percent more likely to develop this complication than white patients. Odds of appendix perforation did not differ by race within county hospitals. Researchers also found that black patients treated at children's and county hospitals had a higher risk of appendix perforation compared with black patients treated at community hospitals.

Beyond what the researchers already know about appendicitis outcomes in children, these findings indicate that hospital type does play an independent role in risk for perforated appendicitis, and that these disparities in appendicitis outcomes exist at different types of hospitals based upon race, Dr. Shew said. "The goal is to figure out why these racial disparities exist and what interventions could be put in place to help eliminate them," he added.

Dr. Shew stressed that further research is still needed on a variety of issues, including whether there is a link between language barriers and understanding symptoms of appendicitis and access to care. "We don't know what explains these findings; however we suspect that there are some other barriers in play," Dr. Shew said. This discovery shows that a critical piece of the puzzle -- what is happening with the child and the parents from the time they first discover the symptoms of appendicitis to the time they seek care -- is still missing.

"As investigators it behooves us to look further into prehospital factors that may contribute to this racial disparity and ultimately find what interventions can be implemented to provide much quicker access to care, so children can get treated more effectively," Dr. Shew said. "But we don't know for sure what would be most beneficial until we really know where the problem lies."

* Addiss DG, Shaffer N, Fowler BS, Tauxe RV. The epidemiology of appendicitis and appendectomy in the United States. Am J Epidemiol 1990;132:910-925.

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The above story is reprinted from materials provided by American College of Surgeons, via EurekAlert!, a service of AAAS.

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Journal Reference:

  1. Lorraine I. Kelley-Quon, Chi-Hong Tseng, Howard C. Jen, Steven L. Lee, Stephen B. Shew. Hospital Type as a Metric for Racial Disparities in Pediatric Appendicitis. Journal of the American College of Surgeons, 2013; 216 (1): 74 DOI: 10.1016/j.jamcollsurg.2012.09.018

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Source: http://feeds.sciencedaily.com/~r/sciencedaily/~3/oEjkJSO94WI/121228133736.htm

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